Ambient temperature and emergency department visits for heat-related illness in North Carolina, 2007-2008
Ambient temperature and emergency department visits for heat-related illness in North Carolina, 2007-2008
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DOI：
10.1016/j.envres.2013.03.009
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发表时间：
2013-07-01
影响因子：
8.3
通讯作者：
Richardson, David B.
中科院分区：
文献类型：
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作者：
Lippmann, Steven J.;Fuhrmann, Christopher M.;Richardson, David B.
目的：估计北卡罗来纳州环境温度与因热相关疾病而急诊就诊的发生率之间的关联。北卡罗来纳州是南方的一个大州，有85个农村县和15个城市县;该州大约一半的人口居住在城市县。合并2007年1月1日至2008年12月31日期间县级每日急诊科就诊次数和每日平均气温，以形成时间序列数据结构。按性别、年龄组、地区、星期几和月份计算发病率。发病率比估计使用分类和线性样条泊松回归模型和异质性的温度急诊科访问协会进行了评估，使用产品的相互作用方面的泊松models.Results：在2007-2008年，有2539急诊科访问热相关疾病的主要诊断。发病率最高的是年轻成年男子（19-44岁年龄组），在农村县和沙丘地区。发病率随着温度超过15.6摄氏度（60华氏度）呈指数级增长。日平均气温每上升摄氏1度而超过摄氏15.6度，整体发病率比率为1.43（95%CI：1.41，1.45）;温度对男性的影响大于女性，45-64奥尔兹的人，农村县居民的影响大于城市县居民。随着热响应计划的制定，它们应该包括对死亡率和发病率的气候影响的研究结果。虽然预报触发的热健康预警系统对于减轻极端高温事件的影响至关重要，但公共卫生准备计划不应忽视更持续观察到的高环境温度的影响，例如北卡罗来纳州整个温暖季节发生的高环境温度。(c)2013 Elsevier Inc. All rights reserved.
Purpose: To estimate the association between environmental temperatures and the occurrence of emergency department visits for heat-related illness in North Carolina, a large Southern state with 85 rural and 15 urban counties; approximately half the state's population resides in urban counties.Methods: County-level daily emergency department visit counts and daily mean temperatures for the period 1/1/2007-12/31/2008 were merged to form a time-series data structure. Incidence rates were calculated by sex, age group, region, day of week, and month. Incidence rate ratios were estimated using categorical and linear spline Poisson regression models and heterogeneity of the temperature-emergency department visit association was assessed using product interaction terms in the Poisson models.Results: In 2007-2008, there were 2539 emergency department visits with heat-related illness as the primary diagnosis. Incidence rates were highest among young adult males (19-44 year age group), in rural counties, and in the Sandhills region. Incidence rates increased exponentially with temperatures over 15.6 degrees C (60 degrees F). The overall incidence rate ratio for each 1 degrees C increase over 15.6 degrees C in daily mean temperature was 1.43 (95%Cl: 1.41, 1.45); temperature effects were greater for males than females, for 45-64 year olds, and for residents of rural counties than residents of urban counties.Conclusions: As heat response plans are developed, they should incorporate findings on climate effects for both mortality and morbidity. While forecast-triggered heat health warning systems are essential to mitigate the effects of extreme heat events, public health preparedness plans should not ignore the effects of more persistently observed high environmental temperatures like those that occur throughout the warm season in North Carolina. (c) 2013 Elsevier Inc. All rights reserved.