Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic

The study examines spatial patterns of effects of high temperature extremes on cardiovascular mortality in the Czech Republic at a district level during 1994–2009. Daily baseline mortality for each district was determined using a single location-stratified generalized additive model. Mean relative deviations of mortality from the baseline were calculated on days exceeding the 90th percentile of mean daily temperature in summer, and they were correlated with selected demographic, socioeconomic, and physical-environmental variables for the districts. Groups of districts with similar characteristics were identified according to socioeconomic status and urbanization level in order to provide a more general picture than possible on the district level. We evaluated lagged patterns of excess mortality after hot spell occurrences in: (i) urban areas vs. predominantly rural areas; and (ii) regions with different overall socioeconomic level. Our findings suggest that climatic conditions, altitude, and urbanization generally affect the spatial distribution of districts with the highest excess cardiovascular mortality, while socioeconomic status did not show a significant effect in the analysis across the Czech Republic as a whole. Only within deprived populations, socioeconomic status played a relevant role as well. After taking into account lagged effects of temperature on excess mortality, we found that the effect of hot spells was significant in highly urbanized regions, while most excess deaths in rural districts may be attributed to harvesting effects.

[1]  A. Schneider,et al.  Modification of Heat-Related Mortality in an Elderly Urban Population by Vegetation (Urban Green) and Proximity to Water (Urban Blue): Evidence from Lisbon, Portugal , 2015, Environmental health perspectives.

[2]  Chuanhua Yu,et al.  The Construction and Validation of the Heat Vulnerability Index, a Review , 2015, International journal of environmental research and public health.

[3]  C. Fuhrmann,et al.  Area-level risk factors for heat-related illness in rural and urban locations across North Carolina, USA , 2015 .

[4]  J. Kyselý,et al.  Contrasting patterns of hot spell effects on morbidity and mortality for cardiovascular diseases in the Czech Republic, 1994–2009 , 2015, International Journal of Biometeorology.

[5]  Christian Schuster,et al.  Land use patterns, temperature distribution, and potential heat stress risk - The case study Berlin, Germany , 2014, Comput. Environ. Urban Syst..

[6]  M. Boeckmann,et al.  Is planned adaptation to heat reducing heat-related mortality and illness? A systematic review , 2014, BMC Public Health.

[7]  Patrick L. Kinney,et al.  Intra-urban vulnerability to heat-related mortality in New York City, 1997–2006 , 2014, Health & place.

[8]  A. Krämer,et al.  The effects of season and meteorology on human mortality in tropical climates: a systematic review. , 2014, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[9]  C. Koppe Influence of heat waves on ischemic heart diseases in Germany – present situation and climate change , 2014 .

[10]  J. Kyselý,et al.  Impacts of hot and cold spells differ for acute and chronic ischaemic heart diseases , 2014, BMC Public Health.

[11]  A. Barnett,et al.  Heat-Related Morbidity in Brisbane, Australia: Spatial Variation and Area-Level Predictors , 2014, Environmental health perspectives.

[12]  F. Dominici,et al.  Heat-Related Mortality and Adaptation to Heat in the United States , 2014, Environmental health perspectives.

[13]  W. Endlicher,et al.  Spatial analysis of hospital admissions for respiratory diseases during summer months in Berlin taking bioclimatic and socio-economic aspects into account , 2014 .

[14]  Woncheol Jang,et al.  Assessing the Performance of a Vulnerability Index during Oppressive Heat across Georgia, United States , 2014 .

[15]  J. Samet,et al.  Commentary: Does air pollution confound studies of temperature? , 2014, Epidemiology.

[16]  Michael V. Saha,et al.  Mortality displacement as a function of heat event strength in 7 US cities. , 2014, American journal of epidemiology.

[17]  Antonis Analitis,et al.  Performance Assessment of a Heat Wave Vulnerability Index for Greater London, United Kingdom , 2014 .

[18]  J. Kyselý,et al.  Comparison of UTCI with Other Thermal Indices in the Assessment of Heat and Cold Effects on Cardiovascular Mortality in the Czech Republic , 2014, International journal of environmental research and public health.

[19]  A. Biggeri,et al.  Impact of Summer Heat on Urban Population Mortality in Europe during the 1990s: An Evaluation of Years of Life Lost Adjusted for Harvesting , 2013, PloS one.

[20]  K. Bhaskaran,et al.  Time series regression studies in environmental epidemiology , 2013, International journal of epidemiology.

