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Open AccessArticle

A Geographical Analysis of Emergency Medical Service Calls and Extreme Heat in King County, WA, USA (2007–2012)

1
Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98105, USA
2
Department of Biostatistics, University of Washington, Seattle, WA 98105, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2017, 14(8), 937; https://doi.org/10.3390/ijerph14080937
Received: 31 July 2017 / Revised: 15 August 2017 / Accepted: 17 August 2017 / Published: 20 August 2017
(This article belongs to the Special Issue Extreme Weather and Public Health)
This research analyzed the relationship between extreme heat and Emergency Medical Service (EMS) calls in King County, WA, USA between 2007 and 2012, including the effect of community-level characteristics. Extreme heat thresholds for the Basic Life Support (BLS) data and the Advanced Life Support (ALS) data were found using a piecewise generalized linear model with Akaike Information Criterion (AIC). The association between heat exposure and EMS call rates was investigated using a generalized estimating equations with Poisson mean model, while adjusting for community-level indicators of poverty, impervious surface, and elderly population (65+). In addition, we examined the effect modifications of these community-level factors. Extreme-heat thresholds of 31.1 °C and 33.5 °C humidex were determined for the BLS and ALS data, respectively. After adjusting for other variables in the model, increased BLS call volume was significantly associated with occurring on a heat day (relative rate (RR) = 1.080, p < 0.001), as well as in locations with higher percent poverty (RR = 1.066, p < 0.001). No significant effect modification was identified for the BLS data on a heat day. Controlling for other variables, higher ALS call volume was found to be significantly associated with a heat day (RR = 1.067, p < 0.001), as well as in locations with higher percent impervious surface (RR = 1.015, p = 0.039), higher percent of the population 65 years or older (RR = 1.057, p = 0.005), and higher percent poverty (RR = 1.041, p = 0.016). Furthermore, percent poverty and impervious surface were found to significantly modify the relative rate of ALS call volumes between a heat day and non-heat day. We conclude that EMS call volume increases significantly on a heat day compared to non-heat day for both call types. While this study shows that there is some effect modification between the community-level variables and call volume on a heat day, further research is necessary. Our findings also suggest that with adequate power, spatially refined analyses may not be necessary to accurately estimate the extreme-heat effect on health. View Full-Text
Keywords: extreme heat; climate change; emergency medical service calls; ambulance calls; community-level characteristics extreme heat; climate change; emergency medical service calls; ambulance calls; community-level characteristics
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MDPI and ACS Style

DeVine, A.C.; Vu, P.T.; Yost, M.G.; Seto, E.Y.W.; Busch Isaksen, T.M. A Geographical Analysis of Emergency Medical Service Calls and Extreme Heat in King County, WA, USA (2007–2012). Int. J. Environ. Res. Public Health 2017, 14, 937. https://doi.org/10.3390/ijerph14080937

AMA Style

DeVine AC, Vu PT, Yost MG, Seto EYW, Busch Isaksen TM. A Geographical Analysis of Emergency Medical Service Calls and Extreme Heat in King County, WA, USA (2007–2012). International Journal of Environmental Research and Public Health. 2017; 14(8):937. https://doi.org/10.3390/ijerph14080937

Chicago/Turabian Style

DeVine, Aubrey C.; Vu, Phuong T.; Yost, Michael G.; Seto, Edmund Y.W.; Busch Isaksen, Tania M. 2017. "A Geographical Analysis of Emergency Medical Service Calls and Extreme Heat in King County, WA, USA (2007–2012)" Int. J. Environ. Res. Public Health 14, no. 8: 937. https://doi.org/10.3390/ijerph14080937

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