Effectiveness of the spanish plan to prevent the health effects of high temperatures

• Autores: Érica Martínez Solanas
• Directores de la Tesis: Xavier Basagaña (dir. tes.)
• Lectura: En la Universitat Pompeu Fabra ( España ) en 2019
• Idioma: español
• Tribunal Calificador de la Tesis: Jordi Sunyer i Deu (presid.), Joan Ballester Claramunt (secret.), Gregory A. Wellenius (voc.)
• Programa de doctorado: Programa de Doctorado en Biomedicina por la Universidad Pompeu Fabra
• Materias:
  • Ciencias médicas
    • Epidemiología
    • Salud publica
• Enlaces
  • Tesis en acceso abierto en: TDX
• Resumen

  • Exposure to ambient temperatures has been widely described as an important health hazard. The most studied effect of temperatures is an increase on mortality; however, there is less evidence on other health impacts. In response to climate change and associated extreme events, public health adaptation has become imperative. The Spanish Government implemented in 2004 a heat health prevention plan (HHPP). This thesis aimed to evaluate the effectiveness of the Spanish HHPP in terms of reductions in mortality and cause-specific hospitalizations, and to assess the effects of weather factors on gastroenteritis and on occupational injuries. Daily maximum and average temperature, and daily precipitation in each capital of province were used as exposure measures. Daily counts of deaths, hospitalizations for cardiovascular, cerebrovascular and respiratory diseases, hospitalizations for infectious gastroenteritis and occupational injuries registered in Spain were included as health outcomes. Our results suggested that the implementation of the HHPP has reduced extreme heat-related mortality and respiratory admissions. By contrast, an increment of moderate heat-related mortality was observed. We also found that the effects of cold temperatures on mortality and respiratory admissions experienced a decrease in the second period, although this was not observed for cardiovascular and cerebrovascular admissions. Cold and heat were also associated with higher risk of gastroenteritis admissions and occupational injuries. An important economic impact of working at non-optimum temperatures has been estimated in this thesis. We observed a protective effect of heavy precipitation on gastroenteritis admissions. This thesis showed some improvements on health outcomes after the implementation of the HHPP. Nonetheless, ambient temperatures still have an important role in increasing health hazards. Public health prevention measures should consider all range of temperatures as well as target specific actions for some vulnerable groups, such as workers or children.