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Zhao Q, Li S, Coelho MSZS, Saldiva PHN, Hu K, Arblaster JM, Nicholls N, Huxley RR, Abramson MJ, Guo Y. Geographic, Demographic, and Temporal Variations in the Association between Heat Exposure and Hospitalization in Brazil: A Nationwide Study between 2000 and 2015. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:17001. [PMID: 30620212 PMCID: PMC6371650 DOI: 10.1289/ehp3889] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Limited evidence is available regarding the association between heat exposure and morbidity in Brazil and how the effect of heat exposure on health outcomes may change over time. OBJECTIVES This study sought to quantify the geographic, demographic and temporal variations in the heat–hospitalization association in Brazil from 2000–2015. METHODS Data on hospitalization and meteorological conditions were collected from 1,814 cities during the 2000–2015 hot seasons. Quasi-Poisson regression with constrained lag model was applied to examine city-specific estimates, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, 10 age groups, and 11 cause categories. Meta-regression was used to examine the temporal change in estimates of heat effect from 2000 to 2015. RESULTS For every 5°C increase in daily mean temperature during the 2000–2015 hot seasons, the estimated risk of hospitalization over lag 0-7 d rose by 4.0% [95% confidence interval (CI): 3.7%, 4.3%] nationwide. Estimated 6.2% [95% empirical CI (eCI): 3.3%, 9.1%] of hospitalizations were attributable to heat exposure, equating to 132 cases (95% eCI: 69%, 192%) per 100,000 residents. The attributable rate was greatest in children [Formula: see text] and was highest for hospitalizations due to infectious and parasitic diseases. Women of reproductive age and those [Formula: see text] had higher heat burden than men. The attributable burden was greatest for cities in the central west and the inland of the northeast; lowest in the north and eastern coast. Over the 16-y period, the estimated heat effects declined insignificantly at the national level. CONCLUSIONS In Brazil's hot seasons, 6% of hospitalizations were estimated to be attributed to heat exposure. As there was no evidence indicating that thermal adaptation had occurred at the national level, the burden of hospitalization associated with heat exposure in Brazil is likely to increase in the context of global warming. https://doi.org/10.1289/EHP3889.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Paulo H N Saldiva
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan, China
| | - Julie M Arblaster
- School of Earth, Atmosphere and Environment, Monash University, Melbourne, Australia
- Centre of Excellence for Climate Extremes, Australian Research Council, Sydney, Australia
| | - Neville Nicholls
- School of Earth, Atmosphere and Environment, Monash University, Melbourne, Australia
| | - Rachel R Huxley
- College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Ayuk AC, Ramjith J, Zar HJ. Environmental risk factors for asthma in 13-14 year old African children. Pediatr Pulmonol 2018; 53:1475-1484. [PMID: 30238644 DOI: 10.1002/ppul.24162] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/22/2018] [Indexed: 12/19/2022]
Abstract
Background Asthma prevalence in African children is high. Factors driving the prevalence or disease severity are poorly understood. This study aims to investigate environmental factors associated with asthma and severity in African children. Methods Population based cross-sectional study of children aged 13-14 years from 10 African centers who participated in ISAAC III. Self-reported environmental exposures included engaging in physical exercise, television watching, various biomass and ETS exposure, consumption of paracetamol, large family sizes and having pets in the home. Univariable and multivariable analyses were done adjusting for center variations. Prevalences, odds ratio and 95% confidence intervals (CI) were calculated. Results There were 258 267 children recruited among the 13-14-year-old participants. Of these, 28,391 respondents from 232 schools completed both the written questionnaire (WQ) and environmental questionnaire (EQ). The prevalence of asthma and severe asthma were 12.8% (CI 12.4-13.2), and 8.7% (CI 8.4-8.0) respectively. Factors strongly associated with asthma were maternal smoking (OR = 1.41; 95%CI: 1.23-1.64), open fire heating (OR = 1.28; 95%CI: 1.08-1.51) electric heating (OR = 1.13; 95%CI: 1.01-1.28), physical exercise (OR = 1.29; 95%CI: 1.11-1.50), monthly paracetamol use (OR 1.23; 95%CI 1.13-1.33), having an elder sibling (OR = 0.87; 95%CI 0.77-0.98). Factors associated with severe asthma were maternal smoking (OR = 1.61; 95%CI: 1.38-1.89), cat pet (OR = 1.14; 95%CI: 1.04-1.25), frequent physical exercise (OR = 1.42; 95%CI: 1.23-1.64) and monthly paracetamol use (OR = 1.20; 95%CI 1.07, 1.34). Conclusion Several environmental exposures were associated with asthma and severe disease.
