Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T17:06:49.874Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardiovascular Mortality — The Hidden Peril of Heat Waves

Published online by Cambridge University Press:  28 June 2012

Sherrilyn H. Wainwright ,
Sharunda D. Buchanan ,
M. Mainzer ,
R. Gibson Parrish  and
Thomas H. Sinks
Sherrilyn H. Wainwright*
Affiliation:
National Center for Environmental Health, Division of Environmental Hazards and Health Effects Centers for Disease Control and Prevention, Atlanta, Georgia. Drs. Wainwright, Buchanan, and Mainzer worked on this study as Epidemic Intelligence Service Officers
Sharunda D. Buchanan
Affiliation:
National Center for Environmental Health, Division of Environmental Hazards and Health Effects Centers for Disease Control and Prevention, Atlanta, Georgia. Drs. Wainwright, Buchanan, and Mainzer worked on this study as Epidemic Intelligence Service Officers
M. Mainzer
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia. Drs. Wainwright, Buchanan, and Mainzer worked on this study as Epidemic Intelligence Service Officers Epidemiology Program Office, Division of Field Epidemiology, Pennsylvania Department of Health
R. Gibson Parrish
Affiliation:
National Center for Environmental Health, Division of Environmental Hazards and Health Effects
Thomas H. Sinks
Affiliation:
National Center for Environmental Health, Division of Environmental Hazards and Health Effects
*
USDA/APHIS/VS 6200 Jefferson St. NE, Suite # 117 Albuquerque, New Mexico 87109 USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

— Define the mortality associated with extremely hot weather during the 04 July through 14 July, 1993 heat wave that struck the northeastern United States.

Methods:

Design — A rapid field assessment was used to compare mortality occurring during the heat wave to mortality occurring during a period in which there was no heat wave using copies of death certificates. The findings of the rapid field assessment were validated, and it was determined whether increases in mortality occurred in other metropolitan east-coast counties also affected by the heat wave, by reviewing computerized mortality files. Setting —Information was collected on all deaths occurring in Baltimore City, Maryland; Baltimore County, Maryland; Essex County, New Jersey; Newcastle County, Delaware; and Philadelphia County, Pennsylvania; during these specified study periods: 08–18 June (comparison period) and 06–16 July (heat wave study period), 1993.

Main Outcome Measures — Ratios for total mortality, cause-specific mortality, and variables such as age, sex, race, residence, and day and place of death, that were available from death certificates were calculated.

Results:

From the rapid field assessment, the following were observed: a 26% increase in total mortality and a 98% increase in cardiovascular mortality associated with the heat wave in Philadelphia. Data from the computerized mortality files showed an increase in total mortality in four of five counties examined and an increase in cardiovascular mortality in all five counties. The risk for death for those dying from cardiovascular disease increased significantly for people older than 64 years, for both sexes, and all races.

Conclusion:

Conclusion: As initially indicated by the Philadelphia Medical Examiner, there was excess mortality associated with a heat wave in Philadelphia. All other nearby counties examined also experienced excess mortality associated with the heat wave, although this excess was not recognized by the local health officials. The true impact of a heat wave that causes excess preventable mortality must be appropriately and rapidly ascertained. Using a national standard to certify a death as heat-related will provide the needed information rapidly so that public health resources can be more effectively allocated and mobilized to prevent further heat-related illnesses and death.

