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Mortality-heat studies included in the systematic review

Author, Year ID Location

Time-series Month

Health data source Weather data source Frequency Method

Temperature measure

Controlled variables Diseases

Harlan, 2014 (1)

Arizona, USA

2000-2008

(9 years) May-Oct

Maricopa County death certificates

Sky Harbor International Airport

Daily death counts

Poisson regression

Daily maximum apparent temperature

Warm seasonHeat, CVD, COPD/Asthma

Burkart, 2014 (2)

26 regions of Bangladesh

2003-2007(5 years) All year

Bangladesh Meteorological Department

Sample Vital Registration System (SVRS), Bangladesh Bureau of Statistics (BBS).

Daily death counts

GAM, Poisson regression, DLNM

Universal Thermal Climate Index (UTCI)

Trend, season, day of the month and equivalent temperature.

CVD, ID

Huang, 2014 (3)

Changsha, China

2008 - 2011(4 years) Jun-Aug

Chinese Centers for Disease Control and Prevention

China Meteorological Data Sharing System

Daily death counts

GAM, DLNM

Mean temperature

Relative humidity, barometric pressure, wind speed, air pollution, long-term trend, season CVD

Yang, 2013 (4)

Guangzhou, China


Guangzhou Center for Disease Control and Prevention

China Meteorological Data Sharing System

Daily death counts

Quasi-Poisson regression, DLNM

Diurnal temperature range

Daily mean temperature, air pollution, long-term trends, season, day of the week

% change per 1°C increase in DTR, lag0-4.CVD1.11(-0.28-2.53) (65-74)0.95(0.06-1.84)(75+)RD0.63(-1.73-3.06)(65-74)0.83(-0.2-2.01)(75+)

Almeida, 2013 (5)

Lisbon and Oporto, Portugal

2000-2004(5 years) Apr-Sep

National Institute of Statistics

National Meterologic Institute. Lisbon: city station, Oporto: airport station

Daily death counts

GEE, Poisson regression

Maximum daily apparent temperature

Barometric pressure,wind speed, air pollution, day ofthe week, holidays, calendar month, long-term trend CVD, RD

Gasparrini, 2012 (6)

England, Wales

1993-2006(14 years) Jun-Sep

Office for National Statistics

29 weather stations from respective Government Office Region

Daily death counts

GLM, threshold model, log-linear increase in risk above a heat threshold

Maximum daily temperature

Day of year (season) and time trend

CBD, IHD, MI, ChIHD, PulHD, AVCD, AtrFib, Arrhyt, HeartFail, All CVD, InfResp, COPD, PulHD , Asthma, RD, Diab, Endocr, Demen, Schizo, Mental, Park, DegDis, Nervous, GUM, Renal, Accid , Ext

Liu, 2011 (7)

Beijing, China

2003-2005(3 years) Apr-Sep

Beijing Centers for Diseases Control and Prevention

China Meteorological Data Sharing Service System

Daily death counts

Generalized semi-parametric Poisson regression

2-day or 15-day mean temperature

Long-term trend, season, day of the week, public holidays

CBD, IHD, CVD, RD, cardio-resp

Mortality-cold studies included in the systematic review

Author, Year ID LocationTime-series Month Health data source

Weather data source

Frequency Method

Temperature measure Controlled variables Diseases

Wong, 2014 (16) Hong Kong2001- 2005

(5 years) Dec - Mar

Cohort of hypertensive patients who attended any public health-care sectors in Hong Kong

Hong Kong Observatory

Daily death counts

Conditional logistic regression analysis, case-crossover design

Mean daily temperature

Seasonality, longer-term trends, days of the week. Sensitivity analysis for public holidays and influenza outbreaks

RD in patients with pre-existing hypertension

Huang, 2014 (3)Changsha, China

2008 - 2011 (4 years) Dec - Feb

Chinese Centers for Disease Control and Prevention


Daily death counts

GAM, followed by the DLNM for lagged effects


Air pollution index, barometric pressure, relative humidity, wind speed, long-term and seasonal trends CVD

Xu, 2013 (17) Hong Kong1998-2001(4 years)

all year, ≤20.8°C

18 Elderly Health Centers (EHC), Census and Statistics Department


Daily death counts

GAM for thresholds. Condititional logistic regression for effect size

Mean daily apparent temperature

Sex, smoking status, physical activity level, education level, housing type, health status, day of the week, influenza epidemics, 2003 SARS epidemic, age, body mass index (BMI), PM10 concentrations CVD, RD

Yu, 2011 (9)Brisbane, Australia

1996-2004(9 years)

Office of Economic and Statistical Research of the Queensland Treasury.

