The accuracy of the heat index to explain the excess of mortality and morbidity during heat waves – a case study in a mediterranean climate

Ana Monteiro, Vânia Carvalho, Sara Velho, Carlos Sousa

DOI: http://dx.doi.org/10.1515/bog-2013-0012

Abstract


The aim of this contribution was to evaluate the accuracy of a well known human comfort index, the heat index, to anticipate the effects of the July 2006 heat wave in mortality (all causes) and morbidity (all causes, respiratory and circulatory disease). Our assessment was done to all citizens, to people of the 75+ cohort and to each gender, in Porto. For further statistical analysis, we calculated an expected number of admissions by averaging the admissions recorded during the comparison period. The 95% confidence interval was calculated, using a standard method based on the t-distribution, for differences between independent means with different population variances, using the Leveane test to evaluate the variance’s homogeneity. During the 2006 heat wave, a 52% mortality excess was registered relatively to the expected mortality (p < 0.001), for all cohorts of the population. The admissions excess for all ages included the admissions due to respiratory diseases (p < 0.029), pneumonia (p < 0.001) and chronic obstructive pulmonary disease (p < 0.001). For the 75+ cohort, the admissions due to respiratory diseases (p < 0.017), pneumonia (p < 0.001) and heart failure (p < 0.610) were also statistically high. The obtained results confirm that the heat index is a truthful method to anticipate the negative impacts of heat waves in human health even in climate contexts adapted to hot summers like at Porto – a Mediterranean tempered climate. The impacts of July 2006’s heat wave in the increase of mortality (all causes) and in respiratory morbidity (all population and 75+cohort) was evident.


Keywords


Mediterranean area; heat wave; heat index; mortality; respiratory disease; circulatory disease

Full Text:

PDF

References


Almeida, S., Casimiro, E. and Calheiros, J., 2010: Effects of apparent temperature on daily mortality in Lisbon and Oporto, Portugal. In: Environmental Health, 9, (12), pp.1–7. DOI: 10.1186/1476-069X-9-12

Ballester, F., Corella, D., Perez-Hoyos, S., Sáez, M. and Hervás, A., 1997: Mortality as a function of temperature: a study in Valencia, Spain, 1991–1993. In: International Journal of Epidemiology, 26, pp. 551–561. DOI: 10.1093/ije/26.3.551

Basu, R. and Samet, J., 2002: Relation between elevated ambient temperature and mortality: A review of the epidemiologic evidence. In: Epidemiologic Reviews, 24, pp. 190–202. DOI: 10.1093/epirev/mxf007 Bioestatística e Informática Médica e Administraçăo Central do Sistema de Saúde, 2011: The heat index “equation”. National Weather Service Technical Attachment P – Portal de Codificaçăo dos GDH, available at: portalcodgdh. min-saude.pt/index.php/All_Patient_Diagnosis_ Related_Groups_(AP-DRG), DoA: 10 February 2011.

Borrel, C., Dell’Olmo, M., Rodríguez-Sanz, M., Garcia- Olalla, P., Cayla, J., Benach, J. and Muntaner, C., 2006: Socioeconomic position and excess mortality during the heat wave of 2003 in Barcelona. In: European Journal of Epidemiology, 21, pp. 633–640. DOI: 10.1007/s10654-006-9047-4

Calado, R., Nogueira, P., Catarino, J., Paixăo, E., Botelho, J., Carreira, M. and Falcăo, J., 2004: A onda de calor de Agosto de 2003 e os seus efeitos sobre a mortalidade da populaçăo portuguesa (The heat wave of August 2003 and its effects on mortality of the Portuguese population – in Portuguese). In: Revista Portuguesa de Saúde Pública, 22 (2), pp. 7–20.

Clarke, J., 1972: Some effects of the urban structure on heat mortality. In: Environmental Research, 5, pp. 93– –104. Dessai, S., 2002: Heat stress mortality in Lisbon Part I – model construction and validation. In: International Journal of Biometeorology, 47, pp. 6–12. DOI: 10.1007/s00484-002-0143-1

Dessai, S., 2003: Heat stress mortality in Lisbon Part II –An assessment of the potential impacts of climate change. In: International Journal of Biometeorology, 48, pp. 37–44. DOI: 10.1007/s00484-003-0180-4

Díaz, J., Garcia, R., Lopez, C. and Jordan, A., 2002a: Heat waves in Madrid 1986–1997: effects on the health of the elderly. In: International Archives of Occupational and Environmental Health, 75, pp. 163– –170. DOI: 10.1007/s00420-001-0290-4

