Environmental-temperature injury in a Canadian metropolis
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Updated: Aug 29, 2026

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Published on: June 15, 2020
Athanasios Tom Koutsavlis1, Tom Kosatsky
1Paladin Labs Inc., 102-6111 Royalmount Avenue, Montreal, Quebec, Canada, H4P 2T4. tkoutsav@paladin-labs.com
Abstract:
This study performed a preliminary investigation of the incidence and determinants of environmental-temperature injury among residents of Montreal Island, Quebec, Canada. Incidence rates, mortality rates and determinants of environmental-temperature injury were estimated for Montreal Island's 1,802,309 urban and suburban residents. Sources of information included coroner's reports, death certificates, hospital discharge summaries, and hospital chart reviews. The estimated incidence rate for environmental-temperature injury requiring hospitalization on Montreal Island was 3.1 per 100,000 person-years. The estimated mortality rate for all environmental-temperature injuries on Montreal Island was 0.3 per 100,000 person-years. The majority of hospitalizations and deaths were due to cold injury. Male gender, alcohol intoxication, psychiatric illness, older age, and homelessness were suggestive of important risk factors in cold injury. All deaths due to heat injury occurred in elderly females. Montreal Island's ambulance transport service, with its unique database, was identified as a novel surveillance design for environmental-temperature injury. Knowing more about the incidence and determinants of environmental-temperature injury may suggest priorities for interventions to decrease morbidity and mortality.
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