The estimated annual death rate in New York City based on data
collected during the week ending Friday, June 15, 1984, was 1,343
per
100,000 population, a 35% increase over the average rate for the
preceding 4 weeks (Figure 7). This was the highest mortality rate
recorded in New York City since January 1981 and was associated
with a
sudden and severe heat wave--mean daily temperatures* rose from
21.1 C
(70 F) in the preceding week to 28.9 C (84 F). The greatest
increase
was for persons aged 75 years and over, among whom the death rate
increased 47%. The death rate for elderly women increased more
than
for elderly men (Figure 8). Among those aged 75-84 years, death
rates
rose 39% for men, compared with 66% for women; among those over 85
years old, increases were 13% for men and 55% for women.
The increased number of deaths was almost exclusively among
nonhospitalized persons living at home (Table 4). Among persons 65
years or older, there was a 150% increase in the number of deaths
occurring at home. There were only small changes in the number of
deaths occurring in hospitals or nursing homes.
These data suggest that the noninstitutionalized elderly,
particularly women, are at highest risk of heat-associated death.
Programs are needed to protect this relatively small but sensitive
group during prolonged or severe heat.
Reported by AR Kristal, DrPH, S Schultz, MD, DJ Sencer, MD, New
York
City Dept of Health; Special Studies Br, Chronic Diseases Div,
Center
for Environmental Health, CDC.
Editorial Note
Editorial Note: This report is consistent with previous
descriptions
of the dramatic increases in total mortality that may accompany
severe
heat. Health effects of heat are particularly prominent in urban
areas (1-6).
In previous episodes of this sort, physicians have attributed
only
10%-60% of the excess deaths directly to the heat, e.g., by a
diagnosis of heat stroke. Increases in deaths attributed to
cerebrovascular disease and ischemic heart disease have accounted
for
a large part of the remainder of the excess (1,4-6). Although heat
stress may aggravate underlying vascular disease, some deaths
attributed to these two causes may be misclassified heatstroke
deaths. The predominance of excess deaths among females described
in
this report was not seen on at least one other occasion when a
similar
analysis was done (7).
Prevention of heat-related illness in the general population
and
in persons occupationally exposed to high temperatures has been
recently discussed (8,9).
References
Jones TS, Liang AP, Kilbourne EM, et al. Morbidity and
mortality
associated with the July 1980 heat wave in St. Louis and Kansas
City, Missouri. J Am Med Assoc 1982;247:3327-31.
Applegate WB, Runyan JW Jr, Brasfield L, et al. Analysis of
the
1980 heat wave in Memphis. Journal of the American Geriatrics
Society 1981;29:337-42.
McFarlane A, Waller RE. Short term increases in mortality
during
heatwaves. Nature 1976;264:434-6.
Ellis FP. Mortality from heat illness and heat-aggravated
illness
in the United States. Env Res 1972;5:1-58.
Schuman SH, Anderson CP, Oliver JT. Epidemiology of successive
heat waves in Michigan in 1962 and 1963. J Am Med Assoc
1964;189:733-8.
Schuman SH. Patterns of urban heat-wave deaths and
implications
for prevention. Data from New York and St. Louis during July
1966.
Bridger CA, Ellis FP, Taylor HL. Mortality in St. Louis,
Missouri, during heat waves in 1936, 1953, 1954, 1955, and
1966.
Env Res 1976;12:38-48.
CDC. Illness and death due to environmental heat--Georgia and
St.
Louis, Missouri, 1983. MMWR 1984;33:325-6.
CDC. Fatalities from occupational heat exposure. MMWR
1984;33:410-2.
*The arithmetic mean of the highest and lowest recorded
temperatures.
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