Cold weather and GP consultations for respiratory conditions by elderly people in␣16 locations in the UK

Background: Cold weather is associated with increases in mortality and demands on hospital services in the UK, particularly by the elderly. Less is known about the relationship with patterns of consultation in primary care. We wished to determine the magnitude and consistency of associations between cold temperature and consultations for respiratory conditions in primary care settings at different sites in the UK. Methods: Time series analysis of any short-term effects of temperature on daily general practitioner (GP) consultations made by elderly people (65+ years) for lower and upper respiratory tract infections (LRTI, URTI) over a 10-year period, 1992–2001. Practices were situated in 16 urban locations across the UK where a Met Office monitoring station was in operation. Results: An association between low temperatures and an increase in LRTI consultations was observed in all 16 locations studied. The biggest increase was estimated for the Norwich practices for which a 19.0% increase in LRTI consultations (95% CI 13.6, 24.7) was associated with every 1 °C drop in mean temperature below 5 °C observed 0–20 days before the day of consultation. Slightly weaker relationships were observed in the case of URTI consultations. A north/south gradient, with larger temperature effects in the north, was in evidence for both LRTI and URTI consultations. Conclusions: An effect that was consistent and generally strongest in populations in the north was observed between cold temperature and respiratory consultations. Better understanding of the mechanisms by which cold weather is associated with increases in consultations for respiratory infections could lead to improved strategies for prevention and reduced burdens for health services.

[1]  M. Lebowitz,et al.  Respiratory symptoms and pulmonary function in an elderly nonsmoking population. , 1999, Chest.

[2]  Trevor Hastie,et al.  ISSUES IN SEMI-PARAMETRIC REGRESSION WITH APPLICATIONS IN TIME SERIES MODELS FOR AIR POLLUTION AND MORTALITY , 2003 .

[3]  Benedict W. Wheeler,et al.  Rurality, deprivation, and excess winter mortality: an ecological study , 2002, Journal of epidemiology and community health.

[4]  S. Hajat,et al.  Associations of cold temperatures with GP consultations for respiratory and cardiovascular disease amongst the elderly in London. , 2002, International journal of epidemiology.

[5]  R. Eccles,et al.  An Explanation for the Seasonality of Acute Upper Respiratory Tract Viral Infections , 2002, Acta oto-laryngologica.

[6]  H. Wright,et al.  Etiological factors in broncho-pneumonia amongst infants in London , 1945, Journal of Hygiene.

[7]  M. Murphy,et al.  The health of adult Britain 1841-1994. , 1997 .

[8]  A. Webster,et al.  Some factors affecting the airborne survival of bacteria outdoors. , 1995, The Journal of applied bacteriology.

[9]  Loudon Rg WEATHER AND COUGH. , 1964 .

[10]  W. T. Russell THE RELATIVE INFLUENCE OF FOG AND LOW TEMPERATURE ON THE MORTALITY FROM RESPIRATORY DISEASE. , 1926 .

[11]  M. Young,et al.  The Influence of Weather Conditions on the Mortality from Bronchitis and Pneumonia in Children , 1924, Journal of Hygiene.

[12]  B. Armstrong,et al.  Mortality and temperature in Sofia and London , 2003, Journal of epidemiology and community health.

[13]  D. Fleming,et al.  Respiratory illness and mortality in England and Wales , 1993, European Journal of Epidemiology.

[14]  G. Donaldson Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe , 1997, The Lancet.

[15]  Winter emergency pressures for the NHS: contribution of respiratory disease, experience in North Staffordshire district. , 2001, Journal of public health medicine.

[16]  J. Healy,et al.  Excess winter mortality in Europe: a cross country analysis identifying key risk factors , 2003, Journal of epidemiology and community health.

[17]  D. Gavhed,et al.  Inhalation of cold air increases the number of inflammatory cells in the lungs in healthy subjects. , 1998, The European respiratory journal.

[18]  Danica Rotar Pavlic,et al.  Information from primary care: its importance and value. A comparison of information from Slovenia and England and Wales, viewed from the 'Health 21' perspective. , 2002, European journal of public health.

[19]  D. Lawlor,et al.  Investigation of the association between excess winter mortality and socio-economic deprivation. , 2000, Journal of public health medicine.

[20]  R. Loudon WEATHER AND COUGH. , 1964, The American review of respiratory disease.

[21]  C. Lowe,et al.  Mortality from ischaemic heart disease--inter-town variation and its association with climate in England and Wales. , 1976, International Journal of Epidemiology.

[22]  J. Alberdi,et al.  Daily mortality in Madrid community 1986–1992: Relationship with meteorological variables , 1998, European Journal of Epidemiology.

[23]  W. Keatinge,et al.  Winter deaths: warm housing is not enough , 2001, BMJ : British Medical Journal.

[24]  C. Spicer,et al.  Influence of the weather on respiratory and heart disease. , 1961, Lancet.

[25]  A Haines,et al.  Impact of hot temperatures on death in London: a time series approach , 2001, Journal of epidemiology and community health.

[26]  J. Peacock,et al.  Deprivation and excess winter mortality. , 1999, Journal of epidemiology and community health.