Impacts of cold weather on emergency hospital admission in Texas, 2004–2013

Tsun Hsuan Chen, Xianglin L Du, Wenyaw Chan, Kai Zhang

Research output: Contribution to journalArticle

Abstract

Cold weather has been identified as a major cause of weather-related deaths in the U.S. Although the effects of cold weather on mortality has been investigated extensively, studies on how cold weather affects hospital admissions are limited particularly in the Southern United States. This study aimed to examine impacts of cold weather on emergency hospital admissions (EHA) in 12 major Texas metropolitan statistical areas (MSAs) for the 10-year period, 2004–2013. A two-stage approach was employed to examine the associations between cold weather and EHA. First, the cold effects on each MSA were estimated using distributed lag non-linear models (DLNM). Then a random effects meta-analysis was applied to estimate pooled effects across all 12 MSAs. Percent increase in risk and corresponding 95% confidence intervals (CIs) were estimated as with a 1 °C (°C) decrease in temperature below a MSA-specific threshold for cold effects. Age-stratified and cause-specific EHA were modeled separately. The majority of the 12 Texas MSAs were associated with an increased risk in EHA ranging from 0.1% to 3.8% with a 1 ⁰C decrease below cold thresholds. The pooled effect estimate was 1.6% (95% CI: 0.9%, 2.2%) increase in all-cause EHA risk with 1 ⁰C decrease in temperature. Cold wave effects were also observed in most eastern and southern Texas MSAs. Effects of cold on all-cause EHA were highest in the very elderly (2.4%, 95% CI: 1.2%, 3.6%). Pooled estimates for cause-specific EHA association were strongest in pneumonia (3.3%, 95% CI: 2.8%, 3.9%), followed by chronic obstructive pulmonary disease (3.3%, 95% CI: 2.1%, 4.5%) and respiratory diseases (2.8%, 95% CI: 1.9%, 3.7%). Cold weather generally increases EHA risk significantly in Texas, especially in respiratory diseases, and cold effects estimates increased by elderly population (aged over 75 years). Our findings provide insight into better intervention strategy to reduce adverse health effects of cold weather among targeted vulnerable populations.

LanguageEnglish
Pages139-146
Number of pages8
JournalEnvironmental Research
Volume169
DOIs
StatePublished - Feb 1 2019

Fingerprint

cardiovascular disease
Weather
Heart Diseases
Emergencies
weather
Temperature
Cold effects
confidence interval
Pulmonary diseases
temperature
Confidence Intervals
respiratory disease
cold
hospital
Wave effects
effect
elderly population
pneumonia
Nonlinear Dynamics
meta-analysis

Keywords

  • Cold wave
  • Cold weather
  • Emergency hospital admission
  • Heart disease
  • Temperature

ASJC Scopus subject areas

  • Biochemistry
  • Environmental Science(all)

Cite this

Impacts of cold weather on emergency hospital admission in Texas, 2004–2013. / Chen, Tsun Hsuan; Du, Xianglin L; Chan, Wenyaw; Zhang, Kai.

In: Environmental Research, Vol. 169, 01.02.2019, p. 139-146.

Research output: Contribution to journalArticle

Chen, Tsun Hsuan ; Du, Xianglin L ; Chan, Wenyaw ; Zhang, Kai. / Impacts of cold weather on emergency hospital admission in Texas, 2004–2013. In: Environmental Research. 2019 ; Vol. 169. pp. 139-146.
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