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Abstract
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High temperatures and extreme heat events are associated with morbidity and mortality; very young and very old people and those with certain medical conditions are at particular risk.1, 2 It is anticipated that the health effects of heat will grow as climate change increases the incidence, magnitude, and duration of extreme heat events.1 In Victoria, the annual number of very hot days could be twice the 1986-2005 mean by the 2050s if the current rate of global warming continues.3
The health effects of extreme heat have been extensively described, but published data that could inform estimates of its impact in Victoria are limited. Jurisdiction-specific data are crucial because regional differences in acclimatisation, adaptation responses, and population susceptibility preclude the simple extrapolation of risk estimates from one area to another.4
During 2010-22, the Victorian Department of Health issued local heat health alerts during summer when the temperature forecast met or exceeded pre-defined thresholds (Supporting Information, section 1). We have analysed associations between these alerts and cause-specific public hospital emergency department presentations by people aged 65 years or older. We analysed Victorian Department of Health public hospital emergency department data (Victorian Emergency Minimum Dataset; VEMD) for 1 November 2010 - 31 March 2022 in a space-time-stratified case-crossover study design; that is, each participant acts as their own control, eliminating the need to account for time-invariant confounders.5 Case periods were defined as the day of and the day after a heat health alert, to account for lagged effects, and were matched to control periods (all days with the same day of the week, month, and year, if these days were not already included as case days). We used conditional logistic regression to compare emergency department presentations by people aged 65 years or older during the case and control periods for a set of International Classification of Diseases, tenth revision (ICD-10) codes selected a priori following a review of the published literature. Analyses were undertaken in R 4.1.2, using the clogit function in the survival package;6 we report odds ratios (ORs) with 95% confidence intervals (CIs) (further details: Supporting Information, part 2). The Australian National University Human Research Ethics Committee approved our study (2022/374), and we report it in accordance with the STROBE statement...
Language: en |
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Keywords
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Humans; Aged; Female; Male; Aged, 80 and over; Cross-Over Studies; Public health; *Emergency Service, Hospital/statistics & numerical data; Climate change; Heat Stress Disorders/epidemiology; Hot Temperature/adverse effects; Nonâcommunicable diseases; Victoria/epidemiology |