Abstract
The aims of this study were to assess impacts of hot summer periods on mortality in the Czech Republic and to quantify the size of the short-term displacement effect which resulted in lower than expected mortality after heat waves. The analysis covered the period 1982–2000 when several extraordinarily hot summers occurred in central Europe. Daily total all-cause mortality and mortality due to cardiovascular diseases (CVD) in the entire population of the Czech Republic (approximately 10 million inhabitants) were examined. The daily death counts were standardized to account for the long-term decline in mortality and the seasonal and weekly cycles. Heat-related mortality is better expressed if 1-day lag after temperature is considered compared to the unlagged relationship. With the 1-day lag, both excess total mortality and excess CVD mortality were positive during all 17 heat waves, and in 14 (12) heat waves the increase in total (CVD) mortality was statistically significant (P=0.05). The mean relative rise in total mortality during heat waves was 13%. The response was greater in females than males and similar regardless of whether total or CVD mortality was used. The largest relative increases, exceeding 20% in both total and CVD mortality, were associated with heat waves which occurred in early summer (the first half of July 1984 and June 1994). The mortality displacement effect played an important role since mortality tended to be lower than expected after hot periods. The mean net mortality change due to heat waves was estimated to be about a 1% increase in the number of deaths. The large relative increases during some heat waves were particularly noteworthy since the study (in contrast to most analyses of the heat stress/mortality relationship) was not restricted to an urban area and/or an elderly population.
Similar content being viewed by others
References
Alberdi JC, Ordovyas M, Quintana F (1995) Elaboration and evaluation of a fast detection system of mortality using Fourier analysis. Study of a value with maximal deviation. Rev Esp Salud Publica 69:207–217
Auliciems A, Frost D, Siskind V (1997) The time factor in mortality: weather associations in a subtropical environment. Int J Biometeorol 40:183–191
Braga ALF, Zanobetti A, Schwartz J (2002) The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. Environ Health Perspect 110:859–863
Czech Statistical Office (2003) Information on regions, cities and municipalities (in Czech). Available at http://www.czso.cz/csu/edicniplan.nsf/p/13n2-03 (accessed 3 August 2003)
Davis RE, Knappenberger PC, Novicoff WM, Michaels PJ (2003) Decadal changes in summer mortality in U.S. cities. Int J Biometeorol 47:166–175
Dessai S (2002) Heat stress and mortality in Lisbon. Part I. Model construction and validation. Int J Biometeorol 47:6–12
Díaz J, Jordán J, García R, López C, Alberdi JC, Hernández E, Otero A (2002a) Heat waves in Madrid 1986–1997: effects on the health of the elderly. Int Arch Occup Environ Health 75:163–170
Díaz J, García R, Velázquez de Castro F, Hernández E, López C, Otero A (2002b) Effects of extremely hot days on people older than 65 years in Seville (Spain) from 1986 to 1997. Int J Biometeorol 46:145–149
Donaldson GC, Keatinge WR, Näyhä S (2003) Changes in summer temperature and heat-related mortality since 1971 in North Carolina, South Finland, and Southeast England. Environ Res 91:1–7
Falcao JM, Valente P (1997) Cerebrovascular diseases in Portugal: some epidemiological aspects. Acta Med Port 10:537–542
Guest CS, Wilson K, Woodward A, Hennessy K, Kalkstein LS, Skinner C, McMichael AJ (1999) Climate and mortality in Australia: retrospective study, 1979–1990 and predicted impacts in five major cities in 2030. Clim Res 13:1–15
Hajat S, Kovats RS, Atkinson RW, Haines A (2002) Impact of hot temperatures on death in London: a time series approach. J Epidemiol Community Health 56:367–372
Höppe P (1999) The physiological equivalent temperature—a universal index for the biometeorological assessment of the thermal environment. Int J Biometeorol 43:71–75
Huynen MMTE, Martens P, Schram D, Weijenberg MP, Kunst AE (2001) The impact of heat waves and cold spells on mortality rates in the Dutch population. Environ Health Perspect 109:463–470
Jones TS, Liang AP, Kilbourne EM (1982) Morbidity and mortality associated with the July, 1980 heat wave in St. Louis and Kansas City. JAMA 247:3327–3331
Kalkstein LS (1993) Health and climate change: direct impacts in cities. Lancet 342:1397–1399
Kalkstein LS (2000) Saving lives during extreme weather in summer. Br Med J 321:650–651
