ArticlesHeat-Related Death and Mental Illness During the 1999 Cincinnati Heat WaveKaiser, Reinhard M.D., M.P.H.; Rubin, Carol H. D.V.M., M.P.H.; Henderson, Alden K. Ph.D., M.P.H.; Wolfe, Mitchell I. M.D., M.P.H.; Kieszak, Stephanie M.A., M.P.H.; Parrott, Carl L. M.D.; Adcock, Malcolm Ph.D. Author Information From the Epidemic Intelligence Service, Epidemiology Program Office, Atlanta, Georgia (R.K., M.I.W.); Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia (R.K., C.H.R., A.K.H., M.I.W., S.K.); Hamilton County Coroner’s Office, Cincinnati, Ohio (C.L.P.); and Cincinnati Health Department, Cincinnati, Ohio (M.A.), U.S.A. Manuscript received November 15, 2000; accepted January 5, 2001. Address correspondence and reprint requests to Dr. Reinhard Kaiser, Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards & Health Effects, Health Studies Branch (E23), 1600 Clifton Rd, NE, Atlanta, GA 30333; email: [email protected] The American Journal of Forensic Medicine and Pathology 22(3):p 303-307, September 2001. Buy Abstract During a 1999 heat wave in Cincinnati, Ohio, the Hamilton County Coroner reported 18 heat-related deaths. The Centers for Disease Control and Prevention and the Cincinnati Department of Health conducted a case–control study using surrogate case information and first-person control information to identify risk factors for mortality during the heat wave. Surrogate data were supplemented by systematic death scene investigation reports and comprehensive toxicologic screens, important sources of data that are routinely collected by the Hamilton County Coroner’s Office. The study included 17 case subjects and 34 controls from the decedents’ neighborhood. Among 17 case subjects, 8 (47.1%) had mental illness (odds ratio [OR], 14.0; 95% confidence interval [CI], 1.8–633). There was a suggestion of an interaction between age and mental health. A working air-conditioner was the strongest protective factor (OR, 0.03; 95% CI, 0–0.2). Toxicologic screening indicated that case subjects with reported mental illness and a prescription for psychotropic drugs may not have been medication compliant. Three decedents lived in group homes for people with mental illness, indicating that opportunities for prevention may have been missed. Systematic death investigations, including toxicologic screening, provide valuable information about the circumstances of heat-related death, particularly the role of medication compliance as a risk factor. Prevention programs during heat waves should target people with mental illness, especially those who take psychotropic medication. © 2001 Lippincott Williams & Wilkins, Inc.