Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/71804
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Type: Journal article
Title: Heat and health in Adelaide, South Australia: Assessment of heat thresholds and temperature relationships
Author: Williams, S.
Nitschke, M.
Sullivan, T.
Tucker, G.
Weinstein, P.
Pisaniello, D.
Parton, K.
Bi, P.
Citation: Science of the Total Environment, 2012; 414:126-133
Publisher: Elsevier Science BV
Issue Date: 2012
ISSN: 0048-9697
1879-1026
Statement of
Responsibility: 
Susan Williams, Monika Nitschke, Thomas Sullivan, Graeme R. Tucker, Philip Weinstein, Dino L. Pisaniello, Kevin A. Parton and Peng Bi
Abstract: BACKGROUND: Climate change projections have highlighted the need for public health planning for extreme heat. In Adelaide, South Australia, hot weather is characteristic of summer and heatwaves can have a significant health burden. This study examines the heat thresholds and temperature relationships for mortality and morbidity outcomes in Adelaide. METHODS: Daily maximum and minimum temperatures, daily mortality, ambulance call-outs, emergency department (ED) presentations and hospital admissions were obtained for Adelaide, between 1993 and 2009. Heat thresholds for health outcomes were estimated using an observed/expected analysis. Generalized estimating equations were used to estimate the percentage increase in mortality and morbidity outcomes above the threshold temperatures, with adjustment for the effects of ozone (O(3)) and particulate matter<10 μm in mass median aerodynamic diameter (PM(10)). Effect estimates are reported as incidence rate ratios (IRRs). RESULTS: Heat-related mortality and morbidity become apparent above maximum and minimum temperature thresholds of 30 °C and 16 °C for mortality; 26 °C and 18 °C for ambulance call-outs; and 34 °C and 22 °C for heat-related ED presentations. Most health outcomes showed a positive relationship with daily temperatures over thresholds. When adjusted for air pollutants, a 10 °C increase in maximum temperature was associated with a 4.9% increase in daily ambulance call-outs (IRR 1.049; 95% CI 1.027-1.072), and a 3.4% increase in mental health related hospital admissions (IRR 1.034; 95% CI 1.009-1.059) for the all-age population. Heat-related ED presentations increased over 6-fold per 10 °C increase in maximum temperature. Daily temperatures were also associated with all-cause and mental health related ED presentations. Associations between temperature over thresholds and daily mortality and renal hospital admissions were not significant when adjusted for ozone and PM(10); however at extreme temperatures mortality increased significantly with increasing heat duration. CONCLUSIONS: Heat-attributable mortality and morbidity are associated with elevated summer temperatures in Adelaide, particularly ambulance call-outs, mental health and heat-related illness.
Keywords: Humans; Ozone; Air Pollutants; Patient Admission; Morbidity; Mortality; Seasons; South Australia; Particulate Matter; Hot Temperature; Climate Change
Rights: © 2011 Elsevier B.V. All rights reserved.
RMID: 0020117086
DOI: 10.1016/j.scitotenv.2011.11.038
Grant ID: http://purl.org/au-research/grants/arc/DP0880933
Appears in Collections:Public Health publications
Environment Institute publications

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