Conti Susanna, Masocco Maria, Meli Paola, Minelli Giada, Palummeri Ernesto, Solimini Renata, Toccaceli Virgilia, Vichi Monica
Istituto Superiore di Sanita, National Centre of Epidemiology, Surveillance and Health Promotion, Viale Regina Elena, no. 299, IT-00161 Roma, Italy.
Environ Res. 2007 Feb;103(2):267-74. doi: 10.1016/j.envres.2006.06.003. Epub 2006 Aug 4.
The effects of heat waves on health can be serious for elderly persons, especially those in urban areas. We investigated in-depth the mortality excess during the 2003 heat wave among elderly persons (>74 years) in the City of Genoa (Italy). The excess in general mortality was calculated for the period July 16-August 31, as the ratio of observed to expected deaths. To evaluate "harvesting", we compared observed and expected mortality in the period September 2003-April 2004. We also studied the relationship between mortality and climatic conditions considering daily maximum temperature and Humidex discomfort degrees, as well as "lag-time". For cause-specific mortality, we considered all pathologies reported on the death certificate. The excess in general mortality was significant and was greatest in the first half of August. During Summer 2003, in Genoa the climatic conditions (described in terms of maximum temperature and Humidex Index) were extremely hot; regarding lag-time, the greatest correlation between the number of observed deaths and the maximum temperature values was observed for the three preceding days (rho=0.568; significance level<0.01). The prominent causes of death, for which an excess was observed, were cerebrovascular diseases, severe respiratory diseases, severe renal diseases, dementia; moreover, certain pathologic conditions and symptoms, usually not lethal, were also frequent causes of death (e.g., hypovolemia, hyperpyrexia, decubitus ulcers and immobilization syndrome). The results of this study confirm the relationship between the heat waves and death among elderly, stressing that, because of their poorer physical health and the prevalence of cognitive disturbances that hinder risk perception, it is necessary to properly care for them during heat waves.
热浪对健康的影响对老年人来说可能很严重，尤其是城市地区的老年人。我们深入调查了2003年热浪期间意大利热那亚市74岁以上老年人的超额死亡率。计算了7月16日至8月31日期间的总超额死亡率，即观察到的死亡人数与预期死亡人数的比率。为了评估“提前死亡”现象，我们比较了2003年9月至2004年4月期间观察到的死亡率和预期死亡率。我们还研究了死亡率与气候条件之间的关系，考虑了每日最高温度和热指数不适度数，以及“滞后时间”。对于特定原因的死亡率，我们考虑了死亡证明上报告的所有病理情况。总超额死亡率显著，在8月上半月最高。2003年夏季，热那亚的气候条件（根据最高温度和热指数描述）极其炎热；关于滞后时间，观察到的死亡人数与最高温度值之间的最大相关性出现在前三天（rho=0.568；显著性水平<0.01）。观察到超额死亡的主要死因是脑血管疾病、严重呼吸系统疾病、严重肾脏疾病、痴呆症；此外，某些通常不致命的病理状况和症状也是常见的死因（例如，血容量不足、高热、褥疮和固定综合征）。这项研究的结果证实了热浪与老年人死亡之间的关系，强调由于他们的身体健康较差以及认知障碍的普遍存在阻碍了风险感知，在热浪期间有必要对他们进行妥善照顾。
