ABSTRACT

Several diseases cause deaths with seasonal periodicity and some may have circadian periodicity. The objective was to identify periodicities in the number of certified deaths in Mexico. We analized death certificates from 2000 to 2010, with the tenth version of the International Classification of Diseases (ICD-10), including date and hour of death and selecting frequent respiratory and general causes of death: chronic obstructive pulmonary disease (COPD), tuberculosis, pneumonia-influenza, heart failure, left heart disease (hypertensive and ischemic), malignant tumors and diabetes mellitus (DM) and the remaining causes of death. We searched for associations between the number of deaths, and the hour, month and year of death, through Poisson regression models, including indicator variables for hour, month and year. Results: Pneumonia and influenza deaths had a marked seasonal pattern (peak in winter), but the pattern was also observed for heart failure, left heart disease, COPD and DM but not in perinatal deaths. We observed a circadian pattern in deaths with a maximum between 7-11 AM, and a second peak about 8 PM in the studied diseases except by perinatal causes. Conclusions: Seasonality of analyzed deaths is likely due to influenza and if this is true, could be preventable with vaccination. The mechanism of diurnal increase in deaths is unknown although usually attributed to increase in symphathetic activity associated to awakening and start of physical activity.

KEYWORDS

Mexico, deaths, death certificates, seasonality, circadian rhythm.

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