title: The 2006 California heat wave: impacts on hospitalizations and emergency department visits.
abstract: BACKGROUND
  Climate models project that heat waves will increase in frequency and severity. Despite many studies of mortality from heat waves, few studies have examined morbidity.
  
  
  OBJECTIVE
  In this study we investigated whether any age or race/ethnicity groups experienced increased hospitalizations and emergency department (ED) visits overall or for selected illnesses during the 2006 California heat wave.
  
  
  METHODS
  We aggregated county-level hospitalizations and ED visits for all causes and for 10 cause groups into six geographic regions of California. We calculated excess morbidity and rate ratios (RRs) during the heat wave (15 July to 1 August 2006) and compared these data with those of a reference period (8-14 July and 12-22 August 2006).
  
  
  RESULTS
  During the heat wave, 16,166 excess ED visits and 1,182 excess hospitalizations occurred statewide. ED visits for heat-related causes increased across the state [RR = 6.30; 95% confidence interval (CI), 5.67-7.01], especially in the Central Coast region, which includes San Francisco. Children (0-4 years of age) and the elderly (> or = 65 years of age) were at greatest risk. ED visits also showed significant increases for acute renal failure, cardiovascular diseases, diabetes, electrolyte imbalance, and nephritis. We observed significantly elevated RRs for hospitalizations for heat-related illnesses (RR = 10.15; 95% CI, 7.79-13.43), acute renal failure, electrolyte imbalance, and nephritis.
  
  
  CONCLUSIONS
  The 2006 California heat wave had a substantial effect on morbidity, including regions with relatively modest temperatures. This suggests that population acclimatization and adaptive capacity influenced risk. By better understanding these impacts and population vulnerabilities, local communities can improve heat wave preparedness to cope with a globally warming future.
authors.affiliation: Health and Environment Program, Natural Resources Defense Council, New York, New York 10011-4231, USA. kknowlton@nrdc.org
authors.forename: Kim
authors.initials: K
authors.lastname: Knowlton
authors.forename: Miriam
authors.initials: M
authors.lastname: Rotkin-Ellman
authors.forename: Galatea
authors.initials: G
authors.lastname: King
authors.forename: Helene G
authors.initials: HG
authors.lastname: Margolis
authors.forename: Daniel
authors.initials: D
authors.lastname: Smith
authors.forename: Gina
authors.initials: G
authors.lastname: Solomon
authors.forename: Roger
authors.initials: R
authors.lastname: Trent
authors.forename: Paul
authors.initials: P
authors.lastname: English
mesh_terms: D002140:California; D004190:Disasters; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006760:Hospitalization; D006358:Hot Temperature