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Mendrinos A, O'Brien J, Davis M, Baldwin A, Zaitchik BF, Britton A, Mwanja I, Gohlke JM. Association between summertime emergency department visits and maximum daily heat index in rural and non-rural areas of Virginia (2015-2022). THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 948:174753. [PMID: 39025140 DOI: 10.1016/j.scitotenv.2024.174753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 06/09/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
There is growing evidence that high ambient temperatures are associated with a range of adverse health outcomes. Further evidence suggests differences in rural versus non-rural populations' vulnerability to heat-related adverse health outcomes. The current project aims to 1) refine estimated associations between maximum daily heat index (HI) and emergency department (ED) visits in regions of Virginia, and 2) compare associations between maximum daily HI and ED visits in rural versus non-rural areas of Virginia and within those areas, for persons 65 years of age and older versus those younger than 65 years. Our study utilized 16,873,213 healthcare visits from Virginia facilities reporting to the Virginia Department of Health syndromic surveillance system between May and September 2015-2022. Federal Office of Rural Health Policy defined rural areas were assigned to patient home ZIP code. The estimated daily maximum HI at which ED visits begin to rise varies between 25 °C and 33 °C across climate zones and regions of Virginia. Across all regions, estimated ED visits attributable to days with maximum HI above 25.7 °C were higher in rural areas (3.7%, 95% CI: 3.5%, 3.9%) versus in non-rural areas (3.1%, 95% CIs: 3.0%, 3.2%). Patients aged 0-64 years had a higher estimated heat attributable fraction of ED visits (4.2%, 95% CI: 4.0%, 4.3%) than patients 65 years and older (3.1%, 95% CI: 2.9%, 3.4%). Rural patients older than 65 have a higher estimated fraction of heat attributable ED visits (2.7%, 95% CI: 2.2%, 3.1%) compared to non-rural patients 65 years and older (1.5%, 95% CI: 1.3%, 1.8%). State-level syndromic surveillance data can be used to optimize heat warning messaging based on expected changes in healthcare visits given a set of meteorological variables, and can be further refined based on climate, rurality and age.
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Affiliation(s)
- Antonia Mendrinos
- Department of Population Health Sciences, Virginia Polytechnic and State University, Blacksburg, VA, USA
| | - Janice O'Brien
- Department of Population Health Sciences, Virginia Polytechnic and State University, Blacksburg, VA, USA
| | - Meredith Davis
- Office of Epidemiology, Virginia Department of Health, Richmond, VA, USA
| | - Alexandra Baldwin
- Office of Epidemiology, Virginia Department of Health, Richmond, VA, USA
| | - Benjamin F Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Annie Britton
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Immaculata Mwanja
- Geospatial Data Services, University Libraries, Virginia Polytechnic and State University, Blacksburg, VA, USA
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Polytechnic and State University, Blacksburg, VA, USA.
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Boudreault J, Lavigne É, Campagna C, Chebana F. Estimating the heat-related mortality and morbidity burden in the province of Quebec, Canada. ENVIRONMENTAL RESEARCH 2024; 257:119347. [PMID: 38844034 DOI: 10.1016/j.envres.2024.119347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND As climate change increases the frequency and intensity of extreme heat events, there is an urgent need to quantify the heat-related health burden. However, most past studies have focussed on a single health outcome (mainly mortality) or on specific heatwaves, thus providing limited knowledge of the total pressure heat exerts on health services. OBJECTIVES This study aims to quantify the heat-related mortality and morbidity burden for five different health outcomes including all-cause mortality, hospitalizations, emergency department (ED) visits, ambulance transports and calls to a health hotline, using the province of Quebec (Canada) as a case study. METHODS A two-step statistical analysis was employed to estimate regional heat-health relationships using Distributed Lag Non-Linear Models (DLNM) and pooled estimates using a multivariate meta-regression. Heat burden was quantified by attributable fraction (AF) and attributable number (AN) for two temperature ranges: all heat (above the minimum mortality/morbidity temperature) and extreme heat (above the 95th percentile of temperature). RESULTS Higher temperatures were associated with greater risk ratios for all health outcomes studied, but at different levels. Significant AF ranging from 2 to 3% for the all heat effect and 0.4-1.0% for extreme heat were found for all health outcomes, except for hospitalizations that had an AF of 0.1% for both heat exposures. The estimated burden of all heat (and extreme heat) every summer across the province was 470 (200) deaths, 225 (170) hospitalizations, 36 000 (6 200) ED visits, 7 200 (1 500) ambulance transports and 15 000 (3 300) calls to a health hotline, all figures significant. DISCUSSION This new knowledge on the total heat load will help public health authorities to target appropriate actions to reduce its burden now and in the future. The proposed state-of-the-art framework can easily be applied to other regions also experiencing the adverse effects of extreme heat.
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Affiliation(s)
- Jérémie Boudreault
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3.
| | - Éric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON, Canada, K1A 0K9; School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, Canada, G1K 5Z3
| | - Céline Campagna
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3; Department of social and preventive medicine, Laval University, 1050 Av. de la Médecine, Québec, QC, Canada, G1V 0A6
| | - Fateh Chebana
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9
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Haque F, Lampe FC, Hajat S, Stavrianaki K, Hasan SMT, Faruque ASG, Ahmed T, Jubayer S, Kelman I. Is heat wave a predictor of diarrhoea in Dhaka, Bangladesh? A time-series analysis in a South Asian tropical monsoon climate. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003629. [PMID: 39226251 PMCID: PMC11371214 DOI: 10.1371/journal.pgph.0003629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 07/29/2024] [Indexed: 09/05/2024]
Abstract
While numerous studies have assessed the association between temperature and diarrhoea in various locations, evidence of relationship between heat wave and diarrhoea is scarce. We defined elevated daily mean and maximum temperature over the 95th and 99th percentiles lasting for at least one day between March to October 1981-2010 as TAV95 and TAV99 and D95 and D99 heat wave, respectively. We investigated the association between heat wave and daily counts of hospitalisations for all-cause diarrhoea in Dhaka, Bangladesh using time series regression analysis employing constrained distributed lag-linear models. Effects were assessed for all ages and children aged under 5 years of age. Diarrhoea hospitalisation increased by 6.7% (95% CI: 4.6%- 8.9%), 8.3% (3.7-13.1), 7.0 (4.8-9.3) and 7.4 (3.1-11.9) in all ages on a TAV95, TAV99, D95 and D99 heat wave day, respectively. These effects were more pronounced for under-5 children with an increase of 13.9% (95% CI: 8.3-19.9), 24.2% (11.3-38.7), 17.0 (11.0-23.5) and 19.5 (7.7-32.6) in diarrhoea hospitalisations on a TAV95, TAV99, D95 and D99 heat wave day, respectively. At lags of 3 days, we noticed a negative association indicating a 'harvesting' effect. Our findings suggest that heat wave was a significant risk factor for diarrhoea hospitalisation in Dhaka. Further research is needed to elucidate the causal pathways and identify the preventive measures necessary to mitigate the impacts of heat waves on diarrhoea. Given that no heat wave definitions exist for Dhaka, these results may help to define heat waves for Dhaka and trigger public health interventions including heat alerts to prevent heat-related morbidity in Dhaka, Bangladesh.
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Affiliation(s)
- Farhana Haque
- Institute for Global Health (IGH), University College London (UCL), London, United Kingdom
- UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Fiona C. Lampe
- Institute for Global Health (IGH), University College London (UCL), London, United Kingdom
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Katerina Stavrianaki
- Department of Statistical Science, Department of Risk and Disaster Reduction, University College London (UCL), London, United Kingdom
| | | | - A. S. G. Faruque
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Shamim Jubayer
- National Heart Foundation Hospital and Research Institute (NHF&RI), Dhaka, Bangladesh
| | - Ilan Kelman
- Department of Risk and Disaster Reduction, Institute for Global Health (IGH), University College London (UCL), London, United Kingdom
- University of Agder, Kristiansand, Norway
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Heidenreich A, Thieken AH. Individual heat adaptation: Analyzing risk communication, warnings, heat risk perception, and protective behavior in three German cities. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:1788-1808. [PMID: 38321845 DOI: 10.1111/risa.14278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 11/22/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
Extreme heat poses severe health threats, as the increased numbers of hospitalizations and fatalities during heat waves show, though little is known about adaptive behavior toward heat. We conducted a household survey on individual perceptions of heat stress and individual heat protection in the summer and autumn of 2019. In total, 1417 people from three medium-sized German cities participated via telephone or online. Based on the Protective Action Decision Model (PADM), which we adapted to heat stress, we analyzed links between risk perception, environmental and demographic factors, perceptions of stakeholders, different heat warning messages, as well as actual and intended adaptive behavior. Overall, the PADM constructs explained around 16% of the variance in protection motivation, 19% in protective response, and 23% in emotion-focused coping. Context factors (i.e., temperature, risk communication, gender, age, and homeownership) were significant predictors of the addressed outcome variables as were psychological factors (i.e., perceived personal vulnerability, response efficacy, response costs, preparedness, and perceived external responsibility). We further explored the effect of different warning messages on situational knowledge and intended behavioral adaptation in an experimental setting. Results showed that respondents felt significantly better informed after receiving a warning with action recommendations and reported more intended specific behaviors. Our research gives insights into individual protective action decision-making processes. Based on our findings, we recommend tailoring risk communication strategies and combining heat warnings with action recommendations whenever possible to increase understanding and individual adaptation.
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Affiliation(s)
- Anna Heidenreich
- Institute of Environmental Science and Geography, University of Potsdam, Potsdam-Golm, Brandenburg, Germany
| | - Annegret H Thieken
- Institute of Environmental Science and Geography, University of Potsdam, Potsdam-Golm, Brandenburg, Germany
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Wei Rong CW, Salleh H, Nishio H, Lee M. The impact of increasing ambient temperature on allergic rhinitis: A systematic review and meta-analysis of observational studies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 947:174348. [PMID: 38960184 DOI: 10.1016/j.scitotenv.2024.174348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION Global warming appears to initiate and aggravate allergic respiratory conditions via interaction with numerous environmental factors. Temperature, commonly identified as a factor in climate change, is important in this process. Allergic rhinitis, a common respiratory allergy, is on the rise and affects approximately 500 million individuals worldwide. The increasing ambient temperature requires evaluation regarding its influence on allergic rhinitis, taking into account regional climate zones. METHODS A detailed search of PubMed, EMBASE, Scopus, Web of Science, MEDLINE, and CINAHL Plus databases, was conducted, encompassing observational studies published from 1991 to 2023. Original studies examining the relationship between increasing temperature and allergic rhinitis were assessed for eligibility followed by a risk of bias assessment. Random effects meta-analysis was utilized to measure the association between a 1 °C increase in temperature and allergic rhinitis-related outcomes. RESULTS 20 studies were included in the qualitative synthesis, with nine of them subsequently selected for the quantitative synthesis. 20 included studies were rated as Level 4 evidence according to the Oxford Centre for Evidence-Based Medicine, and the majority of these reported good-quality evidence based on the Newcastle-Ottawa Quality Rating Scale. Using the Risk of Bias In Non-Randomized Studies of Exposure tool, the majority of studies exhibit a high risk of bias. Every 1 °C increase in temperature significantly raised the risk of allergic rhinitis-related outcomes by 29 % (RR = 1.26, 95 % CI: 1.11 to 1.50). Conversely, every 1 °C rise in temperature showed no significant increase in the odds of allergic rhinitis-related outcomes by 7 % (OR = 1.07, 95 % CI: 0.95 to 1.21). Subsequent subgroup analysis identified climate zone as an influential factor influencing this association. CONCLUSION It is inconclusive to definitively suggest a harmful effect of increasing temperature exposure on allergic rhinitis, due overall very low certainty of evidence. Further original research with better methodological quality is required.
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Affiliation(s)
- Christine Wong Wei Rong
- Public Health Division, Sabah State Health Department, Ministry of Health, Federal House, Mailbox no. 11290, 88814 Kota Kinabalu, Sabah, Malaysia; Graduate School of Public Health, St. Luke's International University, 3-6-2, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| | - Hazeqa Salleh
- Tuaran District Health Office, Sabah State Health Department, Ministry of Health, Mailbox no. 620, 89208 Tuaran, Sabah, Malaysia.
| | - Haruna Nishio
- Graduate School of Public Health, St. Luke's International University, 3-6-2, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| | - Mihye Lee
- Graduate School of Public Health, St. Luke's International University, 3-6-2, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
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Olowoyo JO, Okoya AA, Adesiyan IM, Awe YT, Lion GN, Agboola OO, Oladeji OM. Environmental health science research: opportunities and challenges for some developing countries in Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-25. [PMID: 38909292 DOI: 10.1080/09603123.2024.2370388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
Due to ongoing developmental projects, there is a need for regular monitoring of the impact of pollutants on the environment. This review documented the challenges and opportunities in the field of environmental health sciences in some African countries. A systematic review was used to investigate opportunities and challenges in the field of environmental health science in Africa by examining published work with a specific focus on Africa. The reports showed that funding and infrastructure as the major problems. The study also highlighted recruiting study participants, retention, and compensation as a bane in the field in Africa. The absence of modern equipment also hinders research. The review, however, noted research collaboration from the region including studies on emerging pollutants such as pharmaceuticals, per and polyfluoroalkyl substances (PFAS), and microplastic (MPs) as great opportunities. The study concluded that collaboration with other continents, exchange programs and improved governmental interventions may help.
