Time-series Analysis of Heat Waves and Emergency Department Visits in Atlanta, 1993 to 2012

Heat waves are extreme weather events that have been associated with adverse health outcomes. However, there is limited knowledge of heat waves' impact on population morbidity, such as emergency department (ED) visits. We investigated associations between heat waves and ED visits for 17 outcome...

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Bibliographic Details
Published in:Environmental health perspectives 2017-05, Vol.125 (5), p.057009
Main Authors: Chen, Tianqi, Sarnat, Stefanie E, Grundstein, Andrew J, Winquist, Andrea, Chang, Howard H
Format: Article
Language:English
Subjects:
Acute Kidney Injury - epidemiology
Air conditioners
Air conditioning
Air temperature
Asthma
Climate change
Codes
Confidence intervals
Diabetes
Electrolytes
Emergency medical care
Emergency medical services
Emergency preparedness
Emergency Service, Hospital - statistics & numerical data
Emergency services
Extreme weather
Georgia - epidemiology
Heat
Heat waves
Heatstroke
Hospitals
Hot Temperature - adverse effects
Hot weather
Humans
Intestinal Diseases - epidemiology
Intestine
Ischemia
Kidney diseases
Morbidity
Mortality
Older people
Outdoor air quality
Patient admissions
Population
Public health
Renal failure
Stroke - epidemiology
Studies
Temperature distribution
Temperature effects
Time series
Time series analysis
Urban Population - statistics & numerical data
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Summary:Heat waves are extreme weather events that have been associated with adverse health outcomes. However, there is limited knowledge of heat waves' impact on population morbidity, such as emergency department (ED) visits. We investigated associations between heat waves and ED visits for 17 outcomes in Atlanta over a 20-year period, 1993-2012. Associations were estimated using Poisson log-linear models controlling for continuous air temperature, dew-point temperature, day of week, holidays, and time trends. We defined heat waves as periods of consecutive days with temperatures beyond the 98th percentile of the temperature distribution over the period from 1945-2012. We considered six heat wave definitions using maximum, minimum, and average air temperatures and apparent temperatures. Associations by heat wave characteristics were examined. Among all outcome-heat wave combinations, associations were strongest between ED visits for acute renal failure and heat waves defined by maximum apparent temperature at lag 0 [relative risk (RR) = 1.15; 95% confidence interval (CI): 1.03-1.29], ED visits for ischemic stroke and heat waves defined by minimum temperature at lag 0 (RR = 1.09; 95% CI: 1.02-1.17), and ED visits for intestinal infection and heat waves defined by average temperature at lag 1 (RR = 1.10; 95% CI: 1.00-1.21). ED visits for all internal causes were associated with heat waves defined by maximum temperature at lag 1 (RR = 1.02; 95% CI: 1.00, 1.04). Heat waves can confer additional risks of ED visits beyond those of daily air temperature, even in a region with high air-conditioning prevalence. https://doi.org/10.1289/EHP44.
ISSN:0091-6765
1552-9924
DOI:10.1289/ehp44