Impact of Ontario's Harmonized Heat Warning and Information System on emergency department visits for heat-related illness in Ontario, Canada: a population-based time series analysis

被引：2

作者：

Clemens, Kristin K. ^{[1
,2
,3
]}

Ouedraogo, Alexandra M. ^{[2
]}

Le, Britney ^{[2
]}

Voogt, James ^{[4
]}

MacDonald, Melissa ^{[5
]}

Stranberg, Rebecca ^{[6
]}

Yan, Justin W. ^{[7
]}

Krayenhoff, E. Scott ^{[8
]}

Gilliland, Jason ^{[4
,9
]}

Forchuk, Cheryl ^{[10
]}

Van Uum, Rafique ^{[11
]}

Shariff, Salimah Z. ^{[2
]}

机构：

[1] Western Univ, Dept Med, London, ON, Canada

[2] ICES, Toronto, ON, Canada

[3] St Josephs Hlth Care London, 268 Grosvenor St, London, ON N6A 4V2, Canada

[4] Western Univ, Dept Geog & Environm, London, ON, Canada

[5] Environm & Climate Change Canada, Dartmouth, NS, Canada

[6] Hlth Canada, Hlth Environm & Consumer Safety Branch, Consumer & Hazardous Prod Safety Directorate, Ottawa, ON, Canada

[7] Western Univ, Div Emergency Med, London, ON, Canada

[8] Univ Guelph, Sch Environm Sci, Guelph, ON, Canada

[9] Western Univ, Dept Pediat, London, ON, Canada

[10] Western Univ, Sch Hlth Studies, London, ON, Canada

[11] Univ Toronto, Dept Sci, Toronto, ON, Canada

来源：

CANADIAN JOURNAL OF PUBLIC HEALTH-REVUE CANADIENNE DE SANTE PUBLIQUE | 2022年 / 113卷 / 05期

基金：

加拿大健康研究院;

关键词：

Extreme heat; Temperature; Population health; Environment; Public health; MARICOPA COUNTY; PUBLIC-HEALTH; EXTREME HEAT; MORTALITY; CITIES; WAVES; INDIVIDUALS; STRESS; RISK;

D O I：

10.17269/s41997-022-00665-1

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Intervention Ontario's Harmonized Heat Warning and Information System (HWIS) brings harmonized, regional heat warnings and standard heat-health messaging to provincial public health units prior to periods of extreme heat. Research question Was implementation of the harmonized HWIS in May 2016 associated with a reduction in emergency department (ED) visits for heat-related illness in urban locations across Ontario, Canada? Methods We conducted a population-based interrupted time series analysis from April 30 to September 30, 2012-2018, using administrative health and outdoor temperature data. We used autoregressive integrated moving average models to examine whether ED rates changed following implementation of the harmonized HWIS, adjusted for maximum daily temperature. We also examined whether effects differed in heat-vulnerable groups (>= 65 years or <18 years, those with comorbidities, those with a recent history of homelessness), and by heat warning region. Results Over the study period, heat alerts became more frequent in urban areas (6 events triggered between 2013 and 2015 and 14 events between 2016 and 2018 in Toronto, for example). The mean rate of ED visits was 47.5 per 100,000 Ontarians (range 39.7-60.1) per 2-week study interval, with peaks from June to July each year. ED rates were particularly high in those with a recent history of homelessness (mean rate 337.0 per 100,000). Although rates appeared to decline following implementation of HWIS in some subpopulations, the change was not statistically significant at a population level (rate 0.04, 95% CI: -0.03 to 0.1, p=0.278). Conclusion In urban areas across Ontario, ED encounters for heat-related illness may have declined in some subpopulations following HWIS, but the change was not statistically significant. Efforts to continually improve HWIS processes are important given our changing Canadian climate.

引用

页码：686 / 697

页数：12

共 52 条

[1] Individual and Public-Program Adaptation: Coping with Heat Waves in Five Cities in Canada [J].

Alberini, Anna ;

Gans, Will ;

Alhassan, Mustapha .

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2011, 8 (12) :4679-4701

[2]

[Anonymous], 2016, Heat-Related Illness Syndrome Query: A Guidance Document for Implementing Heat-Related Illness Syndromic Surveillance in Public Health Practice

[3]

[Anonymous], 2016, CLASS COD

[4]

[Anonymous], 2006, EVALUATION TORONTOS

[5] Impact of policy changes on the provision of naloxone by pharmacies in Ontario, Canada: a population-based time-series analysis [J].