Abstract
Heat kills more Australians than any other natural disaster. Previous Australian research has identified increases in Emergency Department presentations in capital cities; however, little research has examined the effects of heat in rural/regional locations. This retrospective cohort study aimed to determine if Emergency Department (ED) presentations across the south-west region of Victoria, Australia, increased on high-heat days (1 February 2017 to 31 January 2020) using the Rural Acute Hospital Data Register (RAHDaR). The study also explored differences in presentations between farming towns and non-farming towns. High-heat days were defined as days over the 95th temperature percentile. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes associated with heat-related illness were identified from previous studies. As the region has a large agricultural sector, a framework was developed to identify towns estimated to have 70% or more of the population involved in farming. Overall, there were 61,631 presentations from individuals residing in the nine Local Government Areas. Of these presentations, 3064 (5.0%) were on days of high-heat, and 58,567 (95.0%) were of days of non-high-heat. Unlike previous metropolitan studies, ED presentations in rural south-west Victoria decrease on high-heat days. This decrease was more prominent in the farming cohort; a potential explanation for this may be behavioural adaption.
Highlights
The climate is changing, and it is predicted that extreme weather will be more frequent and intense [1]
The Rural Acute Hospital Data Register (RAHDaR) database collates detailed data on all presentations to the RAHDaR captures presentations at the lower-resourced south-west Victorian sites, such as the UCCs, and highlights as much as a 35% deficit in the data currently available (Figure 1); this is inclusive of very small rural facilities which run Urgent Care Centres via the government-reported dataset [25,26]
The total population of the farming town cohort was estimated to be 15,890 people, whereas the nonfarming town population was 171,180 [38], resulting in a total target population for the study of 187,070
Summary
The climate is changing, and it is predicted that extreme weather will be more frequent and intense [1]. The most recent five years have been the warmest on record. Research has shown an increase in illness, hospitalisations, and deaths during extreme weather events/days [2–4]. In Australia, 2019 was both the warmest and driest year on record [5]. Heat kills more Australians than any other natural disaster; between 1900 and 2011, extreme heat accounted for 55% (4555 deaths) of the total number of deaths due to natural hazards [6]. Heat-related illness occurs from combined environmental exposure, metabolic demands, and restricted cooling mechanisms, causing the body to be unable to disperse heat adequately, resulting in thermoregulatory dysfunction [7].
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