Technical notes
Defining extreme weather events
The Bureau of Meteorology defines extreme or severe weather as “potentially hazardous or dangerous weather that is not solely related to severe thunderstorms, tropical cyclones or bushfires” (BoM 2022a). In this report we have utilised administrative health and mortality datasets as well as BoM weather data, defining extreme weather or related natural hazards as extreme heat, extreme cold, rain or storms and bushfires.
Table 4 summarises the extent to which weather-related injuries can be identified in existing individual national data sources.
Other existing data sets with the potential to contribute to the weather-related injury knowledge base include:
- transport databases
- drowning databases
- workplace compensation claim data
- Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data
- Ambulance and other emergency management services datasets
Most of these do not include weather-related information but could be of use within a weather-event based approach to analysis. Some of these data sets do not include injury information either (for example, MBS and PBS data) but could provide supporting context where there has been an extreme weather event.
Data source | Injury information included | Weather-related information included | Temporal data included | Location data included |
---|---|---|---|---|
Hospitalisation data: AIHW National Hospital Morbidity Database | Type of injury (for example, fracture of femur) External cause of injury (for example, fall on same level) Limited information on activity being conducted at time of injury may be included (for example, playing basketball, working for income) Limited place of occurrence information may be included (for example, home, school, roadway) | External cause of injury may broadly specify a weather event (for example, storm) | Date of hospitalisation Note: date of injury event is not included
| Area of person’s usual residence (using ABS Statistical Area Level 2 (SA2) categories) Hospital location Note: place of injury event is not included |
Deaths data: AIHW National Mortality Database | Type of injury External cause Information on activity and place of occurrence has data quality issues. | External cause of injury may broadly specify a weather event | Date of death Note: date of injury event is not included | Area of person’s usual residence (SA 2) State of registration of the death Note: place of injury event is not included |
Deaths data: National Coronial Information System (NCIS) | Mechanism of injury Object or substance producing injury Activity being conducted at time of incident Cause of death Police narrative of circumstances, autopsy report, toxicology report, and coroner’s findings | Mechanism of injury or object may broadly specify weather events | Date and time of death Date and time of incident Date and time body found Date and time person last known alive | Place of person’s usual residence (at SA2 level and street level) Location where body was found Location of death Location of incident Location where person was last known alive |
Bureau of Meteorology: Weather data | None | Extensive records on rainfall, temperature, humidity, evaporation, wind, sunshine, cyclones, and thunderstorms which inform data systems on specific climate-related hazards. BOM also publishes the State of the Climate report and multiple tools such as the Heatwave Service for Australia. | Data may be recorded multiple times a day | Data is available from over 7,000 weather stations across the country which take daily measurements. Meteorological conditions are linked to location of events such as bushfires, droughts, floods, heatwaves, severe thunderstorms and cyclones. |
Emergency department data: AIHW National Non-Admitted Patient Emergency Department Care Database | Injury diagnosis information is available (for example, concussion), but external cause of injury is not included for most jurisdictions | None currently. A connection to weather would need to be made by matching time and place information with the time and place of a weather-specific event | Date and time of ED presentation | Area of person’s usual residence (SA2) Hospital location Note: place of injury event is not included for most jurisdictions |
Bureau of Infrastructure, Transport Research Economics Data: Australian Road Deaths Database and the National Crash Database | Some road transport deaths and hospitalisations are identified. No information on the injury is included. | Some states record whether it was raining at the time of the crash. | Time, day of the week, month and year. Date is not included. | Location of injury event (ABS SA4) and local government area |
Safe Work Australia Data: National Dataset for Compensation-based Statistics | Nature of injury, body location and mechanism
| Type of occurrence classification may broadly specify weather events and environmental factors | The date of report to employer, date of claim, first day off work and first day back at work. No time of incident information is provided | State or territory of the injury event. Postcode of residence and of workplace |
Hospitalisations
National hospital separations data were sourced from the Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database (NHMD).
Please refer to the technical notes for Injury in Australia for more detail.
Weather-related ICD code inclusion criteria for hospitalisations
Temperature extremes – heatwaves:
Records were included when there was a principal diagnosis of:
E86 – Volume depletion
L55 – Sunburn
L56 – Other acute skin changes to ultraviolet radiation
P74.1 – Dehydration of newborn
T67– Effects of heat and light
T79.4 – Traumatic shock (including shock (immediate)(delayed) following injury) (including dehydration with shock)
And there was an external cause of injury relating to heat:
X30 – Exposure to excessive natural heat
X32 – Exposure to sunlight
Temperature extremes – excessive cold:
Records were included when there was a principal diagnosis of:
T33–T35 – Frostbite
T68 – Hypothermia
T69 – Other effects of reduced temperature
And there was an external cause of injury relating to excessive cold:
X31 – Exposure to excessive natural cold
Rain- and storm-related injuries:
Records were included when there was a principal diagnosis of:
S00 – T75, T79 – Injury, poisoning and certain other consequences of external causes
And there was an external cause of injury relating to rain and storms:
X33 – Victim of lightning
X36 – Victim of avalanche landslide and other earth movements
X37 – Victim of cataclysmic storm
X38 – Victim of flood
Bushfires:
Records were included when there was a principal diagnosis of:
T20 – T30 – Burns
T58 – Toxic effect of carbon monoxide
T59.8 – Other specified gases, fumes, and vapours
And there was an external cause of injury relating to bushfire or heat:
X01 – Exposure to uncontrolled fire, not in building or structure
X30 – Exposure to excessive natural heat
Note: ICD-10-AM classifications experts were consulted in the compilation of this list. X00 – Exposure to uncontrolled fire, in building or structure was intentionally not included, based on advice received.
