Sara MORAES, University of São Paulo, Brazil
Ricardo ALMENDRA, University of Coimbra, Portugal
Ligia Vizeu BARROZO, University of São Paulo, Brazil
Several studies have reported that extreme air temperature events are associated with an increase in mortality risk. The impacts of heatwaves and cold spells are greater in vulnerable populations, especially among older adults. However, there is no consensus in the literature on the effects of heatwaves and cold spells on cause-specific mortality between sexes. Therefore, this study aimed to investigate the effects of heatwaves and cold spells on cause-specific mortality among people aged ≥65 years stratified by sex in São Paulo from 2006 to 2015. To investigate the association between daily mortality and extreme air temperature events we used a quasi-Poisson generalized linear model with a distributed lag model to estimate the lag effects, according to previous studies (Gasparrini and Armstrong, 2011; Chen et al., 2019; Yin et al., 2018; Zhao et al., 2019). We also compared different heatwave and cold spells intensity and duration definitions to estimate the relative risk. In addition, to assess the differences across relative risks of cause-specific mortality by sex, we calculated the relative risk ratio (RRR) through a two-stage analysis based on Altman and Band (2003) approach. Our results show an increase in cause-specific deaths related to heatwaves and cold spells under several definitions. The highest risk of cardiovascular deaths related to heatwaves was identified mostly at higher temperature thresholds with longer events for males and females. We found that during cold spells women were more likely to die from ischemic heart diseases and have a higher risk of chronic obstructive pulmonary disease in heatwaves events than men. While men presented a higher risk of death due to cerebrovascular diseases and ischemic stroke in some cold spells and heatwaves definitions. Our findings can provide substantial evidence for the development of tailored public health measures to reduce the impacts of extreme air temperature events.
Mots clés : heatwave|cold spells|elderly|cause-specific mortality|sex inequalities
A105235SM