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Skladman R, Tadisina KK, Bettlach CR, Currie KB, Tanaka SA, Mackinnon SE, Fox IK, Sacks JM, Pet MA. The Yearly Periodicity of Operative Upper Extremity Trauma: A Retrospective Study of "Trauma Season". Plast Reconstr Surg 2024; 153:101e-111e. [PMID: 37189241 DOI: 10.1097/prs.0000000000010689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Upper extremity (UE) trauma requiring operative care increases during the summer and fall months, which the authors colloquially refer to as "trauma season." METHODS CPT databases were queried for codes related to acute UE trauma at a single level-1 trauma center. Monthly CPT code volume was tabulated for 120 consecutive months and average monthly volume was calculated. Raw data were plotted as a time series and transformed as a ratio to the moving average. Autocorrelation was applied to the transformed data set to detect yearly periodicity. Multivariable modeling quantified the proportion of volume variability attributable to yearly periodicity. Subanalysis assessed presence and strength of periodicity in four age groups. RESULTS A total of 11,084 CPT codes were included. Monthly trauma-related CPT volume was highest in July through October and lowest in December through February. Time-series analysis revealed yearly oscillation in addition to a growth trend. Autocorrelation revealed statistically significant positive and negative peaks at a lag of 12 and 6 months, respectively, confirming yearly periodicity. Multivariable modeling revealed R 2 attributable to periodicity of 0.53 ( P < 0.01). Periodicity was strongest in younger populations and weaker in older populations. R 2 was 0.44 for ages 0 to 17, 0.35 for ages 18 to 44, 0.26 for ages 45 to 64, and 0.11 for ages 65 and older. CONCLUSIONS Operative UE trauma volumes peak in the summer and early fall and reach a winter nadir. Periodicity accounts for 53% of trauma volume variability. The authors' findings have implications for allocation of operative block time and personnel and expectation management over the course of the year.
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Affiliation(s)
- Rachel Skladman
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Kashyap K Tadisina
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Carrie R Bettlach
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Kelly B Currie
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Shoichiro A Tanaka
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Susan E Mackinnon
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Ida K Fox
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Justin M Sacks
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
| | - Mitchell A Pet
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University
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Xu Z, Watzek JT, Phung D, Oberai M, Rutherford S, Bach AJE. Heat, heatwaves, and ambulance service use: a systematic review and meta-analysis of epidemiological evidence. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1523-1542. [PMID: 37495745 PMCID: PMC10457246 DOI: 10.1007/s00484-023-02525-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/01/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
Ambulance data has been reported to be a sensitive indicator of health service use during hot days, but there is no comprehensive summary of the quantitative association between heat and ambulance dispatches. We conducted a systematic review and meta-analysis to retrieve and synthesise evidence published up to 31 August 2022 about the association between heat, prolonged heat (i.e. heatwaves), and the risk of ambulance dispatches. We initially identified 3628 peer-reviewed papers and included 48 papers which satisfied the inclusion criteria. The meta-analyses showed that, for each 5 °C increase in mean temperature, the risk of ambulance dispatches for all causes and for cardiovascular diseases increased by 7% (95% confidence interval (CI): 5%, 10%) and 2% (95% CI: 1%, 3%), respectively, but not for respiratory diseases. The risk of ambulance dispatches increased by 6% (95% CI: 4%, 7%), 7% (95% CI: 5%, 9%), and 18% (95% CI: 12%, 23%) under low-intensity, severe, and extreme heatwaves, respectively. We observed two potential sources of bias in the existing literature: (1) bias in temperature exposure measurement; and (2) bias in the ascertainment of ambulance dispatch causes. This review suggests that heat exposure is associated with an increased risk of ambulance dispatches, and there is a dose-response relationship between heatwave intensity and the risk of ambulance dispatches. For future studies assessing the heat-ambulance association, we recommend that (1) using data on spatially refined gridded temperature that is either very well interpolated or derived from satellite imaging may be an alternative to reduce exposure measurement bias; and (2) linking ambulance data with hospital admission data can be useful to improve health outcome classification.
