Abstract P069: Heat, Heat Waves and Hospital Admissions in Indianapolis, Indiana

Abstract

Background: The association between heat and hospital admissions is well studied, but in Indiana where the regulatory agencies cites lack of evidence for global climate change, local evidence of such an association is critical for Indiana to mitigate the impact of increasing heat. Methods: Using a distributed-lag non-linear model, we studied the effects of moderate (31.7 °C or 90 th percentile of daily mean apparent temperature (AT)), severe (33.5 °C or 95 th percentile of daily mean apparent temperature (AT)) and extreme (36.4 °C or 99 th percentile of AT) heat on hospital admissions (June-August 2007-2012) for cardiovascular (myocardial infarction, myocardial infarction, heart failure) and heat-related diseases in Indianapolis, Indiana located in Marion County. We also examined the added effects of moderate heat waves (AT above the 90 th percentile lasting 2-6 days), severe heat waves (AT above the 95 th percentile lasting 2-6 days) and extreme heat waves (AT above the 99 th percentile lasting 2-6 days). In sensitivity analysis, we tested robustness of our results to 1) different temperature and lag structures and 2) temperature metrics (daily min, max and diurnal temperature range). Results: The relative risks of moderate heat, relative to 29.2°C (75 th percentile of AT), on admissions for cardiovascular disease (CVD), myocardial infarction (MI), heart failure (HF), and heat-related diseases (HD) were 0.98 (0.67, 1.44), 6.28 (1.48, 26.6), 1.38 (0.81, 2.36) and 1.73 (0.58, 5.11). The relative risk of severe heat on admissions for CVD, MI, HF, and HD were 0.93 (0.60, 1.43), 4.46 (0.85, 23.4), 1.30 (0.72, 2.34) and 2.14 (0.43, 10.7). The relative risk of extreme heat were 0.79 (0.26, 2.39), 0.11 (0.087, 1.32), 0.68 (0.18, 2.61), and 0.32 (0.005, 19.5). We also observed statistically significant added effects of moderate heat waves lasting 4 or 6 days on hospital admission for MI and HD and extreme heat waves lasting 4 days on hospital admissions for HD. Results were strengthened for people older than 65. Conclusions: Moderate heat wave lasting 4-6 days were associated with increased hospital admissions for MI and HD diseases and extreme heat wave lasting 4 days were associated with increased admissions for HD.