DEATHS EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA FROM 1992-2002 Public Health Services Bureau of Public Health Statistics Health Status and Vital Statistics Section ~ Leadership for a Healthy Arizona ~ Janet Napolitano, Governor State of Arizona Catherine R. Eden, Director Arizona Department of Health Services HEALTH STATUS AND VITAL STATISTICS SECTION BUREAU OF PUBLIC HEALTH STATISTICS ARIZONA DEPARTMENT OF HEALTH SERVICES 150 N. 18th Avenue, Suite 550 Phoenix, Arizona 85007-3248 Phone: 602/542-7333; FAX: 602/542-2940 www.hs.state.az.us/plan This publication can be made available in alternative format. Please contact the Bureau of Public Health Statistics at 602/542-7333 (voice) or call 1-800-367-8939 (TDD). The Arizona Department of Health Services is an Equal Employment Opportunity Agency. Permission to quote from or reproduce materials from this publication is granted when due acknowledgment is made. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 by Christopher K. Mrela, Ph.D., Assistant Registrar of Vital Statistics MARCH 2004 Acknowledgments Special gratitude is expressed to Trentham Coe, who developed the GIS map for this report, and to Wes Kortuem for his assistance with this task. Trentham also formatted the manuscript for the Web. Particular thanks are extended to Brian Bender who verified with the Pima County Office of the Medical Examiner the 2002 cases of heat-related deaths in La Paz, Pima, Pinal and Santa Cruz counties. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 TABLE OF CONTENTS PURPOSE ........................................................................................................................................... 1 METHODS AND SOURCES ........................................................................................................................ 1 SUMMARY OF FINDINGS ......................................................................................................................... 1 FINDINGS, FIGURES AND DATA TABLES FIGURE 1. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY YEAR, 1992-2002.................2 FIGURE 2. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY STATE OR COUNTRY OF RESIDENCE AND YEAR, 1992-2002 .........................................................................................3 FIGURE 3. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY MONTH IN THE ELEVEN-YEAR PERIOD, 1992-2002.....................................................................................4 FIGURE 4. PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY MONTH AND RESIDENCE STATUS IN THE ELEVEN-YEAR PERIOD, 1992-2002 .................................5 FIGURE 5. PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY AGE GROUP AND RESIDENCE STATUS IN THE ELEVEN-YEAR PERIOD, 1992-2002.............................6 FIGURE 6. PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RESIDENCE STATUS AND AREA OF OCCURRENCE IN ARIZONA IN THE ELEVEN-YEAR PERIOD, 1992-2002 .......................................7 FIGURE 7. DEATHS OF MIGRANTS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY SPECIFIC LOCATION IN ARIZONA, 2001-2002 ...........................................................................................8 TABLE 1. TABLE 2. TABLE 3. TABLE 4. CHARACTERISTICS OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA 1992-2002 ............................................................................................................9 BY YEAR, CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RESIDENCE 1992-2002 .............................................................................. 11 STATUS, ELEVEN-YEAR SUMMARY, CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY REGION, 1992-2002 ........................................................................................ 13 ELEVEN-YEAR SUMMARY, DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE EIGHTY MIGRANTS TO ARIZONA IN 2002: ................................................................................................................ 