Risco de mortalidade durante ondas de calor no verão 2013-2014 em 18 províncias da Argentina: Estudo ecológico

Chesini, Francisco; Herrera, Natalia; Skansi, Maria de los Milagros; Morinigo, Carolina González; Fontán, Silvia; Savoy, Francisco; Titto, Ernesto de

Francisco Chesini

Salud Ambiental, Ministerio de Salud de la Nación. Av. 9 de Julio 1925. C1073ABA Ciudad Autónoma de Buenos Aires Argentina. ehdetitto@gmail.com

https://orcid.org/0000-0001-6555-458X

Natalia Herrera

Dirección Central de Monitoreo del Clima, Dirección Nacional de Ciencia e Innovación en Productos y Servicios. Ciudad Autónoma de Buenos Aires Argentina.

https://orcid.org/0000-0003-4123-0075

Maria de los Milagros Skansi

Dirección Central de Monitoreo del Clima, Dirección Nacional de Ciencia e Innovación en Productos y Servicios. Ciudad Autónoma de Buenos Aires Argentina.

https://orcid.org/0000-0002-0870-5609

Carolina González Morinigo

Dirección de Servicios Sectoriales, Dirección Nacional de Pronósticos y Servicios para la Sociedad, Servicio Meteorológico Nacional. Ciudad Autónoma de Buenos Aires Argentina.

https://orcid.org/0000-0002-8002-8518

Silvia Fontán

Departamento de Ciencias de la Salud, Universidad Nacional de La Matanza. Provincia de Buenos Aires Argentina.

https://orcid.org/0000-0003-2205-1063

Francisco Savoy

Facultad de Ciencias de la Salud, Universidad Nacional de Entre Ríos. Provincia de Entre Ríos Argentina.

https://orcid.org/0000-0002-9696-8045

Ernesto de Titto

Salud Ambiental, Ministerio de Salud de la Nación. Av. 9 de Julio 1925. C1073ABA Ciudad Autónoma de Buenos Aires Argentina. ehdetitto@gmail.com

https://orcid.org/0000-0002-4375-3278

Collaborations

All authors participated in conceptualization, methodology, formal analysis and writing review. Data acquisition, curation and analysis were performed by F Chesini, N Herrera, MM Skansi and CG Morinigo. Original project writing and editing were made by F Chesini and E de Titto. F Chesini, S Fontán, F Savoy and E de Titto were responsible for financing the acquisition and project administration.

Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Dec-13																	Jan-14		duration	vs 1961-2010*
15	16	17	18	19	20	21	22	23	24	25	26	27	28	29	30	31	1	2	(days)	duration	T. max.	T. min.
Entre Ríos																			16	≥P95	≥P90	≥P80
		Santa Fe																	14	≥P95	≥P95	≥P80
							CABA												9	≥P95	≥P90	≥P85
					La Pampa														5	≥P95	≥P80	≥P90
						San Luis													5	≥P90		≥P90
						Mendoza													5	≥P85		≥P95
						San Juan													5	≥P90		≥P95
						Córdoba													7	≥P95	≥P80	≥P80
							La Rioja												7	≥P95	≥P95	≥P95
							Tucumán												7	≥P95	≥P80	≥P85
								Stgo. del Estero											6		≥P95
									Catamarca										5	≥P90	≥P85
											Corrientes								6	≥P90	≥P85	≥P90
											Chaco								6
											Formosa								6	≥P80
											Jujuy								6	≥P95	≥P95
												Salta							7	≥P95	≥P95	≥P95
Jan-14
							13	14	15	16	17	18	19	20	21	22	23	24	duration	duration	T. max.	T. min.
							Mendoza												9	≥P85	≥P95	≥P95
								San Luis											10	≥P95	≥P85	≥P80
								Córdoba											10	≥P95		≥P90
									La Pampa										6	≥P95	≥P95	≥P95
									CABA										4	≥P80	≥P80	≥P85
									Santa Fe										9	≥P95	≥P85	≥P95
									Entre Ríos										9	≥P90	≥P90	≥P95
											Corrientes								7	≥P95	≥P80	≥P95
												Misiones							7	≥P95
															Chaco				4
															Formosa				4	≥P80
														Salta					4	≥P95		≥P90
														Tucuman					4	≥P85	≥P80	≥P95
														La Rioja					4		≥P95	≥P95
															Catamarca				3		≥P95	≥P95
															Jujuy				3			≥P95
Jan-14					Feb-14
					30	31	1	2	3	4	5	6	7	8	9	10	11	12	duration	duration	T. max.	T. mín.
					Corrientes														13	≥P95	≥P85
						Chaco													12	≥P95	≥P95
							Formosa												11	≥P95
							Misiones												11	≥P95	≥P95	≥P95

