摘要：Experts believe that climate change will impact human health by increasing the incidence of diseases and deaths during intense heat periods. (1) These periods can cause a range of heat-related illnesses (HRI) and exacerbate pre-existing chronic conditions. (2)
Only a few studies have estimated the incidence of heat-related health outcomes (HRHO), all among the general population. (3-8) Monthly incidence rates of emergency department presentation (EDP) for HRI reached 0.2 per 100,000 person-days in the summer months of 2007 and 2008 in North Carolina. (8) Those rates likely underestimate the true occurrence of HRI as a result of underdiagnosis (8) and do not include indirect effect of heat, namely deterioration of pre-existing conditions. Analysis of all-causes HRHO may give a more comprehensive approach to estimate the total burden of heat. (9) All-causes death, hospitalization and EDP rates varied from 2-3, 14-30 and 115-390 per 100,000 person-days respectively according to health regions in Quebec affected by heat waves in 2010 and 2012 through 2014. (3-5,7) Death rates varied according to age groups, with older adults being most at risk compared to other age groups. (3,7)
Heat vulnerability of older adults could be related to multimorbidity (i.e., co-existence of [greater than or equal to] 2 chronic conditions), polypharmacy, loss of autonomy, social isolation, altered physiological response to extreme thermal conditions or a compromised ability to sense heat and to manifest appropriate behaviour such as fluid intake. (10) A recent study showed that heat vulnerability was very common in Quebec, with 87% of older Quebecers presenting simultaneously with at least two medical, social or environmental conditions previously identified as HRHO predictors. (11)
