Cargando…

Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study

OBJECTIVE: To quantify the association between ambient heat and visits to the emergency department (ED) for any cause and for cause specific conditions in the conterminous United States among adults with health insurance. DESIGN: Time stratified case crossover analyses with distributed lag non-linea...

Descripción completa

Detalles Bibliográficos
Autores principales: Sun, Shengzhi, Weinberger, Kate R, Nori-Sarma, Amruta, Spangler, Keith R, Sun, Yuantong, Dominici, Francesca, Wellenius, Gregory A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397126/
https://www.ncbi.nlm.nih.gov/pubmed/34819309
http://dx.doi.org/10.1136/bmj-2021-065653
_version_ 1784772066641182720
author Sun, Shengzhi
Weinberger, Kate R
Nori-Sarma, Amruta
Spangler, Keith R
Sun, Yuantong
Dominici, Francesca
Wellenius, Gregory A
author_facet Sun, Shengzhi
Weinberger, Kate R
Nori-Sarma, Amruta
Spangler, Keith R
Sun, Yuantong
Dominici, Francesca
Wellenius, Gregory A
author_sort Sun, Shengzhi
collection PubMed
description OBJECTIVE: To quantify the association between ambient heat and visits to the emergency department (ED) for any cause and for cause specific conditions in the conterminous United States among adults with health insurance. DESIGN: Time stratified case crossover analyses with distributed lag non-linear models. SETTING: US nationwide administrative healthcare claims database. PARTICIPANTS: All commercial and Medicare Advantage beneficiaries (74.2 million) aged 18 years and older between May and September 2010 to 2019. MAIN OUTCOME MEASURES: Daily rates of ED visits for any cause, heat related illness, renal disease, cardiovascular disease, respiratory disease, and mental disorders based on discharge diagnosis codes. RESULTS: 21 996 670 ED visits were recorded among adults with health insurance living in 2939 US counties. Days of extreme heat—defined as the 95th centile of the local warm season (May through September) temperature distribution (at 34.4°C v 14.9°C national average level)—were associated with a 7.8% (95% confidence interval 7.3% to 8.2%) excess relative risk of ED visits for any cause, 66.3% (60.2% to 72.7%) for heat related illness, 30.4% (23.4% to 37.8%) for renal disease, and 7.9% (5.2% to 10.7%) for mental disorders. Days of extreme heat were associated with an excess absolute risk of ED visits for heat related illness of 24.3 (95% confidence interval 22.9 to 25.7) per 100 000 people at risk per day. Heat was not associated with a higher risk of ED visits for cardiovascular or respiratory diseases. Associations were more pronounced among men and in counties in the north east of the US or with a continental climate. CONCLUSIONS: Among both younger and older adults, days of extreme heat are associated with a higher risk of ED visits for any cause, heat related illness, renal disease, and mental disorders. These results suggest that the adverse health effects of extreme heat are not limited to older adults and carry important implications for the health of adults across the age spectrum.
format Online
Article
Text
id pubmed-9397126
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BMJ Publishing Group Ltd.
record_format MEDLINE/PubMed
spelling pubmed-93971262022-09-06 Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study Sun, Shengzhi Weinberger, Kate R Nori-Sarma, Amruta Spangler, Keith R Sun, Yuantong Dominici, Francesca Wellenius, Gregory A BMJ Research OBJECTIVE: To quantify the association between ambient heat and visits to the emergency department (ED) for any cause and for cause specific conditions in the conterminous United States among adults with health insurance. DESIGN: Time stratified case crossover analyses with distributed lag non-linear models. SETTING: US nationwide administrative healthcare claims database. PARTICIPANTS: All commercial and Medicare Advantage beneficiaries (74.2 million) aged 18 years and older between May and September 2010 to 2019. MAIN OUTCOME MEASURES: Daily rates of ED visits for any cause, heat related illness, renal disease, cardiovascular disease, respiratory disease, and mental disorders based on discharge diagnosis codes. RESULTS: 21 996 670 ED visits were recorded among adults with health insurance living in 2939 US counties. Days of extreme heat—defined as the 95th centile of the local warm season (May through September) temperature distribution (at 34.4°C v 14.9°C national average level)—were associated with a 7.8% (95% confidence interval 7.3% to 8.2%) excess relative risk of ED visits for any cause, 66.3% (60.2% to 72.7%) for heat related illness, 30.4% (23.4% to 37.8%) for renal disease, and 7.9% (5.2% to 10.7%) for mental disorders. Days of extreme heat were associated with an excess absolute risk of ED visits for heat related illness of 24.3 (95% confidence interval 22.9 to 25.7) per 100 000 people at risk per day. Heat was not associated with a higher risk of ED visits for cardiovascular or respiratory diseases. Associations were more pronounced among men and in counties in the north east of the US or with a continental climate. CONCLUSIONS: Among both younger and older adults, days of extreme heat are associated with a higher risk of ED visits for any cause, heat related illness, renal disease, and mental disorders. These results suggest that the adverse health effects of extreme heat are not limited to older adults and carry important implications for the health of adults across the age spectrum. BMJ Publishing Group Ltd. 2021-11-25 /pmc/articles/PMC9397126/ /pubmed/34819309 http://dx.doi.org/10.1136/bmj-2021-065653 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Sun, Shengzhi
Weinberger, Kate R
Nori-Sarma, Amruta
Spangler, Keith R
Sun, Yuantong
Dominici, Francesca
Wellenius, Gregory A
Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study
title Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study
title_full Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study
title_fullStr Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study
title_full_unstemmed Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study
title_short Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study
title_sort ambient heat and risks of emergency department visits among adults in the united states: time stratified case crossover study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397126/
https://www.ncbi.nlm.nih.gov/pubmed/34819309
http://dx.doi.org/10.1136/bmj-2021-065653
work_keys_str_mv AT sunshengzhi ambientheatandrisksofemergencydepartmentvisitsamongadultsintheunitedstatestimestratifiedcasecrossoverstudy
AT weinbergerkater ambientheatandrisksofemergencydepartmentvisitsamongadultsintheunitedstatestimestratifiedcasecrossoverstudy
AT norisarmaamruta ambientheatandrisksofemergencydepartmentvisitsamongadultsintheunitedstatestimestratifiedcasecrossoverstudy
AT spanglerkeithr ambientheatandrisksofemergencydepartmentvisitsamongadultsintheunitedstatestimestratifiedcasecrossoverstudy
AT sunyuantong ambientheatandrisksofemergencydepartmentvisitsamongadultsintheunitedstatestimestratifiedcasecrossoverstudy
AT dominicifrancesca ambientheatandrisksofemergencydepartmentvisitsamongadultsintheunitedstatestimestratifiedcasecrossoverstudy
AT welleniusgregorya ambientheatandrisksofemergencydepartmentvisitsamongadultsintheunitedstatestimestratifiedcasecrossoverstudy