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Affiliation(s)
- J O Olowoyo
- Department of Health Sciences and The Water School, Florida Gulf Coast University, Fort Myers, FL, USA
- Department of Biology and Environmental Sciences, Sefako Makgatho Health Sciences, South Africa
| | - A A Okoya
- Institute of Ecology and Environmental Studies, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - I M Adesiyan
- Department of Environmental and Occupational Health, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | - Y T Awe
- Environmental Management Program, Pan African University of Life and Earth Sciences, University of Ibadan, Oyo State, Nigeria
| | - G N Lion
- Department of Biology and Environmental Sciences, Sefako Makgatho Health Sciences, South Africa
| | - O O Agboola
- Department of Botany, University Lokoja, Kogi State, Nigeria
- Department of Biological Sciences, Federal University of Health Sciences Otukpo, Benue State, Nigeria
| | - O M Oladeji
- Department of Biology and Environmental Sciences, Sefako Makgatho Health Sciences, South Africa
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Chen S, Zhao J, Dou H, Yang Z, Li F, Byun J, Kim SW. A study on the monitoring of heatwaves and bivariate frequency analysis based on mortality risk assessment in Wuhan, China. Front Public Health 2024; 12:1409563. [PMID: 38962759 PMCID: PMC11220200 DOI: 10.3389/fpubh.2024.1409563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
The increasingly frequent occurrence of urban heatwaves has become a significant threat to human health. To quantitatively analyze changes in heatwave characteristics and to investigate the return periods of future heatwaves in Wuhan City, China, this study extracted 9 heatwave definitions and divided them into 3 mortality risk levels to identify and analyze historical observations and future projections of heatwaves. The copula functions were employed to derive the joint distribution of heatwave severity and duration and to analyze the co-occurrence return periods. The results demonstrate the following. (1) As the concentration of greenhouse gas emissions increases, the severity of heatwaves intensifies, and the occurrence of heatwaves increases significantly; moreover, a longer duration of heatwaves correlated with higher risk levels in each emission scenario. (2) Increasing concentrations of greenhouse gas emissions result in significantly shorter heatwave co-occurrence return periods at each level of risk. (3) In the 3 risk levels under each emission scenario, the co-occurrence return periods for heatwaves become longer as heatwave severity intensifies and duration increases. Under the influence of climate change, regional-specific early warning systems for heatwaves are necessary and crucial for policymakers to reduce heat-related mortality risks in the population, especially among vulnerable groups.
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Affiliation(s)
- Si Chen
- School of Resources and Environmental Science, Hubei University, Wuhan, China
- Hubei Key Laboratory of Regional Development and Environmental Response, Hubei University, Wuhan, China
| | - Junrui Zhao
- School of Information and Safety Engineering, Zhongnan University of Economics and Law, Wuhan, China
| | - Haonan Dou
- School of Resources and Environmental Science, Hubei University, Wuhan, China
| | - Zhaoqian Yang
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, China
| | - Fei Li
- School of Information and Safety Engineering, Zhongnan University of Economics and Law, Wuhan, China
| | - Jihye Byun
- Department of Transportation Engineering, University of Seoul, Seoul, Republic of Korea
| | - Seong Wook Kim
- Department of Applied Mathematics, Hanyang University, Ansan, Republic of Korea
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Abrams A, Asmall T, Hlahla S, Carden K, Dalvie MA. Method and process towards developing a Health Vulnerability Index (HVI) for Extreme Weather Events (EWEs) for local residents in South Africa. MethodsX 2024; 12:102725. [PMID: 38660032 PMCID: PMC11041910 DOI: 10.1016/j.mex.2024.102725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024] Open
Abstract
An increase in incidence and amplitude of extreme weather events (EWEs) linked to climate change, has resulted in greater human exposure and vulnerability to weather-related health effects. Increases in the occurrence of EWEs, including storms, flooding, extreme heat and wildfires, will impact health globally, with poor and vulnerable populations disproportionately affected. Vulnerability to EWEs, and the ability to adapt to these weather shocks, are influenced by existing physical, social and political limitations of a given region. As such, developing context-specific health vulnerability indices to inform planning and decision-making for policy makers and citizens alike, should be prioritized. The existence and development of health vulnerability indices in South Africa are limited, therefore, this study provides a foundation from which future indices can build. Mixed methods approaches including evidence and data analysis/synthesis and focus groups are used to understand the interconnections between extreme weather events and human health, including citizens' understanding of emergent vulnerabilities linked to these events. The methods employed in this study include: •A rapid evidence review (RER) including data extraction identifying health impacts and indicators.•Development of a draft health vulnerability index (HVI) framework.•Focus groups and individual interviews testing the draft HVI for citizen input and framework refinement.
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Affiliation(s)
- Amber Abrams
- Future Water Institute, University of Cape Town, Rondebosch, 7700, Cape Town, South Africa
| | - Taherah Asmall
- Future Water Institute, University of Cape Town, Rondebosch, 7700, Cape Town, South Africa
| | - Sithabile Hlahla
- Future Water Institute, University of Cape Town, Rondebosch, 7700, Cape Town, South Africa
| | - Kirsty Carden
- Future Water Institute, University of Cape Town, Rondebosch, 7700, Cape Town, South Africa
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
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Heidenreich A, Deppermann LH, Thieken AH, Otto A. [Heat and heavy rain prevention measures in daycare centres and care facilities: an evaluation of risk perception, communication and information materials]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:730-739. [PMID: 38656348 PMCID: PMC11166820 DOI: 10.1007/s00103-024-03876-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/26/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND AIM Heat and heavy rain can have negative health impacts for people in Germany. Vulnerable groups in particular, such as children and the elderly, are at increased risk and require special precautions. This paper examines how employers of the municipal administration and facilitating organisations perceive the risk of heat and heavy rain for daycare centres and care facilities, and to what extent an exchange takes place between the municipal level and the facilities. In addition, specially developed information materials with recommendations for action for adapting to heat and heavy rain that are aimed at such facilities were evaluated. METHODS In the summer of 2021, we conducted a quantitative survey. A total of 333 respondents from municipal administrations, facilitating organisations and institutions participated. Descriptive analyses and ANOVAs were conducted. RESULTS Risk perception and adaptation knowledge concerning heat was perceived higher than concerning heavy rain. The intention to support institutions in finding measures for adaptation was also higher with regard to heat. The majority of interviewees from municipal administrations and institutions communicated with institutions through various channels on different topics including the natural hazards mentioned. The information material was evaluated positively. DISCUSSION This article shows that facilities are seen as very affected by heat waves. Awareness towards heavy rainfall needs to be raised. The feedback on the information material clearly shows a high need in this area.
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Affiliation(s)
- Anna Heidenreich
- Institut für Umweltwissenschaften und Geographie, Universität Potsdam, Karl-Liebknecht-Straße 24-25, 14476, Potsdam-Golm, Deutschland
- Weizenbaum-Institut, Hardenbergstraße 32, 10623, Berlin, Deutschland
| | - Lara-Heléne Deppermann
- Institut für Umweltwissenschaften und Geographie, Universität Potsdam, Karl-Liebknecht-Straße 24-25, 14476, Potsdam-Golm, Deutschland
| | - Annegret H Thieken
- Institut für Umweltwissenschaften und Geographie, Universität Potsdam, Karl-Liebknecht-Straße 24-25, 14476, Potsdam-Golm, Deutschland
| | - Antje Otto
- Institut für Umweltwissenschaften und Geographie, Universität Potsdam, Karl-Liebknecht-Straße 24-25, 14476, Potsdam-Golm, Deutschland.
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Wang J, Wang P, Liu B, Kinney PL, Huang L, Chen K. Comprehensive evaluation framework for intervention on health effects of ambient temperature. ECO-ENVIRONMENT & HEALTH 2024; 3:154-164. [PMID: 38646097 PMCID: PMC11031729 DOI: 10.1016/j.eehl.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/28/2023] [Accepted: 01/12/2024] [Indexed: 04/23/2024]
Abstract
Despite the existence of many interventions to mitigate or adapt to the health effects of climate change, their effectiveness remains unclear. Here, we introduce the Comprehensive Evaluation Framework for Intervention on Health Effects of Ambient Temperature to evaluate study designs and effects of intervention studies. The framework comprises three types of interventions: proactive, indirect, and direct, and four categories of indicators: classification, methods, scope, and effects. We trialed the framework by an evaluation of existing intervention studies. The evaluation revealed that each intervention has its own applicable characteristics in terms of effectiveness, feasibility, and generalizability scores. We expanded the framework's potential by offering a list of intervention recommendations in different scenarios. Future applications are then explored to establish models of the relationship between study designs and intervention effects, facilitating effective interventions to address the health effects of ambient temperature under climate change.
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Affiliation(s)
- Jiaming Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Peng Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Faculty of Civil Engineering and Mechanics, Jiangsu University, Zhenjiang 212013, China
| | - Beibei Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Patrick L. Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Lei Huang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Center for Public Health Research, Medical School of Nanjing University, Nanjing 210093, China
| | - Kai Chen
- Department of Environmental Health Sciences, Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT 06510, USA
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Rahman MM, Mannan MA, Sarkar MSK, Mallik MAK, Sultana A, Islam MK, Akter MY, Alam E, Islam ARMT. Are hotspots and frequencies of heat waves changing over time? Exploring causes of heat waves in a tropical country. PLoS One 2024; 19:e0300070. [PMID: 38776342 PMCID: PMC11111018 DOI: 10.1371/journal.pone.0300070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/20/2024] [Indexed: 05/24/2024] Open
Abstract
Heat waves significantly impact people's lives and livelihoods and are becoming very alarming and recognized as hot topics worldwide, including in Bangladesh. However, much less is understood regarding recent hotspots, the frequency of heat waves over time, and their underlying causes in Bangladesh. The objective of the study is to explore the current scenario and frequency of heat waves and their possible causes across Bangladesh. The Mann-Kendall and Sen's slope techniques were used to determine seasonal and annual temperature trend patterns of heat wave frequencies. Daily maximum temperature datasets collected from the Bangladesh Meteorological Department (BMD) during 1991-2021 are applied. The frequency of days with Tmax≥ 36°C as the threshold was used to compute different types of heat waves based on the BMD's operational definition. The results show that the mild heat wave (MHW) days followed the subsequent hotspot order: Rajshahi (103) > Chuadanga (79), Ishurdi (60), and Jessore (58), respectively. The frequency of days with Tmax≥36°C was persistence for many days in 2014, especially in the western part of Bangladesh compared to other parts. Similarly, the heat waves condition shown its deadliest event by increasing more days in 2021. The highest increasing trend was identified at the Patuakhali site, with a rate of 0.516 days/year, while the highest decreasing trend was noticed at the Chuadanga site, with a rate of -0.588 days/year. The frequency of days (Tmax≥36°C) is an increasing trend in the south-western part of Bangladesh. The synoptic condition in and around Bangladesh demonstrates that the entrance of heat waves in Bangladesh is due to the advection of higher temperatures from the south/southwest of the Bay of Bengal. The outcomes will guide the national appraisal of heatwave effects, shedding light on the primary causes of definite heatwave phenomena, which are crucial for developing practical adaptation tools.
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Affiliation(s)
| | | | | | | | | | - Md. Kamrul Islam
- Department of Civil and Environmental Engineering, College of Engineering, King Faisal University, AlAhsa, Saudi Arabia
| | - Mst Yeasmin Akter
- Department of Disaster Management, Begum Rokeya University, Rangpur, Bangladesh
| | - Edris Alam
- Department of Geography and Environmental Studies, University of Chittagong, Chittagong, Bangladesh
- Faculty of Resilience, Rabdan Academy, Abu Dhabi, United Arab Emirates
| | - Abu Reza Md. Towfiqul Islam
- Department of Disaster Management, Begum Rokeya University, Rangpur, Bangladesh
- Department of Development studies, Daffodil International University, Dhaka, Bangladesh
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12
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Zhu Q, Ye P, Wang Y, Duan L, He G, Er Y, Jin Y, Ji C, Hu J, Deng X, Ma W, Liu T. Heatwaves increase road traffic injury morbidity risk and burden in China and its provinces. ENVIRONMENT INTERNATIONAL 2024; 188:108760. [PMID: 38788419 DOI: 10.1016/j.envint.2024.108760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/08/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
Previous studies have demonstrated health impacts of climate change, but evidence on heatwaves' associations with road traffic injury (RTI) is limited. In this study, individual information of RTI cases in May-September during 2006-2021 in China were obtained from the National Injury Surveillance System. Daily maximum temperatures (TMmax) during 2006-2021 were collected from the ERA-5 reanalysis, and the projected daily TMmax during 2020-2099 were obtained from the latest Coupled Model Intercomparison Project Phase 6 Shared Socioeconomic Pathways scenarios (SSPs). We used a time-stratified case-crossover analysis to investigate the association between short-term exposure (lag01 days) to heatwaves (exceeding the 92.5th percentile of daily TMmax for ≥ three consecutive days) and RTI, and to project heatwave-related RTI until 2099 across China. Finally, a total of 1 031 082 RTI cases were included in the analyses. Compared with non-heatwaves, the risks of RTI increased by 3.61 % during heatwaves. Greater associations were found in people aged 15-64 years, in people with transportation occupation, for non-motor traffic vehicle injuries, for severe RTI cases, and in Western China particularly in Qinghai province. We projected substantial increases in attributable fraction (AF) of heatwave-related RTI in the future, particularly in Western and Southwest China. The national average increase in AF (per decade) during 2020s-2090s was 0.036 % for SSP1-2.6 scenario, and 0.267 % for SSP5-8.5 scenario. This study provided evidence on the associations of heatwaves with RTI, and the heatwave-related RTI will substantially increase in the future.
