USE OF EMERGENCY ROOM DATA BASES AS A SOURCE FOR DATA TO BE USED IN MEDICAL BIOCLIMATOLOGY AND CLIMATOTHERAPY

Condemi V., Solimene U., Meco R.

Centre for Research on Medical Bioclimatology, Biotechnologies and Natural Medicines of the Milan State University, Italy

(+3902-50318860; e-mail: umberto.solimene@unimi.it)

The challenge of thermalism and health tourism seems to be founded on models characterized by utterly opposed situations, half-way between urban contexts and extra-urban environmental contexts, between well-being and geriatric trends, between acute diseases and ageing disorders of growing importance. In this framework, change processes (global change and climate change) call for an in-depth review of bioclimatic disciplines. Consider, for example, the issue of climate changes, a very interesting one also with reference to health. It is worth mentioning certain evolutionary schemes characterized by strong anthropic transformation, and their impact on the different climatic-environmental contexts, such as climate changing processes, the transformation of ecological sites, the constant increase of the average living standard in developed countries, the significant tourist mobility also for therapeutic purposes (SPAs, resorts, balneotherapy, etc.), the increased consciousness and awareness of environmental issues. With these assumptions in mind, the information provided by the Emergency Room healthcare facilities having the provision of healthcare in emergency and urgency conditions as their sole object, can be used and studied for scientific purposes.

These facilities, both in Italy and in other developed countries, increasingly use very complicated IT instruments to collect all possible information on the attending patients, including age, gender, access date and time, City of residence, symptoms, and the differential diagnoses provided by the ER. Several scientific publications have appeared in the past few years on the subject, along with specific Research Schemes, either in place or currently being implemented at an international level. Two scientific publications are worth mentioning here: Make T. et al, Association of meteorological and day-of-the-week factors with emergency hospital admissions in Fukuoka, Japan, IJB, 2002 and Rusticucci M et al., Association between weather condition and the number of patients at the emergency room in an Argentine hospital, IJB, 2002.

The scope of medical bioclimatology first, as well as of climatotherapy, includes the analysis and the study of the frequencies of ER access for all diseases, and particularly for the so-called climate-sensitive ones, with special focus on monthly, seasonal, and annual frequencies, in which medical bioclimatology has a specific interest.

This scientific paper analyzes two Emergency Room data bases with a potential user base of 500,000 and annual access frequencies close to 75,000. The Emergency Room data bases were analyzed in a significant portion of the City of Milan (urban climatology) and in an Alpine valley characterized, by contrast, by bioclimatic and environmental traits that are very different from the urban context. The analysis excluded the sector of traumatology, less involved in research. Thirteen-thousand internationally codified diseases were divided into two subgroups corresponding to about 300 symptoms and finally recodified in another group of almost 120 items. This study allowed observing a prevalence of cardiovascular, respiratory, and psychiatric diseases. This study will use appropriate bioclimatic indexes (HI, THI, WC, etc.) to correlate physical magnitudes with healthcare magnitudes. The ultimate goal of this work is to define a statistically developed general model to be used profitably for preventive medicine purposes and in the climatotherapic field.