Climate change and human health: present and future risks

Relationships between Renewable Energy and the Prevalence of Morbidity in the Countries of the European Union: A Panel Regression Approach

The main objective of the presented study was to examine the associations between the use of renewable energy sources in selected sectors (transport, electricity, heating, and cooling) and the prevalence of selected groups of diseases in the European Union, with an emphasis on the application of statistical methods considering the structure of data. The analyses included data on 27 countries of the European Union from 2010 to 2019 published in the Eurostat database and the Global Burden of Disease Study. Panel regression models (pooling model, fixed (within) effects model, random effects model) were primarily used in analytical procedures, in which a panel variable was represented by countries. In most cases, positive and significant associations between the use of renewable energy sources and the prevalence of diseases were confirmed. The results of panel regression models could be generally interpreted as meaning that renewable energy sources are associated with the prevalence of diseases such as cardiovascular diseases, diabetes and kidney diseases, digestive diseases, musculoskeletal disorders, neoplasms, sense organ diseases, and skin and subcutaneous diseases at a significance level (α) of 0.05 and lower. These findings could be explained by the awareness of the health problem and the response in the form of preference for renewable energy sources. Regarding statistical methods used for country data or for data with a specific structure, it is recommended to use the methods that take this structure into account. The absence of these methods could lead to misleading conclusions.

Florida’s Harmful Algal Bloom (HAB) Problem: Escalating Risks to Human, Environmental and Economic Health With Climate Change

Harmful Algal Blooms (HABs) pose unique risks to the citizens, stakeholders, visitors, environment and economy of the state of Florida. Florida has been historically subjected to reoccurring blooms of the toxic marine dinoflagellate Karenia brevis (C. C. Davis) G. Hansen & Moestrup since at least first contact with explorers in the 1500’s. However, ongoing immigration of more than 100,000 people year–1 into the state, elevated population densities in coastal areas with attendant rapid, often unregulated development, coastal eutrophication, and climate change impacts (e.g., increasing hurricane severity, increases in water temperature, ocean acidification and sea level rise) has likely increased the occurrence of other HABs, both freshwater and marine, within the state as well as the number of people impacted by these blooms. Currently, over 75 freshwater, estuarine, coastal and marine HAB species are routinely monitored by state agencies. While only blooms of K. brevis, the dinoflagellate Pyrodinium bahamense (Böhm) Steidinger, Tester, and Taylor and the diatom Pseudo-nitzschia spp. have resulted in closure of commercial shellfish beds, other HAB species, including freshwater and marine cyanobacteria, pose either imminent or unknown risks to human, environmental and economic health. HAB related human health risks can be classified into those related to consumption of contaminated shellfish and finfish, consumption of or contact with bloom or toxin contaminated water or exposure to aerosolized HAB toxins. While acute human illnesses resulting from consumption of brevetoxin-, saxitoxin-, and domoic acid-contaminated commercial shellfish have been minimized by effective monitoring and regulation, illnesses due to unregulated toxin exposures, e.g., ciguatoxins and cyanotoxins, are not well documented or understood. Aerosolized HAB toxins potentially impact the largest number of people within Florida. While short-term (days to weeks) impacts of aerosolized brevetoxin exposure are well documented (e.g., decreased respiratory function for at-risk subgroups such as asthmatics), little is known of longer term (>1 month) impacts of exposure or the risks posed by aerosolized cyanotoxin [e.g., microcystin, β-N-methylamino-L-alanine (BMAA)] exposure. Environmental risks of K. brevis blooms are the best studied of Florida HABs and include acute exposure impacts such as significant dies-offs of fish, marine mammals, seabirds and turtles, as well as negative impacts on larval and juvenile stages of many biota. When K. brevis blooms are present, brevetoxins can be found throughout the water column and are widespread in both pelagic and benthic biota. The presence of brevetoxins in living tissue of both fish and marine mammals suggests that food web transfer of these toxins is occurring, resulting in toxin transport beyond the spatial and temporal range of the bloom such that impacts of these toxins may occur in areas not regularly subjected to blooms. Climate change impacts, including temperature effects on cell metabolism, shifting ocean circulation patterns and changes in HAB species range and bloom duration, may exacerbate these dynamics. Secondary HAB related environmental impacts are also possible due to hypoxia and anoxia resulting from elevated bloom biomass and/or the decomposition of HAB related mortalities. Economic risks related to HABs in Florida are diverse and impact multiple stakeholder groups. Direct costs related to human health impacts (e.g., increased hospital visits) as well as recreational and commercial fisheries can be significant, especially with wide-spread sustained HABs. Recreational and tourism-based industries which sustain a significant portion of Florida’s economy are especially vulnerable to both direct (e.g., declines in coastal hotel occupancy rates and restaurant and recreational users) and indirect (e.g., negative publicity impacts, associated job losses) impacts from HABs. While risks related to K. brevis blooms are established, Florida also remains susceptible to future HABs due to large scale freshwater management practices, degrading water quality, potential transport of HABs between freshwater and marine systems and the state’s vulnerability to climate change impacts.

Sustaining planetary health through systems thinking: Public health's critical role

Understanding and responding to adverse human health impacts of global environmental change will be a major priority of 21st century public health professionals. The emerging field of planetary health aims to face this challenge by studying and promoting policies that protect the health of humans and of the Earth's natural systems that support them. Public health, drawing on its experience of guiding policies to improve population health, has contributed to planetary health's development. Yet, few public health practitioners are familiar with planetary health's systems-oriented approaches for understanding relationships between economic development, environmental degradation, and human health. In this narrative review, we present key planetary health concepts and show how systems thinking has guided its development. We discuss historical approaches to studying impacts of economic development on human health and the environment. We then review novel conceptual frameworks adopted by planetary health scientists to study and forecast impacts of policies that influence human health and Earth's natural systems at varying spatiotemporal scales. We conclude by presenting examples of how applying the "Doughnut" model (an economic framework where the needs of people are met without overshooting the world's ecological limits) could guide policies for promoting health co-benefits to humans and natural systems.

Preparing Veterinarians to Address the Health Impacts of Climate Change: Student Perceptions, Knowledge Gaps, and Opportunities

Climate change poses a significant and increasing threat to global health. While veterinarians play integral roles in public and environmental health, the profession has been less engaged in the topic of climate change relative to their human medical counterparts. The objective of this study was to synthesize veterinary students' perceptions and knowledge about the relationship between veterinary medicine and climate change to identify educational gaps and opportunities. An online questionnaire was disseminated to American Veterinary Medical Association (AVMA)-accredited veterinary colleges through the Student American Veterinary Medical Association newsletter. Respondents were overwhelmingly confident that climate change is happening, is due to human activities, and is impacting both human and animal health. Veterinary students also expressed the belief that veterinarians should take a leadership role on the issue of climate change, especially through promoting environmental sustainability in clinical practice. Despite this enthusiasm, most students reported a lack of educational opportunities within their veterinary programs. The results of this survey highlight opportunities for the development of educational resources on the topic, many of which could complement existing material such as that devoted to practice management, economics, and client communication. Veterinarians have the potential to meaningfully contribute to both mitigation and adaptation efforts around climate change; however, they must be equipped with the tools to do so.

Subtractive proteomics approach to Unravel the druggable proteins of the emerging pathogen Waddlia chondrophila and drug repositioning on its MurB protein

Waddlia chondrophila is an emerging pathogen that has been implicated in numerous unpropitious pregnancy events in humans and ruminants. Taking into account its association with abortigenic events, possible modes of transmission, and future risk, immediate clinical measures are required to prevent widespread damage caused by this organism and hence this study. Here, a subtractive proteomics approach was employed to identify druggable proteins of W. chondrophila. Considering the essential genes, antibiotic resistance proteins, and virulence factors, 676 unique important proteins were initially identified for this bacterium. Afterward, NCBI BLASTp performed against human proteome identified 223 proteins that were further pushed into KEGG Automatic Annotation Server (KAAS) for automatic annotation. Using the information from the Kyoto Encyclopedia of Genes and Genomes (KEGG) database 14 Waddlia specific metabolic pathways were identified with respect to humans. Analyzing the data from KAAS and KEGG databases, forty-eight metabolic pathway-dependent, and seventy metabolic pathway independent proteins were identified. Standalone BLAST search against DrugBank FDA approved drug targets revealed eight proteins that are finally considered druggable proteins. Prediction of three-dimensional structures was done for the eight proteins through homology modeling and the Ramachandran plot model showed six models as a valid prediction. Finally, virtual screening against MurB protein was performed using FDA approved drugs to employ the drug repositioning strategy. Three drugs showed promising docking results that can be used for therapeutic purposes against W. chondrophila following the clinical validation of the study.

