The impact on mortality of heat waves in Budapest, Hungary R Sari Kovats, Shakoor Hajat, London School of Hygiene and Tropical Medicine, London, United Kingdom Anna Páldy, Fodor Jozsef National Center for Public Health, National Institute of Environmental Health, Budapest, Hungary János Bobvos Capital Institute of State Public Health Service, Budapest, Hungary
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The impact on mortality of heat waves in Budapest, Hungary R Sari Kovats, Shakoor Hajat, London School of Hygiene and Tropical Medicine, London, United.
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The impact on mortality of heat waves in Budapest, Hungary
R Sari Kovats, Shakoor Hajat, London School of Hygiene and Tropical Medicine,London, United Kingdom
Anna Páldy, Fodor Jozsef National Center for Public Health, National Institute of Environmental Health,
Budapest, Hungary
János Bobvos Capital Institute of State Public Health Service,Budapest, Hungary
Background• Heat wave August 2003 estimated excess deaths
• No standard definition• Events not comparable
– magnitude– duration– time of occurrence
• Methods to create baseline – regression model– episode analysis
• Short term mortality displacement
• France 10,000 excess deaths• Portugal 1,316 excess deaths• Italy reports 20 % more than average in July/Aug• Spain has reported 100 deaths
Objectives• Describe and quantify the
relationship between daily temperature extremes and mortality in Budapest
• Describe any differences between subgroups (by age and cause)
Mortality Mean daily count % of total
All cause 76.6 100%
Cardiovascular 38.6 50.4%Respiratory 2.79 3.6%
All cause: ages 15 to 64 20.3 26.5% ages 65 to 74 18.1 23.6% ages 75+ 37.5 49.0%
Cardiovascular: 38.6 100% ages 15 to 64 6.2 16.2% ages 65 to 74 8.8 22.7% ages 75+ 23.6 61.2%
Variable Mean value Range
Mean temperature (ºC) 11.3 -11, 29Relative humidity (%) 68.8 32, 100
predicted mean alld Deaths: all causes mean temperature heatwave event
01jun2000 01jul2000 01aug2000 31aug2000
0
50
100
Mean temperature
Heat wave 5
Heat wave 6
Excess mortality [all cause, all ages] for each event
0
10
20
30
40
50
60
70
jun 94 aug 94 jul 98 aug 98 jun 00 aug 00
estimate
lcl
ucl
Results by age groupAll cause
Cardiovascular
June 94 Aug 94 Jul 98 Aug 98 Jun 00 Aug 00
15 to 64 11 32 2 3 31 -365 to 74 10 12 18 -4 14 875 plus 49 50 48 33 57 33TOTAL 69 94 66 32 101 38
June 94 Aug 94 Jul 98 Aug 98 Jun 00 Aug 00
15 to 64 -4 2 -1 -1 8 065 to 74 14 6 14 -4 8 075 plus 51 36 22 25 39 27TOTAL 60 45 35 21 55 27
Number of “excess deaths”
-20.0%
-10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
June 94 Aug 94 Jul 98 Aug 98 Jun 00 Aug 00
15-64
65-74
75+
-20.0%
-10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
June 94 Aug 94 Jul 98 Aug 98 Jun 00 Aug 00
15-64
65-74
75+
date
predicted mean alld Deaths: all causes heatwave event twoweek
01jun1994 01aug1994
0
50
100
Short term mortality displacement
Heat wave 1
Short-term mortality
displacement
Two week % excess lower CI upper CIJun-94 6.7 1.2 12.3Aug-94 6.0 0.8 11.3Jul-98 6.7 0.8 12.5
Aug-98 -Jun-00 6.7 0.6 12.8Aug-00 1.3 -1.4 4.0
•Is excess compensated completely by “dip” following heat wave? •We estimated the excess over a one week and a two week period, beginning on the day of the heat wave•Excess over two weeks =6-7%