Australian Bureau of Meteorology

Daily death counts

GAM, DLNM for lagged effect


Day of the week, influenza outbreak, holidays, time trend, air pollution (PM10, NO2 or O3), long term trends, relative humidity CVD

Liu, 2011 (7)Beijing, China

2003-2005(2 years 8 months) Oct - Mar

Beijing Centers for Diseases Control and Prevention


Daily death counts

Generalized semi-parametric Poisson regression

2-day or 15-day mean temperature

Long-term trend, season, day of the week, public holidays

CBD, IHD, CVD, RD, cardio-resp

Wichmann, 2011 (8)

Copenhagen, Denmark

1999-2006(8 years) Oct - Mar

Danish cause of death and hospitaldischarge registers

Copenhagen urban backgroundmonitoring station by the Department of Environmental Sciences, Aarhus University

Daily death counts

GAM, Poisson regression, time-stratified case-crossover design

Maximum daily apparent temperature

Season, holidays, influenza, air pollutants

CVD, CBD, RD

Revich, 2008 (12) Moscow, Russia

2000-2005(6 years)

all year Demographyand Human Ecology Center of Economic

MoscowState University weather station

Daily death counts

Linear regression


NA IHD, CBD, CLRD

ForecastingInstitute, Russian Academy of Sciences

Analitis, 2008 (18)

15 European cities

1990-2000 (5–11 years per city) Oct - Mar

The PHEWE database

The PHEWE database.Air pollution data from: A European Approach (APHEA) database

Daily death counts

City specific: generalized estimating equations as an extension of GLMs,. Pooled: GEE with cubic regression spline

Minimum daily apparent temperature

Holidays, day of the week, barometric pressure, wind speed, air pollution index (nitrogen dioxide 1-hour maximum, black smoke 24-hour average for Dublin)

CVD, CBD, RD

Carder, 2005 (19)

Glasgow, Edinburgh, and Aberdeen. Scotland

1981-2001 (20 years) all year

The Information and Statistics Division (ISD) of the Common Services Agency (CSA) of the Scottish Health Service

The Meteorological Office

Daily death counts

GLM, Poisson regression


City, day of the week, particulate matter (black smoke), season, other long term trends CVD, RD

Cagle, 2005 (20)Washington, USA


Washington State Department of Health, Center for Health Statistics

National Climate Data Center web site for the Seattle–Tacoma International Airport

Daily death counts



Season, year, population size, precipitation, barometric pressure CVD

Gouveia, 2003 (15)

Sao Paulo, Brazil


Cities mortality information system

University of São Paulo, one station close to city central region. Air pollution data from CETESB, the environmental agency in São Paulo

Daily death counts

GAM, Poisson regression


Day of the week, air pollution, season CVD, RD

Morbidity-heat studies included in the systematic review

Author ID LocationTime-series Month Data source Weather data

Health data Method

Temperature measure Controlled for Diseases

Condemi, 2015 (21)

Cuneo, Italy


ED visits database (DB) of the S. Croce and Carle Hospital

Collana di Studi Climatologici in Piemonte and Meteoro- logical Data Bank ARPA Piemonte Emergency

department visits

GAM Poisson regression, DLNM


season, day of week, summer holidays Renal colic and

urinary stones (kidney stones) ICD 9 :592 + other or N20 +other

Han, 2015(22)

Soeul, Korea


The Clinical Research Center for Stroke registry

Meteorologic Administration of South Korea

Hospital discharge diagnosis


Monthly mean temperature NA CBD, IS, IntH

Li, 2014 (23)Ghangzhou, China

2010-2012(3 year)

Sun yatsen University

Guangzhou Meteorological Bureau Emergency

hospital admissions

Negative binomial model


mean temperature, day of the week, and seasonal and long- term trends

RR per 1°C increase in DTR, lag0-2.Respiratory tract infection1.02(1.01-1.06)

