Abstract
BackgroundMany studies have examined the association between ambient temperature and mortality. However, less evidence is available on the temperature effects on gender- and age-specific emergency department visits, especially in developing countries. In this study, we examined the short-term effects of daily ambient temperature on emergency department visits (ED visits) in Shanghai.MethodsDaily ED visits and daily ambient temperatures between January 2006 and December 2011 were analyzed. After controlling for secular and seasonal trends, weather, air pollution and other confounding factors, a Poisson generalized additive model (GAM) was used to examine the associations between ambient temperature and gender- and age-specific ED visits. A moving average lag model was used to evaluate the lag effects of temperature on ED visits.ResultsLow temperature was associated with an overall 2.76% (95% confidence interval (CI): 1.73 to 3.80) increase in ED visits per 1°C decrease in temperature at Lag1 day, 2.03% (95% CI: 1.04 to 3.03) and 2.45% (95% CI: 1.40 to 3.52) for males and females. High temperature resulted in an overall 1.78% (95% CI: 1.05 to 2.51) increase in ED visits per 1°C increase in temperature on the same day, 1.81% (95% CI: 1.08 to 2.54) among males and 1.75% (95% CI: 1.03 to 2.49) among females. The cold effect appeared to be more acute among younger people aged <45 years, whereas the effects were consistent on individuals aged ≥65 years. In contrast, the effects of high temperature were relatively consistent over all age groups.ConclusionsThese findings suggest a significant association between ambient temperature and ED visits in Shanghai. Both cold and hot temperatures increased the relative risk of ED visits. This knowledge has the potential to advance prevention efforts targeting weather-sensitive conditions.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-100) contains supplementary material, which is available to authorized users.
Highlights
Many studies have examined the association between ambient temperature and mortality
Less is known about the association between ambient temperature and morbidity, with most evidence coming from studies of hospital visits [7] and much less from studies of emergency department (ED) visits [3]
We obtained daily number of ED visits for registered residents living in urban Shanghai who participated in workers’ basic medical insurance, including employees of urban businesses, organizations, institutions, and social organizations between January 1, 2006 and December 31, 2011 from the Shanghai Health Insurance Bureau (SHIB)
Summary
Many studies have examined the association between ambient temperature and mortality. We examined the short-term effects of daily ambient temperature on emergency department visits (ED visits) in Shanghai. The association between short-term exposure to high or low ambient temperatures and increased mortality has been well documented worldwide [1,2]. Non-fatal morbidities such as outpatient visits or hospitalizations should be considered in adequately characterizing the health effects of exposure to low or high temperatures [6]. Less is known about the association between ambient temperature and morbidity, with most evidence coming from studies of hospital visits [7] and much less from studies of ED visits [3]. A study from Italy showed a strong relationship between bio-meteorological conditions and ambulance dispatches [9]
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