Abstract：
BACKGROUND: Literature reporting the association between heat stress defined by universal thermal climate index (UTCI) and emergency department visits is mainly conducted in Europe. This study aimed to investigate the association between heat stress, as defined by the UTCI, and visits to the accident and emergency department (AED) in Hong Kong, which represents a subtropical climate region.
METHODS: A retrospective study involving 13,438,846 AED visits in the public sector from May 2000 to September 2016, excluding 2003 and 2009, was conducted in Hong Kong. Age-sex-specific ANCOVA models of daily AED rates on heat stress and prolonged heat stress, adjusting for air quality, prolonged poor air quality, typhoon, rainstorm, year, day of the week, public holiday, summer vacation, and fee charging, were used.
RESULTS: On a day with strong heat stress (32.1 °C ≤ UTCI ≤ 38.0 °C), the AED visit rate (per 100,000) increased by 0.9 (95% CI: 0.5, 1.3) and 1.7 (95% CI: 1.3, 2.1) for females and males aged 19-64 and 4.1 (95% CI: 2.7, 5.4) and 4.1 (95% CI: 2.6, 5.6) for females and males aged ≥ 65, while keeping other variables constant. On a day with very strong heat stress (38.1 °C ≤ UTCI ≤ 46.0 °C), the corresponding rates increased by 0.6 (95% CI: 0.1, 1.2), 2.2 (95% CI: 1.7, 2.7), 4.9 (95% CI: 3.1, 6.7), and 4.7 (95% CI: 2.7, 6.6), respectively. The effect size of heat stress associated with AED visit rates was negligible among those aged ≤ 18. Heat stress showed the greatest effect size for males aged 19-64 among all subgroups.
CONCLUSIONS: Biothermal condition from heat stress was associated with the health of the citizens in a city with a subtropical climate and reflected in the increase of daily AED visit. Public health recommendations have been made accordingly for the prevention of heat-related AED visits.
METHODS: A retrospective study involving 13,438,846 AED visits in the public sector from May 2000 to September 2016, excluding 2003 and 2009, was conducted in Hong Kong. Age-sex-specific ANCOVA models of daily AED rates on heat stress and prolonged heat stress, adjusting for air quality, prolonged poor air quality, typhoon, rainstorm, year, day of the week, public holiday, summer vacation, and fee charging, were used.
RESULTS: On a day with strong heat stress (32.1 °C ≤ UTCI ≤ 38.0 °C), the AED visit rate (per 100,000) increased by 0.9 (95% CI: 0.5, 1.3) and 1.7 (95% CI: 1.3, 2.1) for females and males aged 19-64 and 4.1 (95% CI: 2.7, 5.4) and 4.1 (95% CI: 2.6, 5.6) for females and males aged ≥ 65, while keeping other variables constant. On a day with very strong heat stress (38.1 °C ≤ UTCI ≤ 46.0 °C), the corresponding rates increased by 0.6 (95% CI: 0.1, 1.2), 2.2 (95% CI: 1.7, 2.7), 4.9 (95% CI: 3.1, 6.7), and 4.7 (95% CI: 2.7, 6.6), respectively. The effect size of heat stress associated with AED visit rates was negligible among those aged ≤ 18. Heat stress showed the greatest effect size for males aged 19-64 among all subgroups.
CONCLUSIONS: Biothermal condition from heat stress was associated with the health of the citizens in a city with a subtropical climate and reflected in the increase of daily AED visit. Public health recommendations have been made accordingly for the prevention of heat-related AED visits.
摘要：
背景：报道由通用热气候指数（UTCI）定义的热应激与急诊科就诊之间关联的文献主要在欧洲进行。本研究旨在探讨热应激之间的关联，根据UTCI的定义，并访问香港的事故和急诊室（AED），代表亚热带气候区。
方法：在香港进行了一项回顾性研究，涉及2000年5月至2016年9月在公共部门进行的13,438,846次AED访问，不包括2003年和2009年。热应激和长期热应激的每日AED率的年龄-性别特异性ANCOVA模型，调整空气质量，长期空气质量差，台风,暴雨,Year,星期几,公众假期,暑假,和收费，被使用。
结果：在强烈的热应激（32.1°C≤UTCI≤38.0°C）的一天，年龄在19~64岁的女性和男性的AED访视率(每100,000人)分别增加0.9(95%CI:0.5,1.3)和1.7(95%CI:1.3,2.1)和4.1(95%CI:2.7,5.4)和4.1(95%CI:2.6,5.6),而其他变量保持不变.在具有非常强的热应激（38.1°C≤UTCI≤46.0°C）的一天，相应的比率增加了0.6(95%CI：0.1，1.2)，2.2（95%CI：1.7，2.7），4.9（95%CI：3.1，6.7），和4.7（95%CI：2.7，6.6），分别。在≤18岁的人群中，与AED就诊率相关的热应激的影响大小可以忽略不计。在所有亚组中，热应激对19-64岁男性的影响最大。
结论：在亚热带气候的城市中，来自热应激的生物热条件与公民的健康有关，并反映在每日AED访问的增加上。相应地提出了公共卫生建议，以预防与热有关的AED就诊。
方法：在香港进行了一项回顾性研究，涉及2000年5月至2016年9月在公共部门进行的13,438,846次AED访问，不包括2003年和2009年。热应激和长期热应激的每日AED率的年龄-性别特异性ANCOVA模型，调整空气质量，长期空气质量差，台风,暴雨,Year,星期几,公众假期,暑假,和收费，被使用。
结果：在强烈的热应激（32.1°C≤UTCI≤38.0°C）的一天，年龄在19~64岁的女性和男性的AED访视率(每100,000人)分别增加0.9(95%CI:0.5,1.3)和1.7(95%CI:1.3,2.1)和4.1(95%CI:2.7,5.4)和4.1(95%CI:2.6,5.6),而其他变量保持不变.在具有非常强的热应激（38.1°C≤UTCI≤46.0°C）的一天，相应的比率增加了0.6(95%CI：0.1，1.2)，2.2（95%CI：1.7，2.7），4.9（95%CI：3.1，6.7），和4.7（95%CI：2.7，6.6），分别。在≤18岁的人群中，与AED就诊率相关的热应激的影响大小可以忽略不计。在所有亚组中，热应激对19-64岁男性的影响最大。
结论：在亚热带气候的城市中，来自热应激的生物热条件与公民的健康有关，并反映在每日AED访问的增加上。相应地提出了公共卫生建议，以预防与热有关的AED就诊。
