Using Near Real-Time Morbidity Data to Identify Heat-Related Illness Prevention Strategies in North Carolina

Rhea, Sarah; Ising, Amy; Fleischauer, Aaron; Deyneka, Lana; Vaughan-Batten, Heather; Waller, Anna

doi:10.1007/s10900-011-9469-0

Cited by 35 publications

(36 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In North Carolina, many of the ED visits seen during the July event were likely work-related, as most occupations with high exposure to extreme heat employ individuals in these age categories [33]. Indeed, about onethird of all HRI visits in the NC DETECT dataset from 2008 to 2010 were work-related according to available triage notes [17]. One occupational group that is particularly vulnerable in North Carolina is migrant and seasonal farm workers, who exhibit the highest mortality rates for HRI of all farm workers across the U.S. [34].…”

Section: Discussionmentioning

confidence: 99%

“…Examination of available triage notes in the NC DETECT dataset revealed that [40 % of HRI visits were associated with exercise or recreation, of which two-thirds were linked to organized sports among 10-18 year olds [17]. Football players are particularly vulnerable to HRI due to uniform requirements and physiological characteristics that increase metabolic heat production and storage [39,40].…”

Section: Discussionmentioning

confidence: 99%

“…To investigate this further, we examined several other diseases in this category (not presented in Table 2) and found a statistically significant increase ([10 %, p \ 0.001) in visits with hypertension and rheumatic disease (ICD-9-CM 401-405) during the July event, with negligible and insignificant increases during the other two heat events. Previous research found that about 18 % of ED visits with HRI were associated with hypertension, most within the 25 to 54 age groups [17]. Some research suggests that short-term spikes in blood pressure can occur from exposure to heat, though the pathophysiological link between hypertension and heat stress may manifest through other cardiovascular and respiratory conditions [46].…”

Section: Discussionmentioning

confidence: 99%

“…Health Data [17]. For each ED visit, we obtained all recorded diagnoses (up to 11) using the International Classification of Diseases, 9 th Revision, Clinical Modification (ICD-9-CM) codes, as well as the age and county of residence of the patient.…”

Section: Methodsmentioning

confidence: 99%

“…heat exhaustion, heat stroke) associated with periods of extreme heat in North Carolina, and (2) to characterize the underlying health conditions and disease processes associated with periods of extreme heat. To accomplish these objectives, we analyzed statewide ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), which has been used previously to study HRI in North Carolina [17][18][19]. This research complements those studies by focusing specifically on periods of extreme heat, examining the different forms of HRI, and exploring a broader range of health outcomes and diseases.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007–2011)

et al. 2015

Self Cite

View full text Add to dashboard Cite

Extreme heat is the leading cause of weather-related mortality in the U.S. Extreme heat also affects human health through heat stress and can exacerbate underlying medical conditions that lead to increased morbidity and mortality. In this study, data on emergency department (ED) visits for heat-related illness (HRI) and other selected diseases were analyzed during three heat events across North Carolina from 2007 to 2011. These heat events were identified based on the issuance and verification of heat products from local National Weather Service forecast offices (i.e. Heat Advisory, Heat Watch, and Excessive Heat Warning). The observed number of ED visits during these events were compared to the expected number of ED visits during several control periods to determine excess morbidity resulting from extreme heat. All recorded diagnoses were analyzed for each ED visit, thereby providing insight into the specific pathophysiological mechanisms and underlying health conditions associated with exposure to extreme heat. The most common form of HRI was heat exhaustion, while the percentage of visits with heat stroke was relatively low (<10%). The elderly (>65 years of age) were at greatest risk for HRI during the early summer heat event (8.9 visits per 100,000), while young and middle age adults (18-44 years of age) were at greatest risk during the mid-summer event (6.3 visits per 100,000). Many of these visits were likely due to work-related exposure. The most vulnerable demographic during the late summer heat event was adolescents (15-17 years of age), which may relate to the timing of organized sports. This demographic also exhibited the highest visit rate for HRI among all three heat events (10.5 visits per 100,000). Significant increases (p < 0.05) in visits with cardiovascular and cerebrovascular diseases were noted during the three heat events (3-8%). The greatest increases were found in visits with hypotension during the late summer event (23%) and sequelae during the early summer event (30%), while decreases were noted for visits with hemorrhagic stroke during the middle and late summer events (13-24%) and for visits with aneurysm during the early summer event (15%). Significant increases were also noted in visits with respiratory diseases (5-7%). The greatest increases in this category were found in visits with pneumonia and influenza (16%), bronchitis and emphysema (12%), and COPD (14%) during the early summer event. Significant increases in visits with nervous system disorders were also found during the early summer event (16%), while increases in visits with diabetes were noted during the mid-summer event (10%).

show abstract

Section: Discussionmentioning

confidence: 99%