[21]  S. Tong,et al.  Are heat warning systems effective? , 2013, Environmental Health.

[22]  J. Kyselý,et al.  Heat- and cold-stress effects on cardiovascular mortality and morbidity among urban and rural populations in the Czech Republic , 2013, International Journal of Biometeorology.

[23]  X. Basagaña,et al.  Differences on the effect of heat waves on mortality by sociodemographic and urban landscape characteristics , 2013, Journal of Epidemiology & Community Health.

[24]  J. Kyselý,et al.  Trends in cardiovascular mortality and hospitalisations, and potential contribution of inhospital case-fatality rates to changes in national mortality in the Czech Republic 1994–2009 , 2013, Heart.

[25]  William L. Stefanov,et al.  Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona , 2012, Environmental health perspectives.

[26]  Daniel P. Johnson,et al.  Developing an applied extreme heat vulnerability index utilizing socioeconomic and environmental data , 2012 .

[27]  J. Kyselý,et al.  Declining impacts of hot spells on mortality in the Czech Republic, 1986–2009: adaptation to climate change? , 2012, Climatic Change.

[28]  G. McGregor,et al.  The benefits of quantifying climate model uncertainty in climate change impacts assessment: an example with heat-related mortality change estimates , 2012, Climatic Change.

[29]  Yelena Ogneva-Himmelberger,et al.  The spatial variability of heat-related mortality in Massachusetts , 2012 .

[30]  Michael V. Saha,et al.  Fine-scale spatial variability of heat-related mortality in Philadelphia County, USA, from 1983-2008: a case-series analysis , 2012, Environmental Health.

[31]  Keith W. Oleson,et al.  Contrasting urban and rural heat stress responses to climate change , 2012 .

[32]  J. Balmes,et al.  Evaluation of a Heat Vulnerability Index on Abnormally Hot Days: An Environmental Public Health Tracking Study , 2012, Environmental health perspectives.

[33]  J. Kyselý,et al.  Comparison of hot and cold spell effects on cardiovascular mortality in individual population groups in the Czech Republic , 2011 .

[34]  Matthias Ketzel,et al.  Apparent Temperature and Cause-Specific Mortality in Copenhagen, Denmark: A Case-Crossover Analysis , 2011, International journal of environmental research and public health.

[35]  S. Tong,et al.  Projecting Future Heat-Related Mortality under Climate Change Scenarios: A Systematic Review , 2011, Environmental health perspectives.

[36]  Katharina M. A. Gabriel,et al.  Urban and rural mortality rates during heat waves in Berlin and Brandenburg, Germany. , 2011, Environmental pollution.

[37]  Andreas Matzarakis,et al.  Human biometeorological evaluation of heat-related mortality in Vienna , 2011 .

[38]  Y. Epstein,et al.  Comparison of UTCI to selected thermal indices , 2011, International Journal of Biometeorology.

[39]  Olga V. Wilhelmi,et al.  Intra-urban societal vulnerability to extreme heat: the role of heat exposure and the built environment, socioeconomics, and neighborhood stability. , 2011, Health & place.

[40]  Eva Plavcová,et al.  A critical remark on the applicability of E-OBS European gridded temperature data set for validating control climate simulations , 2010 .

[41]  Xavier Rodó,et al.  Future changes in Central Europe heat waves expected to mostly follow summer mean warming , 2010 .

[42]  J. Kaufman Does air pollution accelerate progression of atherosclerosis? , 2010, Journal of the American College of Cardiology.

[43]  A. Getis The Analysis of Spatial Association by Use of Distance Statistics , 2010 .

[44]  Xiaoshu Cheng,et al.  Effects of climatic temperature stress on cardiovascular diseases. , 2010, European journal of internal medicine.

[45]  J. Kyselý,et al.  Relationships between sudden weather changes in summer and mortality in the Czech Republic, 1986–2005 , 2010, International journal of biometeorology.

[46]  Rupa Basu,et al.  High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008 , 2009, Environmental health : a global access science source.

[47]  S. Hajat,et al.  Heat-related mortality: a review and exploration of heterogeneity , 2009, Journal of Epidemiology & Community Health.

[48]  M. Pelling,et al.  Associations between elevated atmospheric temperature and human mortality: a critical review of the literature , 2009 .

[49]  M. Goldberg,et al.  The effects of outdoor air pollution on chronic illnesses , 2009, McGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students.

