Rajaram Nikhil, Hohenadel Karin, Gattoni Laera, Khan Yasmin, Birk-Urovitz Elizabeth, Li Lennon, Schwartz Brian
Occupational Medicine Residency Program, 4th Fl. Shuter, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1X1, Canada.
Ontario Ministry of Labour, 505 University Avenue, Toronto, ON, M7A 1 T7, Canada.
BMC Public Health. 2016 Jul 11;16:544. doi: 10.1186/s12889-016-3214-7.
Ice, or freezing rain storms have the potential to affect human health and disrupt normal functioning of a community. The purpose of this study was to assess acute health impacts of an ice storm that occurred in December 2013 in Toronto, Ontario, Canada.
Data on emergency department visits were obtained from the National Ambulatory Care Reporting System. Rates of visits in Toronto during the storm period (December 21, 2013 - January 1, 2014) were compared to rates occurring on the same dates in the previous five years (historical comparison) and compared to those in a major unaffected city, Ottawa, Ontario (geographic comparison). Overall visits and rates for three categories of interest (cardiac conditions, environmental causes and injuries) were assessed. Rate ratios were calculated using Poisson regression with population counts as an offset. Absolute counts of carbon monoxide poisoning were compared descriptively in a sub-analysis.
During the 2013 storm period, there were 34 549 visits to EDs in Toronto (12.46 per 1000 population) compared with 10 794 visits in Ottawa (11.55 per 1000 population). When considering year and geography separately, rates of several types of ED visits were higher in the storm year than in previous years in both Toronto and Ottawa. Considering year and geography together, rates in the storm year were higher for overall ED visits (RR: 1.10, 95 % CI: 1.09-1.11) and for visits due to environmental causes (RR: 2.52, 95 % CI: 2.21-2.87) compared to previous years regardless of city. For injuries, visit rates were higher in the storm year in both Toronto and Ottawa, but the increase in Toronto was significantly greater than the increase in Ottawa, indicating a significant interaction between geography and year (RR: 1.23, 95 % CI: 1.16-1.30).
This suggests that the main health impact of the 2013 Ice Storm was an increase in ED visits for injuries, while other increases could have been due to severe weather across Ontario at that time. This study is one of the first to use a population-level database and regression modeling of emergency visit codes to identify acute impacts resulting from ice storms.
冰暴或冻雨有可能影响人类健康并扰乱社区的正常运转。本研究的目的是评估2013年12月发生在加拿大多伦多市的一场冰暴对健康的急性影响。
从国家门诊护理报告系统获取急诊就诊数据。将风暴期间（2013年12月21日至2014年1月1日）多伦多的就诊率与前五年同一日期的就诊率（历史对照）进行比较，并与安大略省一个主要未受影响的城市渥太华的就诊率进行比较（地理对照）。评估了总体就诊情况以及三类关注疾病（心脏疾病、环境相关病因和损伤）的就诊率。使用以人口计数作为偏移量的泊松回归计算率比。在一项亚分析中对一氧化碳中毒的绝对病例数进行了描述性比较。
在2013年风暴期间，多伦多有34549人次前往急诊室就诊（每1000人口中有12.46人次），而渥太华有10794人次就诊（每1000人口中有11.55人次）。分别考虑年份和地理位置时，多伦多和渥太华在风暴年份中几种类型的急诊就诊率均高于前几年。综合考虑年份和地理位置，与前几年相比，无论哪个城市，风暴年份的总体急诊就诊率（率比：1.10，95%置信区间：1.09 - 1.11）以及因环境相关病因导致的就诊率（率比：2.52，95%置信区间：2.21 - 2.87）均更高。对于损伤，多伦多和渥太华在风暴年份的就诊率均有所上升，但多伦多的上升幅度显著大于渥太华，表明地理位置和年份之间存在显著交互作用（率比：1.23，95%置信区间：1.16 - 1.30）。
这表明2013年冰暴对健康的主要影响是因损伤导致的急诊就诊增加，而其他增加可能是由于当时安大略省的恶劣天气。本研究是首批使用人群水平数据库和急诊就诊编码回归模型来确定冰暴造成的急性影响的研究之一。
