NSW Emergency Department Records for Epidemiology (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.
Australian Government Bureau of Meteorology, Climate Data Online, Parramatta North Station.
Emergency department (ED) presentations for temperature-related problems are selected using the following definition:
• Unplanned ED presentations;
• To public hospitals that continuously participated in EDRE between 2007-08 and 2017-18 and that have a reasonably complete diagnosis field;
• By persons of all ages;
• Where the provisional diagnosis was assigned a temperature-related problem ICD-9, ICD-10 or SNOMED-CT code (as summarised in the Codes tab).
Data from 86 NSW public hospital EDs meet this definition and accounted for approximately 87% of all NSW ED (planned and unplanned) activity in the 2017-18 financial year. The data used to produce this report is subject to change from day to day due to data updates at the source ED
This indicator is a measure of ED presentations that are specificly temperature-related. It does not include presentations where temperature is a contributing factor but is not reflected in the provisional diagnosis. The impact of extremely hot or cold periods can also be seen in total unplanned emergency department presentations.
Given that not all emergency departments are included in the data, the number of presentations is an underestimate of the actual number in NSW. However, the trend over time in presentations does reflect the actual trend for the emergency departments included in the data.
The under-estimation differs by geographical area, which precludes analysis by Local Health District, Primary Health Network, Local Government Area and remoteness from service centres.
Data refer to all presentations to the included EDs regardless of patients' district or state of residence.
The NSW Emergency Department Records for Epidemiology (EDRE) is derived from computer databases used for managing patients in Emergency Departments (ED). It is an enhanced version of the NSW Emergency Department Data Collection (EDDC) and is accessed via SAPHaRI.
The EDDC commenced in 1994, but was organised into a formal data collection from July 1996. Only public hospital EDs participate in the EDDC. The number of participating EDs has increased over time from around 52 EDs in 1996-97 to around 184 EDs in 2016-17. The larger EDs participate in the EDDC so a substantial proportion of the NSW population is covered, but this proportion varies over time. Presentations to the 86 NSW public hospital EDs included for reporting from EDRE accounted for approximately 86% of all NSW ED activity in 2017-18.
Analyses based on ED diagnoses are useful for monitoring trends, but accuracy can vary due to the variation in computer programs used and data entry practices in each hospital. Unlike the admitted patient data collection, the EDDC does not have diagnoses formally coded by clinical coders. In EDs, the diagnoses are recorded by staff working in each emergency department. Depending on the computer program used in the hospital at a point in time, the diagnosis is recorded according to one of three classification systems – the International Classification of Disease Revision 9 (ICD-9), Revision 10 (ICD-10) or the Systematized Nomenclature of Medicine - Clinical Terminology (SNOMED-CT). ED diagnoses do not include intent or external cause codes.
Presentations are reported based on where a person presents to ED and not where a person resides, unlike the population denominator. Unplanned presentations include presentations that were not pre-arranged, with the majority classified as emergency presentations. Presentations may be reported by triage category and admission status. For more complete definitions, please refer to the Codes tab.
Depending on the information system used in the emergency department at a point in time, the diagnosis of temperature-related problems is recorded according to one of three classification systems: the International Classification of Diseases, 9th revision (ICD-9), the International Classification of Diseases and Related Health Problems, 10th revision (ICD-10) or the Systematised Nomenclature of Medicine — Clinical Terms (SNOMED-CT).
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• Human health is inextricably linked to the environment.
• The main contributors to air pollution in cities are industry, motor vehicles and wood-burning heaters.
• A range of indicators of the quality of drinking water, and water for recreational use, are monitored continuously. The majority of households in NSW use public water supplies.
• Recent testing of drinking water indicates that drinking water supplied by the Sydney and Hunter Water Corporations meets Drinking Water Guidelines and is of good quality.
• Overall compliance rate for rural water supplies is high, but results from individual supplies vary substantially:
• Leaded petrol has been the main source of lead exposure for most NSW children, except those living near major sites for lead mining. In recent years blood lead levels among preschool children living in Broken Hill, an area with lead mining, have declined steadily.
• The Housing for Health program aims to assess, repair, and replace health hardware in Aboriginal residences. Surveys conducted on houses 6-12 months apart identified major improvements in key areas of safety, and facilities such as working showers and laundries, as a result of the program which has been running in NSW since 1997.
• In 2010, NSW Health published an evaluation of the program that assessed health outcomes from 1998 to 2008. This evaluation, Closing the Gap: 10 Years of Housing for Health in NSW, provides evidence of a 40% reduction in hospitalisation with infectious diseases among residents of houses that received Housing for Health, compared to the rest of the rural NSW Aboriginal population.
Factors in the natural and built environment have direct and indirect effects on human health which can be immediate or long-term. In rural areas issues as diverse as land use, agricultural practice, water quality and biodiversity all affect human health. People in urban and built environments are affected by air and water quality, transport choice, urban form and environmental health infrastructure.
The effects on human health of global phenomena such as population growth and climate change are also recognised at a local level. Potential health impacts include direct (e.g. increasing number of heatwaves and air pollution from bushfires) and indirect (increases in food- and water-borne diseases, increasing prevalence of mosquito-borne diseases from changes to natural ecological systems).
Responding to the large-scale environmental change, the 2008 Public Health Congress called on “all key stakeholders to invest in sustainable policies, actions and infrastructure to address the determinants of health”, including the environmental factors leading to climate change.
Responsibility for the management of environmental health hazards is deployed across three tiers of government. The Commonwealth and States work cooperatively to set environmental standards for drinking water and air quality. In NSW, the NSW Enviromental Protection Authority has carriage of legislation governing controls on air and water quality, chemical hazards, and contaminated land. The NSW Ministry of Health has responsibilities in relation to drinking water, and a variety of infectious hazards linked to premises including Legionella in public air conditioning systems, tattooing and the funeral industry.
The NSW Ministry of Health, Public Health Units in Local Health Districts, and local government manage these hazards in partnership. The NSW Ministry of Health also manages statewide programs such as the Aboriginal Environmental Health Program, the NSW Drinking Water Monitoring Program and the Arboviral Disease Program.
Australian Government Department of the Environment at http://www.environment.gov.au
NSW Office of Environment and Heritage at http://www.environment.nsw.gov.au
Department of Primary Industries Water at http://www.water.nsw.gov.au
Australian Bureau of Statistics at http://www.abs.gov.au
Australian Institute of Health and Welfare at http://www.aihw.gov.au
healthdirect at http://www.healthdirect.gov.au