Urine metabolite profiling of Indian Antarctic Expedition members: NMR spectroscopy-based metabolomic investigation

The southernmost region of earth, Antarctica, has world's most challenging environments. Those who live for long time and work in Antarctic stations are subjected to environmental stresses such as cold weather, photoperiod variations leading to disrupted sleep cycles, constrained living spaces, dry air, non-availability of fresh food items, and high electromagnetic radiations, psychological factors, such as geographical and social isolation, etc. All these factors have a significant impact on the human body. The present study investigated the impact of Antarctica harsh environment on human physiology and its metabolic processes by evaluating urine metabolome, using 1H NMR spectroscopy and analyzing certain physiological and clinical parameters for correlation with physiological expression data and metabolite results. Two study groups - before Antarctic exposure (B) and after Antarctic exposure (E), consisting of 11 subjects, exposed to one-month summer expedition, were compared. 35 metabolites in urine samples were identified from the 700 MHz ¹H NMR spectra from where integral intensity of 22 important metabolites was determined. Univariate analysis indicated significant decrease in the levels of citrate and creatinine in samples collected post-expedition. Multivariate analysis was also performed using 1H NMR spectroscopy, because independent metabolite abundances may complement each other in predicting the dependent variables. 10 metabolites were identified among the groups; the OPLS-DA and VIP score indicated variation in appearance of metabolites over different time periods with insignificant change in the intensities. Metabolite results illustrate the impact of environmental stress or altered life style including the diet with absence of fresh fruits and vegetables, on the pathophysiology of the human health. Metabolic adaptation to Antarctic environmental stressors may help to highlight the effect of short-term physiological status and provide important information during Antarctic expeditions to formulate management programmes.

[Floods and leptospirosis in Brazilian municipalities from 2003 to 2013: use of data mining techniques]

Leptospirosis is related to problems with environmental sanitation, and the incidence tends to increase during flood periods. Considering issues related to climate change, floods can be expected to increase. Floods do not affect populations homogeneously, and communities with worse socioeconomic conditions tend to be impacted more heavily. In order to determine whether the number of floods increases the incidence of leptospirosis and its relationship to contextual variables, the study used socioeconomic, environmental, and disease occurrence data at the municipal (county) level. Municipalities suffering problems with sewage disposal showed a higher risk of leptospirosis incidence. Total flooding since the municipality's declaration of flood emergency was an important risk marker for leptospirosis incidence. Regression tree modeling proved useful for estimating leptospirosis incidence in Brazil.

Sustainable Diets for Cardiovascular Disease Prevention and Management

PURPOSE OF REVIEW

Healthy dietary patterns are recommended for prevention of cardiovascular disease, which remains the leading cause of morbidity and mortality globally. In this review, we discuss dietary patterns that are not only optimal for CVD prevention and management but also sustainable in maximizing health, environmental, and economic benefits.

RECENT FINDINGS

The growing literature on sustainable diets in the context of environmental sustainability includes subtopics of climate change, land use, biodiversity loss, freshwater use, and reactive nitrogen emissions. Similarly, economic sustainability, beyond the retail cost of food, extends to healthcare costs and the economic costs of environmental destruction related to current agricultural practices and food choices. Dietary patterns that are high in plant foods and low in animal foods could maximize health, environmental, and economic benefits; however, questions remain about how to best promote these patterns to achieve wider adoption in an environmentally and economically sustainable way.

Climate Change, Health Risks, and Vulnerabilities in Burkina Faso: A Qualitative Study on the Perceptions of National Policymakers

Climate change (CC) constitutes one of the greatest threats to human health, and requires political awareness for effective and efficient adaptation planning. This study identified the perceptions of climate change and health adaptation (CC&H) among relevant stakeholders, decision-makers, and policymakers (SDPs) in Burkina Faso (BF) by determining their perceptions of CC, of related health risks and vulnerabilities, and of CC impacts on agriculture and food security. We carried out 35 semi-structured, qualitative in-depth interviews with SDPs, representing national governmental institutions, international organizations, and civil society organizations. The interviews were analyzed using content analysis. SDPs shared similar perceptions of CC and concurred with three ideas (1) CC is a real and lived experience in BF; (2) the population is aware of climatic changes in their environment; (3) CC is intertwined with the agricultural and economic development of the country. SDPs identified biodiversity loss, floods, droughts, and extreme heat as posing the highest risk to health. They elaborated five exposure pathways that are and will be affected by CC: water quality and quantity, heat stress, food supply and safety, vector borne diseases, and air quality. In conclusion, SDPs in Burkina Faso are highly aware of CC hazards, relevant health exposure pathways, and their corresponding health outcomes. Mental health and the interplay between social factors and complex health risks constitute perception gaps. SDPs perceived CC&H risks and vulnerabilities align with current evidence.

The spatiotemporal distribution of historical malaria cases in Sweden: a climatic perspective

Background

Understanding of the impacts of climatic variability on human health remains poor despite a possibly increasing burden of vector-borne diseases under global warming. Numerous socioeconomic variables make such studies challenging during the modern period while studies of climate–disease relationships in historical times are constrained by a lack of long datasets. Previous studies have identified the occurrence of malaria vectors, and their dependence on climate variables, during historical times in northern Europe. Yet, malaria in Sweden in relation to climate variables is understudied and relationships have never been rigorously statistically established. This study seeks to examine the relationship between malaria and climate fluctuations, and to characterise the spatio-temporal variations at parish level during severe malaria years in Sweden 1749–1859.

Methods

Symptom-based annual malaria case/death data were obtained from nationwide parish records and military hospital records in Stockholm. Pearson (r_p) and Spearman’s rank (r_s) correlation analyses were conducted to evaluate inter-annual relationship between malaria data and long meteorological series. The climate response to larger malaria events was further explored by Superposed Epoch Analysis, and through Geographic Information Systems analysis to map spatial variations of malaria deaths.

Results

The number of malaria deaths showed the most significant positive relationship with warm-season temperature of the preceding year. The strongest correlation was found between malaria deaths and the mean temperature of the preceding June–August (r_s = 0.57, p < 0.01) during the 1756–1820 period. Only non-linear patterns can be found in response to precipitation variations. Most malaria hot-spots, during severe malaria years, concentrated in areas around big inland lakes and southern-most Sweden.

Conclusions

Unusually warm and/or dry summers appear to have contributed to malaria epidemics due to both indoor winter transmission and the evidenced long incubation and relapse time of P. vivax, but the results also highlight the difficulties in modelling climate–malaria associations. The inter-annual spatial variation of malaria hot-spots further shows that malaria outbreaks were more pronounced in the southern-most region of Sweden in the first half of the nineteenth century compared to the second half of the eighteenth century.

Multidimensional analysis of global climate change: a review

Even though climate change involves much more than warming, it is the name given to a set of physical phenomena. It is a long-term change in weather patterns that characterises different regions of the world. The warming effect in the earth's atmosphere has dramatically increased through the influence of some heat-taping gases emitted by various human activities, especially fossil fuel burning. The more the input of such gases, the more will be the warming effect in the coming times. Global climate change is already visible in various parts of the larger ecosystems like forests, fisheries, biodiversity, and agriculture; however, it is now also influencing the supply of freshwater, human health, and well-being. This paper reviews climate change drivers, its global scenario, major global events, and assessing climate change impacts. The most daunting problem of economic and ecological risks, along with the threats to humanity, is also discussed. The paper further reviews the species' vulnerability to climate change and the heat waves and human migration vis-à-vis climate change. Climate change politics and coverage of climate change episodes in mass media is the special focus of this review that concludes with a few mitigation measures.

Global climate change, diet, and the complex relationship between human host and microbiome: Towards an integrated picture

Dietary changes can alter the human microbiome with potential detrimental consequences for health. Given that environment, health, and evolution are interconnected, we ask: Could diet-driven microbiome perturbations have consequences that extend beyond their immediate impact on human health? We address this question in the context of the urgent health challenges posed by global climate change. Drawing on recent studies, we propose that not only can diet-driven microbiome changes lead to dysbiosis, they can also shape life-history traits and fuel human evolution. We posit that dietary shifts prompt mismatched microbiome-host genetics configurations that modulate human longevity and reproductive success. These mismatches can also induce a heritable intra-holobiont stress response, which encourages the holobiont to re-establish equilibrium within the changed nutritional environment. Thus, while mismatches between climate change-related genetic and epigenetic configurations within the holobiont increase the risk and severity of diseases, they may also affect life-history traits and facilitate adaptive responses. These propositions form a framework that can help systematize and address climate-related dietary challenges for policy and health interventions.

