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Vulnerability to heat-related mortality in Latin America: a case-crossover study in São Paulo, Brazil, Santiago, Chile and Mexico City, Mexico
- Source :
- INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, Artículos CONICYT, CONICYT Chile, instacron:CONICYT, Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual), Universidade de São Paulo (USP), instacron:USP
- Publication Year :
- 2008
- Publisher :
- Oxford University Press, 2008.
-
Abstract
- Background Factors affecting vulnerability to heat-related mortality are not well understood. Identifying susceptible populations is of particular importance given anticipated rising temperatures from climatic change. Methods We investigated heat-related mortality for three Latin American cities (Mexico City, Mexico; Sao Paulo, Brazil; Santiago, Chile) using a case-crossover approach for 754 291 deaths from 1998 to 2002. We considered lagged exposures, confounding by air pollution, cause of death and susceptibilities by educational attainment, age and sex. Results Same and previous day apparent temperature were most strongly associated with mortality risk. Effect estimates remained positive though lowered after adjustment for ozone or PM10. Susceptibility increased with age in all cities. The increase in mortality risk for those ≥65 comparing the 95th and 75th percentiles of same-day apparent temperature was 2.69% (95% CI: −2.06 to 7.88%) for Santiago, 6.51% (95% CI: 3.57–9.52%) for Sao Paulo and 3.22% (95% CI: 0.93–5.57%) for Mexico City. Patterns of vulnerability by education and sex differed across communities. Effect estimates were higher for women than men in Mexico City, and higher for men elsewhere, although results by sex were not appreciably different for any city. In Sao Paulo, those with less education were more susceptible, whereas no distinct patterns by education were observed in the other cities. Conclusions Elevated temperatures are associated with mortality risk in these Latin American cities, with the strongest associations in Sao Paulo, the hottest city. The elderly are an important population for targeted prevention measures, but vulnerability by sex and education differed by city.
- Subjects :
- Adult
Male
medicine.medical_specialty
Latin Americans
Hot Temperature
Adolescent
Epidemiology
Population
Poison control
Young Adult
Ozone
Sex Factors
parasitic diseases
Injury prevention
medicine
Humans
Chile
Cities
Mortality
education
Child
Socioeconomic status
Mexico
SANTIAGO
Aged
education.field_of_study
Air Pollutants
Cross-Over Studies
Fourier Analysis
Public health
Age Factors
Infant, Newborn
Infant
General Medicine
Original Articles
Middle Aged
Apparent temperature
Geography
Child, Preschool
Educational Status
Female
Particulate Matter
sense organs
Brazil
Demography
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, Artículos CONICYT, CONICYT Chile, instacron:CONICYT, Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual), Universidade de São Paulo (USP), instacron:USP
- Accession number :
- edsair.doi.dedup.....7605defcf86c83f74ad1598cc09fae29