Browse > Article
http://dx.doi.org/10.12701/yujm.2019.00248

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)
Publication Information
Journal of Yeungnam Medical Science / v.36, no.3, 2019 , pp. 241-248 More about this Journal
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 $30.0^{\circ}C$.
Keywords
Climate; Heatstroke; Incidence; Meteorology; Policy;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 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.   DOI
2 Ghumman U, Horney J. Characterizing the impact of extreme heat on mortality, Karachi, Pakistan, June 2015. Prehosp Disaster Med 2016;31:263-6.   DOI
3 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.   DOI
4 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.   DOI
5 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.   DOI
6 Kovats RS, Kristie LE. Heatwaves and public health in Europe. Eur J Public Health 2006;16:592-9.   DOI
7 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.   DOI
8 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
9 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
10 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.   DOI
11 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.
12 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.
13 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.   DOI
14 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.
15 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.   DOI
16 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.   DOI
17 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.   DOI
18 Kravchenko J, Abernethy AP, Fawzy M, Lyerly HK. Minimization of heatwave morbidity and mortality. Am J Prev Med 2013;44:274-82.   DOI
19 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.   DOI
20 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.   DOI
21 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.   DOI
22 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.   DOI
23 Canada. Health Canada. Health Environments and Consumer Safety. Heat alert and response systems to protect health: best practices guidebook. Ottawa-Ontario: Health Canada; 2012.
24 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.   DOI
25 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.   DOI
26 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.   DOI
27 Sheridan SC, Kalkstein LS. Progress in heat watch-warning system technology. Bull Am Meteorol Soc 2004;85:1931-42.   DOI
28 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.
29 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.   DOI
30 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.   DOI
31 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.   DOI
32 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.   DOI
33 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.   DOI
34 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.   DOI
35 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/
36 Bouchama A, Knochel JP. Heat stroke. N Engl J Med 2002;346:1978-88.   DOI
37 Jardine DS. Heat illness and heat stroke. Pediatr Rev 2007;28:249-58.   DOI
38 Yan YE, Zhao YQ, Wang H, Fan M. Pathophysiological factors underlying heatstroke. Med Hypotheses 2006;67:609-17.   DOI
39 Yaqub B, Al Deeb S. Heat strokes: aetiopathogenesis, neurological characteristics, treatment and outcome. J Neurol Sci 1998;156:144-51.   DOI
40 Kim DW, Chung JH, Lee JS, Lee JS. Characteristics of heat wave mortality in Korea. Atmosphere 2014;24:225-34.   DOI
41 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.
42 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.   DOI