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. 2017 Feb 13;189(6):E235-E242.
doi: 10.1503/cmaj.161064.

Association between quantity and duration of snowfall and risk of myocardial infarction

Nathalie Auger  1 , Brian J Potter  2 , Audrey Smargiassi  2 , Marianne Bilodeau-Bertrand  2 , Clément Paris  2 , Tom Kosatsky  2
Affiliations

Association between quantity and duration of snowfall and risk of myocardial infarction

Nathalie Auger et al. CMAJ. .

Abstract

Background: Although aggregate data suggest a link between snowfall and myocardial infarction (MI), individual risk has yet to be assessed. We evaluated the association between quantity and duration of snowfall and the risk of MI using nonaggregated administrative health data.

Methods: We used a case-crossover study design to investigate the association between snowfall and hospital admission or death due to MI in the province of Quebec, Canada, between November and April during 1981-2014. The main exposure measures were quantity (in centimetres) and duration (in hours) of snowfall by calendar day. We computed odds ratios (ORs) and 95% confidence intervals (CIs) for the association between daily snowfall and MI, adjusted for minimum daily temperatures.

Results: In all, 128 073 individual hospital admissions and 68 155 deaths due to MI were included in the analyses. The likelihood of MI was increased the day after a snowfall among men but not among women. Compared with 0 cm, 20 cm of snowfall was associated with an OR of 1.16 for hospital admission (95% CI 1.11-1.21) and 1.34 for death (95% CI 1.26-1.42) due to MI the following day among men. Corresponding ORs among women were 1.01 (95% CI 0.95-1.07) and 1.04 (95% CI 0.96-1.13). Similar but smaller associations were observed for snowfall duration (0 h v. 24 h) and MI.

Interpretation: Both the quantity and duration of snowfall were associated with subsequent risk of hospital admission or death due to MI, driven primarily by an effect in men. These data have implications for public health initiatives in regions with snowstorms.

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Figures

Figure 1:
Figure 1:
Association between (A) quantity and (B) duration of snowfall and hospital admission or death due to myocardial infarction (MI) among men and women the day after a snowfall. Odds ratios (central lines) and 95% confidence intervals (outer bands) were adjusted for temperature. Panels for duration of snowfall exclude MI events with missing data on duration. Values above 1.0 indicate an increased risk of hospital admission or death. CI = confidence interval.
Figure 2:
Figure 2:
Association between (A) quantity and (B) duration of snowfall and hospital admission or death due to myocardial infarction (MI) by age group the day after a snowfall. Odds ratios (central lines) and 95% confidence intervals (outer bands) were adjusted for temperature. Panels for duration of snowfall exclude MI events with missing data on duration. Values above 1.0 indicate an increased risk of hospital admission or death. CI = confidence interval.
Figure 3:
Figure 3:
Association between (A) quantity and (B) duration of snowfall and hospital admission or death due to myocardial infarction (MI) the day after a snowfall, according to presence of cardiovascular (CV) comorbidity or risk factors. Odds ratios (central lines) and 95% confidence intervals (outer bands) were adjusted for temperature. Panels for duration of snowfall exclude MI events with missing data on duration. Values above 1.0 indicate an increased risk of hospital admission or death. CI = confidence interval.
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