title: Effect of ambient temperature on emergency department visits in Shanghai, China: a time series study.
abstract: BACKGROUND
  Many studies have examined the association between ambient temperature and mortality. However, less evidence is available on the temperature effects on gender- and age-specific emergency department visits, especially in developing countries. In this study, we examined the short-term effects of daily ambient temperature on emergency department visits (ED visits) in Shanghai.
  
  
  METHODS
  Daily ED visits and daily ambient temperatures between January 2006 and December 2011 were analyzed. After controlling for secular and seasonal trends, weather, air pollution and other confounding factors, a Poisson generalized additive model (GAM) was used to examine the associations between ambient temperature and gender- and age-specific ED visits. A moving average lag model was used to evaluate the lag effects of temperature on ED visits.
  
  
  RESULTS
  Low temperature was associated with an overall 2.76% (95% confidence interval (CI): 1.73 to 3.80) increase in ED visits per 1°C decrease in temperature at Lag1 day, 2.03% (95% CI: 1.04 to 3.03) and 2.45% (95% CI: 1.40 to 3.52) for males and females. High temperature resulted in an overall 1.78% (95% CI: 1.05 to 2.51) increase in ED visits per 1°C increase in temperature on the same day, 1.81% (95% CI: 1.08 to 2.54) among males and 1.75% (95% CI: 1.03 to 2.49) among females. The cold effect appeared to be more acute among younger people aged <45 years, whereas the effects were consistent on individuals aged ≥65 years. In contrast, the effects of high temperature were relatively consistent over all age groups.
  
  
  CONCLUSIONS
  These findings suggest a significant association between ambient temperature and ED visits in Shanghai. Both cold and hot temperatures increased the relative risk of ED visits. This knowledge has the potential to advance prevention efforts targeting weather-sensitive conditions.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.forename: Chenyang
authors.initials: C
authors.lastname: Yan
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
authors.forename: Junshan
authors.initials: J
authors.lastname: Cao
authors.forename: Li
authors.initials: L
authors.lastname: Peng
authors.forename: Jianming
authors.initials: J
authors.lastname: Xu
authors.affiliation: School of Public Health & Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China. wwb@fudan.edu.cn.
authors.forename: Weibing
authors.initials: W
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D000368:Aged; D000393:Air Pollutants / Q000032:analysis; D002681:China / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D003080:Cold Temperature / Q000009:adverse effects*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
chemical_list: D000393:Air Pollutants