[50]  Joel Schwartz,et al.  Mapping Community Determinants of Heat Vulnerability , 2008, Environmental health perspectives.

[51]  Jan Kyselý,et al.  Decreased impacts of the 2003 heat waves on mortality in the Czech Republic: an improved response? , 2008, International journal of biometeorology.

[52]  H. Tomášková,et al.  Analysis of Mortality in the Czech Republic Using the Newly Constructed Socioeconomic Deprivation Index , 2007 .

[53]  Alan Y. Chiang,et al.  Generalized Additive Models: An Introduction With R , 2007, Technometrics.

[54]  M. Medina-Ramón,et al.  Temperature, temperature extremes, and mortality: a study of acclimatisation and effect modification in 50 US cities , 2007, Occupational and Environmental Medicine.

[55]  G. McGregor,et al.  Climate change and heat-related mortality in six cities Part 1: model construction and validation , 2007, International journal of biometeorology.

[56]  S. Hajat,et al.  Heat-related and cold-related deaths in England and Wales: who is at risk? , 2006, Occupational and Environmental Medicine.

[57]  S. Hales,et al.  Climate change and human health: present and future risks , 2006, The Lancet.

[58]  S. Wood Generalized Additive Models: An Introduction with R , 2006 .

[59]  Henrique Andrade,et al.  Nocturnal urban heat island in Lisbon (Portugal): main features and modelling attempts , 2006 .

[60]  M. Rebetez,et al.  Assessing public health risk due to extremely high temperature events: climate and social parameters , 2005 .

[61]  János Unger,et al.  Intra-urban relationship between surface geometry and urban heat island: review and new approach , 2004 .

[62]  J. Samet,et al.  Air Pollution and Cardiovascular Disease: A Statement for Healthcare Professionals From the Expert Panel on Population and Prevention Science of the American Heart Association , 2004, Circulation.

[63]  Radan Huth,et al.  Heat-related mortality in the Czech Republic examined through synoptic and 'traditional' approaches , 2004 .

[64]  Thayne A Munce,et al.  Invited review: aging and human temperature regulation. , 2003, Journal of applied physiology.

[65]  Timothy J. Dolney,et al.  Heat, mortality, and level of urbanization: measuring vulnerability across Ohio, USA , 2003 .

[66]  J. Mercer Cold--an underrated risk factor for health. , 2003, Environmental research.

[67]  Christina Gloeckner,et al.  Modern Applied Statistics With S , 2003 .

[68]  A. Arnfield Two decades of urban climate research: a review of turbulence, exchanges of energy and water, and the urban heat island , 2003 .

[69]  G. Jendritzky,et al.  Effects of the thermal environment on human health: an investigation of 30 years of daily mortality data from SW Germany , 2002 .

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

[71]  J. Kyselý,et al.  Application of spatial synoptic classification in evaluating links between heat stress and cardiovascular mortality and morbidity in Prague, Czech Republic , 2015, International Journal of Biometeorology.

[72]  A. Matzarakis,et al.  Impact of heat waves on mortality in Croatia , 2013, International Journal of Biometeorology.

[73]  M. Novák Use of the UTCI in the Czech Republic , 2013 .

[74]  Wilhelm Kuttler,et al.  Measures against heat stress in the city of Gelsenkirchen, Germany , 2013 .

[75]  Jianguo Tan,et al.  The urban heat island and its impact on heat waves and human health in Shanghai , 2010, International journal of biometeorology.

[76]  G. McGregor,et al.  Climate change and heat-related mortality in six cities Part 2: climate model evaluation and projected impacts from changes in the mean and variability of temperature with climate change , 2009, International journal of biometeorology.

[77]  Stan Openshaw,et al.  Modifiable Areal Unit Problem , 2008, Encyclopedia of GIS.

[78]  T. Wilbanks,et al.  Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change , 2007 .

[79]  G. Henderson,et al.  Home air conditioning in Europe - how much energy would we use if we became more like American households? , 2005 .

[80]  J. Kysel Mortality and displaced mortality during heat waves in the Czech Republic , 2004 .

[81]  Ruth Salway,et al.  A statistical framework for ecological and aggregate studies , 2001 .

[82]  Rafael Lozano,et al.  AGE STANDARDIZATION OF RATES: A NEW WHO STANDARD , 2000 .

[83]  V. Henžlík Forests and Air Pollution in the Czech Republic , 1997 .

[84]  Mcrp Jumin Song Regional focus. , 1987, Nursing Standard.