Influence of Heat Waves on Daily Hospital Visits for Mental Illness in Jinan, ChinaA Case-Crossover Study

Background: Given that more frequent and intensive extreme heat events have been projected based on climate change modeling, it is of significance to have a better understanding of the association between heat waves and mental illnesses. This study aimed to explore the effects of heat waves on daily hospital visits for mental illness in the summer of 2010 in Jinan, China. Methods: A symmetric bidirectional case-crossover study was firstly conducted to determine the relationship between daily hospital visits for mental illness and heat waves in Jinan in 2010. Multifactor logistic regression analysis was then used to analyze the influencing factors for daily hospital visits for mental illness during the heat wave periods. Results: Multivariable analysis showed that the heat wave events were associated with an increased risk of mental illness. The largest odds ratios (ORs) of the heat waves for daily hospital visits for mental illness were 2.231 (95% confidence interval (CI): 1.436-3.466) at a 3-day lag, 2.836 (95% CI: 1.776-4.525) at a 2-day lag, 3.178 (95% CI: 1.995-5.064) at a 3-day lag, and 2.988 (95% CI: 2.158-4.140) at a 2-day lag for the first, second, third, and fourth heat waves, respectively. The elderly, urban residents, outdoor workers, and singles may be high-risk populations for developing heat wave-related mental illness. Conclusions: Our study has supported that there is a positive association between heat waves and hospital visits for mental illness in the study site. Age, home address, occupation, and marital status were associated with daily hospital visits for mental illness during the heat wave periods.