American Journal of Epidemiology Advance Access originally published online on July 28, 2008
American Journal of Epidemiology 2008 168(6):632-637; doi:10.1093/aje/kwn170
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ORIGINAL CONTRIBUTIONS |
A Multicounty Analysis Identifying the Populations Vulnerable to Mortality Associated with High Ambient Temperature in California
From the California Office of Environmental Health Hazard Assessment, Oakland, CA
Correspondence to Dr. Rupa Basu, Air Pollution Epidemiology Section, California Office of Environmental Health Hazard Assessment, 1515 Clay Street, 16th Floor, Oakland, CA 94612 (e-mail: rbasu{at}oehha.ca.gov).
Received for publication November 13, 2007. Accepted for publication May 15, 2008.
The association between ambient temperature and mortality has been established worldwide, including the authors' prior study in California. Here, they examined cause-specific mortality, age, race/ethnicity, gender, and educational level to identify subgroups vulnerable to high ambient temperature. They obtained data on nine California counties from May through September of 1999–2003 from the National Climatic Data Center (countywide weather) and the California Department of Health Services (individual mortality). Using a time-stratified case-crossover approach, they obtained county-specific estimates of mortality, which were combined in meta-analyses. A total of 231,676 nonaccidental deaths were included. Each 10°F (
4.7°C) increase in mean daily apparent temperature corresponded to a 2.6% (95% confidence interval (CI): 1.3, 3.9) increase for cardiovascular mortality, with the most significant risk found for ischemic heart disease. Elevated risks were also found for persons at least 65 years of age (2.2%, 95% CI: 0.04, 4.0), infants 1 year of age or less (4.9%, 95% CI: –1.8, 11.6), and the Black racial/ethnic group (4.9%, 95% CI: 2.0, 7.9). No differences were found by gender or educational level. To prevent the mortality associated with ambient temperature, persons with cardiovascular disease, the elderly, infants, and Blacks among others should be targeted.
California; effect modifiers (epidemiology); heat; mortality; temperature; vulnerable populations
Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; ICD-10, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision