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von Klot, S. ; Zanobetti, A.* ; Schwartz, J.*

Influenza epidemics, seasonality, and the effects of cold weather on cardiac mortality.

Environ. Health 11:74 (2012)
Publ. Version/Full Text Volltext DOI PMC
Open Access Gold
BACKGROUND: More people die in the winter from cardiac disease, and there are competing hypotheses to explain this. The authors conducted a study in 48 US cities to determine how much of the seasonal pattern in cardiac deaths could be explained by influenza epidemics, whether that allowed a more parsimonious control for season than traditional spline models, and whether such control changed the short term association with temperature. METHODS: The authors obtained counts of daily cardiac deaths and of emergency hospital admissions of the elderly for influenza during 1992-2000. Quasi-Poisson regression models were conducted estimating the association between daily cardiac mortality, and temperature. RESULTS: Controlling for influenza admissions provided a more parsimonious model with better Generalized Cross-Validation, lower residual serial correlation, and better captured Winter peaks. The temperature-response function was not greatly affected by adjusting for influenza. The pooled estimated increase in risk for a temperature decrease from 0 to 5degreesC was 1.6% (95% confidence interval (CI) 1.1-2.1%). Influenza accounted for 2.3% of cardiac deaths over this period. CONCLUSIONS: The results suggest that including epidemic data explained most of the irregular seasonal pattern (about 18% of the total seasonal variation), allowing more parsimonious models than when adjusting for seasonality only with smooth functions of time. The effect of cold temperature is not confounded by epidemics.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords AIR-POLLUTION; US CITIES; RESPIRATORY EPIDEMICS; UNITED-STATES; TIME-SERIES; SAO-PAULO; TEMPERATURE; HEAT; IMPACT; ASSOCIATION
e-ISSN 1476-069x
Journal Environmental Health: A Global Access Science Source
Quellenangaben Volume: 11, Issue: 1, Pages: , Article Number: 74 Supplement: ,
Publisher BioMed Central
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)