Abstract
We have investigated the association between heat waves and mortality and hospital admissions for Prague inhabitants for the summer heat waves of August 2003 and July 2006. The effect of heat waves was investigated using negative binomial regression in a generalized additive model. We used a linear model on a logarithmic scale, having 1-day lagged temperature differences from the long-term average, 1-day lagged ambient O3 and PM10 concentration, relative humidity, simple “heat wave” indicator, and smooth seasonal effect as explanatory variables. We found a small increase in daily mortality for the examined period. This increase can be attributed to PM10 concentrations in most cases, and in fewer instances, to air temperature and O3 concentrations. The “heat wave” indicator did not significantly increase the relative risk; the same held for the relative humidity. For the general unstratified population, the highest increase in relative risk of 1.072 (95% CI 1.001–1.147) was observed for cardiovascular mortality and was associated with an increase in temperature of 10 °C, followed by an increase in relative risk of 1.056 (95% CI 1.025–1.087) for respiratory mortality associated with an increase in O3 concentrations by 10 μg.m−3. A higher risk in most cases was found for women. A significant increase of relative risk of 1.013 (95 % CI 1.002–1.024) due to PM10 was found for hospital admissions for cardiovascular causes. This issue should be studied further in view of the anticipated increase in meteorological extremes, including heat waves, in the future, to prepare prevention plans for eliminating their negative effects as far as possible.
Similar content being viewed by others
References
Armstrong BG (2006) Models for the relationship between ambient temperature and daily mortality. Epidemiology 17:624–631
Beniston M, Stephenson DB, Christensen OB et al (2007) Future extreme events in European climate: an exploration of regional climate model projections. Climatic Change 81:71–95
Beranová R, Huth R (2005) Long-term changes in the heat island of Prague under different synoptic conditions. Theoretical and Applied Climatology 82:113–118
Borrell C, Marí-Dell’Olmo M, Rodríguez-Sanz M, Garcia-Olalla P, Cayla JA, Benach J, Muntaner C (2006) Socioeconomic position and excess mortality during the heat wave of 2003 in Barcelona. European Journal of Epidemiology 21:633–640
Brázdil R, Budíková M (1999) An urban bias in air temperature fluctuations at the Klementinum, Prague, Czech Republic. Atmospheric Environment 33:4211–4217
Breitner S, Wolf K, Devlin RB, Diaz-Sanchez D, Peters A, Schneider A (2014) Short-term effects of air temperature on mortality and effect modification by air pollution in three cities of Bavaria, Germany: A time-series analysis. Science of the Total Environment 485–486:49–61
Chen K, Bi J, Chen X, Huang L, Zhou L (2015) Influence of heat wave definitions to the added effect of heat waves on daily mortality in Nanjing, China. Science of Total Environment 506–507:15–25
CHMI (2013) Air pollution in the Czech Republic in 2012. CHMI, Prague
Clarke JF (1972) Some effects of the urban structure on heat mortality. Environmental Research 5:93–104
ČMES (2015): Meteorologický slovník výkladový a terminologický (eMS), ČMeS, available at: http://slovnik.cmes.cz
R Core Team (2015) R: A Language and Environment for Statistical Computing. Available: http://www.rproject.org/
ČSÚ (2015): Počty obyvatel v Praze. Available at: www.http://www.czso.cz.
