Orru et al. (1997-2013)

Northeastern Europe (Estonia)

Maximum temperatures

Seasonality and longer term trends

Deaths from external causes (ICD10 diagnosis codes V00 - Y99)

Poisson regression, combined with a distributed lag non-linear model

External cause mortality significantly increased on hot (the same and previous day) and cold days (a lag of 1 - 3 days)

Joe et al. (18-day period between 15 July and 1 August, 2006)


Heat wave

Underlying demographics that may change over years.

Subgroup analysis in different age groups was done

External causes of death (ICD10 V01 to Y89.9)

Simplified relative risk (RR) approach ( R R = A 1 A 0 / 2 )

Deaths from external causes increased more sharply (RR = 1.18, CI 1.10 - 1.27) than from internal causes (RR = 1.04, CI 1.02 - 1.07)

Shaposhnikov et al. (1999-2007)

Four cities in North Russian (Archangelsk, Murmansk, Yakutsk, Magadan)

Long and short temperature waves defined by daily mean temperatures below the cold threshold (3rd centile) and daily mean temperature above the heat threshold (97th centile)

Not mentioned

All external causes and all non-accidental (non-traumatic)deaths

Poisson distributions of daily deaths; X2 test for frequency tables based on city-specific RR estimates

or fisher’s exact test for the pooled RR estimates

External causes of death could be an important contributing factor to the rise of total mortality during heat waves (they were responsible for about 8% of an increase in total mortality), while they are less important during cold waves (they caused about 3% of an increase)

Smirnova et al. (January 2010 to December 2012)

Russia (Nizhny Novgorod Oblast)

Extremely heat 6 week with T above 95th percentile and wildfire with increased air pollution

Season and other time-varying confounding factors

External cause of death (ICD10 codes: T58; T29 - 32, C76.8)

2 × 2 and 2 × 3 contingency tables; the X2 (X squared) Pearson criterion

The period of AH (Abnormal Heat) was followed by an increase of mortality from external causes (p < 0.01) comparing to the summer 2011