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Table 3 Recent Studies Identifying Vulnerable Subgroups of Mortality from High Ambient Temperature

From: High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008

Reference

Study location

Study design

Exposure

Causes of death

Result

Baccini 2008 [12]

15 European cities, April-September 1990-2000 (5-11 years depending on data availability for city)

Time-series

Maximum apparent temperature (threshold 29.4°C Mediterranean cities and 23.3°C north-continental cities)

Daily all-cause mortality

Respiratory diseases among 75+ years

Basu and Ostro 2008 [14]

9 California counties, May to September 1999-2003

Case-crossover

Mean daily apparent temperature

Cause-specific mortality; all-cause mortality by age, race/ethnicity, gender, education level

Cardiovascular, higher specifically for ischemic heart disease, myocardial infarction, and congestive heart failure, ≤ 1 year, ≤ 5 years, elderly, Black race, out of hospital death; no elevated risks for cerebrovascular, diabetes, respiratory; no difference by gender or high school graduation

Bell 2008 [15]

Sao Paulo, Brazil, Santiago, Chile and Mexico City, Mexico, 1998-2002

Case-crossover

Same day apparent temperature

Daily all-cause mortality

65+ years, women in Mexico City, but men in Santiago and Sao Paulo, less educated in Sao Paulo

Ishigami 2008 [24]

Budapest, London and Milan, 2003

Time-series

Mean daily temperature (lag0 and lag1), PM10 (TSP in Budapest), ozone

Daily all-cause mortality

Increased age, females 65+ years greater risk in London and Milan and non-elderly adults in Milan; mortality from external causes, respiratory and cardiovascular diseases

Stafoggia 2008 [30]

4 Italian cities, 1997-2004

Case-crossover

Apparent temperature 30°C compared to 20°C

Deaths in hospitals for those with 2+ days in hospital

Increased age, single general medicine compared to high and intensive care units, history of psychiatric disorders, cerebrovascular diseases, heart failure, stroke, chronic pulmonary diseases

Vaneckova 2008a [46]

Sydney, Australia, October to March 1993-2001

Time-series

Temporal Synoptic Index (TSI); ratio of highest 10% mortality days within air mass and % frequency of air mass occurrence

Daily all-cause mortality

65+ years, women

Yip 2008 [52]

Maricopa County, Arizona, June to September

2000-2005

Time-series

Heat index

Heat-related deaths

Young and old outdoors, but greater risk for elderly indoors

Hajat 2007 [25]

England and Wales,

1993-2003

Time-series

Heat (> 95th %) and cold (< 5th %) thresholds

All-cause mortality

Elderly, those in nursing care homes respiratory and external causes, women; not modified by deprivation in London

Medina-Ramon 2007 [21]

50 US cities in cold (November to March) and warm (May to September) seasons

Case-crossover

Binary variable as extreme temperature and continuous; ozone

All-cause and CVD mortality

Cities with milder summers, less air conditioning and higher population density

Diaz 2006 [35]

Madrid, January 1986-December 1997

Time-series

T(hwave) = Tmax-36.5C if Tmax>36.5C; 5th % to 95th % temperature, NO2

AR = (RR-1)/RR for daily mortality

Circulatory causes, males 45-64 years

Stafoggia 2006 [16]

Bologna, Milan, Rome, Turin, 1997-2003

Case-crossover

30°C mean apparent temperature (lag01) relative to 20°C; odds ratio

All-cause mortality and previous hospitalization

Increased age and greater for women, widows and widowers, psychiatric disorders, depression, heart and circulatory disorders

Hajat 2005 [48]

Delhi, Sao Paulo, London, January 1991-December 1994

Time-series

Daily temperature

(lag 0,1) greater than 20°C

Daily all-cause mortality

Respiratory deaths in Sao Paulo and London; children in Delhi

O'Neill, Zanobetti and Schwartz 2005 [37]

Chicago, Detroit, Minneapolis, Pittsburgh, 1988-1993 for Chicago and 1986-1993 for other cities

Time-series

Percent change daily mean temperature 29°C relative to 15°C (lag0), barometric pressure, day of the week, PM10

Mortality, prevalence of air conditioner (AC)

Black race, lack of air conditioner

Gouveia 2003 [33]

Sao Paulo, Brazil, 1991-1994

Time-series

Daily mean temperature (lag01), SO2, PM10, CO, O3, NO2, day of the week, season, humidity

Daily all-cause mortality, excluding violent deaths, cardiovascular and respiratory mortality

Greatest for 65+years and < 15 years, also increased for15-64 years; elderly cardiovascular, respiratory for adults and elderly; no modification by socioeconomic status

O'Neill 2003 [38]

7 US cities,

1986-1993

Time-series

Mean daily apparent temperature (% change 29°C and -5°C), PM10

Daily all-cause mortality, looking at effect modification by demographics & other variables

Black race, less educated, and outside hospital

Rainham and Smoyer-Tomic 2003 [42]

Toronto, May 1 to September 30, 1980-1996

Time-series

Humidex, CO, O3, NO2, SO2

Daily all-cause mortality

Females

Curriero 2002 [39]

11 Eastern US cities, 1973-1994

Time-series

Daily mean temperature, dew point temperature; minimum mortality temperature (MMT) range: 65.2-90.3

Daily all-cause mortality, excluding accidents

Higher latitude, more poverty, less air conditioning or heating