The Impact of Heat Waves on Emergency Department Admissions in Charlottesville, Virginia, U.S.A

Abstract

Heat waves have been linked to increases in emergency-related morbidity, but more research is needed on the demographic and disease-specific aspects of these morbidities. Using a case-crossover approach, over 700,000 daily emergency department hospital admissions in Charlottesville, Virginia, U.S.A. from 2005–2016 are compared between warm season heat wave and non-heat wave periods. Heat waves are defined based on the exceedance, for at least three consecutive days, of two apparent temperature thresholds (35 °C and 37 °C) that account for 3 and 6% of the period of record. Total admissions and admissions for whites, blacks, males, females, and 20–49 years old are significantly elevated during heat waves, as are admissions related to a variety of diagnostic categories, including diabetes, pregnancy complications, and injuries and poisoning. Evidence that heat waves raise emergency department admissions across numerous demographic and disease categories suggests that heat exerts comorbidity influences that extend beyond the more well-studied direct relationships such as heat strokes and cardiac arrest.

Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis

“… 32 91 92 During heatwaves, pregnant women might also have higher rates of admission to hospital emergency departments and increased cardiovascular events, such as stroke and myocardial infarction. 93 94 Some studies have also linked emotional stress and sleep disturbance in pregnancy to hot weather. 95 96 Group B streptococcus colonisation of the vagina and cervix of pregnant women could increase at higher ambient temperatures, 97 raising risks for newborn sepsis.…”

“…Heat exposure is implicated in many conditions in pregnant women, with evidence pointing to heat effects on pre-eclampsia, prolonged labour, and antepartum or postpartum haemorrhage 329192. During heatwaves, pregnant women might also have higher rates of admission to hospital emergency departments and increased cardiovascular events, such as stroke and myocardial infarction 9394. Some studies have also linked emotional stress and sleep disturbance in pregnancy to hot weather 9596.…”

At Ground Zero—Emergency Units in Low‐ and Middle‐Income Countries Building Resilience for Climate Change and Human Health

“…The effects of climate change on the emergency care system are well described in HICs (Aitken et al, 2015;Bucher et al, 2018;Chowdhury et al, 2019;Davis & Novicoff, 2018;Doran et al, 2016;Ghazali et al, 2018;Hess, Saha, & Luber, 2014;Hutchinson et al, 2018;Lee et al, 2016;Liang & Messenger, 2018;Malik et al, 2018;McQuade et al, 2018). This data suggests that climate change is likely to increase the incidence of emergency conditions, disproportionately affect patients who rely on acute care in emergency units, present marked increases in vector-borne and environmentally driven diseases, and stress current emergency systems with increased frequency and severity of disasters.…”

Temporal changes in the effects of ambient temperatures on hospital admissions in Spain

“…While the effects of temperatures on mortality have been well documented, less is known about their impact on morbidity. Different outcomes have been examined, such as hospital admissions [4–8], emergency department visits [9–13], outpatient visits [14] or general practice (GP) visits [15], with inconsistent results. For example, an overview of systematic reviews including twenty articles reported no significant heat effects for cardiovascular and cerebrovascular morbidity after conducting a meta-analyses, while a positive association with heat was found for respiratory morbidity among the elderly [16].…”