Heat-related morbidity and mortality in New England: Evidence for local policy.
Heat-related morbidity and mortality in New England: Evidence for local policy.
复制标题
新英格兰与高温相关的发病率和死亡率：地方政策的证据。
DOI：
10.1016/j.envres.2017.02.005
复制
发表时间：
2017
影响因子：
8.3
通讯作者：
Gold,Julia
中科院分区：
文献类型：
--
作者：
Wellenius,GregoryA;Eliot,MelissaN;Bush,KathleenF;Holt,Dennis;Lincoln,RebeccaA;Smith,AndyE;Gold,Julia
BackgroundHeat-related morbidity and mortality is a recognized public health concern. However, public health officials need to base policy decisions on local evidence, which is often lacking for smaller communities.ObjectivesTo evaluate the association between maximum daily heat index (HI) and morbidity and mortality in 15 New England communities (combined population: 2.7 million) in order to provide actionable evidence for local officials.MethodsWe applied overdispersed Poisson nonlinear distributed lag models to evaluate the association between HI and daily (May-September) emergency department (ED) admissions and deaths in each of 15 study sites in New Hampshire, Maine, and Rhode Island, controlling for time trends, day of week, and federal holidays. Site-specific estimates were meta-analyzed to provide regional estimates.ResultsAssociations (sometimes non-linear) were observed between HI and each health outcome. For example, a day with a HI of 95°F vs. 75°F was associated with a cumulative 7.5% (95% confidence interval [CI]: 6.5%, 8.5%) and 5.1% (95% CI: 0.2%, 10.3%) higher rate of all-cause ED visits and deaths, respectively, with some evidence of regional heterogeneity. We estimate that in the study area, days with a HI≥95°F were associated with an annual average of 784 (95% CI: 658, 908) excess ED visits and 22 (95% CI: 3, 39) excess deaths.ConclusionsOur results suggest the presence of adverse health impacts associated with HI below the current local guideline criteria of HI≥100°F used to issue heat advisories. We hypothesize that lowering this threshold may lead to substantially reduced heat-related morbidity and mortality in the study area.
