title: Extreme temperatures and paediatric emergency department admissions.
abstract: BACKGROUND
  Children are particularly vulnerable to the effects of extreme temperatures.
  
  
  OBJECTIVE
  To examine the relationship between extreme temperatures and paediatric emergency department admissions (EDAs) in Brisbane, Australia, during 2003-2009.
  
  
  METHODS
  A quasi-Poisson generalised linear model combined with a distributed lag non-linear model was used to examine the relationships between extreme temperatures and age-, gender- and cause-specific paediatric EDAs, while controlling for air pollution, relative humidity, day of the week, influenza epidemics, public holiday, season and long-term trends. The model residuals were checked to identify whether there was an added effect due to heat waves or cold spells.
  
  
  RESULTS
  There were 131 249 EDAs among children during the study period. Both high (RR=1.27; 95% CI 1.12 to 1.44) and low (RR=1.81; 95% CI 1.66 to 1.97) temperatures were significantly associated with an increase in paediatric EDAs in Brisbane. Male children were more vulnerable to temperature effects. Children aged 0-4 years were more vulnerable to heat effects and children aged 10-14 years were more sensitive to both hot and cold effects. High temperatures had a significant impact on several paediatric diseases, including intestinal infectious diseases, respiratory diseases, endocrine, nutritional and metabolic diseases, nervous system diseases and chronic lower respiratory diseases. Low temperatures were significantly associated with intestinal infectious diseases, respiratory diseases and endocrine, nutritional and metabolic diseases. An added effect of heat waves on childhood chronic lower respiratory diseases was seen, but no added effect of cold spells was found.
  
  
  CONCLUSIONS
  As climate change continues, children are at particular risk of a variety of diseases which might be triggered by extremely high temperatures. This study suggests that preventing the effects of extreme temperature on children with respiratory diseases might reduce the number of EDAs.
authors.affiliation: School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, , Kelvin Grove, Queensland, Australia.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xu
authors.forename: Wenbiao
authors.initials: W
authors.lastname: Hu
authors.forename: Hong
authors.initials: H
authors.lastname: Su
authors.forename: Lyle R
authors.initials: LR
authors.lastname: Turner
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Ye
authors.forename: Jiajia
authors.initials: J
authors.lastname: Wang
authors.forename: Shilu
authors.initials: S
authors.lastname: Tong
mesh_terms: D000367:Age Factors; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006776:Hospitals, Pediatric; D006358:Hot Temperature; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors; D013997:Time Factors; D014505:Urban Population
keywords: Child Health; Communicable Diseases; Environmental Health