Modifiers of the temperature-mortality association in Shanghai, China

Various factors can modify the health effects of temperature. Prior findings about modifiers are inconsistent, and such studies have been conducted mostly in developed countries. We conducted a time-series analysis to examine the modifying effect of gender, age and education on the association between temperature and daily mortality in Shanghai, China, using 4 years (2001-2004) of daily data. A natural spline model was used to analyze the data. Elderly subjects were found to be more vulnerable to temperature health effects compared with younger people. We observed no significant modifying effect of gender or education level. These findings may provide useful information for local governments seeking to take steps to protect vulnerable sub-populations.