Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia
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Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia Xiao-Yu Wang, Adrian Barnett, Yu-Ming Guo, Wei-Wei Yu, Xiao-Ming Shen, Shi-Lu Tong Brisbane, Australia
Methods: Daily data on EHAs for renal diseases in children and exposure to temperature and air pollution were obtained for Brisbane city from January 1, 1996 to December 31, 2005. A time-stratified case-crossover design was used to compare the risks for renal diseases between heatwave and non-heatwave periods. Results: There were 1565 EHAs for renal diseases in children during the study period. Heatwaves exhibited a significant impact on EHAs for renal diseases in children after adjusting for confounding factors (odds ratio: 3.6; 95% confidence interval: 1.4-9.5). The risk estimates differed with lags and the use of different heatwave definitions. Conclusions: There was a significant increase in EHAs for renal diseases in children during heatwaves in Brisbane, a subtropical city where people are well accustomed to warm weather. This finding may have significant implications for pediatric renal care, particularly in subtropical and tropical regions. World J Pediatr March 2014; Online First
Author Affiliations: School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (Wang XY, Barnett A, Guo YM, Yu WW, Tong SL); MOE Shanghai Key Laboratory of Environment and Children's Health, Shanghai Jiao Tong University, Shanghai, China (Shen XM) Corresponding Author: Shi-Lu Tong, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia (Tel: +617-3138 9745; Fax: +61-7-3138 3369; Email: [email protected]) doi: 10.1007/s12519-014-0469-x ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2014. All rights reserved.
World J Pediatr, Online First, February 2014 . www.wjpch.com
Key words: climate change; environmental health; hot temperature; renal diseases
Introduction
H
eatwaves, which are likely to become more common and intense in the future as climate change continues, [1] can cause significant health consequences such as increased mortality and morbidity, particularly among the elderly with chronic illnesses and of low social class. [2-7] Exposure to extreme hot weather can cause heat-related conditions including hyperthermia and heat stress in susceptible individuals, whilst the thermoregulatory physiological and circulatory adjustments necessary to cope with extreme heat can place stress on the kidneys and compromise the function of the renal system.[3,8] Several studies[3,4,8-13] have reported increases in mortality and hospital admissions for renal dysfunction among the elderly during periods of high ambient temperatures. Most patients affected by hyperthermia experienced renal failure shortly after admissions, and severe renal diseases were amongst the promin
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