BMJ Open 2:e001074 doi:10.1136/bmjopen-2012-001074
  • Occupational and environmental medicine
    • Research

Exposure to hot and cold temperatures and ambulance attendances in Brisbane, Australia: a time-series study

  1. Shilu Tong1,3
  1. 1School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
  2. 2School of Environment, Griffith University, Brisbane, Australia
  3. 3School of Public Health, Anhui Medical University Hefei, Anhui, China
  1. Correspondence to Dr Shilu Tong; s.tong{at}
  • Received 29 February 2012
  • Accepted 29 May 2012
  • Published 7 July 2012


Objectives To investigate the effect of hot and cold temperatures on ambulance attendances.

Design An ecological time-series study.

Setting and participants The study was conducted in Brisbane, Australia. The authors collected information on 783 935 daily ambulance attendances, along with data of associated meteorological variables and air pollutants, for the period of 2000–2007.

Outcome measures The total number of ambulance attendances was examined, along with those related to cardiovascular, respiratory and other non-traumatic conditions. Generalised additive models were used to assess the relationship between daily mean temperature and the number of ambulance attendances.

Results There were statistically significant relationships between mean temperature and ambulance attendances for all categories. Acute heat effects were found with a 1.17% (95% CI 0.86% to 1.48%) increase in total attendances for 1°C increase above threshold (0–1 days lag). Cold effects were delayed and longer lasting with a 1.30% (0.87% to 1.73%) increase in total attendances for a 1°C decrease below the threshold (2–15 days lag). Harvesting was observed following initial acute periods of heat effects but not for cold effects.

Conclusions This study shows that both hot and cold temperatures led to increases in ambulance attendances for different medical conditions. Our findings support the notion that ambulance attendance records are a valid and timely source of data for use in the development of local weather/health early warning systems.


  • To cite: Turner LR, Connell D, Tong S. Exposure to hot and cold temperatures and ambulance attendances in Brisbane, Australia: a time-series study. BMJ Open 2012;2:e001074. doi:10.1136/bmjopen-2012-001074

  • Contributors LRT carried out the data analysis and produced the final manuscript. ST was responsible for the design and coordination of the study, and helped with the preparation and revision of the manuscript. DC read and revised the manuscript. All authors read and approved the final manuscript.

  • Funding This research was partly funded by the Australian Research Council (DP1095752 to ST and DC). ST is supported by an NHMRC Research Fellowship (553043).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the QUT Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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