title: Heat waves and morbidity: current knowledge and further direction-a comprehensive literature review.
abstract: In the past few decades, several devastating heat wave events have significantly challenged public health. As these events are projected to increase in both severity and frequency in the future, it is important to assess the relationship between heat waves and the health indicators that can be used in the early warning systems to guide the public health response. Yet there is a knowledge gap in the impact of heat waves on morbidity. In this study, a comprehensive review was conducted to assess the relationship between heat waves and different morbidity indicators, and to identify the vulnerable populations. The PubMed and ScienceDirect database were used to retrieve published literature in English from 1985 to 2014 on the relationship between heat waves and morbidity, and the following MeSH terms and keywords were used: heat wave, heat wave, morbidity, hospital admission, hospitalization, emergency call, emergency medical services, and outpatient visit. Thirty-three studies were included in the final analysis. Most studies found a short-term negative health impact of heat waves on morbidity. The elderly, children, and males were more vulnerable during heat waves, and the medical care demand increased for those with existing chronic diseases. Some social factors, such as lower socioeconomic status, can contribute to heat-susceptibility. In terms of study methods and heat wave definitions, there remain inconsistencies and uncertainties. Relevant policies and guidelines need to be developed to protect vulnerable populations. Morbidity indicators should be adopted in heat wave early warning systems in order to guide the effective implementation of public health actions.
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China. limm55@126.com.|Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing 100005, China. limm55@126.com.|Climate Change and Health Center, Shandong University, Jinan 250012, China. limm55@126.com.
authors.forename: Mengmeng
authors.initials: M
authors.lastname: Li
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China. gushaohua1989@126.com.|Climate Change and Health Center, Shandong University, Jinan 250012, China. gushaohua1989@126.com.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Gu
authors.affiliation: Discipline of Public Health, School of Population Health, The University of Adelaide, Adelaide 5005, Australia. peng.bi@adelaide.edu.au.
authors.forename: Peng
authors.initials: P
authors.lastname: Bi
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China. smart_yjun@163.com.|Climate Change and Health Center, Shandong University, Jinan 250012, China. smart_yjun@163.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China. liuqiyong@icdc.cn.|Climate Change and Health Center, Shandong University, Jinan 250012, China. liuqiyong@icdc.cn.
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Liu
mesh_terms: D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D055874:Extreme Heat / Q000009:adverse effects*; D006304:Health Status; D006760:Hospitalization; D006358:Hot Temperature; D006801:Humans; D019359:Knowledge; D008297:Male; D009017:Morbidity; D011634:Public Health; D035862:Vulnerable Populations
keywords: emergency medical care; heat waves; hospitalization; morbidity