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Kazi DS, Katznelson E, Liu CL, Al-Roub NM, Chaudhary RS, Young DE, Mcnichol M, Mickley L, Kramer DB, Cascio WE, Bernstein AS, Rice MB. Climate Change and Cardiovascular Health: A Systematic Review. JAMA Cardiol 2024; 9:748-757. [PMID: 38865135 PMCID: PMC11366109 DOI: 10.1001/jamacardio.2024.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Importance Climate change may increase the risk of adverse cardiovascular outcomes by causing direct physiologic changes, psychological distress, and disruption of health-related infrastructure. Yet, the association between numerous climate change-related environmental stressors and the incidence of adverse cardiovascular events has not been systematically reviewed. Objective To review the current evidence on the association between climate change-related environmental stressors and adverse cardiovascular outcomes. Evidence Review PubMed, Embase, Web of Science, and Cochrane Library were searched to identify peer-reviewed publications from January 1, 1970, through November 15, 2023, that evaluated associations between environmental exposures and cardiovascular mortality, acute cardiovascular events, and related health care utilization. Studies that examined only nonwildfire-sourced particulate air pollution were excluded. Two investigators independently screened 20 798 articles and selected 2564 for full-text review. Study quality was assessed using the Navigation Guide framework. Findings were qualitatively synthesized as substantial differences in study design precluded quantitative meta-analysis. Findings Of 492 observational studies that met inclusion criteria, 182 examined extreme temperature, 210 ground-level ozone, 45 wildfire smoke, and 63 extreme weather events, such as hurricanes, dust storms, and droughts. These studies presented findings from 30 high-income countries, 17 middle-income countries, and 1 low-income country. The strength of evidence was rated as sufficient for extreme temperature; ground-level ozone; tropical storms, hurricanes, and cyclones; and dust storms. Evidence was limited for wildfire smoke and inadequate for drought and mudslides. Exposure to extreme temperature was associated with increased cardiovascular mortality and morbidity, but the magnitude varied with temperature and duration of exposure. Ground-level ozone amplified the risk associated with higher temperatures and vice versa. Extreme weather events, such as hurricanes, were associated with increased cardiovascular risk that persisted for many months after the initial event. Some studies noted a small increase in cardiovascular mortality, out-of-hospital cardiac arrests, and hospitalizations for ischemic heart disease after exposure to wildfire smoke, while others found no association. Older adults, racial and ethnic minoritized populations, and lower-wealth communities were disproportionately affected. Conclusions and Relevance Several environmental stressors that are predicted to increase in frequency and intensity with climate change are associated with increased cardiovascular risk, but data on outcomes in low-income countries are lacking. Urgent action is needed to mitigate climate change-associated cardiovascular risk, particularly in vulnerable populations.
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Affiliation(s)
- Dhruv S. Kazi
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Harvard Global Health Institute, Cambridge, Massachusetts
| | - Ethan Katznelson
- Department of Cardiology, Weill Cornell Medical Center, New York, NY, United States
| | - Chia-Liang Liu
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Nora M. Al-Roub
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Richard S. Chaudhary
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Diane E. Young
- Knowledge Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Megan Mcnichol
- Knowledge Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Loretta Mickley
- School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts
| | - Daniel B. Kramer
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Wayne E. Cascio
- United States Environmental Protection Agency, Durham, North Carolina
| | - Aaron S. Bernstein
- Harvard Medical School, Boston, Massachusetts
- Harvard Global Health Institute, Cambridge, Massachusetts
- Center for Climate, Health, and Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of General Pediatrics, Boston Children’s Hospital
| | - Mary B. Rice
- Harvard Medical School, Boston, Massachusetts
- Pulmonary, Critical Care & Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Boretti A. Revisiting Masselot et al. (2023): assessing the share of excess mortality linked to cold and hot weather in Europe. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:527-533. [PMID: 38085338 DOI: 10.1007/s00484-023-02598-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/18/2023] [Accepted: 12/07/2023] [Indexed: 02/15/2024]
Abstract
While a considerable focus has been placed on excess fatalities during hot weather, a reanalysis of European data reveals that excess mortality attributed to cold weather is significantly more pronounced, surpassing that linked to hot weather by an order of magnitude. These ratios are noteworthy: 56.32 for the United Kingdom, 43.56 for Northern Europe, 8.49 for Western Europe, 12.41 for Eastern Europe, 5.50 for Southern Europe, and an overall ratio of 10.09 for Europe as a whole. These ratios of cold to hot excess deaths indicate a significant disparity in the number of excess deaths caused by cold weather compared to those caused by hot weather. This significant difference underscores the greater health risks and vulnerabilities associated with cold weather.
