• Nathalie Auger, Brian J Potter, Audrey Smargiassi, Marianne Bilodeau-Bertrand, Clément Paris, and Tom Kosatsky.
• Centre de recherche du Centre hospitalier de l'Université de Montréal (Auger, Potter, Bilodeau-Bertrand); Institut national de santé publique du Québec (Auger, Smargiassi, Bilodeau-Bertrand, Paris); Division of Cardiology, Department of Medicine (Potter), Centre hospitalier de l'Université de Montréal; Department of Occupational and Environmental Health (Smargiassi), School of Public Health, Université de Montréal, Montréal, Que.; Faculty of Science (Paris), Aix-Marseille Université, Marseille, France; National Collaborating Centre for Environmental Health (Kosatsky), British Columbia Centre for Disease Control, Vancouver, BC nathalie.auger@inspq.qc.ca.
• CMAJ. 2017 Feb 13; 189 (6): E235-E242.

BackgroundAlthough 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.MethodsWe 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.ResultsIn 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.InterpretationBoth 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.© 2017 Canadian Medical Association or its licensors.

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