The use of an ‘acclimatisation’ heatwave measure to compare temperature-related demand for emergency services in Australia, Botswana, Netherlands, Pakistan, and USA

van der Linden, N; Longden, T; Richards, JR; Khursheed, M; Goddijn, WMT; van Veelen, MJ; Khan, UR; Christien van der Linden, M

The use of an ‘acclimatisation’ heatwave measure to compare temperature-related demand for emergency services in Australia, Botswana, Netherlands, Pakistan, and USA

van der Linden, N

Longden, T

Richards, JR Khursheed, M Goddijn, WMT van Veelen, MJ Khan, UR Christien van der Linden, M

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Publication Type:: Journal Article
Citation:: PLoS ONE, 2019, 14 (3)
Issue Date:: 2019-03-01

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Field	Value	Language
dc.contributor.author	van der Linden, N https://orcid.org/0000-0003-1646-9834	en_US
dc.contributor.author	Longden, T https://orcid.org/0000-0001-7593-659X	en_US
dc.contributor.author	Richards, JR	en_US
dc.contributor.author	Khursheed, M	en_US
dc.contributor.author	Goddijn, WMT	en_US
dc.contributor.author	van Veelen, MJ	en_US
dc.contributor.author	Khan, UR	en_US
dc.contributor.author	Christien van der Linden, M	en_US
dc.date.available	2019-03-09	en_US
dc.date.issued	2019-03-01	en_US
dc.identifier.citation	PLoS ONE, 2019, 14 (3)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/133444
dc.description.abstract	© 2019 van der Linden et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Heatwaves have been linked to increased risk of mortality and morbidity and are projected to increase in frequency and intensity due to climate change. The current study uses emergency department (ED) data from Australia, Botswana, Netherlands, Pakistan, and the United States of America to evaluate the impact of heatwaves on ED attendances, admissions and mortality. Methods Routinely collected time series data were obtained from 18 hospitals. Two separate thresholds (4 and 7) of the acclimatisation excess heat index (EHIaccl) were used to define “hot days”. Analyses included descriptive statistics, independent samples T-tests to determine differences in case mix between hot days and other days, and threshold regression to determine which temperature thresholds correspond to large increases in ED attendances. Findings In all regions, increases in temperature that did not coincide with time to acclimatise resulted in increases in ED attendances, and the EHIaccl performed in a similar manner. During hot days in California and The Netherlands, significantly more children ended up in the ED, while in Pakistan more elderly people attended. Hot days were associated with more patient admissions in the ages 5–11 in California, 65–74 in Karachi, and 75–84 in The Hague. During hot days in The Hague, patients with psychiatric symptoms were more likely to die. The current study did not identify a threshold temperature associated with particularly large increases in ED demand. Interpretation The association between heat and ED demand differs between regions. A limitation of the current study is that it does not consider delayed effects or influences of other environmental factors. Given the association between heat and ED use, hospitals and governmental authorities should recognise the demands that heat can place on local health care systems. These demands differ substantially between regions, with Pakistan being the most heavily affected within our study sample.	en_US
dc.relation.ispartof	PLoS ONE	en_US
dc.relation.isbasedon	10.1371/journal.pone.0214242	en_US
dc.subject.classification	General Science & Technology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Heat Stress Disorders	en_US
dc.subject.mesh	Seasons	en_US
dc.subject.mesh	Acclimatization	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Child	en_US
dc.subject.mesh	Child, Preschool	en_US
dc.subject.mesh	Emergency Service, Hospital	en_US
dc.subject.mesh	Emergency Medical Services	en_US
dc.subject.mesh	Botswana	en_US
dc.subject.mesh	California	en_US
dc.subject.mesh	Pakistan	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Netherlands	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Extreme Heat	en_US
dc.subject.mesh	Climate Change	en_US
dc.title	The use of an ‘acclimatisation’ heatwave measure to compare temperature-related demand for emergency services in Australia, Botswana, Netherlands, Pakistan, and USA	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	14	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	14	en_US

Abstract:

© 2019 van der Linden et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Heatwaves have been linked to increased risk of mortality and morbidity and are projected to increase in frequency and intensity due to climate change. The current study uses emergency department (ED) data from Australia, Botswana, Netherlands, Pakistan, and the United States of America to evaluate the impact of heatwaves on ED attendances, admissions and mortality. Methods Routinely collected time series data were obtained from 18 hospitals. Two separate thresholds (4 and 7) of the acclimatisation excess heat index (EHIaccl) were used to define “hot days”. Analyses included descriptive statistics, independent samples T-tests to determine differences in case mix between hot days and other days, and threshold regression to determine which temperature thresholds correspond to large increases in ED attendances. Findings In all regions, increases in temperature that did not coincide with time to acclimatise resulted in increases in ED attendances, and the EHIaccl performed in a similar manner. During hot days in California and The Netherlands, significantly more children ended up in the ED, while in Pakistan more elderly people attended. Hot days were associated with more patient admissions in the ages 5–11 in California, 65–74 in Karachi, and 75–84 in The Hague. During hot days in The Hague, patients with psychiatric symptoms were more likely to die. The current study did not identify a threshold temperature associated with particularly large increases in ED demand. Interpretation The association between heat and ED demand differs between regions. A limitation of the current study is that it does not consider delayed effects or influences of other environmental factors. Given the association between heat and ED use, hospitals and governmental authorities should recognise the demands that heat can place on local health care systems. These demands differ substantially between regions, with Pakistan being the most heavily affected within our study sample.

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http://hdl.handle.net/10453/133444