Effect of Elevated Temperature on Daily Emergency Ambulance Calls: A Time Series Analysis in Budapest, Hungary 1998–2004

Anna Páldy3, János Bobvos1, Adrienn Vámos1, László Gorove3, and Márta Buranszki-Sallai4

1 National Institute of Environmental Health, Budapest, Hungary
2 Capital Institute of the National Public Health Service, Budapest, Hungary
3 Budapest Centre of Ambulance Service, Budapest, Hungary
4 National Meteorological Service, Hungary

Corresponding author: Anna Páldy MD. PhD.
    National Institute of Environmental Health
    Gyáli út 2–6, 1097 Budapest, Hungary
    Telephone: +36-1 476 1215
    Fax number: +36-1 215 2046
    E-mail: paldy.anna@oki.antsz.hu

CEJOEM 2007, Vol.13. No.2.: 159–169

Key words:
Elevated temperature, emergency ambulance calls, heat-related morbidity, vulnerable groups, time series analysis

Abstract:
Objectives: The effect of extreme heat on mortality has been thoroughly studied by several expert groups. The impact on heat on emergency ambulance calls are not so widely investigated.
Methods: The authors studied the relationship between daily mean temperature and emergency ambulance calls in Budapest in 1998–2004 for the period of April–September for population groups of 0–14, 15–64 and 65≤ years in time series analysis using GAM model. Meteorological data were gained from the National Meteorological Service. Ambulance calls with the following diagnoses were studied: cardiovascular diseases: ICD-9: 386, 394–438, 458, heat stroke 992; respiratory diseases, 490–519; ill defined symptoms: 780, 781, 784–786. Long term and seasonal trend of emergency calls was considered. The effect of heat was studied on lag0–3 days.
Results: An increase of 10 °C in daily mean temperature significantly increased the risk of emergency ambulance calls of cardiovascular disease symptoms in the age group of 15–64 years on lag0 day (RR=5.36; 95% confidence intervals (95% CI): 2.26–8.46) and on lag1 day (RR=5.38; 95% CI: 2.27–8.49). There was even a much stronger association of extreme temperature on calls due to ill defined symptoms: RR was 30.2% for the total population (95% CI: 27.3–33.1), and it was significant in each age group on lag0 and lag1. The effect of extreme temperature was not significant on respiratory symptoms.
Conclusion: The relationship between daily temperature and emergency ambulance calls can be used in the prediction of the impact of heat waves in heat health warning systems.

Received: 26 October 2007
Accepted: 7 December 2007
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