title: The Impact of Heatwaves on Community Morbidity and Healthcare Usage: A Retrospective Observational Study Using Real-Time Syndromic Surveillance.
abstract: We investigated the impact of a moderate heatwave on a range of presenting morbidities in England. Asthma, difficulty breathing, cerebrovascular accident, and cardiovascular symptoms were analysed using general practitioner in hours (GPIH), out of hours (GPOOH) and emergency department (ED) syndromic surveillance systems. Data were stratified by age group and compared between a heatwave year (2013) and non-heatwave years (2012, 2014). Incidence rate ratios were calculated to estimate the differential impact of heatwave compared to non-heatwave summers: there were no apparent differences for the morbidities tested between the 2013 heatwave and non-heatwave years. A subset of GPIH data were used to study individuals at higher risk from heatwaves based on their pre-existing disease. Higher risk patients were not more likely to present at GPs or ED than other individuals. Comparing GPIH consultations and ED attendances for myocardial infarction/ischaemia (MI), there was evidence of a fall in the presentation of MI during the heatwave, which was particularly noted in the 65-74 years age group (and over 75 years in ED attendances). These results indicate the difficulty in identifying individuals at risk from non-fatal health effects of heatwaves and hot weather.
authors.affiliation: Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK. sue.smith@phe.gov.uk.
authors.forename: Sue
authors.initials: S
authors.lastname: Smith
authors.affiliation: Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK. alex.elliot@phe.gov.uk.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Elliot
authors.affiliation: NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK. shakoor.hajat@lshtm.ac.uk.
authors.forename: Shakoor
authors.initials: S
authors.lastname: Hajat
authors.affiliation: Extreme Events and Health Protection, Public Health England, London SE1 8UG, UK. angie.bone@phe.gov.uk.
authors.forename: Angie
authors.initials: A
authors.lastname: Bone
authors.affiliation: ResearchOne, The Phoenix Partnership, Leeds LS18 5TN, UK. chris.bates@tpp-uk.com.
authors.forename: Chris
authors.initials: C
authors.lastname: Bates
authors.affiliation: Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK. gillian.smith@phe.gov.uk.
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Smith
authors.affiliation: NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK. sari.kovats@lshtm.ac.uk.
authors.forename: Sari
authors.initials: S
authors.lastname: Kovats
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002980:Climate; D003324:Coronary Artery Disease / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D006358:Hot Temperature; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D012621:Seasons; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult
keywords: emergency department; general practitioner; heatwave; syndromic surveillance; telehealth