Abstract
The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016–1.076), urolithiasis (IRR 1.106, 95% 1.046–1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258–1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048–1.133) and AKI (IRR 1.335, 95% CI 1.204–1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.
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Data availability
The climate datasets generated during and analyzed during the current study, from a monitoring station in Kent Town (station number 023090), are available on the Australian Bureau of Meteorology repository, http://www.bom.gov.au/climate/data/stations/.
The datasets containing hospital inpatient and ED admissions data, from the South Australian Department of Health, were aggregated and de-identified to protect patient confidentiality and are not publicly available.
References
Abdel-Halim RE (2005) Urolithiasis in adults. Clinical and biochemical aspects. Saudi Med J 26(5):705–713
Armstrong B, Gasparrini A, Hajat S (2014) Estimating mortality displacement during and after heat waves. Am J Epidemiol 179(12):1405–1406. https://doi.org/10.1093/aje/kwu083
Australian Bureau of Statistics (2018) Regional population growth, Australia, 2016–17. http://www.abs.gov.au/AUSSTATS/abs@.nsf/allprimarymainfeatures/B7616AB91C66CDCFCA25827800183B7B?opendocument. Accessed 3 Jul 2018
Australian Government Bureau of Meteorology (2011) About air temperature data. http://www.bom.gov.au/climate/cdo/about/about-airtemp-data.shtml. Accessed 15 Aug 2016
Australian Government Bureau of Meteorology (2017) Weather station directory. http://www.bom.gov.au/climate/data/stations/. Accessed 2 June 2017
Bobb JF, Obermeyer Z, Wang Y, Dominici F (2014) Cause-specific risk of hospital admission related to extreme heat in older adults. JAMA 312(24):2659–2667. https://doi.org/10.1001/jama.2014.15715
Borg M, Bi P, Nitschke M, Williams S, McDonald S (2017) The impact of daily temperature on renal disease incidence: an ecological study. Environ Health 16(1):114. https://doi.org/10.1186/s12940-017-0331-4
Centers for Disease Control and Prevention (2007) Prevalence of chronic kidney disease and associated risk factors—United States, 1999-2004. MMWR Morb Mortal Wkly Rep 56(8):161–165
Cervellin G, Comelli I, Comelli D, Meschi T, Lippi G, Borghi L (2012) Mean temperature and humidity variations, along with patient age, predict the number of visits for renal colic in a large urban emergency department: results of a 9-year survey. J Epidemiol Glob Health 2(1):31–38. https://doi.org/10.1016/j.jegh.2012.01.001
Commonwealth Scientific and Industrial Research Organisation (2015) Climate change information for Australia. http://www.csiro.au/en/Research/OandA/Areas/Oceans-and-climate/Climate-change-information. Accessed 11 Sept 2016
de Lorenzo A, Liano F (2017) High temperatures and nephrology: the climate change problem. Nefrologia 37(5):492–500. https://doi.org/10.1016/j.nefro.2016.12.008
Evans K, Costabile RA (2005) Time to development of symptomatic urinary calculi in a high risk environment. J Urol 173(3):858–861. https://doi.org/10.1097/01.ju.0000152578.07262.1c
Fakheri RJ, Goldfarb DS (2011) Ambient temperature as a contributor to kidney stone formation: implications of global warming. Kidney Int 79(11):1178–1185. https://doi.org/10.1038/ki.2011.76
