School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Environ Res. 2019 Jan;168:414-419. doi: 10.1016/j.envres.2018.10.013. Epub 2018 Oct 22.
Heatwave impact on morbidity of people in rural areas has rarely been assessed in prior studies, and recently published literature has documented heatwave impact on a wide spectrum of diseases, for example, ear and eye diseases.
To examine the associations between heatwaves and cause-specific emergency department visits (EDVs) across eight communities in both urban and rural regions throughout Queensland, Australia.
Daily data on EDVs, air pollution and climatic conditions during the 1st January 2013 to the 31st December 2015 were obtained from relevant government agencies. Heatwave was defined as ≥ 95th percentile of the mean temperature for three or more consecutive days in each community. A quasi-Poisson generalized additive model with a distributed lag non-linear model was used to assess the heatwave impacts on EDVs. Random effect meta-analysis was performed to investigate the effects of heatwaves on cause-specific EDVs across the urban and rural regions as well as the whole Queensland. The causes of EDVs investigated in this study were infectious and parasitic diseases (ICD code: A00-B99), endocrine, nutritional and metabolic diseases (E00-E90), mental and behavioural disorders (F00-F99), diseases of the nervous system (G00-G99), diseases of the ear and mastoid process (H60-H95), diseases of the circulatory system (I00-I99), diseases of the respiratory system (J00-J99), diseases of the skin and subcutaneous tissue (L00-L99), diseases of the musculoskeletal system and connective tissue (M00-M99), diseases of the genitourinary system (N00-N99), and injury, poisoning and certain other consequences of external causes (S00-T98).
The meta-analysis results showed that there were significant effects of heatwaves on total EDVs and a wide-spectrum of cause-specific EDVs. For example, EDVs for endocrine, nutritional and metabolic diseases (RR: 1.18, 95% CI: 1.04-1.34), diseases of the nervous system (RR: 1.09, 95% CI: 1.02-1.17), and diseases of the genitourinary system (RR: 1.05, 95% CI: 1.00-1.09) increased substantially during heatwave days. The effect of heatwaves on total EDVs was similar for rural (RR: 1.04, 95% CI: 1.01-1.07) and urban regions (RR: 1.04, 95% CI: 1.00-1.07).
A wide range of diseases were sensitive to heatwave impacts. Residents in urban and rural areas were all vulnerable to heatwave impacts, calling for heat adaptation measures to be undertaken in Queensland, Australia.
热浪对农村地区居民发病率的影响在以往的研究中很少被评估，最近发表的文献记录了热浪对广泛疾病的影响，例如耳和眼部疾病。
研究澳大利亚昆士兰州八个城乡社区热浪与特定病因急诊就诊（EDV）之间的相关性。
从相关政府机构获取了 2013 年 1 月 1 日至 2015 年 12 月 31 日期间的每日 EDV、空气污染和气候条件数据。热浪定义为每个社区连续三天或以上的平均温度达到第 95 百分位数以上。采用具有分布滞后非线性模型的拟泊松广义加性模型来评估热浪对 EDV 的影响。采用随机效应荟萃分析来研究热浪对城乡地区以及整个昆士兰州特定病因 EDV 的影响。本研究调查的 EDV 病因包括传染病和寄生虫病（ICD 编码：A00-B99）、内分泌、营养和代谢疾病（E00-E90）、精神和行为障碍（F00-F99）、神经系统疾病（G00-G99）、耳部和乳突疾病（H60-H95）、循环系统疾病（I00-I99）、呼吸系统疾病（J00-J99）、皮肤和皮下组织疾病（L00-L99）、肌肉骨骼系统和结缔组织疾病（M00-M99）、泌尿系统疾病（N00-N99）、损伤、中毒和某些其他外部原因的后果（S00-T98）。
荟萃分析结果表明，热浪对总 EDV 和广泛病因的 EDV 均有显著影响。例如，内分泌、营养和代谢疾病（RR：1.18，95%CI：1.04-1.34）、神经系统疾病（RR：1.09，95%CI：1.02-1.17）和泌尿系统疾病（RR：1.05，95%CI：1.00-1.09）的 EDV 显著增加。热浪对农村（RR：1.04，95%CI：1.01-1.07）和城市地区（RR：1.04，95%CI：1.00-1.07）总 EDV 的影响相似。
多种疾病对热浪的影响较为敏感。城乡地区的居民都容易受到热浪的影响，这就要求在澳大利亚昆士兰州采取适应热浪的措施。