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Affiliation(s)
- Alberto Boretti
- Melbourne Institute of Technology, 288 Latrobe Street, Melbourne, VIC, 3000, Australia.
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Xia Y, Shi C, Li Y, Ruan S, Jiang X, Huang W, Chen Y, Gao X, Xue R, Li M, Sun H, Peng X, Xiang R, Chen J, Zhang L. Association between temperature and mortality: a multi-city time series study in Sichuan Basin, southwest China. Environ Health Prev Med 2024; 29:1. [PMID: 38220147 PMCID: PMC10788187 DOI: 10.1265/ehpm.23-00118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/30/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden. METHODS Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status. RESULTS A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status. CONCLUSIONS Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.
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Affiliation(s)
- Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
- Zigong Center for Disease Control and Prevention, No. 826, Huichuan Road, Ziliujing District, Zigong 643000, China
- School of Public Health, Chengdu Medical College, No. 783, Xindu Road, Xindu District, Chengdu 610500, China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No. 826, Huichuan Road, Ziliujing District, Zigong 643000, China
| | - Yu Chen
- School of Public Health, Chengdu Medical College, No. 783, Xindu Road, Xindu District, Chengdu 610500, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No. 6, Longxiang Road, Wuhou District, Chengdu 610041, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No. 996, Binhebei Road, Lizhou District, Guangyuan 628017, China
| | - Mingjiang Li
- Panzhi hua Center for Disease Control and Prevention, No. 996, Jichang Road, Dong District, Panzhi hua 617067, China
| | - Hongying Sun
- Mianyang Center for Disease Control and Prevention, No. 50, Mianxingdong Road, Gaoxin District, Mianyang 621000, China
| | - Xiaojuan Peng
- Yaan Center for Disease Control and Prevention, No. 9, Fangcao Road, Yucheng District, Yaan 625000, China
| | - Renqiang Xiang
- Fucheng Center for Disease Control and Prevention, No. 116, Changhong Road, Fucheng District, Mianyang 621000, China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
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Moraes SLD, Almendra R, Barrozo LV. Space-time clusters of cardiovascular mortality and the role of heatwaves and cold spells in the city of São Paulo, Brazil. Spat Spatiotemporal Epidemiol 2023; 47:100620. [PMID: 38042539 DOI: 10.1016/j.sste.2023.100620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/07/2023] [Accepted: 09/17/2023] [Indexed: 12/04/2023]
Abstract
The effects extreme air temperature events are related with an increase in cardiovascular mortality among vulnerable groups worldwide. Therefore, we identify spatiotemporal mortality clusters associated with diseases of the cardiovascular system among people ≥ 65 years in São Paulo, from 2006 to 2015, and investigate whether high-risk mortality clusters occurred during or following extreme air temperature events. To detect the clusters, we used daily mortality data and a retrospective space-time scan analysis with a discrete Poisson model. Extreme air temperature events were defined by daily mean temperatures, below the 10th percentile for cold spells and above the 90th percentile for heatwaves, with two or more consecutive days. We found statistically significant high-risk mortality clusters located in the peripheral areas. The spatiotemporal clusters of risk areas for cardiovascular and ischemic heart disease occurred during or following cold spell events, whereas those for stroke and ischemic stroke events were related to heatwaves.
