Tropical cyclone exposure and risk of emergency Medicare hospital admissions for cardiorespiratory diseases in 175 United States counties, 1999-2010
Year: 2019
Type: conference-abstract
Abstract: OPS 12: Morbidity effects of high and low temperatures, Room 315, Floor 3, August 28, 2019, 10:30 AM - 12:00 PM BACKGROUND / AIMS While injury risks during tropical cyclones (TCs) have been well characterized through traditional surveillance, little is known about TCs’ non-injury morbidity impacts. The elderly might be at particularly high risks of such impacts given heightened prevalence of chronic diseases. Methods: We used Medicare claims for 1999–2010 in 180 eastern United States (US) counties to investigate how emergency cardiorespiratory hospital admissions changed during TC exposures. As a primary exposure metric, we classified counties as exposed to TCs when storm-associated maximum sustained winds were ≥ 21 m/s at the county center. We also explored several secondary exposure metrics including using other wind thresholds or storm hazards (rain, floods, tornadoes). For each combination of exposure metric and disease outcome, we estimated how hospitalization risks evolved from two days before to seven days after the storm’s closest approach to the county using distributed lag generalized linear mixed models. Results: For 1999–2010, 74 TCs passed within 250 kilometers of eastern counties, and 175 study counties had at least one storm exposure. Cardiovascular hospitalizations decreased on the day of storm’s closest approach, followed by a significant increase on following days. Respiratory hospitalizations increased immediately and were even higher on the two days following the storm. From two days before to seven days after the storm, cardiovascular hospitalizations increased 3% (95% confidence interval [CI]: 2, 5%) and respiratory hospitalizations increased 16% (CI: 13, 20%) compared to matched unexposed periods. Risks varied across storm exposures, with evidence that risks were higher during more severe wind exposures. Conclusions: These findings add two important insights on TCs’ health impacts among the elderly: first, emergency hospital admissions due to non-injury morbidity (cardiovascular and respiratory diseases) increase significantly during TC exposures; and second, intense wind exposures may be particularly important in identifying TC exposures with high-risk for these outcomes.
Source: Environmental Epidemiology
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $1,200
OpenAlex ID: W2981376188