15 CASE SUMMARIES DATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 Purpose The purpose of this report is to provide information concerning deaths from exposure to heat due to weather conditions occurring in Arizona. Unlike our other reports, designed to monitor health status of the residents of Arizona, this publication is focused on mortality occurring in the State to both residents and non-residents. The data for 2002 (the latest year with complete information) are placed in a temporal context by comparison with the data for the preceding ten years. The report Deaths from exposure to excessive natural heat occurring in Arizona, 1992 – 2002 was prepared as a supplement to injury mortality statistics for Arizona residents. These statistics are updated annually through a series of publications, including the Arizona Health Status and Vital Statistics (http://www.hs.state.az.us/plan/report/ahs/ahs2002/pdf/130.pdf) and Injury Mortality Among Arizona Residents (unintentional injury section: http://www.hs.state.az.us/plan/report/im/index.htm). Methods and Sources Data on the number and characteristics of deaths from heat due to weather conditions were obtained from the mortality database containing information from the death certificates filed with the Arizona Department of Health Services. The International Classification of Diseases (ICD) permits the classification of environmental events and circumstances as the external cause of injury death. Beginning with the 2000 data year in Arizona (1999 nationally) the Tenth Revision of the International Classification of Diseases (ICD-10) has replaced the Ninth Revision (ICD-9), which was in effect since 1979. Exposure to excessive natural heat as the underlying cause of death is identified by a three-character category X30 in the Tenth Revision and corresponding to it code E900.0 in the Ninth Revision. In this report, the deaths from exposure to heat due to weather conditions are classified by ICD-9 for 1992-1999 and by ICD-10 for 2000-2002. In addition to death certificates where exposure to excessive natural heat was indicated as the underlying cause of death, heatstroke or sunstroke may be reported on death certificates as contributing factors that had a bearing on the death, but were not its underlying cause. For example, heatstroke and sunstroke were mentioned in 2002 on death certificates where brain cancer (D43.2), atherosclerotic cardiovascular disease (I25.0), dilated cardiomyopathy (I42.0), urinary tract infection (N39.0), exposure to other and unspecified forces of nature (X39), accidental overdose of narcotics (X42) and other event of undetermined intent (Y33) were reported as the underlying cause of death. Those heat-related deaths are beyond the scope of this report. Summary of Findings From 1992 to 2002, 570 deaths from exposure to heat due to weather conditions occurred in Arizona. The residents of the State accounted for a majority of these deaths (315, or 55.3 percent). On average, 29 Arizona residents died every year from a heatstroke or sunstroke in the eleven-year period 1992-2002. Visitors to Arizona from other U.S. states or Canada experienced 41 deaths from exposure to heat due to weather conditions during the 1992-2002 period. The 214 deaths from exposure to excessive natural heat among the illegal immigrants crossing the Arizona’s border with Mexico accounted for 37.5 percent of all deaths due to this cause that occurred in the State during the 1992-2002 period. The vast majority (196, or 91.6 percent) of these deaths occurred in the five years from 1998 to 2002. Unprecedented increase in the number of deaths from natural heat among migrants (from no fatalities in 1992, to 13 deaths reported in 1998 and 80 deaths in 2002) was likely to be linked to an increase in illegal immigrant traffic across Arizona’s part of the U.S. – Mexico border. Ironically, it may have been to some extent the result of a rather successful crackdown on illegal immigrants in Texas, New Mexico and California. By 1998, there was a substantial decline in the number of arrests in the traditional illegal immigration corridors of these three states, while the Tucson sector of Arizona was to become the busiest illegal-crossing corridor along the Southwest border. Prior to 1998, the average annual mortality from exposure to heat among the illegal immigrants crossing the State’s southern border did not exceed three (3) deaths/year. