The individual and synergistic impacts of windstorms and power outages on injury ED visits in New York State

Background: There is little work in assessing the impact of storm events combined with power outage (PO). In this study, we evaluated the individual and synergistic impacts of wind events and PO on overall and subtypes of injuries in New York State (NYS) and by demographics. Methods: The emergency department (ED) visit data were obtained from the NYS Department of Health from November-April 2005-2013 to identify injury cases, length of stay and care costs. Wind event was defined ac-cording to high wind, strong wind or thunderstorm wind defined by NOAA. PO occurrence was defined when PO coverage exceeded the 50th percentile of its distribution. By comparing non-event days, we used distributed lag nonlinear models to evaluate the impacts of wind events, PO, and their combined effect on injuries during the cold season over a 0-3-day lag period, while controlling for time-varying confounders. The differences in critical care indicators between event and non-event days were also evaluated. Results: Overall injuries ED visits (16,628,812) significantly increased during the wind events (highest Risk Ratio (RR): 1.05; 95% CI: 1.02-1.08), and were highest when wind events cooccurred with PO (highest RR: 1.14; 95% CI: 1.10-1.18), but not during PO alone (RR: 1.00; 95%CI: 0.96-1.04). The increase was also observed with all sub-groups through Day 2 after the event. Greater risks exist for older adults (>= 65 years) and those on Medicaid. After the joint occurrences of wind events and PO, average visits are 0.2 days longer, and cost 13% more, compared to no wind/no PO days. Conclusion: There isa significant increase in ED visits, length of stay and cost of injuries during wind events, es-pecially when they coupled with PO and especially among older cases and Medicaid holders. Our findings may be used for planning disaster preparedness and recovery efforts. (c) 2021 Elsevier B.V. All rights reserved.