title: Association between quantity and duration of snowfall and risk of myocardial infarction.
abstract: BACKGROUND
  Although aggregate data suggest a link between snowfall and myocardial infarction (MI), individual risk has yet to be assessed. We evaluated the association between quantity and duration of snowfall and the risk of MI using nonaggregated administrative health data.
  
  
  METHODS
  We used a case-crossover study design to investigate the association between snowfall and hospital admission or death due to MI in the province of Quebec, Canada, between November and April during 1981-2014. The main exposure measures were quantity (in centimetres) and duration (in hours) of snowfall by calendar day. We computed odds ratios (ORs) and 95% confidence intervals (CIs) for the association between daily snowfall and MI, adjusted for minimum daily temperatures.
  
  
  RESULTS
  In all, 128 073 individual hospital admissions and 68 155 deaths due to MI were included in the analyses. The likelihood of MI was increased the day after a snowfall among men but not among women. Compared with 0 cm, 20 cm of snowfall was associated with an OR of 1.16 for hospital admission (95% CI 1.11-1.21) and 1.34 for death (95% CI 1.26-1.42) due to MI the following day among men. Corresponding ORs among women were 1.01 (95% CI 0.95-1.07) and 1.04 (95% CI 0.96-1.13). Similar but smaller associations were observed for snowfall duration (0 h v. 24 h) and MI.
  
  
  CONCLUSIONS
  Both the quantity and duration of snowfall were associated with subsequent risk of hospital admission or death due to MI, driven primarily by an effect in men. These data have implications for public health initiatives in regions with snowstorms.
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (Auger, Potter, Bilodeau-Bertrand); Institut national de santé publique du Québec (Auger, Smargiassi, Bilodeau-Bertrand, Paris); Division of Cardiology, Department of Medicine (Potter), Centre hospitalier de l'Université de Montréal; Department of Occupational and Environmental Health (Smargiassi), School of Public Health, Université de Montréal, Montréal, Que.; Faculty of Science (Paris), Aix-Marseille Université, Marseille, France; National Collaborating Centre for Environmental Health (Kosatsky), British Columbia Centre for Disease Control, Vancouver, BC nathalie.auger@inspq.qc.ca.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Auger
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (Auger, Potter, Bilodeau-Bertrand); Institut national de santé publique du Québec (Auger, Smargiassi, Bilodeau-Bertrand, Paris); Division of Cardiology, Department of Medicine (Potter), Centre hospitalier de l'Université de Montréal; Department of Occupational and Environmental Health (Smargiassi), School of Public Health, Université de Montréal, Montréal, Que.; Faculty of Science (Paris), Aix-Marseille Université, Marseille, France; National Collaborating Centre for Environmental Health (Kosatsky), British Columbia Centre for Disease Control, Vancouver, BC.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Potter
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (Auger, Potter, Bilodeau-Bertrand); Institut national de santé publique du Québec (Auger, Smargiassi, Bilodeau-Bertrand, Paris); Division of Cardiology, Department of Medicine (Potter), Centre hospitalier de l'Université de Montréal; Department of Occupational and Environmental Health (Smargiassi), School of Public Health, Université de Montréal, Montréal, Que.; Faculty of Science (Paris), Aix-Marseille Université, Marseille, France; National Collaborating Centre for Environmental Health (Kosatsky), British Columbia Centre for Disease Control, Vancouver, BC.
authors.forename: Audrey
authors.initials: A
authors.lastname: Smargiassi
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (Auger, Potter, Bilodeau-Bertrand); Institut national de santé publique du Québec (Auger, Smargiassi, Bilodeau-Bertrand, Paris); Division of Cardiology, Department of Medicine (Potter), Centre hospitalier de l'Université de Montréal; Department of Occupational and Environmental Health (Smargiassi), School of Public Health, Université de Montréal, Montréal, Que.; Faculty of Science (Paris), Aix-Marseille Université, Marseille, France; National Collaborating Centre for Environmental Health (Kosatsky), British Columbia Centre for Disease Control, Vancouver, BC.
authors.forename: Marianne
authors.initials: M
authors.lastname: Bilodeau-Bertrand
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (Auger, Potter, Bilodeau-Bertrand); Institut national de santé publique du Québec (Auger, Smargiassi, Bilodeau-Bertrand, Paris); Division of Cardiology, Department of Medicine (Potter), Centre hospitalier de l'Université de Montréal; Department of Occupational and Environmental Health (Smargiassi), School of Public Health, Université de Montréal, Montréal, Que.; Faculty of Science (Paris), Aix-Marseille Université, Marseille, France; National Collaborating Centre for Environmental Health (Kosatsky), British Columbia Centre for Disease Control, Vancouver, BC.
authors.forename: Clément
authors.initials: C
authors.lastname: Paris
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (Auger, Potter, Bilodeau-Bertrand); Institut national de santé publique du Québec (Auger, Smargiassi, Bilodeau-Bertrand, Paris); Division of Cardiology, Department of Medicine (Potter), Centre hospitalier de l'Université de Montréal; Department of Occupational and Environmental Health (Smargiassi), School of Public Health, Université de Montréal, Montréal, Que.; Faculty of Science (Paris), Aix-Marseille Université, Marseille, France; National Collaborating Centre for Environmental Health (Kosatsky), British Columbia Centre for Disease Control, Vancouver, BC.
authors.forename: Tom
authors.initials: T
authors.lastname: Kosatsky
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D016017:Odds Ratio; D011792:Quebec / Q000453:epidemiology; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D012914:Snow; D013997:Time Factors