title: The impact of heat islands on mortality in Paris during the August 2003 heat wave.
abstract: BACKGROUND
  Heat waves have a drastic impact on urban populations, which could increase with climate change.
  
  
  OBJECTIVE
  We evaluated new indicators of elderly people's exposure to heat in Paris, from a public health prevention perspective, using satellite thermal images.
  
  
  METHODS
  We used a time series of 61 images from the satellites of the National Oceanic and Atmospheric Administration's (NOAA) Advanced Very High Resolution Radiometer (AVHRR) taken from 1 to 13 August 2003 to produce thermal indicators of minimum, maximum, and mean surface temperatures and diurnal temperature amplitude, with different lags between the meteorological data and the health impact. Health data came from a case-control study involving 241 people ≥ 65 years of age who died in the city of Paris or the nearby suburban area of Val-de-Marne during the August 2003 heat wave, and 241 controls who were matched to cases on age, sex, and residential zone. For each person, we integrated the thermal indicators in a conditional logistic regression model, adjusted for age and other potential confounders. We computed odds ratios (ORs) comparing the 90th and 50th percentiles of the temperature differences between cases and controls for various indicators.
  
  
  RESULTS
  Mortality risk was significantly associated with exposure for two indicators: minimum temperatures averaged for 1-13 August [for a 0.41°C increase, OR = 2.17; 95% confidence interval (CI): 1.14, 4.16] and minimum temperature averaged on the day of death and the 6 preceding days (for a 0.51°C increase: OR = 2.24; 95% CI: 1.03, 4.87).
  
  
  CONCLUSIONS
  Our results support the influence of night temperatures on the health impact of heat waves in urban areas. Urban heat exposure indicators based on satellite imagery have the potential to identify areas with higher risk of death, which could inform intervention decisions by key stakeholders.
authors: Institut de veille sanitaire, Département Santé Environnement, Saint-Maurice, France. ka.laaidi@invs.sante.fr
authors: Karine
authors: K
authors: Laaidi
authors: Abdelkrim
authors: A
authors: Zeghnoun
authors: Bénédicte
authors: B
authors: Dousset
authors: Philippe
authors: P
authors: Bretin
authors: Stéphanie
authors: S
authors: Vandentorren
authors: Emmanuel
authors: E
authors: Giraudet
authors: Pascal
authors: P
authors: Beaudeau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D018883:Heat Stroke / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D006358:Hot Temperature; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010297:Paris / Q000453:epidemiology; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D014504:Urban Health; D014887:Weather