Effect of the COVID-19 pandemic on heatstroke-related ambulance dispatch in the 47 prefectures of Japan

Hatakeyama, Koya; Ota, Junko; Takahashi, Yoshiko; Kawamitsu, Saki; Seposo, Xerxes

doi:10.1016/j.scitotenv.2021.145176

Cited by 15 publications

(16 citation statements)

References 18 publications

(20 reference statements)

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“…4 The number of heatstroke‐related ambulance dispatches decreased in the summer of 2020. 13 School restrictions on outdoor activities and event cancellation could also explain this finding. 14 …”

Section: Discussionmentioning

confidence: 97%

Evaluation of the physiological changes in prehospital health‐care providers influenced by environmental factors in the summer of 2020 during the COVID‐19 pandemic

Tanaka

Nakagawa

Ozone

et al. 2021

Acute Medicine & Surgery

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Wearing personal protective equipment (PPE) is essential to prevent infection transmission, but the risk of heatstroke increases with wearing PPE in a humid and hot environment. Therefore, we aimed to examine how environmental parameters change the body physiology in a hot environment during the coronavirus disease (COVID-19) pandemic.Methods: This was a retrospective cohort study extracted from the MEDIC Japan heatstroke prevention database, which was recorded between 1 August and 7 September, 2020. Its database is a registry collection from seven healthy health-care providers. Subjects recorded their own vital signs (forehead and tympanic temperature, blood pressure, pulse rate, and oxygen saturation) and environmental factors (type of weather, wet-bulb globe temperature [WBGT], air temperature, humidity, and location) every hour during their working shift.Results: From 323 records, a weak positive but statistically significant correlation was observed between WBGT and pulse rate (correlation coefficient [95% confidence interval], r = 0.34 [0.23, 0.45]) and between WBGT and core body temperature. Forehead temperature had a stronger correlation than tympanic temperature (forehead, r = 0.33 [0.21, 0.43]; tympanic, r = 0.17 [0.05, 0.28]), which also showed a larger effect (forehead, g 2 = 0.08; tympanic, g 2 = 0.05). The effect size of oxygen saturation measured outdoors was large (g 2 = 0.30). Forehead temperature increased abruptly at 28°C WBGT and at 33°C air temperature. Conclusion:A hot environment significantly affected forehead temperature, and the daytime imposed a high risk of heatstroke. To avoid heatstroke, environmental parameters are important to note as outdoor environments had a large effect on vital sign changes depending on the time of day.

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Section: Discussionmentioning

confidence: 97%

Evaluation of the physiological changes in prehospital health‐care providers influenced by environmental factors in the summer of 2020 during the COVID‐19 pandemic

Tanaka

Nakagawa

Ozone

et al. 2021

Acute Medicine & Surgery

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“…In an online survey conducted from 3 to 25 August 2020 in selected major cities and prefectures in Japan ( n = 12,872), there was an approximately 13.8% increase in time spent indoors during the pandemic compared to pre-pandemic period, which subsequently corresponded to an 18.8% reduction in outdoor activities across the country [ 33 ]. Since HIAT occur mostly in roads (15.6%) and outdoor public areas (12.5%) [ 16 ], the increase in time spent indoor may have led to the attenuation of the heat-related health risks during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…Contrary to expectations, a recent study observed that heat-related illness ambulance transport (HIAT) decreased during the pandemic by 22% [95% Confidence Interval (CI): 18 – 25%] [ 16 ]. The authors noted the role of mobility restrictions as well as remote working in decreasing the exposure of the population to heat, and thus the reduction in HIAT.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic modifies temperature and heat-related illness ambulance transport association in Japan: a nationwide observational study

