The value of local heatwave impact assessment: a case-crossover analysis of hospital emergency department presentations in Tasmania, Australia

Heatwaves have been identified as a threat to human health, with this impact projected torise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policyand preparedness actions. Using a case-crossover methodology, we examined the impact of heatwaveevents on hospital emergency department (ED) presentations in the two most populous regionsof Tasmania, Australia, from 2008–2016. Using conditional logistic regression, we analyzed therelationship between ED presentations and severe/extreme heatwaves for the whole population,specific demographics including age, gender and socio-economic advantage, and diagnostic conditionsthat are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05,95% CI 1.01–1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03–1.24) for children15 years and under, and by 19% (OR 1.19, 95% CI 1.04–1.36) for children 5 years and under. A lessprecise association in the same direction was found for those over 65 years. For diagnostic subgroups,non-significant increases in ED presentations were observed for asthma, diabetes, hypertension,and atrial fibrillation. These findings may assist ED surge capacity planning and public healthpreparedness and response activities for heatwave events in Tasmania, highlighting the importanceof using local research to inform local practice