Neonates in Ahmedabad, India during the 2010 heatwave

Climate change is a growing international concern due to existing and potential human health effects. Urban areas are at particular risk of increased heat due to urban heat island effects. In 2010, Ahmedabad – the fastest growing city in India - experienced a record-setting heat wave with temperatures as high as 46.8°C. The potential burden of disease on vulnerable populations in non-climate controlled buildings such as hospitals has not been the subject of much published research. During an early 2011 workshop on heatwaves, a local pediatrician presented preliminary data using just 2010 data. As a result, the wellborn nursery from the top and hottest floor of the hospital was relocated to a lower and cooler floor. This study compared neonatal morbidity in a non-climate controlled hospital during the 2010 heatwave in Ahmedabad to the prior and subsequent (post-intervention) years. The months of April, May, and June were used as the period of interest for all three years. The outcome was neonatal intensive care unit admissions for heat, as a diagnosis of exclusion. During the months of April, May, and June, 11.2% of all NICU admissions were for heat versus 3.7% and 2.2% in 2009 and 2011 respectively. When considering only babies transferred from the same hospital's well-born nursery, the proportion was 2.5% in the 2010 period versus 0.6% and 0.2% in 2009 and 2011 respectively. Methods of exploring the variation between years of temperature effect size on NICU admissions are currently being explored. This preliminary data demonstrates the importance of simple surveillance measures in motivating a hospital policy change for climate change adaptation – here relocating one ward – and the potential, as yet little studied, increasing health burden of heat in non-climate controlled institutions on vulnerable populations.