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Mortality and temperature in Sofia and London.

S Pattenden1, B Nikiforov, B G Armstrong

  • 1London School of Hygiene and Tropical Medicine, London, UK. Sam.Pattenden@lshtm.ac.uk

Journal of Epidemiology and Community Health
|July 29, 2003
PubMed
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Extreme cold significantly increases mortality in London and Sofia, with effects lasting weeks. Heat also raises death rates, particularly in Sofia. These findings highlight temperature

Area of Science:

  • Environmental epidemiology
  • Public health
  • Biometeorology

Background:

  • Extreme temperatures (heat and cold) are linked to increased mortality, but detailed understanding remains limited.
  • Previous research indicates mortality increases independently of seasonal patterns, necessitating further investigation into specific temperature-mortality relationships.

Purpose of the Study:

  • To investigate the associations between daily mortality and ambient temperature in two distinct European capitals: Sofia and London.
  • To analyze the impact of both extreme cold and heat on all-cause mortality over four-year periods.

Main Methods:

  • Utilized generalized additive models to analyze daily deaths, air pollution, and weather data from Sofia (1996-1999) and London (1993-1996).
  • Employed non-linear modeling for confounders like season and humidity, assessing temperature-mortality relationships using two-day and two-week averages.

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  • Estimated lag effects, linear effects, and attributable fractions for heat and cold.

    • Main Results:

    • Extreme cold (below 10th centile) increased mortality by 4.2% per degree in London and 1.8% in Sofia.
    • Heat (above 95th centile) increased mortality by 1.9% per degree in London and 3.5% in Sofia.
    • Cold effects manifested around three days lag and persisted for at least two weeks, especially in London; heat effects were more immediate.

    Conclusions:

    • Short-term average temperatures may not fully capture the impact of cold, and potentially heat (due to harvesting effects).
    • Cold temperatures pose a significant risk to the general population in London, with effects not limited to those nearing death.
    • Findings underscore the public health impact of temperature extremes and the need for tailored environmental health strategies.