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Zhang, S. ; Breitner-Busch, S. ; de'Donato, F.* ; Stafoggia, M.* ; Nikolaou, N. ; Aunan, K.* ; Peters, A. ; Schneider, A.E.

Heat and cause-specific cardiopulmonary mortality in Germany: A case-crossover study using small-area assessment.

Lancet Reg. Health-Eur. 46:101049 (2024)
Verlagsversion DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
Background High temperatures have been associated with increased mortality, with evidence reported predominately in large cities and for total cardiovascular or respiratory deaths. This case-crossover study examined heat-related cause-specific fi c cardiopulmonary mortality and vulnerability factors using small-area data from Germany. Methods We analyzed daily counts of cause-specific fi c cardiopulmonary deaths from 380 German districts (2000-2016) - 2016) and daily mean temperatures estimated by spatial-temporal - temporal models. We applied conditional quasi-Poisson regression using distributed lag nonlinear models to examine heat effects during May-September - September in each district and random- effects meta-analysis to pool the district-specific fi c estimates. Potential individual- and district-level vulnerability factors were examined by subgroup analyses and meta-regressions, respectively. Findings Heat was associated with increased mortality risks for all cardiopulmonary sub-causes. The relative risk (RR) of total cardiovascular and respiratory mortality for a temperature increment from the 75th to the 99th percentile was 1.24 (95% confidence fi dence interval: 1.23, 1.26) and 1.34 (1.30, 1.38), respectively. The RRs of cardiovascular sub-causes ranged from 1.16 (1.13, 1.19) for myocardial infarction to 1.32 (1.29, 1.36) for heart failure. For respiratory sub- causes, the RR was 1.27 (1.22, 1.31) for COPD and 1.49 (1.42, 1.57) for pneumonia. We observed greater susceptibility related to several individual- and district-level characteristics, e.g., among females or in highly urbanized districts. Heat vulnerability factors remained consistent between urban and rural areas. Interpretation Our study highlights heat-related increases in cause-specific fi c cardiopulmonary mortality across Germany and identifies fi es key vulnerability factors, offering insights for improving public health practices to mitigate heat-related health impacts. Funding European Union's ' s Horizon 2020 research and innovation program; Helmholtz Associations Initiative and Networking Fund. Health 2024;46: Published https://doi.org/10. 1016/j.lanepe.2024. 101049
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Temperature; Cardiovascular disease; Respiratory disease; Vulnerability factor; Urbanization; Air pollution; Greenness; Air-pollution; Temperature; Exposure; Metaanalysis; Pneumonia; Morbidity; Responses; Extremes; Outcomes; Weather
ISSN (print) / ISBN 2666-7762
e-ISSN 2666-7762
Zeitschrift The Lancet Regional Health - Europe
Quellenangaben Band: 46, Heft: , Seiten: , Artikelnummer: 101049 Supplement: ,
Verlag Elsevier
Verlagsort Radarweg 29, 1043 Nx Amsterdam, Netherlands
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Epidemiology II (EPI2)
Förderungen Helmholtz Associations Initiative and Networking Fund
European Union