Objectives: Heatwaves have been linked to increased levels of health service demand in Australia. This systematic literature review aimed to explore health service demand during Australian heatwaves for hospital admissions, emergency department presentations, ambulance call-outs, and risk of mortality.Study design: A systematic review to explore peer-reviewed heatwave literature published from 2000 to 2020.Data sources: Articles were reviewed from six databases (MEDLINE, Scopus, Web of Science, PsychINFO, ProQuest, Science Direct). Search terms included: heatwave, extreme heat, ambulance, emergency department, and hospital. Studies were included if they explored heat for a period of two or more consecutive days. Studies were excluded if they did not define a threshold for extreme heat or if they explored data only from workers compensation claims and major events.Data synthesis: This review was prospectively registered with PROSPERO (#CRD42021227395). Forty-five papers were included in the final review following full-text screening. Following a quality assessment using the GRADE approach, data were extracted to a spreadsheet and compared. Significant increases in mortality, as well as hospital, emergency, and ambulance demand, were found across Australia during heatwave periods. Admissions for cardiovascular, renal, respiratory, mental and behavioural conditions exhibited increases during heatwaves. The most vulnerable groups during heatwaves were children (< 18 years) and the elderly (60+).Conclusions: Heatwaves in Australia will continue to increase in duration and frequency due to the effects of climate change. Health planning is essential at the community, state, and federal levels to mitigate the impacts of heatwaves on health and health service delivery especially for vulnerable populations. However, understanding the true impact of heatwaves on health service demand is complicated by differing definitions and methodology in the literature. The Excess Heat Factor (EHF) is the preferred approach to defining heatwaves given its consideration of local climate variability and acclimatisation. Future research should explore evidence-based and spatially relevant heatwave prevention programs. An enhanced understanding of heatwave health impacts including service demand will inform the development of such programs which are necessary to promote population and health system resilience.

Heatwaves are a significant and growing threat to the health and well-being of the residents of Queensland, Australia. This threat is increasing due to climate change. Excess heat increases the demand for health services, including ambulance calls, and the purpose of this study was to explore this impact across Queensland. A state-wide retrospective analysis of heatwaves and emergency ‘Triple Zero’ (000) calls to Queensland Ambulance (QAS) from 2010–2019 was undertaken. Call data from the QAS and heatwave data from the Bureau of Meteorology were analysed using a case-crossover approach at the postcode level. Ambulance calls increased by 12.68% during heatwaves. The effect was greatest during low-severity heatwaves (22.16%), followed by severe (14.32%) and extreme heatwaves (1.16%). The impact varied by rurality, with those living in very remote areas and major cities most impacted, along with those of low and middle socioeconomic status during low and severe intensity heat events. Lag effects post-heatwave continued for at least 10 days. Heatwaves significantly increase ambulance call centre workload, so ambulance services must actively prepare resources and personnel to address increases in heatwave frequency, duration, and severity. Communities must be informed of the risks of heatwaves at all severities, particularly low severity, and the sustained risks in the days following a heat event.

Background: Improving the health and safety of those working in Australian agriculture and fishery industries is a recognized priority area for preventative activities. With Australian agricultural industries being among the nation’s most dangerous workplaces, there is a need for action. While there are currently known solutions, their implementation is limited. Influential agents, i.e., people who can influence others, are important for helping engender action to enact solutions into practice. Objective: This study examines agents that influence safety behavior either negatively (barriers) or positively (facilitators), in the Australian agriculture and fishery industries. Methods: Focus groups were conducted with producers and industry representatives. Thematic analysis identified barriers and facilitators to improve health and safety. These were assessed against the Socioecological Model, which considers the various, and often intersecting, human (intrapersonal, i.e. values and attitudes, peers, familial, and cultural) factors influencing safety behavior. Results: Seven categories of human influences were identified: self, peers, family, intergenerational change, industry agents, government agents, and other. Peers (including direct managers) and family were seen to be direct influencers. Individuals signal to others that safety is valued and important. This is reinforced by experience, skill, attitudes, and behavior. Safety practice knowledge acquisition occurred via the family unit, specific training, industry, or knowledge transfer between industries. Government influence predominately focused on legislation and while the source of this influence is distant, it does influence behavior. Conclusions/Recommendations: There is a need to support comprehensive programs. These should include strengthening relationships via peer-to-peer networking, sharing information about safety initiatives, appropriate legislation, and enhancing leadership of all influencers with regard to safety.