The Association between ambient temperature and snakebites in Georgia Open Access

Abstract

There is a dearth of epidemiologic research on environmental risk factors for snakebites both internationally and domestically. The World Health Organization has identified snakebites as a highest priority neglected tropical disease. In this study, we use data from the Georgia Hospital Association from January 1, 2014 to December 31, 2018 combined with zip code level climate data to analyze the relationship between short-term temperature variation and Emergency Department visits for snakebite. To do this, we performed a case-crossover analysis using conditional logistic regression modeling. We used a time stratified, bi-directional approach where control days were chosen as the same day of the week within the same month and year.  With adjustment for dew point and precipitation, we found that across the entire study period, temperature is significantly and positively associated with the snakebite outcome (OR 1.064, CI 1.044 -1.084). Seasonal stratification showed that the association is strongest in the spring (OR 1.106, CI 1.070 -1.144) followed by fall (OR 1.065, CI 1.032 - 1.100). In winter and summer, temperature variation was not significantly (P>0.05) predictive of the snakebite outcome. Our results supported our hypothesis that short-term variation in temperature would be a significant predictor for the odds of experiencing a snakebite, and that the effect would be strongest at moderate temperatures. Because snakebites occurred most frequently in the summer, we speculate that there may be human behaviors that we did not analyze which contribute towards higher snakebite counts in Georgia summers.

Table of Contents

Introduction                                                                                                                              1

Methods                                                                                                                                      5

 Results                                                                                                                                        8

 Discussion                                                                                                                                 16

 Conclusions                                                                                                                              21

 Appendix                                                                                                                                   22

 References                                                                                                                                 27

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.S.P.H.
Submission	Master's Thesis
Language	English
Research Field	Biology, Ecology Health Sciences, Public Health
Keyword	Snakes Copperhead temperature season heat Georgia Snakebite
Committee Chair / Thesis Advisor	Noah Scovronick, Emory University

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