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Indoor Air. 2016 Aug;26(4):594-604. doi: 10.1111/ina.12227. Epub 2015 Jul 8.

Summer indoor heat exposure and respiratory and cardiovascular distress calls in New York City, NY, U.S.

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Department of Geography and Program in Public Health, Florida State University, Tallahassee, FL, USA.
Program in Public Health, Florida State University, Tallahassee, FL, USA.
Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City, IA, USA.
Office of Medical Affairs, Fire Department of New York, Brooklyn, NY, USA.
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
Emergency Medicine, Frisbie Memorial Hospital, Rochester, NH, USA.


Most extreme heat studies relate outdoor weather conditions to human morbidity and mortality. In developed nations, individuals spend ~90% of their time indoors. This pilot study investigated the indoor environments of people receiving emergency medical care in New York City, NY, U.S., from July to August 2013. The first objective was to determine the relative influence of outdoor conditions as well as patient characteristics and neighborhood sociodemographics on indoor temperature and specific humidity (N = 764). The second objective was to determine whether cardiovascular or respiratory cases experience hotter and more humid indoor conditions as compared to controls. Paramedics carried portable sensors into buildings where patients received care to passively monitor indoor temperature and humidity. The case-control study compared 338 respiratory cases, 291 cardiovascular cases, and 471 controls. Intuitively, warmer and sunnier outdoor conditions increased indoor temperatures. Older patients who received emergency care tended to occupy warmer buildings. Indoor-specific humidity levels quickly adjusted to outdoor conditions. Indoor heat and humidity exposure above a 26 °C threshold increased (OR: 1.63, 95% CI: 0.98-2.68, P = 0.056), but not significantly, the proportion of respiratory cases. Indoor heat exposures were similar between cardiovascular cases and controls.


Case-control study; Emergency medical service; Extreme heat; Humidity; Indoor; Temperature

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