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      The 2006 California Heat Wave: Impacts on Hospitalizations and Emergency Department Visits

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          Abstract

          Background

          Climate models project that heat waves will increase in frequency and severity. Despite many studies of mortality from heat waves, few studies have examined morbidity.

          Objectives

          In this study we investigated whether any age or race/ethnicity groups experienced increased hospitalizations and emergency department (ED) visits overall or for selected illnesses during the 2006 California heat wave.

          Methods

          We aggregated county-level hospitalizations and ED visits for all causes and for 10 cause groups into six geographic regions of California. We calculated excess morbidity and rate ratios (RRs) during the heat wave (15 July to 1 August 2006) and compared these data with those of a reference period (8–14 July and 12–22 August 2006).

          Results

          During the heat wave, 16,166 excess ED visits and 1,182 excess hospitalizations occurred statewide. ED visits for heat-related causes increased across the state [RR = 6.30; 95% confidence interval (CI), 5.67–7.01], especially in the Central Coast region, which includes San Francisco. Children (0–4 years of age) and the elderly (≥ 65 years of age) were at greatest risk. ED visits also showed significant increases for acute renal failure, cardiovascular diseases, diabetes, electrolyte imbalance, and nephritis. We observed significantly elevated RRs for hospitalizations for heat-related illnesses (RR = 10.15; 95% CI, 7.79–13.43), acute renal failure, electrolyte imbalance, and nephritis.

          Conclusions

          The 2006 California heat wave had a substantial effect on morbidity, including regions with relatively modest temperatures. This suggests that population acclimatization and adaptive capacity influenced risk. By better understanding these impacts and population vulnerabilities, local communities can improve heat wave preparedness to cope with a globally warming future.

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          Most cited references 53

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          More intense, more frequent, and longer lasting heat waves in the 21st century.

          A global coupled climate model shows that there is a distinct geographic pattern to future changes in heat waves. Model results for areas of Europe and North America, associated with the severe heat waves in Chicago in 1995 and Paris in 2003, show that future heat waves in these areas will become more intense, more frequent, and longer lasting in the second half of the 21st century. Observations and the model show that present-day heat waves over Europe and North America coincide with a specific atmospheric circulation pattern that is intensified by ongoing increases in greenhouse gases, indicating that it will produce more severe heat waves in those regions in the future.
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            Modern epidemiology

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              Modern Epidemiology

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                Author and article information

                Affiliations
                [1 ] Health and Environment Program, Natural Resources Defense Council, New York, New York, USA
                [2 ] Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, New York, USA
                [3 ] Health and Environment Program, Natural Resources Defense Council, San Francisco, California, USA
                [4 ] California Department of Public Health, Environmental Health Investigations Branch, Richmond, California, USA
                [5 ] Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California, USA
                [6 ] Pediatric Environmental Health Specialty Unit, California Poison Control System San Francisco, University of California San Francisco, San Francisco, California, USA
                [7 ] School of Medicine, University of California San Francisco, San Francisco, California, USA
                [8 ] California Department of Public Health, Epidemiology and Prevention for Injury Control Branch, Sacramento, California, USA
                Author notes
                Address correspondence to K. Knowlton, Natural Resources Defense Council, 40 West 20th St., New York, NY 10011-4231 USA. Telephone: (212) 727-2700. Fax: (212) 727-1773. E-mail: kknowlton@ 123456nrdc.org

                K.K., M.R.-E., and G.S. are employed by the Natural Resources Defense Council, a nonprofit environmental advocacy organization. The remaining authors declare they have no competing financial interests.

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                1552-9924
                January 2009
                22 August 2008
                : 117
                : 1
                : 61-67
                2627866
                19165388
                10.1289/ehp.11594
                ehp-117-61
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                Categories
                Research

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