The Value of Local Heatwave Impact Assessment: A Case-Crossover Analysis of Hospital Emergency Department Presentations in Tasmania, Australia.
Sharon L CampbellTomas A RemenyiGrant J WilliamsonChristopher J WhiteFay H JohnstonPublished in: International journal of environmental research and public health (2019)
Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events on hospital emergency department (ED) presentations in the two most populous regions of Tasmania, Australia, from 2008-2016. Using conditional logistic regression, we analyzed the relationship between ED presentations and severe/extreme heatwaves for the whole population, specific demographics including age, gender and socio-economic advantage, and diagnostic conditions that are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05, 95% CI 1.01-1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03-1.24) for children 15 years and under, and by 19% (OR 1.19, 95% CI 1.04-1.36) for children 5 years and under. A less precise association in the same direction was found for those over 65 years. For diagnostic subgroups, non-significant increases in ED presentations were observed for asthma, diabetes, hypertension, and atrial fibrillation. These findings may assist ED surge capacity planning and public health preparedness and response activities for heatwave events in Tasmania, highlighting the importance of using local research to inform local practice.
Keyphrases
- emergency department
- public health
- healthcare
- climate change
- human health
- adverse drug
- atrial fibrillation
- risk assessment
- young adults
- type diabetes
- open label
- blood pressure
- chronic obstructive pulmonary disease
- mental health
- global health
- primary care
- heart failure
- cystic fibrosis
- double blind
- metabolic syndrome
- acute care
- lung function
- left atrial appendage
- clinical trial
- adipose tissue
- placebo controlled
- early onset
- catheter ablation
- oral anticoagulants
- acute coronary syndrome
- insulin resistance
- mitral valve
- quality improvement
- left ventricular