Open Access Open Badges Research article

Development of health risk-based metrics for defining a heatwave: a time series study in Brisbane, Australia

Shilu Tong1*, Xiao Yu Wang1, Gerry FitzGerald1, David McRae2, Gerard Neville3, Vivienne Tippett4, Peter Aitken5 and Ken Verrall6

Author Affiliations

1 School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane QLD 4000, Australia

2 Queensland Climate Change Centre of Excellence, Department of Science, Information Technology, Innovation and the Arts, Brisbane, Australia

3 Environmental Health Branch, Queensland Health, Brisbane, Australia

4 School of Clinical Sciences, Queensland University of Technology, Brisbane QLD 4000, Australia

5 Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, Australia

6 Environmental and Resource Sciences Division, Department of Environment and Resource Management, Brisbane, Australia

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BMC Public Health 2014, 14:435  doi:10.1186/1471-2458-14-435

Published: 9 May 2014



This study attempted to develop health risk-based metrics for defining a heatwave in Brisbane, Australia.


Poisson generalised additive model was performed to assess the impact of heatwaves on mortality and emergency hospital admissions (EHAs) in Brisbane.


In general, the higher the intensity and the longer the duration of a heatwave, the greater the health impacts. There was no apparent difference in EHAs risk during different periods of a warm season. However, there was a greater risk for mortality in the 2nd half of a warm season than that in the 1st half. While elderly (≥75 years) were particularly vulnerable to both the EHA and mortality effects of a heatwave, the risk for EHAs also significantly increased for two other age groups (0 – 64 years and 65 – 74 years) during severe heatwaves. Different patterns between cardiorespiratory mortality and EHAs were observed. Based on these findings, we propose the use of a tiered heat warning system based on the health risk of heatwave.


Health risk-based metrics are a useful tool for the development of local heatwave definitions. This tool may have significant implications for the assessment of heatwave-related health consequences and development of heatwave response plans and implementation strategies.

Climate changes; Emergency hospital admissions; Heatwaves; Mean temperature; Mortality; Time series analysis