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Affiliation(s)
- Sara Lopes de Moraes
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo, Brazil; Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.
| | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo, Brazil; Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
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Ohashi Y, Ihara T, Oka K, Takane Y, Kikegawa Y. Machine learning analysis and risk prediction of weather-sensitive mortality related to cardiovascular disease during summer in Tokyo, Japan. Sci Rep 2023; 13:17020. [PMID: 37813975 PMCID: PMC10562479 DOI: 10.1038/s41598-023-44181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/04/2023] [Indexed: 10/11/2023] Open
Abstract
Climate-sensitive diseases developing from heat or cold stress threaten human health. Therefore, the future health risk induced by climate change and the aging of society need to be assessed. We developed a prediction model for mortality due to cardiovascular diseases such as myocardial infarction and cerebral infarction, which are weather or climate sensitive, using machine learning (ML) techniques. We evaluated the daily mortality of ischaemic heart disease (IHD) and cerebrovascular disease (CEV) in Tokyo and Osaka City, Japan, during summer. The significance of delayed effects of daily maximum temperature and other weather elements on mortality was previously demonstrated using a distributed lag nonlinear model. We conducted ML by a LightGBM algorithm that included specified lag days, with several temperature- and air pressure-related elements, to assess the respective mortality risks for IHD and CEV, based on training and test data for summer 2010-2019. These models were used to evaluate the effect of climate change on the risk for IHD mortality in Tokyo by applying transfer learning (TL). ML with TL predicted that the daily IHD mortality risk in Tokyo would averagely increase by 29% and 35% at the 95th and 99th percentiles, respectively, using a high-level warming-climate scenario in 2045-2055, compared to the risk simulated using ML in 2009-2019.
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Affiliation(s)
- Yukitaka Ohashi
- Faculty of Biosphere-Geosphere Science, Okayama University of Science, Kita-Ku, Okayama City, Okayama, Japan.
| | - Tomohiko Ihara
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa City, Chiba, Japan
| | - Kazutaka Oka
- Center for Climate Change Adaptation, National Institute for Environmental Studies (NIES), Tsukuba City, Ibaraki, Japan
| | - Yuya Takane
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba City, Ibaraki, Japan
| | - Yukihiro Kikegawa
- School of Science and Engineering, Meisei University, Hino City, Tokyo, Japan
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Palmeiro-Silva YK, Lescano AG, Flores EC, Astorga E Y, Rojas L, Chavez MG, Mora-Rivera W, Hartinger SM. Identifying gaps on health impacts, exposures, and vulnerabilities to climate change on human health and wellbeing in South America: a scoping review. LANCET REGIONAL HEALTH. AMERICAS 2023; 26:100580. [PMID: 37876675 PMCID: PMC10593580 DOI: 10.1016/j.lana.2023.100580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/29/2023] [Accepted: 08/04/2023] [Indexed: 10/26/2023]
Abstract
There is an important gap in regional information on climate change and health, limiting the development of science-based climate policies in South American countries. This study aims to identify the main gaps in the existing scientific literature on the impacts, exposure, and vulnerabilities of climate change on population health. A scoping review was performed guided by four sub-questions focused on the impacts of climate change on physical and mental health, exposure and vulnerability factors of population to climate hazards. The main findings showed that physical impacts mainly included infectious diseases, while mental health impacts included trauma, depression, and anxiety. Evidence on population exposure to climate hazards is limited, and social determinants of health and individual factors were identified as vulnerability factors. Overall, evidence on the intersection between climate change and health is limited in South America and has been generated in silos, with limited transdisciplinary research. More formal and systematic information should be generated to inform public policy. Funding None.