Deaths
Please refer to the technical notes for injury in Australia for our standard case ascertainment criteria.
Death data are commonly recorded according to the calendar year in which the death was registered. However, in this report data are presented according to the financial year in which each death occurred, because:
- presenting data by year of occurrence is more meaningful than by year of registration, because some cases are registered much later than when the death occurred (sometimes years later).
- reporting by financial year aligns with AIHW reports on injury morbidity, enabling deaths and hospitalisations to be presented for the same period.
The sum of the counts of death by cause may be greater than the total number of injury deaths because some deaths have multiple causes.
The ‘Persons’ total includes deaths for which sex was not reported. All age totals include deaths where age is not reported.
Outlined below are the ICD-10 codes included in the analysis in Chapter 3 (WHO 2019).
Weather-related inclusion for deaths
Temperature extremes - heatwaves:
Records were included for preliminary analysis when there was:
an UCoD of Exposure to excessive natural heat or Exposure to sunlight (X30, X32) or
a MCoD of Exposure to excessive natural heat or Exposure to sunlight (X30, X32) and an injury-related cause of death (S00-T75; T79).
Temperature extremes - cold:
Records were included for preliminary analysis when there was: an UCoD of Exposure to excessive natural cold (X31) or
a MCoD of Exposure to excessive natural cold (X31) and an injury-related cause of death (S00-T75; T79).
Rain and storm-related injuries:
Records were included for preliminary analysis when there was:
an UCoD of Victim of lightning or Victim of avalanche, landslide and other earth movements or Victim of cataclysmic storm or Victim of flood (X33, X36–X38) or
a MCoD of Victim of lightning or Victim of avalanche, landslide and other earth movements or Victim of cataclysmic storm or Victim of flood (X33, X36–X38) and an injury-related cause of death (S00-T75; T79).
Bushfires:
Records were included for preliminary analysis when there was:
an UCoD of Exposure to uncontrolled fire, not in building or structure (X01) or
a MCoD of Exposure to uncontrolled fire, not in building or structure (X01) and an injury-related cause of death (S00-T75; T79).
Defining and counting injury in this report
Some of the ICD10 and external cause coding combinations outlined above could apply to injuries sustained during ‘normal’ weather conditions when combined with inappropriate behaviour or unintended exposure. For example, it is possible to sustain hypothermia due to exposure to cold water in a situation such as falling into the water from a boat.
The codes for bushfires given would also apply to types of outdoor fires other than bushfires, such as an injury from a briefly uncontained campfire. It is not possible to distinguish bushfire-related from other injuries within these codes.
State and territory data are based on the state of usual residence of the case. The exception to this is the analysis of hospitalisations in the Northern Rivers region of NSW during 2021-2022, which is based on state of establishment.
With the data currently available in Australia, there are three approaches to linking an injury event with weather conditions. This report takes an injury-based approach.
- An injury-based approach, where injuries with explicitly weather-related diagnoses or external causes are identified in health care, workers’ compensation and deaths databases. Health care providers record the involvement of weather in an injury event.
- A weather event-based approach, where significant weather events are identified and health care and deaths databases are investigated for any trends or changes in injury data at the time period and location of the weather event.
- Burden-of-disease methodology uses modelling to attribute injuries to weather-related exposures. The Australian Burden of Disease Study currently attributes injuries like those due to fire, burns and scalds to the risk factors of occupational exposures and hazards, and alcohol use. Work is currently underway to develop this methodology in regard to heat-related workplace injuries. This indirect method requires sufficient evidence of a causal association between exposure and health outcomes from high-quality epidemiological studies and to meet a number of criteria to enable estimation and inclusion in the Australian Burden of Disease Study (AIHW 2022).
Australian Institute of Health and Welfare (2022) Australian Burden of Disease Study 2022, AIHW, Australian Government, accessed 19 July 2023.
Bureau of Meteorology (2022) Severe weather hazards, BoM, Australia Government, accessed 10 July 2023.
WHO (World Health Organization) (2019) The international statistical classification of diseases and related health problems, 10th revision (ICD-10), Geneva: WHO, accessed 12 May 2022.
Glossary
ABS | Australian Bureau of Statistics |
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ACCD | Australians Consortium for Classification Development |
AIHW | Australian Institute of Health and Welfare |
ARDD | Australian Road Deaths Database |
BITRE | Bureau of Infrastructure and Transport Research Economics |
DALY | Disability Adjusted Life Years |
DAWE | Department of Agriculture, Water and Environment |
ED | Emergency Department |
EDDC | Emergency Department Data Collection |
EHF | Excess Heat Factor |
HHISS | Heat Health Information Surveillance System |
ICD | International Classification of Disease and Related Health Problems |
IPCC | International Panel on Climate Change |
MBS | Medicare Benefits Scheme |
MCoD | Multiple Cause of Death |
NAEC | Non-Admitted Emergency Care |
NCD | National Crash Database |
NCIS | National Coronial Information System |
NDS | National Dataset for Compensation-based Statistics |
NHISI AA | National Integrated Health Services Information Analysis Asset |
NHMD | National Hospital Morbidity Database |
NMD | National Mortality Database |
NNAPEDCD | National Non-Admitted Patient Emergency Department Care Database |
NSW | New South Wales |
PBS | Pharmaceutical Benefits Scheme |
POLAR | Population Level Analysis and Reporting |
QLD | Queensland |
SNOMED-CT | Systematized Nomenclature of Medicine-Clinical Terms |
SWA | Safe Work Australia |
UCoD | Underlying Cause of Death |
VEMD | Victorian Emergency Minimum Dataset |
WHO | World Health Organization |