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Affiliation(s)
- Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China
| | - Pengpeng Ye
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yuan Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yuliang Er
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Ye Jin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Cuirong Ji
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Xiao Deng
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
| | - Tao Liu
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China.
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13
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Gibb K, Beckman S, Vergara XP, Heinzerling A, Harrison R. Extreme Heat and Occupational Health Risks. Annu Rev Public Health 2024; 45:315-335. [PMID: 38166501 DOI: 10.1146/annurev-publhealth-060222-034715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Climate change poses a significant occupational health hazard. Rising temperatures and more frequent heat waves are expected to cause increasing heat-related morbidity and mortality for workers across the globe. Agricultural, construction, military, firefighting, mining, and manufacturing workers are at particularly high risk for heat-related illness (HRI). Various factors, including ambient temperatures, personal protective equipment, work arrangements, physical exertion, and work with heavy equipment may put workers at higher risk for HRI. While extreme heat will impact workers across the world, workers in low- and middle-income countries will be disproportionately affected. Tracking occupational HRI will be critical to informing prevention and mitigation strategies. Renewed investment in these strategies, including workplace heat prevention programs and regulatory standards for indoor and outdoor workers, will be needed. Additional research is needed to evaluate the effectiveness of interventions in order to successfully reduce the risk of HRI in the workplace.
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Affiliation(s)
- Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Stella Beckman
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | | | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
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14
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Singh N, Areal AT, Breitner S, Zhang S, Agewall S, Schikowski T, Schneider A. Heat and Cardiovascular Mortality: An Epidemiological Perspective. Circ Res 2024; 134:1098-1112. [PMID: 38662866 PMCID: PMC11042530 DOI: 10.1161/circresaha.123.323615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
As global temperatures rise, extreme heat events are projected to become more frequent and intense. Extreme heat causes a wide range of health effects, including an overall increase in morbidity and mortality. It is important to note that while there is sufficient epidemiological evidence for heat-related increases in all-cause mortality, evidence on the association between heat and cause-specific deaths such as cardiovascular disease (CVD) mortality (and its more specific causes) is limited, with inconsistent findings. Existing systematic reviews and meta-analyses of epidemiological studies on heat and CVD mortality have summarized the available evidence. However, the target audience of such reviews is mainly limited to the specific field of environmental epidemiology. This overarching perspective aims to provide health professionals with a comprehensive overview of recent epidemiological evidence of how extreme heat is associated with CVD mortality. The rationale behind this broad perspective is that a better understanding of the effect of extreme heat on CVD mortality will help CVD health professionals optimize their plans to adapt to the changes brought about by climate change and heat events. To policymakers, this perspective would help formulate targeted mitigation, strengthen early warning systems, and develop better adaptation strategies. Despite the heterogeneity in evidence worldwide, due in part to different climatic conditions and population dynamics, there is a clear link between heat and CVD mortality. The risk has often been found to be higher in vulnerable subgroups, including older people, people with preexisting conditions, and the socioeconomically deprived. This perspective also highlights the lack of evidence from low- and middle-income countries and focuses on cause-specific CVD deaths. In addition, the perspective highlights the temporal changes in heat-related CVD deaths as well as the interactive effect of heat with other environmental factors and the potential biological pathways. Importantly, these various aspects of epidemiological studies have never been fully investigated and, therefore, the true extent of the impact of heat on CVD deaths remains largely unknown. Furthermore, this perspective also highlights the research gaps in epidemiological studies and the potential solutions to generate more robust evidence on the future consequences of heat on CVD deaths.
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Affiliation(s)
- Nidhi Singh
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Ashtyn Tracy Areal
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
| | - Siqi Zhang
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Stefan Agewall
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
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15
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Pinna S, Longo D, Zanobini P, Lorini C, Bonaccorsi G, Baccini M, Cecchi F. How to communicate with older adults about climate change: a systematic review. Front Public Health 2024; 12:1347935. [PMID: 38638477 PMCID: PMC11025664 DOI: 10.3389/fpubh.2024.1347935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction Although older adults are particularly vulnerable to the effects of climate change, they seem to be overall less concerned about it, and less inclined to support climate policies. The study aims to identify the communication strategies that have been evaluated in promoting awareness and/or climate friendly behaviors in older adults. Methods We searched multiple electronic databases for studies that evaluated the effects of any interventions aimed at communicating climate change to older persons (over 65 years) and assessed the results as awareness and /or behavioral changes. We selected quantitative, qualitative and mixed methods studies, and we also included systematic reviews for cross-referencing. Risk of bias of included studies was evaluated using different tools according to the study design. Results From a total of 5,486 articles, only 3 studies were included. One mixed-method study engaged older adults to assess the community vulnerability to climate change and to develop adaptation recommendations based on their perspectives; one qualitative study conducted focus groups to identify the more effective language, values and themes based on participants' responses to narratives; one quantitative study utilized a 360-degree audio-visual platform allowing users to engage with immersive visualizations of sea-level rise scenarios. Discussion Despite the paucity of literature, this review demonstrates the potential for different strategies to increase the awareness of older persons about climate change. The involvement of older adults in the communication process, the identification of their priorities, and the integration of technology in their daily lives are promising approaches but more research, including both quantitative and qualitative studies is recommended on this topic. Systematic review registeration For further details about the protocol, this systematic review has been registered on PROSPERO on July 1, 2023 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023438256).
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Affiliation(s)
- Samuele Pinna
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Fondazione don Carlo Gnocchi, Scientific Institute, Florence, Italy
| | - Diego Longo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Patrizio Zanobini
- Department of Health Science, University of Florence, Florence, Italy
| | - Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy
| | | | - Marco Baccini
- Fondazione don Carlo Gnocchi, Scientific Institute, Florence, Italy
| | - Francesca Cecchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Fondazione don Carlo Gnocchi, Scientific Institute, Florence, Italy
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16
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Beggs PJ, Trueck S, Linnenluecke MK, Bambrick H, Capon AG, Hanigan IC, Arriagada NB, Cross TJ, Friel S, Green D, Heenan M, Jay O, Kennard H, Malik A, McMichael C, Stevenson M, Vardoulakis S, Dang TN, Garvey G, Lovett R, Matthews V, Phung D, Woodward AJ, Romanello MB, Zhang Y. The 2023 report of the MJA-Lancet Countdown on health and climate change: sustainability needed in Australia's health care sector. Med J Aust 2024; 220:282-303. [PMID: 38522009 DOI: 10.5694/mja2.52245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/06/2023] [Indexed: 03/25/2024]
Abstract
The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020, 2021 and 2022. It examines five broad domains: health hazards, exposures and impacts; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In this, the sixth report of the MJA-Lancet Countdown, we track progress on an extensive suite of indicators across these five domains, accessing and presenting the latest data and further refining and developing our analyses. Our results highlight the health and economic costs of inaction on health and climate change. A series of major flood events across the four eastern states of Australia in 2022 was the main contributor to insured losses from climate-related catastrophes of $7.168 billion - the highest amount on record. The floods also directly caused 23 deaths and resulted in the displacement of tens of thousands of people. High red meat and processed meat consumption and insufficient consumption of fruit and vegetables accounted for about half of the 87 166 diet-related deaths in Australia in 2021. Correction of this imbalance would both save lives and reduce the heavy carbon footprint associated with meat production. We find signs of progress on health and climate change. Importantly, the Australian Government released Australia's first National Health and Climate Strategy, and the Government of Western Australia is preparing a Health Sector Adaptation Plan. We also find increasing action on, and engagement with, health and climate change at a community level, with the number of electric vehicle sales almost doubling in 2022 compared with 2021, and with a 65% increase in coverage of health and climate change in the media in 2022 compared with 2021. Overall, the urgency of substantial enhancements in Australia's mitigation and adaptation responses to the enormous health and climate change challenge cannot be overstated. Australia's energy system, and its health care sector, currently emit an unreasonable and unjust proportion of greenhouse gases into the atmosphere. As the Lancet Countdown enters its second and most critical phase in the leadup to 2030, the depth and breadth of our assessment of health and climate change will be augmented to increasingly examine Australia in its regional context, and to better measure and track key issues in Australia such as mental health and Aboriginal and Torres Strait Islander health and wellbeing.
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Affiliation(s)
| | | | | | - Hilary Bambrick
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Anthony G Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | | | | | | | | | - Donna Green
- Climate Change Research Centre and ARC Centre of Excellence for Climate Extremes, UNSW, Sydney, NSW
| | - Maddie Heenan
- Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW
- The George Institute for Global Health, Sydney, NSW
| | - Ollie Jay
- Thermal Ergonomics Laboratory, University of Sydney, Sydney, NSW
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | | | | | - Mark Stevenson
- Transport, Health and Urban Design (THUD) Research Lab, University of Melbourne, Melbourne, VIC
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Tran N Dang
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
- Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra, ACT
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, Sydney, NSW
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17
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Xie Y, Zhou Z, Sun Q, Zhao M, Pu J, Li Q, Sun Y, Dai H, Li T. Social-economic transitions and vulnerability to extreme temperature events from 1960 to 2020 in Chinese cities. iScience 2024; 27:109066. [PMID: 38361620 PMCID: PMC10867637 DOI: 10.1016/j.isci.2024.109066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
Climate change leads to more frequent and intense extreme temperature events, causing a significant number of excess deaths. Using an epidemiological approach, we analyze all-cause deaths related to heatwaves and cold spells in 2,852 Chinese counties from 1960 to 2020. Economic losses associated with these events are determined through the value of statistical life. Findings reveal that cold-related cumulative excess deaths (1,133 thousand) are approximately 2.5 times higher than heat-related deaths, despite an increase in heat-related fatalities in recent decades. Monetized mortality due to heat-related events is estimated at 1,284 billion CNY, while cold-related economic loss is 1,510 billion CNY. Notably, cities located in colder regions experience more heat-related excess deaths, and vice versa. Economic development does not significantly reduce mortality risks to heatwaves across China. This study provides insights into the spatial-temporal heterogeneity of heatwaves and cold spells mortality, essential for policymakers ensuring long-term climate adaptation and sustainability.
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Affiliation(s)
- Yang Xie
- School of Economics and Management, Beihang University, Beijing, China
| | - Ziqiao Zhou
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengdan Zhao
- School of Economics and Management, Beihang University, Beijing, China
| | - Jinlu Pu
- School of Economics and Management, Beihang University, Beijing, China
| | - Qiutong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hancheng Dai
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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18
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Yemane GD, Tareke AA, Zakaria HF, Takele BA, Jemal SS. Time to death and its determinants of under-five children in rural Ethiopia by using shared frailty. Sci Rep 2024; 14:5647. [PMID: 38453982 PMCID: PMC10920639 DOI: 10.1038/s41598-024-56063-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
Under-five (U5M) is one of the most significant and sensitive measures of the community's health. Children who live in rural areas are more likely than those who live in urban areas to die before the age of five. Therefore, the study aimed to assess the Survival status of under-five mortality and its determinants in rural Ethiopia. The 2019 Ethiopia Mini Demographic and Health Survey was used in this study as a secondary source (EMDHS). A total of 4426 weighted under-five children were included in the study. To determine survival time and identify predictors of death among children under the age of five, the Cox's gamma shared frailty model and the Kaplan Meier model, respectively, were used. An adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) were used to measure the size and direction of the association. The Study showed that in rural Ethiopia, 6.03% of children died before celebrating their first birthday. The median age of under-five mortality in rural Ethiopia was estimated to be 29 Months. The hazard of death among under-five children and those who had given birth to two children in the last five years was 4.99 times less likely to be at risk of dying than those who had given birth to one Child in the previous five years (AHR 4.99, 95% CI 2.97, 8.83). The Study Concluded that under-five mortality remained high in rural Ethiopia. In the final model, the Age of Mothers, Sex of Household, Breastfeeding, Types of Birth, Sex of Child, Educational Level of Mothers, Wealth Index, Child ever born, Marital Status, and Water Source were significant predictors of under-five mortality. Twins and children who are not breastfed should receive additional attention, along with improving water resources for households and mothers income.
