The impact of heat on mortality and morbidity in the Greater Metropolitan Sydney Region: a case crossover analysis

Environmental Health

Research

Hisham Abu-Rayya¹  Leigh Ann Wilson²  Richard Broome³  Fay H Johnston⁴  Clive Gaskin⁵  Ivan Charles Hanigan⁶  Bin Jalaludin⁷  Geoffrey Gerard Morgan⁸ 

[1] Centre for Epidemiology and Research, NSW Health, Sydney, Australia;Faculty of Health Science, University of Sydney, Sydney, Australia;School of Science and Health, University of Western Sydney, Sydney, Australia;Health Protection New South Wales, Sydney, Australia;Menzies Research Institute, University of Tasmania, Hobart, Australia;NSW Cancer Institute, Sydney, Australia;National Centre for Epidemiology and Population Health, Australian National University, Acton, Australia;School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia;Centre for Research, Evidence Management and Surveillance, South Western Sydney Local Health District, Sydney, Australia;University Centre for Rural Health – North Coast, University of Sydney, Sydney, Australia;North Coast Public Health Unit, Mid North Coast Local Health District, New South Wales, Australia;

关键词: Climate change;    Heat-wave;    Heat-related illness;    Heat threshold;    Case-crossover design;   

DOI  :  10.1186/1476-069X-12-98

 received in 2013-01-08, accepted in 2013-10-23,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThis study examined the association between unusually high temperature and daily mortality (1997–2007) and hospital admissions (1997–2010) in the Sydney Greater Metropolitan Region (GMR) to assist in the development of targeted health programs designed to minimise the public health impact of extreme heat.MethodsSydney GMR was categorized into five climate zones. Heat-events were defined as severe or extreme. Using a time-stratified case-crossover design with a conditional logistic regression model we adjusted for influenza epidemics, public holidays, and climate zone. Odds ratios (OR) and 95% confidence intervals were estimated for associations between daily mortality and hospital admissions with heat-event days compared to non-heat event days for single and three day heat-events.ResultsAll-cause mortality overall had similar magnitude associations with single day and three day extreme and severe events as did all cardiovascular mortality. Respiratory mortality was associated with single day and three day severe events (95thpercentile, lag0: OR = 1.14; 95%CI: 1.04 to 1.24). Diabetes mortality had similar magnitude associations with single day and three day severe events (95thpercentile, lag0: OR = 1.22; 95%CI: 1.03 to 1.46) but was not associated with extreme events. Hospital admissions for heat related injuries, dehydration, and other fluid disorders were associated with single day and three day extreme and severe events. Contrary to our findings for mortality, we found inconsistent and sometimes inverse associations for extreme and severe events with cardiovascular disease and respiratory disease hospital admissions. Controlling for air pollutants did not influence the mortality associations but reduced the magnitude of the associations with hospital admissions particularly for ozone and respiratory disease.ConclusionsSingle and three day events of unusually high temperatures in Sydney are associated with similar magnitude increases in mortality and hospital admissions. The trend towards an inverse association between cardio-vascular admissions and heat-events and the strong positive association between cardio-vascular mortality and heat-events suggests these events may lead to a rapid deterioration in persons with existing cardio-vascular disease resulting in death. To reduce the adverse effects of high temperatures over multiple days, and less extreme but more frequent temperatures over single days, targeted public health messages are critical.

【 授权许可】

Unknown   
© Wilson et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.