Seposo

Madaniyazi

et al. 2021

Environ Health

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Background During the COVID-19 pandemic, several illnesses were reduced. In Japan, heat-related illnesses were reduced by 22% compared to pre-pandemic period. However, it is uncertain as to what has led to this reduction. Here, we model the association of maximum temperature and heat-related illnesses in the 47 Japanese prefectures. We specifically examined how the exposure and lag associations varied before and during the pandemic. Methods We obtained the summer-specific, daily heat-related illness ambulance transport (HIAT), exposure variable (maximum temperature) and covariate data from relevant data sources. We utilized a stratified (pre-pandemic and pandemic), two-stage approach. In each stratified group, we estimated the 1) prefecture-level association using a quasi-Poisson regression coupled with a distributed lag non-linear model, which was 2) pooled using a random-effects meta-analysis. The difference between pooled pre-pandemic and pandemic associations was examined across the exposure and the lag dimensions. Results A total of 321,655 HIAT cases was recorded in Japan from 2016 to 2020. We found an overall reduction of heat-related risks for HIAT during the pandemic, with a wide range of reduction (10.85 to 57.47%) in the HIAT risk, across exposure levels ranging from 21.69 °C to 36.31 °C. On the contrary, we found an increment in the delayed heat-related risks during the pandemic at Lag 2 (16.33%; 95% CI: 1.00, 33.98%). Conclusion This study provides evidence of the impact of COVID-19, particularly on the possible roles of physical interventions and behavioral changes, in modifying the temperature-health association. These findings would have implications on subsequent policies or heat-related warning strategies in light of ongoing or future pandemics.

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“…Some diseases occurred more frequently, while others decreased following the stay-at-home order. A Japanese study based on the data from Fire and Disaster Management Agency database reported a decrease in the incidence of heatstroke due to a decreased exposure to risks following the stay-at-home order (16) .…”

Section: Disaster and Blood Pressure Or Metabolic Syndromementioning

confidence: 99%

The Significance of Observing the Risk of Non-communicable Diseases after Large-scale Disasters and Communicable Disease Epidemics

Metoki

2021

JMA J

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Non-communicable diseases (NCDs) are a global challenge, accounting for 71% of all deaths worldwide. The spread of coronavirus disease 2019 (COVID-19) and past huge disasters have affected the prevention and treatment of NCDs and require urgent action. In this narrative review, I will discuss several reports on the risk of NCDs during past disasters and propose possible future directions. Hypertension, the most common NCD, carries a high risk of death due to cerebrovascular, renal, and other complications. Effective use of information and communication technology-based telemedicine is necessary to manage the risk of cardiovascular diseases during disasters and pandemics. We observed the cumulative incidence of metabolic syndrome in subjects from tsunami-affected areas. We found that moving into prefabricated temporary housing was a risk factor for a higher incidence of metabolic syndrome in elderly females. Our follow-up of 1,009 subjects showed a slight, but significant, increase in HbA1c values after a state of emergency was introduced, even though the lockdown was not as stringent as in other countries. In a study elucidating the prevalence of wheezing and eczema symptoms and the associated factors after the Great East Japan Earthquake, psychological effects, such as depression and self-reported posttraumatic stress disorder, were observed, particularly in people with allergic diseases. In recent years, new birth cohort studies have been initiated to complement the studies designed to collect information across multiple generations, such as the Lifelines study in the Netherlands and the Avon Longitudinal Study of Parents and Children (ALSPAC) study in the UK. It is desirable to assess the effects of COVID-19 to complement the existing cohort studies in Japan as well.

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Effect of the COVID-19 pandemic on heatstroke-related ambulance dispatch in the 47 prefectures of Japan

Cited by 15 publications

References 18 publications

Evaluation of the physiological changes in prehospital health‐care providers influenced by environmental factors in the summer of 2020 during the COVID‐19 pandemic

Evaluation of the physiological changes in prehospital health‐care providers influenced by environmental factors in the summer of 2020 during the COVID‐19 pandemic

COVID-19 pandemic modifies temperature and heat-related illness ambulance transport association in Japan: a nationwide observational study

The Significance of Observing the Risk of Non-communicable Diseases after Large-scale Disasters and Communicable Disease Epidemics

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