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Summer Heat and Children Emergency Department Visits

01/19/2022 | Environmental Health Perspectives

Evidence shows that high temperatures lead to excess morbidity and mortality in adults, but less is known about how heat affects children. Our study, led by Dr. Aaron Bernstein in Environmental Health Perspectives, is the first to evaluate the impacts of heat on children’s health in all major regions around the country.

The study looked at over three million child and adolescent emergency department (ED) visits in children’s hospitals in 27 states from May to September, 2016-2018.

It found that heat increases the number of children who visit the emergency department for any reason in the summer months and this underscores the need for more aggressive adaptation measures, especially given that climate change is anticipated to make summer heat more common and severe. Importantly, the study found that children present to the ED at higher temperatures for different reasons than adults, which underscores children’s unique vulnerabilities.

Key takeaways and insights for clinicians

  • Hotter days were associated with higher risks of ED visits for any reason as well as for specific conditions, including heat-related illnesses, bacterial intestinal infections, ear infections, and nervous system diseases.
    • 11.8% of all warm-season ED visits, 31.0% of ED visits for heat-related illnesses, and 25.2% of visits for bacterial intestinal infections were attributed to heat.
  • Associations between high temperature days and ED visits were not confined to the hottest days, but rather were evident across a range of warm season temperatures. Pediatric care providers may not currently consider temperatures in this range as a risk to child health.
  • ED visits for several conditions, including asthma, respiratory system diseases, and mental, behavioral and neurodevelopmental disorders, were not clearly associated with higher temperatures.
  • Children with existing health conditions, genetic susceptibilities, or who face additional obstacles like housing insecurity or access to clean water may be at particular risk of heat exposure and the ensuing health effects

Read the study


Aaron S. Bernstein MD MPH, Shengzhi Sun PhD, Kate R. Weinberger PhD, Keith R. Spangler PhD, Perry E. Sheffield MD MPH, Gregory A. Wellenius ScD


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Headshot of Dr. Aaron Bernstein, Credit Michael Goderre/Boston Children’s Hospital

Aaron Bernstein MD, MPH

Aaron examines the human health effects of global environmental changes with the aim of promoting a deeper understanding of these subjects among students, educators, policy makers, and the public.

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