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Affiliation(s)
- Adaeze C Ayuk
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital University of Cape Town, Cape Town, South Africa.,Department of Paediatrics, College of Medicine, University of Nigeria Nsukka Enugu campus and University of Nigeria Teaching Hospital Enugu, Enugu, Nigeria
| | - Jordache Ramjith
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital University of Cape Town, Cape Town, South Africa.,SA MRC Unit of Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
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Masselot P, Chebana F, Ouarda TBMJ, Bélanger D, St-Hilaire A, Gosselin P. A new look at weather-related health impacts through functional regression. Sci Rep 2018; 8:15241. [PMID: 30323248 PMCID: PMC6189063 DOI: 10.1038/s41598-018-33626-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 08/17/2018] [Indexed: 12/13/2022] Open
Abstract
A major challenge of climate change adaptation is to assess the effect of changing weather on human health. In spite of an increasing literature on the weather-related health subject, many aspect of the relationship are not known, limiting the predictive power of epidemiologic models. The present paper proposes new models to improve the performances of the currently used ones. The proposed models are based on functional data analysis (FDA), a statistical framework dealing with continuous curves instead of scalar time series. The models are applied to the temperature-related cardiovascular mortality issue in Montreal. By making use of the whole information available, the proposed models improve the prediction of cardiovascular mortality according to temperature. In addition, results shed new lights on the relationship by quantifying physiological adaptation effects. These results, not found with classical model, illustrate the potential of FDA approaches.
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Affiliation(s)
- Pierre Masselot
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada.
| | - Fateh Chebana
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Taha B M J Ouarda
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Diane Bélanger
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
- Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
| | - André St-Hilaire
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Pierre Gosselin
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
- Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
- Institut national de santé publique du Québec (INSPQ), Québec, Canada
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Xu Z, Crooks JL, Davies JM, Khan AF, Hu W, Tong S. The association between ambient temperature and childhood asthma: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:471-481. [PMID: 29022096 DOI: 10.1007/s00484-017-1455-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/18/2017] [Accepted: 09/24/2017] [Indexed: 05/09/2023]
Abstract
The objectives of this study are to review available information on the association between ambient temperature and childhood asthma, and to elucidate the possible underlying mechanisms of this relationship. A systematic review was conducted based on the papers retrieved from four databases, including PubMed, ProQuest, ScienceDirect, and Scopus. Papers examining the association of absolute temperature or temperature variation with childhood asthma published from 1 January 2000 to 31 December 2016 were included. Thirteen papers have quantified the effect of absolute temperature on childhood asthma, and six papers have examined the effect of intra- or inter-day temperature variation on childhood asthma. All studies were conducted in urban areas. Aeroallergen sensitizations were only considered in the analyses of one study. Discrepancy existed in the significance of the relationship between absolute temperature and childhood asthma, and also in the shape of this relationship (i.e. linear or non-linear) and whether temperature effects were lagged. Increasing evidence is suggesting non-linear relationship between absolute temperature and childhood asthma. Future research should investigate the burden of childhood asthma specifically attributable to extreme temperatures and temperature variation using advanced statistical approach, particularly in rural areas, after properly considering aeroallergens and air pollution. Projecting future burden of childhood asthma under climate change scenarios is also warranted.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia.
