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Warm Season and Emergency Department Visits to U.S. Children's Hospitals.

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Title: Warm Season and Emergency Department Visits to U.S. Children's Hospitals.
Authors: Bernstein, Aaron S.1,2 aaron_bernstein@hms.harvard.edu, Shengzhi Sun3 szsun@bu.edu, Weinberger, Kate R.4, Spangler, Keith R.3, Sheffield, Perry E.5, Wellenius, Gregory A.3
Source: Environmental Health Perspectives. Jan2022, Vol. 130 Issue 1, p017001-1-017001-9. 9p. 2 Charts, 2 Graphs, 1 Map.
Subject Terms: *Weather, Dehydration -- Risk factors, Heat, Research, Relative medical risk, Hospital emergency services, Confidence intervals, Otitis externa, Children's hospitals, Multivariate analysis, Medical cooperation, Water-electrolyte imbalances, Seasons, Risk assessment, Time series analysis, Descriptive statistics, Medical appointments, Statistical models, Data analysis software, Poisson distribution, Enteritis, Otitis media, Medical coding, Disease risk factors
Geographic Terms: United States
Abstract: BACKGROUND: Extreme heat exposures are increasing with climate change. Health effects are well documented in adults, but the risks to children are not well characterized. OBJECTIVES: We estimated the association between warm season (May to September) temperatures and cause-specific emergency department (ED) visits among U.S. children and adolescents. METHODS: This multicenter time-series study leveraged administrative data on 3:8 million ED visits by children and adolescents =18 years of age to the EDs of 47 U.S. children’s hospitals from May to September from 2016 to 2018. Daily maximum ambient temperature was estimated in the county of the hospital using a spatiotemporal model. We used distributed-lag nonlinear models with a quasi-Poisson distribution to estimate the association between daily maximum temperature and the relative risk (RR) of ED visits, adjusting for temporal trends. We then used a random-effects metaanalytic model to estimate the overall cumulative association. RESULTS: Extreme heat was associated with an RR of all-cause ED visits of 1.17 (95% CI: 1.12, 1.21) relative to hospital-specific minimum morbidity temperature. Associations were more pronounced for ED visits due to heat-related illness including dehydration and electrolyte disorders (RR = 1.83; 95% CI: 1.31, 2.57), bacterial enteritis (1.35; 95% CI: 1.02, 1.79), and otitis media and externa (1.30; 95% CI: 1.11, 1.52). Taken together, temperatures above the minimum morbidity temperature accounted for an estimated 11.8% [95% empirical 95% confidence interval (eCI): 9.9%, 13.3%] of warm season ED visits for any cause and 31.0% (95% eCI: 17.9%, 36.5%) of ED visits for heat-related illnesses. CONCLUSION: During the warm season, days with higher temperatures were associated with higher rates of visits to children’s hospital EDs. Higher ambient temperatures may contribute to a significant proportion of ED visits among U.S. children and adolescents. [ABSTRACT FROM AUTHOR]
Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Warm Season and Emergency Department Visits to U.S. Children's Hospitals.
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  Data: <searchLink fieldCode="AR" term="%22Bernstein%2C+Aaron+S%2E%22">Bernstein, Aaron S.</searchLink><relatesTo>1,2</relatesTo><i> aaron_bernstein@hms.harvard.edu</i><br /><searchLink fieldCode="AR" term="%22Shengzhi+Sun%22">Shengzhi Sun</searchLink><relatesTo>3</relatesTo><i> szsun@bu.edu</i><br /><searchLink fieldCode="AR" term="%22Weinberger%2C+Kate+R%2E%22">Weinberger, Kate R.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Spangler%2C+Keith+R%2E%22">Spangler, Keith R.</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Sheffield%2C+Perry+E%2E%22">Sheffield, Perry E.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Wellenius%2C+Gregory+A%2E%22">Wellenius, Gregory A.</searchLink><relatesTo>3</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Environmental+Health+Perspectives%22">Environmental Health Perspectives</searchLink>. Jan2022, Vol. 130 Issue 1, p017001-1-017001-9. 9p. 2 Charts, 2 Graphs, 1 Map.
