The association of weather and mortality in Bangladesh from 1983-2009

Introduction: The association of weather and mortality have not been widely studied in subtropical monsoon regions, particularly in Bangladesh. This study aims to assess the association of weather and mortality (measured with temperature and rainfall), adjusting for time trend and seasonal patterns in Abhoynagar, Bangladesh. Material and methods: A sample vital registration system (SVRS) was set up in 1982 to facilitate operational research in family planning and maternal and child health. SVRS provided data on death counts and population from 1983-2009. The Bangladesh Meteorological Department provided data on daily temperature and rainfall for the same period. Time series Poisson regression with cubic spline functions was used, allowing for over-dispersion, including lagged weather parameters, and adjusting for time trends and seasonal patterns. Analysis was carried out using R statistical software. Results: Both weekly mean temperature and rainfall showed strong seasonal patterns. After adjusting for seasonal pattern and time trend, weekly mean temperatures (lag 0) below the 25th percentile and between the 25th and 75th percentiles were associated with increased mortality risk, particularly in females and adults aged 20-59 years by 2.3-2.4% for every 1 degrees C decrease. Temperature above the 75th percentile did not increase the risk. Every 1 mm increase in rainfall up to 14 mm of weekly average rainfall over lag 0-4 weeks was associated with decreased mortality risks. Rainfall above 14 mm was associated with increased mortality risk. Conclusion: The relationships between temperature, rainfall and mortality reveal the importance of understanding the current factors contributing to adaptation and acclimatization, and how these can be enhanced to reduce negative impacts from weather.