Extreme Temperature and Out-of-hospital-cardiac-arrest. Nationwide Study in a Hot Climate Country

Overview

Journal Environ Health

Publisher Biomed Central

Specialty Environmental Health

Date 2021 Apr 6

PMID 33820550

Citations 7

Authors

Hannan Kranc

Victor Novack

Alexandra Shtein

Rimma Sherman

Lena Novack

Affiliations

Soon will be listed here.

Abstract

Background: Out-of-hospital-cardiac arrest (OHCA) is frequently linked to environmental exposures. Climate change and global warming phenomenon have been found related to cardiovascular morbidity, however there is no agreement on their impact on OHCA occurrence. In this nationwide analysis, we aimed to assess the incidence of the OHCA events attended by emergency medical services (EMS), in relation to meteorological conditions: temperature, humidity, heat index and solar radiation.

Methods: We analyzed all adult cases of OHCA in Israel attended by EMS during 2016-2017. In the case-crossover design, we compared ambient exposure within 72 h prior to the OHCA event with exposure prior to the four control times using conditional logistic regression in a lag-distributed non-linear model.

Results: There were 12,401 OHCA cases (68.3% were pronounced dead-on-scene). The patients were on average 75.5 ± 16.2 years old and 55.8% of them were males. Exposure to 90th and 10th percentile of temperature adjusted to humidity were positively associated with the OHCA with borderline significance (Odds Ratio (OR) =1.20, 95%CI 0.97; 1.49 and OR 1.16, 95%CI 0.95; 1.41, respectively). Relative humidity below the 10th percentile was a risk factor for OHCA, independent of temperature, with borderline significance (OR = 1.16, 95%CI 0.96; 1.38). Analysis stratified by seasons revealed an adverse effect of exposure to 90th percentile of temperature when estimated in summer (OR = 3.34, 95%CI 1.90; 3.5.86) and exposure to temperatures below 10th percentile in winter (OR = 1.75, 95%CI 1.23; 2.49). Low temperatures during a warm season and high temperatures during a cold season had a protective effect on OHCA. The heat index followed a similar pattern, where an adverse effect was demonstrated for extreme levels of exposure.

Conclusions: Evolving climate conditions characterized by excessive heat and low humidity represent risk factors for OHCA. As these conditions are easily avoided, by air conditioning and behavioral restrictions, necessary prevention measures are warranted.

Citing Articles

Short-term exposures to temperature and risk of sudden cardiac death in women: A case-crossover analysis in the Nurses' Health Study.

Hart J, Hu C, Yanosky J, Holland I, Iyer H, Borchert W Environ Epidemiol. 2024; 8(4):e322.

PMID: 38983881 PMC: 11233109. DOI: 10.1097/EE9.0000000000000322.

The Impact of Climate Change and Extreme Weather Conditions on Cardiovascular Health and Acute Cardiovascular Diseases.

De Vita A, Belmusto A, Di Perna F, Tremamunno S, De Matteis G, Franceschi F J Clin Med. 2024; 13(3).

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Heatwave Definition and Impact on Cardiovascular Health: A Systematic Review.

Nawaro J, Gianquintieri L, Pagliosa A, Sechi G, Caiani E Public Health Rev. 2023; 44:1606266.

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Air Pollution and Temperature: a Systematic Review of Ubiquitous Environmental Exposures and Sudden Cardiac Death.

Borchert W, Grady S, Chen J, DeVille N, Roscoe C, Chen F Curr Environ Health Rep. 2023; 10(4):490-500.

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Extreme Temperature Exposure and Risks of Preterm Birth Subtypes Based on a Nationwide Survey in China.

Yu G, Yang L, Liu M, Wang C, Shen X, Fan L Environ Health Perspect. 2023; 131(8):87009.

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