– Name: Subject
  Label: Subject Terms
  Group: Su
  Data: *<searchLink fieldCode="DE" term="%22Weather%22">Weather</searchLink><br /><searchLink fieldCode="DE" term="%22Dehydration+--+Risk+factors%22">Dehydration -- Risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Heat%22">Heat</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Relative+medical+risk%22">Relative medical risk</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+emergency+services%22">Hospital emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Otitis+externa%22">Otitis externa</searchLink><br /><searchLink fieldCode="DE" term="%22Children's+hospitals%22">Children's hospitals</searchLink><br /><searchLink fieldCode="DE" term="%22Multivariate+analysis%22">Multivariate analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+cooperation%22">Medical cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Water-electrolyte+imbalances%22">Water-electrolyte imbalances</searchLink><br /><searchLink fieldCode="DE" term="%22Seasons%22">Seasons</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Time+series+analysis%22">Time series analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+appointments%22">Medical appointments</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+models%22">Statistical models</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Poisson+distribution%22">Poisson distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Enteritis%22">Enteritis</searchLink><br /><searchLink fieldCode="DE" term="%22Otitis+media%22">Otitis media</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+coding%22">Medical coding</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND: Extreme heat exposures are increasing with climate change. Health effects are well documented in adults, but the risks to children are not well characterized. OBJECTIVES: We estimated the association between warm season (May to September) temperatures and cause-specific emergency department (ED) visits among U.S. children and adolescents. METHODS: This multicenter time-series study leveraged administrative data on 3:8 million ED visits by children and adolescents =18 years of age to the EDs of 47 U.S. children’s hospitals from May to September from 2016 to 2018. Daily maximum ambient temperature was estimated in the county of the hospital using a spatiotemporal model. We used distributed-lag nonlinear models with a quasi-Poisson distribution to estimate the association between daily maximum temperature and the relative risk (RR) of ED visits, adjusting for temporal trends. We then used a random-effects metaanalytic model to estimate the overall cumulative association. RESULTS: Extreme heat was associated with an RR of all-cause ED visits of 1.17 (95% CI: 1.12, 1.21) relative to hospital-specific minimum morbidity temperature. Associations were more pronounced for ED visits due to heat-related illness including dehydration and electrolyte disorders (RR = 1.83; 95% CI: 1.31, 2.57), bacterial enteritis (1.35; 95% CI: 1.02, 1.79), and otitis media and externa (1.30; 95% CI: 1.11, 1.52). Taken together, temperatures above the minimum morbidity temperature accounted for an estimated 11.8% [95% empirical 95% confidence interval (eCI): 9.9%, 13.3%] of warm season ED visits for any cause and 31.0% (95% eCI: 17.9%, 36.5%) of ED visits for heat-related illnesses. CONCLUSION: During the warm season, days with higher temperatures were associated with higher rates of visits to children’s hospital EDs. Higher ambient temperatures may contribute to a significant proportion of ED visits among U.S. children and adolescents. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1289/EHP8083
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 017001-1
    Subjects:
      – SubjectFull: Weather
        Type: general
      – SubjectFull: Dehydration -- Risk factors
        Type: general
      – SubjectFull: Heat
        Type: general
      – SubjectFull: Research
        Type: general
      – SubjectFull: Relative medical risk
        Type: general
      – SubjectFull: Hospital emergency services
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Otitis externa
        Type: general
      – SubjectFull: Children's hospitals
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Medical cooperation
        Type: general
      – SubjectFull: Water-electrolyte imbalances
        Type: general
      – SubjectFull: Seasons
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Time series analysis
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Medical appointments
        Type: general
      – SubjectFull: Statistical models
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Poisson distribution
        Type: general
      – SubjectFull: Enteritis
        Type: general
      – SubjectFull: Otitis media
        Type: general
      – SubjectFull: Medical coding
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: Warm Season and Emergency Department Visits to U.S. Children's Hospitals.
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            – D: 01
              M: 01
              Text: Jan2022
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              Y: 2022
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