Thermal Conditions and Hospital Admissions: Analysis of Longitudinal Data from Cyprus (2009-2018)

The state of the thermal environment can affect human health and well-being. Heat stress is associated with a wide range of health outcomes increasing morbidity and mortality and is recognized as an important health risk posed by climate change. This study aims at examining the effect of thermal conditions on the daily number of hospital admissions in Cyprus. Data from eight public hospitals located in five districts of Cyprus were analyzed from 2009 to 2018. Meteorological hourly gridded data were extracted by the ERA-5 Land reanalysis database with a spatial horizontal resolution of 0.1 degrees x 0.1 degrees. The Physiologically Equivalent Temperature (PET) and the Universal Thermal Climate Index (UTCI) were calculated as measures of the integrated effect of meteorological variables. Negative binomial regression was fitted to examine associations between the daily number of hospital admissions and meteorological variables, PET, and UTCI. The results showed that the mean daily temperature (Tair) was positively associated with hospital admissions from any cause. Hospital admissions increased by 0.6% (p < 0.001) for each 1 degrees C increase of Tair and by 0.4% (p < 0.001) for each 1 degrees C increase of PET and UTCI. Ozone and nitrogen oxides act as confounding factors. An effect of particulate matter (less than 10 mu m in diameter) was observed when the analysis focused on April to August. Thresholds above which hospital admissions are likely to increase include daily mean Tair = 26.1 degrees C, PET = 29 degrees C, and UTCI = 26 degrees C. Studies on heat-related health effects are necessary to monitor health patterns, raise awareness, and design adaptation and mitigation measures.