Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Determining the correlation between outdoor heatstroke incidence and climate elements in Daegu metropolitan city

  • Kim, Jung Ho (Department of Emergency Medicine, Yeungnam University College of Medicine) ;
  • Ryoo, Hyun Wook (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Moon, Sungbae (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Jang, Tae Chang (Department of Emergency Medicine, Catholic University of Daegu School of Medicine) ;
  • Jin, Sang Chan (Department of Emergency Medicine, Keimyung University School of Medicine) ;
  • Mun, You Ho (Department of Emergency Medicine, Yeungnam University College of Medicine) ;
  • Do, Byung Soo (Department of Emergency Medicine, Yeungnam University College of Medicine) ;
  • Lee, Sam Beom (Department of Emergency Medicine, Yeungnam University College of Medicine) ;
  • Kim, Jong-yeon (Department of Preventive Medicine, Catholic University of Daegu School of Medicine)
  • Received : 2019.04.25
  • Accepted : 2019.06.24
  • Published : 2019.09.30
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Abstract

Background: Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS). Methods: We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression. Results: Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102-3.017). The most suitable cutoff point for MHI by Youden's index was $30.0^{\circ}C$ (sensitivity, 77.4%; specificity, 73.7%). Conclusion: Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was $30.0^{\circ}C$.

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References

  1. NASA's Goddard Institute for Space Studies. July 2017 equaled record July 2016 [Internet]. Pasadena: Earth Science Communications Team at NASA's Jet Propulsion Laboratory; 2017 [cited 2018 Dec 20]. https://climate.nasa.gov/news/2618/july-2017-equaled-record-july-2016/
  2. Bouchama A, Knochel JP. Heat stroke. N Engl J Med 2002;346:1978-88. https://doi.org/10.1056/NEJMra011089
  3. Jardine DS. Heat illness and heat stroke. Pediatr Rev 2007;28:249-58. https://doi.org/10.1542/pir.28-7-249
  4. Wang Y, Bobb JF, Papi B, Wang Y, Kosheleva A, Di Q, et al. Heat stroke admissions during heat waves in 1,916 US counties for the period from 1999 to 2010 and their effect modifiers. Environ Health 2016;15:83. https://doi.org/10.1186/s12940-016-0167-3
  5. Yan YE, Zhao YQ, Wang H, Fan M. Pathophysiological factors underlying heatstroke. Med Hypotheses 2006;67:609-17. https://doi.org/10.1016/j.mehy.2005.12.048
  6. Yaqub B, Al Deeb S. Heat strokes: aetiopathogenesis, neurological characteristics, treatment and outcome. J Neurol Sci 1998;156:144-51. https://doi.org/10.1016/S0022-510X(98)00037-9
  7. Kim DW, Chung JH, Lee JS, Lee JS. Characteristics of heat wave mortality in Korea. Atmosphere 2014;24:225-34. https://doi.org/10.14191/Atmos.2014.24.2.225
  8. Kim J, Lee DG, Park IS, Choi BC, Kim JS. Influences of heat waves on daily mortality in South Korea. Atmosphere 2006;16:269-78.