Kim 2014 (24)Soeul, Korea

2007-2010(4 years) Dec-Feb

National Emergency Department Information System

Korean Meteorological Administration Emergency

department visits

GLMMean daily temperature

O3, PM10, temperature, relative humidity, and air pressure, national holidays and Sundays, long-term trends

Asthma

Giang, 2014 (25)

Thai Nguyen Province, Vietnam


four national and provincial hospitals of Thai Nguyen

Vietnam National Climate and Weather Center, Hanoi

Hospital admissions DLNM


time trends using natural cubic splines, day of the week, and public holidays

CVDAnderson, 2013

(26) 213 USA counties

1999-2008 (10year)

May-Sep Medicare inpatient claims for all fee-for-service Medicare

Ambient air pollution and temperature data -source unknown

Hospital admissions GLM,

overdispersed


Day of the week, dew point temp, long term and

COPD, RD

beneficiaries Poisson regression

seasonal trends. Sensitivity analysis for air pollution

Wang, 2013(27)

Beijing, China

2009-2011 (3 year)

Three large hospitals in Haidian district, Beijing

Weather station in Daxing, Beijing Emergency

hospital admissions



Long-term trends, seasonal patterns, daily mean temperature, relative humidity, air pollution, day of the week, and Holiday

RR per 1°C increase in DTRCVD0.99(0.99-1.0) (65-74)1.02(1.01-1.03) (75+) lag2RD1.02(1.0-1.04)1.17(1.0-1.03)lag7Genitourinary (renal)1.02(0.99-1.04)1.02(1.0-1.04)lag5Digestive0.99(0.98-1.02)1.04(1.02-1.05)lag7

Chan, 2013 (28)Hong Kong

1998-2009 (12 year) Jun-Sep

Hospital Authority in Special Administrative Region (SAR)

Hong Kong SAR Observatory.

Hospital admissions



Time trends, season and air pollution RD, ID

Qiu, 2013 (29)Hong Kong

2000-2007 (8 year)

Hong Kong Hospital authority (public hospital system)


Emergency hospital admissions



Seasonal, long-term trends, daily mean temperature, relative humidity, influenza, day of week, holidays, air pollution

RR per 1°C increase in DTR HF3.29(2.51-4.06) (65-74) lag0-54.13(3.66-4.6) (75+) lag0-5

Wichmann, 2013 (30)

Gothenburg, Sweden.

1985-2010 (26 year) Apr-Sep

National hospital discharge register

Gothenburg Environment and Health Department.

Hospital admissions

Time-stratified case-crossover study. Conditional logistic regression

3hr maximum apparent temperature

Long-term trend, seasonality, air pollution, relative humidity, public holidays. Sensitivity analysis with GAM model.

AMI(31) Adelaide,

Australia2003-2009 (emergency

Oct-Mar South Australian Department of Health

Australian Bureau of Meteorology

hospital admissions

GEE Daily minimum

Day of the week, month, year (from 1

Renal, heat

Williams, 2012

dept visits) (7 year)

and emergency dept visits temperature

July to 30 June), O3, and PM10

Goggins, 2012 (32)

Hong Kong

1999-2006 (8 year)

Hong Kong Hospital Autority Database


Hospital admissions GAM


Air pollutants, flu epidemics, other meteorological variables, day of the week, holidays IS

Wichmann, 2012 (33)

Copenhagen, Denmark.

1999-2006 (8 year Apr-Sep

Danish Hospital Discharge Register

Fixed single urban background monitor, Aarhus University.

Hospital admissions

Time-stratified case-crossover study. Conditional logistic regression


Public holidays, influenza, PM10, NO2 and CO. Sensitivity analysis with GAM and GEE models AMI

Lim, 2012 (34)

4 cities, South Korea

2003-2006 (4 year)

Korea National Health Insurance Corporation (KNHIC)

Korean Meteorological Administration.

