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RESEARCH ARTICLE (Open Access)
Contents Vol 33(4)

Heat illness presentations to emergency departments in Western Sydney: surveillance for environmental, personal and behavioural risk factors

Stephen Conaty A * , Sayontonee Ghosh A , Khizar Ashraf A , Karin Taylor A , George Truman B , Helen Noonan C , Mithilesh Dronavalli A and Bin Jalaludin D E
+ Author Affiliations
- Author Affiliations

A Public Health Unit, South Western Sydney Local Health District, Liverpool, NSW, Australia

B Public Health Unit, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia

C Public Health Unit, Western Sydney Local Health District, Parramatta, NSW, Australia

D School of Population Health, UNSW Sydney, Australia

E Population Health Intelligence, South Western Sydney Local Health District, Liverpool, NSW, Australia

* Correspondence to: stephen.conaty@health.nsw.gov.au

Public Health Research and Practice 33, e3342331 https://doi.org/10.17061/phrp3342331
Published: 6 December 2023

2023 © Conaty et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

Abstract

Objective:To pilot surveillance to describe environmental, personal and behavioural risk factors for people presenting to hospital emergency departments (EDs) with heat illness. Methods: We conducted a retrospective case series and telephone interview study of people presenting to EDs across South Western Sydney, Western Sydney and Nepean Blue Mountains Local Health Districts with heat illness over the 2017/18 and 2018/19 summer periods (1 December to 28 February). We used the Public Health Rapid Emergency Disease Syndromic Surveillance (PHREDSS) ‘heat problems’ syndrome to identify people with heat illness and medical records to find contact details. We developed a detailed questionnaire instrument to guide the telephone interview. Results: A total of 129 individuals presented with ‘heat problems’ (57 in 2017/18 and 72 in 2018/19). The median age was 44 years (range 1–89 years). Most attended hospitals via the NSW Ambulance Service (58%) or private car (40%). Of the total, 53% were classified as triage category 3 (potentially life-threatening), 27% as category 4 (potentially serious) and 16% as category 2 (imminently life-threatening). The main supplementary codes were heat exhaustion (35%), heat syncope (39%), and heat stroke (30%). The majority were discharged from the emergency department after completing treatment (73%), with 21% requiring admission. A total of 38 follow-up interviews were completed (29% response rate). Almost all individuals were exposed to heat outside their home environment: 11 (29%) were engaged in paid work, 5 (13%) in outdoor housework, and 10 (26%) in outdoor recreational activities. Conclusion: Our pilot surveillance study successfully collected home, local environment and behavioural risk factors on a small cohort presenting with ‘heat problems’ to EDs in Western Sydney during the summer months. Most were exposed to heat outdoors while engaged in work or recreation outside the home, and were preventable.