Towards Understanding Interactions between Sustainable Development Goals: The Role of Climate-Well-Being Linkages. Experiences of EU Countries

The 2030 Agenda with 17 Sustainable Development Goals (SDGs) is a challenge for all countries in the world. Their implementation may turn out to be a compromise or the creation of effective interactions that dynamize sustainable development. To achieve the SDGs, it is essential to understand how they interact with each other. It seems that in the times of the climate and health crisis caused by the COVID-19 pandemic, caring for the environment and ensuring a healthy life and promoting well-being at all ages is the basis for environmental, economic and social sustainable development. The aim of the study is to compare the degree of implementation of the goals of sustainable development in the scope of goal 13 “Climate action” and goal 3 “Good health and well-being” in the EU countries. In addition, we analyze how trade-offs and synergies between these goals have developed. Data from the Eurostat database were used to achieve the goal. The study used the method of multivariate comparative analysis—linear ordering of objects. The technique for order preference by similarity to an ideal solution (TOPSIS) method was used to measure the studied phenomenon. The results indicate a different degree of implementation of the sustainable development goals related to climate change and the improvement of health and social well-being. Only a few countries have synergy in achieving these goals, most of them compromise, manifesting themselves in improving one goal over another. In the group of analyzed EU countries, a simultaneous deterioration in the effectiveness of achieving both objectives were also noted. Our research also shows that energy policy is an important attribute in improving the achievement of these goals. The conducted analysis fills the gap in the research on the implementation of selected sustainable development goals and their interactions. It contributes to the discussion on increasing the links between them, in particular with regard to emerging compromises. This research can provide a basis for re-prioritizing and intensifying the actions where individual EU countries are lagging most behind.

Short-term exposure to extreme temperature and risk of hospital admission due to cardiovascular diseases

Objective: Numerous epidemiological studies have reported relevance of morbidity and mortality from cardiovascular diseases with short-term exposure to environmental temperature. In this study, we examined the hypothesis between temperature indices and hospital admission because of cardiovascular diseases. Methods: The daily number of CVDs was obtained from all hospitals of the Sabzevar city. A semi-parametric generalized additive model (GAM) following a quasi-Poisson distribution with distributed lag non-linear model (dlnm) was selected as a modeling framework for time-series analysis. Results: The overall CVD risk comparing the 1st percentile and the 99th percentile relative to the mean temperature (at lag 0) was 1.33 (95% CI, 1.11: 1.61), and 1.34 (95% CI, 1.10: 1.64), respectively. For all indicators, the extremely cold effects persisted for the initial 7 days. Conclusions: Our results suggest that extremely cold and extremely hot temperatures increase the relative risk of cardiovascular diseases.

Anomalously warm weather and acute care visits in patients with multiple sclerosis: A retrospective study of privately insured individuals in the US

BACKGROUND

As the global climate changes in response to anthropogenic greenhouse gas emissions, weather and temperature are expected to become increasingly variable. Although heat sensitivity is a recognized clinical feature of multiple sclerosis (MS), a chronic demyelinating disorder of the central nervous system, few studies have examined the implications of climate change for patients with this disease.

METHODS AND FINDINGS

We conducted a retrospective cohort study of individuals with MS ages 18-64 years in a nationwide United States patient-level commercial and Medicare Advantage claims database from 2003 to 2017. We defined anomalously warm weather as any month in which local average temperatures exceeded the long-term average by ≥1.5°C. We estimated the association between anomalously warm weather and MS-related inpatient, outpatient, and emergency department visits using generalized log-linear models. From 75,395,334 individuals, we identified 106,225 with MS. The majority were women (76.6%) aged 36-55 years (59.0%). Anomalously warm weather was associated with increased risk for emergency department visits (risk ratio [RR] = 1.043, 95% CI: 1.025-1.063) and inpatient visits (RR = 1.032, 95% CI: 1.010-1.054). There was limited evidence of an association between anomalously warm weather and MS-related outpatient visits (RR = 1.010, 95% CI: 1.005-1.015). Estimates were similar for men and women, strongest among older individuals, and exhibited substantial variation by season, region, and climate zone. Limitations of the present study include the absence of key individual-level measures of socioeconomic position (i.e., race/ethnicity, occupational status, and housing quality) that may determine where individuals live-and therefore the extent of their exposure to anomalously warm weather-as well as their propensity to seek treatment for neurologic symptoms.

CONCLUSIONS

Our findings suggest that as global temperatures rise, individuals with MS may represent a particularly susceptible subpopulation, a finding with implications for both healthcare providers and systems.

The delayed effect of cooling reinforced the NAO-plague connection in pre-industrial Europe

Previous studies on the connection between climate and plague were mostly conducted without considering the influence of large-scale atmospheric circulations and long-term historical observations. The current study seeks to reveal the sophisticated role of climatic control on plague by investigating the combined effect of North Atlantic Oscillation (NAO) and temperature on plague outbreaks in Europe from 1347 to 1760 CE. Moving correlation analysis is applied to explore the non-linear relationship between NAO and plague transmission over time. Also, we apply the cross-correlation function to identify the role of temperature in mediating the NAO-plague connection and the lead-lag relationship in between. Our statistical results show that the pathway from climate change to plague incidence is distinctive in its spatial, temporal, and non-linear patterns. The multi-decadal temperature change exerted a 15-22 years lagged impact on the NAO-plague correlation in different European regions. The NAO-plague correlation in Atlantic-Central Europe primarily remained positive, while the correlation in Mediterranean Europe switched between positive and negative alternately. The modulating effect of temperature over the NAO-plague correlation increases exponentially with the magnitude of the temperature anomaly, but the effect is negligible between 0.3 and -0.3 °C anomaly. Our findings show that a lagged influence from the temperature extremes dominantly controls the correlation between NAO and plague incidence. A forecast from our study suggests that large-scale plague outbreaks are unlikely to happen in Europe if NAO remains at its current positive phase during the earth's future warming.

A postbiotic from Aspergillus oryzae attenuates the impact of heat stress in ectothermic and endothermic organisms

Heat stress is detrimental to food-producing animals and animal productivity remains suboptimal despite the use of heat abatement strategies during summer. Global warming and the increase of frequency and intensity of heatwaves are likely to continue and, thus, exacerbate the problem of heat stress. Heat stress leads to the impairment of physiological and cellular functions of ectothermic and endothermic animals. Therefore, it is critical to conceive ways of protecting animals against the pathological effects of heat stress. In experiments with endothermic animals highly sensitive to heat (Bos taurus), we have previously reported that heat-induced systemic inflammation can be ameliorated in part by nutritional interventions. The experiments conducted in this report described molecular and physiological adaptations to heat stress using Drosophila melanogaster and dairy cow models. In this report, we expand previous work by first demonstrating that the addition of a postbiotic from Aspergillus oryzae (AO) into the culture medium of ectothermic animals (Drosophila melanogaster) improved survival to heat stress from 30 to 58%. This response was associated with downregulation of genes involved in the modulation of oxidative stress and immunity, most notably metallothionein B, C, and D. In line with these results, we subsequently showed that the supplementation with the AO postbiotic to lactating dairy cows experiencing heat stress decreased plasma concentrations of serum amyloid A and lipopolysaccharide-binding protein, and the expression of interleukin-6 in white blood cells. These alterations were paralleled by increased synthesis of energy-corrected milk and milk components, suggesting enhanced nutrient partitioning to lactogenesis and increased metabolic efficiency. In summary, this work provides evidence that a postbiotic from AO enhances thermal tolerance likely through a mechanism that entails reduced inflammation.

Tropical cyclone exposure is associated with increased hospitalization rates in older adults

Hurricanes and other tropical cyclones have devastating effects on society. Previous case studies have quantified their impact on some health outcomes for particular tropical cyclones, but a comprehensive assessment over longer periods is currently missing. Here, we used data on 70 million Medicare hospitalizations and tropical cyclone exposures over 16 years (1999-2014). We formulated a conditional quasi-Poisson model to examine how tropical cyclone exposure (days greater than Beaufort scale gale-force wind speed; ≥34 knots) affect hospitalizations for 13 mutually-exclusive, clinically-meaningful causes. We found that tropical cyclone exposure was associated with average increases in hospitalizations from several causes over the week following exposure, including respiratory diseases (14.2%; 95% confidence interval [CI]: 10.9-17.9%); infectious and parasitic diseases (4.3%; 95%CI: 1.2-8.1%); and injuries (8.7%; 95%CI: 6.0-11.8%). Average decadal tropical cyclone exposure in all impacted counties would be associated with an estimated 16,772 (95%CI: 8,265-25,278) additional hospitalizations. Our findings demonstrate the need for targeted preparedness strategies for hospital personnel before, during, and after tropical cyclones.

