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The Impact of the 2008 Cold Spell on Mortality in Shanghai, China

Ma, Wenjuan; Kan, Haidong

doi: 10.1097/01.ede.0000391707.80682.21
Abstracts: ISEE 22nd Annual Conference, Seoul, Korea, 28 August–1 September 2010: Climate Change and Environmental Health

School of Public Health, Fudan University, Shanghai, People's Republic of China.

Abstracts published in Epidemiology have been reviewed by the societies at whose meetings the abstracts have been accepted for presentation. These abstracts have not undergone review by the Editorial Board of Epidemiology.


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Global climate change may cause more occurrence of extreme weather conditions, including both heat wave and cold spell. Although several studies in China have reported the health impact of heat wave, no study has been carried out to examine the relationship between cold spell and adverse health outcomes.

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Cold spell was defined as a period of at least 9 consecutive days with daily temperature below the 3 percentile during the study period, of which at least 6 days have daily average temperatures below the 1 percentile. Between January 2001 and December 2009, Shanghai recorded a cold spell between 27 January and 16 February 2008. We investigated the impact of cold spell on mortality of the residents living in 9 urban Districts of Shanghai. We calculated rate ratios (RRs) during the cold spell compared to a reference period (6–16 January 2008, and 28 February–8 March 2008). Both total and cardiopulmonary mortality were assessed. For total mortality, we stratified the analysis by gender and age.

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During the cold spells, the RR of total mortality was 1.16 (95% confidence interval [CI]: 1.11–1.22). The impact was statistically significant for cardiovascular mortality (RR = 1.24, 95% CI: 1.16–1.33), but not for respiratory mortality (RR = 1.10, 95% CI: 0.96–1.25). For total mortality, gender did not make statistically significant difference for the cold spell impact. Cold spell had significant impact of mortality in both middle-aged people (45–64 years) (RR = 1.16, 95% CI: 1.02–1.31) and elderly people (over 65 years) (RR = 1.16, 95% CI: 1.11–1.23).

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Our analysis showed that the 2008 cold spell had a substantial effect on mortality in Shanghai. Public health programs should be tailored to prevent cold spell-related health problems in the city.

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