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Ambient temperature and risk of death from accidental drug overdose in New York City, 1990–2006

Authors

  • Amy S. B. Bohnert,

    Corresponding author
    1. VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA,
    2. Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA,
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  • Marta R. Prescott,

    1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA,
    2. Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA,
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  • David Vlahov,

    1. Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY, USA,
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  • Kenneth J. Tardiff,

    1. Department of Psychiatry, Weill Cornell Medical College, Cornell University, Ithaca, NY, USA and
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  • Sandro Galea

    1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA,
    2. Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA,
    3. Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Amy S. B. Bohnert, VA Ann Arbor SMITREC (11H), 2215 Fuller Road, Ann Arbor, MI 48105, USA. E-mail: amybohne@med.umich.edu

ABSTRACT

Background Mortality increases as ambient temperature increases. Because cocaine affects core body temperature, ambient temperature may play a role in cocaine-related mortality in particular. The present study examined the association between ambient temperature and fatal overdoses over time in New York City.

Methods Mortality data were obtained from the Office of the Chief Medical Examiner for 1990 to 2006, and temperature data from the National Oceanic and Atmospheric Association. We used generalized additive models to test the relationship between weekly average temperatures and counts of accidental overdose deaths in New York City, controlling for year and average length of daylight hours.

Results We found a significant relation between ambient temperature and accidental overdose fatality for all models where the overdoses were due in whole or in part to cocaine (all P < 0.05), but not for non-cocaine overdoses. Risk of accidental overdose deaths increased for weeks when the average temperature was above 24°Celsius.

Conclusions These results suggest a strong relation between temperature and accidental overdose mortality that is driven by cocaine-related overdoses rising at temperatures above 24°Celsius; this is a substantially lower temperature than prior estimates. To put this into perspective, approximately 7 weeks a year between 1990 and 2006 had an average weekly temperature of 24 or above in New York City. Heat-related mortality presents a considerable public health concern, and cocaine users constitute a high-risk group.

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