Month	Province	Mean values 2010-13		2013-2014		Difference in the number of deaths	RR^†	IC95%^‡
Month	Province	Cases	General Rates*	Cases	General Rates
December	CABA	664	21.8	984	32.1	320	1.48	1.34-1.63
	Catamarca	37	9.8	54	14.2	17	1.42	0.93-2.15
	Chaco	78	8.1	100	9.9	22	1.26	0.94-1.69
	Córdoba	567	16.6	724	20.9	157	1.25	1.12-1.39
	Corrientes	60	7.5	72	9.1	12	1.18	0.84-1.66
	Entre Ríos	366	28.9	487	36.8	121	1.30	1.19-1.43
	Formosa	37	6.7	50	8.9	13	1.31	0.86-2.00
	Jujuy	52	7.6	48	7.4	-4	0.89	0.60-1.32
	La Pampa	33	9.9	24	7.2	-9	0.72	0.43-1.22
	La Rioja	32	9.1	50	13.8	18	1.54	0.98-2.40
	Mendoza	164	9.1	212	12.2	48	1.26	1.03-1.54
	Salta	114	9.0	150	11.7	36	1.28	1.04-1.63
	San Juan	52	7.4	75	10.3	23	1.41	0.99-2.00
	San Luis	38	8.4	41	9.2	3	1.05	0.68-1.63
	Santa Fe	817	27.1	1.080	35.1	263	1.30	1.22-1.38
	Santiago del E	63	7.1	106	12.2	43	1.65	1.21-2.26
	Tucumán	145	9.6	108	6.8	-37	0.72	0.56-0.93
	Subtotal	3319	15.1	4365	19.3	1046	1.28	1.23-1.34
January	CABA	294	9.7	345	11.0	51	1.17	1.05-1.31
	Catamarca	23	5.9	32	8.1	9	1.39	0.90-2.14
	Chaco	33	6.1	30	5.2	-3	0.88	0.58-1.33
	Córdoba	756	21.9	894	24.9	138	1.16	1.08-1.24
	Corrientes	143	13.8	180	17.3	37	1.23	0.99-1.54
	Entre Ríos	205	16.0	227	16.9	22	1.08	0.94-1.25
	Formosa	23	6.3	24	6.2	1	1.02	0.63-1.66
	Jujuy	35	5.0	39	5.4	4	1.10	0.76-1.59
	La Pampa	53	15.8	54	15.9	1	1.01	0.74-1.37
	La Rioja	16	4.6	38	10.1	22	2.30	1.48-3.58
	Mendoza	332	18.3	414	22.2	82	1.22	1.10-1.35
	Misiones	98	8.5	103	8.9	5	1.03	0.83-1.27
	Salta	50	3.9	64	5.1	14	1.23	0.93-1.64
	San Luis	80	17.5	94	20.0	14	1.15	0.91-1.44
	Santa Fe	603	19.2	803	25.1	200	1.31	1.22-1.41
	Tucumán	96	6.3	134	9.3	38	1.36	1.12-1.64
	Subtotal	2840	13.2	3475	15.7	635	1.19	1.14-1.25
February	Chaco	204	18.4	280	24.9	76	1.34	1.18-1.53
	Corrientes	221	21.3	276	26.1	55	1.22	1.08-1.39
	Formosa	100	19.2	109	21.2	9	1.07	0.87-1.32
	Misiones	198	17.3	254	22.4	56	1.25	1.10-1.43
	Subtotal	723	19.0	919	23.5	196	1.24	1.12-1.36
Total		6882	30.0	8759	37.1	1877	1.23	1.20-1.28