| | | | - Janet Mary Davies
- School of Biomedical Sciences & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Al Fazal Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Wenbiao Hu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia
| | - Shilu Tong
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia
- School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
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Park HK. Air pollution and climate change: Effects on asthmatic patients. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.2.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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56
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Heat Exposure and the General Public: Health Impacts, Risk Communication, and Mitigation Measures. SPRINGERBRIEFS IN MEDICAL EARTH SCIENCES 2018. [DOI: 10.1007/978-3-319-75889-3_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ehelepola NDB, Ariyaratne K, Jayaratne A. The association between local meteorological changes and exacerbation of acute wheezing in Kandy, Sri Lanka. Glob Health Action 2018; 11:1482998. [PMID: 29912647 PMCID: PMC7011946 DOI: 10.1080/16549716.2018.1482998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/22/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Severe wheezing is a common medical emergency. Past studies have demonstrated associations between exacerbation of wheezing and meteorological factors and atmospheric pollution. There are no past studies from Sri Lanka that analyzed correlation between daily multiple meteorological variables and exacerbation of wheezing. OBJECTIVES To determine the correlations between daily counts of patients nebulized at the Outpatient Department (OPD) of Teaching Hospital - Kandy (THK) and local meteorological variables, and to explore the utility of that information. DESIGN We considered daily counts of patients nebulized at the OPD of THK as an indicator of exacerbations of wheezing in the population catered to by this hospital. We determined the correlations between daily counts of patients nebulized at OPD and the following meteorological variables for four years: daily rainfall, minimum temperature, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours, daytime humidity, nighttime humidity, barometric pressure and visibility. We utilized wavelet time series method for data analysis. RESULTS All nine meteorological parameters studied were correlated with the daily counts of patients nebulized with average lag periods ranging from 5 to 15 days. Peaks of daily rainfall, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours and daytime humidity were followed by peaks of counts of patients nebulized (positive correlations). Troughs of minimum temperature, nighttime humidity, barometric pressure and visibility were followed by peaks of patients nebulized (negative correlations). CONCLUSIONS The THK shall expect more patients with acute wheezing after extremes of weather. Minimum temperature has been consistently correlated with the exacerbation of respiratory symptoms in the past studies in other countries as well. Hence, prescribing the inhalation of more drugs on unusually cold days (prophylactically) may help prevent acute exacerbation of wheezing in patients on treatment for asthma and COPD.
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Affiliation(s)
- N. D. B. Ehelepola
- Department of Medicine, The Teaching (General) Hospital–Kandy, Kandy, Sri Lanka
| | | | - Amithe Jayaratne
- Department of Medicine, The Teaching (General) Hospital–Kandy, Kandy, Sri Lanka
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Climate and Health in Maryland:: The Maryland Climate Change Health Adaptation Program. Dela J Public Health 2017; 3:44-50. [PMID: 34466941 PMCID: PMC8389712 DOI: 10.32481/djph.2017.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Maryland’s response to climate change has included creation of the Maryland Commission on Climate Change in 2007, and initiatives across many State agencies. The Commission coordinates these initiatives through the State Climate Action Plan. The Maryland Department of Health has partnered with the School of Public Health at the University of Maryland College Park to develop the 2016 Climate and Health Profile report, which estimates the health impacts of climate change in Maryland. Using historical health data and climate model projections, the report found that climate change will have a disproportionate impact on certain populations across the state. For example, extreme heat and extreme precipitation events during summer months increased the risk of hospitalization for asthma in Maryland by 22% and 11% respectively. But the extreme heat related risk for asthma hospitalization was more pronounced among non-Hispanic whites (33%) than non-Hispanic blacks (20%). Based on these findings, the Department and School have begun to engage with community organizations and various stakeholders to develop interventions and adaptations aimed at increasing resilience and mitigating some of the health impacts. Through these partnerships and projects, Maryland is using health data, climate projections, and the State Climate Action Plan to assist local communities and regional partners in climate adaptation activities.
