Abstract
ISEE-300 Introduction: During August 2003 England, along with the rest of Europe, experienced sustained high temperatures. From the 4th to the 13th August 2003 daytime maximum temperatures across much of England were above 30°C and in many areas temperature records were broken. Ozone exposure was also in excess of normal levels. This paper provides the first preliminary quantitative estimates of the impact of the heat wave on mortality and hospital admissions in England, by region and by selected age groups. Methods: The episode was defined as the 4th to the 13th of August based on the pattern of observed sustained increase in daily Central England Temperatures (CET) above average levels for the period 1971–2000. Information on the daily number of deaths and hospital admissions was collected for Government Office Regions and for selected age groups. The number of deaths and hospital admissions, attributable to the heat wave, were calculated by comparing observed 2003 data with a baseline of the five previous years over the same period. Results: During the episode there were an estimated 2,045 more deaths in England and Wales than for the same period between 1998 and 2002. Most of the excess deaths were concentrated in the south east of England, particularly in London. Increased mortality was seen in all age groups, but most notably in the over 75s. However, hospital admissions in London showed no increase for those under the age of 75. The greatest increase in mortality above expected levels was found for regions with prolonged anomalous temperatures. High ozone levels in these regions may also have contributed to increased mortality. Discussion: In terms of the impact on human health, the summer of 2003 ranks alongside those of 1995 and 1976. This paper is unique in providing a quick response to the summer 2003 heat wave, and bringing together information from a variety of different sources. The results have implications in terms of more sophisticated future analyses, public health policies and the development of heat-health watch warning systems.
Highlights
Like other countries in Europe, England experienced a heat wave in early August 2003
Preliminary estimates for mortality in England and Wales were released by the Office for National Statistics (ONS) in October 2003.4 In this article, we investigate in more detail the impact of the heat wave in England, by estimating the attributable mortality and emergency hospital admissions by region and by age group
The impact was greatest in the southern half of England, in London, where deaths increased by 42 per cent (CI: 36–48 per cent) (Table 1)
Summary
Like other countries in Europe, England experienced a heat wave in early August 2003. Hot dry continental air was drawn over England and Wales from the Iberian Peninsula This so-called ‘Spanish Plumeadded further to the high day time heat loads and managed to sustain night time temperatures at 6–8°C above their normal August value. MRSA remained at low levels in the UK until 1992.1 Since both the number of infections caused by MRSA and the proportion of all S. aureus infections that are methicillin resistant has been increasing.[2] Previous analysis of death certificates has found that MRSA is increasingly mentioned on death certificates in England and Wales.[3,4] Mortality rates for deaths involving MRSA increased over 15fold during the period 1993 to 2002; this increase was thought unlikely to be due to an improvement in reporting.[4] Those who die with MRSA are often already very ill and vulnerable to infection.
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