title: August 2003 heat wave in France: risk factors for death of elderly people living at home.
abstract: The August 2003 heat wave in France resulted in many thousands of excess deaths particularly of elderly people. Individual and environmental risk factors for death among the community-dwelling elderly were identified. We conducted a case-control survey and defined cases as people aged 65 years and older who lived at home and died from August 8 through August 13 from causes other than accident, suicide, or surgical complications. Controls were matched with cases for age, sex, and residential area. Interviewers used questionnaires to collect data. Satellite pictures provided profiles of the heat island characteristics around the homes. Lack of mobility was a major risk factor along with some pre-existing medical conditions. Housing characteristics associated with death were lack of thermal insulation and sleeping on the top floor, right under the roof. The temperature around the building was a major risk factor. Behaviour such as dressing lightly and use of cooling techniques and devices were protective factors. These findings suggest people with pre-existing medical conditions were likely to be vulnerable during heat waves and need information on how to adjust daily routines to heat waves. In the long term, building insulation and urban planning must be adapted to provide protection from possible heat waves.
authors.affiliation: Department of Environmental Health, French Institute of Public Health Surveillance, Cedex, France. s.vandentorren@invs.sante.fr
authors.forename: S
authors.initials: S
authors.lastname: Vandentorren
authors.forename: P
authors.initials: P
authors.lastname: Bretin
authors.forename: A
authors.initials: A
authors.lastname: Zeghnoun
authors.forename: L
authors.initials: L
authors.lastname: Mandereau-Bruno
authors.forename: A
authors.initials: A
authors.lastname: Croisier
authors.forename: C
authors.initials: C
authors.lastname: Cochet
authors.forename: J
authors.initials: J
authors.lastname: Ribéron
authors.forename: I
authors.initials: I
authors.lastname: Siberan
authors.forename: B
authors.initials: B
authors.lastname: Declercq
authors.forename: M
authors.initials: M
authors.lastname: Ledrans
mesh_terms: D000369:Aged, 80 and over / Q000706:statistics & numerical data*; D000389:Air Conditioning; D016022:Case-Control Studies; D002958:City Planning; D015897:Comorbidity; D005260:Female; D005602:France; D015577:Geriatric Assessment; D006266:Health Education; D006301:Health Services Needs and Demand; D018883:Heat Stroke / Q000209:etiology* / Q000401:mortality* / Q000517:prevention & control; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008685:Meteorological Concepts; D051346:Mobility Limitation; D015999:Multivariate Analysis; D015980:Public Health Practice; D012111:Residence Characteristics / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013696:Temperature; D014504:Urban Health / Q000706:statistics & numerical data