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 Figure 1 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY YEAR, 1992-2002 Number of deaths In the eleven-year period from 1992 to 2002, 570 deaths from exposure to excessive natural heat occurred in Arizona. The number of deaths from exposure to excessive natural heat has shown a wide variation from year to year (low = 10 deaths in 1992, high = 119 deaths in 2002. On average, 52 people died every year from a heatstroke or sunstroke in the eleven-year period from 1992 to 2002. The number of 119 deaths from exposure to heat due to weather conditions in 2002 accounted for one-fifth (119/570 or 20.9 percent) of these deaths (Figure 1, Table 1). Approximately seven out of every ten deaths from exposure to excessive natural heat in 19922002 were males (412/570 or 72.3 percent, Table 1). 140 119 120 100 74 80 60 45 50 57 54 56 63 O B J E C T I V E 40 20 23 19 10 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). Included are deaths occurring in Arizona from excessive heat due to weather conditions as the cause of heatstroke or sunstroke among both residents of Arizona and non-residents. Excluded are deaths due to excessive heat of man-made origin. 2 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 From 1992 to 2002, the residents of the State accounted for a majority of deaths from exposure to heat due to weather conditions (315/570, or 55.3 percent). Figure 2 Visitors to Arizona from other U.S. states or Canada experienced 41 deaths from exposure to heat due to weather conditions during the 19922002 period. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY STATE OR COUNTRY OF RESIDENCE AND YEAR, 1992-2002 Number of deaths 140 Arizona Other U.S. state Mexico/Other Central or South American country 120 100 80 60 40 20 0 1992 1993 1994 1995 1996 1998 1999 2000 4 13 23 35 9 0 12 4 0 1 45 19 49 30 21 17 34 23 74 57 56 63 119 Mexico/Other Central or South American country 0 Other U.S. state 2 3 4 1 Arizona 8 15 40 47 Total 10 19 45 50 54 1 1 2 10 1997 O B J E C T I 2001V 45 E 2002 80 5 *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). Included are deaths occurring in Arizona from excessive heat due to weather conditions as the cause of heatstroke or sunstroke among both residents of Arizona and non-residents. Excluded are deaths due to excessive heat of man-made origin. __________________________________________________________________________ 1 http://uscis.gov/graphics/publicaffairs/factsheets/bpops.htm http://uscis.gov/graphics/publicaffairs/newsrels/skywatch.htm http:///uscis.gov/graphics/shared/lawenfor/bpatrol/strategy.htm 2 3 The 214 deaths from exposure to excessive natural heat among the illegal immigrants crossing the Arizona’s border with Mexico accounted for 37.5 percent of all deaths due to this cause that occurred in the State during the 1992-2002 period. The vast majority (196, or 91.6 percent) of these deaths occurred in the five years from 1998 to 2002. There was no climate change, which could explain this unprecedented increase in the number of Arizona deaths from natural heat among illegal immigrants (from no fatalities in 1992, to 13 deaths reported in 1998 and 80 deaths in 2002). Rather, the increase in mortality was likely to be linked to an increase in illegal immigrant traffic across Arizona’s part of the U.S. – Mexico border. It is not unreasonable to assume, that it may have been to some extent the result of a rather successful crackdown on illegal immigrants in Texas, New Mexico and California. By 1998, the success1 of several border operations (Operation Gatekeeper in San Diego, Operation Hold the Line in El Paso, Operation Rio Grande in McAllen) effected a substantial decline in the number of arrests in the traditional illegal immigration corridors of these three states, while the Tucson sector of Arizona’s border was to become “the busiest illegal-crossing corridor along the Southwest border”2. Prior to 1998, the average annual mortality from exposure to heat among the illegal immigrants crossing the State’s southern border did not exceed three (3) deaths/year. