Pascal Mathilde, Le Tertre Alain, Saoudi Abdessattar
Institut de Veille Sanitaire, Département Santé Environnement, Saint Maurice, France.
PLoS Curr. 2012 Feb 23;4:RRN1307. doi: 10.1371/currents.RRN1307.
July 2006 was the first major heat wave in France after the creation of a heat prevention plan. Understanding its impacts on health will help improving the efficiency of this plan. We assessed the mortality impact of the heat wave, and investigated the influence of the heat prevention plan.
The study focused on nine French cities. A Poisson regression model was used to analyze the correlation between temperature, air quality and mortality. An additional spline of time was introduced to capture an additional heat wave effect. Heat-action days defined by the prevention plan were introduced as a dummy variable.
411 extra deaths were observed in the nine cities during the 2006 heat wave. Unlike the 2003 heat wave, no additional heat wave effect was observed in 2006. The maximum daily relative risk of mortality varied from 1.45 in Strasbourg (IC 95% [1.01-2.08]) to 1.04 in Lille (IC 95% [0.92-1.18]). The impact on mortality of the implementation of heat-action days was non-significant and highly variable depending on the cities, with a combined excess of relative risk of -3.3% (IC 95% [-10.3%; 4.4%]).
Although no specific heat wave effect was observed, warm temperatures and air pollution were still responsible for a significant excess mortality in France. The absence of a specific heat wave effect may be partly explained by the prevention plan. It may also indicate that higher temperatures are required to observe a mortality outburst.
2006年7月是法国制定防暑计划后的首个重大热浪期。了解其对健康的影响将有助于提高该计划的效率。我们评估了热浪对死亡率的影响，并调查了防暑计划的作用。
该研究聚焦于法国的九个城市。采用泊松回归模型分析温度、空气质量与死亡率之间的相关性。引入时间的附加样条以捕捉额外的热浪效应。将预防计划定义的热行动日作为虚拟变量引入。
在2006年热浪期间，九个城市共观察到411例额外死亡。与2003年热浪不同，2006年未观察到额外的热浪效应。每日最高死亡率相对风险从斯特拉斯堡的1.45（95%置信区间[1.01 - 2.08]）到里尔的1.04（95%置信区间[0.92 - 1.18]）不等。热行动日实施对死亡率的影响不显著，且因城市而异，相对风险综合超额为 -3.3%（95%置信区间[-10.3%；4.4%]）。
尽管未观察到特定的热浪效应，但温暖的气温和空气污染仍导致法国死亡率显著超额。未观察到特定热浪效应可能部分归因于预防计划。这也可能表明需要更高的温度才会出现死亡率激增。