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Ogbomo AS, Gronlund CJ, O'Neill MS, Konen T, Cameron L, Wahl R. Vulnerability to extreme-heat-associated hospitalization in three counties in Michigan, USA, 2000-2009. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:833-843. [PMID: 27796569 PMCID: PMC5410403 DOI: 10.1007/s00484-016-1261-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 05/27/2023]
Abstract
With climate change, extreme heat (EH) events are increasing, so it is important to understand who is vulnerable to heat-associated morbidity. We determined the association between EH and hospitalizations for all natural causes; cardiovascular, respiratory, and renal diseases; diabetes mellitus; and acute myocardial infarction in Michigan, USA, at different intensities and durations. We assessed confounding by ozone and how individual characteristics and health insurance payer (a proxy for income) modified these associations. We obtained Michigan Inpatient Database, National Climatic Data Center, and US Environmental Protection Agency ozone data for May-September, 2000-2009 for three Michigan counties. We employed a case-crossover design and modeled EH as an indicator for temperature above the 95th, 97th, or 99th percentile thresholds for 1, 2, 3, or 4 days. We examined effect modification by patient age, race, sex, and health insurance payer and pooled the county results. Among non-whites, the pooled odds ratio for hospitalization on EH (97th percentile threshold) vs. non-EH days for renal diseases was 1.37 (95 % CI = 1.13-1.66), which increased with increasing EH intensity, but was null among whites (OR = 1.00, 95 % CI = 0.81, 1.25). We observed a null association between EH and cardiovascular hospitalization. EH (99th percentile threshold) was associated with myocardial infarction hospitalizations. Confounding by ozone was minimal. EH was associated with hospitalizations for renal disease among non-whites. This information on vulnerability to heat-associated morbidity helps characterize the public health burden of EH and target interventions including patient education.
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Affiliation(s)
- Adesuwa S Ogbomo
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Carina J Gronlund
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109,, USA.
| | - Marie S O'Neill
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109,, USA
| | - Tess Konen
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Lorraine Cameron
- Division of Environmental Health, Michigan Department of Health and Human Services, 333 South Grand Ave, Lansing, MI, 48913, USA
| | - Robert Wahl
- Lifecourse Epidemiology and Genomics Division, Michigan Department of Health and Human Services, 333 South Grand Ave, Lansing, MI, 48913, USA
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Jagai JS, Grossman E, Navon L, Sambanis A, Dorevitch S. Hospitalizations for heat-stress illness varies between rural and urban areas: an analysis of Illinois data, 1987-2014. Environ Health 2017; 16:38. [PMID: 28388909 PMCID: PMC5384150 DOI: 10.1186/s12940-017-0245-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 03/30/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND The disease burden due to heat-stress illness (HSI), which can result in significant morbidity and mortality, is expected to increase as the climate continues to warm. In the United States (U.S.) much of what is known about HSI epidemiology is from analyses of urban heat waves. There is limited research addressing whether HSI hospitalization risk varies between urban and rural areas, nor is much known about additional diagnoses of patients hospitalized for HSI. METHODS Hospitalizations in Illinois for HSI (ICD-9-CM codes 992.x or E900) in the months of May through September from 1987 to 2014 (n = 8667) were examined. Age-adjusted mean monthly hospitalization rates were calculated for each county using U.S. Census population data. Counties were categorized into five urban-rural strata using Rural Urban Continuum Codes (RUCC) (RUCC1, most urbanized to RUCC5, thinly populated). Average maximum monthly temperature (°C) was calculated for each county using daily data. Multi-level linear regression models were used, with county as the fixed effect and temperature as random effect, to model monthly hospitalization rates, adjusting for the percent of county population below the poverty line, percent of population that is Non-Hispanic Black, and percent of the population that is Hispanic. All analyses were stratified by county RUCC. Additional diagnoses of patients hospitalized for HSI and charges for hospitalization were summarized. RESULTS Highest rates of HSI hospitalizations were seen in the most rural, thinly populated stratum (mean annual summer hospitalization