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 Figure 3 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY MONTH IN THE ELEVEN-YEAR PERIOD, 1992-2002 Number of deaths 210 195 180 Not surprisingly, in Arizona (1992-2002) most deaths from excessive natural heat occurred during summer and late spring (Figure 3, Table 2, Table 3), with the highest number of deaths occurring during the month of July (195), followed by June (131), then August (124), September (53) and May (43). In 1992-2002, ninety-six percent of all deaths from heat to weather conditions occurred during the five months from May through September. 150 131 124 120 90 60 2 O B J E C T I V E 2 NOV DEC 53 43 30 0 1 2 2 JAN FEB MAR 9 APR 6 MAY JUN JUL AUG SEP OCT *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). Included are deaths occurring in Arizona from excessive heat due to weather conditions as the cause of heatstroke or sunstroke among both residents of Arizona and non-residents. Excluded are deaths due to excessive heat of man-made origin. 4 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 Figure 4 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY MONTH AND RESIDENCE STATUS IN THE ELEVEN-YEAR PERIOD, 1992-2002 Percent of deaths in specified group: 50% Arizona resident 40% Among both the residents of Arizona and visitors from other states, most deaths from excessive natural heat occurred during the month of July (Figure 4, Table 2). Among migrants to Arizona from 1992 through 2002, the highest number of deaths occurred during the month of June. The difference in the seasonal pattern of mortality may mean that fewer migrants attempted to cross the border in July and August, the two summer months with the highest temperatures. Resident of other U.S. state or Canada 30% 20% O B J E C T I V E Resident of Mexico or other Central or South American country 10% 0% JAN FEB MARCH APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). 5 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 Figure 5 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY AGE GROUP AND RESIDENCE STATUS IN THE ELEVEN-YEAR PERIOD, 1992-2002 Percent of deaths in specified group: In 1992-2002, deaths from exposure to excessive natural heat among migrants to Arizona occurred at younger ages compared to deaths from natural heat among the State’s residents (Figure 5). Historically, older adults 65 years or older have been at the highest risk of heatstroke or sunstroke among the age groups of Arizona residents. Less than one percent of all deaths from natural heat among migrants were 65 years and older, while 41.3 percent of fatalities due to exposure to heat among Arizona residents were this old. In fact, deaths from excessive heat ranked fifth among the leading causes of accidental death for Arizona elderly 65 years or older in 1992-2002 (http://www.hs.state.az.us/plan/report/im/im/im02/2/xls/t2_14.xls See also Chapter 2 of the report on Injury Mortality Among Arizona Residents, 1990-2002 available at 75% & 60% Arizona resident 45% $' 30% 15% $ &' & ' $ 0% & ' Arizona$ Mexico/Other Central or South American country Other state/country $ &' Infants <1 0% Children 1-14 1.4% Adolescents 15-19 10.7% Resident of other ' U.S. state or Canada $ http://www.hs.state.az.us/plan/report/im/im/im01/im00/imc2.pdf). Not surprisingly, young adults 20-44 years old accounted during 1992-2002 for 65 percent of deaths from exposure to excessive natural heat among the migrants from Mexico and other Central/South American countries. $ ' & O B J E C Resident of Mexico or T other Central or South IAmerican country V E Elderly & Young adults 20-44 65% Middle-aged adults 45-64 10.7% 65+ 0.9% 0% 2.4% 4.9% 39% 29.3% 24.4% 0.3% 1.9% 1.6% 24.1% 30.2% 41.3% *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). Note: the age was unknown for 24 (11.2 percent) of the illegal immigrants from Mexico and other Central or South American countries. 