摘要：Objectives. We sought to reexamine the effects of the 1995 Chicago heat wave on all-cause and cause-specific mortality, including mortality displacement, using advanced time-series analysis methods. Methods. We used Poisson regression with penalized regression splines to model excess mortality and mortality displacement over a 50-day period centered on the day in which the heat wave temperature peaked, adjusting for meteorological and other variables. We controlled for temporal trends by using daily mortality data during 1993–1997. We estimated relative risks (RRs) with reference to the first day of the 50-day period. Results. We estimated that there were 692 excess deaths from June 21, 1995, to August 10, 1995; 26% of these deaths were owing to mortality displacement. RR for all-cause mortality on the day with peak mortality was 1.74 (95% confidence interval=1.67, 1.81). Risk of heat-related death was significantly higher among Blacks, and mortality displacement was substantially lower. Conclusions. The 1995 Chicago heat wave substantially effected all-cause and cause-specific mortality, but mortality displacement was limited. Mortality risks and displacement affected Blacks disproportionally. Appropriately targeted interventions may have a tangible effect on life expectancy. In light of the recent heat waves in the United States 1 and Europe 2 in July 2006, the devastating heat wave in Europe in 2003, 3 and the potential increase of such extreme weather events with climate change, 4 preparedness efforts need to be strengthened, including a better understanding of the population groups at highest risk. Although the effects of high temperatures on mortality have been widely studied, 5 few studies have used advanced time-series methods and measured mortality displacement during heat waves. Even fewer studies have used such methods to analyze specific heat wave periods, 6 , 7 and none of these studies has addressed heat waves on the North American continent. We reexamined all-cause and cause-specific mortality during the 1995 Chicago heat wave with advanced time-series methods that allowed for control of the meteorologic and air pollution variables and the estimation of mortality displacement.
