Loading...
12 results
Search Results
Now showing 1 - 10 of 12
- Assessing the impact of poor housing conditions on human health in PortugalPublication . Vasconcelos, João; Freire, Elisabete; Almendra, Ricardo; Machado, João Reis; Santana, PaulaImprovement on the quality housing is fundamental for reducing thermal discomfort and thus exposure to cold and a better health. Morbidity and mortality has obviously a multivariable cause and one of them is the thermal discomfort in our homes where, as a sedentary being, we spend most of our daily life. A continuous exposure to cold surely debilitates our health and will lead to cardiovascular and respiratory diseases. Most of the Portuguese dwellings show a poor building quality. There are several origins for these deficiencies and with consequences at different levels, in particular, in terms of human comfort. In fact, Portugal is one of the southern European countries that have higher mortality in winter. However, the number of studies relating cold weather and morbidity/mortality is still very rare. These occurrences are suspected to be associated with housing quality especially thermal insulation. In order to assess the relation between the incidence of coronary events and housing, a national survey on patients with acute coronary syndromes in several regions of Portugal was realized during the winter months and data on the housing conditions and behavior attitudes against cold exposure were asked. A better knowledge about the influence of weather and climate on such ailment may be applied to built up a guide for housing design (to new and restorations of old dwellings), inpolicies and strategies for protection and adaptation, health planning, as well as alert systems in order to reduce the number of deaths by cardiovascular failure.
- Seasonal mortality patterns and regional contrasts in PortugalPublication . Almendra, Ricardo; Santana, Paula; Freire, Elisabete; Vasconcelos, JoãoThe main aim of this study is to identify the geographical seasonal mortality patterns in Portugal and, for the first time, to assess the relationship between seasonal and overall mortality. Monthly data from the Portuguese mortality database (2000-2009) by major cause of death were analysed and standardized to 30 days with adjustments for leap years. The chi-square goodness-of-fit test was used to compare the observed monthly deaths with deaths that could be expected if mortality were randomly distributed throughout the year. The seasonal burden was measured using the excess winter deaths (EWD) rate and the seasonal impact of winter on mortality was assessed through the EWD Index. The regions were clustered according to the overall mortality rate and the seasonal impact: 1–low seasonality and high values of overall mortality; 2–high seasonality and high values of overall mortality; 3–low values of seasonality and low overall mortality; 4–high seasonality and low overall mortality. Significant seasonal mortality increases were found in all causes of death. There were 86,000 EWDs, mostly through circulatory and respiratory diseases. 73% of the population lives in regions with high winter vulnerability to respiratory mortality and 60% in regions with high winter vulnerability to circulatory mortality. This study reinforces the idea that vulnerability to cold weather may play an important role in the public health in Portugal. This knowledge may be used to construct a set of regulations or policies designed to implement better health planning procedures and more effective warning systems.
- Seasonal mortality patterns due to diseases of the circulatory system in PortugalPublication . Almendra, Ricardo; Santana, Paula; Vasconcelos, João; Freire, ElisabeteExposure to cold weather has negative consequences on human health. Studies have been showing that the seasonality of mortality has an evident peak during winter months in European countries. However, the highest increases in mortality are registered in countries with mild winters. According to several studies winter deaths seem to be associated with low socioeconomic conditions. The main aims of this study are to identify the trends of mortality due to diseases of the circulatory system and excess winter deaths in Portugal and to assess the geographical pattern of seasonal mortality. In the 20 years under analyses, mortality due to diseases of the circulatory system increased 38% during winter months when compared to the non-winter period. Important regional disparities were found, the Excess Winter Death index ranged from 21% to 48%, the central regions tend to have better results. Our results indicate that although circulatory mortality is significantly decreasing in Portugal, the vulnerability to seasonal cold weather remains as an important public health issue. These findings suggest that the exposure to cold weather is an important determinant of cardiovascular diseases that is still neglected in Portugal.
- Can cold weather be a cardiovascular determinant in warm countries?Publication . Vasconcelos, J.; Freire, E.; Almendra, R.; Santana, P.In almost every temperate region of the world, the number of cardiovascular mortality increases significantly during winter months. This phenomenon has been considered as a public health issue in several countries as many of these deaths are considered to be avoidable. The cause for the excess of winter deaths can be attributed to a number of factors, such as diet, exercise and exposure to cold weather. Curiously, southern European countries, such as Portugal, seem to have the highest excess winter deaths that seem to be related to exposure of cold. However, very few studies have addressed this relationship in Portugal and no quantification of the role of cold weather on cardiovascular diseases has been published. The main goal of this study is to quantify the short effect of cold weather on the cardiovascular morbidity in Portugal Generalized additive Poisson regression models were used in order to obtain the influence of a thermal comfort index (PET) on daily hospitalizations for acute myocardial Infarction in the two most developed metropolitan areas of Portugal: Lisbon and Oporto. All models were adjusted for time and other environmental variables. Influenza was also considered as a confounder. The main results reveal an increase up to 2.2% (95% CI = 0,9%; 3,3%) of daily hospital admissions in winter per degree fall in PET. The increase in daily hospitalizations was greater for the entire population than when only the elderly (>65 years) were considered. View publication
- Human thermal discomfort and health in Portugal: a geographical assessmentPublication . Vasconcelos, J.; Freire, E.; Almendra, R.; Machado, J.R.; Santana, P.
