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Background Seasonal variations in mortality resulting from cardiovascular diseases (CVD) have been demonstrated in many countries, with the highest levels observed during the coldest months of the year. We studied the seasonal changes in CVD mortality in Norway and the Republic of Ireland, two countries which are demographically quite similar, but climatically different; we also examined the relation between CVD mortality and air temperature.Methods Registered monthly data for mortality from CVD for the period 1985-1 995 were obtained from the Norwegian Central Bureau of Statistics and the Irish Central Statistics Office. Meteorological data were provided by the Norwegian Institute of Meteorology and Met Eireann, in Ireland. Monthly mortality ratio for both men and women aged 60 and older was calculated from the mortality date. Mean monthly air temperatures for the two countries were calculated from the meteorological data. ResultsFor the 1 0-year period investigated, the lowest and highest monthly mortality ratios were on average found in August and January, respectively, and mean excess winter mortality, expressed as the difference between the August and January values for the entire 1 0-year period, was 22% (Norway) and 35% (Ireland). However, when the percentage difference in the months with the respective highest and lowest mortality ratios were calculated for each year, the average of these differences for each of the 10 individual years was 29% and 45%. Mortality ratio was found to increase much more steeply with decreasing air temperature in Ireland than in Norway. ConclusionAlthough the seasonal variation between CVD mortality in both countries is similar, the different relation with climatic conditions may result from differences in housing standards, allowing outdoor temperatures to have a greater influence on indoor temperature in Ireland than in Norway.

Background Seasonal variations in mortality due to cardiovascular disease have been demonstrated in many countries, with the highest levels occurring during the coldest months of the year. It has been suggested that this can be explained by cold climate. In this study, we examined the relationship between mortality and two different climatic factors in two densely populated areas (Dublin, Ireland and Oslol Akershus, Norway).Methods Meteorological data (mean daily air temperatures and wind speed) and registered daily mortality data for three groups of cardiovascular disease for the period 1985-1994 were obtained for the two respective areas. The daily mortality ratio for both men and women of 60 years and older was calculated from the mortality data. The wind chill temperature equivalent was calculated from the Siple and Passels formula. ResultsThe seasonal variations in mortality were greater in Dublin than in Oslo I Akershus, with mortality being highest in winter. This pattern was similar to that previously shown f~r the two respective countries as a whole. There was a negative correlation between mortality and both air temperature and wind chill temperature equivalent for all three groups of diseases. The slopes of the linear regression lines describing the relationship between mortality and air temperature were a lot steeper for the Irish data than for the Norwegian data. However, the difference between the steepness of the linear regression lines for the relationship between mortality and wind chill temperature equivalent was considerably less between the two areas. This can be explained by the fact that Dublin is a much windier area than Oslo I Akershus. ConclusionThe results of this study demonstrate that the inclusion of two climatic factors rather than just one changes the impression of the relationship between climate and cardiovascular disease mortality. J Cardiovasc Risk 7:369-375

Boccella, E. (1987). Effects of the Active Parenting program on attitudinal change of parents, parent perceived behavioral change of children, and parent perceived change in family environment. Doctoral dissertation, Temple University.

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