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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Heat and emergency room admissions in the Netherlands

Authors: Joris Adriaan Frank van Loenhout, Tefera Darge Delbiso, Anna Kiriliouk, Jose Manuel Rodriguez-Llanes, Johan Segers, Debarati Guha-Sapir

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Due to a global warming-related increase in heatwaves, it is important to obtain detailed understanding of the relationship between heat and health. We assessed the relationship between heat and urgent emergency room admissions in the Netherlands.

Methods

We collected daily maximum temperature and relative humidity data over the period 2002–2007. Daily urgent emergency room admissions were divided by sex, age group and disease category. We used distributed lag non-linear Poisson models, estimating temperature-admission associations. We estimated the relative risk (RR) for urgent hospital admissions for a range of temperatures compared to a baseline temperature of 21 °C. In addition, we compared the impact of three different temperature scenarios on admissions using the RR.

Results

There is a positive relationship between increasing temperatures above 21 °C and the RR for urgent emergency room admissions for the disease categories ‘Potential heat-related diseases’ and ‘Respiratory diseases’. This relationship is strongest in the 85+ group. The RRs are strongest for lag 0. For admissions for ‘circulatory diseases’, there is only a small significant increase of RRs within the 85+ age group for moderate heat, but not for extreme heat. The RRs for a one-day event with extreme heat are comparable to the RRs for multiple-day events with moderate heat.

Conclusions

Hospitals should adjust the capacity of their emergency departments on warm days, and the days immediately thereafter. The elderly in particular should be targeted through prevention programmes to reduce harmful effects of heat. The fact that this increase in admissions already occurs in temperatures above 21 °C is different from previous findings in warmer countries. Given the similar impact of three consecutive days of moderate heat and one day of extreme heat on admissions, criteria for activation of national heatwave plans need adjustments based on different temperature scenarios.
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Literature
2.
go back to reference Parry ML, Canziani OF, Palutikof JP, van der Linden PJ, Hanson CE. Contribution of working group II to the fourth assessment report of the intergovernmental panel on climate change. 2007. Parry ML, Canziani OF, Palutikof JP, van der Linden PJ, Hanson CE. Contribution of working group II to the fourth assessment report of the intergovernmental panel on climate change. 2007.
3.
go back to reference Baccini M, Kosatsky T, Biggeri A. Impact of summer heat on urban population mortality in Europe during the 1990s: an evaluation of years of life lost adjusted for harvesting. PLoS One. 2013;8(7):e69638.CrossRefPubMedPubMedCentral Baccini M, Kosatsky T, Biggeri A. Impact of summer heat on urban population mortality in Europe during the 1990s: an evaluation of years of life lost adjusted for harvesting. PLoS One. 2013;8(7):e69638.CrossRefPubMedPubMedCentral
4.
go back to reference Oudin Astrom D, Schifano P, Asta F, Lallo A, Michelozzi P, Rocklov J, et al. The effect of heat waves on mortality in susceptible groups: a cohort study of a mediterranean and a northern European City. Environ Health. 2015;14:30.CrossRefPubMedPubMedCentral Oudin Astrom D, Schifano P, Asta F, Lallo A, Michelozzi P, Rocklov J, et al. The effect of heat waves on mortality in susceptible groups: a cohort study of a mediterranean and a northern European City. Environ Health. 2015;14:30.CrossRefPubMedPubMedCentral
5.
go back to reference Gasparrini A, Guo Y, Hashizume M, Lavigne E, Zanobetti A, Schwartz J, et al. Mortality risk attributable to high and low ambient temperature: a multicountry observational study. Lancet. 2015;386(9991):369–75.CrossRefPubMedPubMedCentral Gasparrini A, Guo Y, Hashizume M, Lavigne E, Zanobetti A, Schwartz J, et al. Mortality risk attributable to high and low ambient temperature: a multicountry observational study. Lancet. 2015;386(9991):369–75.CrossRefPubMedPubMedCentral
6.