Hospital admissions

GLM Poisson regression, temperature-matched case-crossover


Time trend, relative humidity,mean temperature, PM10 at lag 1, day of the week and the first day of the month

RR per 1°C increase in DTR, lag0-9Asthma1.04(1.01-1.06)

Basu 2012 (35)California, USA

2005-2008 (4 year) May-Sep

California Office of Statewide Health Planning and Development

California Irrigation Management

Information System17

and the US Environ- mental Protection Agency


Time-stratified case-crossover: Univariate conditional logistic regressions followed by meta-analysis

Daily mean apparent temperature

Air pollution

IHD, Hypotension, Hypertension, Diabetes, heat illness

Vida, 2012 (36)

3 regions in Quebec, Candad

1995-2007 (13 year) May-Sep

Quebec hospitals emergency department database

Interpolated from local weather stations




Over dispersion

Mental relative risk at 25 °CArea 1:1.09(1.03-1.15)Area 2:1.09(0.99-1.19) (Area 3:1.05(0.98-1.12)

Nunes da Silva, 2012 (37)

Sao Paulo

2003-2007 (5 year)

Brazilian National Health System Database (DATASUS)

Congonhas Airport meteorological station Hospital

admissionsLogistic regression


NACVD, RD

Alessandrini, 2011 (38)

9 study areas, Emilia-Romagna, Italy

2002-2006 (5 year) May-Sep

Ambulance dispatch database

Regional Agency for Environmental Protection Emergency

ambulance dispatches

Two stage: GAM Poisson regression. DLNM (for lagged structures) followed by random-effects meta-analysis


Air pollution, seasonality, long-term trend, holidays and weekends

CVD, RD

Pudpong, 2011 (39)

Chang Mai, Thailand

2002-2006 (3 year 11 months) All year

Health Insurance Claims Data, National Health Security Office

2 weather stations-Pollution Control Department (PCD)

Hospital admissions

Generalized negative binomial regression.


Long-term trends, seasonality, day of the week, holiday effects, air pollution. Sensitivity analysis excluded re-admitted patients

RD, CVD, Diab, Intinf

Morabito, 2011 (40)

Tuscany, Italy

1997-2006 (11 year) All year

Tuscany Region Hospitalization Registry

Gridpoint located above tuscany at the NCEP

Primary discharge diagnosis

Two stage: GLM with Poisson link, followed by GAM with Poisson, constrained segmented distributed lag model


Years, seasons, day of the week, public holidays, summer population reduction due to holiday

SAH, IntH, IS, Stroke

Hopstock, 2011 (41)

Tromso, Norway 1974-2004 All year

Discharge Diagnosis Register at the University Hospital of Tromsø

Tromsø Weather Station, Norwegian Meteorology Institute Web Page

Discharge diagnosis

Linear and polynomial terms in separate models, Poisson regression,

Mean temp as a 3-day average (the date of MI event and two previous days).

Season, day of the week MI

Wichmann, 2011 (42)

Copenhagen, Denmark

2002-2006 (5 year) Apr-Sep


Copenhagen urban background monitoring station, Aarhus University.


Time-stratified, case-crossover. Conditional logistic regression


Public holidays. Sensitivity analysis tested for 24hr mean temperature, relative humidity, air pollution, influenza. RD, CVD, CBD

Green, 2010

(43) California, USA

1999-2005 (6 year 4 month)

May-Sep Office of Statewide Health Planning and Development (OSHPD)

California Irrigation Management Information System (CIMIS) and the US Environmental

Hospital admissions

Time-stratified, case-crossover study. Conditional logistic regression

Mean daily apparent temperature

Season, linear term for apparent temperature, day of the week, PM2.5, ozone

Pneumonia, IS, Dehydration, Gastro, Diab, AcuteRen

Protection Agency (US EPA).

Lin, 2009 (44)

New York, USA

1991-2004 (14 year) Jun-Aug

New York State Departmentof Health’s Statewide Planning and Research CooperativeSystem

Data Support Section of the Computational and Information Systems Laboratory at the National Center for Atmospheric Research

Discharge data

GAM, Poisson distributed errors

3- day moving average of mean apparent temperature

Holidays, day of the week, mid-term variation, long-term trends, ozone, barometric pressure and impact of the 2003 blackout CVD, RD

Michelozzi, 2009 (45)

12 european cities

1990-2001 (Minimum 3 years) Apr-Sep

Each city provided hospital admission data

Each city provided meteorological data

Hospital admissions

Two stage: GEE, Random effects meta-analysis

Maximum apparent temperature

Holidays, day of the week, calendar month, barometric pressure (lag 0–3), wind speed, maximum 1-hour daily NO2 (lag 0–1).