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Affiliation(s)
- Getahun Dejene Yemane
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
| | - Abiyu Abadi Tareke
- Zonal COVID-19/EPI Technical Assistant at West Gondar Zone Health Department, Amref Health Africa in Ethiopia, Gondar, Ethiopia
| | - Hamdi Fekredin Zakaria
- Department of Epidemiology and Biostatistics, School of Public Health, Haramaya University, Harar, Ethiopia
| | - Bayley Adane Takele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Sebwedin Surur Jemal
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia
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19
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Kumar P, Debele SE, Khalili S, Halios CH, Sahani J, Aghamohammadi N, Andrade MDF, Athanassiadou M, Bhui K, Calvillo N, Cao SJ, Coulon F, Edmondson JL, Fletcher D, Dias de Freitas E, Guo H, Hort MC, Katti M, Kjeldsen TR, Lehmann S, Locosselli GM, Malham SK, Morawska L, Parajuli R, Rogers CD, Yao R, Wang F, Wenk J, Jones L. Urban heat mitigation by green and blue infrastructure: Drivers, effectiveness, and future needs. Innovation (N Y) 2024; 5:100588. [PMID: 38440259 PMCID: PMC10909648 DOI: 10.1016/j.xinn.2024.100588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
The combination of urbanization and global warming leads to urban overheating and compounds the frequency and intensity of extreme heat events due to climate change. Yet, the risk of urban overheating can be mitigated by urban green-blue-grey infrastructure (GBGI), such as parks, wetlands, and engineered greening, which have the potential to effectively reduce summer air temperatures. Despite many reviews, the evidence bases on quantified GBGI cooling benefits remains partial and the practical recommendations for implementation are unclear. This systematic literature review synthesizes the evidence base for heat mitigation and related co-benefits, identifies knowledge gaps, and proposes recommendations for their implementation to maximize their benefits. After screening 27,486 papers, 202 were reviewed, based on 51 GBGI types categorized under 10 main divisions. Certain GBGI (green walls, parks, street trees) have been well researched for their urban cooling capabilities. However, several other GBGI have received negligible (zoological garden, golf course, estuary) or minimal (private garden, allotment) attention. The most efficient air cooling was observed in botanical gardens (5.0 ± 3.5°C), wetlands (4.9 ± 3.2°C), green walls (4.1 ± 4.2°C), street trees (3.8 ± 3.1°C), and vegetated balconies (3.8 ± 2.7°C). Under changing climate conditions (2070-2100) with consideration of RCP8.5, there is a shift in climate subtypes, either within the same climate zone (e.g., Dfa to Dfb and Cfb to Cfa) or across other climate zones (e.g., Dfb [continental warm-summer humid] to BSk [dry, cold semi-arid] and Cwa [temperate] to Am [tropical]). These shifts may result in lower efficiency for the current GBGI in the future. Given the importance of multiple services, it is crucial to balance their functionality, cooling performance, and other related co-benefits when planning for the future GBGI. This global GBGI heat mitigation inventory can assist policymakers and urban planners in prioritizing effective interventions to reduce the risk of urban overheating, filling research gaps, and promoting community resilience.
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Affiliation(s)
- Prashant Kumar
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
- Institute for Sustainability, University of Surrey, Guildford GU2 7XH, Surrey, UK
- School of Architecture, Southeast University, 2 Sipailou, Nanjing 210096, China
| | - Sisay E. Debele
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Soheila Khalili
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Christos H. Halios
- School of Built Environment, University of Reading, Whiteknights, Reading RG6 6BU, UK
| | - Jeetendra Sahani
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Nasrin Aghamohammadi
- School Design and the Built Environment, Curtin University Sustainability Policy Institute, Kent St, Bentley 6102, Western Australia
- Harry Butler Institute, Murdoch University, Murdoch 6150, Western Australia
| | - Maria de Fatima Andrade
- Atmospheric Sciences Department, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of Sao Paulo, Sao Paulo 05508-090, Brazil
| | | | - Kamaldeep Bhui
- Department of Psychiatry and Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, Oxford, UK
| | - Nerea Calvillo
- Centre for Interdisciplinary Methodologies, University of Warwick, Warwick, UK
| | - Shi-Jie Cao
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
- School of Architecture, Southeast University, 2 Sipailou, Nanjing 210096, China
| | - Frederic Coulon
- Cranfield University, School of Water, Environment and Energy, Cranfield MK43 0AL, UK
| | - Jill L. Edmondson
- Plants, Photosynthesis, Soil Cluster, School of Biosciences, University of Sheffield, Sheffield S10 2TN, UK
| | - David Fletcher
- UK Centre for Ecology & Hydrology, Environment Centre Wales, Deiniol Road, Bangor LL57 2UW, UK
| | - Edmilson Dias de Freitas
- Atmospheric Sciences Department, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of Sao Paulo, Sao Paulo 05508-090, Brazil
| | - Hai Guo
- Air Quality Studies, Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Madhusudan Katti
- Department of Forestry and Environmental Resources, Faculty Excellence Program for Leadership in Public Science, North Carolina State University, Chancellor, Raleigh, NC 27695, USA
| | - Thomas Rodding Kjeldsen
- Departments of Architecture & Civil Engineering, and Chemical Engineering, University of Bath, Bath BA2 7AY, UK
| | - Steffen Lehmann
- School of Architecture, University of Nevada, Las Vegas, NV 89154, USA
| | - Giuliano Maselli Locosselli
- Department of Tropical Ecosystems Functioning, Center of Nuclear Energy in Agriculture, University of São Paulo, Piracicaba 13416-000, Sao Paulo, Brazil
| | - Shelagh K. Malham
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5 AB, UK
| | - Lidia Morawska
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
- International Laboratory for Air Quality and Health, Science and Engineering Faculty, Queensland University of Science and Technology, QLD, Australia
| | - Rajan Parajuli
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
| | - Christopher D.F. Rogers
- Department of Civil Engineering, School of Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Runming Yao
- School of Built Environment, University of Reading, Whiteknights, Reading RG6 6BU, UK
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, School of the Civil Engineering, Chongqing University, Chongqing, China
| | - Fang Wang
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing 210008, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jannis Wenk
- Departments of Architecture & Civil Engineering, and Chemical Engineering, University of Bath, Bath BA2 7AY, UK
| | - Laurence Jones
- UK Centre for Ecology & Hydrology, Environment Centre Wales, Deiniol Road, Bangor LL57 2UW, UK
- Liverpool Hope University, Department of Geography and Environmental Science, Hope Park, Liverpool L16 9JD, UK
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20
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Kapwata T, Abdelatif N, Scovronick N, Gebreslasie MT, Acquaotta F, Wright CY. Identifying heat thresholds for South Africa towards the development of a heat-health warning system. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:381-392. [PMID: 38157021 PMCID: PMC10794383 DOI: 10.1007/s00484-023-02596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
Exposure to heatwaves may result in adverse human health impacts. Heat alerts in South Africa are currently based on defined temperature-fixed threshold values for large towns and cities. However, heat-health warning systems (HHWS) should incorporate metrics that have been shown to be effective predictors of negative heat-related health outcomes. This study contributes to the development of a HHWS for South Africa that can potentially minimize heat-related mortality. Distributed lag nonlinear models (DLNM) were used to assess the association between maximum and minimum temperature and diurnal temperature range (DTR) and population-adjusted mortality during summer months, and the effects were presented as incidence rate ratios (IRR). District-level thresholds for the best predictor from these three metrics were estimated with threshold regression. The mortality dataset contained records of daily registered deaths (n = 8,476,532) from 1997 to 2013 and data for the temperature indices were for the same period. Maximum temperature appeared to be the most statistically significant predictor of all-cause mortality with strong associations observed in 40 out of 52 districts. Maximum temperature was associated with increased risk of mortality in all but three of the districts. Our results also found that heat-related mortality was influenced by regional climate because the spatial distribution of the thresholds varied according to the climate zones across the country. On average, districts located in the hot, arid interior provinces of the Northern Cape and North West experienced some of the highest thresholds compared to districts located in temperate interior or coastal provinces. As the effects of climate change become more significant, population exposure to heat is increasing. Therefore, evidence-based HHWS are required to reduce heat-related mortality and morbidity. The exceedance of the maximum temperature thresholds provided in this study could be used to issue heat alerts as part of effective heat health action plans.
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Affiliation(s)
- Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2028, South Africa.
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa.
| | - Nada Abdelatif
- Biostatistics Research Unit, South African Medical Research Council, Durban, 4001, South Africa
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Michael T Gebreslasie
- School of Agriculture, Earth, and Environmental Sciences, University of KwaZulu-Natal, Durban, 3629, South Africa
| | | | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0084, South Africa
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21
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Oberai M, Xu Z, Bach AJE, Phung D, Watzek JT, Rutherford S. Preparing for a hotter climate: A systematic review and meta-analysis of heatwaves and ambulance callouts in Australia. Aust N Z J Public Health 2024; 48:100115. [PMID: 38286717 DOI: 10.1016/j.anzjph.2023.100115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/05/2023] [Accepted: 11/21/2023] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE The objective of this study was to quantify the impact of heatwaves on likelihood of ambulance callouts for Australia. METHODS A systematic review and meta-analysis was conducted to retrieve and synthesise evidence published from 1 January 2011 to 31 May 2023 about the association between heatwaves and the likelihood of ambulance callouts in Australia. Different heatwave definitions were used ranging from excess heat factor to heatwave defined as a continuous period with temperatures above certain defined thresholds (which varied based on study locations). RESULTS We included nine papers which met the inclusion criteria for the review. Eight were eligible for the meta-analyses. The multilevel meta-analyses revealed that the likelihood of ambulance callouts for all causes and for cardiovascular diseases increased by 10% (95% confidence interval: 8%, 13%) and 5% (95% confidence interval: 1%, 3%), respectively, during heatwave days. CONCLUSIONS Exposure to heatwaves is associated with an increased likelihood of ambulance callouts, and there is a dose-response association between heatwave severity and the likelihood of ambulance callouts. IMPLICATIONS FOR PUBLIC HEALTH The number of heatwave days are going to increase, and this will mean an increase in the likelihood of ambulance callouts, thereby, spotlighting the real burden that heatwaves place on our already stressed healthcare system. The findings of this study underscore the critical need for proactive measures, including the establishment of research initiatives and holistic heat health awareness campaigns, spanning from the individual and community levels to the healthcare system, in order to create a more resilient Australia in the face of heatwave-related challenges.
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Affiliation(s)
- Mehak Oberai
- School of Medicine and Dentistry, Griffith University, Australia.
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Australia; Cities Research Institute, Griffith University, Australia
| | - Aaron J E Bach
- School of Medicine and Dentistry, Griffith University, Australia; Cities Research Institute, Griffith University, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Australia
| | - Jessica T Watzek
- School of Medicine and Dentistry, Griffith University, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Australia; Cities Research Institute, Griffith University, Australia
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22
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Monteiro dos Santos D, Libonati R, Garcia BN, Geirinhas JL, Salvi BB, Lima e Silva E, Rodrigues JA, Peres LF, Russo A, Gracie R, Gurgel H, Trigo RM. Twenty-first-century demographic and social inequalities of heat-related deaths in Brazilian urban areas. PLoS One 2024; 19:e0295766. [PMID: 38265975 PMCID: PMC10807764 DOI: 10.1371/journal.pone.0295766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/28/2023] [Indexed: 01/26/2024] Open
Abstract
Population exposure to heat waves (HWs) is increasing worldwide due to climate change, significantly affecting society, including public health. Despite its significant vulnerabilities and limited adaptation resources to rising temperatures, South America, particularly Brazil, lacks research on the health impacts of temperature extremes, especially on the role played by socioeconomic factors in the risk of heat-related illness. Here, we present a comprehensive analysis of the effects of HWs on mortality rates in the 14 most populous urban areas, comprising approximately 35% of the country's population. Excess mortality during HWs was estimated through the observed-to-expected ratio (O/E) for total deaths during the events identified. Moreover, the interplay of intersectionality and vulnerability to heat considering demographics and socioeconomic heterogeneities, using gender, age, race, and educational level as proxies, as well as the leading causes of heat-related excess death, were assessed. A significant increase in the frequency was observed from the 1970s (0-3 HWs year-1) to the 2010s (3-11 HWs year-1), with higher tendencies in the northern, northeastern, and central-western regions. Over the 2000-2018 period, 48,075 (40,448-55,279) excessive deaths were attributed to the growing number of HWs (>20 times the number of landslides-related deaths for the same period). Nevertheless, our event-based surveillance analysis did not detect the HW-mortality nexus, reinforcing that extreme heat events are a neglected disaster in Brazil. Among the leading causes of death, diseases of the circulatory and respiratory systems and neoplasms were the most frequent. Critical regional differences were observed, which can be linked to the sharp North-South inequalities in terms of socioeconomic and health indicators, such as life expectancy. Higher heat-related excess mortality was observed for low-educational level people, blacks and browns, older adults, and females. Such findings highlight that the strengthening of primary health care combined with reducing socioeconomic, racial, and gender inequalities represents a crucial step to reducing heat-related deaths.
