Extreme temperature and out-of-hospital-cardiac-arrest. Nationwide study in a hot climate country

Environmental Health

Victor Novack¹  Alexandra Shtein²  Hannan Kranc³  Rimma Sherman⁴  Lena Novack⁵ 

[1] Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel;Department of Internal Medicine, Soroka University Medical Center, Beer Sheva, Israel;Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel;Department of Public Health, Faculty of Health Sciences, School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel;Endicott College, Beverly, MA, USA;Negev Environmental Health Research Institute, Soroka University Medical Center, 84101, Beer Sheva, Israel;Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel;

关键词: OHCA;    Meteorology;    Climate change;    Temperature;    Humidity;    Solar radiation;   

DOI  :  10.1186/s12940-021-00722-1

来源: Springer

【 摘 要 】

BackgroundOut-of-hospital-cardiac arrest (OHCA) is frequently linked to environmental exposures. Climate change and global warming phenomenon have been found related to cardiovascular morbidity, however there is no agreement on their impact on OHCA occurrence. In this nationwide analysis, we aimed to assess the incidence of the OHCA events attended by emergency medical services (EMS), in relation to meteorological conditions: temperature, humidity, heat index and solar radiation.MethodsWe analyzed all adult cases of OHCA in Israel attended by EMS during 2016–2017. In the case-crossover design, we compared ambient exposure within 72 h prior to the OHCA event with exposure prior to the four control times using conditional logistic regression in a lag-distributed non-linear model.ResultsThere were 12,401 OHCA cases (68.3% were pronounced dead-on-scene). The patients were on average 75.5 ± 16.2 years old and 55.8% of them were males.Exposure to 90th and 10th percentile of temperature adjusted to humidity were positively associated with the OHCA with borderline significance (Odds Ratio (OR) =1.20, 95%CI 0.97; 1.49 and OR 1.16, 95%CI 0.95; 1.41, respectively). Relative humidity below the 10th percentile was a risk factor for OHCA, independent of temperature, with borderline significance (OR = 1.16, 95%CI 0.96; 1.38). Analysis stratified by seasons revealed an adverse effect of exposure to 90th percentile of temperature when estimated in summer (OR = 3.34, 95%CI 1.90; 3.5.86) and exposure to temperatures below 10th percentile in winter (OR = 1.75, 95%CI 1.23; 2.49). Low temperatures during a warm season and high temperatures during a cold season had a protective effect on OHCA. The heat index followed a similar pattern, where an adverse effect was demonstrated for extreme levels of exposure.ConclusionsEvolving climate conditions characterized by excessive heat and low humidity represent risk factors for OHCA. As these conditions are easily avoided, by air conditioning and behavioral restrictions, necessary prevention measures are warranted.

【 授权许可】

CC BY