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Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France.

Josseran L, Caillère N, Brun-Ney D, Rottner J, Filleul L, Brucker G, Astagneau P - BMC Med Inform Decis Mak (2009)

Bottom Line: Over all health conditions, the total number of patients per day remained equal between the 'on alert' and 'off alert' periods (4,557.7/day vs. 4,511.2/day), but the number of elderly patients increased significantly during the 'on alert' period relative to the 'off alert' period (476.7/day vs. 446.2/day p < 0.05).Our results show the interest to monitor specific indicators during hot periods and to focus surveillance efforts on the elderly.This method of surveillance should therefore be considered as an essential part of efforts to prevent the health effects of heat waves.

View Article: PubMed Central - HTML - PubMed

Affiliation: French Institute for Public Health Surveillance, Saint Maurice, France. l.josseran@invs.sante.fr

ABSTRACT

Background: The health impacts of heat waves are serious and have prompted the development of heat wave response plans. Even when they are efficient, these plans are developed to limit the health effects of heat waves. This study was designed to determine relevant indicators related to health effects of heat waves and to evaluate the ability of a syndromic surveillance system to monitor variations in the activity of emergency departments over time. The study uses data collected during the summer 2006 when a new heat wave occurred in France.

Methods: Data recorded from 49 emergency departments since July 2004, were transmitted daily via the Internet to the French Institute for Public Health Surveillance. Items collected on patients included diagnosis (ICD10 codes), outcome, and age. Statistical t-tests were used to compare, for several health conditions, the daily averages of patients within different age groups and periods (whether 'on alert' or 'off alert').

Results: A limited number of adverse health conditions occurred more frequently during hot period: dehydration, hyperthermia, malaise, hyponatremia, renal colic, and renal failure. Over all health conditions, the total number of patients per day remained equal between the 'on alert' and 'off alert' periods (4,557.7/day vs. 4,511.2/day), but the number of elderly patients increased significantly during the 'on alert' period relative to the 'off alert' period (476.7/day vs. 446.2/day p < 0.05).

Conclusion: Our results show the interest to monitor specific indicators during hot periods and to focus surveillance efforts on the elderly. Syndromic surveillance allowed the collection of data in real time and the subsequent optimization of the response by public health agencies. This method of surveillance should therefore be considered as an essential part of efforts to prevent the health effects of heat waves.

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Evolution of the heat wave disease syndrome indicator and the national mean temperature 49 ED, France, 2006.
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Figure 1: Evolution of the heat wave disease syndrome indicator and the national mean temperature 49 ED, France, 2006.

Mentions: The daily average numbers of ED visits and hospitalisation outcomes for each syndrome and for each age group were compared between ONAP and OFAP. A group of heat wave disease syndromes (HWDS) was defined to include those diagnoses that were significantly more frequent during ONAP than during OFAP. The HWDS indicator based on this group is presented in Figure 1 and is compared with the national temperature recorded by Météo France®. ED visits for other diagnoses were also included in the analysis. Comparisons of proportions and means were done using the Pearson chi square test and Student's t-test. Differences were considered significant when p < 0.05. Statistical analyses were carried out using the Statistical Package for the Social Sciences version 13 program (SPSS® v13).


Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France.

Josseran L, Caillère N, Brun-Ney D, Rottner J, Filleul L, Brucker G, Astagneau P - BMC Med Inform Decis Mak (2009)

Evolution of the heat wave disease syndrome indicator and the national mean temperature 49 ED, France, 2006.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2654446&req=5

Figure 1: Evolution of the heat wave disease syndrome indicator and the national mean temperature 49 ED, France, 2006.
Mentions: The daily average numbers of ED visits and hospitalisation outcomes for each syndrome and for each age group were compared between ONAP and OFAP. A group of heat wave disease syndromes (HWDS) was defined to include those diagnoses that were significantly more frequent during ONAP than during OFAP. The HWDS indicator based on this group is presented in Figure 1 and is compared with the national temperature recorded by Météo France®. ED visits for other diagnoses were also included in the analysis. Comparisons of proportions and means were done using the Pearson chi square test and Student's t-test. Differences were considered significant when p < 0.05. Statistical analyses were carried out using the Statistical Package for the Social Sciences version 13 program (SPSS® v13).

Bottom Line: Over all health conditions, the total number of patients per day remained equal between the 'on alert' and 'off alert' periods (4,557.7/day vs. 4,511.2/day), but the number of elderly patients increased significantly during the 'on alert' period relative to the 'off alert' period (476.7/day vs. 446.2/day p < 0.05).Our results show the interest to monitor specific indicators during hot periods and to focus surveillance efforts on the elderly.This method of surveillance should therefore be considered as an essential part of efforts to prevent the health effects of heat waves.

View Article: PubMed Central - HTML - PubMed

Affiliation: French Institute for Public Health Surveillance, Saint Maurice, France. l.josseran@invs.sante.fr

ABSTRACT

Background: The health impacts of heat waves are serious and have prompted the development of heat wave response plans. Even when they are efficient, these plans are developed to limit the health effects of heat waves. This study was designed to determine relevant indicators related to health effects of heat waves and to evaluate the ability of a syndromic surveillance system to monitor variations in the activity of emergency departments over time. The study uses data collected during the summer 2006 when a new heat wave occurred in France.

Methods: Data recorded from 49 emergency departments since July 2004, were transmitted daily via the Internet to the French Institute for Public Health Surveillance. Items collected on patients included diagnosis (ICD10 codes), outcome, and age. Statistical t-tests were used to compare, for several health conditions, the daily averages of patients within different age groups and periods (whether 'on alert' or 'off alert').

Results: A limited number of adverse health conditions occurred more frequently during hot period: dehydration, hyperthermia, malaise, hyponatremia, renal colic, and renal failure. Over all health conditions, the total number of patients per day remained equal between the 'on alert' and 'off alert' periods (4,557.7/day vs. 4,511.2/day), but the number of elderly patients increased significantly during the 'on alert' period relative to the 'off alert' period (476.7/day vs. 446.2/day p < 0.05).

Conclusion: Our results show the interest to monitor specific indicators during hot periods and to focus surveillance efforts on the elderly. Syndromic surveillance allowed the collection of data in real time and the subsequent optimization of the response by public health agencies. This method of surveillance should therefore be considered as an essential part of efforts to prevent the health effects of heat waves.

Show MeSH
Related in: MedlinePlus