Temperature and Mortality in Nine US Cities

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Background:Extreme temperatures have been associated with increased mortality worldwide. The extent to which air pollutants may confound or modify this association remains unclear.Methods:We examined the association between mean apparent temperature and total mortality in 9 cities across the United States during the warm season (May to September) from 1999 to 2002. We applied case-crossover and time-series analyses, adjusting for day of the week and season in time-series analysis. City-specific estimates were then combined using a meta-analysis. A total of 213,438 deaths for all causes occurred in these cities during the study period.Results:We found that mortality increased with apparent temperature. A 5.5°C (10°F) increase in apparent temperature was associated with an increase in mortality of 1.8% (95% confidence interval = 1.09% to 2.5%) when using case-crossover analysis and with an increase of 2.7% (2.0% to 3.5%) using the time-series analysis.Conclusions:This study provides evidence of increased mortality due to elevated apparent temperature exposure, with no confounding or effect modification due to air pollution.

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