go back to reference Elliot AJ, Bone A, Morbey R, Hughes HE, Harcourt S, Smith S, et al. Using real-time syndromic surveillance to assess the health impact of the 2013 heatwave in England. Environ Res. 2014;135:31–6.CrossRefPubMed Elliot AJ, Bone A, Morbey R, Hughes HE, Harcourt S, Smith S, et al. Using real-time syndromic surveillance to assess the health impact of the 2013 heatwave in England. Environ Res. 2014;135:31–6.CrossRefPubMed
7.
go back to reference Josseran L, Caillere N, Brun-Ney D, Rottner J, Filleul L, Brucker G, et al. Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France. BMC Med Inform Decis Mak. 2009;9:14.CrossRefPubMedPubMedCentral Josseran L, Caillere N, Brun-Ney D, Rottner J, Filleul L, Brucker G, et al. Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France. BMC Med Inform Decis Mak. 2009;9:14.CrossRefPubMedPubMedCentral
8.
go back to reference Michelozzi P, Accetta G, De Sario M, D'Ippoliti D, Marino C, Baccini M, et al. High temperature and hospitalizations for cardiovascular and respiratory causes in 12 European cities. Am J Respir Crit Care Med. 2009;179(5):383–9.CrossRefPubMed Michelozzi P, Accetta G, De Sario M, D'Ippoliti D, Marino C, Baccini M, et al. High temperature and hospitalizations for cardiovascular and respiratory causes in 12 European cities. Am J Respir Crit Care Med. 2009;179(5):383–9.CrossRefPubMed
9.
go back to reference Mastrangelo G, Fedeli U, Visentin C, Milan G, Fadda E, Spolaore P. Pattern and determinants of hospitalization during heat waves: an ecologic study. BMC Public Health. 2007;7:200.CrossRefPubMedPubMedCentral Mastrangelo G, Fedeli U, Visentin C, Milan G, Fadda E, Spolaore P. Pattern and determinants of hospitalization during heat waves: an ecologic study. BMC Public Health. 2007;7:200.CrossRefPubMedPubMedCentral
10.
go back to reference Kovats RS, Hajat S, Wilkinson P. Contrasting patterns of mortality and hospital admissions during hot weather and heat waves in greater London. UK Occup Environ Med. 2004;61(11):893–8.CrossRefPubMed Kovats RS, Hajat S, Wilkinson P. Contrasting patterns of mortality and hospital admissions during hot weather and heat waves in greater London. UK Occup Environ Med. 2004;61(11):893–8.CrossRefPubMed
11.
go back to reference Ministerie van Volksgezondheid, Welzijn en Sport. Nationaal Hitteplan; 2007. Ministerie van Volksgezondheid, Welzijn en Sport. Nationaal Hitteplan; 2007.
12.
go back to reference Huynen MM, Martens P, Schram D, Weijenberg MP, Kunst AE. The impact of heat waves and cold spells on mortality rates in the Dutch population. Environ Health Perspect. 2001;109(5):463–70.CrossRefPubMedPubMedCentral Huynen MM, Martens P, Schram D, Weijenberg MP, Kunst AE. The impact of heat waves and cold spells on mortality rates in the Dutch population. Environ Health Perspect. 2001;109(5):463–70.CrossRefPubMedPubMedCentral
13.
go back to reference Garssen J, Harmsen C, de Beer J. The effect of the summer 2003 heat wave on mortality in the Netherlands. Euro surveill. 2005;10(7):165–8.CrossRefPubMed Garssen J, Harmsen C, de Beer J. The effect of the summer 2003 heat wave on mortality in the Netherlands. Euro surveill. 2005;10(7):165–8.CrossRefPubMed
14.
go back to reference van Daalen E, van Riet NF. Onderzoek naar warmtebeleving bij ouderen – zomer 2010. Brabant Zeeland: Bureau Gezondheid, Milieu en Veiligheid GGD; 2010. van Daalen E, van Riet NF. Onderzoek naar warmtebeleving bij ouderen – zomer 2010. Brabant Zeeland: Bureau Gezondheid, Milieu en Veiligheid GGD; 2010.
