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标题：Evaluating the potential public health impacts of the Toronto cold weather program
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作者：Tarik Benmarhnia ; Xu Zhao ; John Wang 等
期刊名称：Environment International
印刷版ISSN：0160-4120
电子版ISSN：1873-6750
出版年度：2019
卷号：127
页码：1-6
DOI：10.1016/j.envint.2019.03.042
出版社：Pergamon
摘要：Background Extreme cold weather alert programs have been implemented in some areas to address the significant health impacts of exposure to cold. One such program is the Toronto Cold Weather Program (TCWP) that was implemented in the City of Toronto since 1996 to protect the public from extreme weather conditions. In this paper, we aim to evaluate the effectiveness of the TCWP in reducing mortality and morbidity outcomes related to cold temperatures. Methods We applied a quasi-experimental study design using the Difference-in-Differences method coupled with propensity-score-matching to determine the effect of the TCMP on daily hospitalizations and deaths due to cardiovascular disease (CVD), coronary heart disease (CHD) or cerebrovascular disease, using two complementary analytical approaches. Results Overall, the analysis did not detect an impact on reduced mortality/morbidity in the City of Toronto from the TCMP. For example, we obtained a Risk Difference (RD) of −0.88 (per 1,000,000 people) (95% CI: −3.27 to 1.51) and a Risk Ratio (RR) of 0.98 (95% CI: 0.91 to 1.05) people for CVD hospitalizations. Conclusions The TCWP was not found to be effective in reducing cold related mortality and morbidity which demonstrates the importance of improving existing policies related to cold in Canada and other countries.