Temporal changes in temperature-related mortality in Spain and effect of the implementation of a Heat Health Prevention Plan

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• dc.contributor.author Martínez Solanas, Èrica, 1982-
• dc.contributor.author Basagaña Flores, Xavier
• dc.date.accessioned 2020-01-30T09:03:40Z
• dc.date.available 2020-01-30T09:03:40Z
• dc.date.issued 2019
• dc.description.abstract Exposure to extreme ambient temperatures has been widely described to increase mortality. Exploring changes in susceptibility to temperatures over time can provide useful information for policy planning and can provide insights on the effectiveness of health preventive plans. The aims of this study were i) to compare changes in temperature-related mortality in Spain during a 20-year period and ii) to assess whether the number of actions implemented in each region as part of a Heat Health Prevention Plan (HHPP) was associated with the temporal changes in heat-related mortality. Daily counts of deaths and daily maximum temperature were obtained for each Spanish province (1993-2013). We used time-varying distributed lag non-linear models to estimate the relationship between temperature and mortality. We compared the risk of death due to extreme temperatures (cold and heat) in the two periods (1993-2002 and 2004-2013), assuming a constant temperature distribution and different temperature-mortality function. Results were reported as mortality attributable fraction (%) (AF). Overall, there was a decrease in mortality attributable to temperature in period 2, more remarkable for extreme cold (from 1.01% to 0.52%), while for moderate heat there was an increase (from 0.38% to 1.21%). Provinces with more actions implemented in their HHPP showed stronger decreases in mortality attributable to extreme heat. Other variables (e.g. average temperature) could explain this association. The highest mortality-AF reductions were detected among the elderly, in mortality for cardiovascular causes and in towns with high socioeconomic vulnerability. Our results suggest that the implementation of the Spanish HHPP could help reduce heat-related mortality.
• dc.format.mimetype application/pdf
• dc.identifier.citation Martínez-Solanas È, Basagaña X. Temporal changes in temperature-related mortality in Spain and effect of the implementation of a Heat Health Prevention Plan. Environ Res. 2019;169:102-13. DOI: 10.1016/j.envres.2018.11.006
• dc.identifier.doi http://dx.doi.org/10.1016/j.envres.2018.11.006
• dc.identifier.issn 0013-9351
• dc.identifier.uri http://hdl.handle.net/10230/43445
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Environmental Research. 2019;169:102-13
• dc.rights © 2018 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/BY-NC-ND/4.0/
• dc.subject.keyword Adaptation
• dc.subject.keyword Ambient temperatures
• dc.subject.keyword Heat prevention plan
• dc.subject.keyword Heat-waves
• dc.subject.keyword Mortality
• dc.title Temporal changes in temperature-related mortality in Spain and effect of the implementation of a Heat Health Prevention Plan
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion