Abstract
BackgroundThe exposure to extreme ambient temperatures has been reported to increase mortality, although less is known about its impact on morbidity. The analysis of temporal changes in temperature-health associations has also focused on mortality with no studies on hospitalizations worldwide. Studies on temporal variations can provide insights on changes in susceptibility or on effectiveness of public health interventions. We aimed to analyse the effects of temperature on cause-specific hospital admissions in Spain and assess temporal changes using two periods, the second one characterized by the introduction of a heat health prevention plan.MethodsDaily counts of non-scheduled hospital admissions for cardiovascular, cerebrovascular and respiratory diseases and daily maximum temperature were obtained for each Spanish province for the period 1997–2013. The relationship between temperature and hospitalizations was estimated using distributed lag non-linear models. We compared the risk of hospitalization due to temperatures (cold, heat and extreme heat) in two periods (1997–2002 and 2004–2013).ResultsCold temperatures were associated with increased risk of cardiovascular, cerebrovascular and respiratory hospital admissions. Hot temperatures were only associated with higher hospital admissions for respiratory causes while hospitalizations for cardiovascular and cerebrovascular diseases did not increase with heat. There was a small reduction in heat-related respiratory admissions in period 2. Whereas cold-related hospitalizations for cardiovascular and cerebrovascular diseases increased in period 2, a significant reduction for respiratory hospitalizations was reported.ConclusionsOur results suggested that heat had an adverse impact on hospital admissions for respiratory diseases, while cold increased the risk of the three studied cause-specific hospitalizations. Public health interventions should also focus on morbidity effects of temperature.
Highlights
Exposure to extreme ambient temperatures is an important public health hazard
Cold temperatures were associated with increased risk of cardiovascular, cerebrovascular and respiratory hospital admissions
Hot temperatures were only associated with higher hospital admissions for respiratory causes while hospitalizations for cardiovascular and cerebrovascular diseases did not increase with heat
Summary
Exposure to extreme ambient temperatures is an important public health hazard. The most reported health impacts of extreme temperatures have been increases in mortality, especially among the most vulnerable individuals such as the elderly and those with prior medical conditions [1,2]. An overview of systematic reviews including twenty articles reported no significant heat effects for cardiovascular and cerebrovascular morbidity after conducting a meta-analyses, while a positive association with heat was found for respiratory morbidity among the elderly [16]. This was in line with another systematic review, where authors found an increase of 3.2% in respiratory hospitalizations with a 1 ̊C increase during hot days, but uncertain results for cardiovascular hospitalizations [17]. The exposure to extreme ambient temperatures has been reported to increase mortality, less is known about its impact on morbidity. We aimed to analyse the effects of temperature on cause-specific hospital admissions in Spain and assess temporal changes using two periods, the second one characterized by the introduction of a heat health prevention plan
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