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Original research
Ambient temperatures, heatwaves and out-of-hospital cardiac arrest in Brisbane, Australia
  1. Tan N Doan1,2,
  2. Daniel Wilson1,3,
  3. Stephen Rashford1,4,
  4. Emma Bosley1,5
  1. 1Queensland Ambulance Service, Brisbane, Queensland, Australia
  2. 2Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
  3. 3Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  4. 4School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
  5. 5School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
  1. Correspondence to Dr Tan N Doan, Queensland Ambulance Service, Brisbane, Queensland, Australia; tan.doan{at}


Background The health impacts of temperatures are gaining attention in Australia and worldwide. While a number of studies have investigated the association of temperatures with the risk of cardiovascular diseases, few examined out-of-hospital cardiac arrest (OHCA) and none have done so in Australia. This study examined the exposure–response relationship between temperatures, including heatwaves and OHCA in Brisbane, Australia.

Methods A quasi-Poisson regression model coupled with a distributed lag non-linear model was employed, using OHCA and meteorological data between 1 January 2007 and 31 December 2019. Reference temperature was chosen to be the temperature of minimum risk (21.4°C). Heatwaves were defined as daily average temperatures at or above a heat threshold (90th, 95th, 98th, 99th percentile of the yearly temperature distribution) for at least two consecutive days.

Results The effect of any temperature above the reference temperature was not statistically significant; whereas low temperatures (below reference temperature) increased OHCA risk. The effect of low temperatures was delayed for 1 day, sustained up to 3 days, peaking at 2 days following exposures. Heatwaves significantly increased OHCA risk across the operational definitions. When a threshold of 95th percentile of yearly temperature distribution was used to define heatwaves, OHCA risk increased 1.25 (95% CI 1.04 to 1.50) times. When the heat threshold for defining heatwaves increased to 99th percentile, the relative risk increased to 1.48 (1.11 to 1.96).

Conclusions Low temperatures and defined heatwaves increase OHCA risk. The findings of this study have important public health implications for mitigating strategies aimed at minimising temperature-related OHCA.

  • Epidemiology

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  • Contributors Conceptualisation: TND and EB. Data collation: TND and DW. Data analysis and model development: TND. Interpretation of data: all authors. Manuscript writing: all authors. Review and approval of final manuscript: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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