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Affiliation(s)
- Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
| | - Jessica T Watzek
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Mehak Oberai
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
- Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Aaron J E Bach
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
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Skladman R, Tadisina KK, Chi J, Nguyen DC, Patel K, Pet MA. Facial Trauma Operative Volume Demonstrates Consistent and Significant Yearly Periodicity. J Oral Maxillofac Surg 2022; 81:424-433. [PMID: 36587931 DOI: 10.1016/j.joms.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE Facial trauma requiring operative care increases during the summer and fall months, which is colloquially referred to as trauma season. The purpose of this study is to determine if there is a quantifiable and statistically significant yearly periodicity of operative facial trauma volume. MATERIALS AND METHODS To confirm the existence and quantify the magnitude of trauma season, we conducted a retrospective cohort study. The Plastic Surgery divisional billing database was queried for Current Procedural Terminology (CPT) codes related to acute facial trauma. The outcome variable is monthly CPT code volume and calendar month is the predictor. Monthly CPT volume was tabulated for 120 consecutive months. Raw data were plotted as a time series and transformed as a ratio to the moving average. Autocorrelation was applied to the transformed dataset to detect yearly periodicity. Multivariable modeling quantified the proportion of volume variability (R2) attributable to yearly periodicity. Subanalysis assessed presence and strength of periodicity in 4 age groups. Patient identifiers, demographic information, surgeon, and date of surgery were collected as covariates. RESULTS One thousand six hundred fifty eight CPT codes obtained through Plastic Surgery billing records were included. Mean age at presentation was 32.5 ± 16.3 years (range = 85.05). Monthly trauma-related CPT volume was highest in June-September and lowest in December-February. Time series analysis revealed yearly oscillation, in addition to a growth trend. Autocorrelation revealed statistically significant positive and negative peaks at a lag of 12 and 6 months, respectively, confirming the presence of yearly periodicity. Multivariable linear modeling revealed R2 attributable to periodicity of 0.23 (P = .008). Periodicity was strongest in younger populations and weaker in older populations. R2 = 0.25 for ages 0-17, R2 = 0.18 for ages 18-44, R2 = 0.16 for ages 45-64, and R2 = 0.034 for ages ≥ 65. CONCLUSION Operative facial trauma volumes peak in the summer and early fall and reach a winter nadir. This periodicity is statistically significant and accounts for 23% of overall trauma volume variability at our Level 1 trauma hospital. Younger patients drive the majority of this effect. Our findings have implications for operative block time and personnel allocation, in addition to expectation management over the course of the year.
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Affiliation(s)
- Rachel Skladman
- Post-Doctoral Research Fellow, Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, MO
| | - Kashyap K Tadisina
- Fellow, Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, MO
| | - John Chi
- Associate Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Washington University, St. Louis, MO
| | - Dennis C Nguyen
- Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, MO
| | - Kamlesh Patel
- Associate Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, MO
| | - Mitchell A Pet
- Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, MO.
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Tobías A, Casals M, Saez M, Kamada M, Kim Y. Impacts of ambient temperature and seasonal changes on sports injuries in Madrid, Spain: a time-series regression analysis. BMJ Open Sport Exerc Med 2021; 7:e001205. [PMID: 34917395 PMCID: PMC8638454 DOI: 10.1136/bmjsem-2021-001205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 11/08/2022] Open
Abstract
Objectives Recreational physical activity is an integral part of our society, and the injuries caused by sports activities are a concern for public health. We studied the effect of outdoor ambient temperature on hospital emergency department visits caused by sports injuries in Madrid, Spain, and accounted for its seasonal changes. Methods We used a time-series design. Data was analysed with quasi-Poisson regression models. We calculated the proportion of emergency visits attributable to seasonal changes before and after adjusting for daily ambient temperature. We modelled the association between emergency visits and temperature using distributed lag non-linear models. Results The proportion of emergency visits attributable to seasonal changes was 24.1% and decreased to 7.6% after adjusting for temperature. We found a high risk of emergency visits associated with cold and hot temperatures, whereas the risk was higher for heat. Conclusion Sports and recreational physical activity injuries are not rare events; therefore, appropriate healthcare decisions should consider the impact of outdoor ambient temperature and seasonal changes.
