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In general, there are few studies that analyse the impact of low temperatures on mortality, and even fewer that extend this analysis to specific causes of mortality. This study had a twofold aim: Firstly, to analyse the trend in natural-, circulatory- and respiratory-cause mortality associated with cold waves in Castile-La Mancha (Spain) across a period of analysis of 34 years, which would confer an important degree of temporal representativeness on the results obtained; and secondly, to ascertain whether this impact had decreased over the years. Time series analysis using multivariate ARIMA models with data on daily natural-, circulatory- and respiratory-cause mortality in Castile-La Mancha. The independent variables were minimum daily temperature, mean daily pressure and mean daily relative humidity. We controlled for seasonalities and trend of the series, as well as influenza epidemics, cold-wave duration and chronological number in any given year. Data were stratified in three ten-year stages, i.e., 1975-1985, 1986-1996 and 1997-2008. The mortality trigger temperature was set at a minimum daily temperature of −2 °C, corresponding to the 4th ‰ of the minimum temperature series for the winter months considered. The impact on daily natural-cause mortality for each degree that the minimum daily temperature was below −2 °C was: 10.4 % (95 % CI 9.6-11.2) in the first decade; 11.9 % (95 % CI 11.0-12.8) in the second decade; and fell to 1.6 % (95 % CI 0.9-2.3) in the third. This same pattern was observed for circulatory- and respiratory-cause mortality, with the effect of cold being greater for respiratory causes. Socio-economic factors -both of adaptation and demographic- could account for this sharp decrease in mortality associated with low temperatures. These results question climate models which predict the effects of cold over long-term time horizons, while maintaining the risk attributable to low temperatures constant. Studies similar to ours should be undertaken in other regions to confirm whether it is solely local characteristics that explain this pattern or, on the contrary, whether the pattern is generalised. [ABSTRACT FROM AUTHOR]

Few studies have analysed the impact of heat and cold waves on mortality in a given population over the same time period and still fewer studies have analysed this impact in terms of cause-specific mortality. This study analysed the impact of both heat and cold waves on daily all-cause, circulatory-cause and respiratory-cause mortality in the region of Castile-La Mancha (CLM) 1975-2008. The dependent variable was daily all-, circulatory- and respiratory-cause mortality registered in CLM from 01-01-75 to 31-12-08, and the independent variables were maximum, minimum, mean daily temperature daily relative humidity and mean daily air pressure and other related variables, such as heat-wave duration, heat-wave number and pressure trend. Time-series analyses were performed using autoregressive integrated moving average models. The impact of heat on daily mortality was greater than that of cold, with a difference which proved statistically significant for all- and circulatory-cause mortality but not for respiratory-cause mortality. While 16.5 % CI 95 % (15.5-17.4) of summer mortality in CLM was attributable to heat, 12.9 % CI 95 % (12.2-13.8) of daily winter mortality was attributable to low temperatures. The variable, heat-wave duration, was of major importance in all-cause and respiratory-cause mortality, with wave persistence being related to a mean 3.5 % increase in daily organic-cause mortality. Although heat waves have a greater impact on daily mortality than do cold waves, the fact that there were more cold-wave than heat-wave days during the period analysed, coupled with the diseases implicated, means that specific prevention plans should be implemented for both extreme thermal events. [ABSTRACT FROM AUTHOR]

Approximately, 20 % of particulate and aerosol emissions into the urban atmosphere are of natural origin (including wildfires and Saharan dust). During these natural episodes, PM and PM levels usually exceed World Health Organisation (WHO) health protection thresholds. This study sought to evaluate the possible effect of advections of particulate matter from biomass fuel combustion on daily specific-cause mortality among the general population and the segment aged ≥75 years in Madrid. Ecological time-series study in the city of Madrid from January 01, 2004 to December 31, 2009. The dependent variable analysed was daily mortality due to natural (ICD-10:A00-R99), circulatory (ICD-10:I00-I99), and respiratory (ICD-10:J00-J99) causes in the population, both general and aged ≥75 years. The following independent and control variables were considered: a) daily mean PM and PM concentrations; b) maximum daily temperature; c) daily mean O and NO concentrations; d) advection of particulate matter from biomass combustion (), using a dichotomous variable and e) linear trend and seasonalities. We conducted a descriptive analysis, performed a test of means and, to ascertain relative risk, fitted a model using autoregressive Poisson regression and stratifying by days with and without biomass advection, in both populations. Of the 2192 days analysed, biomass advection occurred on 56, with mean PM and PM values registering a significant increase during these days. PM had a greater impact on organic mortality with advection (RRall ages = 1.035 [1.011-1.060]; RR ≥ 75 years = 1.066 [1.031-1.103]) than did PM without advection (RRall ages = 1.017 [1.009-1.025]; RR ≥ 75 years = 1.012 [1.003-1.022]). Among specific causes, respiratory-though not circulatory-causes were associated with PM on days with advection in ≥75 year age group. PM, rather than PM, were associated with an increase in natural cause mortality on days with advection of particulate matter from biomass combustion, particularly in the ≥75 year age group. [ABSTRACT FROM AUTHOR]