Joint effects of heatwaves and air quality on ambulance services for vulnerable populations in Perth, western Australia. (September 2019)

• Record Type: Journal Article
• Authors: Patel, Dimpalben; Jian, Le; Xiao, Jianguo; Jansz, Janis; Yun, Grace; Lin, Ting; Robertson, Andrew
• Is Part Of: Environmental pollution. Volume 252(2019):Part A
• Page Start: 532
• Page End: 542
• Publication Date: 2019-09
• Subjects: Heatwave -- Excess heat factor -- Ambulance callout -- Air quality -- Joint effect; Pollution -- Periodicals; Pollution -- Environmental aspects -- Periodicals; Environmental Pollution -- Periodicals; Pollution -- Périodiques; Pollution -- Aspect de l'environnement -- Périodiques; Pollution -- Effets physiologiques -- Périodiques; Pollution; Pollution -- Environmental aspects; Periodicals; Electronic journals; 363.73
• DOI: 10.1016/j.envpol.2019.05.125
• Languages: English
• ISSNs: 0269-7491

Abstract

Abstract: As the frequency, intensity, and duration of heatwaves increases, emergency health serviceutilization, including ambulance service, has correspondingly increased across the world. The negative effects of air pollution on health complicate these adverse health effects. This research work is the first known study to analyze the joint effects of heatwaves and air quality on the ambulance service in Western Australia (WA). The main objective is to investigate the potential joint effects of heatwaves and air quality on the ambulance service for vulnerable populations in the Perth metropolitan area. A time series design was used. Daily data on ambulance callouts, temperature and air pollutants (CO, SO2, NO2, O3, PM10 and PM2.5 ) were collected for the Perth metropolitan area, WA from 2006 to 2015. Poisson regression modeling was used to assess the association between heatwaves, air quality, and ambulance callouts. Risk assessments on age, gender, socio-economic status (SES), and joint effects between heatwaves and air quality on ambulance callouts were conducted. The ambulance callout rate was higher during heatwave days (14.20/100, 000/day) compared to non-heatwave days (13.95/100, 000/day) with a rate ratio of 1.017 (95% confidence interval 1.012, 1.023). The ambulance callout rate was higher in males, people over 60 years old, people with low SES, and those living in coastal areas during period of heatwaves. Exposure to CO, SO2, O3 and PM2.5 increased risk on ambulance callouts and exposure to NO2 showed joint effect with heatwave and increased risk of ambulance callouts by 3% after adjustment of all other risk factors. Ambulance callouts are an important indicator for evaluating heatwave-related emergency morbidity in WA. As the median concentrations of air pollutants in WA were lower than the Australian National Standards, the interactive effects of heatwaves and air quality on ambulance service need to be further examined, especially when air pollutants exceed the standards. Graphical abstract: Interactive effect of heatwaves and air quality on ambulance services after adjusting for all other risk factors, Perth metropolitan area, 2006–2015. The values were extracted from Table 4 . Image 1 Highlights: Ambulance callout rates were higher during heatwave (HW) days. During HW, risk was higher in males and elders. During HW, risk was higher in people living in coastal areas and during holidays. Exposure to CO, SO2, O3, and PM2.5 increased risk on ambulance callouts. NO2 had joint effect with HW, increased risk on ambulance callouts. Abstract : Ambulance callout rates were higher during heatwave days as compared to non-heatwave days and NO2 showed joint effects with heatwave on ambulance callout rate.