15.
go back to reference van Loenhout JA, le Grand A, Duijm F, Greven F, Vink NM, Hoek G, et al. The effect of high indoor temperatures on self-perceived health of elderly persons. Environ Res. 2016;146:27–34.CrossRefPubMed van Loenhout JA, le Grand A, Duijm F, Greven F, Vink NM, Hoek G, et al. The effect of high indoor temperatures on self-perceived health of elderly persons. Environ Res. 2016;146:27–34.CrossRefPubMed
16.
go back to reference CRED. Centre for Research on the Epidemiology of Disasters: The International Disaster Database - EM-DAT 2017 [Accessed 14 Mar 2017]. Available from: http://www.emdat.be/. CRED. Centre for Research on the Epidemiology of Disasters: The International Disaster Database - EM-DAT 2017 [Accessed 14 Mar 2017]. Available from: http://​www.​emdat.​be/.
18.
go back to reference Dutch Hospital Data. Landelijke Basisregistratie Ziekenhuiszorg. 2014. Dutch Hospital Data. Landelijke Basisregistratie Ziekenhuiszorg. 2014.
19.
go back to reference Semenza JC, McCullough JE, Flanders WD, McGeehin MA, Lumpkin JR. Excess hospital admissions during the July 1995 heat wave in Chicago. Am J Prev Med. 1999;16(4):269–77.CrossRefPubMed Semenza JC, McCullough JE, Flanders WD, McGeehin MA, Lumpkin JR. Excess hospital admissions during the July 1995 heat wave in Chicago. Am J Prev Med. 1999;16(4):269–77.CrossRefPubMed
20.
go back to reference Zanobetti A, Wand MP, Schwartz J, Ryan LM. Generalized additive distributed lag models: quantifying mortality displacement. Biostatistics. 2000;1(3):279–92.CrossRefPubMed Zanobetti A, Wand MP, Schwartz J, Ryan LM. Generalized additive distributed lag models: quantifying mortality displacement. Biostatistics. 2000;1(3):279–92.CrossRefPubMed
21.
go back to reference Armstrong B. Models for the relationship between ambient temperature and daily mortality. Epidemiology. 2006;17(6):624–31.CrossRefPubMed Armstrong B. Models for the relationship between ambient temperature and daily mortality. Epidemiology. 2006;17(6):624–31.CrossRefPubMed
23.
go back to reference Peng RD, Dominici F, Louis TA. Model choice in time series studies of air pollution and mortality. J. R. Stat. Soc A Stat Soc. 2006;169(2):179–203.CrossRef Peng RD, Dominici F, Louis TA. Model choice in time series studies of air pollution and mortality. J. R. Stat. Soc A Stat Soc. 2006;169(2):179–203.CrossRef
24.
go back to reference Team RC. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2017. Team RC. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2017.
26.
go back to reference Hastie TJ, Tibshirani RJ. Generalized additive models, volume 43: CRC press; 1990. Hastie TJ, Tibshirani RJ. Generalized additive models, volume 43: CRC press; 1990.
27.
go back to reference Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36(3):1–48.CrossRef Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36(3):1–48.CrossRef
28.
go back to reference Levy M, Broccoli M, Cole G, Jenkins JL, Klein EY. An analysis of the relationship between the heat index and arrivals in the emergency department. PLoS Curr. 2015;7 Levy M, Broccoli M, Cole G, Jenkins JL, Klein EY. An analysis of the relationship between the heat index and arrivals in the emergency department. PLoS Curr. 2015;7
29.
go back to reference Xu Z, Crooks JL, Black D, Hu W, Tong S. Heatwave and infants' hospital admissions under different heatwave definitions. Environ Pollut. 2017;229:525–30.CrossRefPubMed Xu Z, Crooks JL, Black D, Hu W, Tong S. Heatwave and infants' hospital admissions under different heatwave definitions. Environ Pollut. 2017;229:525–30.CrossRefPubMed
30.