Assessing biophysical and socio-economic impacts of climate change on regional avian biodiversity

Climate change threatens biodiversity directly by influencing biophysical variables that drive species' geographic distributions and indirectly through socio-economic changes that influence land use patterns, driven by global consumption, production and climate. To date, no detailed analyses have been produced that assess the relative importance of, or interaction between, these direct and indirect climate change impacts on biodiversity at large scales. Here, we apply a new integrated modelling framework to quantify the relative influence of biophysical and socio-economically mediated impacts on avian species in Vietnam and Australia and we find that socio-economically mediated impacts on suitable ranges are largely outweighed by biophysical impacts. However, by translating economic futures and shocks into spatially explicit predictions of biodiversity change, we now have the power to analyse in a consistent way outcomes for nature and people of any change to policy, regulation, trading conditions or consumption trend at any scale from sub-national to global.

Effect of extreme hot and cold weather on cause-specific hospitalizations in Sweden: A time series analysis

Considering that several meteorological variables can contribute to weather vulnerability, the estimation of their synergetic effects on health is particularly useful. The spatial synoptic classification (SSC) has been used in biometeorological applications to estimate the effect of the entire suite of weather conditions on human morbidity and mortality. In this study, we assessed the relationships between extremely hot and dry (dry tropical plus, DT+) and hot and moist (moist tropical plus, MT+) weather types in summer and extremely cold and dry (dry polar plus, DP+) and cold and moist (moist polar, MP+) weather types in winter and cardiovascular and respiratory hospitalizations by age and sex. Time-series quasi-Poisson regression with distributed lags was used to assess the relationship between oppressive weather types and daily hospitalizations over 14 subsequent days in the extended summer (May to August) and 28 subsequent days during the extended winter (November to March) over 24 years in 4 Swedish locations from 1991 to 2014. In summer, exposure to hot weather types appeared to reduce cardiovascular hospitalizations while increased the risk of hospitalizations for respiratory diseases, mainly related to MT+. In winter, the effect of cold weather on both cause-specific hospitalizations was small; however, MP+ was related to a delayed increase in cardiovascular hospitalizations, whilst MP+ and DP + increased the risk of hospitalizations due to respiratory diseases. This study provides useful information for the staff of hospitals and elderly care centers who can help to implement protective measures for patients and residents. Also, our results could be helpful for vulnerable people who can adopt protective measures to reduce health risks.

Extreme weather events in europe and their health consequences - A systematic review

BACKGROUND

Due to climate change, the frequency, intensity and severity of extreme weather events, such as heat waves, cold waves, storms, heavy precipitation causing wildfires, floods, and droughts are increasing, which could adversely affect human health. The purpose of this systematic review is therefore to assess the current literature about the association between these extreme weather events and their impact on the health of the European population.

METHODS

Observational studies published from January 1, 2007 to May 17, 2020 on health effects of extreme weather events in Europe were searched systematically in Medline, Embase and Cochrane Central Register of Controlled Trials. The exposures of interest included extreme temperature, heat waves, cold waves, droughts, floods, storms and wildfires. The health impacts included total mortality, cardiovascular mortality and morbidity, respiratory mortality and morbidity, and mental health. We conducted the systematic review following PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis). The quality of the included studies was assessed using the NICE quality appraisal checklist (National Institute for Health and Care Excellence).

RESULTS

The search yielded 1472 articles, of which 35 met the inclusion criteria and were included in our review. Studies regarding five extreme weather events (extreme heat events, extreme cold events, wildfires, floods, droughts) were found. A positive association between extreme heat/cold events and overall, cardiovascular and respiratory mortality was reported from most studies. Wildfires are likely to increase the overall and cardiovascular mortality. Floods might be associated with the deterioration of mental health instead of mortality. Depending on their length, droughts could have an influence on both respiratory and cardiovascular mortality. Contradictory evidence was found in heat-associated morbidity and wildfire-associated respiratory mortality. The associations are inconclusive due to the heterogeneous study designs, study quality, exposure and outcome assessment.

CONCLUSIONS

Evidence from most of the included studies showed that extreme heat and cold events, droughts, wildfires and floods in Europe have negative impacts on human health including mental health, although some of the associations are not conclusive. Additional high-quality studies are needed to confirm our results and further studies regarding the effects of other extreme weather events in Europe are to be expected.

Meteorological Factors and the Transmissibility of Hand, Foot, and Mouth Disease in Xiamen City, China

Background: As an emerging infectious disease, the prevention and control of hand, foot, and mouth disease (HFMD) poses a significant challenge to the development of public health in China. In this study, we aimed to explore the mechanism of the seasonal transmission characteristics of HFMD and to reveal the correlation and potential path between key meteorological factors and the transmissibility of HFMD. Methods: Combined with daily meteorological data such as average temperature, average relative humidity, average wind velocity, amount of precipitation, average air pressure, evaporation capacity, and sunshine duration, a database of HFMD incidence and meteorological factors was established. Spearman rank correlation was used to calculate the correlation between the various meteorological factors and the incidence of HFMD. The effective reproduction number (R eff ) of HFMD was used as an intermediate variable to further quantify the dynamic relationship between the average temperature and R eff . Results: A total of 43,659 cases of HFMD were reported in Xiamen from 2014 to 2018. There was a significantly positive correlation between the average temperature and the incidence of HFMD (r = 0.596, p < 0.001), and a significantly negative correlation between the average air pressure and the incidence of HFMD (r = -0.511, p < 0.001). There was no correlation between the average wind velocity (r = 0.045, p > 0.05) or amount of precipitation (r = 0.043, p > 0.05) and incidence. There was a temperature threshold for HFMD's transmissibility. Owing to the seasonal transmission characteristics of HFMD in Xiamen, the temperature threshold of HFMD's transmissibility was 13.4-18.4°C and 14.5-29.3°C in spring and summer and in autumn and winter, respectively. Conclusions: HFMD's transmissibility may be affected by the average temperature; the temperature threshold range of transmissibility in autumn and winter is slightly wider than that in spring and summer. Based on our findings, we suggest that the relevant epidemic prevention departments should pay close attention to temperature changes in Xiamen to formulate timely prevention strategies before the arrival of the high-risk period.

Potential Impacts of Extreme Heat and Bushfires on Dementia

Australia often experiences natural disasters and extreme weather conditions such as: flooding, sandstorms, heatwaves, and bushfires (also known as wildfires or forest fires). The proportion of the Australian population aged 65 years and over is increasing, alongside the severity and frequency of extreme weather conditions and natural disasters. Extreme heat can affect the entire population but particularly at the extremes of life, and patients with morbidities. Frequently identified as a vulnerable demographic in natural disasters, there is limited research on older adults and their capacity to deal with extreme heat and bushfires. There is a considerable amount of literature that suggests a significant association between mental disorders such as dementia, and increased vulnerability to extreme heat. The prevalence rate for dementia is estimated at 30%by age 85 years, but there has been limited research on the effects extreme heat and bushfires have on individuals living with dementia. This review explores the differential diagnosis of dementia, the Australian climate, and the potential impact Australia's extreme heat and bushfires have on individuals from vulnerable communities including low socioeconomic status Indigenous and Non-Indigenous populations living with dementia, in both metropolitan and rural communities. Furthermore, we investigate possible prevention strategies and provide suggestions for future research on the topic of Australian bushfires and heatwaves and their impact on people living with dementia. This paper includes recommendations to ensure rural communities have access to appropriate support services, medical treatment, awareness, and information surrounding dementia.

A systematic review on lagged associations in climate-health studies

BACKGROUND

Lagged associations in climate-health studies have already been ubiquitously acknowledged in recent years. Despite extensive time-series models having proposed accounting for lags, few studies have addressed the question of maximum-lag specification, which could induce considerable deviations of effect estimates.

METHODS

We searched the PubMed and Scopus electronic databases for existing climate-health literature in the English language with a time-series or case-crossover study design published during 2000-2019 to summarize the statistical methodologies and reported lags of associations between climate variables and 14 common causes of morbidity and mortality. We also aggregated the results of the included studies by country and climate zone.