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Affiliation(s)
- Yasna K. Palmeiro-Silva
- Institute for Global Health, University College London, London, United Kingdom
- Centro de Políticas Públicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andres G. Lescano
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Elaine C. Flores
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- The Stanford Center for Innovation in Global Health, Stanford University, Stanford, CA, USA
| | - Yamileth Astorga E
- Escuela de Tecnologías en Salud, Universidad de Costa Rica, San Pedro, San José, Costa Rica
| | - Luciana Rojas
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mario G. Chavez
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Wendel Mora-Rivera
- InterAmerican Center for Global Health (CISG), Puntarenas, Costa Rica
- Escuela de Enfermería, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Stella M. Hartinger
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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Silveira IH, Hartwig SV, Moura MN, Cortes TR, Junger WL, Cirino G, Ignotti E, de Oliveira BFA. Heat waves and mortality in the Brazilian Amazon: Effect modification by heat wave characteristics, population subgroup, and cause of death. Int J Hyg Environ Health 2023; 248:114109. [PMID: 36599199 DOI: 10.1016/j.ijheh.2022.114109] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND The Brazilian Amazon faces overlapping socio-environmental, sanitary, and climate challenges, and is a hotspot of concern due to projected increases in temperature and in the frequency of heat waves. Understanding the effects of extreme events on health is a central issue for developing climate policies focused on the population's health. OBJECTIVES We investigated the effects of heat waves on mortality in the Brazilian Amazon, examining effect modification according to various heat wave definitions, population subgroups, and causes of death. METHODS We included all 32 Amazonian municipalities with more than 100,000 inhabitants. The study period was from 2000 to 2018. We obtained mortality data from the Information Technology Department of the Brazilian Public Healthcare System, and meteorological data were derived from the ERA5-Land reanalysis dataset. Heat waves were defined according to their intensity (90th; 92.5th; 95th; 97.5th and 99th temperature percentiles) and duration (≥2, ≥3, and ≥4 days). In each city, we used a time-stratified case-crossover study to estimate the effects of each heat wave definition on mortality, according to population subgroup and cause of death. The lagged effects of heat waves were estimated using conditional Poisson regression combined with distributed lag non-linear models. Models were adjusted for specific humidity and public holidays. Risk ratios were pooled for the Brazilian Amazon using a univariate random-effects meta-analysis. RESULTS The pooled relative risks (RR) for mortality from total non-external causes varied between 1.03 (95% CI: 1.01-1.06), for the less stringent heat wave definition, and 1.18 (95% CI: 1.04-1.33) for the more stringent definition. The mortality risk rose as the heat wave intensity increased, although the increase from 2 to 3, and 3-4 days was small. Although not statistically different, our results suggest a higher mortality risk for the elderly, this was also higher for women than men, and for cardiovascular causes than for non-external or respiratory ones. CONCLUSIONS Heat waves were associated with a higher risk of mortality from non-external causes and cardiovascular diseases. Heat wave intensity played a more important role than duration in determining this risk. Suggestive evidence indicated that the elderly and women were more vulnerable to the effects of heat waves on mortality.
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Affiliation(s)
| | | | - Maurício Nascimento Moura
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; Geosciences Institute, Federal University of Pará, Belém, Brazil
| | | | | | - Glauber Cirino
- Geosciences Institute, Federal University of Pará, Belém, Brazil
| | - Eliane Ignotti
- Postgraduate Program in Environmental Sciences, Mato Grosso State University, Cáceres, Brazil
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8
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Xia Y, Shi C, Li Y, Jiang X, Ruan S, Gao X, Chen Y, Huang W, Li M, Xue R, Wen X, Peng X, Chen J, Zhang L. Effects of ambient temperature on mortality among elderly residents of Chengdu city in Southwest China, 2016-2020: a distributed-lag non-linear time series analysis. BMC Public Health 2023; 23:149. [PMID: 36681785 PMCID: PMC9863161 DOI: 10.1186/s12889-022-14931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With complex changes in the global climate, it is critical to understand how ambient temperature affects health, especially in China. We aimed to assess the effects of temperature on daily mortality, including total non-accidental, cardiovascular disease (CVD), respiratory disease, cerebrovascular disease, and ischemic heart disease (IHD) mortality between 2016 and 2020 in Chengdu, China. METHODS We obtained daily temperature and mortality data for the period 2016-2020. A Poisson regression model combined with a distributed-lag nonlinear model was used to examine the association between temperature and daily mortality. We investigated the effects of individual characteristics by sex, age, education level, and marital status. RESULTS We found significant non-linear effects of temperature on total non-accidental, CVD, respiratory, cerebrovascular, and IHD mortality. Heat effects were immediate and lasted for 0-3 days, whereas cold effects persisted for 7-10 days. The relative risks associated with extreme high temperatures (99th percentile of temperature, 28 °C) over lags of 0-3 days were 1.22 (95% confidence interval [CI]: 1.17, 1.28) for total non-accidental mortality, 1.40 (95% CI: 1.30, 1.50) for CVD morality, 1.34 (95% CI: 1.24, 1.46) for respiratory morality, 1.33 (95% CI: 1.20, 1.47) for cerebrovascular mortality, and 1.38 (95% CI: 1.20, 1.58) for IHD mortality. The relative risks associated with extreme cold temperature (1st percentile of temperature, 3.0 °C) over lags of 0-14 days were 1.32 (95% CI: 1.19, 1.46) for total mortality, 1.45 (95% CI: 1.24, 1.68) for CVD morality, 1.28 (95% CI: 1.09, 1.50) for respiratory morality, 1.36 (95% CI: 1.09, 1.70) for cerebrovascular mortality, and 1.26 (95% CI: 0.95, 1.68) for IHD morality. We found that hot and cold affects were greater in those over 85 years of age, and that women, individuals with low education levels, and those who were widowed, divorced, or never married, were more vulnerable. CONCLUSIONS This study showed that exposure to hot and cold temperatures in Chengdu was associated with increased mortality, with people over 85 years old, women, those with low education levels, and unmarried individuals being more affected by hot and cold temperatures.