6 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 Figure 6 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* BY RESIDENCE STATUS AND AREA OF OCCURRENCE IN ARIZONA IN THE ELEVEN-YEAR PERIOD, 1992-2002 Arizona border counties State or country of residence: Arizona Occurrence of death: Central Arizona Northern Arizona counties counties 26.4% 60.3% 13.3% Other U.S. state or Canada Mexico/ Other Central or South 7.0% American country 0.0% 0.0% The four counties along the southern border of Arizona (Cochise, Pima, Santa Cruz, and Yuma) accounted for 93 percent of deaths from excessive heat due to weather conditions among the illegal immigrants (Figure 6, Table 3). In contrast, the centrally situated Maricopa County accounted for the majority of deaths from heat due to weather conditions among both the residents of Arizona and visitors from other States. Beginning with the 2001 data year, information about the specific geographic location of fatal injury was included in the mortality database. In 2001-2002, among the 125 deaths of migrants from exposure to excessive natural heat, 99 occurred in Pima County, most of them in the remote desert areas of the Tohono O’Odham Indian reservation (Figure 7, next page). 31.7% 46.3% 22.0% 93.0% 20.0% 40.0% 60.0% 80.0% *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). 7 100.0% Case summaries of the eighty deaths of migrants to Arizona in 2002, including the geographic location of injury, the city of deaths, the immediate cause of death, age and gender of the deceased, are shown in Table 4. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2002 8 TABLE 1 CHARACTERISTICS OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY YEAR, 1992-2002 Year of death Characteristic Total 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Total State or country of residence Arizona Other U.S. state or Canada Gender Race/ethnic group Age group Mexico/Other Central or South American country Male Female White non-Hispanic Hispanic Black American Indian Asian Undetermined <1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 100+ Unknown 570 315 10 8 19 15 45 40 50 47 54 35 23 19 74 49 57 30 56 21 63 17 119 34 41 2 3 4 1 9 0 12 4 0 1 5 214 0 1 1 2 10 4 13 23 35 45 80 412 158 246 259 17 28 2 18 1 4 1 5 30 43 48 48 44 48 43 37 28 22 24 33 37 18 17 11 1 1 26 4 6 6 3 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 2 0 1 1 2 0 1 0 0 0 0 15 4 9 6 1 2 0 1 0 1 0 1 0 1 1 0 1 1 2 4 1 1 0 2 1 0 0 1 0 0 1 36 9 33 4 3 4 0 1 1 0 0 0 0 1 1 1 3 3 2 4 5 2 3 7 7 2 2 0 0 0 1 38 12 33 11 4 1 1 0 0 0 0 0 1 2 1 4 2 6 1 4 2 6 4 4 3 2 5 2 0 1 0 41 13 32 14 3 5 0 0 0 1 0 1 2 3 2 3 4 1 6 1 6 3 2 3 5 3 3 3 0 0 2 17 6 11 8 0 4 0 0 0 1 0 0 0 1 0 1 3 4 3 2 0 0 0 3 3 1 0 0 0 0 1 62 12 40 29 2 2 0 1 0 1 0 0 8 5 5 1 9 6 7 4 4 2 4 5 4 1 1 2 1 0 4 38 19 23 23 1 5 0 5 0 0 0 0 2 1 5 6 4 4 4 6 1 3 1 1 8 4 1 1 0 0 5 37 19 15 37 1 2 0 1 0 0 0 0 4 6 8 5 6 6 4 1 1 3 5 2 1 2 1 0 0 0 1 40 23 13 44 1 1 0 4 0 0 1 0 3 10 9 8 3 6 3 5 1 2 2 2 0 2 0 1 0 0 5 84 35 31 80 0 2 1 5 0 0 0 3 9 13 16 18 9 11 11 5 5 0 2 3 3 1 3 1 0 0 6 9 TABLE 1 (CONTINUED) CHARACTERISTICS OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY YEAR, 1992-2002 Characteristic County of occurrence Month of occurrence Autopsy performed Total Apache Cochise Coconino Gila Graham Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma La Paz JAN FEB MARCH APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC No Yes 4 15 8 1 1 179 36 3 200 23 6 7 74 13 1 2 2 9 43 131 195 124 53 6 2 2 189 381 Year of death 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 0 0 0 0 3 0 0 0 0 0 1 0 0 0 0 3 2 1 0 3 4 2 0 0 1 1 3 0 0 2 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 3 9 13 17 18 11 37 23 11 10 27 1 1 6 2 5 1 10 0 5 3 2 0 0 1 0 0 0 0 2 0 0 0 2 5 10 12 7 4 11 11 26 37 75 1 2 7 5 1 1 0 0 1 2 3 0 0 0 1 0 0 1 0 2 1 1 0 0 1 1 4 0 0 1 0 0 0 3 1 3 9 6 3 11 17 7 6 8 0 1 3 1 3 1 3 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 2 0 5 0 1 4 1 4 1 0 1 11 14 6 0 6 13 2 15 2 7 17 15 17 37 5 5 18 24 22 8 33 18 16 16 30 4 7 6 19 8 8 26 10 7 7 22 0 0 3 2 3 4 8 5 3 8 17 0 0 0 2 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 3 5 18 25 27 6 24 23 18 13 27 7 14 27 25 27 17 50 34 38 50 92 10 TABLE 2 CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RESIDENCE STATUS, ELEVEN-YEAR SUMMARY FOR 1992-2002 State or country of residence Characteristics Total Arizona Total Year of death Gender Race/ethnic group Age group 570 10 19 45 50 