BACKGROUND: The association between cardiovascular mortality and winter cold spells was evaluated in the population of the Czech Republic over 21-yr period 1986-2006. No comprehensive study on cold-related mortality in central Europe has been carried out despite the fact that cold air invasions are more frequent and severe in this region than in western and southern Europe. METHODS: Cold spells were defined as periods of days on which air temperature does not exceed -3.5 degrees C. Days on which mortality was affected by epidemics of influenza/acute respiratory infections were identified and omitted from the analysis. Excess cardiovascular mortality was determined after the long-term changes and the seasonal cycle in mortality had been removed. Excess mortality during and after cold spells was examined in individual age groups and genders. RESULTS: Cold spells were associated with positive mean excess cardiovascular mortality in all age groups (25-59, 60-69, 70-79 and 80+ years) and in both men and women. The relative mortality effects were most pronounced and most direct in middle-aged men (25-59 years), which contrasts with majority of studies on cold-related mortality in other regions. The estimated excess mortality during the severe cold spells in January 1987 (+274 cardiovascular deaths) is comparable to that attributed to the most severe heat wave in this region in 1994. CONCLUSION: The results show that cold stress has a considerable impact on mortality in central Europe, representing a public health threat of an importance similar to heat waves. The elevated mortality risks in men aged 25-59 years may be related to occupational exposure of large numbers of men working outdoors in winter. Early warnings and preventive measures based on weather forecast and targeted on the susceptible parts of the population may help mitigate the effects of cold spells and save lives.

• MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• interval spolehlivosti MeSH
• kardiovaskulární nemoci diagnóza   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• meteorologické pojmy * MeSH
• multivariační analýza MeSH
• nízká teplota škodlivé účinky   MeSH
• Poissonovo rozdělení MeSH
• pravděpodobnost MeSH
• příčina smrti * MeSH
• roční období MeSH
• rozložení podle pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• surveillance populace MeSH
• věkové rozložení MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The paper examines impacts on mortality of heat waves in 2003, the hottest summer on record in the Czech Republic, and compares them with previous similar events. While most summer heat waves over the period since 1986 were associated with significantly elevated mortality, this was not the case for three out of the four heat waves in 2003. The relatively weak mortality response was particularly noteworthy for the most severe heat wave which occurred in the first 10 days of August 2003 and resulted in enormous excess mortality in some western European countries. A mortality displacement effect and short-term adaptation to heat contributed to the reduced mortality impacts of the heat waves that followed after previous relatively warm periods. However, the decreased mortality response of the 2003 heat waves compared to previous heat waves in the 1990s is also likely to have arisen from positive health-care and other socio-economic changes in the post-communist central European region over the past decade, as well as a better public awareness of heat-related risks due to enhanced media coverage and regular biometeorological forecast and warnings.

• MeSH
• analýza přežití MeSH
• hodnocení rizik metody   MeSH
• incidence MeSH
• lidé MeSH
• mortalita trendy   MeSH
• podnebí * MeSH
• poruchy vyvolané tepelným stresem mortalita   MeSH
• proporcionální rizikové modely * MeSH
• rizikové faktory MeSH
• vysoká teplota * MeSH
• životní prostředí * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Influenza related mortality rates have been established in many countries; nevertheless, studies focusing on the Central European population have been rare to date. We assess mortality attributable to influenza by comparing all cause mortality and mortality due to diseases of the circulatory system during influenza epidemic and non-epidemic periods, as defined by acute respiratory infection surveillance data. Data on total mortality, mortality due to diseases of the circulatory system and surveillance data for influenza and other respiratory infections were used in a general linear model with a logarithmic link for dependence of left censored mortality data over time, and week as a categorical factor. Results of the analysis show statistically significant (p <0.001) differences in excess mortality rates between influenza epidemic and non-epidemic periods in the Czech Republic between 1982 and 2000. We estimate that 2.17% of all cause mortality, and 2.57% of mortality due to diseases of the circulatory system throughout the study period was attributable to influenza, with an estimated annual average of 2661 and 1752 deaths respectively. The highest numbers of deaths were reported during seasons when influenza A/H3N2 was the predominant circulating strain. Improving vaccination coverage against influenza is considered to be the primary strategy for prevention of influenza associated mortality.

• MeSH
• chřipka lidská epidemiologie   mortalita   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• senioři MeSH
• surveillance populace MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The aims of this study were to assess impacts of hot summer periods on mortality in the Czech Republic and to quantify the size of the short-term displacement effect which resulted in lower than expected mortality after heat waves. The analysis covered the period 1982-2000 when several extraordinarily hot summers occurred in central Europe. Daily total all-cause mortality and mortality due to cardiovascular diseases (CVD) in the entire population of the Czech Republic (approximately 10 million inhabitants) were examined. The daily death counts were standardized to account for the long-term decline in mortality and the seasonal and weekly cycles. Heat-related mortality is better expressed if 1-day lag after temperature is considered compared to the unlagged relationship. With the 1-day lag, both excess total mortality and excess CVD mortality were positive during all 17 heat waves, and in 14 (12) heat waves the increase in total (CVD) mortality was statistically significant ( P=0.05). The mean relative rise in total mortality during heat waves was 13%. The response was greater in females than males and similar regardless of whether total or CVD mortality was used. The largest relative increases, exceeding 20% in both total and CVD mortality, were associated with heat waves which occurred in early summer (the first half of July 1984 and June 1994). The mortality displacement effect played an important role since mortality tended to be lower than expected after hot periods. The mean net mortality change due to heat waves was estimated to be about a 1% increase in the number of deaths. The large relative increases during some heat waves were particularly noteworthy since the study (in contrast to most analyses of the heat stress/mortality relationship) was not restricted to an urban area and/or an elderly population.

• MeSH
• dítě MeSH
• dospělí MeSH
• kardiovaskulární nemoci etiologie   mortalita   MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mortalita trendy   MeSH
• novorozenec MeSH
• podnebí MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• roční období MeSH
• senioři MeSH
• vysoká teplota škodlivé účinky   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH