Abstract
Chronic respiratory and ischemic heart diseases are globally important parts of total mortality. This study focuses on the occurrence of mortality due to these disease groups in Germany and possible effects of the thermal environment. A retrospective analysis on the mortality rates of chronic lower respiratory diseases (CLRD) and ischemic heart diseases (IHD) at the regional level in Germany for the period 2001–2015 was done in combination with meteorological observations from the network of the German Meteorological Service. In order to control the mortality data for long-term and seasonal trends, a 365-day Gaussian low-pass filter with a filter response function was applied. The thermal environment was analysed using 2 m air temperature (Ta) and the human biometeorological index Perceived Temperature (PT). The relationship of the Relative Risk (RR) of mortality to the thermal environment is displayed as an exposure–response curve, with threshold values at which RR increases significantly towards higher and lower temperature values. CLRD mortality increases above 17.6 °C, at approximately 4.4%/°C (CI: ± 0.3). The increase of IHD mortality above the threshold of 18.8 °C is less steep, at 3.5%/°C (CI: ± 0.2). During hot periods, CLRD mortality increases by 19.9%, which is twice as much as IHD mortality, with an increase of 9.8%. However, cold days and cold periods affect IHD slightly more than CLRD. The results highlight the concerns of CLRD patients during hot days as well as heat waves. This could lead to better precautions being taken for respiratory patients, which are already established for cardiac patients in Germany.
Highlights
Diseases of the upper and lower respiratory tracts are some of the most common diseases and causes of death in Germany
chronic lower respiratory diseases (CLRD) and ischemic heart diseases (IHD) mortality both display a J-shaped relationship to Ta (Figure 4)
For CLRD mortality, mortality, a temporary increase of mortality is found for Ta values below the THL◦ of −2.7 °C (Table 2), a temporary increase of mortality is found for Ta values below the THL of −2.7 C (Table 2), with further decreasing Ta, Relative Risk (RR) is decreasing as well
Summary
Diseases of the upper and lower respiratory tracts are some of the most common diseases and causes of death in Germany. Chronic diseases such as asthma and chronic obstructive pulmonary disease (COPD), have high social and economic importance in the health sector [1]. In the year 2015, mortality due to chronic lower respiratory diseases (CLRD, ICD-10 code J40–J47) accounted for approximately 35,095 deaths, 88.5% of which had a COPD (ICD code J44) as the main cause, and 3% of which were due to bronchial asthma (J45–J46) [2]. COPDs are hypersensitivity conditions of the bronchial mucosa; bronchial inflammation triggers mostly chronic and irreparable damage of the pulmonary tissue [3]. While COPD affects mostly elderly people, bronchial asthma affects children [4].
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