CVD, CBD, RD

Linares, 2008 (46)

Madrid, Spain

1995-2000 (5 year 4 month) May-Sep

Hospital General Univeristario Gregorio Maranón in Madrid

Spanish National Instiute of Meteorology

Emergency hospital admissions ARIMA modeling

Maximum temperature

Season, weekdays, air pollution RD

Kovats, 2004 (47)

London, UK

1994-2000 (5 year 11 month) All year Department of Health

Met Office, Heathrow Meteorological Station

Emergency hospital admission

GLM, Poission regression


Long term trend, season, day of week, public holidays, Christmas period, influenza, relative humidity, air pollution (ozone, PM10) RD

Koken, 2003 (48)

Denver, USA

1993–1997(5 years) Jul-Aug

Agency for Healthcare Research and Quality

National Climate Data Center

Discharge diagnosis

GLM, Poisson regression, GEE for overdispersion


Yearly trends, day of the week, ambient maximum temperature, dew point temperature

AMI, CorAth, PulHD, Arrhyt, HeartFail

Morbidity-cold studies included in the systematic review

Author ID LocationTime-series Month Data source Weather data Health data Method


Giang, 2014 (25)

Thai Nguyen Province, Vietnam

2008-2012 (5 years) All year

Four national and provincial hospitals of Thai Nguyen

Vietnam National Climate and Weather Center, Hanoi Hospital

admissions DLNMMean daily temperature

Time trends using natural cubic splines, day of the week, and public holidays

CVD

Liu, 2014 (49)Shanghai, China

2008-2011 (4 years)

Shanghai Municipal Medical Insurance System

Shanghai Center for Urban Environmental Meteorology.

Daily hospital admissions GAM, Poisson

regressionMean temperature

Long-term trend, the day of the week (DOW) and air pollutants

Pneumonia

Kim, 2014 (24)Soeul, Korea

2007-2010 (4 years) Dec-Feb

National Emergency Department Information System

Korean Meteorological Administration

Emergency department visits

GLMMean daily temperature

O3, PM10, temperature, relative humidity, and air pressure, national holidays and Sundays, long-term trends

Asthma

Vasconcelos, 2013 (50)

Lisbon and Opoto

2003-2007 (5 years) Nov-Mar

Diagnosis Related Groups Database

National Climatic Data Center from the National Oceanic and Atmospheric Administration available at Meteorological Information Service OGIMET

Hospital admissions


PET index (temperature, humidity, mean radiant temperature, wind speed)

Time trends (day of week, holiday), pneunomia, influenza, pm10 CVD, AMI

Chan, 2013 (28)Hong Kong

1998-2009 (12 years) Nov-Mar

Hong Kong SAR Hospital Authority Database

Hong Kong SAR Observatory

Hospital admissions



Time trends, season, air pollution RD, CVD, ID

Goggins, 2012 (32)

Hong Kong

1999-2006 (8 years)

Hong Kong Hospital Autority Database Hong Kong Observatory

Hospital admissions GAM


Air pollution, flu epidemics, other meteorological variables, day of the week, holidays IS

Wichmann, 2012

(33) Copenhagen, Denmark.

1999-2006 (8 years)

Oct-Mar Danish Hospital Discharge Register

Fixed single urban background monitor, Aarhus University

Hospital admissions

Time-stratified case-crossover. Conditional logistic regression


Public holidays, influenza, PM10, NO2 and CO. Sensitivity analysis with GAM

AMI

and GEE models

Nunes da Silva, 2012 (37)

Sao Paulo

2003-2007 (5 years)

Brazilian National Health System Database (DATASUS)

Congonhas Airport meteorological station Hospital

admissionsLogistic regression

Minimum daily temperature

NACVD, RD

Alessandrini, 2011 (38)

9 study areas, Emilia-Romagna, Italy

2002-2006 (5 years) May-Sep

Ambulance dispatch database

Regional Agency for Environmental Protection

Emergency ambulance dispatches

Two stage:GAM, Poisson regression, DLNM (for lagged structures) followed by random-effects meta-analysis


Air pollution, seasonality, long-term trend, holidays and weekends

CVD, RD

Morabito, 2011 (40)

Tuscany, Italy

1997-2006 (11 years) All year

Tuscany Region Hospitalization Registry

Gridpoint located above Tuscany at the NCEP-DOE reanalysis 2 archive

Primary discharge diagnosis

Two stage:GLM with Poisson link, GAM Poisson regression Constrained segmented distributed lag model


Years, season, day of the week, public holidays, and summer population reduction due to holidays

SAH, IntH, IS, Stroke

Wichmann, 2011 (42)

Copenhagen, Denmark

2002-2006 (5 years) Oct-Mar


Copenhagen urban background monitoring station, Aarhus University


Time-stratified, case-crossover study. Conditional logistic regression


Public holidays. Sensitivity analysis tested for 24hr mean temperature, relative humidity, air pollution, influenza.

