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      Impacto de las temperaturas extremas en la salud pública: futuras actuaciones Translated title: Impact of Extreme Temperatures on Public Health

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          Abstract

          Las temperaturas extremadamente elevadas registradas en el centro de Europa y en el norte y este de España durante el verano de 2003 pusieron de manifiesto la importancia que sobre la salud pública en general presentan las altas temperaturas. Los excesos de morbimortalidad que llevaron asociadas estas temperaturas extremas han hecho que en nuestro país se articularan y llevaran a cabo planes de alerta y prevención durante el año 2004, con el objetivo de minimizar estos efectos. Afortunadamente las temperaturas registradas, mucho menos elevadas que las de 2003, no han servido para evaluar en toda su dimensión estos planes, pero sí para detectar algunas deficiencias que se irán subsanando en el futuro. En este artículo se analizan los principales impactos de las olas de calor, fundamentalmente, y de frío. Se contemplan los factores socioeconómicos que influyen en estos excesos de mortalidad y se plantean las medidas que deben tenerse en cuenta en los planes de prevención. Se hace hincapié en la necesidad de agilización de los registros de morbimortalidad en España y en las políticas necesarias para la minimización del impacto en salud de los eventos térmicos extremos.

          Translated abstract

          The extremely high temperatures recorded in Central Europe and in the northern and eastern of Spain during the summer of 2003 revealed the major impact that high temperatures have on public health. The excessively high death rates and hospital admissions related to these extreme temperatures have led to alert and prevention plans having been set out in our country in 2004 for the purpose of minimizing these effects. Fortunately, the temperatures recorded in 2004, which were much lower than in 2003, have not served to evaluate these plans in their full scope but have indeed served to detect some lacks which will progressively be corrected in the future. This article analyzes the mainly major impacts mainly of heat waves and also of cold waves. The socioeconomic factors having a bearing on these excessively high death rates and the measures set out which must be taken into account in the prevention plans. Particular stress is placed on the need of expediting the recording of disease and death rates in Spain and in the policies necessary for minimizing the impact on health of the extreme temperature events.

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          Most cited references34

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          The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United States.

          Heat and heat waves are projected to increase in severity and frequency with increasing global mean temperatures. Studies in urban areas show an association between increases in mortality and increases in heat, measured by maximum or minimum temperature, heat index, and sometimes, other weather conditions. Health effects associated with exposure to extreme and prolonged heat appear to be related to environmental temperatures above those to which the population is accustomed. Models of weather-mortality relationships indicate that populations in northeastern and midwestern U.S. cities are likely to experience the greatest number of illnesses and deaths in response to changes in summer temperature. Physiologic and behavioral adaptations may reduce morbidity and mortality. Within heat-sensitive regions, urban populations are the most vulnerable to adverse heat-related health outcomes. The elderly, young children, the poor, and people who are bedridden or are on certain medications are at particular risk. Heat-related illnesses and deaths are largely preventable through behavioral adaptations, including the use of air conditioning and increased fluid intake. Overall death rates are higher in winter than in summer, and it is possible that milder winters could reduce deaths in winter months. However, the relationship between winter weather and mortality is difficult to interpret. Other adaptation measures include heat emergency plans, warning systems, and illness management plans. Research is needed to identify critical weather parameters, the associations between heat and nonfatal illnesses, the evaluation of implemented heat response plans, and the effectiveness of urban design in reducing heat retention.
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            Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe

            (1997)
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              Outdoor air temperature and mortality in The Netherlands: a time-series analysis.

              Death rates become progressively higher when outdoor air temperature rises above or falls below 20-25 degrees C. This study addresses the question of whether this relation is largely attributable to the direct effects of exposure to heat and cold on the human body in general, and on the circulatory system in particular. The association between daily mortality and daily temperatures in the Netherlands in the period 1979-1987 was examined by controlling for influenza incidence, air pollution, and "season"; distinguishing lag periods; examining effect modification by wind speed and relative humidity; and distinguishing causes of death. Important direct effects of exposure to cold and heat on mortality were suggested by the following findings: 1) control for influenza incidence reduced cold-related mortality by only 34% and reduced heat-related mortality by 23% (the role of air pollution and "season" was negligible); 2) 62% of the "unexplained" cold-related mortality, and all heat-related mortality, occurred within 1 week; and 3) effect modification by wind speed was in the expected direction. The finding that 57% of "unexplained" cold-related mortality and 26% of the "unexplained" heat-related mortality was attributable to cardiovascular diseases suggests that direct effects are only in part the result of increased stress on the circulatory system. For heat-related mortality, direct effects on the respiratory system are probably more important. For cold-related mortality, the analysis yielded evidence of an important indirect effect involving increased incidence of influenza and other respiratory infections.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad Servicios Sociales e Igualdad (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                April 2005
                : 79
                : 2
                : 145-157
                Affiliations
                [02] orgnameUniversidad Autónoma de Madrid orgdiv1Departamento de Medicina Preventiva y Salud Pública
                [01] orgnameUniversidad Complutense de Madrid orgdiv1Facultad de Ciencias Físicas orgdiv2Departamento de Física del Aire
                Article
                S1135-57272005000200004
                10.1590/s1135-57272005000200004
                9c2228d8-7951-4494-823c-89fddca82762

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 13
                Product

                SciELO Spain


                Calor,Mortalidad,Ola de calor,Sistemas de registro,Hot,Mortality,Heat weare

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