Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department Visits

Abstract High ambient temperature poses significant health risk globally. However, the relative importance of different exposure pathways leading to health risks remains unclear. For 9 US states during 2016–2018, ED visit records for heat exhaustion and heat stroke (HEAT), fluid and electrolyte imba...

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Main Authors: Chen Li, Hua Hao, Morgan Lane, Noah Scovronick, Rebecca Zhang, Stefanie Ebelt, Howard H. Chang
Format: Article
Language:English
Published: American Geophysical Union (AGU) 2025-04-01
Series:GeoHealth
Subjects:
Online Access:https://doi.org/10.1029/2024GH001287
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author Chen Li
Hua Hao
Morgan Lane
Noah Scovronick
Rebecca Zhang
Stefanie Ebelt
Howard H. Chang
author_facet Chen Li
Hua Hao
Morgan Lane
Noah Scovronick
Rebecca Zhang
Stefanie Ebelt
Howard H. Chang
author_sort Chen Li
collection DOAJ
description Abstract High ambient temperature poses significant health risk globally. However, the relative importance of different exposure pathways leading to health risks remains unclear. For 9 US states during 2016–2018, ED visit records for heat exhaustion and heat stroke (HEAT), fluid and electrolyte imbalance (FEI), volume depletion (VD), and acute kidney injury (AKI) were identified via diagnosis codes. Co‐diagnosed Y92 subcodes (Y codes) were used to categorize the patient's location at the time of injury or condition. Logistic regressions were used to estimate nonlinear associations between same‐day temperature and Y codes for 11 non‐residential versus residential locations among heat‐related ED visits, including stratified analyses by patient age, race, and ethnicity. Odds ratios (OR) were calculated between the 95th versus 50th percentile of temperature. Overall, higher temperature was associated with increased risks of ED visits with Y codes for non‐residential locations. HEAT ED visits were more likely to have Y codes for streets compared to residential locations (OR:1.68, 95% CI: 1.12–2.51). Similarly, VD visits were more likely to have Y codes for industrial area (OR: 2.68, 95% CI: 1.98–3.63), farms (OR:7.66, 95% CI: 4.05–14.50), recreation areas (OR:2.25, 95% CI: 1.78–2.84), and streets (OR:1.54, 95% CI: 1.39–1.70), but were less likely to have Y codes for public places (OR: 0.89, 95% CI: 0.84, 0.94). Similar associations were observed for FEI and AKI ED visits. Locations associated with higher heat risks may be due to exposure outdoor temperature and activities, supporting the need to develop strategies and interventions that minimize heat exposure in these areas.
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spelling doaj-art-46dc1cb4e3fa43cc8a1fdd0b71b5eb6d2025-08-20T02:19:38ZengAmerican Geophysical Union (AGU)GeoHealth2471-14032025-04-0194n/an/a10.1029/2024GH001287Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department VisitsChen Li0Hua Hao1Morgan Lane2Noah Scovronick3Rebecca Zhang4Stefanie Ebelt5Howard H. Chang6Department of Biostatistics and Bioinformatics Emory University Atlanta GA USAGangarosa Department of Environmental Health Emory University Atlanta GA USAGangarosa Department of Environmental Health Emory University Atlanta GA USAGangarosa Department of Environmental Health Emory University Atlanta GA USADepartment of Biostatistics and Bioinformatics Emory University Atlanta GA USAGangarosa Department of Environmental Health Emory University Atlanta GA USADepartment of Biostatistics and Bioinformatics Emory University Atlanta GA USAAbstract High ambient temperature poses significant health risk globally. However, the relative importance of different exposure pathways leading to health risks remains unclear. For 9 US states during 2016–2018, ED visit records for heat exhaustion and heat stroke (HEAT), fluid and electrolyte imbalance (FEI), volume depletion (VD), and acute kidney injury (AKI) were identified via diagnosis codes. Co‐diagnosed Y92 subcodes (Y codes) were used to categorize the patient's location at the time of injury or condition. Logistic regressions were used to estimate nonlinear associations between same‐day temperature and Y codes for 11 non‐residential versus residential locations among heat‐related ED visits, including stratified analyses by patient age, race, and ethnicity. Odds ratios (OR) were calculated between the 95th versus 50th percentile of temperature. Overall, higher temperature was associated with increased risks of ED visits with Y codes for non‐residential locations. HEAT ED visits were more likely to have Y codes for streets compared to residential locations (OR:1.68, 95% CI: 1.12–2.51). Similarly, VD visits were more likely to have Y codes for industrial area (OR: 2.68, 95% CI: 1.98–3.63), farms (OR:7.66, 95% CI: 4.05–14.50), recreation areas (OR:2.25, 95% CI: 1.78–2.84), and streets (OR:1.54, 95% CI: 1.39–1.70), but were less likely to have Y codes for public places (OR: 0.89, 95% CI: 0.84, 0.94). Similar associations were observed for FEI and AKI ED visits. Locations associated with higher heat risks may be due to exposure outdoor temperature and activities, supporting the need to develop strategies and interventions that minimize heat exposure in these areas.https://doi.org/10.1029/2024GH001287heatemergency department visitexposure pathwayY codeepidemiology
spellingShingle Chen Li
Hua Hao
Morgan Lane
Noah Scovronick
Rebecca Zhang
Stefanie Ebelt
Howard H. Chang
Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department Visits
GeoHealth
heat
emergency department visit
exposure pathway
Y code
epidemiology
title Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department Visits
title_full Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department Visits
title_fullStr Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department Visits
title_full_unstemmed Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department Visits
title_short Associations Between Temperature and Location of Injury or Condition Among Heat‐Related Emergency Department Visits
title_sort associations between temperature and location of injury or condition among heat related emergency department visits
topic heat
emergency department visit
exposure pathway
Y code
epidemiology
url https://doi.org/10.1029/2024GH001287
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