Has there been a decrease in mortality due to heat waves in Spain? Findings from a multicity case study

Abstract

Since the heat wave that took place in the summer of 2003, many heat wave prevention plans have been implemented in Europe but very few have been evaluated from the point of view of reducing mortality. In Spain, the Ministry of Health implemented the National Plan for Preventive Actions against the Health Effects of Excess Temperatures in 2004. Using the definition of heat wave threshold temperature based on the 95th percentile of the daily maximum temperature in the summer months, we fitted ARIMA models for attributable mortality due to natural causes (ICD-10:A00-R99), for each year from 1991 to 2008, for each provincial capital city in Castile-La Mancha. The impact on mortality for each degree Celsius was compared with the results before and after implementation of the 2004 Plan. The results indicate that, although a significant decrease in heat-related mortality was observed in some provinces, in others this decrease was not significant. Heat waves having a lower Heat Wave Index, which occurred after 2004, had a higher impact on daily mortality than did those, which occurred before this date. Hence, it cannot be concluded that the observed decrease in mortality is due to the implementation of the prevention plans.

Heat-health action plans in Europe: Challenges ahead and how to tackle them

“…In the city of Madrid, the implementation of a HHAP did not seem to decrease heat-related mortality in the 2005 heat wave, less intense than that of 2003 but deadlier on the basis of mortality increase per 1ºC hike in temperature (Culqui et al, 2014). Moreover, other studies show that the decrease in heat-related mortality in Spain cannot be consistently attributed to prevention plans and that it varies spatially (Linares et al, 2015).…”

Temporal trends in human vulnerability to excessive heat

“…Li et al (2017) Heat-effect has increased with higher respiratory-related deaths in the most recent time period om Ningbo, China. Linares et al (2015) In Spain, a significant decrease in heat-related mortality was observed in some locations while others did not show any change. Marmor (1975) Excess mortality during first summer heatwave may have decreased in New York City but no trend is observed for later season events, using 1949-1971 data.…”

“…Several studies have confirmed a decrease in heatrelated mortality in Italy following implementation of a heat warning system after 2003 (Michelozzi et al 2006, Morabito et al 2012, Schifano et al 2012, similar to Ebi et al (2004) for Philadelphia, USA. Linares et al (2015), however, note that the decrease in mortality in Spain following implementation of a heat warning system in 2004 was inconclusive and varied spatially. draws attention to the need to monitor and review such systems.…”

Spatial variability in threshold temperatures of heat wave mortality: impact assessment on prevention plans

“…Since the first heat wave prevention plans were implemented in Europe in 2004 (Matthies et al 2008;WHO 2009aWHO , 2009bWHO , 2011, these have been the subject of different evaluations and improvements aimed at minimising the impact of high temperatures on health (Fouillet et al 2008;Lowe et al 2011;Kovats and Bickler 2012;Culqui et al 2014;Bittner et al 2014;Linares, Sánchez, et al 2015).…”