Journal Article

High Temperature and Hospitalizations for Cardiovascular and Respiratory Causes in 12 European Cities

Anderson, H. Ross, Forsberg, Bertil, Forastiere, Francesco, Marino, Claudia, Katsouyanni, Klea, Medina, Sylvia, Sunyer, Jordi, Biggeri, Annibale, Goodman, Patrick G, Baccini, Michela, Accetta, Gabriele, Perucci, Carlo A, on behalf of PHEWE Collaborative Group, D'Ippoliti, Daniela, Ballester, Ferran, Paldy, Anna, Cadum, Ennio, Schindler, Christian, Michelozzi, Paola, De Sario, Manuela, Kirchmayer, Ursula, Bisanti, Luigi, Hojs, Ana

2009

Overview

Abstract Rationale Episode analyses of heat waves have documented a comparatively higher impact on mortality than on morbidity (hospital admissions) in European cities. The evidence from daily time series studies is scarce and inconsistent. Objectives To evaluate the impact of high environmental temperatures on hospital admissions during April to September in 12 European cities participating in the Assessment and Prevention of Acute Health Effects of Weather Conditions in Europe (PHEWE) project. Methods For each city, time series analysis was used to model the relationship between maximum apparent temperature (lag 0–3 days) and daily hospital admissions for cardiovascular, cerebrovascular, and respiratory causes by age (all ages, 65–74 age group, and 75+ age group), and the city-specific estimates were pooled for two geographical groupings of cities. Measurements and Main Results For respiratory admissions, there was a positive association that was heterogeneous between cities. For a 1°C increase in maximum apparent temperature above a threshold, respiratory admissions increased by +4.5% (95% confidence interval, 1.9–7.3) and +3.1% (95% confidence interval, 0.8–5.5) in the 75+ age group in Mediterranean and North-Continental cities, respectively. In contrast, the association between temperature and cardiovascular and cerebrovascular admissions tended to be negative and did not reach statistical significance. Conclusions High temperatures have a specific impact on respiratory admissions, particularly in the elderly population, but the underlying mechanisms are poorly understood. Why high temperature increases cardiovascular mortality but not cardiovascular admissions is also unclear. The impact of extreme heat events on respiratory admissions is expected to increase in European cities as a result of global warming and progressive population aging.

• Publisher: Am Thoracic Soc,Oxford University Press,American Thoracic Society
• Subject: Adolescent / Adult / Age Factors / Age groups / Aged / Aged, 80 and over / Air Pollutants - analysis / Air Pollutants - poisoning / Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy / Biological and medical sciences / Cardiovascular Diseases - epidemiology / Cerebrovascular Disorders - epidemiology / Child / Child, Preschool / Cities / Climate change / Confidence intervals / Emergency and intensive respiratory care / Europe - epidemiology / Female / Heat / High temperature / Hot Temperature - adverse effects / Humans / Infant / Infant, Newborn / Intensive care medicine / Male / Medical sciences / Middle Aged / Morbidity / Mortality / Nitrogen dioxide / Older people / Patient Admission - statistics & numerical data / Patient admissions / Poisson Distribution / Respiratory diseases / Respiratory Tract Diseases - epidemiology / Time series / Urban Health - statistics & numerical data / Weather / Young Adult