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Affiliation(s)
- Aurelio Tobías
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Catalunya, Spain.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Martí Casals
- Sport and Physical Activity Studies Centre, Faculty of Medicine, Universitat de Vic - Universitat Central de Catalunya, Vic, Catalunya, Spain.,Physical Activity and Sport, Institut Nacional d'Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health, University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Masamitsu Kamada
- Department of Health Education and Health Sociology, The University of Tokyo, Bunkyo-ku, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, The University of Tokyo, Bunkyo-ku, Japan
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Chae SM, Kim D. Research Trends in Agenda-setting for Climate Change Adaptation Policy in the Public Health Sector in Korea. J Prev Med Public Health 2020; 53:3-14. [PMID: 32023669 PMCID: PMC7002993 DOI: 10.3961/jpmph.19.326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/10/2020] [Indexed: 11/18/2022] Open
Abstract
Many studies have been conducted to assess the health effects of climate change in Korea. However, there has been a lack of consideration regarding how the results of these studies can be applied to relevant policies. The current study aims to examine research trends at the agenda-setting stage and to review future ways in which health-related adaptation to climate change can be addressed within national public health policy. A systematic review of previous studies of the health effects of climate change in Korea was conducted. Many studies have evaluated the effect of ambient temperature on health. A large number of studies have examined the effects on deaths and cardio-cerebrovascular diseases, but a limitation of these studies is that it is difficult to apply their findings to climate change adaptation policy in the health sector. Many infectious disease studies were also identified, but these mainly focused on malaria. Regarding climate change-related factors other than ambient temperature, studies of the health effects of these factors (with the exception of air pollution) are limited. In Korea, it can be concluded that studies conducted as part of the agenda-setting stage are insufficient, both because studies on the health effects of climate change have not ventured beyond defining the problem and because health adaptation to climate change has not been set as an important agenda item. In the future, the sharing and development of relevant databases is necessary. In addition, the priority of agenda items should be determined as part of a government initiative.
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Affiliation(s)
- Su-Mi Chae
- Center for Research on Future Disease Response, Korea Institute for Health and Social Affairs, Sejong, Korea
| | - Daeeun Kim
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Wong HT, Lin JJ. The effects of weather on daily emergency ambulance service demand in Taipei: a comparison with Hong Kong. THEORETICAL AND APPLIED CLIMATOLOGY 2020; 141:321-330. [PMID: 32421067 PMCID: PMC7223070 DOI: 10.1007/s00704-020-03213-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 04/02/2020] [Indexed: 05/08/2023]
Abstract
Numerous studies have examined the effects of weather on emergency ambulance service (EAS) demand. Given Taipei's unique physical and social environments, empirical evidence collected from other regions may not be applicable. Collecting more information about the characteristics of vulnerable groups and the effects of weather could help the EAS managing authority in formulating cost-effective EAS policies. This study aims to look at the effects of weather on EAS demand in Taipei and to make a comparison with Hong Kong, which is also an Asian city and has a similar cultural context. The study analyzed over 370,000 EAS usage records from the Taipei City Fire Department. These records were aggregated into time series data according to patients' characteristics and then regressed on meteorological data via multivariate forward regression. The effect size differences of the variance explained by different groups of EAS users' regression models were compared. Afterward, the results of the regression analysis from Taipei were compared with those from a Hong Kong study. Elderly and critical patients in both cities showed significantly more sensitivity to weather than other patients. Further analysis showed that non-trauma cases were related to weather in Taipei. Although both cities had similar results, the Taipei study clearly showed that elderly and critical patients were more sensitive to weather than other patient subgroups. Health education programs should focus on the vulnerable groups identified in this study in order to increase their awareness and help them protect themselves before the onset of adverse weather conditions. By generating results that are directly applicable to Taipei, the formulation of inappropriate EAS policies can be prevented.
