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Maud M.T.E. Huynen,¹ Pim Martens,¹ Dieneke Schram,¹ Matty P. Weijenberg,² and Anton E. Kunst³

¹International Centre for Integrative Studies, and ²Department of Epidemiology, Maastricht University, Maastricht, The Netherlands; ³Department of Public Health, Erasmus University Rotterdam, Rotterdam, The Netherlands

Abstract

We conducted the study described in this paper to investigate the impact of ambient temperature on mortality in the Netherlands during 1979-1997, the impact of heat waves and cold spells on mortality in particular, and the possibility of any heat wave- or cold spell-induced forward displacement of mortality. We found a V-like relationship between mortality and temperature, with an optimum temperature value (e.g., average temperature with lowest mortality rate) of 16.5°C for total mortality, cardiovascular mortality, respiratory mortality, and mortality among those 65 year of age. For mortality due to malignant neoplasms and mortality in the youngest age group, the optimum temperatures were 15.5°C and 14.5°C, respectively. For temperatures above the optimum, mortality increased by 0.47, 1.86, 12.82, and 2.72% for malignant neoplasms, cardiovascular disease, respiratory diseases, and total mortality, respectively, for each degree Celsius increase above the optimum in the preceding month. For temperatures below the optimum, mortality increased 0.22, 1.69, 5.15, and 1.37%, respectively, for each degree Celsius decrease below the optimum in the preceding month. Mortality increased significantly during all of the heat waves studied, and the elderly were most effected by extreme heat. The heat waves led to increases in mortality due to all of the selected causes, especially respiratory mortality. Average total excess mortality during the heat waves studied was 12.1%, or 39.8 deaths/day. The average excess mortality during the cold spells was 12.8% or 46.6 deaths/day, which was mostly attributable to the increase in cardiovascular mortality and mortality among the elderly. The results concerning the forward displacement of deaths due to heat waves were not conclusive. We found no cold-induced forward displacement of deaths. Key words: cold spells, heat waves, mortality, mortality displacement, Netherlands, temperature. Environ Health Perspect 109:463-470 (2001) . [Online 3 May 2001]

http://ehpnet1.niehs.nih.gov/docs/2001/109p463-470huynen/ abstract.html

Address correspondence to M.M.T.E. Huynen, International Centre for Integrative Studies, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Telephone: +31-43-3883610. Fax: +31-43-3884916. E-mail: m.huynen@ icis.unimaas.nl

We thank K. Ebi, S. Kovats, G. Jendritzky, and two anonymous reviewers for detailed and helpful comments.

This research was made possible through a grant by the Electric Power Research Institute (WO 8246-03) . Discussions at the workshop "The Health Impacts of Heatwaves in Europe," held in London on 20-21 March 2000, were very helpful in writing this paper.

Received 14 September 2000 accepted 14 November 2000.