Rey Grégoire, Jougla Eric, Fouillet Anne, Pavillon Gérard, Bessemoulin Pierre, Frayssinet Philippe, Clavel Jacqueline, Hémon Denis
Univ Paris-Sud, UMR-S754, IFR69, Villejuif, France and INSERM, U754, 16, avenue Paul Vaillant-Couturier, 94800, Villejuif Cedex, France.
Int Arch Occup Environ Health. 2007 Jul;80(7):615-26. doi: 10.1007/s00420-007-0173-4. Epub 2007 Feb 14.
The aim of the study was to identify the major heat waves (HW) that occurred in France from 1971 to 2003 and describe their impact on all-cause and cause-specific mortality.
Heat waves were defined as periods of at least three consecutive days when the maximum and the minimum temperature, averaged over the whole France, were simultaneously greater than their respective 95th percentile. The underlying causes of death were regrouped into 18 categories. Heatstroke, hyperthermia and dehydration were assigned to the "heat-related causes" (HRC) category. The numbers of deaths observed (O) during the identified HW were compared to those expected (E) on the basis of the mortality rates reported for the three preceding years.
Six HW were identified from the period 1971 to 2003. They were associated with great excess mortality (from 1,300 to 13,700 deaths). The observations are compatible with a moderate harvesting effect for four of the six HW. The mortality ratios increased with age for subjects aged over 55 years and were higher for women than for men over 75 years. For the six HW, the excess mortality was significant for almost all the causes of death: (1) the greatest excess mortality (O-E) were observed for cardiovascular diseases, neoplasms, respiratory system diseases, HRC, ill-defined conditions and injury and poisoning, and (2) the mortality ratios (O/E) were highest for HRC, respiratory diseases, nervous system diseases, mental disorders, infectious diseases, and endocrine and nutritional diseases.
Heat waves associated with excess mortality are not rare events in this temperate-climate country. The excess mortality is much greater than HRC mortality. Some populations are particularly vulnerable to HW: the elderly, women and people with some specific diseases. However, no segment of the population may be considered protected from the risks associated with HW.
本研究旨在确定1971年至2003年期间在法国发生的主要热浪，并描述其对全因死亡率和特定病因死亡率的影响。
热浪被定义为法国全国平均最高气温和最低气温同时连续至少三天高于各自第95百分位数的时期。死亡的潜在原因被重新划分为18类。中暑、体温过高和脱水被归入“与热相关的病因”（HRC）类别。将在确定的热浪期间观察到的死亡人数（O）与根据前三年报告的死亡率预期的死亡人数（E）进行比较。
在1971年至2003年期间确定了六次热浪。它们与极高的超额死亡率相关（1300至13700人死亡）。观察结果与六次热浪中的四次存在适度的收获效应相符。55岁以上人群的死亡率随年龄增长而增加，75岁以上女性的死亡率高于男性。对于这六次热浪，几乎所有死因的超额死亡率都很显著：（1）心血管疾病、肿瘤、呼吸系统疾病、HRC、病因不明的疾病以及损伤和中毒的超额死亡率（O-E）最高，（2）HRC、呼吸系统疾病、神经系统疾病、精神障碍、传染病以及内分泌和营养疾病的死亡率比值（O/E）最高。
在这个温带气候国家，与超额死亡率相关的热浪并非罕见事件。超额死亡率远高于HRC死亡率。一些人群特别容易受到热浪影响：老年人、女性和患有某些特定疾病的人。然而，没有任何人群可以被认为能免受与热浪相关的风险。
