Using the excess heat factor to indicate heatwave-related urinary disease: a case study in Adelaide, South Australia

Matthew Borg, Monika Nitschke, Susan Williams, Stephen McDonald, John Nairn, Peng Bi

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9 Citations (Scopus)


The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016–1.076), urolithiasis (IRR 1.106, 95% 1.046–1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258–1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048–1.133) and AKI (IRR 1.335, 95% CI 1.204–1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.

Original languageEnglish
Pages (from-to)435-447
Number of pages13
JournalInternational Journal of Biometeorology
Issue number4
Publication statusPublished or Issued - 15 Apr 2019


  • Climate change
  • Diseases of the urinary system
  • Excess heat factor
  • Heat
  • Heatwaves

ASJC Scopus subject areas

  • Ecology
  • Atmospheric Science
  • Health, Toxicology and Mutagenesis

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