Heat warnings, mortality, and hospital admissions among older adults in the United States.
Heat warnings, mortality, and hospital admissions among older adults in the United States.
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美国老年人的高温警告、死亡率和住院情况。
DOI：
10.1016/j.envint.2021.106834
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发表时间：
2021
影响因子：
11.8
通讯作者：
Wellenius,GregoryA
中科院分区：
文献类型：
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作者：
Weinberger,KateR;Wu,Xiao;Sun,Shengzhi;Spangler,KeithR;Nori-Sarma,Amruta;Schwartz,Joel;Requia,Weeberb;Sabath,BenjaminM;Braun,Danielle;Zanobetti,Antonella;Dominici,Francesca;Wellenius,GregoryA
高温警告是在极端高温事件发生之前发布的，但几乎没有证据表明它们在减少与高温有关的疾病和死亡方面的有效性。我们估计了2006- 2016年美国国家气象局发布的高温警告和警报（统称为“警报”）与2，817个县65岁及以上的医疗保险受益人的全因死亡率和特定原因住院的关联。我们使用条件泊松回归模型分层县，调整年，一周，联邦假期，和滞后的每日最大热index.ResultsWe确定了一个匹配的非热警报日为92,029热警报日在2,817个县，或54.6%的所有热警报日在研究期间。与预期相反，发热警报与死亡风险降低无关（RR：1.005 [95% CI：0.997，1.013]）。然而，发热警报与因体液和电解质紊乱（RR：1.040 [95% CI：1.015，1.065]）和中暑（RR：1.094 [95% CI：1.038，1.152]）住院的风险较高相关。敏感性分析的结果相似，另外调整了当天的热指数，臭氧和PM2.5。结论我们的研究结果表明，热警报与死亡风险降低无关，但可能与较高的住院率的液体和电解质紊乱和中暑，潜在地表明，热警报导致更多的人寻求或获得护理。
BackgroundHeat warnings are issued in advance of forecast extreme heat events, yet little evidence is available regarding their effectiveness in reducing heat-related illness and death. We estimated the association of heat warnings and advisories (collectively, “alerts”) issued by the United States National Weather Service with all-cause mortality and cause-specific hospitalizations among Medicare beneficiaries aged 65 years and older in 2,817 counties, 2006–2016.MethodsIn each county, we compared days with heat alerts to days without heat alerts, matched on daily maximum heat index and month. We used conditional Poisson regression models stratified on county, adjusting for year, day of week, federal holidays, and lagged daily maximum heat index.ResultsWe identified a matched non-heat alert day for 92,029 heat alert days in 2,817 counties, or 54.6% of all heat alert days during the study period. Contrary to expectations, heat alerts were not associated with lower risk of mortality (RR: 1.005 [95% CI: 0.997, 1.013]). However, heat alerts were associated with higher risk of hospitalization for fluid and electrolyte disorders (RR: 1.040 [95% CI: 1.015, 1.065]) and heat stroke (RR: 1.094 [95% CI: 1.038, 1.152]). Results were similar in sensitivity analyses additionally adjusting for same-day heat index, ozone, and PM2.5.ConclusionsOur results suggest that heat alerts are not associated with lower risk of mortality but may be associated with higher rates of hospitalization for fluid and electrolyte disorders and heat stroke, potentially suggesting that heat alerts lead more individuals to seek or access care.