title: Using an Emergency Department Syndromic Surveillance System to investigate the impact of extreme cold weather events.
abstract: This report describes the development of novel syndromic cold weather public health surveillance indicators for use in monitoring the impact of extreme cold weather on attendances at EDs, using data from the 2010-11 and 2011-12 winters. A number of new surveillance indicators were created specifically for the identification and monitoring of cold weather related ED attendances, using the diagnosis codes provided for each attendance in the Emergency Department Syndromic Surveillance System (EDSSS), the first national syndromic surveillance system of its kind in the UK. Using daily weather data for the local area, a time series analysis to test the sensitivity of each indicator to cold weather was undertaken. Diagnosis codes relating to a health outcome with a potential direct link to cold weather were identified and assigned to a number of 'cold weather surveillance indicators'. The time series analyses indicated strong correlations between low temperatures and cold indicators in nearly every case. The strongest fit with temperature was cold related fractures in females, and that of snowfall was cold related fractures in both sexes. Though currently limited to a small number of sentinel EDs, the EDSSS has the ability to give near real-time detail on the magnitude of the impact of weather events. EDSSS cold weather surveillance fits well with the aims of the Cold Weather Plan for England, providing information on those particularly vulnerable to cold related health outcomes severe enough to require emergency care. This timely information aids those responding to and managing the effects on human health, both within the EDs themselves and in the community as a whole.
authors: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK. Electronic address: helen.hughes@phe.gov.uk.
authors: H E
authors: HE
authors: Hughes
authors: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
authors: R
authors: R
authors: Morbey
authors: Emergency Department, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK; The College of Emergency Medicine, London, UK.
authors: T C
authors: TC
authors: Hughes
authors: The College of Emergency Medicine, London, UK; Emergency Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors: T E
authors: TE
authors: Locker
authors: Emergency Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors: T
authors: T
authors: Shannon
authors: Extreme Events and Health Protection, Public Health England, London, UK.
authors: C
authors: C
authors: Carmichael
authors: Extreme Events and Health Protection, Public Health England, London, UK.
authors: V
authors: V
authors: Murray
authors: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
authors: S
authors: S
authors: Ibbotson
authors: Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
authors: M
authors: M
authors: Catchpole
authors: Global Health, Public Health England, London, UK.
authors: B
authors: B
authors: McCloskey
authors: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
authors: G
authors: G
authors: Smith
authors: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
authors: A J
authors: AJ
authors: Elliot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004739:England; D055873:Extreme Cold / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance / Q000379:methods*; D012621:Seasons; D014947:Wounds and Injuries / Q000209:etiology* / Q000628:therapy; D055815:Young Adult
keywords: Cold weather; Emergency department; Injury; Syndromic surveillance