Secondary Logo

Journal Logo

Abstracts of the 2019 Annual Conference of the International Society for Environmental Epidemiology, August 25-28 2019, Utrecht, the Netherlands

A case-crossover analysis of indoor heat exposure on mortality and hospitalizations among the elderly in Houston, Texas

C, O’lenick1; A, Baniassadi2; R, Michael1; A, Monaghan3; J, Boehnert1; X, Yu4; M, Hayden5; C, Wiedinmyer3; K, Zhang4; D, Sailor2; Wilhelmi

Author Information
Environmental Epidemiology: October 2019 - Volume 3 - Issue - p 293
doi: 10.1097/01.EE9.0000609172.69291.2f
  • Open

TPS 664: Climate change: temperature effects 2, Exhibition Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM

Background. Despite the substantial role indoor heat exposure has played in temperature-related mortality, few epidemiological studies have examined the health effects of exposure to indoor heat. As a result, knowledge gaps regarding indoor heat-health thresholds, vulnerability, and adaptive capacity persist. Methods. We evaluate the role of indoor heat exposure on heat-related mortality and morbidity among the elderly (≥ 65 years) in Houston, Texas. Mortality and emergency hospital admission data from 2004-2013 were obtained through the Texas Department of State Health Services. Indoor heat exposure was estimated at the census block group level using building energy models, outdoor weather data, and parcel data from Houston’s tax assessor database. To assess indoor heat-health associations, we used time-stratified case-crossover models, controlling for temporal trends and meteorology, and matching on census block group of residence, year, month, and day of the adverse health event. Separate models were fitted for three indoor exposure metrics, for lag days 0–6 and for 3-day moving averages. Results. Positive, significant odds ratios (OR) were observed between circulatory and heat-related mortality and maximum indoor Discomfort Index (combined measure of temperature and humidity), suggesting an increase in the odds of death due to exposure to high indoor heat. [e.g., OR per 5°C =1.31 (95% CI: 1.10, 1.57)]. For circulatory deaths, associations were strongest when indoor heat exposure was defined using minimum indoor temperature [e.g., OR per 5°C =1.37 (95% CI: 1.03, 1.82)], suggesting that high nighttime temperatures may play a prominent role in disease processes that lead specifically to circulatory related deaths. At both the individual and neighborhood level, effect modification analyses suggest stronger associations between indoor heat exposure and health outcomes among African Americans compared to Caucasians. Conclusion. These findings underscore the importance of characterizing harmful indoor conditions and including estimates of indoor exposure in population-based health studies.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Environmental Epidemiology. All rights reserved.