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Affiliation(s)
| | - Renata Libonati
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Universidade de Lisboa, Faculdade de Ciências, Instituto Dom Luiz, Lisbon, Portugal
- Forest Research Centre, School of Agriculture, University of Lisbon, Lisbon, Portugal
| | - Beatriz N. Garcia
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - João L. Geirinhas
- Universidade de Lisboa, Faculdade de Ciências, Instituto Dom Luiz, Lisbon, Portugal
| | - Barbara Bresani Salvi
- Escola Nacional de Saúde Pública Sergio Arouca - ENSP/ Fiocruz - Programa de Pós Graduação em Saúde Pública e Meio Ambiente
| | - Eliane Lima e Silva
- Departamento de Geografia, Universidade de Brasilia, Distrito Federal, Brazil
- LMI Sentinela, International Joint Laboratory “Sentinela” (Fiocruz, UnB, IRD), Distrito Federal, Brazil
| | - Julia A. Rodrigues
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo F. Peres
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Russo
- Universidade de Lisboa, Faculdade de Ciências, Instituto Dom Luiz, Lisbon, Portugal
| | - Renata Gracie
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde - ICICT/Fiocruz Rio de Janeiro, Rio de Janeiro, Brazil
| | - Helen Gurgel
- Departamento de Geografia, Universidade de Brasilia, Distrito Federal, Brazil
- LMI Sentinela, International Joint Laboratory “Sentinela” (Fiocruz, UnB, IRD), Distrito Federal, Brazil
| | - Ricardo M. Trigo
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Universidade de Lisboa, Faculdade de Ciências, Instituto Dom Luiz, Lisbon, Portugal
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23
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Oh J, Kim E, Kwag Y, An H, Kim HS, Shah S, Lee JH, Ha E. Heat wave exposure and increased heat-related hospitalizations in young children in South Korea: A time-series study. ENVIRONMENTAL RESEARCH 2024; 241:117561. [PMID: 37951381 DOI: 10.1016/j.envres.2023.117561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Numerous studies have investigated the association between heat wave exposure increased heat-related hospitalizations in the general population. However, little is known about heat-related morbidity in young children who are more vulnerable than the general population. Therefore, we aimed to evaluate the association between hospitalization for heat-related illness in children and heat wave exposure in South Korea. METHODS We used the National Health Insurance Service (NHIS) database, which provides medical records from 2015 to 2019 in South Korea. We defined daily hospitalizations for heat-related illness of children younger than five years during the summer period (June to August). We considered the definition of heat waves considering the absolute temperature and percentile. A total of 12 different heat waves were used. A time-series analysis was used to investigate the association between heat wave exposure and heat-related hospitalization among children younger than five years. We used a two-stage design involving a meta-analysis after modeling by each region. RESULTS We included 16,879 daily heat-related hospitalizations among children younger than five years. Overall, heat wave exposure within two days was most related for heat-related hospitalizations in young children. The relative risk (RR) due to heat wave exposure within two days (lag2) (12 definitions: 70th to 90th percentile of maximum temperature) ranged from 1.038 (95% confidence interval (CI): 0.971, 1.110) to 1.083 (95% CI: 1.036, 1.133). We found that boys were more vulnerable to heat exposure than girls. In addition, we found that urban areas were more vulnerable to heat exposure than rural areas. CONCLUSIONS In our study, heat wave exposure during summer was found to be associated with an increased risk of hospitalization for heat-related illness among children younger than five years. Our findings suggest the need for summer heat wave management and prevention for children.
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Affiliation(s)
- Jongmin Oh
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Republic of Korea; Department of Human Systems Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Republic of Korea
| | - Eunji Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Youngrin Kwag
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyungmi An
- Institute of Convergence Medicine Ewha Womans University Mokdong Hospital, Republic of Korea
| | - Hae Soon Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Surabhi Shah
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Ji Hyen Lee
- Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Republic of Korea; Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
| | - Eunhee Ha
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Republic of Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
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Lai P, Zhang L, Qiu Y, Ren J, Sun X, Zhang T, Wang L, Cheng S, Liu S, Zhuang H, Lu D, Zhang S, Liang H, Chen S. Heat stress reduces brown adipose tissue activity by exacerbating mitochondrial damage in type 2 diabetic mice. J Therm Biol 2024; 119:103799. [PMID: 38342042 DOI: 10.1016/j.jtherbio.2024.103799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/13/2024]
Abstract
Epidemiological evidence shows that diabetic patients are susceptible to high temperature weather, and brown adipose tissue (BAT) activity is closely related to type 2 diabetes (T2DM). Activation of BAT under cold stress helps improve T2DM. However, the impact of high temperature on the activity of BAT is still unclear. The study aimed to investigate the impact of heat stress on glucose and lipid metabolism in T2DM mice by influencing BAT activity. High-fat feeding and injecting streptozotocin (STZ) induced model of T2DM mice. All mice were randomly divided into three groups: a normal(N) group, a diabetes (DM) group and a heat stress diabetes (DMHS) group. The DMHS group received heat stress intervention for 3 days. Fasting blood glucose, fasting serum insulin and blood lipids were measured in all three groups. The activity of BAT was assessed by using quantitative real-time PCR (qRT-PCR), electron microscopy, and PET CT. Furthermore, the UHPLC-Q-TOF MS technique was employed to perform metabolomics analysis of BAT on both DM group and DMHS group. The results of this study indicated that heat stress aggravated the dysregulation of glucose and lipid metabolism, exacerbated mitochondrial dysfunction in BAT and reduced the activity of BAT in T2DM mice. This may be related to the abnormal accumulation of branched-chain amino acids (BCAAs) in the mitochondria of BAT.
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Affiliation(s)
- Penghua Lai
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China; School of Traditional Chinese Medicine, Xiamen University, Malaysia
| | - Linlin Zhang
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Yan Qiu
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Jie Ren
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Xue Sun
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Ting Zhang
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Liuyi Wang
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Sijie Cheng
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Sijia Liu
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Hongli Zhuang
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Xiamen University, China
| | - Daiwei Lu
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Shaoliang Zhang
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China
| | - Huiqing Liang
- Liver Disease Center, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, 361009, Fujian Province, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
| | - Shaodong Chen
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian Province, China; School of Traditional Chinese Medicine, Xiamen University, Malaysia.
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25
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Lo Y, Vosper E, Higgins JP, Howard G. Heat impacts on human health in the Western Pacific Region: an umbrella review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100952. [PMID: 38022710 PMCID: PMC10652124 DOI: 10.1016/j.lanwpc.2023.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Background High temperatures and heatwaves are occurring more frequently and lasting longer because of climate change. A synthesis of existing evidence of heat-related health impacts in the Western Pacific Region (WPR) is lacking. This review addresses this gap. Methods The Scopus and PubMed databases were searched for reviews about heat impacts on mortality, cardiovascular morbidity, respiratory morbidity, dehydration and heat stroke, adverse birth outcomes, and sleep disturbance. The last search was conducted in February 2023 and only publications written in English were included. Primary studies and reviews that did not include specific WPR data were excluded. Data were extracted from 29 reviews. Findings There is strong evidence of heat-related mortality in the WPR, with the evidence concentrating on high-income countries and China. Associations between heat and cardiovascular or respiratory morbidity are not robust. There is evidence of heat-related dehydration and stroke, and preterm and still births in high-income countries in the WPR. Some evidence of sleep disturbance from heat is found for Australia, Japan and China. Interpretation Mortality is by far the most studied and robust health outcome of heat. Future research should focus on morbidity, and lower income countries in continental Asia and Pacific Island States, where there is little review-level evidence. Funding Funded by the World Health Organization WPR Office.
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Affiliation(s)
- Y.T.Eunice Lo
- Cabot Institute for the Environment, University of Bristol, UK
- Elizabeth Blackwell Institute for Health Research, University of Bristol, UK
| | - Emily Vosper
- Cabot Institute for the Environment, University of Bristol, UK
- School of Geographical Sciences, University of Bristol, UK
| | - Julian P.T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Guy Howard
- Cabot Institute for the Environment, University of Bristol, UK
- School of Civil, Aerospace and Design Engineering, University of Bristol, UK
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26
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Paganini M, Lamine H, Della Corte F, Hubloue I, Ragazzoni L, Barone-Adesi F. Factors causing emergency medical care overload during heatwaves: A Delphi study. PLoS One 2023; 18:e0295128. [PMID: 38117826 PMCID: PMC10732456 DOI: 10.1371/journal.pone.0295128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/15/2023] [Indexed: 12/22/2023] Open
Abstract
Heatwaves pose an important risk for population health and are associated with an increased demand for emergency care. To find factors causing such overload, an online Delphi study included 15 experts in emergency medicine, disaster medicine, or public health. One open-ended question was delivered in the first round. After content analysis, the obtained statements were sent to the experts in two rounds to be rated on a 7-point linear scale. Consensus was defined as a standard deviation ≤ 1.0. Thirty-one statements were obtained after content analysis. The experts agreed on 18 statements, mostly focusing on the input section of patient processing and identifying stakeholders, the population, and primary care as targets of potential interventions. Additional dedicated resources and bed capacity were deemed important as per throughput and output sections, respectively. These findings could be used in the future to implement and test solutions to increase emergency healthcare resilience during heatwaves and reduce disaster risk due to climatic change.
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Affiliation(s)
- Matteo Paganini
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Hamdi Lamine
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
| | - Francesco Della Corte
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Ives Hubloue
- Research Group on Emergency and Disaster Medicine, Vrije Universiteit Brussel, Brussels, Belgium
| | - Luca Ragazzoni
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
| | - Francesco Barone-Adesi
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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27
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Noh E, Kim J, Jun SY, Pak G, Kim JH, Kim HG. Atmospheric pathway of marine heatwaves over the Northwestern Pacific. Sci Rep 2023; 13:22821. [PMID: 38129479 PMCID: PMC10739699 DOI: 10.1038/s41598-023-49833-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
This study analyzes the influence of the Pacific-Japan (PJ) atmospheric teleconnection pattern and its interaction with oceanic processes on sea surface warming over the Northwestern Pacific. The PJ pattern is a thermally driven Rossby wave that originates over the tropical western Pacific through deep convection and propagates toward high latitudes. It plays a significant role in sea surface warming by inducing anticyclonic circulation and the corresponding northwestward extension of the subtropical high over the Northwestern Pacific. This study revealed that the key processes responsible for sea surface warming were an increase in insolation and a decrease in the ocean-to-atmosphere latent heat flux under the anticyclonic conditions driven by the PJ. This finding provides valuable insights into the role of atmospheric processes, we refer to it as the "atmospheric pathway", in the development of East Asian marine heatwaves (MHWs). A detailed understanding of this process will contribute to the prediction and mitigation of MHWs in East Asian countries.
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Affiliation(s)
- El Noh
- Department of Atmospheric Science, Kongju National University, Gongju, South Korea
- Korea Polar Research Institute, Inchon, South Korea
| | - Joowan Kim
- Department of Atmospheric Science, Kongju National University, Gongju, South Korea.
- Earth Environment Research Center, Kongju National University, Gongju, South Korea.
| | | | - Gyundo Pak
- Korea Institute of Ocean Science and Technology, Pusan, South Korea
| | - Joo-Hong Kim
- Korea Polar Research Institute, Inchon, South Korea
| | - Hyeong-Gyu Kim
- Department of Atmospheric Science, Kongju National University, Gongju, South Korea
- Korea Polar Research Institute, Inchon, South Korea
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Rezaee R, Fathi S, Maleki A, Aboubakri O, Li G, Safari M, Sharafkhani R, Zarei M. Summer heat waves and their mortality risk over a 14-year period in a western region of Iran. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2081-2091. [PMID: 37845501 DOI: 10.1007/s00484-023-02564-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/08/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
Compared to previous decade, impact of heat waves (HWs) on mortality in recent years needs to be discussed in Iran. We investigated temporal change in added impact of summer HWs on mortality in eight cities of Iran. The pooled length of HWs was compared between 2015-2022 and 2008-2014 using random and fixed-effects of meta-analysis regression model. The temporal change in impact of HWs was evaluated through interaction effect between crossbasis function of HW and year in a two-stage time varying model. In order to pool the reduced coefficients of each period, multivariate meta-regression model, including city-specific temperature and temperature range as heterogenicity factors, was used. In addition to relative risk (RR), attributable fraction (AF) of HW in the two periods was also estimated in each city. In the last years, the frequency of all HWs was higher and the weak HWs were significantly longer. The only significant RR was related to the lowest and low severe HWs which was observed in the second period. In terms of AF, compared to the strong HWs, all weak HWs caused a considerable excess mortality in all cities and second period. The subgroup analysis revealed that the significant impact in the second period was mainly related to females and elderlies. The increased risk and AF due to more frequent and longer HWs (weak HWs) in the last years highlights the need for mitigation strategies in the region. Because of uncertainty in the results of severe HWs, further elaborately investigation of the HWs is need.