D’Ippoliti D, Michelozzi P, de Donato F, Menne B, Katsouyanni K et al (2010) The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project. Environmental Health 9:37–43
Davis RE, Knappenberger PC, Novicoff WM, Michaels PJ (2003) Decadal changes in summer mortality in U.S. cities. International Journal of Biometeorology 47:166–175
de Almeida SP, Casimiro E, Calheiros J (2011) Short-term association between exposure to ozone and mortality in Oporto, Portugal. Environ Res 111:406–410
de Bono A, Giuliani G, Kluser S, Peduzzi P (2004) Impacts of summer 2003 heat wave in Europe. Europe Environment Alert Bulletin 2:1–4
Díaz J, García R, Velázquez de Castro F, Hernández E, López C, Otero A (2002) Effects of extremely hot days on people older than 65 years in Seville (Spain) from 1986 to 1997. International Journal of Biometeorology 46:145–149
Diffenbaugh NS, Field CB (2013) Changes in Ecologically Critical Terrestrial Climate Conditions. Science 341(6145):486–492
EC (2008): Directive 2008/50/EC of the European Parliament and of the Council of 21 May 2008 on ambient air quality and cleaner air for Europe. OJEC L 152
Fialová L, Bartoňová D, Burcin B, Kalibová K, Kocourková J, Kučera T, Rychtaříková J (2009) Population development in the Czech Republic 2007, 1st edn. Prague, SLON
Franklin BA, Brook R, Pope CA III (2015) Air Pollution and Cardiovascular Disease. Current Problems in Cardiology 40:207–238
Gardner W, Mulvey EP, Shaw EC (1995) Regression Analyses of Counts and Rates: Poisson, Overdispersed Poisson, and Negative Binomial Models. Psychological Bulletin 118:392–404
Gasparrini A, Armstrong BG (2011) The impact of heat waves on mortality. Epidemiology 22:68–73
Gershunov A, Cayan DR, Iacobellis SF (2009) The Great 2006 Heat Wave over California and Nevada: Signal of An Increasing Trend. Journal of Climate 22:6181–6203
Goodman JE, Sax SN, Lange S, Rhomberg LR (2015) Are the elements of the proposed ozone national Ambient Air Quality Standards informed by the best available science? Regulatory Toxicology and Pharmacology 72:134–140
Gosling SN, Lowe JA, McGregor GR, Pelling M, Malamud BD (2009) Associations between elevated atmospheric temperature and human mortality: a critical review of the literature. Climatic Change 92:299–341
Grize L, Huss A, Thommen O, Schindler C, Braun-Fahrlander C (2005) Heat wave 2003 and mortality in Switzerland. Swiss Medicinal Weekly 135:200–205
Hajat S, Armstrong BG, Gouveia N, Wilkinson P (2005) Mortality displacement of heat-related deaths. A comparison of Delhi, São Paulo, and London. Epidemiology 16(5):613–20
Hammersley R, Westlake T (1996) Planning in the Prague region. Cities 13:247–256
Hastie TJ, Tibshirani RJ (1990) Generalized Additive Models. Chapman & Hall/CRC
Hůnová I (2001) Spatial Interpretation of ambient air quality for the territory of the Czech Republic. Environmental Pollution 112:107–119
Hůnová I, Malý M, Knobová V, Braniš M (2013) Association between ambient ozone and health outcomes in Prague. International Archives of Occupational and Environmental Health 86:89–97
Hutter H-P, Moshammer H, Wallner P, Leitner B, Kundi M (2007) Heatwaves in Vienna: effects on mortality. Wiener Klinische Wochenschrift 119:223–227
INSTRAW (2004): The situation of elderly women: available statistics and indicators. Joint publication of the United Nations International Research and Training Institute for the Advancement of Women (INSTRAW) and the Statistics Division of the United Nations Secretariat, 72 p
IPCC (2007): Climate Change 2007. Synthesis report. IPCC, Geneva, 104 p.
