Heat-related mortality in selected United States cities, summer 1999

As part of a Public health response to severe heat waves in the midwestern and northeastern United States in the summer of 1999, the authors actively solicited the number of heat-related deaths from 38 medical examiner and co roner jurisdictions comprising 35 metropolitan areas to enumerate heat-rela ted deaths in areas affected by heat waves. They also determined the useful ness of these data for surveillance and rapid investigation of heat-related deaths. A total of 334 heat-related deaths were reported during the study period of July 1-August 31. Minor changes in data collection and diagnostic criteria in some medical examiner and coroner jurisdictions would allow fo r greater comparability among jurisdictions. The National Association of Me dical Examiners' position paper on heat-related mortality diagnosis provide s important guidance to medical examiners and coroners, regarding the certi fication of heat-related deaths and may require some refinement to address certain issues. Among these are certifying manner of death and classifying potential causes of heat-related death not involving hyperthermia or heat s troke. but where heat is a potential contributing factor to death, Medical examiners and coroners are an important resource for heat-related mortality research, and improvements in data collection and reporting could yield tr emendous benefits to our understanding of and interventions for heat-relate d deaths.