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Affiliation(s)
- Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No.6, Longxiang Road, Wuhou District, Chengdu, 610041 China
| | - Yu Chen
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No.826, Huichuan Road, Ziliujing District, Zigong, 643000 China
| | - Mingjiang Li
- Panzhi Hua Center for Disease Control and Prevention, Dong District, No.996, Jichang Road617067, Panzhi Hua, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No.996, Binhebei RoadLizhou District, Guangyuan, 628017 China
| | - Xianying Wen
- Mianyang Center for Disease Control and Prevention, Gaoxin District, No.50, Mianxingdong Road, Mianyang, 621000 China
| | - Xiaojuan Peng
- Yaan Center for Disease Control and Prevention, No.9, Fangcao Road, Yucheng District, Yaan, 625000 China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
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Bakhtsiyarava M, Schinasi LH, Sánchez BN, Dronova I, Kephart JL, Ju Y, Gouveia N, Caiaffa WT, O'Neill MS, Yamada G, Arunachalam S, Diez-Roux AV, Rodríguez DA. Modification of temperature-related human mortality by area-level socioeconomic and demographic characteristics in Latin American cities. Soc Sci Med 2023; 317:115526. [PMID: 36476939 PMCID: PMC9870751 DOI: 10.1016/j.socscimed.2022.115526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND In Latin America, where climate change and rapid urbanization converge, non-optimal ambient temperatures contribute to excess mortality. However, little is known about area-level characteristics that confer vulnerability to temperature-related mortality. OBJECTIVES Explore city-level socioeconomic and demographic characteristics associated with temperature-related mortality in Latin American cities. METHODS The dependent variables quantify city-specific associations between temperature and mortality: heat- and cold-related excess death fractions (EDF, or percentages of total deaths attributed to cold/hot temperatures), and the relative mortality risk (RR) associated with 1 °C difference in temperature in 325 cities during 2002-2015. Random effects meta-regressions were used to investigate whether EDFs and RRs associated with heat and cold varied by city-level characteristics, including population size, population density, built-up area, age-standardized mortality rate, poverty, living conditions, educational attainment, income inequality, and residential segregation by education level. RESULTS We find limited effect modification of cold-related mortality by city-level demographic and socioeconomic characteristics and several unexpected associations for heat-related mortality. For example, cities in the highest compared to the lowest tertile of income inequality have all-age cold-related excess mortality that is, on average, 3.45 percentage points higher (95% CI: 0.33, 6.56). Higher poverty and higher segregation were also associated with higher cold EDF among those 65 and older. Large, densely populated cities, and cities with high levels of poverty and income inequality experience smaller heat EDFs compared to smaller and less densely populated cities, and cities with little poverty and income inequality. DISCUSSION Evidence of effect modification of cold-related mortality in Latin American cities was limited, and unexpected patterns of modification of heat-related mortality were observed. Socioeconomic deprivation may impact cold-related mortality, particularly among the elderly. The findings of higher levels of poverty and income inequality associated with lower heat-related mortality deserve further investigation given the increasing importance of urban adaptation to climate change.
