On the association between high temperature and mortality in warm climates

We conducted a time-series analysis of 1997-1999 data records of air temperature and all-cause mortality in Greater Beirut, using bi-linear Poisson auto-regressive models, and published our findings in the Science of the Total Environment El-Zein, A., Tewtel-Salem, M., Nehme, G., 2004. A time-series analysis of mortality and air temperature in Greater Beirut. Sci. Total Environ. 330, 71-80]. We compared our results to those of Curriero et al. Curriero, F.C., Heiner, K.S., Samet, J.M., Zeger, S.L., Strug, L., Patz, J.A., 2002. Temperature and mortality in 11 cities of the Eastern United States. Am. J. Epidemiol. 155(1) 80-87.], who subsequently reported that their original results were inaccurate and published new results Curriero, F.C., Heiner, K.S., Samet, J.M., Zeger, S.L., Strug, L., Patz, J.A., 2002. Temperature and mortality in 11 cities of the Eastern United States. Am. J. Epidemiol. 155(1) 80-87; Curriero, F.C., Samet, J.M., Zeger, S.L., 2003. Letter to the Editor re. On the Use of Generalized Additive Models in Time-Series Studies of Air Pollution and Health" and "Temperature and Mortality in 11 Cities of the Eastern United States". Am. J. Epidemiol. 158(1) 93-94.]. In this letter, we report two changes in the interpretation of our findings as a result of the change in the results of Curriero et al. Curriero, F.C., Heiner, K.S., Samet, J.M., Zeger, S.L., Strug, L., Patz, J.A., 2002. Temperature and mortality in 11 cities of the Eastern United States. Am. J. Epidemiol. 155(1) 80-87]. Their newly-reported results reinforce our conclusion that heat-related mortality can be a significant public health issue even in temperate to warm climates. However, our findings raise a question concerning the ability of socioeconomic indicators to explain differences in vulnerability to heat between high-income and low-income countries.