Title High Ambient Temperatures and Child/Young Adult Injury Emergency Department Visits in NYC Authors Blean Girma, Bian Liu, Ellen Kinnee, Leah H Schinasi, Jane Clougherty, Perry E Sheffield Abstract BACKGROUND AND AIM Despite a growing literature on effects of ambient temperature and climate change on health, there remains little research quantifying associations between ambient temperature and violence-related or unintentional injury, particularly among children and adolescents. Here, we examined associations between ambient minimum daily temperature (Tmin) and emergency department (ED) visits for pediatric injury during warm months in New York City (NYC). METHODS We examined all ED visits among patients 0-25 years, during May-September 2010, with primary injury diagnosis (ICD-9) (n=108,447). We performed conditional logistic regression, in a case-crossover design, using distributed lag non-linear functions (DLNMs), adjusting for long-term time trends and daily relative humidity. We modeled the lag-response curve across lag days 0-5, estimating cumulative odds ratios (OR) across lag days, compared to odds at observed minimum-injury temperature (MIT, 42° F)). We also stratified analyses by age and injury type. RESULTS Across all ages and injury type, case-day Tmin was significantly associated with increased odds of injury, though associations were inconsistent across lag days. Across five-year age groups, children aged 5-9 (n =17,810) had the highest odds of injury [adj OR = 1.66 (95% CI: 1.24 - 2.24)] for days with Tmin >95th percentile (78 °F) compared to the MIT, with elevated risks of violence-related and unintentional injury (OR =1.74 (95% CI: 1.18-2.57) and OR = 1.66 (95% CI: 1.42-1.93, respectively)). CONCLUSIONS Elevated ambient temperature was associated with higher risk of ED visits for injury among ages 0-25. Future analyses will explore variation in effects of heat by socio-economic position and discriminatory race-based policies (e.g., redlining) over an extended observation period. KEYWORDS Climate change, pediatric environmental health, heat, injury, violence
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