RESULTS

The associations between infectious-disease outcomes and temperatures were found to be lagged for ∼1-2 weeks for influenza, 3-6 weeks for diarrhoea, 7-12 weeks for malaria and 6-16 weeks for dengue fever. Meanwhile, the associations between both cardiovascular and respiratory diseases and hot temperatures lasted for <5 days, whereas the associations between cardiovascular diseases and cold temperatures were observed to be 10-20 days. In addition, rainfall showed a 4- to 10-week lagged association with infectious diarrheal diseases, whereas the association could be further delayed to 8-12 weeks for vector-borne diseases.

CONCLUSION

Our findings indicated some general patterns for possible lagged associations between some common health outcomes and climatic exposures, and suggested a necessity for a biologically plausible and reasonable definition of the effect lag in the modelling practices for future environmental epidemiological studies.

Influence of air temperature and implemented veterinary measures on the incidence of human salmonellosis in the Czech Republic during 1998-2017

Background

The aim of our study was to analyse the influence of air temperature and implemented veterinary measures on salmonellosis incidence in the Czech Republic (CZ).

Methods

We conducted a descriptive analysis of salmonellosis as reported to the Czech national surveillance system during 1998–2017 and evaluated the influence of applied veterinary measures (started in January 2008) on salmonellosis incidence by comparing two 9-year periods (1998–2006, 2009–2017). Using a generalized additive model, we analysed association between monthly mean air temperature and log-transformed salmonellosis incidence over the entire twenty-year period.

Results

A total of 410,533 salmonellosis cases were reported during the study period in the CZ. Annual mean incidences of salmonellosis were 313.0/100,000 inhabitants before and 99.0/100,000 inhabitants after implementation of the veterinary measures. The time course of incidence was non-linear, with a sharp decline during 2006–2010. Significant association was found between disease incidence and air temperature. On average, the data indicated that within a common temperature range every 1 °C rise in air temperature contributed to a significant 6.2% increase in salmonellosis cases.

Conclusions

Significant non-linear effects of annual trend, within-year seasonality, and air temperature on the incidence of salmonellosis during 1998–2017 were found. Our study also demonstrates significant direct effect of preventive veterinary measures taken in poultry in reducing incidence of human salmonellosis in the CZ. The annual mean number of salmonellosis cases in the period after introducing the veterinary measures was only 32.5% of what it had been in the previous period.

COVID-19 Pandemic Prompts a Paradigm Shift in Global Emergency Medicine: Multidirectional Education and Remote Collaboration

To date, the practice of global emergency medicine (GEM) has involved being "on the ground" supporting in-country training of local learners, conducting research, and providing clinical care. This face-to-face interaction has been understood as critically important for developing partnerships and building trust. The COVID-19 pandemic has brought significant uncertainty worldwide, including international travel restrictions of indeterminate permanence. Following the 2020 Society for Academic Emergency Medicine meeting, the Global Emergency Medicine Academy (GEMA) sought to enhance collective understanding of best practices in GEM training with a focus on multidirectional education and remote collaboration in the setting of COVID-19. GEMA members led an initiative to outline thematic areas deemed most pertinent to the continued implementation of impactful GEM programming within the physical and technologic confines of a pandemic. Eighteen GEM practitioners were divided into four workgroups to focus on the following themes: advances in technology, valuation, climate impacts, skill translation, research/scholastic projects, and future challenges. Several opportunities were identified: broadened availability of technology such as video conferencing, Internet, and smartphones; online learning; reduced costs of cloud storage and printing; reduced carbon footprint; and strengthened local leadership. Skills and knowledge bases of GEM practitioners, including practicing in resource-poor settings and allocation of scarce resources, are translatable domestically. The COVID-19 pandemic has accelerated a paradigm shift in the practice of GEM, identifying a previously underrecognized potential to both strengthen partnerships and increase accessibility. This time of change has provided an opportunity to enhance multidirectional education and remote collaboration to improve global health equity.

Human Health and Ocean Pollution

Background

Pollution - unwanted waste released to air, water, and land by human activity - is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood.

Goals

(1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health.

Methods

Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention.

Environmental Findings

Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources - coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths.

Ecosystem Findings

Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the Vibrio species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks.

Human Health Findings

Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants in utero to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children's risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals - phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them released into the seas from plastic waste - can disrupt endocrine signaling, reduce male fertility, damage the nervous system, and increase risk of cancer. HABs produce potent toxins that accumulate in fish and shellfish. When ingested, these toxins can cause severe neurological impairment and rapid death. HAB toxins can also become airborne and cause respiratory disease. Pathogenic marine bacteria cause gastrointestinal diseases and deep wound infections. With climate change and increasing pollution, risk is high that Vibrio infections, including cholera, will increase in frequency and extend to new areas. All of the health impacts of ocean pollution fall disproportionately on vulnerable populations in the Global South - environmental injustice on a planetary scale.

Conclusions

Ocean pollution is a global problem. It arises from multiple sources and crosses national boundaries. It is the consequence of reckless, shortsighted, and unsustainable exploitation of the earth's resources. It endangers marine ecosystems. It impedes the production of atmospheric oxygen. Its threats to human health are great and growing, but still incompletely understood. Its economic costs are only beginning to be counted.Ocean pollution can be prevented. Like all forms of pollution, ocean pollution can be controlled by deploying data-driven strategies based on law, policy, technology, and enforcement that target priority pollution sources. Many countries have used these tools to control air and water pollution and are now applying them to ocean pollution. Successes achieved to date demonstrate that broader control is feasible. Heavily polluted harbors have been cleaned, estuaries rejuvenated, and coral reefs restored.Prevention of ocean pollution creates many benefits. It boosts economies, increases tourism, helps restore fisheries, and improves human health and well-being. It advances the Sustainable Development Goals (SDG). These benefits will last for centuries.

Recommendations

World leaders who recognize the gravity of ocean pollution, acknowledge its growing dangers, engage civil society and the global public, and take bold, evidence-based action to stop pollution at source will be critical to preventing ocean pollution and safeguarding human health.Prevention of pollution from land-based sources is key. Eliminating coal combustion and banning all uses of mercury will reduce mercury pollution. Bans on single-use plastic and better management of plastic waste reduce plastic pollution. Bans on persistent organic pollutants (POPs) have reduced pollution by PCBs and DDT. Control of industrial discharges, treatment of sewage, and reduced applications of fertilizers have mitigated coastal pollution and are reducing frequency of HABs. National, regional and international marine pollution control programs that are adequately funded and backed by strong enforcement have been shown to be effective. Robust monitoring is essential to track progress.Further interventions that hold great promise include wide-scale transition to renewable fuels; transition to a circular economy that creates little waste and focuses on equity rather than on endless growth; embracing the principles of green chemistry; and building scientific capacity in all countries.Designation of Marine Protected Areas (MPAs) will safeguard critical ecosystems, protect vulnerable fish stocks, and enhance human health and well-being. Creation of MPAs is an important manifestation of national and international commitment to protecting the health of the seas.

Exposure to suboptimal ambient temperature during specific gestational periods and adverse outcomes in mice

Exposure to suboptimal ambient temperature during pregnancy has been reported as a potential teratogen of fetal development. However, limited animal evidence is available regarding the impact of extreme temperatures on maternal pregnancy and the subsequent adverse pregnancy outcomes. Our objective in this study is to investigate the relationship between temperature and maternal stress during pregnancy in mice. This study used the Naval Medical Research Institute (NMRI) mice during the second and third pregnant weeks with the gestational day (GD) (GD 6.5-14.5 and GD 14.5-17.5). Mice were exposed to suboptimal ambient temperature (1 °C, 5 °C, 10 °C, 15 °C, 40 °C, 42 °C, 44 °C, 46 °C, and 48 °C for the experimental group and 23 °C for the control group) 1 h per day, 7 days a weekin each trimester. Measurements of placental development (placental weight [PW] and placental diameter [PD]) and fetal growth (fetal weight [FW] and crown-to-rump length [CRL]) between experimental and control groups were compared using analysis of variance (ANOVA). Data on the occurrence of preterm birth (PTB) and abnormalities were also collected. The results showed that exposure to both cold and heat stress in the second and third weeks of pregnancy caused significant decreases in measurements of placental development (PW and PD) and fetal growth (FW and CRL). For all temperature exposures, 15 °C was identified as the optimal temperature in the development of the embryo. Most PTB occurrences were observed in high-temperature stress groups, with the highest PTB number seen in the exposure group at 48 °C, whereas PTB occurred only at 1 °C among cold stress groups. In the selected exposure experiments, an approximate U-shaped relation was observed between temperature and number of abnormality occurrence. The highest percentage of these anomalies occurred at temperatures of 1 °C and 48 °C, while no abnormalities were observed at 15 °C and in the control group. Our findings strengthened the evidence that exposure to suboptimal ambient temperatures may trigger adverse pregnancy outcomes and worsen embryo and fetal development in mice.

