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Overall and Cause-Specific Mortality in Relation to Heat Illness

Robert F. Wallace, ScD, MPH1, David Kriebel, ScD2, Laura Punnett, ScD2, David H. Wegman, MD, MPH2, Richard R. Gonzalez, PhD1, and Paul J. Amoroso, MD, MPH1. (1) U.S. Army Research Institute of Environmental Medicine, 42 Kansas Street, Natick, MA 01760, 508-233-4815, robert.wallace@na.amedd.army.mil, (2) Department of Work Environment, University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854

Objectives: We investigated the potential increased risk of cause specific and total mortality among individuals hospitalized for severe heat illness at some prior time. Previous evidence suggests that severe heat illness may cause irreversible acute damage to the heart, kidney and liver, which may lead to chronic and even fatal disorders. Methods: A cohort mortality study was carried out among male and female U.S. Army personnel hospitalized for heat illness (HI) during 1971-2000. Appendicitis (APX) during the same period was used as a reference cause of hospitalization. Hospitalization records were obtained from the Total Army Injury and Health Outcomes Database (TAIHOD) for 3,971 cases of HI and 17,233 APX cases. Vital status was determined through the National Death Index (NDI); 115 HI and 585 APX cases were found to have died. Cox proportional hazards regression was used to model age-adjusted risk of death. Results: HI cases had a 40% increased rate of all-cause mortality compared to APX cases. Further examining cause-specific deaths, male cases of HI were at increased risk of death from cardiovascular disease (CVD), ischemic heart disease (IHD), and heat-related sites (CVD, liver [non-alcohol] and kidney disease deaths combined) compared to APX cases. Conclusions: These results provide preliminary evidence for increased risk of mortality among those who have experienced prior hospitalization for heat illness.

Learning Objectives:

Keywords: Environmental Health, Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Public Health in the Environment 2

The 132nd Annual Meeting (November 6-10, 2004) of APHA