• Benjamin D Scalley, Tony Spicer, Le Jian, Jianguo Xiao, John Nairn, Andrew Robertson, and Tarun Weeramanthri.
• Public Health Division, Department of Health, Government of Western Australia.
• Aust N Z J Public Health. 2015 Dec 1; 39 (6): 582-7.

ObjectiveTo determine which measures of heatwave have the greatest predictive power for increases in health service utilisation in Perth, Western Australia.MethodsThree heatwave formulas were compared, using Poisson or zero-inflated Poisson regression, against the number of presentations to emergency departments from all causes, and the number of inpatient admissions from heat-related causes. The period from July 2006 to June 2013 was included. A series of standardised thresholds were calculated to allow comparison between formulas, in the absence of a gold standard definition of heatwaves.ResultsOf the three heatwave formulas, Excess Heat Factor (EHF) produced the most clear dose-response relationship with Emergency Department presentations. The EHF generally predicted periods that resulted in a similar or higher rate of health service utilisation, as compared to the two other formulas, for the thresholds examined.ConclusionsThe EHF formula, which considers a period of acclimatisation as well as the maximum and minimum temperature, best predicted periods of greatest health service demand. The strength of the dose-response relationship reinforces the validity of the measure as a predictor of hazardous heatwave intensity.ImplicationsThe findings suggest that the EHF formula is well suited for use as a means of activating heatwave plans and identifies the required level of response to extreme heatwave events as well as moderate heatwave events that produce excess health service demand.© 2015 Public Health Association of Australia.

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