Next Article in Journal
Dust and Cobalt Levels in the Austrian Tungsten Industry: Workplace and Human Biomonitoring Data
Previous Article in Journal
Psychometric Properties and Clinical Usefulness of the Youth Self-Report DSM-Oriented Scales: A Field Study among Detained Male Adolescents
Article Menu

Export Article

Open AccessArticle
Int. J. Environ. Res. Public Health 2016, 13(9), 933;

Impact of Heat Wave Definitions on the Added Effect of Heat Waves on Cardiovascular Mortality in Beijing, China

Department of Occupational and Environmental Health, School of Public Health, Peking University, No. 38, Xueyuan Rd, Haidian District, Beijing 100191, China
Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
Department of psychology, DePauw University, 408 South Locust Street, Greencastle, IN 46135, USA
Author to whom correspondence should be addressed.
Academic Editor: Kim Natasha Dirks
Received: 14 July 2016 / Revised: 30 August 2016 / Accepted: 4 September 2016 / Published: 21 September 2016
Full-Text   |   PDF [846 KB, uploaded 21 September 2016]   |  


Heat waves are associated with increased mortality, however, few studies have examined the added effect of heat waves. Moreover, there is limited evidence for the influence of different heat wave definitions (HWs) on cardiovascular mortality in Beijing, the capital of China. The aim of this study was to find the best HW definitions for cardiovascular mortality, and we examined the effect modification by an individual characteristic on cardiovascular mortality in Beijing, a typical northern city in China. We applied a Poisson generalized additive approach to estimate the differences in cardiovascular mortality during heat waves (using 12 HWs) compared with non-heat-wave days in Beijing from 2006 to 2009. We also validated the model fit by checking the residuals to ensure that the autocorrelation was successfully removed. In addition, the effect modifications by individual characteristics were explored in different HWs. Our results showed that the associations between heat waves and cardiovascular mortality differed from different HWs. HWs using the 93th percentile of the daily average temperature (27.7 °C) and a duration ≥5 days had the greatest risk, with an increase of 18% (95% confidence interval (CI): 6%, 31%) in the overall population, 24% (95% CI: 10%, 39%) in an older group (ages ≥65 years), and 22% (95% CI: 3%, 44%) in a female group. The added effect of heat waves was apparent after 5 consecutive heat wave days for the overall population and the older group. Females and the elderly were at higher risk than males and younger subjects (ages <65 years). Our findings suggest that heat wave definitions play a significant role in the relationship between heat wave and cardiovascular mortality. Using a suitable definition may have implications for designing local heat early warning systems and protecting the susceptible populations during heat waves. View Full-Text
Keywords: heat waves; added effect; different definitions; cardiovascular mortality; modification heat waves; added effect; different definitions; cardiovascular mortality; modification

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Supplementary material


Share & Cite This Article

MDPI and ACS Style

Dong, W.; Zeng, Q.; Ma, Y.; Li, G.; Pan, X. Impact of Heat Wave Definitions on the Added Effect of Heat Waves on Cardiovascular Mortality in Beijing, China. Int. J. Environ. Res. Public Health 2016, 13, 933.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top