The Role of Gender in the Impact Evaluation of Heat Waves on Mortality in European Cities

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ISEE-547 Objective: The effect of heat waves on short-term mortality is well documented throughout Europe. Among the individual factors associated to an increase in heat-related vulnerability, the role of gender has not yet been fully clarified and results from recent studies are contradictory. Materials and Methods: Within the European project “Improving Public Health responses to Heat-waves” (EuroHEAT), the impact of maximum apparent temperature and minimum temperature on mortality in 9 European cities (Athens, Barcelona, Budapest, London, Milan, Munich, Paris, Rome, Valencia) was investigated during summer months. Total and cause-specific mortality by age and gender was analyzed for the time period 1990–2004 through episode analysis accounting also for heat wave characteristics in terms of duration, intensity, and time interval between heat waves. For all cities a common GEE model was applied, using daily counts of deaths as outcome and heat wave as exposure. Results: Considering all natural causes, a stronger effect of heat waves on mortality for females with respect to males was found in the age group of 65 to 74 years in all cities except London and Valencia. The percent increase of mortality among males varied between 4.2 in Barcelona and 20.9 in Rome, whereas for females the percent increase ranged between 12.3 in Munich and 30.3 in Milan. In older ages, (75–84, 85+), the higher risk for females was also observed, even if the differences between genders were smaller. Results of the cause-specific analysis showed an increased risk for females for cardiovascular mortality, whereas for respiratory causes females were not always at higher risk. When the heat wave characteristics were taken into consideration the higher risk for females was confirmed. Conclusions: In conclusion, a stronger impact of heat waves on mortality was observed among females, even if no clear pattern between cities was identified. These findings underline the importance of including gender as potential effect modifier in the evaluation of heat-related mortality.

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