Epidemiological characteristics of heat-related illness: a nationwide study in Taiwan

Background: Heat-related illness (HRI) is expected to occur more frequently and become a prominent issue worldwide in the context of global warming and climate change. Previous epidemiological studies of HRI were generally limited to selected populations or specific settings. The objective of this study was to characterize the epidemiological characteristics of HRI in a general population at the national level to fill the data gaps. Methods: Using the National Health Insurance Research Database, we identified all HRI patients in Taiwan between 2000 and 2018. We described the epidemiological characteristics of the patients and evaluated the differences between the two sexes. In addition, we evaluated the mortality rates of different types of HRI. Results: We identified 101,614 HRI patients, and male patients constituted the majority (56.2%). The mean age was 48.2 years, and most of the patients were between 20 and 44 years old (44.8%). In comparison with female patients, male patients were younger (46.4 vs. 50.5 years, p < 0.001) and more likely to receive treatment in hospitals (51.6% vs. 25.3%, p < 0.001). Among HRI, heat stroke was the most common diagnosis and had the highest mortality rate. The 7-day, 1-month, and 3-month mortality rates in heat stroke patients were 0.5%, 0.7% and 1.0%, respectively. Conclusions: In Taiwan, patients with HRI are more likely to males and between 20 and 44 years old. Male patients were younger and more likely to receive treatment in hospitals. Heat stroke was the most common HRI and had the highest mortality rate, which calls for establishment of the prevention and treatment strategies.