RD, CVD, CBD

Bhaskaran, 2010 (51)

England and Wales

2003-2006 (4 years)

Myocardial Ischaemia National Audit project

British Atmospheric Data Centre

Hospital admissions GLM


Day of the week, public holiday, influenza and RSV levels, PM 10, ozone, daily relative humidity MI

Ebi, 2004 (52)

3 cities, California, USA

1983-1998 (15 years 5 month)

California’s Office of Statewide Health Planning and Development

National Climatic Data Center of the National Oceanic and Atmospheric Administration

Hospital admissions


Maximum Temperature

CBD, AMI, Angina, Heartfail

Hong 2003 (53) Incheon, Korea

1998 - 2000 (3 years)

All year Inha University Hospital

National Meteorological Office.

Hospital admissions

Bi-directional case-crossover study. Conditional logistic regression


Relative humidity, barometric pressure, air pollution, circadian rhythm, day of the

IS

week

Hajat, 2002 (54) London1992-1995 (4 years)

General Practice Research database Meteorological Office

General Practice visits GAM


Season, long-term trend, day of the week, Christmas, New Year, Easter, Bank Holidays and Thunderstorm effects

RD, Asthma, Lower Resp. Disease, Upper Resp. disease, CVD

Ebi, 2001 (55)

3 cities, California, USA

1983-1998 (15 years 5 month) Oct-Apr

California’s Office of Statewide Health Planning and Development

National Climatic Data Center of the National Oceanic and Atmospheric Administration

Hospital admissions


Minimum daily Temperature Time trend

Viral Pneumonia

Supplementary file 2 (S2): Detailed study characteristics. Effect estimates are given for studies only included in the systematic review. The effect estimates of studies included in the meta-analysis can be found in Supplementary file 6 (forest plots).

Mortality studies comparing two reference temperatures



Breitner, 2014 (56)

Bavaria, Germany

1990-2006 (17 years)

Heat: Jun-AugCold: Dec-Feb

Bavarian State Office for Statistics and Data Processing

German Weather Service and the Bavarian Environment Agency

Daily death counts

Generalised semiparametric quasi-Poisson models

Mean daily temperature Heat: 20 vs 24.4°CCold: -7.5 vs-1.0°C

Long-term trend, seasonality, weekday variations, influenza epidemics, relative humidity and barometric pressure

CBD relative riskHeat:1.13(1.06-1.12)Cold: 1.09(1.02-1.16)CVDHeat: 1.13)1.06-1.12)Cold: 1.14(1.01-1.28)IHDHeat: 1.09(1.10-1.18)Cold: 1.03(0.88-1.12)Other heart diseaseHeat:1.15(1.05-1.27)Cold:1.14(1.04-1.24)

Tian, 2012 (57)Beijing, China


Death classification system, Beijing public security bureau

China meteorological data sharing service system Daily death

counts

DLNM, compared to case-crossover conditional logistic regression

Mean daily temperatureHeat: 30.5 vs 27°CCold: -7.6 vs -2.2°C

Season, long-term trend

Coronary heart disease % changeHeat:1.47(1.13-1.91) time-seriesHeat:1.48(1.05-2.08) case-crossoverCold:1.29(1.06-1.58) time-seriesCold:1.49(1.15-1.93) case-crossover

Lin, 2011 (58)4 regions, Taiwan

1994-2007 (14 years)

May-Oct (heat)

Nov–Dec and Jan–Apr (cold)

Executive Yuan Department of Health and The Ministry of Interior

The Central Weather Bureau

Daily death counts

Two stage: DLNM, random-effect meta-analysis of all 4 regions

Mean daily temperatureHeat: 30 vs 26 °CCold: 18 vs 26°C

Consecutive days of temperature extremes, daily city-specific averages of PM10, NOx, O3, and RH, daily mortality from pneumonia and influenza, gender, holiday effects, day of the week, and long-term trends