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Affiliation(s)
- Ho Ting Wong
- Institute of Health Care Management, Department of Business Management, National Sun Yat-sen University, 70 Lienhai Rd., Kaohsiung, 80424 Taiwan
| | - Jen-Jia Lin
- Department of Geography, National Taiwan University, Taipei City, Taiwan
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7
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Is it ever too hot for orthopaedic trauma? CURRENT ORTHOPAEDIC PRACTICE 2018. [DOI: 10.1097/bco.0000000000000576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Abstract
Heat stress increases human morbidity and mortality compared to normothermic conditions. Many occupations, disease states, as well as stages of life are especially vulnerable to the stress imposed on the cardiovascular system during exposure to hot ambient conditions. This review focuses on the cardiovascular responses to heat stress that are necessary for heat dissipation. To accomplish this regulatory feat requires complex autonomic nervous system control of the heart and various vascular beds. For example, during heat stress cardiac output increases up to twofold, by increases in heart rate and an active maintenance of stroke volume via increases in inotropy in the presence of decreases in cardiac preload. Baroreflexes retain the ability to regulate blood pressure in many, but not all, heat stress conditions. Central hypovolemia is another cardiovascular challenge brought about by heat stress, which if added to a subsequent central volumetric stress, such as hemorrhage, can be problematic and potentially dangerous, as syncope and cardiovascular collapse may ensue. These combined stresses can compromise blood flow and oxygenation to important tissues such as the brain. It is notable that this compromised condition can occur at cardiac outputs that are adequate during normothermic conditions but are inadequate in heat because of the increased systemic vascular conductance associated with cutaneous vasodilation. Understanding the mechanisms within this complex regulatory system will allow for the development of treatment recommendations and countermeasures to reduce risks during the ever-increasing frequency of severe heat events that are predicted to occur.
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Affiliation(s)
- Craig G Crandall
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center, Dallas, Texas Marian University College of Osteopathic Medicine, Indianapolis, Indiana
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Lee WK, Lee HA, Hwang SS, Kim H, Lim YH, Hong YC, Ha EH, Park H. Does Temperature Modify the Effects of Rain and Snow Precipitation on Road Traffic Injuries? J Epidemiol 2015; 25:544-52. [PMID: 26073021 PMCID: PMC4517993 DOI: 10.2188/jea.je20140244] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There are few data on the interaction between temperature and snow and rain precipitation, although they could interact in their effects on road traffic injuries. METHODS The integrated database of the Korea Road Traffic Authority was used to calculate the daily frequency of road traffic injuries in Seoul. Weather data included rain and snow precipitation, temperature, pressure, and fog from May 2007 to December 2011. Precipitation of rain and snow were divided into nine and six temperature range categories, respectively. The interactive effects of temperature and rain and snow precipitation on road traffic injuries were analyzed using a generalized additive model with a Poisson distribution. RESULTS The risk of road traffic injuries during snow increased when the temperature was below freezing. Road traffic injuries increased by 6.6% when it was snowing and above 0 °C, whereas they increased by 15% when it was snowing and at or below 0 °C. In terms of heavy rain precipitation, moderate temperatures were related to an increased prevalence of injuries. When the temperature was 0-20 °C, we found a 12% increase in road traffic injuries, whereas it increased by 8.5% and 6.8% when it was <0 °C and >20 °C, respectively. The interactive effect was consistent across the traffic accident subtypes. CONCLUSIONS The effect of adverse weather conditions on road traffic injuries differed depending on the temperature. More road traffic injuries were related to rain precipitation when the temperature was moderate and to snow when it was below freezing.
