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Susceptibility to mortality in weather extremes: effect modification by personal and small-area characteristics
Zanobetti A, O'Neill MS, Gronlund CJ, Schwartz JD.. Epidemiology (Cambridge, Mass.), 2013-11-01
Topic: Air pollution and environmental exposures
Background Extremes of temperature have been associated with short-term increases in daily mortality. We identified subpopulations with increased susceptibility to dying during temperature extremes, based on personal demographics, small-area characteristics, and preexisting medical conditions. Methods We examined Medicare participants in 135 US cities and identified preexisting conditions based on hospitalization records before their deaths, from 1985 to 2006. Personal characteristics were obtained from the Medicare records, and area characteristics were assigned based on zip code of residence. We conducted a case-only analysis of over 11 million deaths and evaluated modification of the risk of dying associated with extremely hot days and extremely cold days, continuous temperatures, and water vapor pressure. Modifiers included preexisting conditions, personal characteristics, zip code-level population characteristics, and land cover characteristics. For each effect modifier, a city-specific logistic regression model was fitted and then an overall national estimate was calculated using meta-analysis. Results People with certain preexisting conditions were more susceptible to extreme heat, with an additional 6% (95% confidence interval = 4%-8%) increase in the risk of dying on an extremely hot day in subjects with previous admission for atrial fibrillation, an additional 8% (4%-12%) in subjects with Alzheimer disease, and an additional 6% (3%-9%) in subjects with dementia. Zip code level and personal characteristics were also associated with increased susceptibility to temperature. Conclusions We identified several subgroups of the population who are particularly susceptible to temperature extremes, including persons with atrial fibrillation.
Key findings
- Background Extremes of temperature have been associated with short-term increases in daily mortality.
- We conducted a case-only analysis of over 11 million deaths and evaluated modification of the risk of dying associated with extremely hot days and extremely cold days, continuous temperatures, and water vapor pressure.
- For each effect modifier, a city-specific logistic regression model was fitted and then an overall national estimate was calculated using meta-analysis.
- Results People with certain preexisting conditions were more susceptible to extreme heat, with an additional 6% (95% confidence interval = 4%-8%) increase in the risk of dying on an extremely hot day in subjects with previous admission for atrial fibrillation, an additional 8% (4%-12%) in subjects with Alzheimer disease, and an additional 6% (3%-9%) in subjects with dementia.
- Zip code level and personal characteristics were also associated with increased susceptibility to temperature.
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Study details
- Study designmeta-analysis
- Evidence strengthHigh
How this study scored 64/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. Scored zero for sample size, effect reported and studied in people because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 37 of the 58 points we could judge it on, which is 64 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Epidemiology (Cambridge, Mass.)) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24045717) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 37 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 37 of the 58 points we could judge it on is 64 out of 100. |
| Total | 64 / 100 | — |
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APA 7th
Zanobetti, A., O'Neill, M. S., Gronlund, C. J., & Schwartz, J. D. (2013). Susceptibility to mortality in weather extremes: effect modification by personal and small-area characteristics. Epidemiology (Cambridge, Mass.). https://doi.org/10.1097/01.ede.0000434432.06765.91
Vancouver
Zanobetti A, O'Neill MS, Gronlund CJ, Schwartz JD. Susceptibility to mortality in weather extremes: effect modification by personal and small-area characteristics. Epidemiology (Cambridge, Mass.). 2013. doi:10.1097/01.ede.0000434432.06765.91. PMID: 24045717.
BibTeX
@article{zanobetti2013-24045717,
author = {Zanobetti, A. and O'Neill, M. S. and Gronlund, C. J. and Schwartz, J. D.},
title = {{Susceptibility to mortality in weather extremes: effect modification by personal and small-area characteristics}},
journal = {Epidemiology (Cambridge, Mass.)},
year = {2013},
doi = {10.1097/01.ede.0000434432.06765.91},
pmid = {24045717},
url = {https://doi.org/10.1097/01.ede.0000434432.06765.91}
}