  9. Pryor RR, Bennett BL, O'Connor FG, Young JM, Asplund CA. Medical evaluation for exposure extremes: heat. Wilderness Environ Med 2015;26(4 Suppl):S69-75. https://doi.org/10.1016/j.wem.2015.09.009
  10. Kim SH, Jo SN, Myung HN, Jang JY. The effect of pre-existing medical conditions on heat stroke during hot weather in South Korea. Environ Res 2014;133:246-52. https://doi.org/10.1016/j.envres.2014.06.003
  11. Ghumman U, Horney J. Characterizing the impact of extreme heat on mortality, Karachi, Pakistan, June 2015. Prehosp Disaster Med 2016;31:263-6. https://doi.org/10.1017/S1049023X16000273
  12. Alberini A, Gans W, Alhassan M. Individual and public-program adaptation: coping with heat waves in five cities in Canada. Int J Environ Res Public Health 2011;8:4679-701. https://doi.org/10.3390/ijerph8124679
  13. Anderson GB, Bell ML, Peng RD. Methods to calculate the heat index as an exposure metric in environmental health research. Environ Health Perspect 2013;121:1111-9. https://doi.org/10.1289/ehp.1206273
  14. Hajat S, Sheridan SC, Allen MJ, Pascal M, Laaidi K, Yagouti A, et al. Heat-health warning systems: a comparison of the predictive capacity of different approaches to identifying dangerously hot days. Am J Public Health 2010;100:1137-44. https://doi.org/10.2105/AJPH.2009.169748
  15. Kovats RS, Kristie LE. Heatwaves and public health in Europe. Eur J Public Health 2006;16:592-9. https://doi.org/10.1093/eurpub/ckl049
  16. Toloo G, FitzGerald G, Aitken P, Verrall K, Tong S. Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence. Int J Public Health 2013;58:667-81. https://doi.org/10.1007/s00038-013-0465-2
  17. Korea Meteorological Administration. [Korean climate resources] [Internet]. Seoul: Korea Meteorological Administration; 2019 [cited 2018 Dec 20]. http://www.kma.go.kr/weather/climate/average_south.jsp
  18. National Centers for Environmental Information. Climate change and variability [Internet]. Asheville: National Centers for Environmental Information; 2018 [cited 2018 Dec 20]. https://www.ncdc.noaa.gov/climate-information/climate-change-and-variability
  19. Sung TI, Wu PC, Lung SC, Lin CY, Chen MJ, Su HJ. Relationship between heat index and mortality of 6 major cities in Taiwan. Sci Total Environ 2013;442:275-81. https://doi.org/10.1016/j.scitotenv.2012.09.068
  20. Jo YH, Shin SD, Kim DH, Jo IJ, Rhee JE, Suh GJ, et al. Descriptive study of prognostic factors of exertional heat stroke in military personnel. J Korean Soc Emerg Med 2003;14:409-14.
  21. LoVecchio F. Heat emergencies. In: Tintinalli JE, Stapczynski JS, MA OJ, Cline DM, Meckler GD, Yealy DM, editors. Tintinalli's emergency medicine: a comprehensive study guide. 8th ed. New York: McGraw-Hill Education; 2016. p. 1365-71.
  22. Harlan SL, Ruddell DM. Climate change and health in cities: impacts of heat and air pollution and potential co-benefits from mitigation and adaptation. Curr Opin Environ Sustain 2011;3:126-34. https://doi.org/10.1016/j.cosust.2011.01.001
  23. Marchetti E, Capone P, Freda D. Climate change impact on microclimate of work environment related to occupational health and productivity. Ann Ist Super Sanita 2016;52:338-42.
  24. Murakami S, Miyatake N, Sakano N. Changes in air temperature and its relation to ambulance transports due to heat stroke in all 47 prefectures of Japan. J Prev Med Public Health 2012;45:309-15. https://doi.org/10.3961/jpmph.2012.45.5.309
  25. Schmeltz MT, Petkova EP, Gamble JL. Economic burden of hospitalizations for heat-related illnesses in the United States, 2001-2010. Int J Environ Res Public Health 2016;13:pii:E894. https://doi.org/10.3390/ijerph13090894
  26. Zhang Y, Nitschke M, Bi P. Risk factors for direct heat-related hospitalization during the 2009 Adelaide heatwave: a case crossover study. Sci Total Environ 2013;442:1-5. https://doi.org/10.1016/j.scitotenv.2012.10.042
  27. Kravchenko J, Abernethy AP, Fawzy M, Lyerly HK. Minimization of heatwave morbidity and mortality. Am J Prev Med 2013;44:274-82. https://doi.org/10.1016/j.amepre.2012.11.015
  28. Li Y, Li C, Luo S, He J, Cheng Y, Jin Y. Impacts of extremely high temperature and heatwave on heatstroke in Chongqing, China. Environ Sci Pollut Res Int 2017;24:8534-40. https://doi.org/10.1007/s11356-017-8457-z
  29. Williams S, Nitschke M, Weinstein P, Pisaniello DL, Parton KA, Bi P. The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994-2008. Environ Int 2012;40:33-8. https://doi.org/10.1016/j.envint.2011.11.011
  30. Kenney WL, DeGroot DW, Alexander LM. Extremes of human heat tolerance: life at the precipice of thermoregulatory failure. J Therm Biol 2004;29:479-85. https://doi.org/10.1016/j.jtherbio.2004.08.017
  31. Kosaka M, Yamane M, Ogai R, Kato T, Ohnishi N, Simon E. Human body temperature regulation in extremely stressful environment: epidemiology and pathophysiology of heat stroke. J Therm Biol 2004;29:495-501. https://doi.org/10.1016/j.jtherbio.2004.08.019
  32. Canada. Health Canada. Health Environments and Consumer Safety. Heat alert and response systems to protect health: best practices guidebook. Ottawa-Ontario: Health Canada; 2012.
  33. Josseran L, Fouillet A, Caillere N, Brun-Ney D, Ilef D, Brucker G, et al. Assessment of a syndromic surveillance system based on morbidity data: results from the Oscour network during a heat wave. PLoS One 2010;5:e11984. https://doi.org/10.1371/journal.pone.0011984
  34. Li T, Ding F, Sun Q, Zhang Y, Kinney PL. Heat stroke internet searches can be a new heatwave health warning surveillance indicator. Sci Rep 2016;6:37294. https://doi.org/10.1038/srep37294
  35. Mendez-Lazaro P, Muller-Karger FE, Otis D, McCarthy MJ, Rodriguez E. A heat vulnerability index to improve urban public health management in San Juan, Puerto Rico. Int J Biometeorol 2018;62:709-22. https://doi.org/10.1007/s00484-017-1319-z
  36. Nitschke M, Tucker GR, Hansen AL, Williams S, Zhang Y, Bi P. Impact of two recent extreme heat episodes on morbidity and mortality in Adelaide, South Australia: a case-series analysis. Environ Health 2011;10:42. https://doi.org/10.1186/1476-069X-10-42
  37. Sheridan SC, Kalkstein LS. Progress in heat watch-warning system technology. Bull Am Meteorol Soc 2004;85:1931-42. https://doi.org/10.1175/BAMS-85-12-1931
  38. O'Neill MS, Carter R, Kish JK, Gronlund CJ, White-Newsome JL, Manarolla X, et al. Preventing heat-related morbidity and mortality: new approaches in a changing climate. Maturitas 2009;64:98-103. https://doi.org/10.1016/j.maturitas.2009.08.005
  39. Harlan SL, Chowell G, Yang S, Petitti DB, Morales Butler EJ, Ruddell BL, et al. Heat-related deaths in hot cities: estimates of human tolerance to high temperature thresholds. Int J Environ Res Public Health 2014;11:3304-26. https://doi.org/10.3390/ijerph110303304
  40. Lee MS, Hong KJ, Shin SD, Song KJ, Ryoo HW, Song SW, et al. Development and implementation of emergency department based heat related illness active surveillance system: effect of heat index on daily emergency department visits due to heat related illness. J Korean Soc Emerg Med 2014;25:595-601.
  41. Bai L, Ding G, Gu S, Bi P, Su B, Qin D, et al. The effects of summer temperature and heat waves on heat-related illness in a coastal city of China, 2011-2013. Environ Res 2014;132:212-9. https://doi.org/10.1016/j.envres.2014.04.002
  42. Kalkstein AJ, Sheridan SC. The social impacts of the heat-health watch/warning system in Phoenix, Arizona: assessing the perceived risk and response of the public. Int J Biometeorol 2007;52:43-55. https://doi.org/10.1007/s00484-006-0073-4