title: Association between Floods and Acute Cardiovascular Diseases: A Population-Based Cohort Study Using a Geographic Information System Approach.
abstract: BACKGROUND
  Floods represent a serious threat to human health beyond the immediate risk of drowning. There is few data on the potential link between floods and direct consequences on health such as on cardiovascular health. This study aimed to explore the impact of one of the worst floods in the history of Quebec, Canada on acute cardiovascular diseases (CVD).
  
  
  METHODS
  A cohort study with a time series design with multiple control groups was built with the adult population identified in the Quebec Integrated Chronic Disease Surveillance System. A geographic information system approach was used to define the study areas. Logistic regressions were performed to compare the occurrence of CVD between groups.
  
  
  RESULTS
  The results showed a 25%-27% increase in the odds in the flooded population in spring 2011 when compared with the population in the same area in springs 2010 and 2012. Besides, an increase up to 69% was observed in individuals with a medical history of CVD.
  
  
  CONCLUSIONS
  Despite interesting results, the association was not statistically significant. A possible explanation to this result can be that the population affected by the flood was probably too small to provide the statistical power to answer the question, and leaves open a substantial possibility for a real and large effect.
authors.affiliation: Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada. Alain.Vanasse@USherbrooke.ca.|Research center of the Centre Hospitalier Universitaire de Sherbrooke (CHUS), 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada. Alain.Vanasse@USherbrooke.ca.
authors.forename: Alain
authors.initials: A
authors.lastname: Vanasse
authors.affiliation: Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada. Alan.Cohen@USherbrooke.ca.|Research center of the Centre Hospitalier Universitaire de Sherbrooke (CHUS), 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada. Alan.Cohen@USherbrooke.ca.
authors.forename: Alan
authors.initials: A
authors.lastname: Cohen
authors.affiliation: Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada. Josiane.Courteau@USherbrooke.ca.
authors.forename: Josiane
authors.initials: J
authors.lastname: Courteau
authors.affiliation: Department of Biological Sciences, Bishop's University, 2600 College Street, Sherbrooke (Québec), QC J1M, Canada. patrick.bergeron@ubishops.ca.
authors.forename: Patrick
authors.initials: P
authors.lastname: Bergeron
authors.affiliation: Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada. Roxanne.Dault2@USherbrooke.ca.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Dault
authors.affiliation: Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada. pierre.gosselin@inspq.qc.ca.|Research center of the Centre Hospitalier Universitaire de Québec (CHUQ), Delta II building, 6th floor, 2875 Laurier Boulevard, Québec (Québec), QC G1V 2M2, Canada. pierre.gosselin@inspq.qc.ca.
authors.forename: Pierre
authors.initials: P
authors.lastname: Gosselin
authors.affiliation: Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada. claudia.blais@inspq.qc.ca.|Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec (Québec), QC G1V 0A6, Canada. claudia.blais@inspq.qc.ca.
authors.forename: Claudia
authors.initials: C
authors.lastname: Blais
authors.affiliation: Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada. louis.rochette@inspq.qc.ca.|Research center of the Centre Hospitalier Universitaire de Québec (CHUQ), Delta II building, 6th floor, 2875 Laurier Boulevard, Québec (Québec), QC G1V 2M2, Canada. louis.rochette@inspq.qc.ca.|The Eau Terre Environment Research center, Institute National de la Recherche Scientifique (INRS), 490 Couronne Street, Québec (Québec), QC G1K 9A9, Canada. louis.rochette@inspq.qc.ca.
authors.forename: Diane
authors.initials: D
authors.lastname: Bélanger
authors.affiliation: Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada. diane.belanger@crchudequebec.ulaval.ca.
authors.forename: Louis
authors.initials: L
authors.lastname: Rochette
authors.affiliation: The Eau Terre Environment Research center, Institute National de la Recherche Scientifique (INRS), 490 Couronne Street, Québec (Québec), QC G1K 9A9, Canada. fateh.chebana@ete.inrs.ca.
authors.forename: Fateh
authors.initials: F
authors.lastname: Chebana
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D057231:Climate Change; D004189:Disaster Planning; D004781:Environmental Exposure / Q000009:adverse effects* / Q000517:prevention & control / Q000706:statistics & numerical data; D055868:Floods / Q000401:mortality; D040362:Geographic Information Systems; D006801:Humans; D016015:Logistic Models; D008297:Male; D052638:Particulate Matter; D011634:Public Health; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014871:Water Microbiology
chemical_list: D052638:Particulate Matter
keywords: Canada; cardiovascular diseases; climate change; floods; health problems; public health
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