Shifts in mortality during a hot weather event in Vancouver, British Columbia: rapid assessment with case-only analysis.

OBJECTIVES We assessed shifts in patterns of mortality during a hot weather event in greater Vancouver, British Columbia. METHODS We used a case-only analysis to compare characteristics of individuals who died during the hottest week of 2009 with those who died (1) during earlier summer weeks in 2009 and (2) during the same calendar weeks in the summers of 2001 through 2008. RESULTS Compared with the 8 previous weeks of 2009, odds of mortality during the summer's hottest week were highest in the 65 to 74 years age category, compared with the 85 years and older category (odds ratio [OR] = 1.47; 95% confidence interval [CI] = 1.06, 2.03). The number of deaths at home increased over deaths in hospitals or institutions (OR = 1.43; 95% CI = 1.10, 1.86). Densely populated administrative health areas were more affected. CONCLUSIONS A shift toward deaths at home suggests that in-home-based protective measures should be part of planning for hot weather events in greater Vancouver. Targeting should be considered for those aged 65 to 74 years. The case-only approach is quick and easy to apply and can provide useful information about localized, time-limited events.

[1]  S. Hajat,et al.  Heat stress and public health: a critical review. , 2008, Annual review of public health.

[2]  W D Flanders,et al.  Nontraditional epidemiologic approaches in the analysis of gene-environment interaction: case-control studies with no controls! , 1996, American journal of epidemiology.

[3]  N Benbow,et al.  Mortality in Chicago attributed to the July 1995 heat wave. , 1997, American journal of public health.

[4]  James Díaz.  Mortality Among Patients Admitted to Hospitals on Weekends as Compared With Weekdays , 2002 .

[5]  Antonella Zanobetti,et al.  Extreme Temperatures and Mortality: Assessing Effect Modification by Personal Characteristics and Specific Cause of Death in a Multi-City Case-Only Analysis , 2006, Environmental health perspectives.

[6]  S B Thacker,et al.  Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo. , 1982, JAMA.

[7]  Joel Schwartz,et al.  Who is Sensitive to Extremes of Temperature?: A Case-Only Analysis , 2005, Epidemiology.

[8]  D. Hémon,et al.  The impact of major heat waves on all-cause and cause-specific mortality in France from 1971 to 2003 , 2007, International archives of occupational and environmental health.

[9]  Alexandra Schneider,et al.  The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project , 2010, Environmental health : a global access science source.

[10]  A. Zeghnoun,et al.  August 2003 heat wave in France: risk factors for death of elderly people living at home. , 2006, European journal of public health.

[11]  T. Kosatsky,et al.  How Toronto and Montreal (Canada) Respond to Heat , 2005 .

[12]  Wei Huang,et al.  The impact of the 2003 heat wave on mortality in Shanghai, China. , 2010, The Science of the total environment.

[13]  G. Jenks.  The Data Model Concept in Statistical Mapping , 1967 .

[14]  Jack A. Taylor,et al.  Non-hierarchical logistic models and case-only designs for assessing susceptibility in population-based case-control studies. , 1994, Statistics in medicine.

[15]  Scott L Zeger,et al.  Temperature and mortality in 11 cities of the eastern United States. , 2002, American journal of epidemiology.

[16]  M. Weijenberg,et al.  The impact of heat waves and cold spells on mortality rates in the Dutch population. , 2001, Environmental health perspectives.

[17]  H. R. Anderson,et al.  Heat Effects on Mortality in 15 European Cities , 2008, Epidemiology.

[18]  J. Knochel,et al.  Medical progress: Heat stroke , 2002 .

[19]  Antonella Zanobetti,et al.  The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. , 2002, Environmental health perspectives.

[20]  L. Kuller,et al.  Effects of the summer heat wave of 1988 on daily mortality in Allegheny County, PA. , 1990, Public health reports.

[21]  A. Spira,et al.  Excess deaths during the August 2003 heat wave in Paris, France. , 2006, Revue d'epidemiologie et de sante publique.

[22]  Mathilde Pascal,et al.  Mortality in 13 French cities during the August 2003 heat wave. , 2004, American journal of public health.

[23]  B. Armstrong,et al.  Fixed Factors that Modify the Effects of Time-Varying Factors: Applying the Case-Only Approach , 2003, Epidemiology.

[24]  Wilhelm Kirch,et al.  Extreme weather events and public health responses , 2005 .

[25]  Denis Hémon,et al.  Excess mortality related to the August 2003 heat wave in France , 2006, International archives of occupational and environmental health.

[26]  H. Howe,et al.  Heat-related deaths during the July 1995 heat wave in Chicago. , 1996, The New England journal of medicine.

[27]  P. Gottschalk,et al.  Heat Stroke , 1912 .

[28]  A. Henschel,et al.  An analysis of the heat deaths in St. Louis during July, 1966. , 1969, American journal of public health and the nation's health.