Abstract
Introduction France was affected in early August 2003 by a heat wave with an exceptional health impact. Many studies on mortality were conducted but few data are available on morbidity. The objectives of this study were to describe the impact of the 2003 heat wave in the general population of elderly people and to determine individual factors associated with morbidity. Methods A cross-sectional study nested in two prospective cohorts, the PAQUID and the Three-City (3C) studies, was performed. The sample included 2295 subjects from the general population, aged 67 and over who were interviewed by a phone questionnaire to complete data available in the database of the two cohorts. Two variables assessing morbidity (felt by the person and objectively observed) were created. Relationship between morbidity and individual factors were explored in univariate analyses; then multiple logistic regressions were conducted. Results During the heat wave, 8.8% of the subjects felt a deterioration of their health, and 7.8% declared an objective morbid outcome. In the univariate analyses, many factors were associated with morbidity. After multiple adjustments, few associations were still observed but some factors were associated with a decreased risk (presence of a bathroom, dressing lighter than usually) or an increased risk (stopping usual activities, presence of chronic diseases). Conclusion This study showed a non-negligible impact of the 2003 heat wave in term of felt and objective morbidity. Several individual factors were shown to be associated with morbidity and should be taken into account for the elaboration of prevention plans.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
3C Study Group. Vascular factors and risk of dementia: design of the Three-City Study and baseline characteristics of the study population. Neuroepidemiology 2003;22:316–25.
Basu R, Samet JM. Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence. Epidemiol Rev 2002;24:190–202.
Canoui-Poitrine F, Cadot E, Spira A. Excess deaths during the August 2003 heat wave in Paris, France. Rev Epidemiol Sante Publique 2006;54:127–35.
Dartigues JF, Gagnon M, Barberger-Gateau P, Letenneur L, Commenges D, Sauvel C, Michel P, Salamon R. The Paquid epidemiological program on brain ageing. Neuroepidemiology 1992;11 Suppl (1):14–8.
Davido A, Patzak A, Dart T, Sadier MP, Meraud P, Masmoudi R, Sembach N, Cao TH. Risk factors for heat related death during the August 2003 heat wave in Paris, France, in patients evaluated at the emergency department of the Hopital Europeen Georges Pompidou. Emerg Med J 2006;23:515–8.
Faunt JD, Wilkinson TJ, Aplin P, Henschke P, Webb M, Penhall RK. The effete in the heat: heat-related hospital presentations during a ten day heat wave. Aust N Z J Med 1995;25:117–21.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.
Fouillet A, Rey G, Laurent F, Pavillon G, Bellec S, Guihenneuc-Jouyaux C, Clavel J, Jougla E, Hemon D. Excess mortality related to the August 2003 heat wave in France. Int Arch Occup Environ Health 2006.
Holstein J, Canoui-Poitrine F, Neumann A, Lepage E, Spira A. Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France? J Public Health (Oxf) 2005;27:359–65.
Institut de veille sanitaire. Evaluation de l’impact de la vague de chaleur de l’été 2003 sur la morbidité hospitalière infantile. 2005a.
Institut de veille sanitaire. Etude des facteurs de risque de décès des personnes âgées résidant en établissement durant la vague de chaleur d’août 2003. 2005b.
Institut de veille sanitaire. Etude des facteurs de décès des personnes âgées résidant à domicile durant la vague de chaleur d’août 2003. 2004a.
Institut de veille sanitaire. Impact sanitaire de la vague de chaleur d’août 2003 en France. Bilan et Perspectives. 2004b.
Kilbourne EM, Choi K, Jones TS, Thacker SB. Risk factors for heatstroke. A case-control study. JAMA 1982;247:3332–6.
Kosatsky T. The 2003 European heat waves. Euro Surveill 2005;10.
Laaidi K, Pascal M, Ledrans M, Le Tertre A, Medina S, Caserio C, Cohen JC, Manach J, Beaudeau P, Empereur-Bissonnet P. Le système français d’alerte canicule et santé 2004 (SACS 2004). Un dispositif intégré au Plan National Canicule. Bulletin Epidémiologique Hebdomadaire 2004;30–31:134–6.
Mastrangelo G, Hajat S, Fadda E, Buja A, Fedeli U, Spolaore P. Contrasting patterns of hospital admissions and mortality during heat waves: are deaths from circulatory disease a real excess or an artifact? Med Hypotheses 2006;66:1025–8.
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–44.
Pirard P, Vandentorren S, Pascal M, Laaidi K, Le TA, Cassadou S, Ledrans M. Summary of the mortality impact assessment of the 2003 heat wave in France. Euro Surveill 2005;10.
Semenza JC, McCullough JE, Flanders WD, McGeehin MA, Lumpkin JR. Excess hospital admissions during the July 1995 heat wave in Chicago. Am J Prev Med 1999;16:269–77.
Trejo O, Miro O, de la RG, Collvinent B, Bragulat E, Asenjo MA, Salmeron JM, Sanchez M. Emergency department activity during the 2003 summer heat wave. Med Clin (Barc) 2005;125:205–9.
Vandentorren S, Pirard P, Delmas MC, Donadieu J. Impact sanitaire de la vague de chaleur d’août 2003: premiers résultats des travaux à mener. Enquête sur les interventions sanitaires. Bulletin Epidémiologique Hebdomadaire 2003;45–6.
Acknowledgements
The PAQUID project was funded by: ARMA (Bordeaux)—Caisse Nationale d’Assurance Maladie des Travailleurs Salariés (CNAMTS)—Conseil Général de la Dordogne—Conseil Général de la Gironde—Conseil Régional d’Aquitaine—France Alzheimer (Paris)—Institut National de la Santé et de la Recherche Médicale (INSERM)—Mutuelle Générale de l’Education Nationale (MGEN)—Mutualité Sociale Agricole (MSA)—NOVARTIS Pharma (France)—SCOR Insurance (France). The Fondation pour la Recherche Médicale funded the preparation and initiation of the 3C Study, which is also supported by: Caisse Nationale Maladie des Travailleurs Salariés, Agence Française de Sécurité Sanitaire des Produits de Santé, Direction Générale de la Santé, Conseils Régionaux of Aquitaine and Bourgogne, Fondation de France, Ministry of Research-INSERM Programme ‘Cohortes et collections de données biologiques’. Financial sponsors did not play any role on the study. All the subjects included in this study who gave their informed consent to participate.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Larrieu, S., Carcaillon, L., Lefranc, A. et al. Factors associated with morbidity during the 2003 heat wave in two population-based cohorts of elderly subjects: PAQUID and Three City. Eur J Epidemiol 23, 295–302 (2008). https://doi.org/10.1007/s10654-008-9229-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10654-008-9229-3