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Use of “Cold Spell” indices to quantify excess chronic obstructive pulmonary disease (COPD) morbidity during winter (November to March 2000–2007): case study in Porto

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Abstract

The aim of this study was to examine the relationship between the occurrence of cold episodes and excess hospital admissions for chronic obstructive pulmonary disease (COPD) in Porto, Portugal, in order to further understand the effects of cold weather on health in milder climates. Excess COPD winter morbidity was calculated from admissions for November to March (2000–2007) in the Greater Porto Metropolitan Area (GPMA). Cold spells were identified using several indices (Díaz, World Meteorological Organization, Cold Spell Duration Index, Australian Index and Ondas’ Project Index) for the same period. Excess admissions in the periods before and after the occurrence of cold spells were calculated and related to the cold spells identified. The COPD seasonal variation admission coefficient (CVSA) showed excess winter admissions of 59 %, relative to other months. The effect of cold spell on the aggravation of COPD occurs with a lag of at least 2 weeks and differs according to the index used. This study indicates the important role of the persistence of cold periods of at least 2 weeks duration in the increase in COPD admissions. The persistence of moderate temperatures (Tmin ≤5 °C) for a week can be more significant for increasing COPD admissions than very low temperatures (Tmin ≤ 1.6 °C) for just a few days. The Ondas projects’ index provides the most accurate detection of the negative impacts of cold persistency on health, while the Diaz index is better at evaluating the consequences of short extreme cold events.

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Notes

  1. Ondas’s Project (PTDC/SAU-ESA/73016/2006) is a research project funded by the National Foundation for Science and Technology (FCT) and by EU FEDER grants through the COMPETE Programme that studies the risks for the human health caused by cold spells and heat waves at the Greater Porto Metropolitan Area (GPMA) at Portugal from 2000 to 2007. The research done analyzed the daily mortality and morbidity excess in comparison with the socio economic, demographic, environmental and climatic context of the individuals that died or that were admitted to the four main public hospitals. The main milestones of this project are the climatic risk maps and the vulnerability maps for a list of selected diseases.

  2. Ordinance nr. 110-A/2007 of 23 January in Republic Diary, 1st series, nr 16—January 23th 2007.

  3. From the total admissions in the 8 years studied, the period from November to March represents 42 % (349,527 out of 825,395), for COPD, the percentage is 53 % (3,310 out of 6,218).

  4. In once case there was a delay of at least 15 days in the impacts on health caused by cold spells; also, to include December 2007 we need to have data from January 2008, which is not available.

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Acknowledgments

We wish to thank Dr. Fátima Candoso (Health System Central Administration—ACSS) and Dr. Fernando Lopes (São João Hospital—SJH) for support. This work is supported by FEDER grants throught COMPETE (Programa Operacional Factores de Competitividade) and nationally throught the FCT (Fundação para a Ciência e Tecnologia) namely via the Project PTDC/SAU-ESA/73016/2006 “The risks to human health caused by heat waves and cold spells in Porto”.

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Authors and Affiliations

  1. ISPUP (Institute of Public Health from the University of Porto), CITTA, Department of Geography, University of Porto, Project FCT PTDC/SAU‐ESA/73016/2006, Via Panorâmica s/n, 4050-564, Porto, Portugal

    Ana Monteiro

  2. ISPUP (Institute of Public Health from the University of Porto), Faculty of Medicine, University of Porto, Project FCT PTDC/SAU‐ESA/73016/2006, Rua das Taipas 135, 4050-600, Porto, Portugal

    Vânia Carvalho & Carlos Sousa

  3. ISPUP (Institute of Public Health from the University of Porto), CIGAR, Faculty of Engineering, University of Porto, Project FCT PTDC/SAU‐ESA/73016/2006, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal

    Joaquim Góis

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  1. Ana Monteiro
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Monteiro, A., Carvalho, V., Góis, J. et al. Use of “Cold Spell” indices to quantify excess chronic obstructive pulmonary disease (COPD) morbidity during winter (November to March 2000–2007): case study in Porto. Int J Biometeorol 57, 857–870 (2013). https://doi.org/10.1007/s00484-012-0613-z

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