Neonates in Ahmedabad, India, during the 2010 Heat Wave: A Climate Change Adaptation Study

Health effects from climate change are an international concern with urban areas at particular risk due to urban heat island effects. The burden of disease on vulnerable populations in non-climate-controlled settings has not been well studied. This study compared neonatal morbidity in a non-air-conditioned hospital during the 2010 heat wave in Ahmedabad to morbidity in the prior and subsequent years. The outcome of interest was neonatal intensive care unit (NICU) admissions for heat. During the months of April, May, and June of 2010, 24 NICU admissions were for heat versus 8 and 4 in 2009 and 2011, respectively. Both the effect of moving the maternity ward and the effect of high temperatures were statistically significant, controlling for each other. Above 42 degrees Celsius, each daily maximum temperature increase of a degree was associated with 43% increase in heat-related admissions (95% CI 9.2–88%). Lower floor location of the maternity ward within hospital which occurred after the 2010 heat wave showed a protective effect. These findings demonstrate the importance of simple surveillance measures in motivating a hospital policy change for climate change adaptation—here relocating one ward—and the potential increasing health burden of heat in non-climate-controlled institutions on vulnerable populations. 1. Introduction/Background Climate change is a growing international concern with current and future global effects. The Intergovernmental Panel on Climate Change (IPCC) reports unequivocal evidence for the warming of climate systems with a global mean temperature rising 0.74°C between 1906 and 2005, and the 11 years 1995–2006 have been reported as being among the 12 warmest years since 1850 [1]. These rising temperatures are especially disconcerting for urban areas. Specifically, in urban areas the warming from climate change increases the risk of heat waves by compounding the existing problem of urban heat islands—a result of urban areas being hotter than surrounding rural areas due to more impervious and heat absorbing surfaces that retain and subsequently reradiate incident solar radiation, less vegetation, and more local heat production [2, 3]. As such, climate change affecting these areas will have far-reaching consequences, as the proportion of the global population living in urban areas increases. For example, the urban proportion of the global population increased from 30% in the 1950s to over 50% in the early 2000s and, by the year 2030, 60% of the world’s population is expected to live in cities, according to the United Nations (2001)