Excess deaths during the August 2003 heat wave in Paris, France
Excess deaths during the August 2003 heat wave in Paris, France
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DOI：
10.1016/s0398-7620(06)76706-2
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发表时间：
2006-04-01
影响因子：
0.9
通讯作者：
Spira, A
中科院分区：
文献类型：
--
作者：
Canouï-Poitrine, F;Cadot, E;Spira, A
背景：2003年8月法国热浪期间，记录了近15,000人超额死亡，巴黎受到严重影响，超额死亡率为141%。这项研究有两个目的：确定与城市环境中热浪中死亡人数过多相关的个体因素，并描述法国首都内死亡的空间分布。方法：研究人群包括2003年8月1日至20日期间在家中死亡的所有人(N=961)。我们通过将研究人群的社会人口学特征与在参考年份(2000、2001、2002)相同时期在家中死亡的人的社会人口学特征进行比较，确定了与过度死亡相关的因素(N=530)。通过计算2003年8月期间巴黎的相对死亡率，分析了空间差异。结果：与超额死亡相关的主要因素有：年龄>75岁(调整后OR=1.44(1.10~1.90))，女性(调整后OR=1.43(1.11~1.83))，未婚(调整后OR=1.63(1.23~2.15))。身为外国人似乎是保护女性的一个因素。按社区划分的比较死亡率显示，从西北部到东南部，超额死亡人数呈梯度变化。死亡率为5.44(5.10~5.79)，南部(12区、13区、14区和15区)的超额死亡率非常高。结论：2003年8月巴黎热浪与死亡率的异常升高、死亡特征和死亡空间分布的变化有关。了解热浪对死亡率的影响可能会通过两个层面的风险分析来改善：个人和背景。
Background: During the August 2003 heat wave in France, almost 15,000 excess deaths were recorded Paris was severely affected, with an excess death rate of 141%. This study had two aims: to identify individual factors associated with excess deaths during a heat wave in an urban environment and to describe the spatial distribution of deaths within the French capital.Methods: The study population included all people who died at home between August 1(st) and 20(th), 2003 (N=961). We identified factors associated with excess deaths by comparing the sociodemographic characteristics of the study population with those of people who died at home during the same period in reference years (2000, 2001, 2002) (N=530). Spatial differences were analysed by calculating comparative mortality rates within Paris during August 2003. Mortality ratio was determined to demonstrate temporal variations in mortality between the heat wave period and reference years.Results: The major factors associated with excess death were: age over 75 years (adjusted OR=1.44 (1.10-1.90), being female (adjusted OR=1.43 (1.11-1.83)), not being married (adjusted OR=1.63 (1.23-2.15)), particularly for men. Being a foreigner appeared to be a protective factor for women. Comparative mortality rates by neighbourhood showed a gradient in excess deaths from North-West to South-East. The mortality ratio was 5.44 (5.10-5.79), with very high rates of excess death in the South (12(th), 13(th), 14(th) and 15(th) "arrondissement").Conclusion: The August 2003 heat wave in Paris was associated with both an exceptional increase in mortality rates and changes in the characteristics of those dying and spatial distribution of mortality. Understanding the effects of a heat wave on mortality can probably be improved by an analysis of risk at two levels: individual and contextual.