title: Environmental temperature and thermal indices: what is the most effective predictor of heat-related mortality in different geographical contexts?
abstract: The aim of this study is to identify the most effective thermal predictor of heat-related very-elderly mortality in two cities located in different geographical contexts of central Italy. We tested the hypothesis that use of the state-of-the-art rational thermal indices, the Universal Thermal Climate Index (UTCI), might provide an improvement in predicting heat-related mortality with respect to other predictors. Data regarding very elderly people (≥ 75 years) who died in inland and coastal cities from 2006 to 2008 (May-October) and meteorological and air pollution were obtained from the regional mortality and environmental archives. Rational (UTCI) and direct thermal indices represented by a set of bivariate/multivariate apparent temperature indices were assessed. Correlation analyses and generalized additive models were applied. The Akaike weights were used for the best model selection. Direct multivariate indices showed the highest correlations with UTCI and were also selected as the best thermal predictors of heat-related mortality for both inland and coastal cities. Conversely, the UTCI was never identified as the best thermal predictor. The use of direct multivariate indices, which also account for the extra effect of wind speed and/or solar radiation, revealed the best fitting with all-cause, very-elderly mortality attributable to heat stress.
authors: Department of Agrifood Production and Environmental Sciences, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy ; Interdepartmental Centre of Bioclimatology, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy ; Center for Civil Protection and Risk Studies, University of Florence (CESPRO), Viale Morgagni 48, 50134 Florence, Italy.
authors: Marco
authors: M
authors: Morabito
authors: Institute of Biometeorology, National Research Council, Via Giovanni Caproni 8, 50145 Florence, Italy.
authors: Alfonso
authors: A
authors: Crisci
authors: Interdepartmental Centre of Bioclimatology, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy.
authors: Alessandro
authors: A
authors: Messeri
authors: Institute of Biometeorology, National Research Council, Via Giovanni Caproni 8, 50145 Florence, Italy.
authors: Valerio
authors: V
authors: Capecchi
authors: Interdepartmental Centre of Bioclimatology, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy ; Clinica Medica e Cardiologia, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
authors: Pietro Amedeo
authors: PA
authors: Modesti
authors: Interdepartmental Centre of Bioclimatology, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy ; Clinica Medica e Cardiologia, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
authors: Gian Franco
authors: GF
authors: Gensini
authors: Department of Agrifood Production and Environmental Sciences, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy ; Interdepartmental Centre of Bioclimatology, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy ; Center for Civil Protection and Risk Studies, University of Florence (CESPRO), Viale Morgagni 48, 50134 Florence, Italy.
authors: Simone
authors: S
authors: Orlandini
mesh_terms: D000397:Air Pollution; D018882:Heat Stress Disorders / Q000453:epidemiology / Q000401:mortality*; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D015233:Models, Statistical; D012307:Risk Factors