Fletcher BA, Lin S, Fitzgerald EF, Hwang SA (2012) Association of summer temperatures with hospital admissions for renal diseases in New York state: a case-crossover study. Am J Epidemiol 175(9):907–916. https://doi.org/10.1093/aje/kwr417
Goldie J, Alexander L, Lewis SC, Sherwood S (2017) Comparative evaluation of human heat stress indices on selected hospital admissions in Sydney, Australia. Aust N Z J Public Health 41(4):381–387. https://doi.org/10.1111/1753-6405.12692
Government of South Australia (2016) SA health extreme heat strategy. Adelaide, Australia
Griffin T, McCaskill M (1986) Atlas of South Australia. South Australian Government Printing Division, Adelaide
Hansen A, Bi P, Nitschke M, Ryan P, Pisaniello D, Tucker G (2008) The effect of heat waves on mental health in a temperate Australian city. Environ Health Perspect 116(10):1369–1375. https://doi.org/10.1289/ehp.11339
Hansen A, Bi P, Ryan P, Nitschke M, Pisaniello D, Tucker G (2008) The effect of heat waves on hospital admissions for renal disease in a temperate city of Australia. Int J Epidemiol 37(6):1359–1365. https://doi.org/10.1093/ije/dyn165
Hatvani-Kovacs G, Belusko M, Pockett J, Boland J (2016) Can the excess heat factor indicate heatwave-related morbidity? A case study in Adelaide, South Australia. EcoHealth 13(1):100–110. https://doi.org/10.1007/s10393-015-1085-5
Intergovernmental Panel on Climate Change (2018) Special Report on Global Warming of 1.5°C. Incheon, Republic of Korea
Iseki K (2008) Gender differences in chronic kidney disease. Kidney Int 74(4):415–417. https://doi.org/10.1038/ki.2008.261
Jegasothy E, McGuire R, Nairn J, Fawcett R, Scalley B (2017) Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales. Int J Biometeorol 61:1359–1370. https://doi.org/10.1007/s00484-017-1313-5
Jian L, Scalley B, Xiao A, Nairn J, Spicer T, Somerford P, Ostendorf B, Weeramanthri T (2015) Is excess heat factor a good indicator for assessing heatwave related health outcomes in Western Australia? Int J Epidemiol 44(suppl_1):i65
Khalaj B, Lloyd G, Sheppeard V, Dear K (2010) The health impacts of heat waves in five regions of New South Wales, Australia: a case-only analysis. Int Arch Occup Environ Health 83(7):833–842. https://doi.org/10.1007/s00420-010-0534-2
Knowlton K, Rotkin-Ellman M, King G, Margolis HG, Smith D, Solomon G, Trent R, English P (2009) The 2006 California heat wave: impacts on hospitalizations and emergency department visits. Environ Health Perspect 117(1):61–67. https://doi.org/10.1289/ehp.11594
Langlois N, Herbst J, Mason K, Nairn J, Byard RW (2013) Using the excess heat factor (EHF) to predict the risk of heat related deaths. J Forensic Legal Med 20(5):408–411. https://doi.org/10.1016/j.jflm.2012.12.005
Larrieu S, Carcaillon L, Lefranc A, Helmer C, Dartigues JF, Tavernier B, Ledrans M, Filleul L (2008) Factors associated with morbidity during the 2003 heat wave in two population-based cohorts of elderly subjects: PAQUID and three City. Eur J Epidemiol 23(4):295–302. https://doi.org/10.1007/s10654-008-9229-3
Li M, Gu S, Bi P, Yang J, Liu Q (2015) Heat waves and morbidity: current knowledge and further direction—a comprehensive literature review. Int J Environ Res Public Health 12(5):5256–5283. https://doi.org/10.3390/ijerph120505256
Loridan T, Coates L, Argüeso D, Perkins-Kirkpatrick S, McAneney J (2016) The excess heat factor as a metric for heat-related fatalities: defining heatwave risk categories. AJEM 31(4):31–37.
