Citation

Anderson GB, Dominici F, Wang Y, McCormack MC, Bell ML, Peng RD. Am. J. Respir. Crit. Care Med. 2013; 187(10): 1098-1103.

Affiliation

Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.

Copyright

(Copyright © 2013, American Thoracic Society)

DOI

10.1164/rccm.201211-1969OC

PMID

23491405

Abstract

RATIONALE: The heat-related risk of hospitalization for respiratory diseases among the elderly has not been quantified in the United States on a national scale. With climate change predictions of more frequent and more intense heat waves, it is of paramount importance to quantify the health risks related to heat, especially for the most vulnerable. OBJECTIVES: To estimate the risk of hospitalization for respiratory diseases associated with outdoor heat in the US elderly. METHODS: An observational study of ~12.5 million Medicare beneficiaries in 213 United States counties, January 1, 1999-December 31, 2008. We estimate a national average relative risk of hospitalization for each 10oF (5.6oC) increase in daily outdoor temperature using Bayesian hierarchical models. MEASUREMENTS AND MAIN RESULTS: We obtained daily county-level rates of Medicare emergency respiratory hospitalizations (ICD-9 464-466, 480-487, 490-492) in 213 United States counties for 1999-2008. Overall, each 10oF increase in daily temperature was associated with a 4.3% increase in same-day emergency hospitalizations for respiratory diseases (95% posterior interval: 3.8, 4.8%). Counties' relative risks were significantly higher in counties with cooler average summer temperatures. CONCLUSIONS: We found strong evidence of an association between outdoor heat and respiratory hospitalizations in the largest population of elderly studied to date. Given projections of increasing temperatures from climate change and the increasing global prevalence of chronic pulmonary disease, the relationship between heat and respiratory morbidity is a growing concern.

Language: en