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 Over five winters in Boston, Massachusetts, researchers found that
admissions for health issues like abnormal heart rhythm and heart
attacks were 32 percent lower on the day of a major storm than on
days without snow.
But two days after a major snowfall, patients were 22 percent more
likely to be admitted to the hospital for cardiovascular disease
than on days without snow. During major storms in the study, at
least 10 inches of snow accumulated.
“One explanation for the dip in cardiovascular disease admissions on
the day of the storm could be that the individuals most susceptible
to cardiovascular events or falls tend to stay inside during the
most severe weather conditions, and therefore would not be exposed
to the health hazards posed by these conditions on the day of the
storm,” said lead study author Dr. Jennifer Bobb, of the Group
Health Research Institute in Seattle.
“It’s also possible that individuals may delay going to the hospital
during high snowfall days, especially when there is a declared snow
emergency or travel ban, leading them to come to the hospital in the
next few days instead,” Bobb, who worked on the study as a
researcher at Harvard University in Boston, said by email.
Previous research has documented the potential for people to face an
increased risk of heart attacks and other cardiac problems after
storms, often due to overexertion while shoveling show, researchers
note in the American Journal of Epidemiology.
For the current study, Bobb and colleagues wanted to see how the
odds of hospital admissions for heart problems, weather-related
issues like frostbite and injuries like falls fluctuated before,
during and after storms.
Besides looking at the timing of hospital admissions relative to
when the storms hit, researchers also looked at how heavy snowfall
versus moderate snow accumulation of just 5 to 10 inches influenced
the number of people who arrived and what ailments brought them in.
They examined data on about 433,000 adults hospitalized at the four
largest hospitals in Boston over five winter seasons from November
2010 to April 2015. Out of 906 days studied, 110 had low snowfall of
less than 5 inches, 11 had moderate snowfall and 10 had heavy
snowfall.
On heavy snowfall days, cold weather related admissions for things
like frostbite increased by more than four-fold compared with days
it didn’t snow. Admissions related to cold exposure remained higher
than average for five days after storms.
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Admissions for falls were 18 percent higher about six days following
a moderate snowfall than when it didn’t snow, the study also found.
“Increased exposure to cold, which could be due to spending time
outside shoveling snow or other activities, as well as icy and
uncleared sidewalks and roadways, seem to be likely suspects for
explaining the increase in cold-related admissions and falls
requiring admission,” Bobb said.
Limitations of the study include the reliance on data from a single
location in Boston to assess the amount of snowfall, which can vary
across the city, the authors note. The study also didn’t examine
other outcomes that might be influenced by winter weather, such as
emergency department admissions or clinic visits.
Still, the spike in cardiac admissions two days after major storms
makes sense because it can take the body a couple of days to react
to the cold, said Dr. Yihai Cao, a researcher at the Karolinska
Institute in Stockholm, Sweden, who wasn’t involved in the study.
Metabolic changes can start happening when the body is exposed to
cold that can exacerbate cardiovascular disease, Cao said.
“As for a dip of cardiovascular disease on snowstorm days, I think
that this is due to inconvenience of traffic situation,” Cao added
by email. “Patients would bear their symptoms at home on those days
and there is no clear scientific rationale.”
SOURCE: http://bit.ly/2ka16Ja American Journal of Epidemiology,
online January 30, 2017.
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