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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: SherrilynH.Wainwright@usda.gov
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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

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