go back to reference Xu Z, FitzGerald G, Guo Y, Jalaludin B, Tong S. Impact of heatwave on mortality under different heatwave definitions: a systematic review and meta-analysis. Environ Int. 2016;89-90:193–203.CrossRefPubMed Xu Z, FitzGerald G, Guo Y, Jalaludin B, Tong S. Impact of heatwave on mortality under different heatwave definitions: a systematic review and meta-analysis. Environ Int. 2016;89-90:193–203.CrossRefPubMed
31.
go back to reference Bobb JF, Obermeyer Z, Wang Y, Dominici F. Cause-specific risk of hospital admission related to extreme heat in older adults. JAMA. 2014;312(24):2659–67.CrossRefPubMedPubMedCentral Bobb JF, Obermeyer Z, Wang Y, Dominici F. Cause-specific risk of hospital admission related to extreme heat in older adults. JAMA. 2014;312(24):2659–67.CrossRefPubMedPubMedCentral
32.
go back to reference Bai L, Cirendunzhu, Woodward A, Dawa, Zhaxisangmu, Chen B, et al. Temperature, hospital admissions and emergency room visits in Lhasa, Tibet: a time-series analysis. Sci Total Environ. 2014;490:838–48.CrossRefPubMed Bai L, Cirendunzhu, Woodward A, Dawa, Zhaxisangmu, Chen B, et al. Temperature, hospital admissions and emergency room visits in Lhasa, Tibet: a time-series analysis. Sci Total Environ. 2014;490:838–48.CrossRefPubMed
33.
go back to reference Anderson GB, Dominici F, Wang Y, MC MC, Bell ML, Peng RD. Heat-related emergency hospitalizations for respiratory diseases in the Medicare population. Am J Respir Crit Care Med. 2013;187(10):1098–103.CrossRefPubMedPubMedCentral Anderson GB, Dominici F, Wang Y, MC MC, Bell ML, Peng RD. Heat-related emergency hospitalizations for respiratory diseases in the Medicare population. Am J Respir Crit Care Med. 2013;187(10):1098–103.CrossRefPubMedPubMedCentral
34.
go back to reference Giang PN, do V D, Bao Giang K, Vinhc HV, Rocklov J. The effect of temperature on cardiovascular disease hospital admissions among elderly people in Thai Nguyen Province, Vietnam. Glob Health Action. 2014;7:23649.CrossRefPubMed Giang PN, do V D, Bao Giang K, Vinhc HV, Rocklov J. The effect of temperature on cardiovascular disease hospital admissions among elderly people in Thai Nguyen Province, Vietnam. Glob Health Action. 2014;7:23649.CrossRefPubMed
35.
go back to reference Phung D, Thai PK, Guo Y, Morawska L, Rutherford S, Chu C. Ambient temperature and risk of cardiovascular hospitalization: an updated systematic review and meta-analysis. Sci Total Environ. 2016;550:1084–102.CrossRefPubMed Phung D, Thai PK, Guo Y, Morawska L, Rutherford S, Chu C. Ambient temperature and risk of cardiovascular hospitalization: an updated systematic review and meta-analysis. Sci Total Environ. 2016;550:1084–102.CrossRefPubMed
36.
go back to reference Linares C, Diaz J. Impact of high temperatures on hospital admissions: comparative analysis with previous studies about mortality (Madrid). Eur J Pub Health. 2008;18(3):317–22.CrossRef Linares C, Diaz J. Impact of high temperatures on hospital admissions: comparative analysis with previous studies about mortality (Madrid). Eur J Pub Health. 2008;18(3):317–22.CrossRef
37.
go back to reference Oktay C, Luk JH, Allegra JR, Kusoglu L. The effect of temperature on illness severity in emergency department congestive heart failure patients. Ann Acad Med Singap. 2009;38(12):1081–4.PubMed Oktay C, Luk JH, Allegra JR, Kusoglu L. The effect of temperature on illness severity in emergency department congestive heart failure patients. Ann Acad Med Singap. 2009;38(12):1081–4.PubMed
38.
