High temperature effects on out-patient visits and hospital admissions in Chiang Mai, Thailand.
Pudpong, Nareerut;
Hajat, Shakoor;
(2011)
High temperature effects on out-patient visits and hospital admissions in Chiang Mai, Thailand.
The Science of the total environment, 409 (24).
pp. 5260-5267.
ISSN 0048-9697
DOI: https://doi.org/10.1016/j.scitotenv.2011.09.005
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
OBJECTIVES: This study investigated the short-term effects of temperature on out-patient visits and hospital admissions in Chiang Mai, Thailand. While mortality outcomes in the literature have been reported, there is less evidence of morbidity effects with very few studies conducted in developing countries with subtropical or tropical climate. METHODS: Time-series regression analysis was employed using generalized negative binomial regression to model the short-term relationships between temperature and morbidity after controlling for seasonal patterns and other potential confounders. Lag effects up to 13 days and effect modification by age (0-14 years, 15-64 years, ≥65 years) were examined. RESULTS: Temperature effects with wide confidence intervals were found, with an increase in diabetic visits of 26.3% (95% CI: 7.1%-49.0%), and circulatory visits of 19.2% (95% CI: 7.0%-32.8%) per 1 °C increase in temperature above an identified threshold of 29 °C. Additionally, there was a rise of both visits (3.7% increase, 95% CI: 1.5%-5.9%) and admissions (5.8% increase, 95% CI: 2.3%-9.3%) due to intestinal infectious disease in association with each 1 °C increase across the whole temperature range. The effects of temperature were stronger in the elderly though not statistically significant. CONCLUSIONS: Daily morbidity in Chiang Mai was positively associated with temperature with a lag effect of up to 2 weeks, which was longer than lag effects previously reported. Public health preparedness and interventions should be considered to minimise possible increased hospital visits and admissions during hot weather.