Assessment of short-term heat effects on cardiovascular mortality and vulnerability factors using small area data in Europe.

Autor: Zhang S; Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany. Electronic address: siqi.zhang@helmholtz-munich.de., Breitner S; Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany., Rai M; Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany., Nikolaou N; Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany., Stafoggia M; Department of Epidemiology, Lazio Regional Health Service - ASL ROMA 1, Rome, Italy., De' Donato F; Department of Epidemiology, Lazio Regional Health Service - ASL ROMA 1, Rome, Italy., Samoli E; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Zafeiratou S; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Katsouyanni K; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Rao S; Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway., Palomares AD; Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway., Gasparrini A; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK., Masselot P; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK., Aunan K; CICERO Center for International Climate Research, Norway., Peters A; Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany., Schneider A; Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
Jazyk: angličtina
Zdroj: Environment international [Environ Int] 2023 Sep; Vol. 179, pp. 108154. Date of Electronic Publication: 2023 Aug 16.
DOI: 10.1016/j.envint.2023.108154
Abstrakt: Background: Short-term associations between heat and cardiovascular disease (CVD) mortality have been examined mostly in large cities. However, different vulnerability and exposure levels may contribute to spatial heterogeneity. This study assessed heat effects on CVD mortality and potential vulnerability factors using data from three European countries, including urban and rural settings.
Methods: We collected daily counts of CVD deaths aggregated at the small-area level in Norway (small-area level: municipality), England and Wales (lower super output areas), and Germany (district) during the warm season (May-September) from 1996 to 2018. Daily mean air temperatures estimated by spatial-temporal models were assigned to each small area. Within each country, we applied area-specific Quasi-Poisson regression using distributed lag nonlinear models to examine the heat effects at lag 0-1 days. The area-specific estimates were pooled by random-effects meta-analysis to derive country-specific and overall heat effects. We examined individual- and area-level heat vulnerability factors by subgroup analyses and meta-regression, respectively.
Results: We included 2.84 million CVD deaths in analyses. For an increase in temperature from the 75th to the 99th percentile, the pooled relative risk (RR) for CVD mortality was 1.14 (95% CI: 1.03, 1.26), with the country-specific RRs ranging from 1.04 (1.00, 1.09) in Norway to 1.24 (1.23, 1.26) in Germany. Heat effects were stronger among women [RRs (95% CIs) for women and men: 1.18 (1.08, 1.28) vs. 1.12 (1.00, 1.24)]. Greater heat vulnerability was observed in areas with high population density, high degree of urbanization, low green coverage, and high levels of fine particulate matter.
Conclusion: This study provides evidence for the heat effects on CVD mortality in European countries using high-resolution data from both urban and rural areas. Besides, we identified individual- and area-level heat vulnerability factors. Our findings may facilitate the development of heat-health action plans to increase resilience to climate change.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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