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The Impact of Heat on an Emergency Department in Italy: Attributable Visits among Children, Adults, and the Elderly during the Warm Season.

Ghirardi L, Bisoffi G, Mirandola R, Ricci G, Baccini M - PLoS ONE (2015)

Bottom Line: We found a positive and immediate association between event occurrence and mean apparent temperatures exceeding a threshold located around 28-29°C.Focusing only on high-priority visits, the estimated percent change was larger and the greatest effect was among children.Due to the record high temperatures observed in 2012 in Italy and in Europe, the impact in 2012 was much larger than in 2011, and consisted in 34 high-priority visits every 10000 children, 30 every 10000 people aged 15-64, and 38 every 10000 people aged 65 and over.

View Article: PubMed Central - PubMed

Affiliation: Department of Statistics, Informatics and Applications ''G. Parenti", University of Florence, Florence, Italy.

ABSTRACT

Introduction: Recent studies suggest that heat is associated with an increase in the number of ambulance calls and emergency department visits. We investigated the association between heat and daily number of emergency department visits at the University Hospital of Verona during the warm seasons 2011-2012 and we assessed the magnitude of the impact in terms of attributable events, focusing on the role of age and triage codification.

Materials and methods: We used a Poisson model to analyse the association between daily number of visits and daily mean apparent temperature, accounting for air pollution level and seasonality. The analyses were stratified by age group and were performed both on the total number of emergency department visits and on the subsample of high-priority visits. Impact estimates were obtained only for this subsample, using a Monte Carlo approach to account for sampling variability. Number of attributable events and attributable community rate were calculated.

Results: We found a positive and immediate association between event occurrence and mean apparent temperatures exceeding a threshold located around 28-29°C. The estimated percent change in the total number of visits per 1°C increase of exposure above the threshold was equal to 3.75 (90% CI: 3.01; 4.49). Focusing only on high-priority visits, the estimated percent change was larger and the greatest effect was among children. We estimated that apparent temperatures above the threshold were responsible for 1177 high-priority visits during the study period. Due to the record high temperatures observed in 2012 in Italy and in Europe, the impact in 2012 was much larger than in 2011, and consisted in 34 high-priority visits every 10000 children, 30 every 10000 people aged 15-64, and 38 every 10000 people aged 65 and over.

Discussion: Our results indicate that heat affects not only the elderly, but also children and non-elderly adults, stressing the need for developing public health preparedness plans for the entire community.

No MeSH data available.


Related in: MedlinePlus

Daily mean apparent temperatures at lag 0–3 and expected daily numbers of attributable no-white tag visits during the study period.Daily mean apparent temperatures at lag 0–3 in 2011 and 2012 (upper panel); expected daily numbers of attributable no-white tag visits (for each day the median of the distribution is reported) in 2011 and 2012 (lower panel). In the upper panel, horizontal continuous lines represent the estimated threshold and dotted lines represent the associated 90% confidence interval (CI); in the lower panel, dotted lines represent the 10th and 90th percentiles of the distribution of the daily number of attributable visits. The values on the x axis refer to the calendar days within each warm season, from 1, representing May 15th, to 122, representing September 15th.
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pone.0141054.g002: Daily mean apparent temperatures at lag 0–3 and expected daily numbers of attributable no-white tag visits during the study period.Daily mean apparent temperatures at lag 0–3 in 2011 and 2012 (upper panel); expected daily numbers of attributable no-white tag visits (for each day the median of the distribution is reported) in 2011 and 2012 (lower panel). In the upper panel, horizontal continuous lines represent the estimated threshold and dotted lines represent the associated 90% confidence interval (CI); in the lower panel, dotted lines represent the 10th and 90th percentiles of the distribution of the daily number of attributable visits. The values on the x axis refer to the calendar days within each warm season, from 1, representing May 15th, to 122, representing September 15th.

Mentions: Fig 2 shows the daily mean apparent temperatures at lag 0–3 (upper panel) and the expected daily number of attributable no-white tag visits (lower panel) during 2011 and 2012.


