@article{ref1,
title="Syndromic surveillance use to detect the early effects of heat-waves: an analysis of NHS direct data in England",
journal="Sozial und Praventivmedizin",
year="2006",
author="Leonardi, G. S. and Hajat, Shakoor and Kovats, R. S. and Smith, G. E. and Cooper, David and Gerard, E.",
volume="51",
number="4",
pages="194-201",
abstract="OBJECTIVES: To investigate the effects of high ambient temperatures, including the summer 2003 heat-episode, on NHS Direct usage and its suitability as a surveillance tool in heat health warning systems. METHODS: Analyses of data on calls to NHS Direct in English Regions in the period Dec 2001-May 2004. Outcomes were daily rates of all symptomatic calls, and daily proportion of calls for selected causes (fever, vomiting, difficulty breathing, heat/sun-stroke) RESULTS: Total calls were moderately increased as environmental temperature increased; this effect was greatest in calls for young children and for fever. Total calls were moderately elevated during two summer heat episodes in 2003: calls specifically for heat/sun stroke increased acutely in response to these episodes. No association was apparent between environmental temperature and proportion of calls for vomiting and difficulty breathing. CONCLUSIONS: Calls to NHS Direct are sensitive to daily temperatures and extreme weather. NHS Direct is timely and has great potential in health surveillance. Calls for heat- and sun-stroke are now routinely monitored as part of the UK Heat-wave plan.   <p></p>  <p>Language: en</p>",
language="en",
issn="0303-8408",
doi="",
url="http://dx.doi.org/"
}