Spatial and temporal variation in emergency transport during periods of extreme heat in Japan: A nationwide study

Several studies have reported the burden of climate change on extreme heat-related mortality or morbidity. However, few studies have investigated the spatial and temporal variation in emergency transport during periods of extreme heat on a national scale. Daily emergency ambulance dispatch data from...

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Bibliographic Details
Published in:The Science of the total environment Vol. 544; pp. 220 - 229
Main Authors: Onozuka, Daisuke, Hagihara, Akihito
Format: Journal Article
Language:English
Published: Netherlands Elsevier B.V 15.02.2016
Subjects:
Ambulances - statistics & numerical data
cardiovascular diseases
Climate Change
Climatic change
Emergency transport
Emergency Treatment - statistics & numerical data
Environmental Exposure - statistics & numerical data
Extreme Heat
Heat
Humans
Japan
Morbidity
mortality
Nonlinear Dynamics
nonlinear models
public health
relative risk
respiratory tract diseases
Risk
Spatial
spatial variation
Spatio-Temporal Analysis
summer
Temporal
temporal variation
Variation
weather
INW, Japan
Japan
Heat
Climatic change
Temporal
Spatial
CI
ICD
Variation
Emergency transport
ISSN:0048-9697, 1879-1026, 1879-1026
Online Access:Get full text
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Summary:Several studies have reported the burden of climate change on extreme heat-related mortality or morbidity. However, few studies have investigated the spatial and temporal variation in emergency transport during periods of extreme heat on a national scale. Daily emergency ambulance dispatch data from 2007 to 2010 were acquired from all 47 prefectures of Japan. The temporal variability in the relationship between heat and morbidity in each prefecture was estimated using Poisson regression combined with a distributed lag non-linear model and adjusted for time trends. The spatial variability in the heat-morbidity relationships between prefectures was estimated using a multivariate meta-analysis. A total of 5,289,660 emergency transports were reported during the summer months (June through September) within the study period. The overall cumulative relative risk (RR) at the 99th percentile vs. the minimum morbidity percentile was 1.292 (95% CI: 1.251–1.333) for all causes, 1.039 (95% CI: 0.989–1.091) for cardiovascular diseases, and 1.287 (95% CI: 1.210–1.368) for respiratory diseases. Temporal variation in the estimated effects indicated a non-linear relationship, and there were differences in the temporal variations between heat and all-cause and cause-specific morbidity. Spatial variation between prefectures was observed for all causes (Cochran Q test, p<0.001; I2=45.8%); however, there was no significant spatial heterogeneity for cardiovascular (Cochran Q test, p=0.054; I2=15.1%) and respiratory (Cochran Q test, p=0.681; I2=1.0%) diseases. Our nationwide study demonstrated differences in the spatial and temporal variations in the relative risk for all-cause and cause-specific emergency transport during periods of extreme heat in Japan between 2007 and 2010. Our results suggest that public health strategies aimed at controlling heat-related morbidity should be tailored according to region-specific weather conditions. [Display omitted] •We estimated variations in the association of heat and emergency transport.•We observed temporal variations in RRs for heat-related emergency transport.•Spatial heterogeneity among prefectures was observed for emergency transport.
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ISSN:0048-9697
1879-1026
1879-1026
DOI:10.1016/j.scitotenv.2015.11.098