Association of heat exposure and emergency ambulance calls: A multi-city study

Evidence of the impact ambient temperatures on emergency ambulance calls (EACs) in developing countries contributes to improvement and complete understanding acute health effects temperatures. This study aimed examine impacts burden heat EACs China, quantify contributions regional modifiers, identify vulnerable populations. A semi-parametric generalized additive model with a Poisson distribution was used analyze city-specific daily maximum temperature (Tmax) June–August 2014–2017. Stratified analyses by sex age were performed sub-populations. Meta-analysis undertaken illustrate pooled associations. Further subgroup analysis, stratified climate, latitude, per capita disposable income (PCDI), meta-regression analysis conducted explore heterogeneity possible modifiers. The city- region-specific attributable fractions calculated. Strong associations observed between Tmax total all cities. 11.7% (95% confidence interval (CI): 11.2%–12.3%) attributed high ten Chinese cities, central region low level PCDI had highest fraction 17.8% CI: 17.2%–18.4%). People living lower PCDI, those aged 18–44 0–6 years more than others. combined temperature, latitude contributed 88.6% heterogeneity. results complemented quantitative contribution