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American Journal of Epidemiology Advance Access originally published online on October 24, 2008
American Journal of Epidemiology 2008 168(12):1397-1408; doi:10.1093/aje/kwn266
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Effects of Cold Weather on Mortality: Results From 15 European Cities Within the PHEWE Project

A. Analitis, K. Katsouyanni, A. Biggeri, M. Baccini, B. Forsberg, L. Bisanti, U. Kirchmayer, F. Ballester, E. Cadum, P. G. Goodman, A. Hojs, J. Sunyer, P. Tiittanen and P. Michelozzi

Correspondence to Dr. K. Katsouyanni, Department of Hygiene, Epidemiology and Medical Statistics, 75 Mikras Asias Street, Medical School, University of Athens, Athens 115 27 Greece (e-mail: kkatsouy{at}med.uoa.gr).

Received for publication November 22, 2007. Accepted for publication July 31, 2008.

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°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.

cold; Europe; mortality; temperature; urban health; weather

Abbreviations: PHEWE, Assessment and Prevention of Acute Health Effects of Weather Conditions in Europe


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