Díaz, J., Garcia, R., Velasquez de Castro, F., Hernandez, E., Lopez, C. and Otero, A., 2002b: Effects of extremely hot days on people older than 65 years in Seville (Spain) from 1986 to 1997. In: International Journal of Biometeorology, 46, pp. 145–149. DOI: 10.1007/s00484-002-0129-z

Díaz, J., Garcia-Herrera, T.R. and Linares, C., 2006: The impact of summer 2003 heat wave in Iberia: how should we measure it? In: International Journal of Biometeorology, 50, pp. 159–166. DOI: 10.1007/s00484- 005-0005-8

D’lppoliti, D., Michelozzi, P., Marino, C., Donato, F., Menne, B., Katsouyanni, K., Kirchmayer, U., Analitis, A., Medina-Ramón, M., Paldy, A., Atkinson, R., Kovats, S., Bisanti, L., Schneider, A., Lefranc, A., Ińiguez, C. and Perucci, C., 2010: The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project. In: Environmental Health, 9:37, pp. 1–9. DOI: 10.1186/1476-069X-9-37

Ellis, F. and Nelson, F., 1975: Mortality in the elderly in a heat wave in New York City. In: Environmental Research, 978(15), pp. 504–512.

Ellis, F., Nelson, F. and Pincus, L., 1975: Mortality during heat waves in New York City July, 1972 and August and September, 1973. In: Environmental Research, 10, pp. 1–13.

Fouillet, A., Rey, G., Laurent, F., Pavillon, G., Bellee, S., Guihenneue-Jouyaux, C.J., Jougla, E. and Hémon, D., 2006: Excess mortality related to the August 2003 heat wave in France. In: International Archives of Occupational and Environmental Health, 80, pp. 16– –24. DOI: 10.1007/s00420-006-0089-4

Frota, A. and Schiffer, S., 1987: Manual de Conforto Térmico. 5Ş Ediçăo (Handbook of Thermal Comfort. 5th Edition – in Portuguese), Săo Paulo: Studio Nobel.

Gaffin, S., Rosenzweig, C., Khanbilvardi, R., Parshall, L., Mahani, S., Glickman, H., Goldberg, R., Blake, R., Slosberg, R. and Hillel, D., 2008: Variations in New York City’s urban heat island strength over time and space. In: Theoretical and Applied Climatology, 94., pp. 1–11. DOI: 10.1007/s00704–007-0368-3

Grize, L., Hussa, A., Thommena, O., Schindlera, C. and Braun-Fahrländera, C., 2005: Heat wave 2003 and mortality in Switzerland. In: Swiss Medical Weekly, 135, pp. 200–205. DOI: 10.1007/s00484-012-0543-9

Hajat, S., Kovats, R., Atkinson, R. and Haines, A., 2002: Impact of hot temperatures on death in London: a time series approach. In: Journal of Epidemiology and Community Health, 56, pp. 367–72. DOI: 10.1136/jech.56.5.367

Hertel, S., Tertre, A., Jockel, K. and Hoffmann, B., 2009: Quantification of the heat wave effect on cause-specific mortality in Essen, Germany. In: European Journal of Epidemiology, 24, pp. 407–414. DOI: 10.1007/ s10654-009-9359-2

Hutter, P., Moshammer, H., Wallner, P., Leitner, B. and Kundi, M., 2007: Heatwaves in Vienna: effects on mortality. In: Wien Klin Wochenschr, 119 (7–8), pp. 223–227. DOI: 10.1007/s00508–006–0742–7

Huynen, M., Martens, P., Schram, D., Weijenberg, M. and Kunst, A., 2001: The Impact of heat waves and cold spells on mortality rates in the Dutch population. In: Environmental Health Perspectives, 109 (5), pp. 463–470. Instituto Nacional de Estatística (National Institute of Statistics), 2001: General Population and Northern Region’s Housing Census, available at: http://www.ine. pt, DoA: 1 April 2011.

Jendritzky, G., 1993: Human biometeorology, part I. In: Experientia, 499, pp. 733–740.

Keatinge, W., Coleshaw, S., Easton, J., Cotter, F., Mattock, M. and Chelliah, R., 1986: Increased platelet and red cell counts, blood viscosity, and plasma cholesterol levels during heat stress, and mortality from coronary and cerebral thrombosis. In: American Journal of Medicine, 81, pp. 795–800.

Kenney, W., 1997: Thermoregulation at rest and during exercise in healthy older adults. In: Exercise and Sport Sciences Reviews, 25, pp. 41–76.

Kilbourne, E., 1999: The spectrum of illness during heat waves. In: American Journal of Preventive Medicine, 16 (4), pp. 359–360

Klinenberg, E., 2002: Heat wave: A social autopsy of disaster in Chicago, Chicago: University of Chicago Press, p. 305, ISBN 0–226–44321–3.

Koppe, C., Jendritzky, G., Kovats, R. and Menne, B., 2003: Heatwaves: impacts and responses, Copenhagen: World Health Organization.

Kovats, R. and Ebi, K., 2006: Heatwaves and public health in Europe. In: European Journal of Public Health, 16 (6), pp. 592–599. DOI: 10.1093/eurpub/ckl049

Kyselý, J., 2004: Mortality and displaced mortality during heat waves in the Czech Republic. In: International Journal of Biometeorology, 49, pp. 91–97. DOI: 10.1007/s00484–004–0218–2

Linares, D. and Díaz, J., 2007: Impact of high temperatures on hospital admissions: comparative analysis with previous studies about mortality (Madrid). In: European Journal of Public Health, 18 (3), pp. 317– –322. DOI: 10.1093/eurpub/ckm108

Mastrangelo, G., Fedeli, U., Visentin, C., Milan, G., Fadda, E. and Spolaore, P., 2007: Pattern and determinants of hospitalization during heat waves: an ecologic study. In: BMC Public Health, 7, 200, pp. 1–8. DOI: 10.1186/1471–2458–7–200

McGeehin, M. and Mirabelli, M., 2001: The potential impacts of climate variability and change on temperature related morbidity and mortality in the United States. In: Environmental Health Perspectives, 109 (Supplement 2), pp. 185–189.

Meehl, G. and Tebaldi, C., 2004: More intense, more frequent, and longer lasting heat waves in the 21st century. In: Science, 305, pp. 994–997. DOI: 10.1126/ science.1098704

Metzger, B., Ito, K. and Matte, T., 2010: Summer heat and mortality in New York City: How hot is too hot? In: Environmental Health Perspectives 118 (1), pp. 80– –91. DOI:10.1289/ehp.0900906

Michelozzi, P., Sario, M., Acetta, G., Donato, F., Kirchmayer, U., Ovidio, M. and Perucci, C., 2006: Temperature and summer mortality: geographical and temporal variations in four Italian cities. In: Journal of Epidemiology and Community Health, 60, pp. 417– –423. DOI: 10.1136/jech.2005.040857

Monteiro, A., Fonseca, L., Almeida, M., Sousa, C., Velho, S. and Carvalho, V., 2012a: Atlas da saúde e da doença – vulnerabilidades climáticas e socioeconómicas na Grande Área Metropolitana do Porto e Concelho do Porto (Atlas of health and sickness–climatic and socio–economic vulnerabilities in the Greater Metropolitan Area of Porto and Concelho Port – in Portuguese). Available at: https://www.dropbox.com/ sh/2jad5pdf1hf978x/_MsLVsdvsp, DoA: 13 February 2011.

Monteiro, A., Velho, S. and Góis, J., 2012b: A importância da fragmentaçăo das paisagens urbanas na Grande Área Metropolitana do Porto para a modelizaçăo das ilhas de calor urbano – uma abordagem metodológica (The importance of fragmentation of urban landscapes in the Greater Metropolitan Area of Porto to the modeling of urban heat islands – a methodological approach – in Portuguese). In: Revista da Faculdade de Letras – Geografia. Universidade do Porto, série III, 1, pp.123–159. Available at: http://ler.letras. up.pt/uploads/ficheiros/10548.pdf, DoA: 13 February 2011.

Monteiro A., Carvalho, V., Oliveira T. and Sousa, C., 2012c: Excess mortality and morbidity during July 2006 Heat Wave in Porto, Portugal. In: International Journal of Biometeorology, 57:1, pp. 155–67. DOI: 10.1007/s00484–012–0543–9

Monteiro, A., Carvalho, V., Velho S. and Sousa, C., 2011: Assessing and monitoring urban resilience using COPD in Porto. In Science of the Total Environment, 414, pp.113–119. DOI: 10.1016/j.scitotenv. 2011.11.009 National Weather Service Weather Forecast Office Summer Weather Safety and Survival. Heat Index, available at: http://www.weather.gov/, DoA: 10 February 2011.

Naughton, M., Henderson, A., Mirabelli, M., Kaiser, R., Wilhelm, J., Kieszak, S., Rubin, C. and McGeehin, M., 2002: Heat–related mortality during a 1999 heat wave in Chicago. In: American Journal of Preventive Medicine, 22 (4), pp. 221–227.