Katsouyanni K, Pantanzopoulou A, Toulomi G (1993) Evidence for interaction between air pollution and high temperature in the causation of excess mortality. Archives of Environmental Health 48:235–242
Keatinge WR, Donaldson GC (2006) Heat acclimatization and sunshine cause false indications of mortality due to ozone. Environmental Research 100:387–393
Kent ST, McClure LA, Zaitchik BF, Smith TT, Gohlke JM (2014) Heat waves and health outcomes in Alabama (USA): the importance of heat wave definition. Environmental Health perspectives 122:151–158
Kosatsky T et al (2005) The 2003 European heat waves. Eurosurveillance 10(7–9):148–149
Kyselý J (2004) Mortality and displaced mortality during heat waves in the Czech Republic. International Journal of Biometeorology 49:91–97
Kyselý J (2010) Recent severe heat waves in Central Europe: how to view them in a long-term prospect? International Journal of Climatology 30:89–109
Kyselý J, Kříž B (2008) Decreased impacts of the 2003 heat waves on mortality in the Czech Republic: an improved response? International Journal of Biometeorology 52:733–745
Lafortezza R, Carrus G, Sanesi G, Davies C (2009) Benefits and well-being perceived by people visiting green spaces in periods of heat stress. Urban Forestry and Urban Greening 8:97–108
Lam C.K.C. (2014): Air pollution, heat and mortality in urban populations. Reinvention: an International Journal of Undergraduate Research 7, issue 1, http://www.warwick.ac.uk/reinventionjournal/issues/volume7issue1/hong [June 24, 2014]
Lawless JF (1987) Negative binomial and mixed Poisson regression. The Canadian Journal of Statistics 15:209–225
Le Tertre A, Lefranc A, Eilstein D (2006) Impacts of the 2003 heatwave on all-cause mortality in 9 French cities. Epidemiology 17:75–79
Li T, Yan M, Ma W, Ban J, Liu T, Lin H, Liu Z (2015) Short-term effects of multiple ozone metrics on daily mortality in a megacity of China. Environmental Science and Pollution Research 22:8738–8746
Linares C, Diaz J (2007) Impact of high temperatures on hospital admissions: comparative analysis with previous studies about mortality (Madrid). European Journal of Public Health 18:317–322
Luterbacher J, Dietrich D, Xoplaki E, Grosjean M, Wanner H (2004) European seasonal and annual temperature variability, trends, and extremes since 1500. Science 303:1499–1503
Madronich S, Shao M, Wilson SR, Solomon KR, Longstreth JD, Tang XY (2015) Changes in air quality and tropospheric composition due to depletion of stratospheric ozone and interactions with changing climate: implications for human and environmental health. Photochemical & Photobiological Sciences 14:149–169
McGeehin MA, Mirabelli M (2001) The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United States. Environmental Health Perspectives 109:185–189
McMichael AJ (2013) Globalization, climate change, and human health. The New England Journal of Medicine 368:1335–1343
Meehl GA, Tebaldi C (2004) More intense, more frequent, and longer lasting heat waves in the 21st century. Science 305:994–997
Michelozzi P, de Donato F, Bisanti AL, Cadum E, DeMaria M, D’Ovidio M, Costa G, Perucci CA (2005) The impact of the summer 2003 heat waves on mortality in four Italian cities. Eurosurveillance 10:161–165
O’Neil MS, Zanobetti A, Schwartz J (2003) Modifiers of the temperature and mortality association in seven US cities. American Journal of Epidemiology 157:1074–1082
Pascal M, Falq G, Wagner V, Chatignoux E, Corso M, Blanchard M, Host S, Pascal L, Larrieu S (2014) Short-term impacts of particulate matter (PM10, p M10–2.5, PM2.5) on mortality in nine French cities. Atmospheric Environment 95:175–184
Pirard P, Vandentorren S, Pascal M, Laaidi K, Le Tertre A, Cassadou S, Ledrans M (2005) Summary of the mortality impact assessment of the 2003 heat wave in France. Eurosurveillance 10(7–9):153–156
Plavcová E, Kyselý J (2009) Comparison of the impacts of temperature extremes on mortality in Prague and other regions of the Czech Republic. Sustainable Development and Bioclimate: Reviewed Conference Proceedings, 213–214
