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Analysis of Drug Sales in Pharmacies to Determine the Effects of Heat Waves on Chronic Diseases in Istanbul
https://doi.org/10.35627/22195238/2025-33-6-34-39
Abstract
Introduction: Heat waves (HWs) are one of the most important atmospheric events that negatively affect human health. Studies show that HWs trigger many diseases causing an increase in hospital admissions, ambulance calls, and emergency department visits during HW periods.
Objective: To analyze changes in drug sales in pharmacies during HW periods in order to determine human health effects of HWs and to establish the most affected chronic diseases based on calculated sales growth.
Materials and methods: For this study, drug sales data were obtained from eight pharmacies located in different districts of Istanbul and classified according to the indications they contained. Meteorological data were obtained from the Istanbul Meteorological Directorate. HWs are defined as temperatures at a threshold of 90 % of daily maximum temperatures lasting for at least 3 or more consecutive days. Using this definition, it was determined that a 14-day HW occurred in Istanbul on July 12–26, 2023. In the analysis, pharmaceutical sales data between the 12th and 26th days of each month, April, May, and June, were used as a reference. Risk ratios were found by comparing the drug sales rate in the HW period with those in the reference periods. The significance values were calculated using the logarithmic Z test.
Results: During the heat wave, the sales of eye drops increased by 104 %, cardiovascular and blood pressure medicines by 38 %, psychology and depression medicines by 37 %, respiratory and chest disease medicines by 17 %, and antihistamines by 12 %.
Conclusions: The findings demonstrate that high temperatures triggered eye, chronic heart, psychological, and chronic respiratory allergic diseases, as shown by increased sales of drugs used to treat these conditions. The results of the study will guide future preventions to be taken against HWs.
About the Author
Yu. Öztürk
Turkish Ministry of National Education
Turkey
Turkey
Yunus Öztürk - PhD
510 Street, Kesikkapi, Fethiye, Muğla Province, 48300
References
1. Lissner TK, Holsten A, Walther C, Kropp JP. Towards sectoral and standardised vulnerability assessments: The example of heatwave impacts on human health. Clim Change. 2012;112(3):687-708. doi: 10.1007/s10584-011-0231-5
2. Smoyer-Tomic KE, Kuhn R, Hudson A. Heat wave hazards: An overview of heat wave impacts in Canada. Nat Hazards. 2003;28:465-486. doi: 10.1023/A:1022946528157
3. Hong YJ, Min YK, Lee S, Choi S. Expanded orientation of urban public health policy in the climate change era: Response to and prevention of heat wave in Paris and Seoul: A brief review. Iran J Public Health. 2022;51(7):1461-1468. doi: 10.18502/ijph.v51i7.10080
4. Huang C, Barnett AG, Wang X, Tong S. Effects of extreme temperatures on years of life lost for cardiovascular deaths: A time series study in Brisbane, Australia. Circ Cardiovasc Qual Outcomes. 2012;5(5):609-614. doi: 10.1161/CIRCOUTCOMES.112.965707
5. Robine JM, Michel JP, Herrmann FR. Excess male mortality and age-specific mortality trajectories under different mortality conditions: A lesson from the heat wave of summer 2003. Mech Ageing Dev. 2012;133(6):378-386. doi: 10.1016/j.mad.2012.04.004
6. Pirard P, Vandentorren S, Pascal M, et al. Summary of the mortality impact assessment of the 2003 heat wave in France. Euro Surveill. 2005;10(7):153-156.
7. Can G, Şahin Ü, Sayılı U, et al. Excess mortality in Istanbul during extreme heat waves between 2013 and 2017. Int J Environ Res Public Health. 2019;16(22):4348. doi: 10.3390/ijerph16224348
8. Oray CN, Oray D, Aksay E, Atilla R, Bayram B. The impact of a heat wave on mortality in the emergency department. Medicine (Baltimore). 2018;97(52):e13815. doi: 10.1097/MD.0000000000013815
9. Ozturk Y, Baltaci H, Akkoyunlu BO. The impacts of heat waves on hospital admissions and mortality in the Fethiye Province of Türkiye. Port J Public Health. 2023;41(2):94-101. doi: 10.1159/000530747
10. Yin J, Wang S, Deng J, et al. Associations of heatwaves and their characteristics with ischaemic stroke hospital admissions. Sci Rep. 2025;15(1):4929. doi: 10.1038/s41598-025-88557-5
11. Zottarelli LK, Chowdhury S, Xiaohe X, Sunil T. Effects of heat waves and fine particulate matter (PM2.5 ) air pollution on emergency medical services call volume in San Antonio, Texas. Texas Public Health J. 2025;77(1):25.