Lotan Y, Daudon M, Bruyere F, Talaska G, Strippoli G, Johnson RJ, Tack I (2013) Impact of fluid intake in the prevention of urinary system diseases: a brief review. Curr Opin Nephrol Hypertens 22(Suppl 1):S1–S10. https://doi.org/10.1097/MNH.0b013e328360a268
Loughnan ME, Carroll M, Tapper N (2014) Learning from our older people: pilot study findings on responding to heat. Australas J Ageing 33(4):271–277. https://doi.org/10.1111/ajag.12050
Lujan M, Sanchez MT, Turo J, Pascual C, Chiva V, Martin C, Torres J (2011) Climate and epidemiological characteristics of renal colic attendances in an urban setting in Spain. Actas Urol Esp 35(8):481–486. https://doi.org/10.1016/j.acuro.2011.03.007
Mayner L, Arbon P, Usher K (2010) Emergency department patient presentations during the 2009 heatwaves in Adelaide. Collegian 17(4):175–182
McTavish RK, Richard L, McArthur E, Shariff SZ, Acedillo R, Parikh CR, Wald R, Wilk P, Garg AX (2017) Association between high environmental heat and risk of acute kidney injury among older adults in a northern climate: a matched case-control study. Am J Kidney Dis 71:200–208. https://doi.org/10.1053/j.ajkd.2017.07.011
Nairn JR, Fawcett R (2013) Defining heatwaves: heatwave defined as a heat impact event servicing all community and business sectors in Australia, CAWCR Technical Report No. 60. Melbourne, Australia
Nairn JR, Fawcett RJ (2014) The excess heat factor: a metric for heatwave intensity and its use in classifying heatwave severity. Int J Environ Res Public Health 12(1):227–253. https://doi.org/10.3390/ijerph120100227
Nitschke M, Tucker GR, Bi P (2007) Morbidity and mortality during heatwaves in metropolitan Adelaide. Med J Aust 187(11–12):662–665
Nitschke M, Tucker GR, Hansen AL, Williams S, Zhang Y, Bi P (2011) Impact of two recent extreme heat episodes on morbidity and mortality in Adelaide, South Australia: a case-series analysis. Environ Health 10:42. https://doi.org/10.1186/1476-069X-10-42
Nitschke M, Tucker G, Hansen A, Williams S, Zhang Y, Bi P (2016) Evaluation of a heat warning system in Adelaide, South Australia, using case-series analysis. BMJ Open 6(7):e012125. https://doi.org/10.1136/bmjopen-2016-012125
Ostro B, Rauch S, Green R, Malig B, Basu R (2010) The effects of temperature and use of air conditioning on hospitalizations. Am J Epidemiol 172(9):1053–1061. https://doi.org/10.1093/aje/kwq231
Park HK, Bae SR, Kim SE, Choi WS, Paick SH, Ho K, Kim HG, Lho YS (2015) The effect of climate variability on urinary stone attacks: increased incidence associated with temperature over 18 degrees C: a population-based study. Urolithiasis 43(1):89–94. https://doi.org/10.1007/s00240-014-0741-5
Pincus S, Macbean C, Taylor D (2010) The effects of temperature, age and sex on presentations of renal colic in Melbourne, Australia. Eur J Emerg Med 17(6):328–331. https://doi.org/10.1097/MEJ.0b013e32833547b7
Rohini P, Rajeevan M, Srivastava AK (2016) On the variability and increasing trends of heat waves over India. Sci Rep 6:26153. https://doi.org/10.1038/srep26153
Rowe TA, Juthani-Mehta M (2014) Diagnosis and management of urinary tract infection in older adults. Infect Dis Clin N Am 28(1):75–89. https://doi.org/10.1016/j.idc.2013.10.004
Saha MV, Davis RE, Hondula DM (2014) Mortality displacement as a function of heat event strength in 7 US cities. Am J Epidemiol 179(4):467–474. https://doi.org/10.1093/aje/kwt264
Scalley BD, Spicer T, Jian L, Xiao J, Nairn J, Robertson A, Weeramanthri T (2015) Responding to heatwave intensity: excess heat factor is a superior predictor of health service utilisation and a trigger for heatwave plans. Aust N Z J Public Health 39:582–587. https://doi.org/10.1111/1753-6405.12421
Sherbakov T, Malig B, Guirguis K, Gershunov A, Basu R (2018) Ambient temperature and added heat wave effects on hospitalizations in California from 1999 to 2009. Environ Res 160:83–90. https://doi.org/10.1016/j.envres.2017.08.052
Sirohi M, Katz BF, Moreira DM, Dinlenc C (2014) Monthly variations in urolithiasis presentations and their association with meteorologic factors in new York City. J Endourol 28(5):599–604. https://doi.org/10.1089/end.2013.0680
South Australian State Emergency Service (2010) Extreme heat arrangements, annex a to extreme weather hazard plan. Adelaide, Australia
