Role of El Niño Southern Oscillation (ENSO) in Extreme Event Related Adverse Health Outcomes in Maryland, USA

Introduction: Increasing body of literature suggests frequency, duration, and intensity of extreme events are rising and will increase in response to changing climate. Others have linked such extreme events with adverse health outcomes. Large-scale weather phenomenon (i.e., ENSO) is known to impact US weather patterns, but no studies to date have investigated how ENSO may modulate the associations between extreme events and adverse health outcomes. Methods: We linked hospitalization records for asthma/MI and culture-confirmed campylobacter/salmonella infections with extreme heat and precipitation events in Maryland. Extreme events were identified based on local climatology specific to each county derived from a 30-year baseline. We obtained data on phases of ENSO (El Nino, La Nina, Neutral) from the National Weather Service Climate Prediction Center. A time-stratified case-crossover design was used to examine associations between exposure to extreme events exposure and chronic health outcomes, while infec...