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Affiliation(s)
- Won-Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine
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10
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Schlader ZJ, Gagnon D, Adams A, Rivas E, Cullum CM, Crandall CG. Cognitive and perceptual responses during passive heat stress in younger and older adults. Am J Physiol Regul Integr Comp Physiol 2015; 308:R847-54. [PMID: 25786484 PMCID: PMC4436980 DOI: 10.1152/ajpregu.00010.2015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/15/2015] [Indexed: 12/22/2022]
Abstract
We tested the hypothesis that attention, memory, and executive function are impaired to a greater extent in passively heat-stressed older adults than in passively heat-stressed younger adults. In a randomized, crossover design, 15 older (age: 69 ± 5 yr) and 14 younger (age: 30 ± 4 yr) healthy subjects underwent passive heat stress and time control trials. Cognitive tests (outcomes: accuracy and reaction time) from the CANTAB battery evaluated attention [rapid visual processing (RVP), choice reaction time (CRT)], memory [spatial span (SSP), pattern recognition memory (PRM)], and executive function [one touch stockings of Cambridge (OTS)]. Testing was undertaken on two occasions during each trial, at baseline and after internal temperature had increased by 1.0 ± 0.2°C or after a time control period. For tests that measured attention, reaction time during RVP and CRT was slower (P ≤ 0.01) in the older group. During heat stress, RVP reaction time improved (P < 0.01) in both groups. Heat stress had no effect (P ≥ 0.09) on RVP or CRT accuracy in either group. For tests that measured memory, accuracy on SSP and PRM was lower (P < 0.01) in the older group, but there was no effect of heat stress (P ≥ 0.14). For tests that measured executive function, overall, accuracy on OTS was lower, and reaction time was slower in the older group (P ≤ 0.05). Reaction time generally improved during heat stress, but there was no effect of heat stress on accuracy in either group. These data indicate that moderate increases in body temperature during passive heat stress do not differentially compromise cognitive function in younger and older adults.
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Affiliation(s)
- Zachary J Schlader
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Daniel Gagnon
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Amy Adams
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Eric Rivas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Kinesiology, Texas Woman's University, Denton, Texas; and
| | - C Munro Cullum
- Departments of Psychiatry and Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Craig G Crandall
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas;
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11
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Ali AM, Willett K. What is the effect of the weather on trauma workload? A systematic review of the literature. Injury 2015; 46:945-53. [PMID: 25816705 DOI: 10.1016/j.injury.2015.03.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 03/03/2015] [Accepted: 03/06/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hospital admission rates for a number of conditions have been linked to variations in the weather. It is well established that trauma workload displays significant seasonal variation. A reliable predictive model might enable targeting of high-risk groups for intervention and planning of hospital staff levels. To our knowledge there have been no systematic reviews of the literature on the relationship between weather and trauma workload, and predictive models have thus far been informed by the results of single studies. METHODS We conducted a systematic review of bibliographic databases and reference lists up to June 2014 to identify primary research papers assessing the effect of specified weather conditions including temperature, rainfall, snow, fog, hail, humidity and wind speed on trauma workload, defined as admission to hospital, fracture or a Road Traffic Accident (RTA) resulting in a seriously injured casualty or fatality. RESULTS 11,083 papers were found through electronic and reference search. 83 full papers were assessed for eligibility. 28 met inclusion criteria and were included in the final review; 6 of these related to the effect of the weather on trauma admissions, one to ambulance call out for trauma, 13 to fracture rate and 8 to RTAs. Increased temperature is positively correlated with trauma admissions. The rate of distal radius fractures is more sensitive to adverse weather than the rate of hip fractures. Paediatric trauma, both in respect of trauma admissions and fracture rate, is more sensitive to the weather than adult trauma. Adverse weather influences both RTA frequency and severity, but the nature of the relationship is dependent upon the timecourse of the weather event and the population studied. Important methodological differences between studies limit the value of the existing literature in building consensus for a generalisable predictive model. CONCLUSIONS Weather conditions may have a substantial effect on trauma workload independent of the effects of seasonal variation; the population studied and timecourse of weather events appear critical in determining this relationship. Methodological differences between studies limit the validity of conclusions drawn from analysis of the literature, and we identify a number of areas that future research might address.