12. Hosseinzadeh A, Aghababaeian H, Ostadtaghizadeh A, et al. Pre hospital emergency medical dispatches following heat waves: A systematic review study and meta-analysis. J Therm Biol. 2025;129:104086. doi: 10.1016/j.jtherbio.2025.104086
13. Knowlton K, Rotkin-Ellman M, King G, et al. The 2006 California heat wave: Impacts on hospitalizations and emergency department visits. Environ Health Perspect. 2009;117(1):61-67. doi: 10.1289/ehp.11594
14. Alessandrini E, Sajani SZ, Scotto F, Miglio R, Marchesi S, Lauriola P. Emergency ambulance dispatches and ap parent temperature: A time series analysis in Emilia Romagna, Italy. Environ Res. 2011;111(8):1192-1200. doi: 10.1016/j.envres.2011.07.005
15. Schaffer A, Muscatello D, Broome R, Corbett S, Smith W. Emergency department visits, ambulance calls, and mortality associated with an exceptional heat wave in Sydney, Australia, 2011: A time–series analysis. Environ Health. 2012;11(1):3. doi: 10.1186/1476-069X-11-3
16. Williams S, Nitschke M, Weinstein P, Pisaniello DL, Parton KA, Bi P. The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994–2008. Environ Int. 2012;40:33-38. doi: 10.1016/j.envint.2011.11.011
17. Gronlund CJ, Zanobetti A, Schwartz JD, Wellenius GA, O’Neill MS. Heat, heat waves, and hospital admissions among the elderly in the United States, 1992–2006. Environ Health Perspect. 2014;122(11):1187-1192. doi: 10.1289/ehp.1206132
18. Son JY, Lee JT, Anderson GB, Bell ML. The impact of heat waves on mortality in seven major cities in Korea. Environ Health Perspect. 2012;120(4):566-571. doi: 10.1289/ehp.1103759
19. Huang Q, Ke L, Liu L, et al. Heatwave warnings mitigate long-term cardiovascular diseases risk from heat-related illness: A real-world prospective cohort study. Lancet Reg Health West Pac. 2025;55:101468. doi: 10.1016/j.lanwpc.2025.101468
20. Yin Q, Wang J. The association between consecutive days’ heat wave and cardiovascular disease mortality in Beijing, China. BMC Public Health. 2017;17(1):223. doi: 10.1186/s12889-017-4129-7
21. Kenney WL, Craighead DH, Alexander LM. Heat wa ves, aging, and human cardiovascular health. Med Sci Sports Exerc. 2014;46(10):1891-1899. doi: 10.1249/MSS.0000000000000325
22. Joshi M, Goraya H, Joshi A, Bartter T. Climate change and respiratory diseases: A 2020 perspective. Curr Opin Pulm Med. 2020;26(2):119-127. doi: 10.1097/MCP.0000000000000656
23. Liu L, Zhang JL. [A case-crossover study between heat waves and daily death from cardiovascular and cerebrovascular disease.] Zhonghua Liu Xing Bing Xue Za Zhi. 2010;31(2):179-184. (In Chinese.)
