Heat and cause-specific cardiopulmonary mortality in Germany

Zhang, Siqi ; Breitner, Susanne; de' Donato, Francesca ; Stafoggia, Massimo ; Nikolaou, Nikolaos ; Aunan, Kristin; Peters, Annette und Schneider, Alexandra (6. September 2024): Heat and cause-specific cardiopulmonary mortality in Germany. A case-crossover study using small-area assessment. In: Lancet Regional Health - Europe, Bd. 46, 101049

Abstract

Background: High temperatures have been associated with increased mortality, with evidence reported predominately in large cities and for total cardiovascular or respiratory deaths. This case-crossover study examined heat-related cause-specific cardiopulmonary mortality and vulnerability factors using small-area data from Germany.

Methods: We analyzed daily counts of cause-specific cardiopulmonary deaths from 380 German districts (2000–2016) and daily mean temperatures estimated by spatial–temporal models. We applied conditional quasi-Poisson regression using distributed lag nonlinear models to examine heat effects during May–September in each district and random-effects meta-analysis to pool the district-specific estimates. Potential individual- and district-level vulnerability factors were examined by subgroup analyses and meta-regressions, respectively.

Findings: Heat was associated with increased mortality risks for all cardiopulmonary sub-causes. The relative risk (RR) of total cardiovascular and respiratory mortality for a temperature increment from the 75th to the 99th percentile was 1.24 (95% confidence interval: 1.23, 1.26) and 1.34 (1.30, 1.38), respectively. The RRs of cardiovascular sub-causes ranged from 1.16 (1.13, 1.19) for myocardial infarction to 1.32 (1.29, 1.36) for heart failure. For respiratory sub-causes, the RR was 1.27 (1.22, 1.31) for COPD and 1.49 (1.42, 1.57) for pneumonia. We observed greater susceptibility related to several individual- and district-level characteristics, e.g., among females or in highly urbanized districts. Heat vulnerability factors remained consistent between urban and rural areas.

Interpretation: Our study highlights heat-related increases in cause-specific cardiopulmonary mortality across Germany and identifies key vulnerability factors, offering insights for improving public health practices to mitigate heat-related health impacts.

• Dokumententyp: Zeitschriftenartikel
• EU Funded Grant Agreement Number: 820655
• EU-Projekte: Horizon 2020 ; Horizon Europe
• Fakultät: Medizin > Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2666-7762
• Sprache: Englisch