Time-series analysis of daily ambient temperature and emergency department visits in five US cities with a comparison of exposure metrics derived from 1-km meteorology products

• Type of Material: Article
• Authors: Nikita Thomas, Emory University; Stefanie Ebelt, Emory University; Andrew J Newman, National Center for Atmospheric Research; Noah Scovronick, Emory University; Rohan R D'Souza, Emory University; Shannon E Moss, Emory University; Joshua L Warren, Yale University; Matthew Strickland, Emory University; Lyndsey Darrow, Emory University; Howard Chang, Emory University
• Language: English
• Date: 2021-05-07
• Publisher: BMC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12940-021-00735-w
• Title of Journal or Parent Work: ENVIRONMENTAL HEALTH
• Volume: 20
• Issue: 1
• Start Page: 55
• End Page: 55
• Grant/Funding Information: This research was supported by the National Institute of Environmental Health Sciences (NIEHS) of the National Institutes of Health (NIH) under Award R01 ES027892, R01 ES028346, and R21 ES023763. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIH and does not endorse the purchase of any commercial products or services mentioned in this manuscript.
• Keywords: Environmental Sciences; Environmental Sciences & Ecology; Emergency department visits; Science & Technology; HEAT-RELATED MORTALITY; IMPACT; RISK; Exposure assessment; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; URBAN CANOPY MODEL; MEASUREMENT ERROR; WAVES; Daymet; ISLANDS; Health effect; NEW-YORK-CITY; SPATIAL VARIATION; VULNERABILITY; Temperature
• Research Categories: Health Sciences, Public Health; Biology, Biostatistics

Abstract

Background: Ambient temperature observations from single monitoring stations (usually located at the major international airport serving a city) are routinely used to estimate heat exposures in epidemiologic studies. This method of exposure assessment does not account for potential spatial variability in ambient temperature. In environmental health research, there is increasing interest in utilizing spatially-resolved exposure estimates to minimize exposure measurement error. Methods: We conducted time-series analyses to investigate short-term associations between daily temperature metrics and emergency department (ED) visits for well-established heat-related morbidities in five US cities that represent different climatic regions: Atlanta, Los Angeles, Phoenix, Salt Lake City, and San Francisco. In addition to airport monitoring stations, we derived several exposure estimates for each city using a national meteorology data product (Daymet) available at 1 km spatial resolution. Results: Across cities, we found positive associations between same-day temperature (maximum or minimum) and ED visits for heat-sensitive outcomes, including acute renal injury and fluid and electrolyte imbalance. We also found that exposure assessment methods accounting for spatial variability in temperature and at-risk population size often resulted in stronger relative risk estimates compared to the use of observations at airports. This pattern was most apparent when examining daily minimum temperature and in cities where the major airport is located further away from the urban center. Conclusion: Epidemiologic studies based on single monitoring stations may underestimate the effect of temperature on morbidity when the station is less representative of the exposure of the at-risk population.