Temporal changes in temperature-related mortality in Spain and effect of the implementation of a Heat Health Prevention Plan

Exposure to extreme ambient temperatures has been widely described to increase mortality. Exploring changes in susceptibility to temperatures over time can provide useful information for policy planning and can provide insights on the effectiveness of health preventive plans. The aims of this study...

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Detalles Bibliográficos
Autores: Martínez Solanas, Èrica, 1982-, Basagaña Flores, Xavier
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/43445
Acceso en línea:http://hdl.handle.net/10230/43445
http://dx.doi.org/10.1016/j.envres.2018.11.006
Access Level:acceso abierto
Palabra clave:Adaptation
Ambient temperatures
Heat prevention plan
Heat-waves
Mortality
Descripción
Sumario:Exposure to extreme ambient temperatures has been widely described to increase mortality. Exploring changes in susceptibility to temperatures over time can provide useful information for policy planning and can provide insights on the effectiveness of health preventive plans. The aims of this study were i) to compare changes in temperature-related mortality in Spain during a 20-year period and ii) to assess whether the number of actions implemented in each region as part of a Heat Health Prevention Plan (HHPP) was associated with the temporal changes in heat-related mortality. Daily counts of deaths and daily maximum temperature were obtained for each Spanish province (1993-2013). We used time-varying distributed lag non-linear models to estimate the relationship between temperature and mortality. We compared the risk of death due to extreme temperatures (cold and heat) in the two periods (1993-2002 and 2004-2013), assuming a constant temperature distribution and different temperature-mortality function. Results were reported as mortality attributable fraction (%) (AF). Overall, there was a decrease in mortality attributable to temperature in period 2, more remarkable for extreme cold (from 1.01% to 0.52%), while for moderate heat there was an increase (from 0.38% to 1.21%). Provinces with more actions implemented in their HHPP showed stronger decreases in mortality attributable to extreme heat. Other variables (e.g. average temperature) could explain this association. The highest mortality-AF reductions were detected among the elderly, in mortality for cardiovascular causes and in towns with high socioeconomic vulnerability. Our results suggest that the implementation of the Spanish HHPP could help reduce heat-related mortality.