Spatial analysis of heat-related mortality among the elderly between 1993 and 2004 in Sydney, Australia.

This study analyzed the geographical patterns of heat-related mortality among the population aged 65 and over within the metropolitan area of Sydney, Australia between 1993 and 2004, and evaluated the role of some physical and socio-demographic risk factors associated with it. The effect of temperature on all-cause mortality during unusually hot days was investigated using spatial analytic techniques, such as cluster analysis and spatial regression analysis. Generalized Linear Models (GLMs) were used to investigate the role of daily average temperature, ozone (O(3)) and particulate matter of diameter less than 10 microm (PM(10)) at the regions that showed a significant increase in mortality on unusually hot days. Spatial variation in mortality on unusually hot days was observed among the population 65 and over. Elderly people living within 5-20 km south-west and west of the Sydney Central Business District (CBD) were found to be more vulnerable. However, analysis using GLMs showed temperature to be a significant modifier of daily mortality in the region to the south-west of the CBD only. O(3) and PM(10) were found to be non-significant factors in the regions where air pollutants were studied. Socio-economic status and the proportion of vegetation or developed land in each Statistical Local Area (SLA) were also not a significant factor explaining the increased mortality. A combination of social and environmental factors may be at play. Our results suggest an effect of temperature on mortality of the elderly population in Sydney Statistical Division at the SLA level. More spatially-based research would be beneficial once climate datasets with improved spatial coverage become available.

[1]  N. Nicholls,et al.  A simple heat alert system for Melbourne, Australia , 2008, International journal of biometeorology.

[2]  David J. Unwin,et al.  GIS, spatial analysis and spatial statistics , 1996 .

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

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

[5]  Robert Haining,et al.  Spatial Data Analysis: Theory and Practice , 2003 .

[6]  Kerrie Mengersen,et al.  Temperature, air pollution and total mortality during summers in Sydney, 1994–2004 , 2008, International journal of biometeorology.

[7]  Pavla Vaneckova,et al.  Effect of temperature on mortality during the six warmer months in Sydney, Australia, between 1993 and 2004. , 2008, Environmental research.

[8]  W. Stefanov,et al.  Neighborhood microclimates and vulnerability to heat stress. , 2006, Social science & medicine.

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

[10]  L. Waller,et al.  Applied Spatial Statistics for Public Health Data , 2004 .

[11]  T. Rothenhaus,et al.  Heat-related illness. , 2004, Emergency medicine clinics of North America.

[12]  M. Hart,et al.  Synoptic analysis of heat-related mortality in Sydney, Australia, 1993–2001 , 2008, International journal of biometeorology.

[13]  S. Corbett,et al.  Air pollution and daily mortality in Sydney, Australia, 1989 through 1993. , 1998, American journal of public health.

[14]  N. Nicholls,et al.  International Journal of Health Geographics Open Access Demographic, Seasonal, and Spatial Differences in Acute Myocardial Infarction Admissions to Hospital in Melbourne Australia , 2008 .

[15]  H. Akaike A new look at the statistical model identification , 1974 .

[16]  Antonella Zanobetti,et al.  The Time Course of Weather-Related Deaths , 2001, Epidemiology.

[17]  O. G. Edholm,et al.  Man and his thermal environment , 1985 .

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

[19]  W. S. Robinson Ecological correlations and the behavior of individuals. , 1950, International journal of epidemiology.

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

[21]  Eric Klinenberg,et al.  Heat Wave: A Social Autopsy of Disaster in Chicago , 2002 .

[22]  M. Karlsson,et al.  Only in the Heat of the Moment? A Study of the Relation between Weather and Mortality in Germany , 2011 .

[23]  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.

[24]  A. Woodward,et al.  Climate and mortality in Australia: retrospective study, 1979-1990 and predicted impacts in five major cities in 2030. , 1999 .

[25]  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.

[26]  K. Smoyer Putting risk in its place: methodological considerations for investigating extreme event health risk. , 1998, Social science & medicine.

[27]  R. Woodruff HUMAN HEALTH AND CLIMATE CHANGE IN OCEANIA: A RISK ASSESSMENT , 2003 .

[28]  Shakoor Hajat,et al.  An ecological time-series study of heat-related mortality in three European cities , 2008, Environmental Health.

[29]  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 .

[30]  Paul Wilkinson,et al.  Mortality Displacement of Heat-Related Deaths: A Comparison of Delhi, São Paulo, and London , 2005, Epidemiology.

[31]  J. Monteith,et al.  Boundary Layer Climates. , 1979 .

[32]  L. Kalkstein,et al.  An evaluation of climate/mortality relationships in large U.S. cities and the possible impacts of a climate change. , 1997, Environmental health perspectives.

[33]  G Laschewski,et al.  Atmospheric heat exchange of the human being, bioclimate assessments, mortality and thermal stress. , 2000, International journal of circumpolar health.

[34]  T. K. Young,et al.  Geographic analysis of diabetes prevalence in an urban area. , 2003, Social science & medicine.

[35]  S. Roberts Interactions between particulate air pollution and temperature in air pollution mortality time series studies. , 2004, Environmental research.

[36]  Scott C Sheridan,et al.  The relationship between extreme heat and ambulance response calls for the city of Toronto, Ontario, Canada. , 2004, Environmental research.

[37]  Michelle L Bell,et al.  Vulnerability to heat-related mortality in Latin America: a case-crossover study in Sao Paulo, Brazil, Santiago, Chile and Mexico City, Mexico. , 2008, International journal of epidemiology.

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

[39]  M. Kulldorff A spatial scan statistic , 1997 .

[40]  D. Altman,et al.  Multiple significance tests: the Bonferroni method , 1995, BMJ.

[41]  Mohamed Shoukri,et al.  Prognostic factors in heat wave related deaths: a meta-analysis. , 2007, Archives of internal medicine.

[42]  J. Mackenbach,et al.  Outdoor air temperature and mortality in The Netherlands: a time-series analysis. , 1993, American journal of epidemiology.