91b8e24877b3925c414ebeab433277a6 pmc_32276439.pdf 19e83f80155a5c0c2ceec9d0aae2ff63158d304c pmc_32276439.pdf 3481f39adfdba5325ad9e231444741421bb4a5d30d8f98e56297cb5153ad25a4 pmc_32276439.pdf Title: Spatial Variability of Heat-Related Mortality in Barcelona from 1992–2015: A Case Crossover Study Design Subject: Numerous studies have demonstrated the relationship between summer temperatures and increased heat-related deaths. Epidemiological analyses of the health effects of climate exposures usually rely on observations from the nearest weather station to assess exposure-response associations for geographically diverse populations. Urban climate models provide high-resolution spatial data that may potentially improve exposure estimates, but to date, they have not been extensively applied in epidemiological research. We investigated temperature-mortality relationships in the city of Barcelona, and whether estimates vary among districts. We considered georeferenced individual (natural) mortality data during the summer months (June–September) for the period 1992–2015. We extracted daily summer mean temperatures from a 100-m resolution simulation of the urban climate model (UrbClim). Summer hot days (above percentile 70) and reference (below percentile 30) temperatures were compared by using a conditional logistic regression model in a case crossover study design applied to all districts of Barcelona. Relative Risks (RR), and 95% Confidence Intervals (CI), of all-cause (natural) mortality and summer temperature were calculated for several population subgroups (age, sex and education level by districts). Hot days were associated with an increased risk of death (RR = 1.13; 95% CI = 1.10–1.16) and were significant in all population subgroups compared to the non-hot days. The risk ratio was higher among women (RR = 1.16; 95% CI= 1.12–1.21) and the elderly (RR = 1.18; 95% CI = 1.13–1.22). Individuals with primary education had similar risk (RR = 1.13; 95% CI = 1.08–1.18) than those without education (RR = 1.10; 95% CI= 1.05–1.15). Moreover, 6 out of 10 districts showed statistically significant associations, varying the risk ratio between 1.12 (95% CI = 1.03–1.21) in Sants-Montjuïc and 1.25 (95% CI = 1.14–1.38) in Sant Andreu. Findings identified vulnerable districts and suggested new insights to public health policy makers on how to develop district-specific strategies to reduce risks. Keywords: heat-related mortality; UrbClim; spatial analysis; urban heat island effect; summer extreme heat Author: Vijendra Ingole, Marc Marí-Dell’Olmo, Anna Deluca, Marcos Quijal, Carme Borrell, Maica Rodríguez-Sanz, Hicham Achebak, Dirk Lauwaet, Joan Gilabert, Peninah Murage, Shakoor Hajat, Xavier Basagaña and Joan Ballester Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Wed Apr 8 14:35:47 2020 CEST ModDate: Wed Apr 8 14:35:47 2020 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1911545 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JJXFKR+URWPalladioL-Ital Type 1 Custom yes yes no 93 0 JAUGMS+URWPalladioL-Bold Type 1 Custom yes yes no 94 0 WLENKM+VnURWPalladioL-Bold Type 1 Custom yes 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ABCDEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 276 0 ABCDEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 277 0 TimesNewRomanPSMT TrueType WinAnsi no no no 278 0 ABCDEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 279 0 ABCDEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 302 0 ABCDEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 303 0 ABCDEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 304 0 TimesNewRomanPSMT TrueType WinAnsi no no no 305 0 ABCDEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 306 0 ABCDEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 350 0 ABCDEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 351 0 ABCDEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 352 0 TimesNewRomanPSMT TrueType WinAnsi no no no 353 0 ABCDEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 354 0 VSHNAE+Rpcxr Type 1 Builtin yes yes no 491 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 04:12:17 CEST 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ごとづ〠こばちぴどちぬ〠いどびぴひどぢふぴどはの〠はて〠えづちぴ〭げづぬちぴづつ〠きはひぴちぬどぴべ〠ぢべ〠いどびぴひどっぴ〠 Item: Title: ごとづ〠こばちぴどちぬ〠いどびぴひどぢふぴどはの〠はて〠えづちぴ〭げづぬちぴづつ〠きはひぴちぬどぴべ〠げづびふぬぴび〠こぴひちぴどてどづつ〠ぢべ〠ぁでづ〬〠こづへ〠ちのつ〠ぅつふっちぴどはの〠 Item: Title: いどびっふびびどはの〠 Children: Item: Title: こふねねちひべ〠はて〠きちどの〠げづびふぬぴび〠 Item: Title: こばちぴどちぬ〠いどててづひづのっづび〠ぢべ〠ぁでづ〬〠こづへ〠ちのつ〠ぅつふっちぴどはの〠 Item: Title: こはっどは〭ぅっはのはねどっ〠ちのつ〠あふどぬぴ〠ぅのぶどひはのねづのぴちぬ〠うちっぴはひび〠 Item: Title: こぴひづのでぴとび〠ちのつ〠がどねどぴちぴどはのび〠 Item: Title: ぃはのっぬふびどはのび〠 Item: Title: げづてづひづのっづび Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: MWCXBX+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 241 FontDescriptor: FontName: MWCXBX+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: WOTZAR+VnURWPalladioL FontSubset: true FirstChar: 157 LastChar: 243 FontDescriptor: FontName: WOTZAR+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: 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