Keywords

cardiovascular mortalitydeath certificatesheat-related mortalityheat wavesmortality filesprevention of heat-related mortalityrapid field assessment
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 14 , Issue 4 , December 1999 , pp. 18 - 27
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Jones, TS, Liang, AP, Kilbourne, EM et al. : Morbidity and mortality associated with the July 1980 heat wave in St. Louis and Kansas City, Mo. JAMA 1982;247:3327–3331.CrossRefGoogle Scholar
2. Ellis, FP: Mortality from heat illness and heat-aggravated illness in the United States. Environ Res 1972;5:1–58.CrossRefGoogle ScholarPubMed
3. Hodge, WT: Weather-related variations in U.S. daily mortality. Conference on Agriculture & Forest Meteorology, 2–6 April, 1979, Minneapolis, MN. American Meteorological Society, Boston, MA. 1979;294–297.Google Scholar
4. National Center for Health Statistics: Public Use Data Tape Documentation for the Compressed Mortality File (CMF). U.S. Centers for Disease Control and Prevention. National Center for Health Statistics, 1979–1991. Washington DC.Google Scholar
5. U.S. Centers for Disease Control and Prevention: Heat-related illnesses and deaths—United States, 1994–1995. MMWR 1995;44:465–468.Google Scholar
6. Kilbourne, EM: Heat Waves. In: Gregg, MB, (ed.), The Public Health Consequences of Disasters 1989. U.S. DHHS/U.S. Centers for Disease Control and Prevention, Public Health Service, September 1989; pp 51–61.Google Scholar
7. Yarbrough, BE, Hubbard, RW: Heat-related illnesses. In: Auerbach, PS, Geehr, EC, (eds.) Management of wilderness and environmental emergencies. 2nd ed. St. Louis: C.V. Mosby Company, 1989; pp 131–132.Google Scholar
8. Centers for Disease Control and Prevention: Heat-related deaths—Philadelphia and United States, 1993–1994. MMWR 1994;43:453–455.Google Scholar
9. Marder, D: Philadelphia takes some heat over death statistics. Philadelphia Inquirer 1993 Jul:1(col 1).Google Scholar
10. National Climatic Data Center, National Environmental Satellite Data and Information Service, National Oceanic and Atmospheric Administration, U.S. Department of Commerce: Hourly Surface Airways Observations. Asheville, North Carolina. TD-3280. 1992–1993.Google Scholar
11. EarthInfo's National Climatic Data Center: Surface Airways. Boulder, Colorado, EarthInfo, Inc. 1988–1991.Google Scholar
12. National Center for Health Statistics: Vital Statistics of the United States, 1990, Vol II, Mortality, Part A. Washington, DC: Public Health Service. 1994. U.S. DHHS Pub. No. (PHS) 95–1101:383.Google Scholar
13. National Center for Health Statistics. The Advanced Report of Final Mortality Statistics, 1979. Monthly Vital Statistics Report, vol 31 no 6, suppl (9). Hyattsville, Maryland: Public Health Service.Google Scholar
14. World Health Organization: Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Eased on the Recommendations of the Ninth Revision Conference, 1975. Geneva: Worl Health Organization. 1977.Google Scholar
15. National Center for Health Statistics: Vital statistics, ICD–9 Automated Classification of Medical Entities (ACME) Decision Tables for Classifying Underlying Causes of Death. Instruction Manual; Part 2c. Hyattsville, Maryland: Public Health Service. 1981.Google Scholar
16. Lilienfeld, AM, Lilienfeld, DE: Foundations of Epidemiology. New York: Oxford University Press, 1980; pp 344–346.Google Scholar
17. Kochanek, KD, Hudson, BL: Advance Report of Final Mortality Statistics, 1992. Monthly Vital Statistics Report, 1995; Vol 43 No 6, suppl. Hyattsville, Maryland: National Center for Health Statistics; pp 71–72.Google Scholar
18. U.S. Bureau of the Census: U.S. Population and Housing (CPH), 1990. Public Law 94–171 Data on the CD-ROM/ prepared by the Bureau of the Census. Washington, D.C.: U.S. Bureau of the Census, 1991.Google Scholar
19. National Association of Medical Examiners: Development of criteria for certifying a death as heat-related. NAME News. St. Louis, MO, 1995;3:3.Google Scholar
20. Centers for Disease Control and Prevention: Heat-related-mortality—Chicago, July 1995. MMWR 1995;44:577–579.Google Scholar
21. National Center for Health Statistics: Mortality Medical Indexing, Classification, and Retrieval System (MICAR). Instruction Manual, Part 2h. National Center for Health Statistics. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. 1991.Google Scholar
22. Clarke, JF: Some climatological aspects of heat waves in the contiguous United States. Environ Res 1972; 5:76–84.CrossRefGoogle ScholarPubMed
23. Buechley, RW, Van Bruggen, J, Truppi, LE: Heat island = death island? Environ Res 1972;5:85–92.CrossRefGoogle ScholarPubMed
24. Clarke, JF: Some effects of the urban structure on heat mortality. Environ Res 1972;5:93–104.CrossRefGoogle ScholarPubMed
25. Kilbourne, EM, Choi, K, Jones, TS, Thacker, SB, and the Field Investigation Team: Risk factors for heatstroke: A case-control study. JAMA 1982;247:3332–3336.CrossRefGoogle ScholarPubMed
26. Martinez, BF, Annest, JL, Kilbourne, EM et al. : Geographic distribution of heat-related deaths among elderly persons. JAMA 1989;262:2246–2250.CrossRefGoogle ScholarPubMed
27. Schuman, SH: Patterns of urban heat-wave deaths and implications for prevention: Data from New York and St. Louis during July 1966. Environ Res 1972;5:59–75.CrossRefGoogle Scholar