Climate, Health & Sustainable Care Seed Grant Recipient Dr. Kate Hanneman has published her funded research in Radiology.
Kate Hanneman, Omar Taboun, Anish Kirpalani, Birgit Ertl-Wagner, Julien Aguet, Scott Delaney, Rachel C. Nethery, Joseph Choi, Hayley Panet, Maura J. Brown, Heidi Schmidt, Ania Kielar, Michael Patlas
Background: Climate change adversely affects human health, resulting in higher demand for health care services. However, the impact of climate-related environmental exposures on medical imaging utilization is currently unknown.
Purpose: To determine associations of short-term exposures to ambient heat and particulate air pollution with utilization of emergency department medical imaging.
Materials and Methods: In this retrospective time-stratified case-crossover study, daily imaging utilization counts from four emergency departments were linked to local daily environmental data—including fine particulate matter with 2.5-µm or smaller aerodynamic diameter (PM2.5) and ambient temperature—over 10 years (January 2013 to December 2022). Conditional Poisson regression models were used to evaluate the associations between daily imaging utilization and environmental exposures on the same day and each of the 7 days preceding imaging, lag days 0–7, controlling for day of the week, month, and year. Moving averages of mean daily PM2.5 and temperature were calculated to account for lagged exposure effects. Imaging counts were also stratified by modality (CT, radiography, US, and MRI).Results: In an analysis of 1 666 420 emergency department imaging studies, a rise of 10 °C in the 2-day moving average of mean daily temperature and a rise of 10 μg/m3 in the 3-day moving average of mean daily PM2.5 were associated with overall imaging utilization increases of 5.1% (incidence rate ratio [IRR], 1.051; 95% CI: 1.045, 1.056) and 4.0% (IRR, 1.040; 95% CI: 1.035, 1.046), respectively. Heat exposure days (mean temperature>20 °C) and air pollution exposure days (mean PM2.5 >12 μg/m3) were associated with same-day excess absolute risk of 5.5 and 6.4 imaging studies per 1 million people at risk per day, respectively. Heat exposure days and air pollution exposure days were associated with increased utilization of radiography (excess relative risk, 2.7% [P < .001] and 2.1% [P < .001], respectively) and CT (excess relative risk, 2.0% [P = .001] and 2.7% [P < .001])but not US (P = .14 and P = .14) or MRI (P = .70 and P = .65).Conclusion: Short-term exposures to ambient heat and particulate air pollution were associated with increased utilization of radiography and CT but not US or MRI.