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

Naomi van der Linden, Thomas Longden, John R Richards, Munawar Khursheed, Wilhelmina M.T. Goddijn, Michiel J. van Veelen, Uzma Rahim Khan, M. Christien van der Linden

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numbere0214242
JournalPloS one
Volume14
Issue number3
DOIs
StatePublished - Mar 1 2019

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Botswana
Emergency services
Acclimatization
Pakistan
Netherlands
Hospital Emergency Service
acclimation
Emergencies
heat
Temperature
temperature
Hot Temperature
Health care
Climate change
health services
signs and symptoms (animals and humans)
morbidity
Time series
time series analysis
statistics

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

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, Naomi; Longden, Thomas; Richards, John R; Khursheed, Munawar; Goddijn, Wilhelmina M.T.; van Veelen, Michiel J.; Khan, Uzma Rahim; Christien van der Linden, M.

In: PloS one, Vol. 14, No. 3, e0214242, 01.03.2019.

Research output: Contribution to journalArticle

van der Linden, Naomi ; Longden, Thomas ; Richards, John R ; Khursheed, Munawar ; Goddijn, Wilhelmina M.T. ; van Veelen, Michiel J. ; Khan, Uzma Rahim ; 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. In: PloS one. 2019 ; Vol. 14, No. 3.
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