The Impact of Heat on an Emergency Department in Italy: Attributable Visits among Children, Adults, and the Elderly during the Warm Season.

Ghirardi L, Bisoffi G, Mirandola R, Ricci G, Baccini M - PLoS ONE (2015)

Daily mean apparent temperatures at lag 0–3 and expected daily numbers of attributable no-white tag visits during the study period.Daily mean apparent temperatures at lag 0–3 in 2011 and 2012 (upper panel); expected daily numbers of attributable no-white tag visits (for each day the median of the distribution is reported) in 2011 and 2012 (lower panel). In the upper panel, horizontal continuous lines represent the estimated threshold and dotted lines represent the associated 90% confidence interval (CI); in the lower panel, dotted lines represent the 10th and 90th percentiles of the distribution of the daily number of attributable visits. The values on the x axis refer to the calendar days within each warm season, from 1, representing May 15th, to 122, representing September 15th.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4626073&req=5

pone.0141054.g002: Daily mean apparent temperatures at lag 0–3 and expected daily numbers of attributable no-white tag visits during the study period.Daily mean apparent temperatures at lag 0–3 in 2011 and 2012 (upper panel); expected daily numbers of attributable no-white tag visits (for each day the median of the distribution is reported) in 2011 and 2012 (lower panel). In the upper panel, horizontal continuous lines represent the estimated threshold and dotted lines represent the associated 90% confidence interval (CI); in the lower panel, dotted lines represent the 10th and 90th percentiles of the distribution of the daily number of attributable visits. The values on the x axis refer to the calendar days within each warm season, from 1, representing May 15th, to 122, representing September 15th.
Mentions: Fig 2 shows the daily mean apparent temperatures at lag 0–3 (upper panel) and the expected daily number of attributable no-white tag visits (lower panel) during 2011 and 2012.

Bottom Line: We found a positive and immediate association between event occurrence and mean apparent temperatures exceeding a threshold located around 28-29°C.Focusing only on high-priority visits, the estimated percent change was larger and the greatest effect was among children.Due to the record high temperatures observed in 2012 in Italy and in Europe, the impact in 2012 was much larger than in 2011, and consisted in 34 high-priority visits every 10000 children, 30 every 10000 people aged 15-64, and 38 every 10000 people aged 65 and over.

View Article: PubMed Central - PubMed

Affiliation: Department of Statistics, Informatics and Applications ''G. Parenti", University of Florence, Florence, Italy.

ABSTRACT

Introduction: Recent studies suggest that heat is associated with an increase in the number of ambulance calls and emergency department visits. We investigated the association between heat and daily number of emergency department visits at the University Hospital of Verona during the warm seasons 2011-2012 and we assessed the magnitude of the impact in terms of attributable events, focusing on the role of age and triage codification.

Materials and methods: We used a Poisson model to analyse the association between daily number of visits and daily mean apparent temperature, accounting for air pollution level and seasonality. The analyses were stratified by age group and were performed both on the total number of emergency department visits and on the subsample of high-priority visits. Impact estimates were obtained only for this subsample, using a Monte Carlo approach to account for sampling variability. Number of attributable events and attributable community rate were calculated.

Results: We found a positive and immediate association between event occurrence and mean apparent temperatures exceeding a threshold located around 28-29°C. The estimated percent change in the total number of visits per 1°C increase of exposure above the threshold was equal to 3.75 (90% CI: 3.01; 4.49). Focusing only on high-priority visits, the estimated percent change was larger and the greatest effect was among children. We estimated that apparent temperatures above the threshold were responsible for 1177 high-priority visits during the study period. Due to the record high temperatures observed in 2012 in Italy and in Europe, the impact in 2012 was much larger than in 2011, and consisted in 34 high-priority visits every 10000 children, 30 every 10000 people aged 15-64, and 38 every 10000 people aged 65 and over.

Discussion: Our results indicate that heat affects not only the elderly, but also children and non-elderly adults, stressing the need for developing public health preparedness plans for the entire community.

No MeSH data available.


Related in: MedlinePlus