School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK.
Indian Institute of Public Health, Bhubaneswar, Public Health Foundation of India 267/3408, Mayfair Road, Jayadev Vihar, Bhubaneswar, Odisha 751013, India.
Int J Environ Res Public Health. 2019 Dec 12;16(24):5065. doi: 10.3390/ijerph16245065.
Extreme heat and heat illness are becoming very frequent in India. We aimed to identify the factors associated with heat illness and the coping practices among city dwellers of Odisha, India during the summer.
A cross-sectional study included 766 households (HHs) in twin cities of Odisha covering a population of 1099 (slum: 404 and non-slum: 695) in the year 2017. We collected information on sociodemographic, household characteristics, coping practices to heat and the heat illness history reported during the summer. Multivariate logistic regression accounting for clustering effects at the household and slum levels was used to identify the associated factors of heat illness after adjustment of other variables.
Nearly, 49% of the study participants were female and the mean age was 38.36 years (95% confidence interval (CI): 37.33-39.39 years). A significant difference of living environment was seen across the groups. More than two-thirds of the study participants at least once had heat illness. In the non-slum population, males (adjusted odds ratio (aOR): 3.56; 95% CI: 2.39-5.29), persons under medication (aOR: 3.09; 95% CI: 1.15-8.29), and chronic conditions had higher association with heat illness. Whereas, in the slum population, having a kitchen outside the home (aOR: 1.63; 95% CI: 1.02-3.96) and persons with chronic conditions were positively associated with heat illness. Use of cooling practices in slum areas reduced the risk of heat illness by 60%.
Heat illness is associated with the living environment and physical health of the individuals. Identifying the vulnerable population and scaling up adaptive practices can strengthen the public health preparedness.
在印度，极端高温和与高温相关的疾病正变得愈发频繁。本研究旨在确定印度奥里萨邦城镇居民在夏季与高温相关疾病相关的因素和应对做法。
本横断面研究纳入了 2017 年奥里萨邦双子城的 766 户家庭（HH），共涵盖了 1099 人（贫民窟：404 人，非贫民窟：695 人）。我们收集了社会人口学、家庭特征、应对高温的措施以及夏季报告的高温相关疾病史等信息。采用多变量逻辑回归模型，在家庭和贫民窟两个层面上考虑聚类效应，调整其他变量后，识别高温相关疾病的相关因素。
研究参与者中近 49%为女性，平均年龄为 38.36 岁（95%置信区间（CI）：37.33-39.39 岁）。不同组别的居住环境存在显著差异。超过三分之二的研究参与者至少有过一次高温相关疾病史。在非贫民窟人群中，男性（调整后的优势比（aOR）：3.56；95%CI：2.39-5.29）、正在服药的人（aOR：3.09；95%CI：1.15-8.29）和患有慢性病的人，与高温相关疾病的关联度更高。而在贫民窟人群中，家中厨房在室外（aOR：1.63；95%CI：1.02-3.96）和患有慢性病的人，与高温相关疾病呈正相关。在贫民窟地区采用降温措施，可使高温相关疾病的风险降低 60%。
高温相关疾病与个人的生活环境和身体健康状况相关。确定弱势群体并扩大适应性措施可以增强公共卫生的准备工作。
