Impact of two recent extreme heat episodes on morbidity and mortality in Adelaide, South Australia: a case-series analysis.
Impact of two recent extreme heat episodes on morbidity and mortality in Adelaide, South Australia: a case-series analysis.
复制标题
DOI：
10.1186/1476-069x-10-42
复制
发表时间：
2011-05-19
期刊：
影响因子：
--
通讯作者：
Bi P
中科院分区：
文献类型：
--
作者：
Nitschke M;Tucker GR;Hansen AL;Williams S;Zhang Y;Bi P
2008年和2009年夏天，南澳的阿德莱德发生了极端热浪。这两次热浪的持续时间都是独一无二的（分别为15天和13天），2009年的热浪强度也很明显，最高温度达到45.7 ° C。将这两次前所未有的热浪与阿德莱德以前的热浪对健康的影响进行比较是很有趣的。使用病例系列分析，将2008年和2009年发生的热浪（≥ 35 ° C持续3天或3天以上）以及1993年至2008年发生的热浪期间的每日发病率和死亡率与所有非热浪日（10月1日至3月31日）的发病率和死亡率进行比较。建立了救护车出诊、住院、急诊和死亡率的发病率比（IRR）。研究了热浪持续时间和强度的剂量反应效应。2008年和2009年极端事件期间的救护车呼叫量分别增加了10%和16%，而之前的热浪期间为4.4%。除了2008年急诊科的情况外，医院和急诊机构的总体增加幅度不大，但观察到特定保健类别的增加。在两次热浪期间，老年人的肾脏发病率都有所增加。在2009年的热浪中，与热浪直接相关的入院人数增加了14倍，而2008年和之前的热浪中则增加了3倍。2009年，15 - 64岁年龄组的缺血性心脏病发病率显著上升。只有2009年的热浪与总死亡率的显著增加相关，特别是影响15 - 64岁年龄组（1.37; 95% CI，1.09，1.71），而老年组不受影响。观察到热浪持续时间（救护车，医院和急诊室）和强度（救护车和死亡率）的显着剂量反应关系。虽然2008年的发病率和死亡率仅比以前的调查结果略有增加，但2009年热浪对健康的影响突出。这些发现发出了一个信号，即2009年强烈而漫长的热浪可能已经超过了人口的应对能力。重要的是，对造成不良健康结果的风险因素进行调查，以进一步改进预防战略。
Extreme heatwaves occurred in Adelaide, South Australia, in the summers of 2008 and 2009. Both heatwaves were unique in terms of their duration (15 days and 13 days respectively), and the 2009 heatwave was also remarkable in its intensity with a maximum temperature reaching 45.7°C. It is of interest to compare the health impacts of these two unprecedented heatwaves with those of previous heatwaves in Adelaide. Using case-series analysis, daily morbidity and mortality rates during heatwaves (≥35°C for three or more days) occurring in 2008 and 2009 and previous heatwaves occurring between 1993 and 2008 were compared with rates during all non-heatwave days (1 October to 31 March). Incidence rate ratios (IRRs) were established for ambulance call-outs, hospital admissions, emergency department presentations and mortality. Dose response effects of heatwave duration and intensity were examined. Ambulance call-outs during the extreme 2008 and 2009 events were increased by 10% and 16% respectively compared to 4.4% during previous heatwaves. Overall increases in hospital and emergency settings were marginal, except for emergency department presentations in 2008, but increases in specific health categories were observed. Renal morbidity in the elderly was increased during both heatwaves. During the 2009 heatwave, direct heat-related admissions increased up to 14-fold compared to a three-fold increase seen during the 2008 event and during previous heatwaves. In 2009, marked increases in ischaemic heart disease were seen in the 15-64 year age group. Only the 2009 heatwave was associated with considerable increases in total mortality that particularly affected the 15-64 year age group (1.37; 95% CI, 1.09, 1.71), while older age groups were unaffected. Significant dose-response relationships were observed for heatwave duration (ambulance, hospital and emergency setting) and intensity (ambulance and mortality). While only incremental increases in morbidity and mortality above previous findings occurred in 2008, health impacts of the 2009 heatwave stand out. These findings send a signal that the intense and long 2009 heatwave may have exceeded the capacity of the population to cope. It is important that risk factors contributing to the adverse health outcomes are investigated to further improve preventive strategies.