Planton, S., Déqué, M., Chauvin, F. and Terray, L., 2008: Expected impacts of climate change on extreme climate events. In: Comptes Rendus Geoscience, 340, pp. 564–574. DOI:10.1016/j.crte.2008.07.009

Pirard, P., Vandentorren, S., Pascal, M., Laaidi, K., Le Tertre, A., Cassadou, S. and Ledrans, M., 2005: Summary of the mortality impact assessment of the 2003 heat wave in France. In: Euro Surveill, 10 (7). Available at: www.eurosurveillance.org/ViewArticle. aspx?ArticleId=554; DoA: 13 February 2011.

Rey, G., Jougla, E., Fouillet, A., Pavillon, G., Bessemoulin, P., Fraussinet, P., Clavel, J. and Hémon, D., 2007: The impact of major hear waves on all–cause and cause–specific mortality in France from 1971 to 2003. In: International Archives of Occupational and Environmental Health, 80, pp. 615–626. DOI: 10.1007/s00420–007–0173–4

Rooney, C., McMichael, A., Kovats, R. and Coleman, M., 1998: Excess mortality in England and Wales, and in Greater London, during the 1995 heatwave. In: Journal of Epidemiology and Community Health, 482 (52), pp. 482–486.

Rooke, G., Savage, M. and Brengelmann, G., 1994: Maximal skin blood flow is decreased in elderly men. In: Journal of Applied Psychology, 77, pp. 11–14.

Rothfusz, L., 1990: The heat index “equation”, National Weather Service Technical Attachment (SR 90–23).

Saez, M., Sunyer, J., Castellsagué, J., Murillo, C. and Antó, J., 1995: Relationship between weather temperature and mortality: a time series analysis approach in Barcelona. In: International Journal of Epidemiology, 24, pp. 576–582.

Schiffano, P., Cappai, G., Sario, M., Michelozzi, P., Marino, C., Bargagli, A. and Peruci, C., 2009: Susceptibility to heat wave–related mortality: a follow–up study of a cohort of elderly in Rome. In: Environmental Health, 8:50, pp.1–14. DOI: 10.1186/1476– 069X–8–50

Schulman, S., Lakatta, E., Fleg, J., Lakatta, L., Becker, L. and Gerstenblith, G., 1992: Age related decline in left ventricular filling at rest and exercise. In: American Journal of Pshychology, 263, pp. 1932–1938.

Semenza, J., Carol, M., Rubin, H., Kenneth, M., Falter, H., Selanikiom J., Flanders, D., Howe, H. and Wilhelm, J., 1996: Heat–related deaths during the July 1995 heat wave in Chicago. In: New England Journal of Medicine, 335 (2), pp. 84–90.

Semenza, J., McCullough, J., Flanders, W., McGeehin, M. and Lumpkin, J., 1999: Excess hospital admissions during the July 1995 heat wave in Chicago. In: American Journal of Preventive Medicine, 16 (4), pp. 269–277.

Steadman, R., 1979a: The assessment of sultriness. Part I: A Temperature–Humidity Index based on human physiology and clothing science. In: Journal of Applied Meteorology, 18 (7), pp. 861–873.

Steadman, R., 1979b: The assessment of sultriness. Part II: Effect of wind, extra radiation, and barometric pressure on apparent temperature. In: Journal of Applied Meteorology, 18 (7), pp. 874–884. Steadman, R., 1984: A universal scale of apparent temperature. In: Journal of Climate and Applied Meteorology, 23 (12), pp. 1674–1687.

Tan, J., Zheng, Y., Song, G., Kalkstein, L., Kalkstein, J. and Tang, X., 2007: Heat wave impacts on mortality in Shanghai, 1998 and 2003. In: International Journal of Biometeorology, 51, pp. 193–200. DOI: 10.1007/ s00484–006–0058–3

Weisskopf, M., Anderson, H., Foldy, S., Hanrahan, L., Blair, K., Török, T. and Rumm, P., 2002: Heat wave morbidity and mortality, Milwaukee, Wis, 1999 vs 1995: An improved response? In: American Journal of Public Health, Research and Practice, 92 (5), pp. 830–833.

Whitman, S., Good, G., Donoghue, E., Benbow, N., Shou, W. and Mou, S., 1997: Mortality in Chicago attributed to the July 1995 heat wave. In: American Journal of Public Health, 87 (9), pp. 1515–1518.








Print ISSN: 1732-4254
Online ISSN: 2083-8298

Partnerzy platformy czasopism