Association between compound extreme weather event types and the spectrum of emergency ambulance calls: A metropolitan study in Shenzhen.

ABSTRACT

BACKGROUND: Compound extreme weather events, a combination of weather and climate drivers that lead to potentially high-impact events, are becoming more frequent with climate change. The number of emergency ambulance calls (EACs) is expected to increase during compound extreme weather events. However, the extent of these increases and the trends over time have not been fully assessed. METHODS: We obtained 242,165 EAC records for Shenzhen from January 1, 2020, to June 30, 2023. A compound extreme weather event was defined as the occurrence of at least two extreme weather events on the same day. A distributed lag non-linear model was used to explore the exposure-response and lag-response relationships between various compound extreme weather events and all-cause and specific-cause EACs. FINDING: Compound Cold & Strong Monsoon events had more significant impacts on EACs for all causes and endocrine diseases, with the cumulative relative risk (CRR) of 1.401 (95% confidence interval (CI)1.290-1.522) and 1.641 (95% CI1.279-2.105). Compound Heat Wave & Lightning events had more obvious impacts on digestive disease and endocrine disease EACs, with the CRRs of 1.185 (95% CI1.041-1.348) and 1.278 (95% CI0.954-1.711), respectively. Compound Rainstorm & Lightning & Heat Wave events also led to increased RRs of EACs for all causes (CRR 1.168, 95% CI1.012-1.348), cardiovascular diseases (CRR 1.221, 95% CI0.917-1.624), digestive diseases (CRR 1.395, 95% CI1.130-1.721), and endocrine diseases (CRR 1.972, 95% CI1.235-3.149). There was no increased RR in the compound Rainstorm & Lightning events for all types of EACs. INTERPRETATION: Our study explored the relationship between EACs and compound extreme weather events, suggesting that compound extreme weather events are associated with the acute onset of cardiovascular diseases, digestive diseases, and endocrine diseases, increasing the burden on emergency ambulance resources for both all causes and specific diseases mentioned above.