Kalkstein LS, Smoyer KE (1993) The impact of climate change on human health: some international implications. Experientia 49:969–979
Kalkstein LS, Jamason PF, Greene JS, Libby J, Robinson L (1996) The Philadelphia hot weather-health watch/warning system: development and application, summer 1995. Bull Am Meteorol Soc 77:1519–1528
Katsouyanni K, Pantazopoulou A, Touloumi G, Tselepidaki I, Moustris K, Asimakopoulos D, Poulopoulou G, Trichopoulos D (1993) Evidence for interaction between air pollution and high temperature in the causation of excess mortality. Arch Environ Health 48:235–242
Keatinge WR, Donaldson GC, Cordioli E, Martinelli M, Kunst AE, Mackenbach JP, Näyhä S, Vuori I (2000) Heat related mortality in warm and cold regions of Europe: observational study. Br Med J 321:670–673
Kunst AE, Looman CWN, Mackenbach JP (1993) Outdoor air temperature and mortality in the Netherlands: a time-series analysis. Am J Epidemiol 137:331–341
Kyselý J (2002a) Temporal fluctuations in heat waves at Prague-Klementinum, the Czech Republic, from 1901–1997, and their relationships to atmospheric circulation. Int J Climatol 22:33–50
Kyselý J (2002b) Probability estimates of extreme temperature events: stochastic modelling approach versus extreme value distributions. Stud Geophys Geod 46:93–112
Kyselý J, Huth R (2004) Heat-related mortality in the Czech Republic examined through synoptic and ‘traditional’ approaches. Clim Res 25:265–274
Kyselý J, Kříž B (2003) High summer temperatures and mortality in the Czech Republic in 1982–2000 (in Czech, with summary in English). Epidemiol Mikrobiol Imunol 52:105–116
Laschewski G, Jendritzky G (2002) Effects of the thermal environment on human health: an investigation of 30 years of daily mortality data from SW Germany. Clim Res 21:91–103
Lerchl A (1998) Changes in the seasonality of mortality in Germany from 1946 to 1995: the role of temperature. Int J Biometeorol 42:84–88
Mackenbach JP, Borst V, Schols J (1997) Heat-related mortality among nursing-home patients. Lancet 349:1297–1298
Mammarella A, Paoletti V (1989) Illnesses associated with high environmental temperature. Clin Ter 131:195–201
Matzarakis A, Mayer H (1991) The extreme heat wave in Athens in July 1987 from the point of view of human biometeorology. Atmos Environ–Urb Atmos 25:203–211
Matzarakis A, Mayer H (1997) Heat stress in Greece. Int J Biometeorol 41:34–39
Pan W-H, Li L-A (1995) Temperature extremes and mortality from coronary heart disease and cerebral infarction in elderly Chinese. Lancet 345:353–356
Ramlow JM, Kuller LH (1990) Effects of the summer heat wave of 1988 on daily mortality in Allegheny County, PA. Public Health Rep 105:283–289
Rooney C, McMichael AJ, Kovats RS, Coleman MP (1998) Excess mortality in England and Wales, and in Greater London, during the 1995 heatwave. J Epidemiol Community Health 52:482–486
Sartor F, Snacken R, Demuth C, Walckiers D (1995) Temperature, ambient ozone levels, and mortality during summer 1994, in Belgium. Environ Res 70:105–113
Sartor F, Demuth C, Snacken R, Walckiers D (1997) Mortality in the elderly and ambient ozone concentration during the hot summer, 1994, in Belgium. Environ Res 72:109–117
Smoyer KE, Kalkstein LS, Greene JS, Ye H (2000a) The impacts of weather and pollution on human mortality in Birmingham, Alabama and Philadelphia, Pennsylvania. Int J Climatol 20:881–897
Smoyer KE, Rainham DGC, Hewko JN (2000b) Heat-stress-related mortality in five cities in Southern Ontario: 1980–1996. Int J Biometeorol 44:190–197
Wang H, Sekine M, Chen X, Kagamimori S (2002) A study of weekly and seasonal variation of stroke onset. Int J Biometeorol 47:13–20
Whitman S, Good G, Donoghue ER, Benbow N, Shou WY, Mou SX (1997) Mortality in Chicago attributed to the July 1995 heat wave. Am J Public Health 87:1515–1518
Zauli Sajani S, Garaffoni G, Goldoni CA, Ranzi A, Tibaldi S, Lauriola P (2002) Mortality and bioclimatic discomfort in Emilia-Romagna, Italy. J Epidemiol Community Health 56:536–537
Acknowledgements
Data were kindly provided by the Czech Hydrometeorological Institute, the Institute of Health Information and Statistics, and Bohumír Kříž, the State Health Institute, Prague. Thanks are due to Radan Huth, Institute of Atmospheric Physics, Prague, for helpful comments on the manuscript. The study was supported by the Grant Agency of the Czech Republic under project 205/01/D040.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kyselý, J. Mortality and displaced mortality during heat waves in the Czech Republic. Int J Biometeorol 49, 91–97 (2004). https://doi.org/10.1007/s00484-004-0218-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00484-004-0218-2