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Affiliation(s)
- Reza Rezaee
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Serveh Fathi
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Afshin Maleki
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Omid Aboubakri
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - Mahdi Safari
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Rahim Sharafkhani
- School of Public Health, Khoy University of Medical Sciences, Khoy, Iran
| | - Mozhdeh Zarei
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Deputy of Research and Technology, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Liu L, Qin X. Analysis of heatwaves based on the universal thermal climate index and apparent temperature over mainland Southeast Asia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2055-2068. [PMID: 37878089 DOI: 10.1007/s00484-023-02562-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/18/2023] [Accepted: 09/30/2023] [Indexed: 10/26/2023]
Abstract
Heatwaves have caused significant damage to human health, infrastructure, and economies in recent decades, and the occurrences of heatwaves are becoming more frequent and severe across the globe under climate change. The previous studies on heatwaves have primarily focused on air temperature, neglecting other variables like wind speed, relative humidity, and radiation, which could lead to a serious underestimation of the adverse effects of heatwaves. To address this issue, this study proposed to the use of more sophisticated thermal indices, such as universal thermal climate index (UTCI) and apparent temperature (AT), to define heatwaves and carry out a comprehensive heatwave assessment over mainland southeast Asia (MSEA) from 1961 to 2020. The traditional temperature-based method was also compared. The results of the study demonstrate that the annual maximum temperature in heatwave days (HWA) and the annual average temperature in heatwave days (HWM) are significantly underestimated if only air temperature is considered. However, UTCI and AT tend to predict a lower frequency of yearly heatwave occurrences and shorter durations. Trend analysis indicates a general increase in heatwave occurrences across MSEA under all thermal indices in the past six decades, particularly in the last 30 years. This study's approach and findings provide a holistic view of heatwave characteristics based on thermal indices and highlight the risk of intensified heat stress during heatwaves in MSEA.
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Affiliation(s)
- Lilingjun Liu
- School of Civil and Environmental Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Xiaosheng Qin
- School of Civil and Environmental Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore.
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Wu WJ, Hutton J, Zordan R, Ranse J, Crilly J, Tutticci N, English T, Currie J. Review article: Scoping review of the characteristics and outcomes of adults presenting to the emergency department during heatwaves. Emerg Med Australas 2023; 35:903-920. [PMID: 37788821 DOI: 10.1111/1742-6723.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 10/05/2023]
Abstract
As a result of climate change heatwaves are expected to increase in frequency and intensity and will have detrimental impacts on human health globally. EDs are often the critical point of care for acute heat illnesses and other conditions associated with heat exposure. Existing literature has focused on heatwave-related hospitalisation and mortality. This scoping review aimed to identify, evaluate and summarise current literature regarding patient characteristics and outcomes of ED admissions from heatwaves. A scoping review of the literature was conducted using six databases: Medline, EMBASE, EMCARE, CINAHL, PsycINFO, and Scopus, using MeSH terms and keywords related to 'heatwave' and 'Emergency Department'. Articles were included if they were: published in English from January 2000 to August 2021, related to ED, and examined high temperature periods consistent with heatwave criteria. Articles were appraised using the Mixed Methods Appraisal Tool (MMAT). Thirty-one studies were included, mostly from the United States, Australia, and France. The study designs include retrospective case analysis, case-control, and time-series analysis. Eight studies examined known heatwaves, 21 used different criteria to identify heatwave occurrence, and two focused on heat-related illness. The selected articles display a moderate-high quality on MMAT. ED admissions for both heat-related illnesses and other conditions increased during heatwaves, with up to 18.5 times risk increase. The risk was elevated for all population groups, and substantially in the elderly, male patients with certain comorbidities, medications, or lower socioeconomic status. Outcomes including hospitalisation and mortality rates after ED admissions showed positive associations with heatwaves. The heatwaves resulting from climate change will place increasing demands on EDs providing care for increasingly susceptible populations. Significant public heatwave planning across multiple sectors is required to reduce the risk of overwhelming EDs with these patients.
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Affiliation(s)
- Wendy Jingyi Wu
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennie Hutton
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Rachel Zordan
- Education and Learning, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Julia Crilly
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Naomi Tutticci
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Timothy English
- Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Currie
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Thomson TN, Rupasinghe R, Hennessy D, Easton M, Stewart T, Mulvenna V. Population vulnerability to heat: A case-crossover analysis of heat health alerts and hospital morbidity data in Victoria, Australia. Aust N Z J Public Health 2023; 47:100092. [PMID: 37852815 DOI: 10.1016/j.anzjph.2023.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE From 2010 to 2022, the Victorian Department of Health operated a heat health alert system. We explored whether changes to morbidity occurred during or directly after these alerts, and how this differed for certain population groups. METHODS We used a space-time-stratified case-crossover design and conditional logistic regression to examine the associations between heat health alerts and heat-related and all-cause emergency department (ED) presentations and hospital admissions at the state-wide level, with models created for the whole population and subgroups. Data were included for the warm season (November-March) from 2014 to 2021. RESULTS Increases occurred in heat-related ED presentations (OR 1.73, 95% CI: 1.53-1.96) and heat-related hospital admissions (OR 1.23, 95% CI: 1.16-1.30) on days on or after heat health alerts. Effect sizes were largest for those 65 years and older, Aboriginal and Torres Strait Islander people, and those living in the most disadvantaged areas. CONCLUSIONS We confirm that increases in morbidity occurred in Victoria during heat health alerts and describe which population groups are more likely to require healthcare in a hospital. IMPLICATIONS FOR PUBLIC HEALTH These findings can inform responses before and during periods of extreme heat, data-driven adaptation strategies, and the development of heat health surveillance systems.
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Affiliation(s)
- Tilda N Thomson
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia; Public Health Division, Victorian Department of Health, Melbourne, Australia.
| | - Rayiky Rupasinghe
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Daneeta Hennessy
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Marion Easton
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Tony Stewart
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Vanora Mulvenna
- Public Health Division, Victorian Department of Health, Melbourne, Australia
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Sixtus RP, Bailey DM. Burning fuels burns the brain's bioenergetic bridges: On the importance of physiological resilience. Exp Physiol 2023; 108:1366-1369. [PMID: 37742138 PMCID: PMC10988455 DOI: 10.1113/ep091424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/11/2023] [Indexed: 09/25/2023]
Affiliation(s)
- Ryan P. Sixtus
- School of Biomedical Sciences, Sir Martin Evans BuildingCardiff UniversityGlamorganUK
| | - Damian M. Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesGlamorganUK
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Yang Y, Zhao N. Vulnerability assessment of urban agglomerations to the risk of heat waves in China since the 21st century. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122443. [PMID: 37643676 DOI: 10.1016/j.envpol.2023.122443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/06/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
In the context of global warming, frequent heat wave disasters have seriously threatened the safety of human life and property. The urban agglomeration, as the main region with a high concentration of population and economy, is susceptible to heat weaves due to the existing urban heat island effect. In this study, we investigated the temporal and spatial characteristics of heat waves (heat index, HI) in China from 2000 to 2020 and assess the vulnerability of 19 urban agglomerations to heat waves from the perspective of exposure, sensitivity and adaptability. The results show that: (1) In the past 20 years, the frequency and intensity of HI (greater than 26.67 °C) both showed an upward trend. (2) Shandong Peninsula, Central Henan, Yangtze River Delta, Middle Reaches of Yangtze River, and Mid-southern Liaoning urban agglomerations always maintain a high vulnerability. (3) From 2000 to 2020, the vulnerability of Beijing-Tianjin-Hebei, Yangtze River Delta, Chengdu-Chongqing, Middle reaches of Yangtze River, Guangdong-Fujian-Zhejiang, Harbin-Changchun and Mid-southern Liaoning urban agglomerations were always dominated by exposure. The vulnerability of Shandong Peninsula, Beibu Gulf and Central Henan urban agglomeration has always been dominated by sensitivity. The vulnerability of North Tianshan Mountain, Lanzhou-Xining, Guanzhong and Hu-Bao-E-Yu urban agglomeration has always been dominated by inadequate adaptability. (4) Recently, the factors that contributed most to exposure, sensitivity and adaptability were population density, the proportion of outdoor workers and water supply, with contribution rates of 38%, 55% and 26%, respectively. This study can provide a scientific basis for the rational allocation of resources among urban agglomerations, effectively formulating policies and guiding population migration from high temperature disasters.
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Affiliation(s)
- Yang Yang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Na Zhao
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China; Jiangsu Center for Collaborative Innovation in Geographic Information Resource Development and Application, Nanjing, 210023, China.
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Sapari H, Selamat MI, Isa MR, Ismail R, Wan Mahiyuddin WR. The Impact of Heat Waves on Health Care Services in Low- or Middle-Income Countries: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e44702. [PMID: 37843898 PMCID: PMC10616749 DOI: 10.2196/44702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/02/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce. OBJECTIVE This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs. METHODS We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity. RESULTS This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs. CONCLUSIONS The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities. TRIAL REGISTRATION PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44702.
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Affiliation(s)
- Hadita Sapari
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Ikhsan Selamat
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Rodi Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
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Campbell SL, Remenyi T, Johnston FH. Methods of Assessing Health Care Costs in a Changing Climate: A Case Study of Heatwaves and Ambulance Dispatches in Tasmania, Australia. GEOHEALTH 2023; 7:e2023GH000914. [PMID: 37811340 PMCID: PMC10558064 DOI: 10.1029/2023gh000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
Anthropogenic climate change is causing a rise in global temperatures, with this trend projected to increase into the future. Rising temperatures result in an increase in the frequency and severity of heatwave events, with an associated increase in poor health outcomes for vulnerable individuals. This places an increasing strain on health care services. However, methods calculating future health care costs associated with this trend are poorly understood. We calculated health care costs attributable to heatwave events in Tasmania 2009-2019, using ambulance dispatches as a case study. We also modeled the expected health and economic burden for projected heatwave frequencies between 2010 and 2089. We developed our models based on two possible approaches to describing population adaptation to heatwaves-an adapted population calculated by determining heatwave episodes using a rolling baseline, and a non-adapted population calculated by determining heatwave episodes using a static baseline. Using a rolling baseline calculation for 2010 to 2089, we estimated additional ambulance costs averaging AUD$57,147 per year and totaling AUD$4,571,788. For the same period using a static baseline, we estimated additional ambulance costs averaging AUD$517,342 per year and totaling AUD$41,387,349. While this method is suitable for estimating the health care costs associated with heatwaves, it could be utilized for estimating health care costs related to other climate-related extreme events. Different methods of estimating heatwaves, modeling an adapted versus non-adapted population, provide substantial differences in projected costs. There is potential for considerable health system cost savings when a population is supported to adapt to extreme heat.
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Affiliation(s)
- Sharon L. Campbell
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTASAustralia
- Public Health ServicesDepartment of Health (Tasmania)HobartTASAustralia
| | - Tomas Remenyi
- Climate Futures Research GroupSchool of GeographyPlanning and Spatial SciencesUniversity of TasmaniaHobartTASAustralia
| | - Fay H. Johnston
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTASAustralia
- Public Health ServicesDepartment of Health (Tasmania)HobartTASAustralia
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Sahani J, Kumar P, Debele SE. Efficacy assessment of green-blue nature-based solutions against environmental heat mitigation. ENVIRONMENT INTERNATIONAL 2023; 179:108187. [PMID: 37699297 DOI: 10.1016/j.envint.2023.108187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/09/2023] [Accepted: 09/03/2023] [Indexed: 09/14/2023]
Abstract
Nature-based solutions (NBS) such as green (vegetation) and blue (waterbodies) infrastructure are being promoted as cost-effective and sustainable strategies for managing the heatwaves risks, but long-term monitoring evidence is needed to support their implementation. This work aims to conduct a comparative assessment of the cooling efficiency of green (woodland and grassland) and blue (waterbody) NBS in contrast to a built-up area. Over a year of continuous fixed monitoring showed that the average daily maximum temperatures at NBS locations were 2-3 °C (up-to 15%) lower than the built-up area. Woodland showed the maximum temperature reduction in almost all seasons, followed by waterbody and grassland. NBS performed the best during the summers, peak sunshine, and heatwave hours (up to ∼ 6 °C cooler than built-up area). Using an e-bike for mobile monitoring, the areas where green-blue NBS were combined showed the highest spatial cooling extent, followed by waterbody, woodland, and grassland areas. The database generated can validate city-scale environmental models and assist city planners to incorporate NBS into urban dwellings based on the opportunity, need and scope, aligning with Sustainable Development Goals 11 (sustainable cities and communities) and 13 (climate action).
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Affiliation(s)
- Jeetendra Sahani
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Prashant Kumar
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Institute for Sustainability, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom.
| | - Sisay E Debele
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom
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Klingelhöfer D, Braun M, Brüggmann D, Groneberg DA. Heatwaves: does global research reflect the growing threat in the light of climate change? Global Health 2023; 19:56. [PMID: 37568208 PMCID: PMC10422716 DOI: 10.1186/s12992-023-00955-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND With the increasing impacts of climate change, heatwaves are placing an enormous burden on health and social systems and threatening ecological diversity around the world. Heatwaves are increasing not only in frequency but also in severity and magnitude. They are causing the deaths of thousands of people. Research is needed on a multidisciplinary, supra-regional, and regional level. METHODS A detailed evaluation of the research conducted is not yet available. Therefore, this study provides a detailed insight into the publication landscape to identify key players, incentives, and requirements for future scientific efforts that are useful not only for scientists but also to stakeholders and project funders. RESULTS The number of publications on heatwaves is increasing, outpacing the trend of research indexed by the Science Citation Index Expanded. However, funding is lagging behind comparatively. Looking at absolute numbers, the USA, Australia, China, and some European countries have been identified as major players in heatwave research. If socio-economic numbers are included, Switzerland and Portugal lead the way. Australia and the UK dominate if the change in heatwave-exposed people is included. Nevertheless, exposure and economic strength of publishing countries were identified as the main drivers of national research interests. Previous heatwaves, in particular, have driven research efforts primarily at the national level. CONCLUSION For an efficient monitoring or early detection system that also includes the economically weak regions, internationally networked efforts are necessary to enable preventive measures and damage limitation against heatwaves. Regardless of previous regional extreme heat events, research approaches should be focused to the global level.
