High-Heat Days and Presentations to Emergency Departments in Regional Victoria, Australia

Abstract

Heat kills more Australians than any other natural disaster. Previous Australian research has identified increases in Emergency Department presentations in capital cities; however, little research has examined the effects of heat in rural/regional locations. This retrospective cohort study aimed to determine if Emergency Department (ED) presentations across the south-west region of Victoria, Australia, increased on high-heat days (1 February 2017 to 31 January 2020) using the Rural Acute Hospital Data Register (RAHDaR). The study also explored differences in presentations between farming towns and non-farming towns. High-heat days were defined as days over the 95th temperature percentile. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes associated with heat-related illness were identified from previous studies. As the region has a large agricultural sector, a framework was developed to identify towns estimated to have 70% or more of the population involved in farming. Overall, there were 61,631 presentations from individuals residing in the nine Local Government Areas. Of these presentations, 3064 (5.0%) were on days of high-heat, and 58,567 (95.0%) were of days of non-high-heat. Unlike previous metropolitan studies, ED presentations in rural south-west Victoria decrease on high-heat days. This decrease was more prominent in the farming cohort; a potential explanation for this may be behavioural adaption.

Emergency presentations for farm‐related injuries in older adults residing in south‐western Victoria, Australia

“…reported that the majority (83%) of patients presenting to the Emergency Department of a Victorian regional hospital during 2010–2015 arrived by private car. Another study by Adams et al 32 . used data from RAHDaR to examine emergency presentations of farmers and non‐farmers during high heat days, reporting that 82.4% arrived by “other” transportation (including private car).…”

“…For example, Brumby et al 25 reported that the majority (83%) of patients presenting to the Emergency Department of a Victorian regional hospital during 2010-2015 arrived by private car. Another study by Adams et al 32 used data from RAHDaR to examine emergency presentations of farmers and non-farmers during high heat days, reporting that 82.4% arrived by "other" transportation (including private car). However, it is also possible that the majority of incidents occurring in this study were non-life threatening and therefore a road ambulance was not required.…”

“…37,38 This may also result in family members performing some work without adequate training, leading to a higher risk of injury. In addition, a study by Adams et al 32 reported that heat-related injuries are often not coded using the specific ICD-10 codes. Farm-related injuries can also be under-reported as many farmers accept that the work can be dangerous and that injuries are inevitable rather than preventable.…”

Examining the Heat Health Burden in Australia: A Rapid Review

“…There were 27 articles (20% of all the articles included in this review) that used data from Victoria (including articles that included multiple cities/whole of Australia). Studies were mainly Melbourne focused, with three exceptions: those that examined data for the whole of Victoria [44], inner and outer regional areas such as Bendigo, Wodonga, Latrobe Valley, Horsham, Hamilton, Lakes Entrance, Geelong, Shepparton, Ballarat and Mildura [45] and inner regional areas of South West Victoria [46]. There were 15 articles (11%, including Australia-wide and multi-city studies) in Western Australia (WA), predominantly focussed on Perth (n = 11), with two articles including the whole of WA [47,48].…”

“…In Victoria, one state-wide study assessed ED presentations in nine Southwest Victorian hospitals [46]. Melbourne-focussed articles used ED visits [94,124], hospital admissions [111,124,141] and one at a sexual health centre presentation [113].…”