rate of 1.16 hospitalizations per 100,000 population in the thinly populated strata vs. 0.45 per 100,000 in the metropolitan urban strata). A one-degree Celsius increase in maximum monthly average temperature was associated with a 0.34 increase in HSI hospitalization rate per 100,000 population in the thinly populated counties compared with 0.02 per 100,000 in highly urbanized counties. The most common additional diagnoses of patients hospitalized with HSI were dehydration, electrolyte abnormalities, and acute renal disorders. Total and mean hospital charges for HSI cases were $167.7 million and $20,500 (in 2014 US dollars). CONCLUSION Elevated temperatures appear to have different impacts on HSI hospitalization rates as function of urbanization. The most rural and the most urbanized counties of Illinois had the largest increases in monthly hospitalization rates for HSI per unit increase in the average monthly maximum temperature. This suggests that vulnerability of communities to heat is complex and strategies to reduce HSI may need to be tailored to the degree of urbanization of a county.
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Affiliation(s)
- Jyotsna S. Jagai
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Elena Grossman
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Livia Navon
- Centers for Disease Control and Prevention, Illinois Department of Public Health, Chicago, USA
| | - Apostolis Sambanis
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Samuel Dorevitch
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
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Rossati A. Global Warming and Its Health Impact. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:7-20. [PMID: 28051192 PMCID: PMC6679631 DOI: 10.15171/ijoem.2017.963] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 11/29/2016] [Indexed: 12/30/2022]
Abstract
Since the mid-19th century, human activities have increased greenhouse gases such as carbon dioxide, methane, and nitrous oxide in the Earth's atmosphere that resulted in increased average temperature. The effects of rising temperature include soil degradation, loss of productivity of agricultural land, desertification, loss of biodiversity, degradation of ecosystems, reduced fresh-water resources, acidification of the oceans, and the disruption and depletion of stratospheric ozone. All these have an impact on human health, causing non-communicable diseases such as injuries during natural disasters, malnutrition during famine, and increased mortality during heat waves due to complications in chronically ill patients. Direct exposure to natural disasters has also an impact on mental health and, although too complex to be quantified, a link has even been established between climate and civil violence. Over time, climate change can reduce agricultural resources through reduced availability of water, alterations and shrinking arable land, increased pollution, accumulation of toxic substances in the food chain, and creation of habitats suitable to the transmission of human and animal pathogens. People living in low-income countries are particularly vulnerable. Climate change scenarios include a change in distribution of infectious diseases with warming and changes in outbreaks associated with weather extreme events. After floods, increased cases of leptospirosis, campylobacter infections and cryptosporidiosis are reported. Global warming affects water heating, rising the transmission of water-borne pathogens. Pathogens transmitted by vectors are particularly sensitive to climate change because they spend a good part of their life cycle in a cold-blooded host invertebrate whose temperature is similar to the environment. A warmer climate presents more favorable conditions for the survival and the completion of the life cycle of the vector, going as far as to speed it up as in the case of mosquitoes. Diseases transmitted by mosquitoes include some of the most widespread worldwide illnesses such as malaria and viral diseases. Tick-borne diseases have increased in the past years in cold regions, because rising temperatures accelerate the cycle of development, the production of eggs, and the density and distribution of the tick population. The areas of presence of ticks and diseases that they can transmit have increased, both in terms of geographical extension than in altitude. In the next years the engagement of the health sector would be working to develop prevention and adaptation programs in order to reduce the costs and burden of climate change.
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Affiliation(s)
- Antonella Rossati
- Department of Infectious Diseases, University Hospital "Maggiore della Carità", Novara, Italy.
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