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Affiliation(s)
- Doris Klingelhöfer
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Markus Braun
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Dörthe Brüggmann
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - David A Groneberg
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
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Sixtus RP, Gray C, Berry MJ, Dyson RM. Preterm-born individuals: a vulnerable population at risk of cardiovascular morbidity and mortality during thermal extremes? Exp Physiol 2023; 108:1011-1025. [PMID: 37084061 PMCID: PMC10988436 DOI: 10.1113/ep091152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
NEW FINDINGS What is the topic of this review? Thermal extremes disproportionately affect populations with cardiovascular conditions. Preterm birth, across all gestational age ranges below 37 weeks, has been identified as a non-modifiable risk factor for cardiovascular disease. The hypothesis is presented that individuals born preterm are at an increased risk of cardiovascular morbidity and mortality during thermal extremes. What advances does it highlight? Cardiovascular stress tests performed in preterm-born populations, from infancy through adulthood, highlight a progression of cardiovascular dysfunction accelerating through adolescence and adulthood. This dysfunction has many similarities with populations known to be at risk in thermal extremes. ABSTRACT Preterm-born individuals are a uniquely vulnerable population. Preterm exposure to the extrauterine environment and the (mal)adaptations that occur during the transitional period can result in alterations to their macro- and micro-physiological state. The physiological adaptations that increase survival in the short term may place those born preterm on a trajectory of lifelong dysfunction and later-life decompensation. Cardiovascular compensation in children and adolescents, which masks this trajectory of dysfunction, is overcome under stress, such that the functional cardiovascular capacity is reduced and recovery impaired following physiological stress. This has implications for their response to thermal stress. As the Anthropocene introduces greater changes in our environment, thermal extremes will impact vulnerable populations as yet unidentified in the climate change context. Here, we present the hypothesis that individuals born preterm are a vulnerable population at an increased risk of cardiovascular morbidity and mortality during thermal extremes.
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Affiliation(s)
- Ryan Phillip Sixtus
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Clint Gray
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Mary Judith Berry
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Rebecca Maree Dyson
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
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Gwon Y, Ji Y, Bell JE, Abadi AM, Berman JD, Rau A, Leeper RD, Rennie J. The Association between Drought Exposure and Respiratory-Related Mortality in the United States from 2000 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6076. [PMID: 37372663 DOI: 10.3390/ijerph20126076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Climate change has brought increasing attention to the assessment of health risks associated with climate and extreme events. Drought is a complex climate phenomenon that has been increasing in frequency and severity both locally and globally due to climate change. However, the health risks of drought are often overlooked, especially in places such as the United States, as the pathways to health impacts are complex and indirect. This study aims to conduct a comprehensive assessment of the effects of monthly drought exposure on respiratory mortality for NOAA climate regions in the United States from 2000 to 2018. A two-stage model was applied to estimate the location-specific and overall effects of respiratory risk associated with two different drought indices over two timescales (the US Drought Monitor and the 6-month and 12-month Evaporative Demand Drought Index). During moderate and severe drought exposure, respiratory mortality risk ratio in the general population increased up to 6.0% (95% Cr: 4.8 to 7.2) in the Northeast, 9.0% (95% Cr: 4.9 to 13.3) in the Northern Rockies and Plains, 5.2% (95% Cr: 3.9 to 6.5) in the Ohio Valley, 3.5% (95% Cr: 1.9 to 5.0) in the Southeast, and 15.9% (95% Cr: 10.8 to 20.4) in the Upper Midwest. Our results showed that age, ethnicity, sex (both male and female), and urbanicity (both metro and non-metro) resulted in more affected population subgroups in certain climate regions. The magnitude and direction of respiratory risk ratio differed across NOAA climate regions. These results demonstrate a need for policymakers and communities to develop more effective strategies to mitigate the effects of drought across regions.
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Affiliation(s)
- Yeongjin Gwon
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Daugherty Water for Food Global Institute, University of Nebraska, Lincoln, NE 68588, USA
| | - Yuanyuan Ji
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Jesse E Bell
- Daugherty Water for Food Global Institute, University of Nebraska, Lincoln, NE 68588, USA
- School of Natural Resources, University of Nebraska, Lincoln, NE 68588, USA
- Department of Environmental Agriculture Occupational and Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Azar M Abadi
- Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Jesse D Berman
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Austin Rau
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ronald D Leeper
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh, NC 27695, USA
| | - Jared Rennie
- NOAA's National Centers for Environmental Information, Asheville, NC 28801, USA
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40
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Moyo E, Nhari LG, Moyo P, Murewanhema G, Dzinamarira T. Health effects of climate change in Africa: A call for an improved implementation of prevention measures. ECO-ENVIRONMENT & HEALTH (ONLINE) 2023; 2:74-78. [PMID: 38075293 PMCID: PMC10702879 DOI: 10.1016/j.eehl.2023.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 12/23/2023]
Abstract
The world's climate, particularly in Africa, has changed substantially during the past few decades, contributed by several human activities. Africa is one of the continents that is most vulnerable to climate change globally. Since the beginning of 2022, extreme weather events in Africa have affected about 19 million people and killed at least 4,000 individuals. Cyclones, floods, heatwaves, wildfires, droughts, and famine were among the severe weather occurrences. Natural disasters and extreme weather events brought on by climate change may compromise access to clean water, sanitation systems, and healthcare facilities, making people more vulnerable to a number of illnesses. Floods and drought can lead to both communicable and non-communicable diseases. The African population is more likely to experience more mental health disorders than before because of natural disasters, which result in the loss of property and sometimes loss of lives more frequently. We, therefore, call for an improved implementation of strategies to prevent the health effects of climate change so that the health of the people in Africa can be maintained.
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Affiliation(s)
- Enos Moyo
- Oshakati Medical Centre, Oshakati, Namibia
| | - Leroy Gore Nhari
- National Pathology Research and Diagnostic Center, Midlands State University, Gweru, Zimbabwe
| | | | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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41
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Ke D, Takahashi K, Takakura J, Takara K, Kamranzad B. Effects of heatwave features on machine-learning-based heat-related ambulance calls prediction models in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 873:162283. [PMID: 36801340 DOI: 10.1016/j.scitotenv.2023.162283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/24/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Researchers agree that there is substantial evidence of an increasing trend in both the frequency and duration of extreme temperature events. Increasing extreme temperature events will place more pressure on public health and emergency medical resources, and societies will need to find effective and reliable solutions to adapt to hotter summers. This study developed an effective method to predict the number of daily heat-related ambulance calls. Both national- and regional-level models were developed to evaluate the performance of machine-learning-based methods on heat-related ambulance call prediction. The national model showed a high prediction accuracy and can be applied over most regions, while the regional model showed extremely high prediction accuracy in each corresponding region and reliable accuracy in special cases. We found that the introduction of heatwave features, including accumulated heat stress, heat acclimatization, and optimal temperature, significantly improved prediction accuracy. The adjusted coefficient of determination (adjusted R2) of the national model improved from 0.9061 to 0.9659 by including these features, and the adjusted R2 of the regional model also improved from 0.9102 to 0.9860. Furthermore, we used five bias-corrected global climate models (GCMs) to forecast the total number of summer heat-related ambulance calls under three different future climate scenarios nationally and regionally. Our analysis demonstrated that, at the end of the 21st century, the total number of heat-related ambulance calls in Japan will reach approximately 250,000 per year (nearly four times the current amount) under SSP-5.85. Our results suggest that disaster management agencies can use this highly accurate model to forecast potential high emergency medical resource burden caused by extreme heat events, allowing them to raise and improve public awareness and prepare countermeasures in advance. The method proposed in Japan in this paper can be applied to other countries that have relevant data and weather information systems.
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Affiliation(s)
- Deng Ke
- Graduate School of Advanced Integrated Studies in Human Survivability, Kyoto University, Yoshida-Nakaadachi 1, Sakyo-ku, Kyoto 606-8306, Japan.
| | - Kiyoshi Takahashi
- Center for Social & Environmental Systems Research, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Jun'ya Takakura
- Center for Social & Environmental Systems Research, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Kaoru Takara
- Disaster Prevention Research Institute (DPRI), Kyoto University, Uji, Kyoto 611-0011, Japan
| | - Bahareh Kamranzad
- Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow G11XJ, United Kingdom
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42
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Wen B, Ademi Z, Wu Y, Xu R, Yu P, Ye T, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Productivity-adjusted life years lost due to non-optimum temperatures in Brazil: A nationwide time-series study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 873:162368. [PMID: 36828065 DOI: 10.1016/j.scitotenv.2023.162368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Non-optimal temperatures are associated with premature deaths globally. However, the evidence is limited in low- and middle-income countries, and the productivity losses due to non-optimal temperatures have not been quantified. We aimed to estimate the work-related impacts and economic losses attributable to non-optimal temperatures in Brazil. We collected daily mortality data from 510 immediate regions in Brazil during 2000 and 2019. A two-stage time-series analysis was applied to evaluate the association between non-optimum temperatures and the Productivity-Adjusted Life-Years (PALYs) lost. The temperature-PALYs association was fitted for each location in the first stage and then we applied meta-analyses to obtain the national estimations. The attributable fraction (AF) of PALY lost due to ambient temperatures and the corresponding economic costs were calculated for different subgroups of the working-age population. A total of 3,629,661 of PALYs lost were attributed to non-optimal temperatures during 2000-2019 in Brazil, corresponding to 2.90 % (95 % CI: 1.82 %, 3.95 %) of the total PALYs lost. Non-optimal temperatures have led to US$104.86 billion (95 % CI: 65.95, 142.70) of economic costs related to PALYs lost and the economic burden was more substantial in males and the population aged 15-44 years. Higher risks of extreme cold temperatures were observed in the South region in Brazil while extreme hot temperatures were observed in the Central West and Northeast regions. In conclusion, non-optimal temperatures are associated with considerable labour losses as well as economic costs in Brazil. Tailored policies and adaptation strategies should be proposed to mitigate the impacts of non-optimal temperatures on the labour supply in a changing climate.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Zanfina Ademi
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC, 3052, Australia
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | | | | | - Yuming Guo
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
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Dong D, Tao H, Zhang Z. Historic evolution of population exposure to heatwaves in Xinjiang Uygur Autonomous Region, China. Sci Rep 2023; 13:7401. [PMID: 37149675 PMCID: PMC10164190 DOI: 10.1038/s41598-023-34123-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/25/2023] [Indexed: 05/08/2023] Open
Abstract
Heatwaves have pronounced impacts on human health and the environment on a global scale. Although the characteristics of heatwaves has been well documented, there still remains a lack of dynamic studies of population exposure to heatwaves (PEH), particularly in the arid regions. In this study, we analyzed the spatio-temporal evolution characteristics of heatwaves and PEH in Xinjiang using the daily maximum temperature (Tmax), relative humidity (RH), and high-resolution gridded population datasets. The results revealed that the heatwaves in Xinjiang occur more continually and intensely from 1961 to 2020. Furthermore, there is substantial spatial heterogeneity of heatwaves with eastern part of the Tarim Basin, Turpan, and Hami been the most prone areas. The PEH in Xinjiang showed an increasing trend with high areas mainly in Kashgar, Aksu, Turpan, and Hotan. The increase in PEH is mainly contributed from population growth, climate change and their interaction. From 2001 to 2020, the climate effect contribution decreased by 8.5%, the contribution rate of population and interaction effects increased by 3.3% and 5.2%, respectively. This work provides a scientific basis for the development of policies to improve the resilience against hazards in arid regions.
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Affiliation(s)
- Diwen Dong
- College of Ecology and Environment, Xinjiang University, Urumqi, 830046, China
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
- College of Statistics & Data Science, Xinjiang University of Finance & Economics, Urumqi, 830012, China
| | - Hui Tao
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China
| | - Zengxin Zhang
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China.
- Joint Innovation Center for Modern Forestry Studies, College of Forestry, Nanjing Forestry University, Nanjing, 210037, Jiangsu, China.
