title: Effect of heat waves on morbidity and mortality due to Parkinson's disease in Madrid: A time-series analysis.
abstract: BACKGROUND
  Parkinson's disease (PD) is one of the factors which are associated with a higher risk of mortality during heat waves. The use of certain neuroleptic medications to control some of this disease's complications would appear to be related to an increase in heat-related mortality.
  
  
  OBJECTIVE
  To analyse the relationship and quantify the short-term effect of high temperatures during heat wave episodes in Madrid on daily mortality and PD-related hospital admissions.
  
  
  METHODS
  We used an ecological time-series study and fit Poisson regression models. We analysed the daily number of deaths due to PD and the number of daily PD-related emergency hospital admissions in the city of Madrid, using maximum daily temperature (°C) as the main environmental variable and chemical air pollution as covariates. We controlled for trend, seasonalities, and the autoregressive nature of the series.
  
  
  RESULTS
  There was a maximum daily temperature of 30°C at which PD-related admissions were at a minimum. Similarly, a temperature of 34°C coincides with an increase in the number of admissions. For PD-related admissions, the Relative Risk (RR) for every increase of 1°C above the threshold temperature was 1.13 IC95%:(1.03-1.23) at lags 1 and 5; and for daily PD-related mortality, the RR was 1.14 IC95%:(1.01-1.28) at lag 3.
  
  
  CONCLUSIONS
  Our results indicate that suffering from PD is a risk factor that contributes to the excess morbidity and mortality associated with high temperatures, and is relevant from the standpoint of public health prevention plans.
authors.affiliation: National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Linares
authors.affiliation: National Centre of Epidemiology, Carlos III Institute of Health and CIBERNED, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
authors.affiliation: National Centre of Epidemiology, Carlos III Institute of Health and CIBERNED, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodríguez-Blázquez
authors.affiliation: National School of Public Health, Carlos III Institute of Health, Madrid, Spain; REDISSEC, Spain.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Forjaz
authors.affiliation: National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Carmona
authors.affiliation: National School of Public Health, Carlos III Institute of Health, Madrid, Spain. Electronic address: j.diaz@isciii.es.
authors.forename: Julio
authors.initials: J
authors.lastname: Díaz
mesh_terms: D000397:Air Pollution / Q000032:analysis*; D002947:Cities; D018882:Heat Stress Disorders / Q000150:complications / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data; D006358:Hot Temperature; D006801:Humans; D008962:Models, Theoretical; D009017:Morbidity / Q000639:trends; D010300:Parkinson Disease / Q000150:complications / Q000401:mortality*; D011634:Public Health; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Heat wave; Morbidity; Mortality; Parkinson; Temperature