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Effects of temperature and heat waves on emergency department visits and emergency ambulance dispatches in Pudong New Area, China: a time series analysis.

Sun X, Sun Q, Yang M, Zhou X, Li X, Yu A, Geng F, Guo Y - Environ Health (2014)

Bottom Line: Immediate effects of temperature on EDV and EAD were detected, after controlling for trends of time and day of week.The relative increase of EAD were 4.85% (95% CI: 1.42%, 8.39%) and 3.94% (95% CI: 0.88%, 7.10%).This wider view of the health effect of temperature indicated that interventions for both public health education and health services management should be considered in the study region.

View Article: PubMed Central - PubMed

Affiliation: Center for Disease Prevention and Control of Pudong New Area, Shanghai, 3039 Zhangyang Rd, Shanghai 200136, People's Republic of China. lunwen@pdcdc.sh.cn.

ABSTRACT

Background: In July 2013, an extended heat episode with extreme high temperature covered Pudong New Area, the largest district in Shanghai. The current study estimates the impacts of temperature and heat waves on emergency department visits (EDV) and emergency ambulance dispatches (EAD) using time-series approaches in Pudong, from 2011 to 2013.

Methods: An over-dispersed Poisson generalized additive model was used to examine the association between temperature and EDV and EAD. Heat wave effects with different heat wave definitions considering both the intensity and durations were also estimated.

Results: Immediate effects of temperature on EDV and EAD were detected, after controlling for trends of time and day of week. The exposure-response relationships showed J-shaped curves with higher threshold temperature of EDV than that of EAD visually. When estimating risk changes on heat days compared with non-heat days using different percentiles of daily mean temperature in definition, EAD showed significant increases while non-significant or even negative associations were found for EDV. Heat wave with intensity above the 90th percentile had 2.62% (95% CI: 1.78%, 3.46%) and 0.95% (95% CI: 0.22%, 1.69%) increases in EDV for a duration of at least 2 days and 3 days respectively. The relative increase of EAD were 4.85% (95% CI: 1.42%, 8.39%) and 3.94% (95% CI: 0.88%, 7.10%).

Conclusions: Varied effects of temperature and heat waves on emergency department visits and emergency ambulance dispatches were investigated. This wider view of the health effect of temperature indicated that interventions for both public health education and health services management should be considered in the study region.

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Related in: MedlinePlus

Emergency department visits (upper), emergency ambulance dispatches (middle) and daily mean temperature (down) in Pudong, 2011–2013.
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Fig1: Emergency department visits (upper), emergency ambulance dispatches (middle) and daily mean temperature (down) in Pudong, 2011–2013.

Mentions: Figure 1 shows the time series of EDV and EAD, along with the daily mean temperature. No obvious seasonal patterns showed in these two morbidity indicators. The EDV data showed three spikes: one early in 2011, another in July 2012, and a third on Jan. 30th 2013. As no obvious cause was detected after considering holidays and influenza information, we re-run the analyses by removing this three spikes in our sensitivity analyses (results shown later).Table 1


Effects of temperature and heat waves on emergency department visits and emergency ambulance dispatches in Pudong New Area, China: a time series analysis.

Sun X, Sun Q, Yang M, Zhou X, Li X, Yu A, Geng F, Guo Y - Environ Health (2014)

Emergency department visits (upper), emergency ambulance dispatches (middle) and daily mean temperature (down) in Pudong, 2011–2013.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4201734&req=5

Fig1: Emergency department visits (upper), emergency ambulance dispatches (middle) and daily mean temperature (down) in Pudong, 2011–2013.
Mentions: Figure 1 shows the time series of EDV and EAD, along with the daily mean temperature. No obvious seasonal patterns showed in these two morbidity indicators. The EDV data showed three spikes: one early in 2011, another in July 2012, and a third on Jan. 30th 2013. As no obvious cause was detected after considering holidays and influenza information, we re-run the analyses by removing this three spikes in our sensitivity analyses (results shown later).Table 1

Bottom Line: Immediate effects of temperature on EDV and EAD were detected, after controlling for trends of time and day of week.The relative increase of EAD were 4.85% (95% CI: 1.42%, 8.39%) and 3.94% (95% CI: 0.88%, 7.10%).This wider view of the health effect of temperature indicated that interventions for both public health education and health services management should be considered in the study region.

View Article: PubMed Central - PubMed

Affiliation: Center for Disease Prevention and Control of Pudong New Area, Shanghai, 3039 Zhangyang Rd, Shanghai 200136, People's Republic of China. lunwen@pdcdc.sh.cn.

ABSTRACT

Background: In July 2013, an extended heat episode with extreme high temperature covered Pudong New Area, the largest district in Shanghai. The current study estimates the impacts of temperature and heat waves on emergency department visits (EDV) and emergency ambulance dispatches (EAD) using time-series approaches in Pudong, from 2011 to 2013.

Methods: An over-dispersed Poisson generalized additive model was used to examine the association between temperature and EDV and EAD. Heat wave effects with different heat wave definitions considering both the intensity and durations were also estimated.

Results: Immediate effects of temperature on EDV and EAD were detected, after controlling for trends of time and day of week. The exposure-response relationships showed J-shaped curves with higher threshold temperature of EDV than that of EAD visually. When estimating risk changes on heat days compared with non-heat days using different percentiles of daily mean temperature in definition, EAD showed significant increases while non-significant or even negative associations were found for EDV. Heat wave with intensity above the 90th percentile had 2.62% (95% CI: 1.78%, 3.46%) and 0.95% (95% CI: 0.22%, 1.69%) increases in EDV for a duration of at least 2 days and 3 days respectively. The relative increase of EAD were 4.85% (95% CI: 1.42%, 8.39%) and 3.94% (95% CI: 0.88%, 7.10%).

Conclusions: Varied effects of temperature and heat waves on emergency department visits and emergency ambulance dispatches were investigated. This wider view of the health effect of temperature indicated that interventions for both public health education and health services management should be considered in the study region.

Show MeSH
Related in: MedlinePlus