54 23 74 57 56 63 119 412 158 246 259 17 28 2 18 1 10 30 231 130 142 26 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Male Female White non-Hispanic Hispanic Black American Indian Asian Undetermined Infants <1 Children 1-14 Adolescents 15-19 Young adults 20-44 Middle-aged adults 45-64 Elderly 65+ Unknown 11 315 8 15 40 47 35 19 49 30 21 17 34 236 79 222 49 15 26 2 1 1 6 5 76 95 130 2 Other U.S. state or Canada 41 2 3 4 1 9 0 12 4 0 1 5 30 11 23 14 2 2 0 0 0 1 2 16 12 10 0 Mexico/Other Central or South American country 214 0 1 1 2 10 4 13 23 35 45 80 146 68 1 196 0 0 0 17 0 3 23 139 23 2 24 TABLE 2 CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RESIDENCE STATUS, ELEVEN-YEAR SUMMARY FOR 1992-2002 State or country of residence Characteristics Total Other U.S. state or Canada Arizona Occurrence of death* Month of death Autopsy performed Border counties Central Arizona counties Northern Arizona counties JAN FEB MARCH APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC No Yes 295 224 51 1 2 2 9 43 131 195 124 53 6 2 2 189 381 * Border counties: Cochise, Pima, Santa Cruz and Yuma. Central Arizona counties: Gila, Graham, La Paz, Maricopa, Pinal and Yavapai. Northern Arizona counties: Apache, Coconino, Greenlee, Mohave and Navajo. 12 83 190 42 1 2 1 2 11 62 134 80 20 1 0 1 131 184 13 19 9 0 0 0 1 3 11 13 12 1 0 0 0 11 30 Mexico/Other Central or South American country 199 15 0 0 0 1 6 29 58 48 32 32 5 2 1 47 167 TABLE 3 CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY REGION, ELEVEN-YEAR SUMMARY FOR 1992-2002 570 10 19 45 50 54 23 74 57 56 63 119 412 158 246 259 17 28 2 18 1 10 30 231 130 142 26 315 41 295 5 6 13 22 16 9 24 28 38 48 86 202 93 58 210 7 6 0 14 0 5 22 153 47 46 22 83 13 Central Arizona counties 224 4 12 24 25 27 13 40 25 12 12 30 174 50 151 47 10 10 2 4 1 4 6 69 64 76 4 190 19 214 199 15 Total Total Year of death Gender Race/ethnic group Age group State or country of residence 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Male Female White non-Hispanic Hispanic Black American Indian Asian Undetermined Infants <1 Children 1-14 Adolescents 15-19 Young adults 20-44 Middle-aged adults 45-64 Elderly 65+ Unknown Arizona Other U.S. state or Canada Mexico/Other Central or South American country 13 Border counties Northern Arizona counties 51 1 1 8 3 11 1 10 4 6 3 3 36 15 37 2 0 12 0 0 0 1 2 9 19 20 0 42 9 0 TABLE 3 (CONTINUED) CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY REGION, ELEVEN-YEAR SUMMARY FOR 1992-2002 Total Month of death Autopsy performed JAN FEB MARCH APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC No Yes 1 2 2 9 43 131 195 124 53 6 2 2 189 381 Border counties: Cochise, Pima, Santa Cruz and Yuma. Central Arizona counties: Gila, Graham, La Paz, Maricopa, Pinal, Yavapai. Northern Arizona counties: Apache, Coconino, Greenlee, Mohave and Navajo. 14 Border counties 0 1 1 6 33 79 74 54 39 5 2 1 80 215 Central Arizona counties 0 0 1 3 7 40 108 53 11 0 0 1 79 145 Northern Arizona counties 1 1 0 0 3 12 13 17 3 1 0 0 30 21 TABLE 4 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE EIGHTY MIGRANTS TO ARIZONA IN 2002: CASE SUMMARIES Condition causing death as entered on the death 2 certificate Underlying Month of cause of death Case Number Place of injury 1 as entered on the death certificate 1 5/10 M N OF 10 M E 191, RUCKER CANYON DR, ELFRIDA, AZ ELFRIDA COCHISE EXPOSURE TO ELEMENTS X30 APRIL 2 E OF MP31, HWY 191, ELFRIDA, AZ DOUGLAS COCHISE THERMAL REGULATORY FAILURE X30 APRIL 3 N 32.33.297/W112.50.932, GILA BEND AZ GILA BEND MARICOPA HYPERTHERMIA AND DEHYDRATION X30 JULY 4 HIGHWAY 86/MILEPOST 59, AJO, AZ PHOENIX MARICOPA COMPLICATIONS OF HYPERTHERMIA X30 MAY 5 SR 86 MP 120.5 LITTLE TUCSON VILLAGE, AZ LITTLE TUCSON PIMA HEAT STROKE X30 SEPT 6 SR 86 MP 124 (100 WEST), SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA X30 SEPT 7 2/3 MI E/O ST RT 85 MP 60 WHY AZ WHY PIMA PROBABLE HEAT STROKE X30 SEPT 8 6 MILES EAST OF FR 19, SELLS AZ SELLS PIMA HYPERTHERMIA & POSSIBLE DEHYDRATION X30 SEPT 9 FR 161 1.1 MI S/O WATER TANK, LITTLE TUCSON VILLAGE LITTLE TUCSON PIMA HYPERTHERMIA & POSSIBLE DEHYDRATION X30 SEPT 10 1 MI SOUTH SR 86 MP 103, SELLS, ARIZONA SELLS PIMA HEAT STROKE X30 SEPT 