title: Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS--A Rural Setting in Western India.
abstract: Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, <25 °C) over the period January 2003 to December 2012. Delays of 0 and 0-4 days were considered and relative risks (RR) with 95% confidence intervals (CI) were calculated. Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18-2.10). There was an increase in the risk of total mortality in the age group 12-59 years on lag 0 day (RR = 1.43; CI: 1.02-1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05-1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003-2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures.
authors.affiliation: Vadu Rural Health Program, KEM Hospital Research Centre, Pune 411011, India. Vijendra.ingole@gmail.com.|Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. Vijendra.ingole@gmail.com.|INDEPTH Network, Accra KD 213, Ghana. Vijendra.ingole@gmail.com.
authors.forename: Vijendra
authors.initials: V
authors.lastname: Ingole
authors.affiliation: Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. joacim.rocklov@umu.se.
authors.forename: Joacim
authors.initials: J
authors.lastname: Rocklöv
authors.affiliation: Vadu Rural Health Program, KEM Hospital Research Centre, Pune 411011, India. sanjay.juvekar@gmail.com.|INDEPTH Network, Accra KD 213, Ghana. sanjay.juvekar@gmail.com.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Juvekar
authors.affiliation: Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. barbara.schumann@umu.se.|Centre for Demographic and Ageing Research, Umeå University, Umeå 901 87, Sweden. barbara.schumann@umu.se.
authors.forename: Barbara
authors.initials: B
authors.lastname: Schumann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature / Q000009:adverse effects*; D003906:Developing Countries; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: India; cause-specific mortality; cold; heat; mortality; temperature