- Padrões e sazonalidade do enfarte agudo do miocárdio em PortugalPublication . Almendra, Ricardo; Santana, Paula; Vasconcelos, João; Freire, ElisabeteApesar do decréscimo verificado nos últimos anos, a mortalidade por doença cardiovascular em Portugal continua a ser a principal causa de morte e de internamento hospitalar. Esta patologia apresenta uma forte sazonalidade, verificando-se a concentração de óbitos e de internamentos durante os meses de inverno. A análise dos padrões e da sazonalidade do enfarte agudo do miocárdio possibilita a reconhecimento de populações em risco e a identificação de situações em que é necessário intervir. Foi observada uma distribuição espacial contrastada no risco de internamento durante os meses de inverno, tendo sido identificado o sul e o interior do país como áreas onde o problema é mais evidente.
- Excess winter mortality patterns and regional differences in PortugalPublication . Freire, Elisabete; Santana, Paula; Almendra, Ricardo; Vasconcelos, JoãoThe mortality fluctuation over the year is associated with increases in both the warm and cold seasons. Portugal is often described as the European country with highest excess winter mortality. The main aim of this study is to identify the seasonal patterns of mortality within Portugal and to assess their geography. The chi-square goodness of fit test was used to identify the existence of a significant seasonal increase in mortality by cause of death. The number of excess winter deaths and the excess winter death index were calculated to measure the winter death toll. The main results shown important seasonal mortality increases in almost all causes of death, the mortality due to cardiovascular and respiratory diseases are the main responsible for the winter burden. The number of excess winter death is related to the overall incidence of the disease and their determinants, but the seasonal increase is related to other socioeconomic and behavior factors.
- Excesso de mortalidade no inverno nos países da Europa mediterrâneaPublication . Almendra, Ricardo; Freire, Elisabete; Vasconcelos, João Viljoen de; Santana, PaulaO objetivo deste estudo é identificar e analisar a evolução da incidência da doença cerebrovascular e da doença isquémica cardíaca, e os padrões do excesso de mortalidade no Inverno em quatro países da Europa mediterrânea: Portugal, Espanha, Itália e Grécia. Apesar da mortalidade por doença cardiovascular estar a diminuir a sua sazonalidade é evidente nos países mediterrâneos, onde, apesar de invernos amenos, o excesso de mortes associadas ao frio é mais importante. Portugal apresenta as taxas mais elevadas, e em vários anos regista resultados piores que a média do Mediterrâneo.
- Mortalidade sazonal em PortugalPublication . Almendra, Ricardo; Santana, Paula; Freire, Elisabete; Vasconcelos, JoãoO principal objetivo deste estudo é analisar os padrões geográficos da mortalidade sazonal em Portugal, para tal serão identificadas as causas de morte com maior componente sazonal e os territórios mais vulneráveis. Utilizou-se o chi-square goodness of fit teste para comparar o número de óbitos mensais observados com os esperados (considerando que a mortalidade se encontraria distribuída de forma homogénea ao longo do ano) e identificar a existência de aumentos sazonais estatisticamente significativos. Estimou-se o número de óbitos em excesso no inverno comparando o número de óbitos verificados nos meses de inverno (Dezembro a Março) com a média dos registados no período não-inverno (de Agosto a Novembro e de Abril a Julho). O impacte sazonal das causas de morte foi analisado através do índice de excesso de óbitos no inverno, e dos seus intervalos de confiança; este índice indica o aumento percentual do número de óbitos durante o inverno, comparando-o com o que se verifica no período não-inverno. As regiões foram classificadas em quatro classes conforme sejam territórios com: elevada mortalidade geral e elevada mortalidade sazonal; baixa mortalidade geral e elevada mortalidade sazonal; elevada mortalidade geral e baixa mortalidade sazonal; baixa mortalidade geral e baixa mortalidade sazonal. Verificaram-se importantes aumentos sazonais no inverno em quase todas as causas de morte, sendo as doenças do sistema respiratório e circulatório as principais responsáveis por este aumento. O número de óbitos em excesso encontra-se estreitamente relacionado com a mortalidade geral e os seus determinantes, mas o aumento sazonal da mortalidade poderá encontrar-se relacionado com outros determinantes socioeconómicos ou com fatores comportamentais. Estes resultados revelam que as condições meteorológicas influenciam a saúde, mas que não têm o mesmo impacte em todos os grupos populacionais.
- The impact of winter cold weather on acute myocardial infarctions in PortugalPublication . Vasconcelos, João; Freire, Elisabete; Almendra, Ricardo; Silva, Giovani L.; Santana, PaulaMortality due to cardiovascular diseases shows a seasonal trend that can be associated with cold weather. Portugal is the European country with the highest excess winter mortality, but nevertheless, the relationship between cold weather and health is yet to be assessed. The main aim of this study is to identify the contribution of cold weather to cardiovascular diseases within Portugal. Poisson regression analysis based on generalized additive models was applied to estimate the influence of a human-biometeorological index (PET) on daily hospitalizations for myocardial infarction. The main results revealed a negative effect of cold weather on acute myocardial infarctions in Portugal. For every degree fall in PET during winter, there was an increase of up to 2.2% (95% CI ¼ 0.9%; 3.3%) in daily hospital admissions. This paper shows the need for public policies that will help minimize or, indeed, prevent exposure to cold.