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The European Journal of Public Health Advance Access originally published online on October 6, 2006
The European Journal of Public Health 2006 16(6):583-591; doi:10.1093/eurpub/ckl063
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Heat-related mortality

August 2003 Heat Wave in France: Risk Factors for Death of Elderly People Living at Home

S. Vandentorren1, P. Bretin1, A Zeghnoun1, L. Mandereau-Bruno1, A. Croisier1, C. Cochet2, J. Ribéron2, I. Siberan1, B. Declercq1 and M. Ledrans1

1 Department of Environmental Health, French Institute of Public Health Surveillance, Cedex, France
2 Technical and Scientific Building Center (CSTB), Paris, France

Correspondence: Stéphanie Vandentorren, MD, Department of Environmental Health, Institute for Public Health Surveillance, 12 rue du val d'Osne, 94415 Saint Maurice Cedex, France, tel: +33 1 55 12 53 08, fax: +33 1 41 79 67 68, e-mail: s.vandentorren{at}invs.sante.fr

The August 2003 heat wave in France resulted in many thousands of excess deaths particularly of elderly people. Individual and environmental risk factors for death among the community-dwelling elderly were identified. We conducted a case–control survey and defined cases as people aged 65 years and older who lived at home and died from August 8 through August 13 from causes other than accident, suicide, or surgical complications. Controls were matched with cases for age, sex, and residential area. Interviewers used questionnaires to collect data. Satellite pictures provided profiles of the heat island characteristics around the homes. Lack of mobility was a major risk factor along with some pre-existing medical conditions. Housing characteristics associated with death were lack of thermal insulation and sleeping on the top floor, right under the roof. The temperature around the building was a major risk factor. Behaviour such as dressing lightly and use of cooling techniques and devices were protective factors. These findings suggest people with pre-existing medical conditions were likely to be vulnerable during heat waves and need information on how to adjust daily routines to heat waves. In the long term, building insulation and urban planning must be adapted to provide protection from possible heat waves.

Keywords: deaths, elderly, epidemiological survey, heat wave


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