The Impact of Heatwaves on Community Morbidity and Healthcare Usage: A Retrospective Observational Study Using Real-Time Syndromic Surveillance.

Sue Smith,Alex Elliot,Angie Bone,Chris Bates,Sari Kovats,Gillian Smith,Shakoor Hajat

doi:10.3390/ijerph13010132

Abstract

We investigated the impact of a moderate heatwave on a range of presenting morbidities in England. Asthma, difficulty breathing, cerebrovascular accident, and cardiovascular symptoms were analysed using general practitioner in hours (GPIH), out of hours (GPOOH) and emergency department (ED) syndromic surveillance systems. Data were stratified by age group and compared between a heatwave year (2013) and non-heatwave years (2012, 2014). Incidence rate ratios were calculated to estimate the differential impact of heatwave compared to non-heatwave summers: there were no apparent differences for the morbidities tested between the 2013 heatwave and non-heatwave years. A subset of GPIH data were used to study individuals at higher risk from heatwaves based on their pre-existing disease. Higher risk patients were not more likely to present at GPs or ED than other individuals. Comparing GPIH consultations and ED attendances for myocardial infarction/ischaemia (MI), there was evidence of a fall in the presentation of MI during the heatwave, which was particularly noted in the 65–74 years age group (and over 75 years in ED attendances). These results indicate the difficulty in identifying individuals at risk from non-fatal health effects of heatwaves and hot weather.

Highlights

Heatwaves impact on community morbidity and mortality in the United Kingdom (UK) [1,2,3].Exposure to high temperatures can cause a range of heat conditions such as heat exhaustion or heatstroke, and cardiovascular disease, renal disease and respiratory problems, in turn leading to excess emergency department attendances and ambulance calls-outs [4]
Rates of cerebrovascular accident (CVA) and myocardial infarction did not increase during the 2013 heatwave and were similar to other years, general practitioner in hours (GPIH) myocardial infarction consultations in the 65–74 years age group decreased over the heatwave period as the temperature increased (Figure 1)
The weekly incidence rate ratio (IRR) for weeks 28 to 30 (8 July through 28 July 2013) showed a 23% decrease compared to the same period for 2012 and 2014 combined, this result was not significant (IRR 0.77 (CI 0.30–1.23); Table 2)

Summary

Introduction

Heatwaves impact on community morbidity and mortality in the United Kingdom (UK) [1,2,3]. In the UK, general practitioner (GP) consultations for heat conditions have been shown to increase during heatwaves [5]. Heatwaves and hot weather are associated with increases in daily mortality (heat-related mortality) [6,7,8,9,10]. During the major European heatwave of August 2003, excess mortality was recorded across western and central Europe [11]. France reported over 15,000 excess deaths during a 16 day period of high day and night temperatures, the majority occurring in the elderly [14,15]

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