Backgrounds: In recent years, the impact of extreme temperature on mortality has been studied in Seoul, Korea. However, only few studies were conducted for heat and cold extremes to find susceptible groups by causes and to see if temporal variation of the effect alters by those groups. Objectives: We aimed to analyze the association of extreme temperature with cause specific mortality on susceptible groups and to see if the temporal variation varies on those populations. Methods: We obtained data on daily mortality, temperatures and particulate matter(PM) in Seoul, Korea from 1995 to 2011. We applied time-series analysis with distributed lag non-linear model to set lag structures for temperature and PM up to 30 days. Seasonal and time trend were adjusted. Age, gender and mortality were stratified. To see a temporal variation of the impact of extremes, we separated by windows of five years. Results: The overall heat effect for all-cause mortality was a 8.8% (95% CI: 5.2, 12.6) increase in risk comparing 29? to 22?. For cardiovascular mortality on people between 20 and 64 year-olds, the increase in risk was a 20.8% (0.86, 44). Among them, males showed higher risk increment to 29% (2.8, 63.0). Heat effect-related mortality after a year of 2000 has declined and this pattern has been markedly on elders. As we using indicators for heat wave, estimates was bigger but declining pattern was attenuated. For cold effect, the overall increment in risk of all-cause mortality was a 6.5% (1.0, 12.3) and of cardiovascular mortality on people from 20 to 64 year-olds was 42.1% (3.9, 94.4) comparing -8°C to 4°C. No consistently varying trends of cold effect was found. Discussions: Our finding suggests susceptible groups may vary by cause specific mortality and anthropogenic factors such as age and sexuality. In this study, the declining pattern of temporal variation on heat effect was markedly on elders. This may indicate that further studies is needed for younger population.
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