Atmospheric pollutants and their association with olive and grass aeroallergen concentrations in Córdoba (Spain)

Cumulative data indicate that pollen grains and air pollution reciprocally interact. Climate changes seem also to influence pollen allergenicity. Depending on the plant species and on the pollutant type and concentration, this interaction may modify the features and metabolism of the pollen grain. Previous results revealed a significant positive correlation between pollen and aeroallergen, even using two different samplers. However, some discrepancy days have been also detected with low pollen but high aeroallergen concentrations. The main aim of the present paper is to find how the environmental factors, and specially pollutants, could affect the amount of allergens from olive and grass airborne pollen. Pollen grains were collected by a Hirst-type volumetric spore trap. Aeroallergen was simultaneously sampled by a low-volume Cyclone Burkard sampler. Phl p 5 and Ole e 1 aeroallergen were quantified by double-sandwich ELISA test. The data related to air pollutants, pollen grains, and aeroallergens were analyzed with descriptive statistic. Spearman's correlation test was used to identify potential correlations between these variables. There is a significant positive correlation between aeroallergens and airborne pollen concentrations, in both studied pollen types, so allergen concentrations could be explained with the pollen concentration. The days with unlinked events coincide between olive and grass allergens. Nevertheless, concerning to our results, pollutants do not affect the amount of allergens per pollen. Even if diverse pollutants show an unclear relationship with the allergen concentration, this association seems to be a casual effect of the leading role of some meteorological parameters.

Thermoregulatory and Behavioral Responses of Buffaloes With and Without Direct Sun Exposure During Abnormal Environmental Condition in Marajó Island, Pará, Brazil

This study aimed to assess the effect of thermal-hydraulic variables in female buffaloes with or without direct solar exposure in a year of strong El Niño through behavior responses and infrared thermography to reinforce the environmental comfort indicators, in Marajó Island, Pará, Brazil. The experiment was carried out in Cachoeira do Arari municipality and 20 female Murrah buffaloes were randomly assigned to two groups: Group WS (n = 10) was kept in pickets with native trees. Group NS (n = 10) was kept in crush squeeze with no shade. Data on air temperature (AT, °C), relative air humidity (RH, %), wind velocity (WV, m/s), rectal temperature (RT), respiratory rate (RR), and body surface temperature (BST) were collected. Practical Buffalo Comfort Climatic Condition Index (BCCCI), practical Buffalo Environmental Comfort Index (BECI), Temperature and Humidity Index (THI) and Benezra's Thermal Comfort Index (BTCI) were obtained. Infrared thermography analysis was carried out with a FLIR T-series T640bx camera. Data on time spent grazing, ruminating, idleness, and in other activities were recorded. A significant difference in AT of ~1°C was found between the groups at 6 a.m., 10 a.m. and 6 p.m. THI indicated emergency conditions. Female buffaloes were at danger PBCCCI conditions at 2 p.m. There was also significant difference for RT between treatments at 10 a.m., 2 p.m. and 6 p.m., whose values were higher (P < 0.05) for animals from NS Group, with the highest mean time at 2 p.m. Pearson correlation was significant and positive (P < 0.01) between RT mean and VUL, TI and ORB mean, maximum and minimum temperatures. The total time given to grazing was 518.2 min for the group NS and 629.5 min for the group WS. Rumination was more pronounced in the afternoon shift for the group NS. Buffaloes kept in a system with trees graze, ruminate and perform other activities with more intensity than animals raised in systems without access to shade, and tend to hyperthermia, mainly at 10 a.m. and 2 p.m., in Marajó Island, Pará, Brazil.

Effect of Extreme Weather Events on Mental Health: A Narrative Synthesis and Meta-Analysis for the UK

Extreme weather events are increasing in frequency and severity as a consequence of climate change and pose a significant threat to population mental health. This is the case even in temperate regions such as the United Kingdom (UK) where flooding and heat waves are forecast to become more common. We conducted a systematic review to quantify the prevalence and describe the causes of common mental health problems in populations exposed to extreme weather events in the UK. We searched Web of Science, EMBASE and PsycINFO for studies that measured the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) in populations exposed to extreme weather events in the UK, published up to 12 December 2019. We included 17 studies, four of which were included in meta-analyses to determine the point prevalence of common mental health problems in the period within 12 months following extreme weather events. The point prevalence was 19.8% for anxiety (k = 4; n = 1458; 95% CI 7.42 to 32.15), 21.35% for depression (k = 4; n = 1458; 95% CI 9.04 to 33.65) and 30.36% for PTSD (k = 4; n = 1359; 95% CI 11.68 to 49.05). Key factors that affected mental ill health in people exposed to flooding were water depth and absence of flood warnings. Displacement from home underscored the narratives associated with people's perceptions of the impact of flooding. The high prevalence of common mental health problems suggests that the prevention of mental ill health in populations at risk or exposed to extreme weather events should be a UK public health priority.

Exploring Vector-Borne Disease Surveillance and Response Systems in Beijing, China: A Qualitative Study from the Health System Perspective

Background: Climate change may contribute to higher incidence and wider geographic spread of vector borne diseases (VBDs). Effective monitoring and surveillance of VBDs is of paramount importance for the prevention of and timely response to outbreaks. Although international regulations exist to support this, barriers and operational challenges within countries hamper efficient monitoring. As a first step to optimise VBD surveillance and monitoring, it is important to gain a deeper understanding of system characteristics and experiences in to date non-endemic regions at risk of becoming endemic in the future. Therefore, this study qualitatively analyses the nature and flexibility of VBD surveillance and response in Beijing. Methods: In this qualitative study, eleven experts working in Beijing’s vector-borne diseases surveillance and response system were interviewed about vector-borne disease surveillance, early warning, response, and strengths and weaknesses of the current approach. Results: Vector-borne disease surveillance occurs using passive syndromic surveillance and separate vector surveillance. Public health authorities use internet reporting networks to determine vector-borne disease risk across Beijing. Response toward a vector-borne disease outbreak is uncommon in this setting due to the currently low occurrence of outbreaks. Conclusions: A robust network of centralised institutions provides the continuity and flexibility needed to adapt and manage possible vector-borne disease threats. Opportunities exist for population-based health promotion and the integration of environment and climate monitoring in vector-borne disease surveillance.

Do extreme summers increase blood vitamin D (25-hydroxyvitamin D) levels?

Climate change is expected to increase the frequency of extreme weather events, such as extended heat waves and droughts in the northern hemisphere. Besides affecting ecosystems worldwide, these changes in climate patterns will also affect the environmental health of human populations. While the medical community is mostly concerned with the negative impact of climate change, there might also be some beneficial effects. In this study we used laboratory data from a large university clinic in Germany (n = 13 406), to test for any detectable impact of two extreme summers on Vitamin-D [25(OH)D] plasma concentrations over a six year period (2014-2019). For the two years with extreme summers (2018 and 2019) the 25(OH)D plasma concentrations were significantly higher than in the previous four years (p < 0.001). A time series analysis (autoregressive term, AR, φ = 0.84, with an AR of one indicating a persistent effect) showed that 25(OH)D concentrations rise by 0.04 nmol/l (95% CI: 0.04-0.05 nmol/l) per hour of sunshine. The incidence of vitamin D deficiency was generally high (60% for 2014-2017) but dropped by 10% in 2018 and 2019. As such, the summers of 2018 and 2019, which are among the hottest and driest in Germany since the start of modern climate recordings, had a measurable positive effect on 25(OH)D plasma levels of the examined population. Given that 25(OH)D deficiency is widespread in higher latitudes, this implies that while mostly considered negative, climate change might also confer some health benefits with regard to vitamin D related medical conditions.