24. Ozturk Y, Baltaci H, Akkoyunlu BO. The effects of heatwaves on hospital admissions in the Edirne pro vince of Türkiye: A cohort study. Medicine (Baltimore). 2023;102(28):e34299. doi: 10.1097/MD.0000000000034299
25. Tong S, Wang XY, Barnett AG. Assessment of heat- related health impacts in Brisbane, Australia: Comparison of different heatwave definitions. PloS One. 2010;5(8):e12155. doi: 10.1371/journal.pone.0012155
26. Baltaci H, Ozturk Y, Akkoyunlu BO. Long-term varia tions and synoptic features of heat waves in Turkiye. Int J Glob Warm. 2024;33(1):51-68. doi: 10.1504/IJGW.2024.10062599
27. Perkins SE, Alexander LV. On the measurement of heat waves. J Clim. 2013;26(13):4500-4517. doi: 10.1175/JCLI-D-12-00383.1
28. Tian Z, Li S, Zhang J, Guo Y. The characteristic of heat wave effects on coronary heart disease morta lity in Beijing, China: A Time Series study. PLoS One. 2013;8(9):e77321. doi: 10.1371/journal.pone.0077321
29. D’Ippoliti D, Michelozzi P, Marino C, et al. The impact of heat waves on mortality in 9 European cities: Results from the EuroHEAT project. Environ Health. 2010;9:37. doi: 10.1186/1476-069X-9-37
30. Nitschke M, Tucker GR, Bi P. Morbidity and mortality during heatwaves in metropolitan Adelaide. Med J Aust. 2007;187(11-12):662-665. doi: 10.5694/j.1326-5377.2007.tb01466.x
31. Zhang K, Chen TH, Begley CE. Impact of the 2011 heat wave on mortality and emergency department visits in Houston, Texas. Environ Health. 2015;14:11. doi: 10.1186/1476-069X-14-11
32. Schmeisser L, Bond NA, Siedlecki SA, Ackerman TP. The role of clouds and surface heat fluxes in the maintenance of the 2013–2016 Northeast Pacific marine heatwave. J Geophys Res Atmos. 2019;124(20):10772-10783. doi: 10.1029/2019JD030780
33. Kalisa E, Fadlallah S, Amani M, Nahayo L, Habiyaremye G. Temperature and air pollution relationship during heatwaves in Birmingham, UK. Sustain Cities Soc. 2018;43:111-120. doi: 10.1016/j.scs.2018.08.033
34. Echevarría-Lucas L, Senciales-González JM, Medial dea-Hurtado ME, Rodrigo-Comino J. Impact of climate change on eye diseases and associated economical costs. Int J Environ Res Public Health. 2021;18(13):7197. doi: 10.3390/ijerph18137197
35. Auger N, Rhéaume MA, Bilodeau-Bertrand M, Tang T, Kosatsky T. Climate and the eye: Case–crossover analy sis of retinal detachment after exposure to ambient heat. Environ Res. 2017;157:103-109. doi: 10.1016/j.envres.2017.05.017
36. Zacharias S, Koppe C, Mücke HG. Influence of heat waves on ischemic heart diseases in Germany. Climate. 2014;2(3):133-152. doi: 10.3390/cli2030133
37. Cheng J, Xu Z, Bambrick H, et al. Cardiorespiratory effects of heatwaves: A systematic review and meta-analy sis of global epidemiological evidence. Environ Res. 2019;177:108610. doi: 10.1016/j.envres.2019.108610
38. Wongpanarak N, Langkulsen U. Climate change and mental health in Northeast of Thailand. Int J Environ Health Res. 2024;34(11):3860-3875. doi: 10.1080/09603123.2024.2328741
39. Thompson R, Hornigold R, Page L, Waite T. Associa tions between high ambient temperatures and heat waves with mental health outcomes: A systematic review. Public Health. 2018;161:171-191. doi: 10.1016/j.puhe.2018.06.008
40. Zhang A, Hu W, Li J, Wei R, Lin J, Ma W. Impact of heatwaves on daily outpatient visits of respiratory disease: A time-stratified case-crossover study. Environ Res. 2019;169:196-205. doi: 10.1016/j.envres.2018.10.034
41. D’Amato G, Chong-Neto HJ, Monge Ortega OP, et al. The effects of climate change on respiratory allergy and asthma induced by pollen and mold allergens. Allergy. 2020;75(9):2219-2228. doi: 10.1111/all.14476
42. Seah A, Aik J, Ng LC, Tam CC. The effects of maximum ambient temperature and heatwaves on dengue infec tions in the tropical city–state of Singapore – A time series analysis. Sci Total Environ. 2021;775:145117. doi: 10.1016/j.scitotenv.2021.145117
43. Milazzo A, Giles LC, Zhang Y, Koehler AP, Hiller JE, Bi P. The effects of ambient temperature and heatwaves on daily Campylobacter cases in Adelaide, Australia, 1990–2012. Epidemiol Infect. 2017;145(12):2603-2610. doi: 10.1017/S095026881700139X
Review
For citations:
Öztürk Yu. Analysis of Drug Sales in Pharmacies to Determine the Effects of Heat Waves on Chronic Diseases in Istanbul. Public Health and Life Environment – PH&LE. 2025;33(6):34-39. https://doi.org/10.35627/22195238/2025-33-6-34-39
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