title: The impact of the February 2012 cold spell on health in Italy using surveillance data.
abstract: In February 2012 Italy was hit by an exceptional cold spell with extremely low temperatures and heavy snowfall. The aim of this work is to estimate the impact of the cold spell on health in the Italian cities using data from the rapid surveillance systems. In Italy, a national mortality surveillance system has been operational since 2004 in 34 cities for the rapid monitoring of daily mortality. Data from this system were used to evaluate the impact of the February 2012 cold spell on mortality shortly after the occurrence of the event. Furthermore, a cause-specific analysis was conducted in Roma using the Regional Mortality Registry and the emergency visits (ER) surveillance system. Cold spell episodes were defined as days when mean temperatures were below the 10(th) percentile of February distribution for more than three days. To estimate the impact of the cold spell, excess mortality was calculated as the difference between observed and daily expected values. An overall 1578 (+25%) excess deaths among the 75+ age group was recorded in the 14 cities that registered a cold spell in February 2012. A statistically significant excess in mortality was observed in several cities ranging from +22% in Bologna to +58% in Torino. Cause-specific analysis conducted in Roma showed a statistically significant excess in mortality among the 75+ age group for respiratory disease (+64%), COPD (+57%), cardiovascular disease +20% ischemic heart disease (14%) and other heart disease (+33%). Similar results were observed for ER visits. Surveillance systems need to become are a key component of prevention plans as they can help improve public health response and are a valid data source to rapidly quantify the impact on health. Cold-related mortality is still an important issue and should not be underestimated by public health Authorities.
authors: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy. f.dedonato@deplazio.it
authors: Francesca K
authors: FK
authors: de'Donato
authors: Michela
authors: M
authors: Leone
authors: Damia
authors: D
authors: Noce
authors: Marina
authors: M
authors: Davoli
authors: Paola
authors: P
authors: Michelozzi
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002947:Cities; D003080:Cold Temperature; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D062665:Epidemiological Monitoring; D006801:Humans; D007558:Italy / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000401:mortality*; D014887:Weather
references: BMJ. 2010 Aug 10;341:c3823
references: 20699305
references: Int J Environ Res Public Health. 2010 May;7(5):2256-73
references: 20623023
references: PLoS One. 2010 Jul 16;5(7):e11626
references: 20661275
references: Am J Public Health. 1997 Dec;87(12):1944-50
references: 9431281
references: Environ Health Perspect. 2004 Feb;112(2):179-85
references: 14754572
references: Am J Epidemiol. 2002 Jan 1;155(1):80-7
references: 11772788
references: J Community Health. 2012 Apr;37(2):495-500
references: 21882040
references: Int J Circumpolar Health. 2002 Nov;61(4):292-9
references: 12546188
references: Environ Health Perspect. 2012 Jan;120(1):19-28
references: 21824855
references: Environ Health. 2012 Oct 01;11:74
references: 23025494
references: BMC Public Health. 2009 Jan 15;9:19
references: 19144206
references: Biomed Pharmacother. 1999 Oct;53(9):397-404
references: 10554674
references: Eur Respir J. 2009 Feb;33(2):245-51
references: 18799511
references: Int J Public Health. 2010 Aug;55(4):251-9
references: 20376690
references: Environ Health Perspect. 2001 May;109(5):463-70
references: 11401757
references: Lancet. 1997 May 10;349(9062):1341-6
references: 9149695
references: BMJ. 2010 Aug 10;341:c3720
references: 20699304
references: J Epidemiol Community Health. 2003 Oct;57(10):790-1
references: 14573582
references: J Am Med Dir Assoc. 2012 Mar;13(3):309.e1-7
references: 21764645
references: Am J Epidemiol. 2004 Sep 1;160(5):492-502
references: 15321847
references: Occup Environ Med. 2007 Feb;64(2):93-100
references: 16990293
references: Sci Total Environ. 2012 Feb 1;416:97-104
references: 22209370
references: BMC Public Health. 2007 Aug 09;7:200
references: 17688689
references: Epidemiology. 2009 Jul;20(4):575-83
references: 19295435
references: BMC Public Health. 2005 Dec 22;5:141
references: 16372902
references: Crit Care. 2006;10(6):R156
references: 17096836
references: Epidemiology. 2009 Mar;20(2):205-13
references: 19194300
references: Am J Epidemiol. 2008 Dec 15;168(12):1397-408
references: 18952849
references: Int J Biometeorol. 2005 Jan;49(3):179-83
references: 15290433
references: Environ Res. 2012 Jan;112:218-24
references: 22226140
references: PLoS One. 2011;6(7):e22719
references: 21818372
references: J Epidemiol Community Health. 1997 Dec;51(6):643-8
references: 9519127
references: Health Stat Q. 2005 Spring;(25):6-11
references: 15804164
references: BMC Med Inform Decis Mak. 2009 Feb 20;9:14
references: 19232122