It's HOT Outside...Check on Your Elderly Neighbors!

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Elderly suffer most in this type of heat from unconditioned homes and respiratory problems.
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Elderly Women Susceptible to Heat Wave Deaths, Mostly From Respiratory Causes
Emma Hitt, PhD

 

July 16, 2010 — Researchers have defined heat wave intensity and have compared the effect of heat waves on European cities, showing a significant increase in total daily mortality with heat waves, especially in elderly women, mostly from respiratory causes.
Daniela D'Ippoliti, PhD, from the Regional Health Authority, Rome, Italy, and colleagues reported their findings online July 15 in Environmental Health.
"This study is the first in Europe to compare the impact of heat waves on mortality in different cities using a common heat wave definition and a standardized methodological approach," the researchers note.
The researchers investigated 9 European cities (Athens, Greece; Barcelona, Spain; Budapest, Hungary; London, United Kingdom; Milan, Italy; Munich, Germany; Paris, France; Rome, Italy; and Valencia, Spain) as part of the EuroHEAT project, which is evaluating the specific contribution of heat wave events to mortality, allowing for a comparison among cities. Both temperature and humidity levels during the day, as well as high nighttime temperatures, were considered when defining heat waves.
The researchers' definition of a heat wave was a period of at least 2 days when Tappmax, an interaction between maximum air temperature and humidity, was among the highest monthly 10%, or when the minimum temperature was among the highest 10%, with Tappmax above the average.
Heat waves of long duration had the greatest effect on mortality, resulting in a 1.5- to 3-fold higher daily mortality than for shorter heat waves. Duration of heat waves was defined in relation to the median length of time — heat waves lasting longer than the median were considered long duration, whereas those lasting fewer days than the median were classified as short duration. The elderly, especially women, appeared to be most at risk during heat waves, and the excess mortality was mostly from respiratory — not cardiovascular — causes.
In 2003, there was a heat wave across Europe, which was considered in a separate analysis. In the study period from 1990 to 2002 and 2004, a significant increase in total daily mortality was observed in all cities, with the greatest increase in Milan (+33.6%; 95% confidence interval, 28.5% - 39.0%) and the lowest in Munich (+7.6%; 90% confidence interval, 3.8% - 11.5%).
During the 2003 heat wave, all cities except Athens and Budapest showed an increased mortality, with the rate of mortality increasing by about more than 30% to roughly 100% compared with other years. "The greatest impact on mortality was observed in cities where heat wave episodes are rare events or were characterized by temperatures largely outside the usual meteorological conditions," the authors note.
According to the researchers, a greater effect of heat waves of longer duration and high intensity was observed in most cities, and the findings suggest that heat wave duration has a greater effect on mortality than intensity. The researchers also report that when stratified by sex and age, the greatest increase in mortality was "observed for respiratory diseases and among women aged 75-84 years."
One limitation of the trial, among others, was lack of investigation of lag time effect.
"Considering our results," Dr. D'Ippoliti and colleagues conclude, "prevention programs should specifically target the elderly, especially women, and those suffering from chronic respiratory disorders, in order to reduce in the future the burden of heat-related mortality."
The EuroHEAT Project was coordinated by the World Health Organization Regional Office for Europe and was cofunded by a grant from the European Commission. The study authors have disclosed no relevant financial relationships.
Environ Health. Published online July 15, 2010.