EVALUATION OF THE SHORT-TERM AND DELAYED RISKS OF THE ABNORMAL SUMMER 2010 HEAT IMPACT IN SEVERAL DISTRICTS OF NIZHNY NOVGOROD OBLAST, CLOSE TO WILDFIRES, ON THE MORBIDITY AND MORTALITY OF INHABITANTS

The influence of abnormal summer heat (AH) in the year 2010 on morbidity and mortality in Russian Federation regions is not studied good enough. Nizhny Novgorod Oblast was one of the most involved and harmed.

Aim. Retrospective assessment of short- and long-term influence of AH and fires of the summer 2010 on the course of cardiovascular diseases living in several districts of Nizhny Novgorod Oblast.

Material and methods. Totally, 779 inhabitants of Vyksunsky district of Nizhny Novgorod Oblast were included. The analysis of outpatient charts was done (data 2010-2014), questionnaires were used.

Results. The period of AH (PAH) was followed by the increase of mortality from external causes (p<0,01) comparing to the summer 2011. Mortality in September-December 2010, cardiovascular as from other reasons, was significantly lower that during the same period in 2011 (p<0,05). Combination endpoints (CEP) were more common for PAH comparing to the same period of 2011 and 2012, and September-December 2010. CEP were lower in September-December 2010 than in 2012. Quantity of cardiovascular complications (CVC) in PAH did not differ from average for this period of the year, and was lower than in fall-winter period of 2011 and 2012. More CVC in PAH developed in cardiovascular patients, with arterial hypertension, post infarction cardio sclerosis, cerebrovascular disease. An independent risk factor for CEP in PAH were age, for CVC — functional class of chronic heart failure. Predictors of life quality worsening in PAH: male sex, smoking, living close to roads and on upper floors, higher education. With better life quality in PAH were associated the presence of climat-control of even ventilator, higher body mass index and taking of angiotensin-converting enzyme inhibitor.

Conclusion. AH led to the increase of general mortality but did not led significantly to increase of cardiovascular morbidity and CV complications. With the highest risk of complications during the heat were associated: existence of arterial hypertension, post infarction cardio sclerosis, chronic heart failure, cerebrovascular disease, older age.

1. Baccini M, Kosatsky T, Analitis A. Impact of heat on mortality in 15 European cities: attributable deaths under different weather scenarios. J Epidemiol Community Health 2010; 4: 137.

2. Whitman S, Good G, Donoghue ER, et al. Mortality in Chicago Attributed to the July 1995 Heat Wave. Am J Public Health 1997; 87(9): 1515-8.

3. Poumadere M, Mays M, LeMer S. The 2003 heat wave in France: dangerous climate change here and now. Risk analysis 2005; 25(6): 1483-94.

4. Revich BA, Maleev VV. Climate change and the health of the population of Russia: situation analysis and forecast estimates. M., Lenand 2011; 208 р. Russian (Ревич Б.А., Малеев В.В. Изменения климата и здоровье населения России: анализ ситуации и прогнозные оценки. М.: ЛЕНАНД 2011; 208 с).

5. Revich Boris. Temperature curves of mortality and the area of thermal comfort: heat waves and mortality: Hot summer of 2010 in Moscow ELECTRONIC VERSION NEWSLETTER “Population and Society” of Polit.ru “NASELENIE I OBSHHESTVO” POLIT.RU: http://www.polit.ru available 25.02.14. Russian (Ревич Борис. Температурные кривые смертности и область температурного комфорта: Волны жары и смертность: Горячее лето 2010-го в Москве. Электронная версия бюллетеня “Население и общество” ПОЛИТ.РУ: 19.10.11. www.polit. ru›article/2010/11/15/demoscope439/ доступно 4.09.2015).

6. Chazov EI, Boytsov SA. Influence of abnormal increase in air temperature on mortality. Therapeutic Archives 2012; 1: 29-36. Russian (Чазов Е.И., Бойцов С.А. Влияние аномального повышения температуры воздуха на смертность населе- ния. Терапевтический архив 2012; 1: 29-36).

7. Shoenfeld Y, Udassin R, Shapiro Y, et al. Age and sex differences in response to short exposure to extreme dry heat. J Appl Physiol 1978; 44: 1-4.

8. Hausfater Р, Megarbane B, Dautheville S, et al. Prognostic factors in non-exertional heat stroke. Intensive Care Med 2010; 36 (2): 272-80.

9. Ageev FT, Smirnova MD, Rodnenkov OV. Heat and cardiovascular system, Moscow, “Praktika” 2015; 181 р. Russian (Агеев Ф.Т., Смирнова М.Д., Родненков О.В. Жара и сердечно-сосудистая система. Москва “Практика” 2015; 181 с).

10. Ageev FT, Smirnova MD, Svirida ON, et al. Influence of cardiology drugs on adaptation to high temperatures patients with cardiovascular diseases in the conditions abnormally hot summer of 2010. Therapeutic Archives 2013; 3: 45-51. Russain (Агеев Ф.Т., Смирнова М.Д., Свирида О.Н. и др. Влияние приема кардиопрепаратов на адаптацию к высоким температурам больных сердечно-сосудистыми заболеваниями в условиях аномально жаркого лета 2010 года. Терапевтический архив 2013; 3: 45-51).

11. Ageev FT, Smirnova MD, Galaninskij PV. Evaluation of immediate and delayed effects of abnormally hot summer of 2010, during the cardiovascular diseases in ambulatory practice. Therapeutic Archives 2012; 8: 45-51. Russian (Агеев Ф. Т., Смирнова М.Д., Галанинский П.В. Оценка непосредственного и отсроченного воздействия аномально жаркого лета 2010 г. на течение сердечно-сосудистых заболеваний в амбулаторной практике. Терапевтический архив 2012; 8: 45-51).

12. Wildfires and heat waves in the Russian Federation. Health rekomendatsii19 August 2010 http://www.euro.who.int/PubRequest?language=Russian. Available 25/09/15. Russian (Природные пожары и аномальная жара в Российской Федерации. Медико-санитарные рекомендации 19 августа 2010 г. http://www.euro.who.int/PubRequest?language=Russian. Доступно 25.09.15).

13. Koppe C, Kovats S, Jendritzky G, et al., edited by David J Breuer. Heat waves: risks and responses. World Health Organization 2005; 122 p. Russian (Koppe C, Kovats S, Jendritzky G. и др. Под редакцией David J Breuer. Периоды сильной жары: угрозы и ответные меры. Всемирная организация здравоохранения 2005; 122 с).

14. Keim SM, Guisto JA, Sullivan JB. Environmental thermal stress. Ann Agric Environ Med 2002; 9: 1-15.

15. Kaiser R, Rubin CH, Henderson AK, et al. Heat-related death and mental illness during the 1999 Cincinnati heat wave. Am J Forensic Medicine and Pathology 2001; 22: 303-7