reference : Extreme temperatures and mortality: Assessing effect modification by personal characteristics and specific cause of death in a multi-city case-only analysis

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/reference/cc49dc7d-d481-4103-a681-a17fe17d35c2
Bibliographic fields
reftype Journal Article
Abstract BACKGROUND: Extremes of temperature are associated with short-term increases in daily mortality. OBJECTIVES: We set out to identify subpopulations and mortality causes with increased susceptibility to temperature extremes. METHODS: We conducted a case-only analysis using daily mortality and hourly weather data from 50 U.S. cities for the period 1989–2000, covering a total of 7,789,655 deaths. We used distributions of daily minimum and maximum temperature in each city to define extremely hot days (≥ 99th percentile) and extremely cold days (≤ 1st percentile), respectively. For each (hypothesized) effect modifier, a city-specific logistic regression model was fitted and an overall estimate calculated in a subsequent meta-analysis. RESULTS: Older subjects [odds ratio (OR) = 1.020; 95% confidence interval (CI), 1.005–1.034], diabetics (OR = 1.035; 95% CI, 1.010–1.062), blacks (OR = 1.037; 95% CI, 1.016–1.059), and those dying outside a hospital (OR = 1.066; 95% CI, 1.036–1.098) were more susceptible to extreme heat, with some differences observed between those dying from a cardiovascular disease and other decedents. Cardiovascular deaths (OR = 1.053; 95% CI, 1.036–1.070), and especially cardiac arrest deaths (OR =1.137; 95% CI, 1.051–1.230), showed a greater relative increase on extremely cold days, whereas the increase in heat-related mortality was marginally higher for those with coexisting atrial fibrillation (OR = 1.059; 95% CI, 0.996–1.125). CONCLUSIONS: In this study we identified several subpopulations and mortality causes particularly susceptible to temperature extremes. This knowledge may contribute to establishing health programs that would better protect the vulnerable.
Author Medina-Ramón, Mercedes; Zanobetti, Antonella; Cavanagh, David Paul; Schwartz, Joel
DOI 10.1289/ehp.9074
Date 07/06 02/06/received 07/05/accepted
ISSN 0091-6765 1552-9924
Issue 9
Journal Environmental Health Perspectives
Name of Database PMC
Notes ehp0114-001331[PII] 16966084[pmid] Environ Health Perspect
Pages 1331-1336
Publisher National Institute of Environmental Health Sciences
Title Extreme temperatures and mortality: Assessing effect modification by personal characteristics and specific cause of death in a multi-city case-only analysis
Volume 114
Year 2006
Bibliographic identifiers
_record_number 23824
_uuid cc49dc7d-d481-4103-a681-a17fe17d35c2