CVD relative riskHeat: 1.08Cold:1.2RDHeat:1.06Cold:1.06

O’Neill, 2003 (65+)

(59) 7 counties, Chicago, USA

1986-1993 (8 years)

All year National Center for Health Statistics mortality

Airport weather station nearest to each of the 7 counties county

Daily death counts

Two stage: Poisson regression, random-effects meta-analysis

Mean daily apparent temperature Heat: 29 vs 18°CCold: -5 vs

Daily barometric pressure, particulate matter, apparent temperature, day of the week, and day of study (to control for

CVD % changeHeat: 1.63(-2.5-5.9)Cold: 9.7(7-12.4)RDHeat: -2.5(-11.2-7.1)Cold:14.3(8.3-20.6)

15°C

long-term and seasonal trends).

Pan, 1995 (60) Taiwan1981-1991 (11 years) All year

Department of health

Central Weather Bureau, Taiwan

Daily death counts

Logistic Regression analysis

Mean daily temperatureHeat: IS:29 vs 32, HS:28 vs 32°C, IHD:26 vs 32Cold:IS:29 vs 9, HS:28 vs 13°C, IHD:26 vs 9

NA

IS odds ratioHeat: 1.66(1.33-2.08)Cold: 1.92(1.50-2.46)HSHeat: 1.56(1.32-1.83)Cold: 0.73(0.56-0.95)IHDHeat: 1.22(0.98-1.51)Cold: 1.55(1.22-1.96)

Morbidity study comparing two reference temperatures



Son, 2014 (61)8 Korean cities

2003-2008 (6 years)

Mar-Aug (heat)Sep-Feb (cold)

National health insurance corporation

National meteorological administration

Hopsital admissions

GLM, followed by bayesian heirarchical model

Mean daily temperature Heat: 25 vs 15, Cold:2 vs 15°C

1st day of each month, daily mean temperature, day of the week, relative humidity, and time trends

CVD % changeHeat:1.66(1.33-2.08) (65-74)1.92(1.50-2.46) (75+)Allergic diseaseCold:22.6(-6.9-61.3) (65-74)4.4(-41.4-86.1) (75+)AsthmaCold:15.1(-12.3-51.2) (65-74)10.5(-29.9-74.3) (75+)Selected RDCold:31.7(-17.9-111.4) (65-74)23(-16.5-81.2) (75+)

References of included papers:

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2. Burkart K, Breitner S, Schneider A, Khan MMH, Krämer A, Endlicher W. An analysis of heat effects in different subpopulations of Bangladesh. Int J Biometeorol. 2014 Mar;58(2):227–37.

3. Huang J, Wang J, Yu W. The Lag Effects and Vulnerabilities of Temperature Effects on Cardiovascular Disease Mortality in a Subtropical Climate Zone in China. Int J Environ Res Public Health. 2014 Apr;11(4):3982–94.

4. Yang J, Liu H-Z, Ou CQ, Lin G-Z, Zhou Q, Shen G-C, et al. Global climate change: impact of diurnal temperature range on mortality in Guangzhou, China. Environ Pollut. 2013 Apr;175:131–6.

5. Almeida S, Casimiro E, Analitis A. Short-term effects of summer temperatures on mortality in Portugal: a time-series analysis. J Toxicol Environ Health Part A. 2013;76(7):422–8.

6. Gasparrini A, Armstrong B, Kovats S, Wilkinson P. The effect of high temperatures on cause-specific mortality in England and Wales. Occupational and Environmental Medicine. 2012 Jan;69(1):56–61.

7. Liu L, Breitner S, Pan X, Franck U, Leitte AM, Wiedensohler A, et al. Associations between air temperature and cardio-respiratory mortality in the urban area of Beijing, China: a time-series analysis. Environ Health. 2011;10(1):51.

8. Wichmann J, Andersen ZJ, Ketzel M, Ellermann T, Loft S. Apparent temperature and cause-specific mortality in Copenhagen, Denmark: a case-crossover analysis. Int J Environ Res Public Health. 2011 Sep;8(9):3712–27.

9. Yu W, Hu W, Mengersen K, Guo Y, Pan X, Connell D, et al. Time course of temperature effects on cardiovascular mortality in Brisbane, Australia. Heart. 2011 Jul;97(13):1089–93.

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