The Effect of Retail Electricity Price Levels on the FI Values of Smart-Grid Rooftop Solar Power Systems: A Case Study in the Central Highlands of Vietnam

Smart-grid rooftop solar electricity (SG rooftop PV) is an alternative sustainable energy resource. This research was conducted in the Central Highlands of Vietnam (CHV) in light of the different levels of retail electricity pricing, the sunshine duration, and the implementation of a feed-in-tariff system, in order to calculate the financial indicators (FIs) of SG rooftop PV, which would supply investors, companies supplying SG rooftop PV, and policymakers with useful information. The FI values were calculated based on the net present value, the payback period, and the internal return rate. The results show that the electricity retail price level affects the FI of SG rooftop PV. SG rooftop PV is installed to satisfy higher electricity consumption levels, which attracts a higher retail electricity price. As a result of the greater benefits, especially if SG rooftop PV is installed and the highest level of electricity (exceeds 400 kWh) is used to satisfy domestic consumption, users will recoup their investment in only four years and after that will enjoy free electricity. All the FI values derived from this research show that people in the CHV can derive benefits from installing SG rooftop PV.

Climate Variability and Child Nutrition: Findings from Sub-Saharan Africa

Climatic variability affects many underlying determinants of child malnutrition, including food availability, access, and utilization. Evidence of the effects of changing temperatures and precipitation on children's nutritional status nonetheless remains limited. Research addressing this knowledge gap is merited given the short- and long-run consequences of malnutrition. We address this issue by estimating the effects of temperature and precipitation anomalies on the weight and wasting status of children ages 0-59 months across 16 countries in sub-Saharan Africa. Linear regression models show that high temperatures and low precipitation are associated with reductions in child weight, and that high temperatures also lead to increased risk of wasting. We find little evidence of substantively meaningful differences in these effects across sub-populations of interest. Our results underscore the vulnerability of young children to climatic variability and its second-order economic and epidemiological effects. The study also highlights the corresponding need to design and assess interventions to effectively mitigate these impacts.

Biogeochemical transformation of greenhouse gas emissions from terrestrial to atmospheric environment and potential feedback to climate forcing

Carbon dioxide (CO₂) is mainly universal greenhouse gas associated with climate change. However, beyond CO₂, some other greenhouse gases (GHGs) like methane (CH₄) and nitrous oxide (N₂O), being two notable gases, contribute to global warming. Since 1900, the concentrations of CO₂ and non-CO₂ GHG emissions have been elevating, and due to the effects of the previous industrial revolution which is responsible for climate forcing. Globally, emissions of CO₂, CH₄, and N₂O from agricultural sectors are increasing as around 1% annually. Moreover, deforestation also contributes 12-17% of total global GHGs. Perhaps, the average temperature is likely to increase globally, at least 2 °C by 2100-by mid-century. These circumstances are responsible for climate forcing, which is the source of various human health diseases and environmental risks. From agricultural soils, rhizospheric microbial communities have a significant role in the emissions of greenhouse gases. Every year, microbial communities release approximately 1.5-3 billion tons of carbon into the atmospheric environment. Microbial nitrification, denitrification, and respiration are the essential processes that affect the nitrogen cycle in the terrestrial environment. In the twenty-first century, climate change is the major threat faced by human beings. Climate change adversely influences human health to cause numerous diseases due to their direct association with climate change. This review highlights the different anthropogenic GHG emission sources, the response of microbial communities to climate change, climate forcing potential, and mitigation strategies through different agricultural management approaches and microbial communities.

Change in China's SRB: A Dynamic Spatial Panel Approach

There has been some research on factors affecting China's rising sex ratio at birth (SRB), but the spatial dependence has been largely neglected. With China's census and sample survey data and the dynamic spatial Durbin model; we analyzed the changes in SRB in China. We found that SRB and its influencing factors were spatially correlated at the provincial level. For direct effects; urbanization significantly reduced SRB in this region; while strict family planning policies increased SRB in the local region. For indirect effects; the increase in per capita Gross Domestic Product and urbanization led to an increase in the SRB of the neighboring regions through population mobility. By comparison; educational improvement in one region benefited the neighboring provinces and reduced SRB.

Long-Term Monitoring of Noxious Bacteria for Construction of Assurance Management System of Water Resources in Natural Status of the Republic of Korea

Climate change is expected to affect not only availability and quality of water, the valuable resource of human life on Earth, but also ultimately public health issue. A six-year monitoring (total 20 times) of Escherichia coli O157, Salmonella enterica, Legionella pneumophila, Shigella sonnei, Campylobacter jejuni, and Vibrio cholerae was conducted at five raw water sampling sites including two lakes, Hyundo region (Geum River) and two locations near Water Intake Plants of Han River (Guui region) and Nakdong River (Moolgeum region). A total 100 samples of 40 L water were tested. Most of the targeted bacteria were found in 77% of the samples and at least one of the target bacteria was detected (65%). Among all the detected bacteria, E. coli O157 were the most prevalent with a detection frequency of 22%, while S. sonnei was the least prevalent with a detection frequency of 2%. Nearly all the bacteria (except for S. sonnei) were present in samples from Lake Soyang, Lake Juam, and the Moolgeum region in Nakdong River, while C. jejuni was detected in those from the Guui region in Han River. During the six-year sampling period, individual targeted noxious bacteria in water samples exhibited seasonal patterns in their occurrence that were different from the indicator bacteria levels in the water samples. The fact that they were detected in the five Korea's representative water environments make it necessary to establish the chemical and biological analysis for noxious bacteria and sophisticated management systems in response to climate change.

Time series analysis of cumulative incidences of typhoid and paratyphoid fevers in China using both Grey and SARIMA models

Typhoid and paratyphoid fevers are common enteric diseases causing disability and death in China. Incidence data of typhoid and paratyphoid between 2004 and 2016 in China were analyzed descriptively to explore the epidemiological features such as age-specific and geographical distribution. Cumulative incidence of both fevers displayed significant decrease nationally, displaying a drop of 73.9% for typhoid and 86.6% for paratyphoid in 2016 compared to 2004. Cumulative incidence fell in all age subgroups and the 0–4 years-old children were the most susceptible ones in recent years. A cluster of three southwestern provinces (Yunnan, Guizhou, and Guangxi) were the top high-incidence regions. Grey model GM (1,1) and seasonal autoregressive integrated moving average (SARIMA) model were employed to extract the long-term trends of the diseases. Annual cumulative incidence for typhoid and paratyphoid were formulated by GM (1,1) as x^(t)=−14.98(e−0.10(t−2004)−e−0.10(t−2005)) and x^(t)=−4.96(e−0.19(t−2004)−e−0.19(t−2005)) respectively. SARIMA (0,1,7) × (1,0,1)₁₂ was selected among a collection of constructed models for high R² and low errors. The predictive models for both fevers forecasted cumulative incidence to continue the slightly downward trend and maintain the cyclical seasonality in near future years. Such data-driven insights are informative and actionable for the prevention and control of typhoid and paratyphoid fevers as serious infectious diseases.

Simulating the Impact of Future Climate Change and Ecological Restoration on Trade-Offs and Synergies of Ecosystem Services in Two Ecological Shelters and Three Belts in China

Development of suitable ecological protection and restoration policies for sustainable management needs to assess the potential impacts of future land use and climate change on ecosystem services. The two ecological shelters and three belts (TSTB) are significant for improving ecosystem services and ensuring China’s and global ecological security. In this study, we simulated land use in 2050 and estimated the spatial distribution pattern of net primary productivity (NPP), water yield, and soil conservation from 2010 to 2050 under future climate change. The results showed that water yield, NPP, and soil conservation exhibited a spatial pattern of decreasing from southeast to northwest, while in terms of the temporal pattern, water yield and NPP increased, but soil conservation decreased. Water yield was mainly influenced by precipitation, NPP was affected by temperature and implementation of ecological restoration, and soil conservation was controlled by precipitation and slope. There was a strong spatial heterogeneity between trade-offs and synergies. In terms of the temporal, with the combination of climate change and ecological restoration, there was a synergistic relationship between water yield and NPP. However, the relationships between water yield and soil conservation, and between NPP and soil conservation were characterized by trade-offs. In the process of ecological construction, it is necessary to consider the differences between overall and local trade-offs and synergies, as well as formulate sustainable ecological management policies according to local conditions. Understanding the response of ecosystem services to future climate change and land use policies can help address the challenges posed by climate change and achieve sustainable management of natural resources.

