Summer heat in hospitals increases deaths of respiratory patients

The risk of dying when hospitalized for a respiratory illness in summer is noticeably higher than in winter. The reason is that the lack of adequate air conditioning in many healthcare facilities is not only annoying but can also kill. The notice is launched by experts from the Barcelona Institute for Global Health (ISGlobal), a research alliance promoted by Fundación La Caixa. They have managed to certify and quantify the relationship in Spain between high ambient temperature and the mortality of patients admitted for respiratory pathologies and demonstrate the worsening of the problem with global warming caused by climate change.

The study that has validated the hypothesis of the researchers led by Hicham Achebak is the result of analyzing the details and circumstances of the deaths of patients with respiratory pathologies in the hospitals of the Community of Madrid and the province of Barcelona for fifteen years, between 2006 and 2019. The deaths were crossed with the number of daily hospitalizations for these pathologies, the temperature and humidity of each day and the rates in the air of both territories of the most harmful pollutants (nitrogen dioxide, ozone and suspended microparticles).

The first confirmation came when it was found that although the number of admissions of patients with pneumonia, chronic obstructive disease, asthma, bronchitis or other respiratory pathologies is notably higher in winter – with the highest time of the year in January and the lowest in August –, the highest mortality rates among those hospitalized are, however, recorded during the summer, between June and September. The investigation made it possible to rule out relative humidity and episodes of high pollution as factors with a significant impact on the death of hospitalized patients and, on the other hand, clearly pointed out excessive temperatures and increasingly frequent waves of heat as risk factors. heat.

Climate change has exacerbated the problem and increased fatality rates, especially among women, according to research by ISGlobal.

The researchers consider that they can attribute to the high summer temperatures the death of 16% of respiratory patients admitted to hospitals in Madrid during those fifteen years and 22% of the deaths among the same type of patients treated on the floors of the Barcelona centers. Summer death rates were especially relevant among those hospitalized for acute bronchitis, bronchiolitis, pneumonia and respiratory failure.

Aggravation of pathologies

The highest incidence of mortality in the study was detected among two of the groups of respiratory patients who were admitted, those with chronic pathologies and women. The first fact is proven by the fact that the highest death rate occurred immediately, in the first three days of exposure to excessive temperatures. The reason is that the increase in respiratory problems due to heat is due to an aggravation of already existing diseases or infections, not to first diagnoses, which would take many more days to present symptoms.

The greater vulnerability and risk of female patients is linked by ISGlobal researchers to “the physiological differences in thermoregulation” between both sexes. «Women have a higher temperature threshold above which sweating mechanisms are activated, and less sweat production than men, which translates into less heat loss through evaporation and, therefore, greater susceptibility to the effects of heat,” explains Joan Ballester, researcher and signatory of the study.

Experts consider that the fact that high temperatures in hospitals are associated with higher mortality and that the same does not occur with low temperatures is due to the fact that health centers are well prepared to combat peaks of winter cold, but not for of heat. “Unless effective adaptation measures are taken in facilities, global warming will aggravate the mortality burden of patients hospitalized for respiratory diseases during the summer period,” warns Hicham Achebak.

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