Temperature-induced excess mortality in Moscow, Russia.

After considering the observed long-term trends in average monthly temperatures distribution in Moscow, the authors evaluated how acute mortality responded to changes in daily average, minimum and maximum temperatures throughout the year, and identified vulnerable population groups, by age and causes of death. A plot of the basic mortality-temperature relationship indicated that this relationship was V-shaped with the minimum around 18 degrees C. Each 1 degree C increment of average daily temperature above 18 degrees C resulted in an increase in deaths from all non-accidental causes by 2.8%, from coronary heart disease by 2.7%, from cerebrovascular diseases by 4.7%, and from respiratory diseases by 8.7%, with a lag of 0 or 1 day. Each 1 degrees C drop of average daily temperature from +18 degrees C to -10 degrees C resulted in an increase in deaths from all non-accidental causes by 0.49%, from coronary heart disease by 0.57%, from cerebrovascular diseases by 0.78%, and from respiratory diseases by 1.5%, with lags of maximum association varying from 3 days for non-accidental mortality to 6 days for cerebrovascular mortality. In the age group 75+ years, corresponding risks were consistently higher by 13-30%. The authors also estimated the increase in non-accidental deaths against the variation of daily temperatures. For each 1 degrees C increase of variation of temperature throughout the day, mortality increased by 0.3-1.9%, depending on other assumptions of the model.