Temperature and Risk for Post-Neonatal Mortality in California

Abstract

Temperature and Risk for Post-Neonatal Mortality in CaliforniaAbstract Number:2050 Dharshani Pearson*, Rupa Basu, Brian Malig, and Rachel Broadwin Dharshani Pearson* California Environmental Protection Agency/ Office of Environmental Health Hazard Assessment, United States, E-mail Address: [email protected] Search for more papers by this author , Rupa Basu California Environmental Protection Agency/ Office of Environmental Health Hazard Assessment, United States, E-mail Address: [email protected] Search for more papers by this author , Brian Malig California Environmental Protection Agency/ Office of Environmental Health Hazard Assessment, United States, E-mail Address: [email protected] Search for more papers by this author , and Rachel Broadwin California Environmental Protection Agency/ Office of Environmental Health Hazard Assessment, United States, E-mail Address: [email protected] Search for more papers by this author AbstractBackground: Infants have limited ability to adapt to temperature extremes because they lack well-developed thermoregulatory response mechanisms. However, very few studies of temperature and adverse health outcomes have focused on infants. Aim: To examine the relationship between apparent temperature, a combination of heat and humidity, and mortality among infants between 28 and 365 days old (post-neonatal period).Methods: Using California death certificates from 1999 to 2011, we used a case-crossover analysis to investigate the effects of mean daily apparent temperature on post-neonatal mortality. First, we identified post-neonates who died in California from May through October. We then combined these data with mean daily apparent temperature gathered from meteorological monitors located within 20 kilometers of each mother’s residential zip code to comprise our final study population of 3,398 cases. We examined deaths from circulatory causes (International Classification of Disease [ICD]-10 No. I00-I99), respiratory causes (ICD J00-J98) and sudden infant death syndrome (SIDS [ICD R95]), in addition to all-cause mortality (ICD A00-Y899). Overall, mean daily apparent temperature was associated with post-neonatal deaths related to circulatory causes (excess risk: 36.9% per 5.6°C (10°F)); 95% confidence interval: -0.7, 88.8). We found this effect to be larger in non-coastal areas (43.5%; 2.0, 101.8). When stratifying by race/ethnicity, we noted that Hispanics (46.4%; -6.8, 129.8) and Whites (73.6%,-5.5, 218.9) both showed elevated mortality associated with circulatory causes.Conclusions: Our findings suggest that parents of children under one year of age, especially those with known preexisting circulatory conditions, should receive advance warning of potential harmful health outcomes associated with high outdoor temperature.