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Background: Hypothermia can result from exposure to cold or as a consequence of underlying physiologic vulnerabilities. Who, where, when and how British Columbians (and Canadians) die of hypothermia have received little research attention. The objective of this study was to describe the epidemiology of mortality due to hypothermia among residents of British Columbia. Methods: We examined all records in the death registry of the British Columbia Vital Statistics Agency between 1998 and 2012 that had an underlying or contributing cause of death coded for hypothermia or exposure to excessive natural cold. Results: Hypothermia or exposure to excessive natural cold was found to be the underlying or contributing cause in 384 deaths between 1998 and 2012. Mean age of decedents was 52 (SD 20.78) years and 73.2% were male. The annual death rate for hypothermia increased with age, ranging from 0.3 per 100 000 population among people aged 1-34 years to 1.6 per 100 000 population among those older than 75 years of age. The highest annual death rate occurred among older males (2.1 per 100 000 population) followed by older females (1.3 per 100 000 population). Although hypothermia-related deaths occurred year-round, 45.9% occurred during winter months (December, January and February) and, in particular, on days with lower temperatures (mean 0.56°C). Use of alcohol (40.1%) and other psychoactive substances (22.7%) were the most common additional causes of death identified among deaths due to hypothermia. Areas of British Columbia with the lowest population density or lowest socioeconomic status were found to have the highest crude hypothermia-related mortality rates. Interpretation: Our results showed that older people are at higher risk of hypothermia-related death. Among residents of British Columbia who died of hypothermia, the most frequent additional causes of death were alcohol and nonalcohol psychoactive substances. However, further assessment of both the occurrence and determinants of mortality due to hypothermia are needed to inform measures to reduce its impact. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of mortality and morbidity from carbon monoxide poisoning in Canada has received little attention. Our objective was to evaluate trends in mortality and hospital admission rates for unintentional nonfire-related carbon monoxide poisoning across Canada. Methods: Age- and sex-standardized mortality (1981-2009) and hospital admission (1995-2010) rates by age group, sex and site of carbon monoxide exposure were calculated for each province and for all of Canada. We quantified the long-term trends by calculating the average annual percent change. Multivariable Poisson regression was used to estimate incidence rate ratios (IRRs) of carbon monoxide poisoning across age groups, sex and month of occurrence. Results: In Canada, there were 1808 unintentional nonfire-related carbon monoxide poisoning deaths between 1981 and 2009 and 1984 admissions to hospital between 1995 and 2010. Average annual decreases of 3.46% (95% confidence interval [CI] -4.59% to -2.31%) and 5.83% (95% CI -7.79% to -3.83%) were observed for mortality and hospital admission rates, respectively. Mortality (IRR 5.31, 95% CI 4.57 to 6.17) and hospital admission (IRR 2.77, 95% CI 2.51 to 3.03) rates were elevated in males compared with females. Decreased trends in the rates were observed for all sites of carbon monoxide exposure, but the magnitude of this decrease was lowest in residential environments. Deaths and admissions to hospital were most frequent from September to April, with peaks in December and January. Interpretation: Mortality and hospital admission rates for unintentional nonfire-related carbon monoxide poisoning in Canada have declined steadily. Continued efforts should focus on reducing carbon monoxide poisoning during the cooler months and in residential environments. [ABSTRACT FROM AUTHOR]

Background: Persons exposed to residential traffic have increased rates of respiratory morbidity and mortality. As poverty is an important determinant of ill health, some have argued that these associations may relate to the lower socioeconomic status of those living along major roads. Aims: The objective was to evaluate the association between traffic intensity at home and hospital admissions for respiratory disease among Montreal residents of 60 years and older. Methods: Case hospitalisations were those with respiratory diagnoses and control hospitalisations were those where the primary discharge diagnosis was non-respiratory. Morning peak traffic estimates from the EMME/2 Montreal traffic model (MOTREM98) were used as an indicator of exposure to road traffic outside the homes of those hospitalised. The crude association between traffic intensity and hospitalisation for respiratory disease was adjusted by an area based estimate of the appraised value of patients' residences, expressed as a dollar average over a small segment of road (lodging value). This indicator of socioeconomic status, as calculated from the Montreal property assessment database, is available at a finer geographical scale than the neighbourhood socioeconomic indicators accessible from the Canadian census. Results: Increased odds of being hospitalised for a respiratory compared with a control diagnosis were associated with higher levels of estimated road traffic nearby patients' homes, even after adjustment for lodging value (crude OR 1.35, C195% 1.22 to 1.49; adjusted OR 1.18, C195% 1.06 to 1.31 for >3160 vehicles passing during the three hour morning traffic peak compared with secondary roads off network). Conclusion: The results suggest that road traffic intensity itself, may affect the respiratory health of elderly residents of a large Canadian city, an association that is not solely a reflection of socioeconomic status. [ABSTRACT FROM AUTHOR]