Michelozzi P, de Donato F, Bisanti L, Russo A, Cadum E, DeMaria M, D'Ovidio M, Costa G, Perucci C A
Department of Epidemiology, ASL RM/E, Rome, Italy.
Euro Surveill. 2005 Jul;10(7):161-5.
This study evaluates the impact of the 2003 heat wave on cause-specific mortality and the role of demographic characteristics and socioeconomic conditions that may have increased the risk of mortality in four Italian cities: Bologna, Milan, Rome and Turin. Daily mortality counts, for the resident population by age, sex and cause of death were considered. Daily excess mortality was calculated as the difference between the number of deaths observed and the smoothed average. The impact of heat on health is measured in terms of maximum apparent temperature. The greatest excess in mortality was observed in the north west of Italy (Turin, +23% and Milan, +23%). The old (75-84 years) and the very old (85+ years) were the age groups most affected, and when stratifying by sex, the increase in mortality seemed to be greater among females. The greatest excess in mortality was registered in those with low socioeconomic status in Rome (+17.8%) and in those with lower education levels in Turin (+43%). The analysis of cause-specific mortality not only confirms results from previous studies of an increase in heat-related mortality by respiratory and cardiovascular diseases, but also shows a significant excess in mortality for diseases of the central nervous system and for metabolic/endocrine disorders. Results from 2003 highlight the necessity of targeting future prevention programmes at the susceptible sub-groups identified. The introduction of warning systems alongside efficient preventive plans and the monitoring of mortality during heat waves may represent a valid tool for the reduction of heat-related deaths.
本研究评估了2003年热浪对特定病因死亡率的影响，以及人口特征和社会经济状况在意大利四个城市（博洛尼亚、米兰、罗马和都灵）可能增加死亡风险方面所起的作用。研究考虑了按年龄、性别和死因划分的常住人口每日死亡人数。每日超额死亡率通过观察到的死亡人数与平滑平均死亡人数之间的差值来计算。热对健康的影响以最高体感温度来衡量。在意大利西北部（都灵，+23%；米兰，+23%）观察到的死亡率超额幅度最大。老年人（75 - 84岁）和高龄老人（85岁及以上）是受影响最大的年龄组，按性别分层时，女性的死亡率增幅似乎更大。在罗马，社会经济地位低的人群死亡率超额幅度最大（+17.8%），在都灵，受教育程度较低的人群死亡率超额幅度最大（+43%）。对特定病因死亡率的分析不仅证实了先前研究中关于呼吸系统和心血管疾病导致的与热相关死亡率上升的结果，还显示中枢神经系统疾病和代谢/内分泌紊乱导致的死亡率显著超额。2003年的研究结果凸显了针对已确定的易感亚组制定未来预防计划的必要性。引入预警系统，同时制定有效的预防计划，并在热浪期间监测死亡率，可能是减少与热相关死亡的有效工具。
