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. 2022 Nov 24;19(23):15592.
doi: 10.3390/ijerph192315592.

Emergency Department Visits and Summer Temperatures in Bologna, Northern Italy, 2010-2019: A Case-Crossover Study and Geographically Weighted Regression Methods

Francesco Guolo  1   2 , Elisa Stivanello  1 , Lorenzo Pizzi  3 , Teodoro Georgiadis  4 , Letizia Cremonini  4 , Muriel Assunta Musti  1 , Marianna Nardino  4 , Filippo Ferretti  1 , Paolo Marzaroli  1 , Vincenza Perlangeli  1 , Paolo Pandolfi  1 , Rossella Miglio  2
Affiliations

Emergency Department Visits and Summer Temperatures in Bologna, Northern Italy, 2010-2019: A Case-Crossover Study and Geographically Weighted Regression Methods

Francesco Guolo et al. Int J Environ Res Public Health. .

Abstract

The aim of the study is to evaluate the association between summer temperatures and emergency department visits (EDVs) in Bologna (Italy) and assess whether this association varies across areas with different socioeconomic and microclimatic characteristics. We included all EDVs within Bologna residences during the summers of 2010-2019. Each subject is attributed a deprivation and a microclimatic discomfort index according to the residence. A time-stratified case-crossover design was conducted to estimate the risk of EDV associated with temperature and the effect modification of deprivation and microclimatic characteristics. In addition, a spatial analysis of data aggregated at the census block level was conducted by applying a Poisson and a geographically weighted Poisson regression model. For each unit increase in temperature above 26 °C, the risk of EDV increases by 0.4% (95%CI: 0.05-0.8). The temperature-EDV relationship is not modified by the microclimatic discomfort index but rather by the deprivation index. The spatial analysis shows that the EDV rate increases with deprivation homogeneously, while it diminishes with increases in median income and microclimatic discomfort, with differences across areas. In conclusion, in Bologna, the EDV risk associated with high temperatures is not very relevant overall, but it tends to increase in areas with a low socioeconomic level.

Keywords: case-crossover; emergency department visits; geographically weighted regression; high temperature; microclimate classification.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Map of the distribution of the microclimatic discomfort index from Nardino et al. modified [13], Bologna.
Figure 2
Figure 2
Map of the distribution of the deprivation index, Bologna.
Figure 3
Figure 3
Map of the distribution of the EDV rate ×100, Bologna. The map does not include the block with a rate of 171.4%, because it was derived from a tiny population (n = 7).
Figure 4
Figure 4
Map of the distribution of the local parameter estimates of GWR: coefficients for median income, Bologna.
Figure 5
Figure 5
Map of the distribution of the local parameter estimates of GWR: coefficients for microclimatic discomfort index, Bologna.
See this image and copyright information in PMC

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