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Biostatistics Advance Access published online on February 27, 2008
Biostatistics, doi:10.1093/biostatistics/kxm057
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Modeling temperature effects on mortality: multiple segmented relationships with common break points

Vito M. R. Muggeo

Dipartimento di Scienze Statistiche e Matematiche `S. Vianelli'—Università di Palermo, viale delle Scienze, edificio 13–90128 Palermo, Italy vmuggeo{at}dssm.unipa.it

We present a model for estimation of temperature effects on mortality that is able to capture jointly the typical features of every temperature–death relationship, that is, nonlinearity and delayed effect of cold and heat over a few days. Using a segmented approximation along with a doubly penalized spline-based distributed lag parameterization, estimates and relevant standard errors of the cold- and heat-related risks and the heat tolerance are provided. The model is applied to data from Milano, Italy.

Keywords: Break points; Distributed lag; Penalized splines; Segmented regression; Temperature effects

Received June 26, 2006; revised May 14, 2007; revised September 18, 2007; revised October 30, 2007; accepted for publication December 17, 2007.


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