EXCESS MORTALITY IN ENGLAND AND WALES, AND IN GREATER LONDON, DURING THE 1995 HEATWAVE

Study objective-To assess the impact on mortality of the heatwave in E ngland and Wales during July and August 1995 and to describe any diffe rence in mortality impact between the Greater London urban population and the national population. Design-Analysis of variation in daily mor tality in England and Wales and in Greater London during a five day he atwave in July and August 1995, by age, sex, and cause. Setting-Englan d and Wales, and Greater London. Main results-An estimated 619 extra d eaths (8.9% increase, approximate 95% confidence interval 6.4, 11.3%) were observed during this heatwave in England and Wales, relative to t he expected number of deaths based on the 31-day moving average for th at period. Excess deaths were apparent in all age groups, most noticea bly in women and for deaths from respiratory and cerebrovascular disea se. Using published daily mortality risk coefficients for air pollutan ts in London, it was estimated that up to 62% of the excess mortality in England and Wales during the heatwave may be attributable to concur rent increases in air pollution. In Greater London itself, where dayti me temperatures were higher (and with lesser falls at night), mortalit y increased by 16.1% during the heatwave. Using the same risk coeffici ents to estimate the excess mortality apparently attributable to air p ollution, more than 60% of the total excess in London was apparently a ttributable to the effects of heat. Conclusion-Analysis of this episod e shows that exceptionally high temperatures in England and Wales, tho ugh rare, do cause increases in daily mortality.