Time-series Analysis of Heat Waves and Emergency Department Visits in Atlanta, 1993 to 2012

Chen, Tianqi; Sarnat, Stefanie; Grundstein, Andrew; Winquist, Andrea; Chang, Howard H.

doi:10.1289/ehp44

Cited by 61 publications

(40 citation statements)

References 68 publications

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“…Two studies in Adelaide, Australia, showed increased admissions for renal disease during heatwaves through all ages, by 10% and 13%, respectively [ 10 , 11 ], and another study in Adelaide also identified an association between temperature and renal disease [ 12 ]. International studies have shown similar results [ 3 , 13 – 15 ]. Studies in the United States of America (USA) linked incremental rises in same-day apparent temperatures to an increased occurrence of renal disease and acute kidney injury (AKI, also known as acute renal failure) [ 1 , 13 ].…”

Section: Introductionsupporting

confidence: 64%

“…In many cities, high temperatures have been linked to an increased occurrence of AKI [ 3 , 11 , 13 , 15 – 17 ] and chronic kidney disease (CKD, also known as chronic renal failure) [ 18 , 19 ]. A study in Sydney, Australia, reported that the incidence of AKI and renal failure (AKI and CKD combined) increased if the daily temperature was above the 95th percentile range for one day, and this further increased if the high temperature persisted for three days [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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The impact of daily temperature on renal disease incidence: an ecological study

et al. 2017

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BackgroundExtremely high temperatures over many consecutive days have been linked to an increase in renal disease in several cities. This is becoming increasingly relevant with heatwaves becoming longer, more intense, and more frequent with climate change. This study aimed to extend the known relationship between daily temperature and kidney disease to include the incidence of eight temperature-prone specific renal disease categories – total renal disease, urolithiasis, renal failure, acute kidney injury (AKI), chronic kidney disease (CKD), urinary tract infections (UTIs), lower urinary tract infections (LUTIs) and pyelonephritis.MethodsDaily data was acquired for maximum, minimum and average temperature over the period of 1 July 2003 to 31 March 2014 during the warm season (October to March) in Adelaide, South Australia. Data for daily admissions to all metropolitan hospitals for renal disease, including 83,519 emergency department admissions and 42,957 inpatient admissions, was also obtained. Renal outcomes were analyzed using time-stratified negative binomial regression models, with the results aggregated by day. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated for associations between the number of admissions and daily temperature.ResultsIncreases in daily temperature per 1 °C were associated with an increased incidence for all renal disease categories except for pyelonephritis. Minimum temperature was associated with the greatest increase in renal disease followed by average temperature and then maximum temperature. A 1°C increase in daily minimum temperature was associated with an increase in daily emergency department admissions for AKI (IRR 1.037, 95% CI: 1.026–1.048), renal failure (IRR 1.030, 95% CI: 1.022–1.039), CKD (IRR 1.017, 95% CI: 1.001–1.033) urolithiasis (IRR 1.015, 95% CI: 1.010–1.020), total renal disease (IRR 1.009, 95% CI: 1.006–1.011), UTIs (IRR 1.004, 95% CI: 1.000–1.007) and LUTIs (IRR 1.003, 95% CI: 1.000–1.006).ConclusionsAn increased frequency of renal disease, including urolithiasis, acute kidney injury and urinary tract infections, is predicted with increasing temperatures from climate change. These results have clinical and public health implications for the management of renal diseases and demand tailored health services. Future research is warranted to analyze individual renal diseases with more comprehensive information regarding renal risk factors, and studies examining mortality for specific renal diseases.Electronic supplementary materialThe online version of this article (10.1186/s12940-017-0331-4) contains supplementary material, which is available to authorized users.

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Section: Introductionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

The impact of daily temperature on renal disease incidence: an ecological study

et al. 2017

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“…The results suggest opportunities for improvement and for refinement of prevention messaging as well as coordination between meteorological and public health authorities at multiple levels before, during, and after periods of extreme heat. that morbidity impacts, when available, may be most appropriate, as these outcomes are more prevalent than mortality endpoints (14,15).…”

Section: Significancementioning

confidence: 99%

Assessment of extreme heat and hospitalizations to inform early warning systems

Vaidyanathan

Saha

Vicedo‐Cabrera

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

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Heat early warning systems and action plans use temperature thresholds to trigger warnings and risk communication. In this study, we conduct multistate analyses, exploring associations between heat and all-cause and cause-specific hospitalizations, to inform the design and development of heat–health early warning systems. We used a two-stage analysis to estimate heat–health risk relationships between heat index and hospitalizations in 1,617 counties in the United States for 2003–2012. The first stage involved a county-level time series quasi-Poisson regression, using a distributed lag nonlinear model, to estimate heat–health associations. The second stage involved a multivariate random-effects meta-analysis to pool county-specific exposure–response associations across larger geographic scales, such as by state or climate region. Using results from this two-stage analysis, we identified heat index ranges that correspond with significant heat-attributable burden. We then compared those with the National Oceanic and Atmospheric Administration National Weather Service (NWS) heat alert criteria used during the same time period. Associations between heat index and cause-specific hospitalizations vary widely by geography and health outcome. Heat-attributable burden starts to occur at moderately hot heat index values, which in some regions are below the alert ranges used by the NWS during the study time period. Locally specific health evidence can beneficially inform and calibrate heat alert criteria. A synchronization of health findings with traditional weather forecasting efforts could be critical in the development of effective heat–health early warning systems.

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“…Wang et al (2012) indicated a signi cant association between heat waves and diabetes mortality of the elderly aged over 75 years. No signi cant association between heat waves and diabetes was found in other four studies (Campbell et al 2019;Sherbakov et al 2018;Wilson et al 2013;Chen et al 2017).…”

Section: Overall Analysis Of Extreme Temperatures On Diabetesmentioning

confidence: 71%

Impact of short-term exposure to extreme temperatures on diabetes mellitus morbidity and mortality? A systematic review and meta-analysis

Song

Jiang

Zhang

et al. 2021

Environ Sci Pollut Res

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The relationship between diabetes mellitus and short-term exposure to extreme temperatures remains controversial. A systematic review and metaanalysis were performed to assess the association between extreme temperatures and diabetes mellitus morbidity and mortality. PubMed, Embase, the Cochrane Library, Web of Science and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched since inception to January 1, 2019, and updated on November 17, 2020. The results were combined using random effects model and reported as relative risk (RR) with 95% con dence interval (CI). 32 studies met the included criteria. (1) Both heat and cold exposures have impact on diabetes. (2) For heat exposure, the subgroup analysis revealed that the effect on diabetes mortality (RR = 1.139, 95% CI: 1.089-1.192) was higher than morbidity (RR = 1.012, 95% CI: 1.004-1.019). (3) With the increase of de nition threshold, the impact of heat exposure on diabetes rised. (4) A stronger association between heat exposure and diabetes was observed in the elderly (≥ 60 years old) (RR = 1.040, 95% CI: 1.017-1.064). In conclusion, both short-term exposure to heat and cold temperatures have impact on diabetes. The elderly is the vulnerable population of diabetes exposure to heat temperature. Developing de nitions of heatwaves at the regional level are suggested.

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Time-series Analysis of Heat Waves and Emergency Department Visits in Atlanta, 1993 to 2012

Cited by 61 publications

References 68 publications

The impact of daily temperature on renal disease incidence: an ecological study

The impact of daily temperature on renal disease incidence: an ecological study

Assessment of extreme heat and hospitalizations to inform early warning systems

Impact of short-term exposure to extreme temperatures on diabetes mellitus morbidity and mortality? A systematic review and meta-analysis

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