title: Excessive heat and respiratory hospitalizations in New York State: estimating current and future public health burden related to climate change.
abstract: BACKGROUND
  Although many climate-sensitive environmental exposures are related to mortality and morbidity, there is a paucity of estimates of the public health burden attributable to climate change.
  
  
  OBJECTIVE
  We estimated the excess current and future public health impacts related to respiratory hospitalizations attributable to extreme heat in summer in New York State (NYS) overall, its geographic regions, and across different demographic strata.
  
  
  METHODS
  On the basis of threshold temperature and percent risk changes identified from our study in NYS, we estimated recent and future attributable risks related to extreme heat due to climate change using the global climate model with various climate scenarios. We estimated effects of extreme high apparent temperature in summer on respiratory admissions, days hospitalized, direct hospitalization costs, and lost productivity from days hospitalized after adjusting for inflation.
  
  
  RESULTS
  The estimated respiratory disease burden attributable to extreme heat at baseline (1991-2004) in NYS was 100 hospital admissions, US$644,069 in direct hospitalization costs, and 616 days of hospitalization per year. Projections for 2080-2099 based on three different climate scenarios ranged from 206-607 excess hospital admissions, US$26-$76 million in hospitalization costs, and 1,299-3,744 days of hospitalization per year. Estimated impacts varied by geographic region and population demographics.
  
  
  CONCLUSIONS
  We estimated that excess respiratory admissions in NYS due to excessive heat would be 2 to 6 times higher in 2080-2099 than in 1991-2004. When combined with other heat-associated diseases and mortality, the potential public health burden associated with global warming could be substantial.
authors.affiliation: Center for Environmental Health, New York State Department of Health, Albany, New York 12237, USA. sxl05@health.state.ny.us
authors.forename: Shao
authors.initials: S
authors.lastname: Lin
authors.forename: Wan-Hsiang
authors.initials: WH
authors.lastname: Hsu
authors.forename: Alissa R
authors.initials: AR
authors.lastname: Van Zutphen
authors.forename: Shubhayu
authors.initials: S
authors.lastname: Saha
authors.forename: George
authors.initials: G
authors.lastname: Luber
authors.forename: Syni-An
authors.initials: SA
authors.lastname: Hwang
mesh_terms: D001499:Bayes Theorem; D057231:Climate Change; D055874:Extreme Heat / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D008297:Male; D009017:Morbidity; D009518:New York / Q000453:epidemiology; D011634:Public Health; D012140:Respiratory Tract Diseases / Q000191:economics* / Q000453:epidemiology* / Q000209:etiology; D018570:Risk Assessment; D012621:Seasons; D012737:Sex Factors