Month	Province	Woman			Men			60-79 years old			over 79 years old
Month	Province	RR*	CI95%‡		RR	CI95%		RR	CI95%		RR	CI95%
December	CABA	1.6	1.39	1.80	1.3	1.15	1.57	1.3	1.09	1.53	1.7	1.47	1.90
	Catamarca	1.3	0.73	2.38	1.5	0.84	2.75	1.0	0.47	2.02	1.8	0.72	4.64
	Chaco	1.5	0.94	2.24	1.1	0.73	1.66	1.3	0.80	1.99	1.4	0.83	2.27
	Córdoba	1.3	1.07	1.46	1.2	1.06	1.45	1.2	0.98	1.40	1.3	1.14	1.58
	Corrientes	1.1	0.65	1.71	1.3	0.82	2.17	1.2	0.73	2.12	1.2	0.69	2.25
	Entre Ríos	1.5	1.27	1.86	1.1	0.90	1.33	1.2	0.97	1.49	1.3	1.09	1.67
	Formosa	1.5	0.81	2.66	1.2	0.64	2.13	1.3	0.64	2.47	1.4	0.58	3.23
	Jujuy	1.0	0.59	1.78	0.8	0.44	1.36	0.9	0.47	1.54	0.8	0.41	1.57
	La Pampa	0.6	0.30	1.35	0.8	0.39	1.70	0.8	0.32	1.83	0.7	0.32	1.51
	La Rioja	1.7	0.89	3.18	1.4	0.75	2.62	2.0	0.97	4.15	1.6	0.73	3.47
	Mendoza	1.2	0.88	1.56	1.4	1.01	1.81	1.1	0.80	1.52	1.3	0.94	1.78
	Salta	1.5	1.03	2.08	1.1	0.80	1.58	0.7	0.46	1.00	1.1	0.67	1.78
	San Juan	1.4	0.83	2.22	1.5	0.88	2.43	1.4	0.81	2.48	1.3	0.72	2.30
	San Luis	1.6	0.84	2.99	0.7	0.36	1.30	1.1	0.57	2.06	1.1	0.51	2.39
	Santa Fe	1.4	1.23	1.59	1.2	1.06	1.37	1.2	1.06	1.41	1.5	1.28	1.69
	Santiago del E	1.7	1.05	2.64	1.6	1.07	2.51	1.5	0.94	2.47	1.5	0.89	2.51
	Tucumán	0.7	0.48	0.99	0.8	0.54	1.08	0.9	0.59	1.27	0.5	0.35	0.84
January	CABA	1.1	0.49	2.28	1.3	1.12	1.58	1.3	0.97	1.70	1.1	0.87	1.33
	Catamarca	1.3	0.50	3.16	1.6	0.75	3.36	1.3	0.57	2.86	1.8	0.72	4.64
	Chaco	0.5	0.12	1.91	1.4	0.80	2.45	0.9	0.44	1.89	1.3	0.57	3.03
	Córdoba	1.1	0.67	1.79	1.2	1.11	1.35	1.1	0.90	1.23	1.3	1.10	1.47
	Corrientes	1.2	0.90	1.71	1.2	0.90	1.65	1.2	0.82	1.63	1.2	0.80	1.68
	Entre Ríos	1.1	0.84	1.49	1.0	0.84	1.42	1.3	0.97	1.75	1.0	0.72	1.30
	Formosa	0.7	0.18	2.82	1.2	0.62	2.22	0.8	0.33	2.16	1.7	0.62	4.85
	Jujuy	1.1	0.28	4.35	1.1	0.65	1.83	1.6	0.80	3.14	0.9	0.40	2.14
	La Pampa	1.0	0.49	1.84	1.1	0.69	1.62	0.9	0.47	1.62	1.2	0.71	2.03
	La Rioja	2.4	0.80	7.14	2.2	1.15	4.34	2.4	0.99	5.70	3.0	0.94	9.73
	Mendoza	1.3	0.78	2.16	1.1	0.97	1.32	1.3	1.06	1.65	1.1	0.89	1.40
	Misiones	0.8	0.59	1.21	1.2	0.89	1.56	1.2	0.78	1.84	1.0	0.58	1.57
	Salta	1.3	0.30	5.48	1.2	0.78	1.80	0.9	0.49	1.60	1.3	0.70	2.60
	San Luis	1.2	0.66	2.05	1.2	0.86	1.65	1.3	0.82	2.02	1.1	0.69	1.84
	Santa Fe	1.2	0.74	2.03	1.4	1.26	1.55	1.3	1.08	1.51	1.4	1.20	1.65
	Tucumán	1.1	0.37	3.39	1.6	1.21	2.02	1.2	0.79	1.76	1.6	1.00	2.50
February	Chaco	1.3	0.72	2.18	1.4	1.20	1.68	1.2	0.87	1.52	1.5	1.08	2.07
	Corrientes	1.2	0.70	1.93	1.3	1.08	1.54	1.1	0.84	1.46	1.2	0.92	1.69
	Formosa	1.0	0.57	1.80	1.1	0.84	1.49	1.6	1.07	2.39	1.1	0.64	1.83
	Misiones	1.4	1.11	1.67	1.2	0.97	1.41	1.2	0.92	1.63	1.3	0.93	1.85

