Risk, Attributable Fraction and Attributable Number of Cause-Specific Heat-Related Emergency Hospital Admissions in Switzerland

Overview

Journal Int J Public Health

Specialty Public Health

Date 2024 Oct 22

PMID 39435310

Authors

Florian Schulte

Martin Roosli

Martina S Ragettli

Affiliations

Soon will be listed here.

Abstract

Objectives: We assessed the relationship between heat and emergency hospital admissions (EHAs) in Switzerland using clinically relevant metrics.

Methods: Applying distributed lag non-linear models, we investigated temperature-admission associations between May and September 1998-2019 for various disease groups, by age class and gender. We estimated the relative risk (RR) for moderate (29°C) and extreme (34°C) daily maximum temperatures relative to disease-specific optimum temperature, and calculated attributable fractions (AFs) for hot days and the following week. We also calculated the total number of heat-related EHAs.

Results: We attributed 31,387 (95% confidence interval: 21,567-40,408) EHAs to above-optimal temperatures, 1.1% (0.7%-1.4%) of the total. Extreme temperatures increased the EHA risk for mental, infectious and neurological diseases. We observed particularly high AFs due to extreme heat for dehydration (85.9%, 95% CI: 82.4%-88.8%) and acute kidney injury (AKI, 56.1%, 95% CI: 45.3%-64.7%). While EHA risk generally increased with age, we also found high RRs for infectious diseases in children (0-15 years) and AKI in young adults (15-64 years).

Conclusion: Hot weather increases the EHA risk in Switzerland. Therefore a comprehensive clinical and public health response is needed.

References

Guo Q, Mistry M, Zhou X, Zhao G, Kino K, Wen B . Regional variation in the role of humidity on city-level heat-related mortality. PNAS Nexus. 2024; 3(8):pgae290. PMC: 11305137. DOI: 10.1093/pnasnexus/pgae290. View

Hill A . THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION?. Proc R Soc Med. 1965; 58:295-300. PMC: 1898525. DOI: 10.1177/003591576505800503. View

Tong S, Wang X, Barnett A . Assessment of heat-related health impacts in Brisbane, Australia: comparison of different heatwave definitions. PLoS One. 2010; 5(8):e12155. PMC: 2921381. DOI: 10.1371/journal.pone.0012155. View

Williams S, Nitschke M, Sullivan T, Tucker G, Weinstein P, Pisaniello D . Heat and health in Adelaide, South Australia: assessment of heat thresholds and temperature relationships. Sci Total Environ. 2011; 414:126-33. DOI: 10.1016/j.scitotenv.2011.11.038. View

Kaufman J, Vicedo-Cabrera A, Tam V, Song L, Coffel E, Tasian G . The impact of heat on kidney stone presentations in South Carolina under two climate change scenarios. Sci Rep. 2022; 12(1):369. PMC: 8748744. DOI: 10.1038/s41598-021-04251-2. View

Mastrangelo G, Fedeli U, Visentin C, Milan G, Fadda E, Spolaore P . Pattern and determinants of hospitalization during heat waves: an ecologic study. BMC Public Health. 2007; 7:200. PMC: 1988820. DOI: 10.1186/1471-2458-7-200. View

Basu R, Pearson D, Malig B, Broadwin R, Green R . The effect of high ambient temperature on emergency room visits. Epidemiology. 2012; 23(6):813-20. DOI: 10.1097/EDE.0b013e31826b7f97. View

Lee S, Lee H, Myung W, Kim E, Kim H . Mental disease-related emergency admissions attributable to hot temperatures. Sci Total Environ. 2017; 616-617:688-694. DOI: 10.1016/j.scitotenv.2017.10.260. View

Parsons L, Shindell D, Tigchelaar M, Zhang Y, Spector J . Increased labor losses and decreased adaptation potential in a warmer world. Nat Commun. 2021; 12(1):7286. PMC: 8671389. DOI: 10.1038/s41467-021-27328-y. View

10.

Hansen A, Bi P, Ryan P, Nitschke M, Pisaniello D, Tucker G . The effect of heat waves on hospital admissions for renal disease in a temperate city of Australia. Int J Epidemiol. 2008; 37(6):1359-65. DOI: 10.1093/ije/dyn165. View

11.

Khosla R, Guntupalli K . Heat-related illnesses. Crit Care Clin. 1999; 15(2):251-63. DOI: 10.1016/s0749-0704(05)70053-1. View

12.

Buckley J, Samet J, Richardson D . Commentary: Does air pollution confound studies of temperature?. Epidemiology. 2014; 25(2):242-5. DOI: 10.1097/EDE.0000000000000051. View

13.

Benmarhnia T, Deguen S, Kaufman J, Smargiassi A . Review Article: Vulnerability to Heat-related Mortality: A Systematic Review, Meta-analysis, and Meta-regression Analysis. Epidemiology. 2015; 26(6):781-93. DOI: 10.1097/EDE.0000000000000375. View

14.

Oberlin M, Tubery M, Cances-Lauwers V, Ecoiffier M, Lauque D . Heat-related illnesses during the 2003 heat wave in an emergency service. Emerg Med J. 2010; 27(4):297-9. DOI: 10.1136/emj.2008.067934. View

15.

Bobb J, Obermeyer Z, Wang Y, Dominici F . Cause-specific risk of hospital admission related to extreme heat in older adults. JAMA. 2014; 312(24):2659-67. PMC: 4319792. DOI: 10.1001/jama.2014.15715. View

16.

van Loenhout J, Delbiso T, Kiriliouk A, Rodriguez-Llanes J, Segers J, Guha-Sapir D . Heat and emergency room admissions in the Netherlands. BMC Public Health. 2018; 18(1):108. PMC: 5756417. DOI: 10.1186/s12889-017-5021-1. View

17.

Gronlund C, Zanobetti A, Schwartz J, Wellenius G, ONeill M . Heat, heat waves, and hospital admissions among the elderly in the United States, 1992-2006. Environ Health Perspect. 2014; 122(11):1187-92. PMC: 4216145. DOI: 10.1289/ehp.1206132. View

18.

Perez L, Kunzli N . From measures of effects to measures of potential impact. Int J Public Health. 2009; 54(1):45-8. DOI: 10.1007/s00038-008-8025-x. View

19.

Sun S, Weinberger K, Nori-Sarma A, Spangler K, Sun Y, Dominici F . Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study. BMJ. 2021; 375:e065653. PMC: 9397126. DOI: 10.1136/bmj-2021-065653. View

20.

Bastakoti M, Muhailan M, Nassar A, Sallam T, Desale S, Fouda R . Discrepancy between emergency department admission diagnosis and hospital discharge diagnosis and its impact on length of stay, up-triage to the intensive care unit, and mortality. Diagnosis (Berl). 2021; 9(1):107-114. DOI: 10.1515/dx-2021-0001. View