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Zhou W, Wang Q, Li R, Kadier A, Wang W, Zhou F, Ling L. Combined effects of heatwaves and air pollution, green space and blue space on the incidence of hypertension: A national cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 867:161560. [PMID: 36640878 DOI: 10.1016/j.scitotenv.2023.161560] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 06/17/2023]
Abstract
Extreme heat exposure has been associated with hypertension. However, its interactive influences with air pollution, green and blue spaces are unclear. This study aimed to explore the interaction between heatwaves, air pollution, green and blue spaces on hypertension. Cohort data enrolled 6448 Chinese older adults aged 65 years and over were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 2008 and 2018. Nine heatwave definitions, combining three heat thresholds (92.5th, 95th, and 97.5th percentiles of daily maximum temperature) and three durations (≥2, 3 and 4 days) were used as time-varying variables in the analysis and were the one-year exposure before survival events. Fine particulate matter (PM ≤2.5 μm in aerodynamic diameter (PM2.5)), the Normalized Difference Vegetation Index (NDVI) and the average proportion of open water bodies were used to reflect the air pollution, green and blue space exposures, respectively. PM2.5, green and blue space exposures were time-varying indicators and contemporaneous with heatwaves. Mixed Cox models with time-varying variables were fitted to assess the multiplicative and additive interaction of heatwaves, PM2.5, and green and blue spaces on hypertension, measured by a traditional product term with the ratio of hazard ratio (HR) and relative risk due to interaction (RERI), respectively. A positive multiplicative (HRs >1) and additive interaction (RERIs >0) between heatwaves and higher PM2.5 levels was observed. There was a synergistic effect between heatwaves and decreasing greenness levels on hypertension incidence on additive and multiplicative scales. No significant interaction between heatwaves and blue space was observed in the analysis. The combined effects of heatwaves, air pollution, green and blue space exposures on the risk of hypertension varied with age, gender, and educational attainment. This study's findings complemented the existing evidence and revealed synergistic harmful impacts for heatwaves with air pollution and lack of green space on hypertension incidence.
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Affiliation(s)
- Wensu Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qiong Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rui Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Aimulaguli Kadier
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenjuan Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fenfen Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; Clinical research design division, Clinical research center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Mason HM, King JC, Peden AE, Watt K, Bosley E, Fitzgerald G, Nairn J, Miller L, Mandalios N, Franklin RC. Determining the Impact of Heatwaves on Emergency Ambulance Calls in Queensland: A Retrospective Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20064875. [PMID: 36981787 PMCID: PMC10049657 DOI: 10.3390/ijerph20064875] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 06/01/2023]
Abstract
Heatwaves are a significant and growing threat to the health and well-being of the residents of Queensland, Australia. This threat is increasing due to climate change. Excess heat increases the demand for health services, including ambulance calls, and the purpose of this study was to explore this impact across Queensland. A state-wide retrospective analysis of heatwaves and emergency 'Triple Zero' (000) calls to Queensland Ambulance (QAS) from 2010-2019 was undertaken. Call data from the QAS and heatwave data from the Bureau of Meteorology were analysed using a case-crossover approach at the postcode level. Ambulance calls increased by 12.68% during heatwaves. The effect was greatest during low-severity heatwaves (22.16%), followed by severe (14.32%) and extreme heatwaves (1.16%). The impact varied by rurality, with those living in very remote areas and major cities most impacted, along with those of low and middle socioeconomic status during low and severe intensity heat events. Lag effects post-heatwave continued for at least 10 days. Heatwaves significantly increase ambulance call centre workload, so ambulance services must actively prepare resources and personnel to address increases in heatwave frequency, duration, and severity. Communities must be informed of the risks of heatwaves at all severities, particularly low severity, and the sustained risks in the days following a heat event.
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Affiliation(s)
- Hannah M. Mason
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Jemma C. King
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Amy E. Peden
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kerrianne Watt
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
- Information Support, Research & Evaluation, Queensland Ambulance Service, Brisbane, QLD 4031, Australia
| | - Emma Bosley
- Information Support, Research & Evaluation, Queensland Ambulance Service, Brisbane, QLD 4031, Australia
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Gerard Fitzgerald
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - John Nairn
- School of Biological Sciences, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Lauren Miller
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Nicole Mandalios
- Disaster Management Branch, Queensland Health, Brisbane, QLD 4000, Australia
| | - Richard C. Franklin
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
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46
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Franklin RC, Mason HM, King JC, Peden AE, Nairn J, Miller L, Watt K, FitzGerald G. Heatwaves and mortality in Queensland 2010-2019: implications for a homogenous state-wide approach. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:503-515. [PMID: 36735072 PMCID: PMC9974727 DOI: 10.1007/s00484-023-02430-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 11/10/2022] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. Individuals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk.
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Affiliation(s)
- Richard C Franklin
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia.
| | - Hannah M Mason
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
| | - Jemma C King
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
| | - Amy E Peden
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - John Nairn
- School of Biological Sciences, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Adelaide, SA, Australia
| | - Lauren Miller
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
| | - Kerrianne Watt
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
- Information Support, Research & Evaluation, Queensland Ambulance Service, Brisbane, QLD, Australia
| | - Gerard FitzGerald
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Sydney, NSW, Australia
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Perry T, Obolski U, Peretz C. The Association Between High Ambient Temperature and Mortality in the Mediterranean Basin: a Systematic Review and Meta-analysis. Curr Environ Health Rep 2023; 10:61-71. [PMID: 36417094 DOI: 10.1007/s40572-022-00386-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW The Mediterranean basin is highly vulnerable to climate change. This study is aimed at quantifying the risk of mortality associated with exposure to high ambient temperature in the Mediterranean basin in the general population and in vulnerable sub-populations. RECENT FINDINGS We retrieved effect estimates from studies linking temperature and mortality in the Mediterranean basin, between 2000 and 2021. In a meta-analysis of 16 studies, we found an increased risk of all-cause mortality due to ambient heat/high temperature exposure in the Mediterranean basin, with a pooled RR of 1.035 (95%CI 1.028-1.041) per 1 °C increase in temperature above local thresholds (I2 = 79%). Risk was highest for respiratory mortality (RR = 1.063, 95% CI 1.052-1.074) and cardiovascular mortality (RR = 1.046, 95% CI 1.036-1.057). Hot ambient temperatures increase the mortality risk across the Mediterranean basin. Further studies, especially in North African, Asian Mediterranean, and eastern European countries, are needed to bolster regional preparedness against future heat-related health burdens.
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Affiliation(s)
- Talila Perry
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Obolski
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Porter School of the Environment and Earth Sciences, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Chava Peretz
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Silveira IH, Hartwig SV, Moura MN, Cortes TR, Junger WL, Cirino G, Ignotti E, de Oliveira BFA. Heat waves and mortality in the Brazilian Amazon: Effect modification by heat wave characteristics, population subgroup, and cause of death. Int J Hyg Environ Health 2023; 248:114109. [PMID: 36599199 DOI: 10.1016/j.ijheh.2022.114109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND The Brazilian Amazon faces overlapping socio-environmental, sanitary, and climate challenges, and is a hotspot of concern due to projected increases in temperature and in the frequency of heat waves. Understanding the effects of extreme events on health is a central issue for developing climate policies focused on the population's health. OBJECTIVES We investigated the effects of heat waves on mortality in the Brazilian Amazon, examining effect modification according to various heat wave definitions, population subgroups, and causes of death. METHODS We included all 32 Amazonian municipalities with more than 100,000 inhabitants. The study period was from 2000 to 2018. We obtained mortality data from the Information Technology Department of the Brazilian Public Healthcare System, and meteorological data were derived from the ERA5-Land reanalysis dataset. Heat waves were defined according to their intensity (90th; 92.5th; 95th; 97.5th and 99th temperature percentiles) and duration (≥2, ≥3, and ≥4 days). In each city, we used a time-stratified case-crossover study to estimate the effects of each heat wave definition on mortality, according to population subgroup and cause of death. The lagged effects of heat waves were estimated using conditional Poisson regression combined with distributed lag non-linear models. Models were adjusted for specific humidity and public holidays. Risk ratios were pooled for the Brazilian Amazon using a univariate random-effects meta-analysis. RESULTS The pooled relative risks (RR) for mortality from total non-external causes varied between 1.03 (95% CI: 1.01-1.06), for the less stringent heat wave definition, and 1.18 (95% CI: 1.04-1.33) for the more stringent definition. The mortality risk rose as the heat wave intensity increased, although the increase from 2 to 3, and 3-4 days was small. Although not statistically different, our results suggest a higher mortality risk for the elderly, this was also higher for women than men, and for cardiovascular causes than for non-external or respiratory ones. CONCLUSIONS Heat waves were associated with a higher risk of mortality from non-external causes and cardiovascular diseases. Heat wave intensity played a more important role than duration in determining this risk. Suggestive evidence indicated that the elderly and women were more vulnerable to the effects of heat waves on mortality.
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Affiliation(s)
| | | | - Maurício Nascimento Moura
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; Geosciences Institute, Federal University of Pará, Belém, Brazil
| | | | | | - Glauber Cirino
- Geosciences Institute, Federal University of Pará, Belém, Brazil
| | - Eliane Ignotti
- Postgraduate Program in Environmental Sciences, Mato Grosso State University, Cáceres, Brazil
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49
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Nhung NTT, Hoang LT, Tuyet Hanh TT, Toan LQ, Thanh ND, Truong NX, Son NA, Nhat HV, Quyen NH, Nhu HV. Effects of Heatwaves on Hospital Admissions for Cardiovascular and Respiratory Diseases, in Southern Vietnam, 2010-2018: Time Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20053908. [PMID: 36900919 PMCID: PMC10001990 DOI: 10.3390/ijerph20053908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 06/01/2023]
Abstract
This study investigated the associations between heatwaves and daily hospital admissions for cardiovascular and respiratory diseases in two provinces in Viet Nam known to be vulnerable to droughts during 2010-2018. This study applied a time series analysis with data extracted from the electronic database of provincial hospitals and meteorological stations from the corresponding province. To eliminate over-dispersion, this time series analysis used Quasi-Poisson regression. The models were controlled for the day of the week, holiday, time trend, and relative humidity. Heatwaves were defined as the maximum temperature exceeding P90th over the period from 2010 to 2018 during at least three consecutive days. Data from 31,191 hospital admissions for respiratory diseases and 29,056 hospitalizations for cardiovascular diseases were investigated in the two provinces. Associations between hospital admissions for respiratory diseases and heatwaves in Ninh Thuan were observed at lag 2, with excess risk (ER = 8.31%, 95% confidence interval: 0.64-16.55%). However, heatwaves were negatively associated with cardiovascular diseases in Ca Mau, which was determined amongst the elderly (age above 60), ER = -7.28%, 95%CI: -13.97--0.08%. Heatwaves can be a risk factor for hospital admission due to respiratory diseases in Vietnam. Further studies need to be conducted to assert the link between heat waves and cardiovascular diseases.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | - Le Tu Hoang
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | - Tran Thi Tuyet Hanh
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | - Luu Quoc Toan
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | | | | | | | | | - Nguyen Huu Quyen
- Institute of Hydrology and Meteorology Science and Climate Change, Hanoi 10000, Vietnam
| | - Ha Van Nhu
- Faculty of Basic Medicine, Hanoi University of Public Health, Hanoi 10000, Vietnam
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Aghababaeian H, Ostadtaghizadeh A, Ardalan A, Asgary A, Akbary M, Yekaninejad MS, Sharafkhani R, Stephens C. Mortality Risk Related to Heatwaves in Dezful City, Southwest of Iran. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302231151538. [PMID: 36762075 PMCID: PMC9903032 DOI: 10.1177/11786302231151538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND We aimed to evaluate the impact of heatwaves on daily deaths due to non-accidental, cardiovascular and respiratory causes in the city of Dezful in Iran from 2013 to 2019. METHOD We collected daily ambient temperature and mortality and defined 2 types of heatwaves by combining daily temperature ⩾90th in each month of the study period or since 30 years with duration ⩾2 and 3 days. We used a distributed lag non-linear model to study the association between each type of heatwave definition, and deaths due to non-accidental, cardiovascular and respiratory causes with lags up to 13 days. RESULTS There was no discernible correlation in this area, despite the fact that heatwaves raised the risk of death from cardiovascular causes and lowered the risk from respiratory causes. On the other hand, the risk of total non-accidental mortality on days with the heatwaves is significantly higher than normal days. In main effects, the heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, Cumulative Excess Risk (CER) in lag0-2 was 10.4 and in second heatwave definition, CER values in lag0, 0-2, and 0-6 were 12.4, 29.2, and 38.8 respectively). Also, in added effects, heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, CER in lag0 and 0-2 were 1.79 and 4.11 and in the second heatwave definition, CER values in lag0, 0-2, and 0-6 were 7.76, 18.35 and 24.87 respectively). In addition, heatwaves appeared to contribute to a cumulative excess risk of non-accidental death among the male group as well as the older adults. CONCLUSION However, the results showed that heatwaves could have detrimental effects on health, even in populations accustomed to the extreme heat. Therefore, early warning systems which monitor heatwaves should provide the necessary warnings to the population, especially the most vulnerable groups.
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Affiliation(s)
- Hamidreza Aghababaeian
- Center for Climate Change and Health research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ostadtaghizadeh
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asgary
- Disaster and Emergency Management, School of Administrative Studies, York University, Toronto, Canada
| | - Mehry Akbary
- Department of Climatology, Faculty of Geographical Sciences, Kharazmi University, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Sharafkhani
- School of Public Health, Khoy University of Medical Sciences, Khoy, Iran
| | - Carolyn Stephens
- UCL Bartlett Development Planning Unit, London School of Hygiene & Tropical Medicine, London, UK
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