title: High temperature and hospitalizations for cardiovascular and respiratory causes in 12 European cities.
abstract: BACKGROUND
  Episode analyses of heat waves have documented a comparatively higher impact on mortality than on morbidity (hospital admissions) in European cities. The evidence from daily time series studies is scarce and inconsistent.
  
  
  OBJECTIVE
  To evaluate the impact of high environmental temperatures on hospital admissions during April to September in 12 European cities participating in the Assessment and Prevention of Acute Health Effects of Weather Conditions in Europe (PHEWE) project.
  
  
  METHODS
  For each city, time series analysis was used to model the relationship between maximum apparent temperature (lag 0-3 days) and daily hospital admissions for cardiovascular, cerebrovascular, and respiratory causes by age (all ages, 65-74 age group, and 75+ age group), and the city-specific estimates were pooled for two geographical groupings of cities.
  
  
  RESULTS
  For respiratory admissions, there was a positive association that was heterogeneous between cities. For a 1 degrees C increase in maximum apparent temperature above a threshold, respiratory admissions increased by +4.5% (95% confidence interval, 1.9-7.3) and +3.1% (95% confidence interval, 0.8-5.5) in the 75+ age group in Mediterranean and North-Continental cities, respectively. In contrast, the association between temperature and cardiovascular and cerebrovascular admissions tended to be negative and did not reach statistical significance.
  
  
  CONCLUSIONS
  High temperatures have a specific impact on respiratory admissions, particularly in the elderly population, but the underlying mechanisms are poorly understood. Why high temperature increases cardiovascular mortality but not cardiovascular admissions is also unclear. The impact of extreme heat events on respiratory admissions is expected to increase in European cities as a result of global warming and progressive population aging.
authors.affiliation: Department of Epidemiology Local Health Authority Rome E, Rome, Italy. michelozzi@asplazio.it
authors.forename: Paola
authors.initials: P
authors.lastname: Michelozzi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Accetta
authors.forename: Manuela
authors.initials: M
authors.lastname: De Sario
authors.forename: Daniela
authors.initials: D
authors.lastname: D'Ippoliti
authors.forename: Claudia
authors.initials: C
authors.lastname: Marino
authors.forename: Michela
authors.initials: M
authors.lastname: Baccini
authors.forename: Annibale
authors.initials: A
authors.lastname: Biggeri
authors.forename: H Ross
authors.initials: HR
authors.lastname: Anderson
authors.forename: Klea
authors.initials: K
authors.lastname: Katsouyanni
authors.forename: Ferran
authors.initials: F
authors.lastname: Ballester
authors.forename: Luigi
authors.initials: L
authors.lastname: Bisanti
authors.forename: Ennio
authors.initials: E
authors.lastname: Cadum
authors.forename: Bertil
authors.initials: B
authors.lastname: Forsberg
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Goodman
authors.forename: Ana
authors.initials: A
authors.lastname: Hojs
authors.forename: Ursula
authors.initials: U
authors.lastname: Kirchmayer
authors.forename: Sylvia
authors.initials: S
authors.lastname: Medina
authors.forename: Anna
authors.initials: A
authors.lastname: Paldy
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Perucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000032:analysis / Q000506:poisoning; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010343:Patient Admission / Q000706:statistics & numerical data; D016012:Poisson Distribution; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D014504:Urban Health / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000393:Air Pollutants