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Examining the health impacts of climate change through electronic health records: a rapid review

Examining the health impacts of climate change through electronic health records: a rapid review
Examining the health impacts of climate change through electronic health records: a rapid review
Introduction: temperature extremes, including elevated heat and cold, are important environmental determinants of health whose frequency and duration are increasing due to climate change. Ecological and time-series studies have established links with adverse outcomes but often lack individual-level detail. Electronic health records (EHR) provide an alternative source, yet their use in climate-health research remains inconsistent.

Methods: we conducted a rapid review of peer-reviewed studies using EHR data to examine associations between temperature extremes and health outcomes across healthcare settings. The aim was to assess how health impacts of temperature extremes have been captured and coded within EHR-based research, and to identify methodological and coding-related gaps. Searches of seven databases identified eligible studies, and data were extracted on exposure definitions, outcome coding, methods, findings, and limitations.

Results: of 1,616 records identified, 526 duplicates were removed, leaving 1,090 for screening; 58 studies met inclusion criteria. Extreme heat was most frequently studied, with fewer analyses of cold. Common outcomes included morbidity, cardiovascular admissions, asthma, and pregnancy-related conditions. Mental health outcomes were rarely examined, subgroup analyses were mostly age-based, and studies focused on high-income countries. Exposure metrics and coding practices varied widely, with limited reporting of diagnostic codes and individual-level mediators.

Conclusion: harmonized exposure definitions, broader outcome coverage, and integration of socio-demographic and individual-level factors are needed to strengthen EHR-based climate-health research and guide targeted interventions.
medRxiv
Dahil, Arun
a20c2e72-f9fb-49b2-acb1-f06015dd0469
Pinn, Cameron
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Smith, Lucy
835f8b9b-b6e0-4f5f-b6b4-a48c7913b463
Hassan, Nehal
4afc726d-c9b7-4193-bb70-6ecbbdef8497
Esteves, Nuno Koch
c3310d39-48af-4724-bf88-c05400aaf6cb
Simpson, Glenn
802b50d9-aa00-4cca-9eaf-238385f8481c
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Dahil, Arun
a20c2e72-f9fb-49b2-acb1-f06015dd0469
Pinn, Cameron
9a644e42-8b09-4a15-8c23-8413395ebf23
Smith, Lucy
835f8b9b-b6e0-4f5f-b6b4-a48c7913b463
Hassan, Nehal
4afc726d-c9b7-4193-bb70-6ecbbdef8497
Esteves, Nuno Koch
c3310d39-48af-4724-bf88-c05400aaf6cb
Simpson, Glenn
802b50d9-aa00-4cca-9eaf-238385f8481c
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1

[Unknown type: UNSPECIFIED]

Record type: UNSPECIFIED

Abstract

Introduction: temperature extremes, including elevated heat and cold, are important environmental determinants of health whose frequency and duration are increasing due to climate change. Ecological and time-series studies have established links with adverse outcomes but often lack individual-level detail. Electronic health records (EHR) provide an alternative source, yet their use in climate-health research remains inconsistent.

Methods: we conducted a rapid review of peer-reviewed studies using EHR data to examine associations between temperature extremes and health outcomes across healthcare settings. The aim was to assess how health impacts of temperature extremes have been captured and coded within EHR-based research, and to identify methodological and coding-related gaps. Searches of seven databases identified eligible studies, and data were extracted on exposure definitions, outcome coding, methods, findings, and limitations.

Results: of 1,616 records identified, 526 duplicates were removed, leaving 1,090 for screening; 58 studies met inclusion criteria. Extreme heat was most frequently studied, with fewer analyses of cold. Common outcomes included morbidity, cardiovascular admissions, asthma, and pregnancy-related conditions. Mental health outcomes were rarely examined, subgroup analyses were mostly age-based, and studies focused on high-income countries. Exposure metrics and coding practices varied widely, with limited reporting of diagnostic codes and individual-level mediators.

Conclusion: harmonized exposure definitions, broader outcome coverage, and integration of socio-demographic and individual-level factors are needed to strengthen EHR-based climate-health research and guide targeted interventions.

Text
2025.08.27.25334567v1.full - Author's Original
Available under License Creative Commons Attribution.
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Published date: 28 August 2025

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Local EPrints ID: 505993
URI: http://eprints.soton.ac.uk/id/eprint/505993
PURE UUID: a6717244-f4ce-40f0-9699-d649a89b9dc2
ORCID for Nuno Koch Esteves: ORCID iD orcid.org/0000-0002-0580-7642
ORCID for Glenn Simpson: ORCID iD orcid.org/0000-0002-1753-942X
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X

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Date deposited: 27 Oct 2025 17:43
Last modified: 01 Nov 2025 03:08

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Contributors

Author: Arun Dahil
Author: Cameron Pinn
Author: Lucy Smith
Author: Nehal Hassan
Author: Nuno Koch Esteves ORCID iD
Author: Glenn Simpson ORCID iD

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