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      Apparent Temperature and Cause-Specific Mortality in Copenhagen, Denmark: A Case-Crossover Analysis


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          Temperature, a key climate change indicator, is expected to increase substantially in the Northern Hemisphere, with potentially grave implications for human health. This study is the first to investigate the association between the daily 3-hour maximum apparent temperature (Tapp max), and respiratory, cardiovascular and cerebrovascular mortality in Copenhagen (1999–2006) using a case-crossover design. Susceptibility was investigated for age, sex, socio-economic status and place of death. For an inter-quartile range (7 °C) increase in Tapp max, an inverse association was found with cardiovascular mortality (−7% 95% CI −13%; −1%) and none with respiratory and cerebrovascular mortality. In the cold period all associations were inverse, although insignificant.

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          Most cited references30

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          Heat stress and public health: a critical review.

          Heat is an environmental and occupational hazard. The prevention of deaths in the community caused by extreme high temperatures (heat waves) is now an issue of public health concern. The risk of heat-related mortality increases with natural aging, but persons with particular social and/or physical vulnerability are also at risk. Important differences in vulnerability exist between populations, depending on climate, culture, infrastructure (housing), and other factors. Public health measures include health promotion and heat wave warning systems, but the effectiveness of acute measures in response to heat waves has not yet been formally evaluated. Climate change will increase the frequency and the intensity of heat waves, and a range of measures, including improvements to housing, management of chronic diseases, and institutional care of the elderly and the vulnerable, will need to be developed to reduce health impacts.
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            Effects of cold weather on mortality: results from 15 European cities within the PHEWE project.

            Weather-related health effects have attracted renewed interest because of the observed and predicted climate change. The authors studied the short-term effects of cold weather on mortality in 15 European cities. The effects of minimum apparent temperature on cause- and age-specific daily mortality were assessed for the cold season (October-March) by using data from 1990-2000. For city-specific analysis, the authors used Poisson regression and distributed lag models, controlling for potential confounders. Meta-regression models summarized the results and explored heterogeneity. A 1 degrees C decrease in temperature was associated with a 1.35% (95% confidence interval (CI): 1.16, 1.53) increase in the daily number of total natural deaths and a 1.72% (95% CI: 1.44, 2.01), 3.30% (95% CI: 2.61, 3.99), and 1.25% (95% CI: 0.77, 1.73) increase in cardiovascular, respiratory, and cerebrovascular deaths, respectively. The increase was greater for the older age groups. The cold effect was found to be greater in warmer (southern) cities and persisted up to 23 days, with no evidence of mortality displacement. Cold-related mortality is an important public health problem across Europe. It should not be underestimated by public health authorities because of the recent focus on heat-wave episodes.
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              Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence.


                Author and article information

                Int J Environ Res Public Health
                International Journal of Environmental Research and Public Health
                Molecular Diversity Preservation International (MDPI)
                September 2011
                16 September 2011
                : 8
                : 9
                : 3712-3727
                [1 ]Section of Environmental Health, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen DK-1014, Denmark; E-Mail: stl@ 123456sund.ku.dk
                [2 ]Institute of Cancer Epidemiology, Danish Cancer Society, 49 Strandboulevarden, Copenhagen DK-2100, Denmark; E-Mail: zorana@ 123456cancer.dk
                [3 ]Department of Environmental Sciences, Aarhus University, Frederiksborgvej 399, Roskilde DK-4000, Denmark; E-Mails: mke@ 123456dmu.dk (M.K.); tel@ 123456dmu.dk (T.E.)
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: jawic@ 123456sund.ku.dk ; Tel.: +45-353-27622; Fax: +45-353-27686.
                © 2011 by the authors; licensee MDPI, Basel, Switzerland

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                : 20 July 2011
                : 22 August 2011
                : 05 September 2011

                Public health
                Public health
                respiratory, case-crossover, mortality, temperature, cerebrovascular, cardiovascular, epidemiology


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