Cold weather and GP consultations for respiratory conditions by elderly people in 16 locations in the UK

European Journal of Epidemiology 19: 959968, 2004.

2004 Kluwer Academic Publishers. Printed in the Netherlands.Cold weather and GP consultations for respiratory conditions by elderly people

in 16 locations in the UKShakoor Hajata, William Birdc & Andy HainesbaPublic and Environmental Health Research Unit, bLondon School of Hygiene and Tropical Medicine, Keppel Street, LondonWC1E 7HT, UK;cMet OceAccepted in revised form 5 April 2004Abstract. Background: Cold weather is associated

with increases in mortality and demands on hospital

services in the UK, particularly by the elderly. Less is

known about the relationship with patterns of consultation in primary care. We wished to determine the

magnitude and consistency of associations between

cold temperature and consultations for respiratory

conditions in primary care settings at dierent sites in

the UK. Methods: Time series analysis of any shortterm eects of temperature on daily general practitioner (GP) consultations made by elderly people

(65+ years) for lower and upper respiratory tract

infections (LRTI, URTI) over a 10-year period,

19922001. Practices were situated in 16 urban locations across the UK where a Met Oce monitoring

station was in operation. Results: An association

between low temperatures and an increase in LRTI

consultations was observed in all 16 locations studied. The biggest increase was estimated for the Norwich practices for which a 19.0% increase in LRTI

consultations (95% CI 13.6, 24.7) was associated with

every 1 C drop in mean temperature below 5 C

observed 020 days before the day of consultation.

Slightly weaker relationships were observed in the

case of URTI consultations. A north/south gradient,

with larger temperature eects in the north, was in

evidence for both LRTI and URTI consultations.

Conclusions: An eect that was consistent and generally strongest in populations in the north was

observed between cold temperature and respiratory

consultations. Better understanding of the mechanisms by which cold weather is associated with increases in consultations for respiratory infections

could lead to improved strategies for prevention and

reduced burdens for health services.Key words: Cold weather, Primary care, Time seriesIntroductionEver since the 19th century a detrimental eect of

cold weather on health has been observed in the UK[1]. The particular role of low temperatures was

demonstrated using a variety of dierent health

endpoints throughout the early part of the 20th century [27]. More recent studies have...