Tasian GE, Pulido JE, Gasparrini A, Saigal CS, Horton BP, Landis JR, Madison R, Keren R, Urologic Diseases in America P (2014) Daily mean temperature and clinical kidney stone presentation in five U.S. metropolitan areas: a time-series analysis. Environ Health Perspect 122(10):1081–1087. https://doi.org/10.1289/ehp.1307703
Tiu A, Tang V, Gubicak S, Knight P, Haxhimolla H (2010) Seasonal variation of acute urolithiasis at an Australian tertiary hospital. Australas Med J 3(13):851–854. https://doi.org/10.4066/amj.2010.502
Urban A, Hanzlikova H, Kysely J, Plavcova E (2017) Impacts of the 2015 heat waves on mortality in the Czech Republic—a comparison with previous heat waves. Int J Environ Res Public Health 14(12). https://doi.org/10.3390/ijerph14121562
Wang Y, Nordio F, Nairn J, Zanobetti A, Schwartz JD (2018) Accounting for adaptation and intensity in projecting heat wave-related mortality. Environ Res 161:464–471. https://doi.org/10.1016/j.envres.2017.11.049
Williams S, Nitschke M, Sullivan T, Tucker GR, Weinstein P, Pisaniello DL, Parton KA, Bi P (2012) Heat and health in Adelaide, South Australia: assessment of heat thresholds and temperature relationships. Sci Total Environ 414:126–133. https://doi.org/10.1016/j.scitotenv.2011.11.038
Williams S, Nitschke M, Tucker G, Bi P (2011) Extreme heat arrangements in South Australia: an assessment of trigger temperatures. Health Promot J Austr 22 Spec No: S21–27
Williams S, Venugopal K, Nitschke M, Nairn J, Fawcett R, Beattie C, Wynwood G, Bi P (2018) Regional morbidity and mortality during heatwaves in South Australia. Int J Biometeorol 62:1911–1926. https://doi.org/10.1007/s00484-018-1593-4
Wilson LA, Morgan GG, Hanigan IC, Johnston FH, Abu-Rayya H, Broome R, Gaskin C, Jalaludin B (2013) The impact of heat on mortality and morbidity in the greater metropolitan Sydney region: a case crossover analysis. Environ Health 12, 98. https://doi.org/10.1186/1476-069x-12-98
Woodruff RE, McMichael T, Butler C, Hales S (2006) Action on climate change: the health risks of procrastinating. Aust N Z J Public Health 30(6):567–571
World Health Organisation (2007) Improving public health responses to extreme weather/heat-waves—EuroHEAT. Bonn, Germany
World Meteorological Organization, World Health Organization (2015) Heatwaves and health: guidance on warning-system development. http://www.who.int/globalchange/publications/WMO_WHO_Heat_Health_Guidance_2015.pdf. Accessed 21 Dec 2016
Xiang J, Hansen A, Pisaniello D, Bi P (2015) Extreme heat and occupational heat illnesses in South Australia, 2001-2010. Occup Environ Med 72(8):580–586. https://doi.org/10.1136/oemed-2014-102706
Xiao J, Spicer T, Jian L, Yun GY, Shao C, Nairn J, Fawcett RJB, Robertson A, Weeramanthri TS (2017) Variation in population vulnerability to heat wave in Western Australia. Front Public Health 5:64. https://doi.org/10.3389/fpubh.2017.00064
Zhang Y, Nitschke M, Bi P (2013) Risk factors for direct heat-related hospitalization during the 2009 Adelaide heatwave: a case crossover study. Sci Total Environ 442:1–5. https://doi.org/10.1016/j.scitotenv.2012.10.042
Zhang Y, Nitschke M, Krackowizer A, Dear K, Pisaniello D, Weinstein P, Tucker G, Shakib S, Bi P (2017) Risk factors for deaths during the 2009 heat wave in Adelaide, Australia: a matched case-control study. Int J Biometeorol 61(1):35–47. https://doi.org/10.1007/s00484-016-1189-9
Acknowledgements
We acknowledge the SA Department of Health for providing hospital admissions data and the Australian Bureau of Meteorology for providing climate data. We also acknowledge Mr. Graeme Tucker and Ms. Anh-Minh Nguyen for their advice on statistical analysis and Dr. Alana Hansen for her assistance and suggestions. Funding was not applicable for this project.
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Borg, M., Nitschke, M., Williams, S. et al. Using the excess heat factor to indicate heatwave-related urinary disease: a case study in Adelaide, South Australia. Int J Biometeorol 63, 435–447 (2019). https://doi.org/10.1007/s00484-019-01674-5
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DOI: https://doi.org/10.1007/s00484-019-01674-5