Temperature Extremes Exposure and Children’s Health: Extreme Heat- and Cold-Related Impacts in Edmonton, Alberta

Abstract

In the current context of escalating climate change effects on public health, Canada's distinctive geographic position causes it to warm at double the global average rate. This phenomenon leads to potentially heightened health risks for its residents through direct and indirect mechanisms. Particularly at risk are the most vulnerable age groups, such as children aged 0-5 years. Extreme temperature events—both hot and cold—pose latent health threats, especially to this demographic. It is imperative to note that while all children within this age range are at risk, certain age-specific and sex-specific factors may exacerbate or mitigate their vulnerability. Given the transformative developmental stages within these early years and the pronounced physiological differences between sexes, these factors are crucial to understand. This study, focusing on Edmonton, AB, aims to explore the health ramifications of such temperature extremes on children aged 0-5. To achieve a comprehensive analysis, the research segments its investigation based on age brackets (0-1, 2-3, 4-5 years) and sex (male and female). The objective is to examine the association between outdoor exposure to extreme temperature conditions and the incidence rate of hospital admissions and emergency visits for children in this age group. It utilizes health data from Alberta Health Services (AHS) and environmental data from the Alberta Climate Information Service (ACIS) from 2015 to 2018, focusing on age- and sex-specific trends. Time-series analysis, including Poisson and negative binomial regression, were applied to examine the correlation between temperature extremes—quantified by the 95th and 5th percentiles of weekly average temperatures—and pediatric hospital admissions and emergency visits. The analyses were stratified by age and sex and adjusted for confounding variables such as air pollution, relative humidity, seasonality, and long-term trends. During the study period, we recorded 5,970 hospital admissions and emergency visits for the 0-5 age group, with a notable majority (92.2%) for respiratory diseases. A significant increase in health service utilization was found in the 2–3-year age group during extreme heat (IRR= 1.36, 95% CI 1.03-1.80, p=0.03) and cold (IRR= 1.30, 95% CI 1.01-1.67, p=0.05) events. No significant associations were found in the 0-1- and 4-5-year age brackets, nor were there sex-based differences in health outcomes. The study revealed that pediatric respiratory diseases, such as asthma, bronchiolitis, and pneumonia, were significantly associated with extreme temperature events in the 2–3-year age group. The effects of cold temperatures persisted up to four weeks post-exposure (IRR= 1.30, 95% CI 1.00-1.69, p=0.05), while the impact of heat was more immediate (IRR= 1.36, 95% CI 1.01-1.83, p=0.04), suggesting different temporal patterns of risk. These findings demonstrate a rising trend in the risk of negative respiratory health effects in young children linked to extreme hot and cold temperatures, highlighting the need for a more thorough assessment across various health outcomes. Additionally, they emphasize the need for ongoing research to refine our understanding of how these events affect pediatric health and develop comprehensive mitigation and adaptation strategies. Future studies should investigate more precise and direct methods for assessing the health impacts of such events, explore the contributing factors of these temperature extremes, including the role of climate change, and explore preventative strategies to mitigate their effects. This research is crucial for developing robust measures to protect our youngest and most vulnerable residents from the health hazards of extreme climate variability.