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Int. J. Environ. Res. Public Health 2016, 13(1), 132; doi:10.3390/ijerph13010132

The Impact of Heatwaves on Community Morbidity and Healthcare Usage: A Retrospective Observational Study Using Real-Time Syndromic Surveillance

Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
Extreme Events and Health Protection, Public Health England, London SE1 8UG, UK
ResearchOne, The Phoenix Partnership, Leeds LS18 5TN, UK
Author to whom correspondence should be addressed.
Academic Editors: Jan C. Semenza and Paul B. Tchounwou
Received: 30 November 2015 / Revised: 23 December 2015 / Accepted: 9 January 2016 / Published: 16 January 2016
(This article belongs to the Special Issue Climate Change and Human Health)
View Full-Text   |   Download PDF [868 KB, uploaded 16 January 2016]   |  


We investigated the impact of a moderate heatwave on a range of presenting morbidities in England. Asthma, difficulty breathing, cerebrovascular accident, and cardiovascular symptoms were analysed using general practitioner in hours (GPIH), out of hours (GPOOH) and emergency department (ED) syndromic surveillance systems. Data were stratified by age group and compared between a heatwave year (2013) and non-heatwave years (2012, 2014). Incidence rate ratios were calculated to estimate the differential impact of heatwave compared to non-heatwave summers: there were no apparent differences for the morbidities tested between the 2013 heatwave and non-heatwave years. A subset of GPIH data were used to study individuals at higher risk from heatwaves based on their pre-existing disease. Higher risk patients were not more likely to present at GPs or ED than other individuals. Comparing GPIH consultations and ED attendances for myocardial infarction/ischaemia (MI), there was evidence of a fall in the presentation of MI during the heatwave, which was particularly noted in the 65–74 years age group (and over 75 years in ED attendances). These results indicate the difficulty in identifying individuals at risk from non-fatal health effects of heatwaves and hot weather. View Full-Text
Keywords: heatwave; general practitioner; emergency department; telehealth; syndromic surveillance heatwave; general practitioner; emergency department; telehealth; syndromic surveillance

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Smith, S.; Elliot, A.J.; Hajat, S.; Bone, A.; Bates, C.; Smith, G.E.; Kovats, S. The Impact of Heatwaves on Community Morbidity and Healthcare Usage: A Retrospective Observational Study Using Real-Time Syndromic Surveillance. Int. J. Environ. Res. Public Health 2016, 13, 132.

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