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Heat effects on mortality in 15 European cities

Baccini, M. and Biggeri, A. and Accetta, G. and Kosatsky, T. and Katsouyanni, K. and Analitis, A. and Anderson, H. R. and Bisanti, L. and D'Ippoliti, D. and Danova, J. and Forsberg, B. and Medina, S. and Paldy, A. and Rabczenko, D. and Schindler, C. and Michelozzi, P.. (2008) Heat effects on mortality in 15 European cities. Epidemiology, Vol. 19. S. 711-719.

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Official URL: http://edoc.unibas.ch/dok/A6005529

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Abstract

BACKGROUND: Epidemiologic studies show that high temperatures are related to mortality, but little is known about the exposure-response function and the lagged effect of heat. We report the associations between daily maximum apparent temperature and daily deaths during the warm season in 15 European cities. METHODS: The city-specific analyses were based on generalized estimating equations and the city-specific results were combined in a Bayesian random effects meta-analysis. We specified distributed lag models in studying the delayed effect of exposure. Time-varying coefficient models were used to check the assumption of a constant heat effect over the warm season. RESULTS: The city-specific exposure-response functions have a V shape, with a change-point that varied among cities. The meta-analytic estimate of the threshold was 29.4 degrees C for Mediterranean cities and 23.3 degrees C for north-continental cities. The estimated overall change in all natural mortality associated with a 1 degrees C increase in maximum apparent temperature above the city-specific threshold was 3.12% (95% credibility interval = 0.60% to 5.72%) in the Mediterranean region and 1.84% (0.06% to 3.64%) in the north-continental region. Stronger associations were found between heat and mortality from respiratory diseases, and with mortality in the elderly. CONCLUSIONS: There is an important mortality effect of heat across Europe. The effect is evident from June through August; it is limited to the first week following temperature excess, with evidence of mortality displacement. There is some suggestion of a higher effect of early season exposures. Acclimatization and individual susceptibility need further investigation as possible explanations for the observed heterogeneity among cities.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Environmental Exposures and Health > Physical Hazards and Health (Röösli)
UniBasel Contributors:Schindler, Christian
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:Lippincott Williams & Wilkins
ISSN:1044-3983
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Mar 2013 11:08
Deposited On:11 Oct 2012 15:27

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