Causes of death		Buenos Aires City		Córdoba		Entre Ríos	Mendoza		Misiones		Santa Fe
Causes of death		Dec.^‡	Jan.^§	Dec.	Jan	Dec.	Dec.	Jan.	Feb.^║	Dec.	Jan.
Cerebral-vascular disease	Cases			59					46
	Rates			1.69					3.92
	RR^†			1.54					2.88
	CI95%			1.03-2.33					1.91-4.36
Diabetes Mellitus	Cases										29
	Rates*										0.91
	RR^†										1.99
	CI95%										1.21-3.29
Ischemic heart	Cases	135		70	95			44	50
	Rates	4.43		2.01	2.69			2.36	4.26
	RR^†	1.62		1.83	1.84			1.82	1.85
	CI95%	1.33-1.96		1.23-2.73	1.45-2.35			1.25-2.65	1.30-2.63
Other forms of heart disease	Cases	189
	Rates	6.21
	RR^†	1.54
	CI95%	1.31-1.80
Chronic lower respiratory tract	Cases	21								26	17
	Rates	0.69								0.85	0.53
	RR^†	2.32								2.02	2.18
	CI95%	1.22-4.43								1.03-2.63	1.05-4.52
Pneumonia	Cases	101	37		62	36	13			85	59
	Rates	3.32	1.21		1.76	2.78	0.71			2.77	1.85
	RR^†	2.20	1.54		1.58	1.76	3.18			2.03	1.71
	CI95%	1.74-2.80	1.03-2.30		1.17-2.14	1.12-2.14	1.13-8.94			1.40-2.95	1.25-2.33
Renal insufficiency/kidney failure	Cases	35
	Rates	1.15
	RR^†	2.28
	CI95%	1.44-3.60

[1] Collaborations

All authors participated in conceptualization, methodology, formal analysis and writing review. Data acquisition, curation and analysis were performed by F Chesini, N Herrera, MM Skansi and CG Morinigo. Original project writing and editing were made by F Chesini and E de Titto. F Chesini, S Fontán, F Savoy and E de Titto were responsible for financing the acquisition and project administration.

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Risco de mortalidade durante ondas de calor no verão 2013-2014 em 18 províncias da Argentina: Estudo ecológico

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