11 2 1/2 MILES W/O ST RT 286 MP 31, TUCSON, ARIZONA TUCSON PIMA PROBABLE HYPERTHERMIA X30 SEPT 12 UNKNOWN SAN MIGUEL PIMA PROBABLE HYPERTHERMIA X30 APRIL 13 1 MI S/O SR 86 MP 103, SELLS AZ SELLS PIMA HEAT STROKE X30 SEPT 14 8 MI N 15 MI E OF FR 10 AND FR 9, FRESNAL CANYON, ARIZONA FRESNAL CANYON PIMA HEAT STROKE X30 SEPT 15 UNKNOWN AJO, ARIZONA AJO PIMA PROBABLE HYPERTHERMIA X30 MAY City of death County of death 15 (ICD-10 code) 3 death TABLE 4 (CONTINUED) DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE EIGHTY MIGRANTS TO ARIZONA IN 2002: CASE SUMMARIES Condition causing death as entered on the death 2 certificate Underlying Month of cause of death Case Number Place of injury 1 as entered on the death certificate 16 7 MILE S.SR 86 MP 126.8 SELLS, ARIZONA SELLS PIMA PROBABLE HEAT STROKE X30 MAY 17 1.5 MILE S. SR 86 MP 126.8 SELLS, ARIZONA SELLS PIMA HEAT STROKE X30 MAY 18 AVE 5E CTY 24TH ST YUMA YUMA HEAT EXPOSURE X30 JUNE 19 AVE 11 3/4 AT COUNTY 14 1/2 E YUMA YUMA EXPOSURE TO ELEMENTS X30 JUNE 20 1.6 MILES S OF LITTLE TUCSON VLG (AL CUKSON) SELLS AZ SELLS PIMA PROBABLE HYPERTHERMIA WITH DEHYDRATION X30 MAY 21 DESERT SE OF YUMA, YUMA, AZ YUMA YUMA EXPOSURE TO ELEMENTS X30 JUNE 22 E/O ST RT 85 MP 61 WHY ARIZONA WHY PIMA PROBABLE HYPERTHERMIA X30 SEPT 23 FED RT 35 MP 7.0, SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA X30 SEPT 24 2.5 MI S/O FR 19 MP 19 TOPAWA VILLIAGE, AZ TOPAWA PIMA PROBABLE HYPERTHERMIA X30 SEPT 25 UNKNOWN, UNKNOWN, PHOENIX MARICOPA FINDINGS CONSISTENT WITH DEHYDRATION ELECTROLYTE IMBALANCE X30 JUNE 26 2 MILES SOUTH OF STATE ROUTE 86, MP 126.5, SELLS SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 27 STATE ROUTE 86 MP 74, SELLS SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 28 8 MILES SOUTH OF STATE ROUTE 86, MP 73.6, SELLS SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 29 3.6 MILES NORTH / FEDERAL ROUTE 19, MP 17, SELLS SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE City of death County of death 16 (ICD-10 code) 3 death TABLE 4 (CONTINUED) DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE EIGHTY MIGRANTS TO ARIZONA IN 2002: CASE SUMMARIES Condition causing death as entered on the death 2 certificate Underlying Month of cause of death Case Number Place of injury 1 as entered on the death certificate 30 3.6 MILES NORTH / FEDERAL ROUTE 19, MP 17, SELLS SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 31 GAS LINE RD, MP 55 HICKIWAN VLG, ARIZONA HICKIWAN VLG PIMA PROBABLE HYPERTHERMIA X30 JUNE 32 6 MILES WEST SILVERBELL MINE, TUCSON TUCSON PIMA PROBABLE HYPERTHERMIA X30 JUNE 33 5 MILES NW OF ST RT 86, MP 7 SELLS, ARIZONA SELLS PIMA HYPERTHERMIA AND PROBABLE DEHYDRATION X30 JUNE 34 2.5 MILES SW OF MP 126.5, HWY 86, SELLS, AZ SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 35 UNKNOWN SELLS, ARIZONA TUCSON PIMA HYPERTHERMIA X30 JUNE 36 GPS 32-19.447 N 113 01.148W AJO, ARIZONA AJO PIMA HEAT STROKE X30 JUNE 37 32 DEGREES BY 10.75 N 43212W TUCSON, ARIZONA TUCSON PIMA PROBABLE HYPERTHERMIA X30 JUNE 38 UNKNOWN TUCSON PIMA COMPLICATIONS OF HYPERTHERMIA WITH DEHYDRATION X30 JUNE 39 9 MI. N. SAN PEDRO VILLAGE SAN PEDRO VILLAGE, ARIZONA SAN PEDRO VILLAGE PIMA PROBABLE HEAT STROKE X30 JUNE 40 4 MILES NORTH OF STATE RTE 86, MP 136.5, SAN PEDRO VLG SAN PEDRO VILLAGE PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 41 UNKNOWN SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 42 N32.00664; W111.55.768 SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA X30 JUNE City of death County of death 17 (ICD-10 code) 3 death TABLE 4 (CONTINUED) DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE EIGHTY MIGRANTS TO ARIZONA IN 2002: CASE SUMMARIES Case Number Place of injury 1 as entered on the death certificate 43 UNKNOWN 44 City of death County of death Condition causing death as entered on the death 2 certificate Underlying cause of death (ICD-10 code) Month of death 3 PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 4 MILES S/O ST RT 86 MP 126.5 SELLS, SELLS ARIZONA PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JULY 45 1.5 MILES SOUTHWEST OF SAN MIGUEL VLG, SAN MIGUEL VL SAN MIGUEL VILLAGE PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JUNE 