How emergency departments might alert for prehospital heat-related excess mortality?

Claessens, Yann-Érick; Taupin, Pierre; Kierzek, G.; Pourriat, Jean-Louis; Baud, Michel; Ginsburg, C.; Jaı̈s, Jean-Philippe; Jougla, Éric; Riou, Bruno; Dhainaut, Jean-François; Landais, Paul

doi:10.1186/cc5092

Cited by 37 publications

(9 citation statements)

References 22 publications

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“…It is now well accepted that ED activity reflects the overall state of health of a population [ 26 ]. ED activity should therefore be considered as a public health 'sentinel' indicator, and health surveillance of EDs should be used to design appropriate public health interventions [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France

Josseran

Caillère

Brun‐Ney

et al. 2009

BMC Med Inform Decis Mak

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BackgroundThe health impacts of heat waves are serious and have prompted the development of heat wave response plans. Even when they are efficient, these plans are developed to limit the health effects of heat waves. This study was designed to determine relevant indicators related to health effects of heat waves and to evaluate the ability of a syndromic surveillance system to monitor variations in the activity of emergency departments over time. The study uses data collected during the summer 2006 when a new heat wave occurred in France.MethodsData recorded from 49 emergency departments since July 2004, were transmitted daily via the Internet to the French Institute for Public Health Surveillance. Items collected on patients included diagnosis (ICD10 codes), outcome, and age. Statistical t-tests were used to compare, for several health conditions, the daily averages of patients within different age groups and periods (whether 'on alert' or 'off alert').ResultsA limited number of adverse health conditions occurred more frequently during hot period: dehydration, hyperthermia, malaise, hyponatremia, renal colic, and renal failure. Over all health conditions, the total number of patients per day remained equal between the 'on alert' and 'off alert' periods (4,557.7/day vs. 4,511.2/day), but the number of elderly patients increased significantly during the 'on alert' period relative to the 'off alert' period (476.7/day vs. 446.2/day p < 0.05).ConclusionOur results show the interest to monitor specific indicators during hot periods and to focus surveillance efforts on the elderly. Syndromic surveillance allowed the collection of data in real time and the subsequent optimization of the response by public health agencies. This method of surveillance should therefore be considered as an essential part of efforts to prevent the health effects of heat waves.

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Section: Discussionmentioning

confidence: 99%

Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France

Josseran

Caillère

Brun‐Ney

et al. 2009

BMC Med Inform Decis Mak

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“…Other studies have focused specifically on ED data. For example, the Paris Index of Heat stroke Related Excess Mortality was formulated to warn of mortality increases during heat waves [ 8 ]. A study from Italy showed a strong relationship between bio-meteorological conditions and ambulance dispatches [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of ambient temperature on emergency department visits in Shanghai, China: a time series study

et al. 2014

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BackgroundMany studies have examined the association between ambient temperature and mortality. However, less evidence is available on the temperature effects on gender- and age-specific emergency department visits, especially in developing countries. In this study, we examined the short-term effects of daily ambient temperature on emergency department visits (ED visits) in Shanghai.MethodsDaily ED visits and daily ambient temperatures between January 2006 and December 2011 were analyzed. After controlling for secular and seasonal trends, weather, air pollution and other confounding factors, a Poisson generalized additive model (GAM) was used to examine the associations between ambient temperature and gender- and age-specific ED visits. A moving average lag model was used to evaluate the lag effects of temperature on ED visits.ResultsLow temperature was associated with an overall 2.76% (95% confidence interval (CI): 1.73 to 3.80) increase in ED visits per 1°C decrease in temperature at Lag1 day, 2.03% (95% CI: 1.04 to 3.03) and 2.45% (95% CI: 1.40 to 3.52) for males and females. High temperature resulted in an overall 1.78% (95% CI: 1.05 to 2.51) increase in ED visits per 1°C increase in temperature on the same day, 1.81% (95% CI: 1.08 to 2.54) among males and 1.75% (95% CI: 1.03 to 2.49) among females. The cold effect appeared to be more acute among younger people aged <45 years, whereas the effects were consistent on individuals aged ≥65 years. In contrast, the effects of high temperature were relatively consistent over all age groups.ConclusionsThese findings suggest a significant association between ambient temperature and ED visits in Shanghai. Both cold and hot temperatures increased the relative risk of ED visits. This knowledge has the potential to advance prevention efforts targeting weather-sensitive conditions.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-100) contains supplementary material, which is available to authorized users.

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“…Systems have been developed to monitor mortality [2], non-fatal outcomes [3]–[6] as well as specific syndromic events, like influenza [7]. More recently, surveillance systems have also been used to specifically monitor the health effects of environmental exposures such as heat waves [3], [6], [8], [9] and to give rapid estimates of the health effects of extreme events. In Italy, a rapid mortality surveillance system was set up in 2004 in collaboration with Municipal Registry Offices to evaluate the impact of heat waves on health during summer [9].…”

Section: Introductionmentioning

confidence: 99%

The Impact of the February 2012 Cold Spell on Health in Italy Using Surveillance Data

et al. 2013

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In February 2012 Italy was hit by an exceptional cold spell with extremely low temperatures and heavy snowfall. The aim of this work is to estimate the impact of the cold spell on health in the Italian cities using data from the rapid surveillance systems. In Italy, a national mortality surveillance system has been operational since 2004 in 34 cities for the rapid monitoring of daily mortality. Data from this system were used to evaluate the impact of the February 2012 cold spell on mortality shortly after the occurrence of the event. Furthermore, a cause-specific analysis was conducted in Roma using the Regional Mortality Registry and the emergency visits (ER) surveillance system. Cold spell episodes were defined as days when mean temperatures were below the 10th percentile of February distribution for more than three days. To estimate the impact of the cold spell, excess mortality was calculated as the difference between observed and daily expected values. An overall 1578 (+25%) excess deaths among the 75+ age group was recorded in the 14 cities that registered a cold spell in February 2012. A statistically significant excess in mortality was observed in several cities ranging from +22% in Bologna to +58% in Torino. Cause-specific analysis conducted in Roma showed a statistically significant excess in mortality among the 75+ age group for respiratory disease (+64%), COPD (+57%), cardiovascular disease +20% ischemic heart disease (14%) and other heart disease (+33%). Similar results were observed for ER visits. Surveillance systems need to become are a key component of prevention plans as they can help improve public health response and are a valid data source to rapidly quantify the impact on health. Cold-related mortality is still an important issue and should not be underestimated by public health Authorities.

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How emergency departments might alert for prehospital heat-related excess mortality?

Cited by 37 publications

References 22 publications

Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France

Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France

Effect of ambient temperature on emergency department visits in Shanghai, China: a time series study

The Impact of the February 2012 Cold Spell on Health in Italy Using Surveillance Data

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