Abstract

BackgroundThis study aimed to assess the relationship between cold temperature and daily mortality in the Republic of Ireland (ROI) and Northern Ireland (NI), and to explore any differences in the population responses between the two jurisdictions.MethodsA time-stratified case-crossover approach was used to examine this relationship in two adult national populations, between 1984 and 2007. Daily mortality risk was examined in association with exposure to daily maximum temperatures on the same day and up to 6 weeks preceding death, during the winter (December-February) and an extended cold period (October-March), using distributed lag models. Model stratification by age and gender assessed for modification of the cold weather-mortality relationship.ResultsIn the ROI, the impact of cold weather in winter persisted up to 35 days, with a cumulative mortality increase for all-causes of 6.4% (95% CI = 4.8%-7.9%) in relation to every 1°C drop in daily maximum temperature, similar increases for cardiovascular disease (CVD) and stroke, and twice as much for respiratory causes. In NI, these associations were less pronounced for CVD causes, and overall extended up to 28 days. Effects of cold weather on mortality increased with age in both jurisdictions, and some suggestive gender differences were observed.ConclusionsThe study findings indicated strong cold weather-mortality associations in the island of Ireland; these effects were less persistent, and for CVD mortality, smaller in NI than in the ROI. Together with suggestive differences in associations by age and gender between the two Irish jurisdictions, the findings suggest potential contribution of underlying societal differences, and require further exploration. The evidence provided here will hope to contribute to the current efforts to modify fuel policy and reduce winter mortality in Ireland.

Highlights

  • This study aimed to assess the relationship between cold temperature and daily mortality in the Republic of Ireland (ROI) and Northern Ireland (NI), and to explore any differences in the population responses between the two jurisdictions

  • Non-accidental deaths were used for this study (ICD-9 codes 001-799/International classification of diseases (ICD)-10 codes A00-R99), further categorised to primary cause-specific mortality for cardiovascular disease (CVD) (390–429; I01-I52), ischaemic heart disease (IHD) (410–414, 429.2; I20-I52), myocardial infarction (MI) (410; I21-I22), respiratory disease (460–519; J0-J99), pneumonia (480–486; J12-J18), chronic obstructive pulmonary disease (COPD) (490–492, 494–496; J40-J44, J47), and stroke (430–438; I60-I69)

  • Similar associations were observed for CVD mortality; effects were seen up to the preceding 4 weeks

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Summary

Introduction

This study aimed to assess the relationship between cold temperature and daily mortality in the Republic of Ireland (ROI) and Northern Ireland (NI), and to explore any differences in the population responses between the two jurisdictions. Full list of author information is available at the end of the article health and societal impacts of extreme winter weather, despite the rise in global average temperatures [3,6]. The large death toll and the disruption associated with the cold weather in Europe in the winter of 2005–2006 was a timely reminder of how poorly prepared many populations were to the dangers of extreme cold temperatures [7]. Taking into consideration the differences in underlying population health, public policies targeted at preventing winter mortality, health care provision, and socioeconomic and demographic construct of the two Irish

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