title: Risk factors for deaths during the 2009 heat wave in Adelaide, Australia: a matched case-control study.
abstract: The extreme heat wave in Australia in 2009 resulted in significantly increased number of daily deaths. The circumstances that lead to deaths during extreme heat have not been explored before in Australia. This study aims to identify the individual and community risk factors for deaths during this extreme heat wave in Adelaide. A matched case-control study was conducted. Cases were those who died in the Adelaide metropolitan area during the heat wave period. For each case, two community controls were randomly selected, matched by age and gender. Face-to-face or telephone interviews were conducted to collect data of demographic information, living environment, social support, health status and behavioural changes during the heat wave. Descriptive analysis, as well as simple and multiple conditional logistic regressions were performed. In total, 82 deaths and 164 matched community controls were included in the analysis, with a median age of 77.5 (range 26.6-100.7). The multiple logistic regression model indicated that, compared with controls, the risk of death during the heat wave was significantly increased for people living alone (AOR = 42.31, 95 % CI 2.3, 792.8) or having existing chronic heart disease (AOR = 22.4, 95 % CI 1.7, 303.0). In addition, having air conditioning in bedrooms (AOR = 0.004, 95 % CI 0.00006, 0.28) and participating in social activities more than once a week (AOR = 0.011, 95 % CI 0.0004, 0.29) indicated significant protective effects. We have identified factors that could significantly impact on the likelihood of deaths during heat waves. Our findings could assist in the development of future intervention programs and policies to reduce mortality associated with a warmer climate.
authors.affiliation: School of Public Health, China Studies Centre, University of Sydney, Sydney, NSW, Australia. ying.zhang@sydney.edu.au.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia.
authors.forename: Monika
authors.initials: M
authors.lastname: Nitschke
authors.affiliation: School of Population Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Krackowizer
authors.affiliation: Global Health Institute, Duke University and Duke Kunshan University, Kunshan, China.
authors.forename: Keith
authors.initials: K
authors.lastname: Dear
authors.affiliation: School of Population Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Dino
authors.initials: D
authors.lastname: Pisaniello
authors.affiliation: School of Biological Sciences, University of Adelaide, Adelaide, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Weinstein
authors.affiliation: South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Tucker
authors.affiliation: Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Sepehr
authors.initials: S
authors.lastname: Shakib
authors.affiliation: School of Population Health, University of Adelaide, Adelaide, South Australia, Australia. peng.bi@adelaide.edu.au.
authors.forename: Peng
authors.initials: P
authors.lastname: Bi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002947:Cities / Q000453:epidemiology; D005260:Female; D006801:Humans; D007259:Infrared Rays / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D013021:South Australia / Q000453:epidemiology
keywords: Case-control; Comorbidity; Heat wave; Mortality; Risk factors