go back to reference Lee S, Lee E, Park MS, Kwon BY, Kim H, Jung DH, et al. Short-term effect of temperature on daily emergency visits for acute myocardial infarction with threshold temperatures. PLoS One. 2014;9(4):e94070.CrossRefPubMedPubMedCentral Lee S, Lee E, Park MS, Kwon BY, Kim H, Jung DH, et al. Short-term effect of temperature on daily emergency visits for acute myocardial infarction with threshold temperatures. PLoS One. 2014;9(4):e94070.CrossRefPubMedPubMedCentral
39.
go back to reference Nitschke M, Tucker GR, Hansen AL, Williams S, Zhang Y, Bi P. Impact of two recent extreme heat episodes on morbidity and mortality in Adelaide, South Australia: a case-series analysis. Environ Health. 2011;10:42.CrossRefPubMedPubMedCentral Nitschke M, Tucker GR, Hansen AL, Williams S, Zhang Y, Bi P. Impact of two recent extreme heat episodes on morbidity and mortality in Adelaide, South Australia: a case-series analysis. Environ Health. 2011;10:42.CrossRefPubMedPubMedCentral
40.
go back to reference Zhang Y, Yan C, Kan H, Cao J, Peng L, Xu J, et al. Effect of ambient temperature on emergency department visits in shanghai, China: a time series study. Environ Health. 2014;13:100.CrossRefPubMedPubMedCentral Zhang Y, Yan C, Kan H, Cao J, Peng L, Xu J, et al. Effect of ambient temperature on emergency department visits in shanghai, China: a time series study. Environ Health. 2014;13:100.CrossRefPubMedPubMedCentral
41.
go back to reference Tong S, Wang XY, FitzGerald G, McRae D, Neville G, Tippett V, et al. Development of health risk-based metrics for defining a heatwave: a time series study in Brisbane, Australia. BMC Public Health. 2014;14:435.CrossRefPubMedPubMedCentral Tong S, Wang XY, FitzGerald G, McRae D, Neville G, Tippett V, et al. Development of health risk-based metrics for defining a heatwave: a time series study in Brisbane, Australia. BMC Public Health. 2014;14:435.CrossRefPubMedPubMedCentral
42.
go back to reference Wang XY, Barnett AG, Yu W, FitzGerald G, Tippett V, Aitken P, et al. The impact of heatwaves on mortality and emergency hospital admissions from non-external causes in Brisbane, Australia. Occup Environ Med. 2012;69(3):163–9.CrossRefPubMed Wang XY, Barnett AG, Yu W, FitzGerald G, Tippett V, Aitken P, et al. The impact of heatwaves on mortality and emergency hospital admissions from non-external causes in Brisbane, Australia. Occup Environ Med. 2012;69(3):163–9.CrossRefPubMed
43.
go back to reference Gronlund CJ, Zanobetti A, Schwartz JD, Wellenius GA, O'Neill MS. Heat, heat waves, and hospital admissions among the elderly in the United States, 1992-2006. Environ Health Perspect. 2014;122(11):1187–92.PubMedPubMedCentral Gronlund CJ, Zanobetti A, Schwartz JD, Wellenius GA, O'Neill MS. Heat, heat waves, and hospital admissions among the elderly in the United States, 1992-2006. Environ Health Perspect. 2014;122(11):1187–92.PubMedPubMedCentral
44.
go back to reference Pillai SK, Noe RS, Murphy MW, Vaidyanathan A, Young R, Kieszak S, et al. Heat illness: predictors of hospital admissions among emergency department visits-Georgia, 2002-2008. J Community Health. 2014;39(1):90–8.CrossRefPubMed Pillai SK, Noe RS, Murphy MW, Vaidyanathan A, Young R, Kieszak S, et al. Heat illness: predictors of hospital admissions among emergency department visits-Georgia, 2002-2008. J Community Health. 2014;39(1):90–8.CrossRefPubMed
45.
go back to reference Bunker A, Wildenhain J, Vandenbergh A, Henschke N, Rocklov J, Hajat S, et al. Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly; a systematic review and meta-analysis of epidemiological evidence. EBioMedicine. 2016;6:258–68.CrossRefPubMedPubMedCentral Bunker A, Wildenhain J, Vandenbergh A, Henschke N, Rocklov J, Hajat S, et al. Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly; a systematic review and meta-analysis of epidemiological evidence. EBioMedicine. 2016;6:258–68.CrossRefPubMedPubMedCentral
46.
