Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study

Abstract

Objective: To assess how effectively measures adopted in extreme cold in Yakutsk control winter mortality. Design: Interviews to assess outdoor clothing and measure indoor temperatures; regressions of these and of delayed cause-specific mortalities on temperature. Setting Yakutsk, east Siberia, Russia. Subjects:All people aged 50-59 and 65-74 years living within 400 km of Yakutsk during 1989-95 and sample of 1002 men and women who agreed to be interviewed. Main outcome measures Daily mortality from all causes and from ischaemic heart, cerebrovascular, and respiratory disease. Results: Mean temperature for October-March 1989-95 was −26.6°C. At 10.2°C people wore 3.30 (95% confidence interval 3.08 to 3.53) layers of clothing outdoors, increasing to 4.39 (4.13 to 4.66; PConclusions: People in Yakutsk wore very warm clothing, and in extremely cold weather stayed indoors in warm housing, preventing the increases in mortality seen in winter in milder regions of the world. Only respiratory mortality rose, perhaps because of breathing cold air. Death rates from ischaemic heart, cerebrovascular, and respiratory disease and all causes have been shown to increase as air temperature falls In Yakutsk, Russia, mortality from cerebrovascular and ischaemic heart disease and all causes among people aged 50-59 and 65-74 was unchanged as temperature fell to 48.2°C Mortality from respiratory disease increased as temperatures fell below −20°C but this was more than offset by a decrease in deaths from accidents Exceptionally warm clothing, with reduction of outdoor excursions at temperatures below −20°C, prevented overall outdoor cold stress