Rainham DGC, Smoyer-Tomic KE (2003) The role of air pollution in the relationship between a heat stress index and human mortality in Toronto. Environmental Research 93:9–19
Rebetez M, Dupont O, Giroud M (2009) An analysis of the July 2006 heatwave extent in Europe compared to the record year of 2003. Theoretical and Applied Climatology 95:1–7
Reid CE, Snowden JM, Kontgis C, Tager IB (2012) The role of ambient ozone in epidemiologic studies of heat-related mortality. Environmental Health Perspectives 120:1627–1630
Roberts S (2004) Interactions between particulate air pollution and temperature in air pollution mortality time series studies. Environmental Research 96:328–337
Robine J-M, Cheung SLK, Le Roy S, Van Oyen H, Griffith C, Michel J-P, Herrmann FR (2008) Death toll exceeded 70,000 in Europe during the summer of 2003. CR Biologies 331:171–178
Robine J-M, Michel J-P, Herrmann FR (2012) Excess male mortality and age-specific mortality trajectories under different mortality conditions: a lesson from the heat wave of summer 2003. Mechanisms of Ageing and Development 133:378–386
Robinson PJ (2001) On the definition of a heat wave. Journal of Applied Meteorology 40:762–775
Rodopoulou S, Samoli E, Analitis A, Atkinson RW, de Donato FK, Katsouyanni K (2015) Searching for the best modelling specification for assessing the effects of temperature and humidity on health: a time series analysis in three European cities. Int J Biometeorol 59:1585–1596
Seinfeld JH, Pandis SN (2006) Atmospheric chemistry and physics. From air pollution to climate change. Wiley, New York
Smoyer KE, Rainham DG, Hewko JN (2000) Heat-stress related mortality in five cities in southern Ontario: 1980–1996. International Journal of Biometeorology 44:190–197
Trigo RM, Ramos A, Nogueira P, Santos F, Garcia-Herrera R, Gouveia C, Santo F (2009) Evaluating the impact of extreme temperature based indices in the 2003 heatwave excessive mortality in Portugal. Environmental Science & Policy 12:844–854
Wang XY, Guo Y, FitzGerald G, Aitken P, Tippett V, Chen D, Wang X, Tong S (2015) The impacts of heatwaves on mortality differ with different study periods: a multi-city time series investigation. PLoS ONE 10(7), e0134233
WHO (2000) Air quality guidelines for Europe, 2nd edn. WHO Regional Office, Copenhagen
WHO (2004) Heat-waves: risks and responses. Health and global environmental change series, no. 2. WHO Regional Office, Copenhagen
WHO (2013) Health effects of particulate matter. Policy implications for countries of eastern Europe, Caucasus and central Asia. WHO Regional Office, Copenhagen
Wilson A, Rappold AG, Neas LM, Reich BJ (2014) Modeling the effects of temperature on ozone-related mortality. Annals of Applied Statistics 8:1728–1749
Wood SN (2006) Generalized additive models: an introduction with R. Chapman & Hall/CRC
Wood SN (2011) Fast stable restricted maximum likelihood and marginal likelihood estimation of semiparametric generalized linear models. Journal of the Royal Statistical Society (B) 73(1):3–36
Ye X, Wolff R, Yu W, Vaneckova P, Pan X, Tong S (2012) Ambient temperature and morbidity: a review of epidemiological evidence. Environmental Health Perspective 120:19–28
Acknowledgments
This study was funded partly by the Ministry of Education, Youth and Sports of the Czech Republic under the NPVII research programme, Grant No. 2B08077 (Project INAIR) and supported partly by the Academy of Sciences of the Czech Republic, project No. M100300904. The data on air pollution and meteorology were kindly provided by the Czech Hydrometeorological Institute. We highly appreciate the comments of Professor Jonathan M. Samet that helped to improve our manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Hůnová, I., Brabec, M., Malý, M. et al. Major heat waves of 2003 and 2006 and health outcomes in Prague. Air Qual Atmos Health 10, 183–194 (2017). https://doi.org/10.1007/s11869-016-0419-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11869-016-0419-y