46 1.5 MILES S/W OF LITTLE TUCSON, LITTLE TUCSON, ARIZONA LITTLE TUCSON PIMA PROBABLY HYPERTHERMIA WITH DEHYDRATION X30 JUNE 47 N 32, 22, 57 W 112, 51, 26 AJO ARIZONA AJO PIMA PROBABLE HYPERTHERMIA X30 JUNE 48 1.5 MI S/W OF SAN MIGUEL VILLAGE, SAN MIGUEL VLG, AZ SAN MIGUEL VLG PIMA PROBABLE HYPERTHERMIA WITH DEHYDRATION X30 JUNE 49 N 33 DEG 07.654/W 111DEG 27.342 FLORENCE, ARIZONA FLORENCE PINAL PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JULY 50 FR 20 MP 11.4 SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA X30 JUNE 51 UNKNOWN TUCSON PIMA COMPLICATIONS OF HYPERTHERMIA X30 JULY 52 3 MILES SOUTHWEST / STATE ROUTE 286, MP 25, TUCSON TUCSON PIMA HEAT STROKE X30 JULY 53 1 1/2 MI. EAST OF WATER TANK/FR 161, LITTLE TUCSON LITTLE TUCSON PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JULY 54 SR 86, MP 119.8 SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA X30 JULY 55 N 3149.069; W 11146.884, SELLS SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JULY 56 FR 19, MP 13 SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA X30 JULY THREE POINTS 18 TABLE 4 (CONTINUED) DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE EIGHTY MIGRANTS TO ARIZONA IN 2002: CASE SUMMARIES Condition causing death as entered on the death 2 certificate Underlying Month of cause of death Case Number Place of injury 1 as entered on the death certificate 57 N 3202.463; W 11238.199, SELLS SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JULY 58 SR 86 MP 120 SELLS, ARIZONA SELLS PIMA PROBABLE HEAT STROKE X30 JULY 59 8 MILES S/O ST RT 86 MP 108 SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JULY 60 2 MILES SOUTHEAST OF COWLIC VLG, ARIZONA COWLIC VLG PIMA PROBABLE HYPERTHERMIA AND DEHYDRATION X30 JULY 61 N31, 33, 33.0 W 111.47,0.36 SELLS, ARIZONA SELLS PIMA PROBABLE HEAT STROKE X30 JULY 62 DESERT 7 MI. S/W COWLIC VILLAGE COWLIC VILLAGE, ARIZ COWLIC VILLAGE PIMA HEAT STROKE X30 AUG 63 EAST OF FR 19 MP 5, SAN MIGUEL VILLAGE TUCSON PIMA COMPLICATIONS OF HYPERTHERMIA X30 AUG 64 1/10 MILE S/O END OF FR 161, LITTLE TUCSON LITTLE TUCSON PIMA HEAT STROKE X30 AUG 65 DESERT AREA WEST OF VILL, BIG FIELD VILLAGE, ARIZONA BIG FIELD VILLAGE PIMA HEAT STROKE X30 AUG 66 1/4 MI. S/O MP 128 ON SR 86 SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA X30 AUG 67 ST RT 86 MP 126.5 SELLS, ARIZONA SELLS PIMA PROBABLE HYPERTHERMIA WITH DEHYDRATION X30 AUG 68 N32 14.357 W112.44.909 WHY, ARIZONA WHY PIMA PROBABLE HEAT STROKE X30 AUG 69 4 MILES N OF VAMORI VILLAGE VAMORI VILLAGE, ARIZONA VAMORI VILLAGE PIMA PROBABLE HYPERTHERMIA WITH DEHYDRATION X30 AUG City of death County of death 19 (ICD-10 code) 3 death TABLE 4 (CONTINUED) DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE EIGHTY MIGRANTS TO ARIZONA IN 2002: CASE SUMMARIES Condition causing death as entered on the death 2 certificate Underlying Month of cause of death Case Number Place of injury 1 as entered on the death certificate 70 6 MILES W/O SR 86 & OLD TRADING POST RD. SELLS, AZ SELLS PIMA HEAT STROKE X30 AUG 71 17300 E HUNT HIGHWAY QUEEN CREEK AZ QUEEN CREEK MARICOPA CONSISTENT WITH HEAT STROKE X30 AUG 72 2735 WEST SWEETWATER AVENUE, PHOENIX PHOENIX MARICOPA COMPLICATIONS OF HYPERTHERMIA X30 AUG 73 COUNTY ROAD 23 AND AVE C, YUMA, AZ PHOENIX MARICOPA HYPERTHERMIA AND DEHYDRATION X30 AUG 74 AVE F CTY 23RD ST, SAN LUIS, AZ SAN LUIS YUMA ENVIRONMENTAL (HEAT) EXPOSURE AND DEHYDRATION X30 SEPT 75 AVE E AND JUAN SANCHEZ BLVD SAN LUIS AZ YUMA YUMA ENVIRONMENT HEAT EXPOSURE WITH DEHYDRATION X30 SEPT 76 3 MI SW MP 55 ON SR 85 WHY, ARIZONA WHY PIMA PROBABLE HEAT STROKE X30 AUG 77 3.3 MILES SW RT 86 MP 55.9 WHY, ARIZONA WHY PIMA PROBABLE HEAT STROKE X30 AUG 78 ST RT 86,1 MILE S/O MP 126, SELLS, AZ SELLS PIMA PROBABLE HEAT STROKE X30 JULY 79 5 MILES S/O ARIVACA/SASABE RD MP10, SASABE, AZ SASABE PIMA PROBABLE HEAT STROKE X30 APRIL 80 4.6 MILES S/O OLD RUBY RD & SR 289 NOGALES, AZ NOGALES SANTA CRUZ PROBABLE HEAT STROKE X30 SEPT City of death County of death 1 Not available in the electronic mortality database prior to 2001. The immediate cause of death 3 The underlying (external) cause of death: exposure to excessive natural heat as the cause of heatstroke (sunstroke). 2 20 (ICD-10 code) 3 death