Monitoring Culicine Mosquitoes (Diptera: Culicidae) as a Vector of Flavivirus in Incheon Metropolitan City and Hwaseong-Si, Gyeonggi-Do, Korea, during 2019

The flaviviruses are small single-stranded RNA viruses that are typically transmitted by mosquitoes or tick vectors and are etiological agents of acute zoonotic infections. The viruses are found around the world and account for significant cases of human diseases. We investigated population of culicine mosquitoes in central region of Korean Peninsula, Incheon Metropolitan City and Hwaseong-si. Aedes vexans nipponii was the most frequently collected mosquitoes (56.5%), followed by Ochlerotatus dorsalis (23.6%), Anopheles spp. (10.9%), and Culex pipiens complex (5.9%). In rural regions of Hwaseong, Aedes vexans nipponii was the highest population (62.9%), followed by Ochlerotatus dorsalis (23.9%) and Anopheles spp. (12.0%). In another rural region of Incheon (habitat of migratory birds), Culex pipiens complex was the highest population (31.4%), followed by Ochlerotatus dorsalis (30.5%), and Aedes vexans vexans (27.5%). Culex pipiens complex was the predominant species in the urban region (84.7%). Culicine mosquitoes were identified at the species level, pooled up to 30 mosquitoes each, and tested for flaviviral RNA using the SYBR Green-based RT-PCR and confirmed by cDNA sequencing. Three of the assayed 2,683 pools (989 pools without Anopheles spp.) were positive for Culex flaviviruses, an insect-specific virus, from Culex pipiens pallens collected at the habitats for migratory birds in Incheon. The maximum likelihood estimation (the estimated number) for Culex pipiens pallens positive for Culex flavivirus was 25. Although viruses responsible for mosquito-borne diseases were not identified, we encourage intensified monitoring and long-term surveillance of both vector and viruses in the interest of global public health.

Knowledge Graph Analysis of Human Health Research Related to Climate Change

In order to explore the development status, knowledge base, research hotspots, and future research directions related to the impacts of climate change on human health, a systematic bibliometric analysis of 6719 published articles from 2003 to 2018 in the Web of Science was performed. Using data analytics tools such as HistCite and CiteSpace, the time distribution, spatial distribution, citations, and research hotspots were analyzed and visualized. The analysis revealed the development status of the research on the impacts of climate change on human health and analyzed the research hotspots and future development trends in this field, providing important knowledge support for researchers in this field.

Environmental changes and their impact on human behaviour - Case study of the incidence of skin cancer

Climatological research over the past two decades makes it clear that the Earth's climate will change. Climate change has many, mostly adverse, effects on the human health. Environmental anthropogenic changes represent significant health risks including factors that may increase probability and seriousness of skin cancer diseases. There are many scientific studies on skin cancer but only a few of them are focused on environment changes and their influence on the behaviour of humans, which may lead to skin cancer. The goal of the research was to analyse environment changes in the city of Brno (Czech Republic) and their influence on the behaviour of people and some skin diseases. A research hypothesis was set up that total increase in the incidence of skin diseases would be monitored. 1757 patients aged 25-65 years participated in the research. The analysis was performed based on measured (mean annual temperatures, average monthly temperatures, ultraviolet index values, and numbers of sunny days and sunny hours) data in 2011-2019. In order to monitor the trend, temperature data from 1961 to 2019 were evaluated too. The analysed data indicate that the trend of average monthly and annual temperatures observed was increasing in recent years. Moreover, based on data obtained from the analysed doctor's office it was found out that the incidence of skin diseases increased in the studied period. The main reasons to increase include excessive exposure to sun, extended average age of the population, ozone layer depletion, climatic and weather changes, increased migration and behaviour of people.

Examining Land Use/Land Cover Change and the Summertime Surface Urban Heat Island Effect in Fast-Growing Greater Hefei, China: Implications for Sustainable Land Development

In this study, a retrospective analysis of the relationship between the land use/land cover (LULC) change and associated surface urban heat island (SUHI) effect in fast-growing Greater Hefei between 1995 and 2016 was performed. Our results reveal the heterogeneous patterns of LULC change. The concentric buffer-based urban–rural gradient analysis reveals that most of the newly emerging developed land occurred within downtown Hefei. In contrast, in three suburban municipality/county jurisdictions, the overall area change in the non-developed land was much lower, but the net increase in developed land is remarkable. Meanwhile, the spatiotemporal patterns of SUHI are in good agreement with that of the developed land, as evidenced by the notable increase in SUHI intensity (SUHII) levels and SUHI spatial extent (SUHISE) in response to the rapid urban expansion, particularly along transportation corridors. In addition, partial least square regression (PLSR) models indicate that the buffer-based predictors/independent variables are significantly related to the responses (SUHII and SUHISE), explaining approximately 61.3% of the variance in the SUHII and 79.8% of the variance in the SUHISE, respectively. Furthermore, the relative strength of the independent variables in determining the relationship was quantitatively examined. The findings of this study provide clear evidence for decision making for sustainable land development and mitigation of the SUHI effect.

A database of chlorophyll and water chemistry in freshwater lakes

Measures of chlorophyll represent the algal biomass in freshwater lakes that is often used by managers as a proxy for water quality and lake productivity. However, chlorophyll concentrations in lakes are dependent on many interacting factors, including nutrient inputs, mixing regime, lake depth, climate, and anthropogenic activities within the watershed. Therefore, integrating a broad scale dataset of lake physical, chemical, and biological characteristics can help elucidate the response of freshwater ecosystems to global change. We synthesized a database of measured chlorophyll a (chla) values, associated water chemistry variables, and lake morphometric characteristics for 11,959 freshwater lakes distributed across 72 countries. Data were collected based on a systematic review examining 3322 published manuscripts that measured lake chla, and we supplemented these data with online repositories such as The Knowledge Network for Biocomplexity, Dryad, and Pangaea. This publicly available database can be used to improve our understanding of how chlorophyll levels respond to global environmental change and provide baseline comparisons for environmental managers responsible for maintaining water quality in lakes.

Investigating Seasonal Effects of Dominant Driving Factors on Urban Land Surface Temperature in a Snow-Climate City in China

Land surface temperature (LST) is a crucial parameter in surface urban heat island (SUHI) studies. A better understanding of the driving mechanisms, influencing variations in LST dynamics, is required for the sustainable development of a city. This study used Changchun, a city in northeast China, as an example, to investigate the seasonal effects of different dominant driving factors on the spatial patterns of LST. Twelve Landsat 8 images were used to retrieve monthly LST, to characterize the urban thermal environment, and spectral mixture analysis was employed to estimate the effect of the driving factors, and correlation and linear regression analyses were used to explore their relationships. Results indicate that, (1) the spatial pattern of LST has dramatic monthly and seasonal changes. August has the highest mean LST of 38.11 °C, whereas December has the lowest (−19.12 °C). The ranking of SUHI intensity is as follows: summer (4.89 °C) > winter with snow cover (1.94 °C) > spring (1.16 °C) > autumn (0.89 °C) > winter without snow cover (−1.24 °C). (2) The effects of driving factors also have seasonal variations. The proportion of impervious surface area (ISA) in summer (49.01%) is slightly lower than those in spring (56.64%) and autumn (50.85%). Almost half of the area is covered with snow (43.48%) in winter. (3) The dominant factors are quite different for different seasons. LST possesses a positive relationship with ISA for all seasons and has the highest Pearson coefficient for summer (r = 0.89). For winter, the effect of vegetation on LST is not obvious, and snow becomes the dominant driving factor. Despite its small area proportion, water has the strongest cooling effect from spring to autumn, and has a warming effect in winter. (4) Human activities, such as agricultural burning, harvest, and different choices of crop species, could also affect the spatial patterns of LST.

Uncertainty Analysis of Monthly Precipitation in GCMs Using Multiple Bias Correction Methods under Different RCPs

This study quantified the uncertainties in historical and future average monthly precipitation based on different bias correction methods, General Circulation Models (GCMs), Representative Concentration Pathways (RCPs), projection periods, and locations within the study area (i.e., the coastal and inland areas of South Korea). The GCMs were downscaled using deep learning, random forest, and nine quantile mapping bias correction methods for 22 gauge stations in South Korea. Data from the Korean Meteorology Administration (1970–2005) were used as the reference data in this study. Two statistical measures, the standard deviation and interquartile range, were used to quantify the uncertainties. The probability distribution density was used to assess the similarity/variation in rainfall distributions. For the historical period, the uncertainty in the selection of bias correction methods was greater than that in the selection of GCMs, whereas the opposite pattern was observed for the projection period. The projection period had the lowest level of uncertainty in the selection of RCP scenarios, and for the future, the uncertainly related to the time period was slightly lower than that for the other sources but was much greater than that for the RCP selection. In addition, it was clear that the level of uncertainty of inland areas is much lower than that of coastal areas. The uncertainty in the selection of the GCMs was slightly greater than that in the selection of the bias correction method. Therefore, the uncertainty in the selection of coastal areas was intermediate between the selection of bias correction methods and GCMs. This paper contributes to an improved understanding of the uncertainties in climate change projections arising from various sources.