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Affiliation(s)
- A M Ali
- Kadoorie Centre for Critical Care Research; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom.
| | - K Willett
- Kadoorie Centre for Critical Care Research; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom
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12
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Chen Y, Lai Y, Ke J, Chen Y, Xu Y, Ma Y, Yuan J, Liang T, Mai P, Lin C, Xie Y, Huang K. Impact of subtropical climate on frequency of ambulance use for trauma patients in a coastal area of China. Chin J Traumatol 2015; 18:141-6. [PMID: 26643239 DOI: 10.1016/j.cjtee.2015.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To explore the impact of subtropical maritime monsoon climate on the frequency of ambulance use for trauma patients in a coastal region in China. METHOD Statistical analysis of data on ambulance use from the 120 Emergency Command Center in Shantou City, Guangdong Province, from January to December 2012 as well as daily meteorological data from a Shantou observatory was performed to determine how climatic factors (seasons, time, and weather) affect the frequency of ambulance use for trauma patients. RESULTS The daily ambulance use for trauma patients differed between spring and summer or autumn (p<0.05), between sunny and rainy days (p<0.05), and between cloudy and lightly or moderately rainy days (p<0.05).We found a linear correlation between daily maximum temperature and daily ambulance use for trauma patients (R² =0.103, p<0.05). In addition, there was significant difference in ambulance use between good and bad weather (p<0.05). CONCLUSION Frequency of ambulance use for trauma patients is affected by the subtropical maritime monsoon climate in the coastal region. Better weather contributes to increased daily frequency of ambulance use, which is the highest in autumn and lowest in spring.
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Affiliation(s)
- Yuqiang Chen
- Emergency Department, the Second Affiliated Hospital of Shantou University Medical College, Guangdong 515041, China
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13
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Lee WK, Lee HA, Hwang SS, Kim H, Lim YH, Hong YC, Ha EH, Park H. A time series study on the effects of cold temperature on road traffic injuries in Seoul, Korea. ENVIRONMENTAL RESEARCH 2014; 132:290-6. [PMID: 24834824 DOI: 10.1016/j.envres.2014.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Although traffic accidents are associated with weather, the influence of temperature on injuries from traffic accidents has not been evaluated sufficiently. The objective of this study was to evaluate the effect of temperature, especially cold temperatures, on injuries from traffic accidents in Seoul, Korea. We also explored the relationship of temperature with different types of traffic accident. METHODS The daily frequencies of injuries from traffic accidents in Seoul were summarized from the integrated database established by the Korea Road Traffic Authority. Weather data included temperature, barometric pressure, rainfall, snow, and fog from May 2007 to December 2011. The qualitative relationship between daily mean temperature and injuries from traffic accidents was evaluated using a generalized additive model with Poisson distribution. Further analysis was performed using piecewise linear regression if graph the showed non-linearity with threshold. RESULTS The incidence of injuries was 216 per 100,000 person-months in Seoul. The effect of temperature on injuries from traffic accidents was minimal during spring and summer. However, injuries showed a more striking relationship with temperature in winter than in other seasons. In winter, the number of injuries increased as the temperature decreased to <0°C. The injuries increased by 2.1% per 1°C decrease under the threshold of the daily average temperature -5.7°C, which is 10-fold greater than the effect of temperature above the threshold. Some groups were more susceptible to injuries, such as young and male drivers, according to the types of traffic accident when the temperature decreased to below the freezing temperature. CONCLUSIONS The incidence of injuries increased sharply when the temperature decreased below freezing temperature in winter. Temperature can be effectively used to inform high risk of road traffic injuries, thus helping to prevent road traffic injuries.
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Affiliation(s)
- Won-Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Republic of Korea; Department of Preventive Medicine, School of Medicine, Ewha Womans University, 071, Anyangcheon-ro, Yangcheon-ku, Seoul 158-710, Republic of Korea
| | - Hye-Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, 071, Anyangcheon-ro, Yangcheon-ku, Seoul 158-710, Republic of Korea
| | - Seung-sik Hwang
- Department of Social and Preventive Medicine, Inha University School of Medicine, Republic of Korea
| | - Ho Kim
- Department of Epidemiology and Biostatistics, Seoul National University, Seoul, Republic of Korea
| | - Youn-Hee Lim
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, School of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Eun-Hee Ha
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, 071, Anyangcheon-ro, Yangcheon-ku, Seoul 158-710, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, 071, Anyangcheon-ro, Yangcheon-ku, Seoul 158-710, Republic of Korea.
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14
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Affiliation(s)
- Xavier Basagaña
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
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