go back to reference Flynn A, McGreevy C, Mulkerrin EC. Why do older patients die in a heatwave? QJM. 2005;98(3):227–9.CrossRefPubMed Flynn A, McGreevy C, Mulkerrin EC. Why do older patients die in a heatwave? QJM. 2005;98(3):227–9.CrossRefPubMed
48.
go back to reference Xu Z, Hu W, Su H, Turner LR, Ye X, Wang J, et al. Extreme temperatures and paediatric emergency department admissions. J Epidemiol Community Health. 2014;68(4):304–11.CrossRefPubMed Xu Z, Hu W, Su H, Turner LR, Ye X, Wang J, et al. Extreme temperatures and paediatric emergency department admissions. J Epidemiol Community Health. 2014;68(4):304–11.CrossRefPubMed
49.
go back to reference Xu Z, Huang C, Hu W, Turner LR, Su H, Tong S. Extreme temperatures and emergency department admissions for childhood asthma in Brisbane. Australia Occup Environ Med. 2013;70(10):730–5.CrossRefPubMed Xu Z, Huang C, Hu W, Turner LR, Su H, Tong S. Extreme temperatures and emergency department admissions for childhood asthma in Brisbane. Australia Occup Environ Med. 2013;70(10):730–5.CrossRefPubMed
50.
go back to reference Knowlton K, Rotkin-Ellman M, King G, Margolis HG, Smith D, Solomon G, et al. The 2006 California heat wave: impacts on hospitalizations and emergency department visits. Environ Health Perspect. 2009;117(1):61–7.CrossRefPubMed Knowlton K, Rotkin-Ellman M, King G, Margolis HG, Smith D, Solomon G, et al. The 2006 California heat wave: impacts on hospitalizations and emergency department visits. Environ Health Perspect. 2009;117(1):61–7.CrossRefPubMed
51.
go back to reference Baccini M, Biggeri A, Accetta G, Kosatsky T, Katsouyanni K, Analitis A, et al. Heat effects on mortality in 15 European cities. Epidemiology. 2008;19(5):711–9.CrossRefPubMed Baccini M, Biggeri A, Accetta G, Kosatsky T, Katsouyanni K, Analitis A, et al. Heat effects on mortality in 15 European cities. Epidemiology. 2008;19(5):711–9.CrossRefPubMed
52.
go back to reference Wilson LA, Morgan GG, Hanigan IC, Johnston FH, Abu-Rayya H, Broome R, et al. The impact of heat on mortality and morbidity in the greater metropolitan Sydney region: a case crossover analysis. Environ Health. 2013;12:98.CrossRefPubMedPubMedCentral Wilson LA, Morgan GG, Hanigan IC, Johnston FH, Abu-Rayya H, Broome R, et al. The impact of heat on mortality and morbidity in the greater metropolitan Sydney region: a case crossover analysis. Environ Health. 2013;12:98.CrossRefPubMedPubMedCentral
53.
go back to reference de’ Donato FK, Leone M, Scortichini M, De Sario M, Katsouyanni K, Lanki T, et al. Changes in the effect of heat on mortality in the last 20 years in nine European cities. Results from the PHASE project. Int J Environ Res Public Health. 2015;12(12):15567–83.CrossRef de’ Donato FK, Leone M, Scortichini M, De Sario M, Katsouyanni K, Lanki T, et al. Changes in the effect of heat on mortality in the last 20 years in nine European cities. Results from the PHASE project. Int J Environ Res Public Health. 2015;12(12):15567–83.CrossRef
Metadata
Title
Heat and emergency room admissions in the Netherlands
Authors
Joris Adriaan Frank van Loenhout
Tefera Darge Delbiso
Anna Kiriliouk
Jose Manuel Rodriguez-Llanes
Johan Segers
Debarati Guha-Sapir
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-5021-1

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