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Affiliation(s)
- Maryia Bakhtsiyarava
- Institute of Transportation Studies, University of California, Berkeley, CA, USA.
| | - Leah H Schinasi
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA; Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Iryna Dronova
- Department of Environmental Science, Policy & Management, University of California, Berkeley, USA; Department of Landscape Architecture & Environmental Planning, University of California, Berkeley, USA
| | - Josiah L Kephart
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Yang Ju
- School of Architecture and Urban Planning, Nanjing University, Nanjing, China
| | - Nelson Gouveia
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Waleska Teixeira Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marie S O'Neill
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, USA
| | - Goro Yamada
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Sarav Arunachalam
- Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Ana V Diez-Roux
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Daniel A Rodríguez
- Institute of Transportation Studies, University of California, Berkeley, CA, USA; Department of City and Regional Planning and Institute Transportation Studies, University of California, Berkeley, USA
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10
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López-Bueno JA, Navas-Martín MA, Díaz J, Mirón IJ, Luna MY, Sánchez-Martínez G, Culqui D, Linares C. Population vulnerability to extreme cold days in rural and urban municipalities in ten provinces in Spain. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 852:158165. [PMID: 35988600 DOI: 10.1016/j.scitotenv.2022.158165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The objective was to analyze whether there are differences in vulnerability to Extreme Cold Days (ECD) between rural and urban populations in Spain. METHODOLOGY Time series analysis carried out from January 1, 2000, through December 31, 2013. Municipalities with over 10,000 inhabitants were included from 10 Spanish provinces, classified into 42 groups by isoclimate and urban/rural character as defined by Eurostat criteria. The statistical strategy was carried out in two phases. First: It was analyzed the relationship between minimum daily temperature (Tmin) (source: AEMET) and the rate of daily winter mortality due to natural causes -CIE-10: A00 - R99- (source: National Statistics Institute). Then, It was determinated the threshold of Tmin that defines the ECD and its percentile in the series of winter Tmin (Pthreshold), which is a measure of vulnerability to ECD so that the higher the percentile, the higher the vulnerability. Second: possible explanatory variables of vulnerability were explored using Mixed Generalized Models, using 13 independent variables related to meteorology, environment, socioeconomics, demographics and housing quality. RESULTS The average Pthreshold was 18 %. The final model indicated that for each percentage point increase in unemployment, the vulnerability to ECD increased by 0.4 (0.2, 0.6) points. Also, with each point increase in rurality index, this vulnerability decreased by -6.1 (-2.1, -10.0) points. Although less determinant, other factors that could contribute to explaining vulnerability at the province level included minimum winter daily temperatures and the percentage of housing with poor insulation. CONCLUSIONS The vulnerability to ECD was greater in urban zones than in rural zones. Socioeconomic status is a key to understanding how this vulnerability is distributed. These results suggest the need to implement public health prevention plans to address ECD at the state level. These plans should be based on threshold temperatures determined at the smallest scale possible.
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Affiliation(s)
- J A López-Bueno
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
| | - M A Navas-Martín
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, Spain
| | - J Díaz
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, Spain
| | - I J Mirón
- Consejería de Sanidad, Junta de Comunidades de Castilla la Mancha, Toledo, Spain
| | - M Y Luna
- Agencia Estatal de Meteorología, Madrid, Spain
| | | | - D Culqui
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, Spain
| | - C Linares
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, Spain
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11
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Roca-Barceló A, Fecht D, Pirani M, Piel FB, Nardocci AC, Vineis P. Trends in Temperature-associated Mortality in São Paulo (Brazil) between 2000 and 2018: an Example of Disparities in Adaptation to Cold and Heat. J Urban Health 2022; 99:1012-1026. [PMID: 36357626 PMCID: PMC9727050 DOI: 10.1007/s11524-022-00695-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/12/2022]
Abstract
Exposure to non-optimal temperatures remains the single most deathful direct climate change impact to health. The risk varies based on the adaptation capacity of the exposed population which can be driven by climatic and/or non-climatic factors subject to fluctuations over time. We investigated temporal changes in the exposure-response relationship between daily mean temperature and mortality by cause of death, sex, age, and ethnicity in the megacity of São Paulo, Brazil (2000-2018). We fitted a quasi-Poisson regression model with time-varying distributed-lag non-linear model (tv-DLNM) to obtain annual estimates. We used two indicators of adaptation: trends in the annual minimum mortality temperature (MMT), i.e., temperature at which the mortality rate is the lowest, and in the cumulative relative risk (cRR) associated with extreme cold and heat. Finally, we evaluated their association with annual mean temperature and annual extreme cold and heat, respectively to assess the role of climatic and non-climatic drivers. In total, we investigated 4,471,000 deaths from non-external causes. We found significant temporal trends for both the MMT and cRR indicators. The former was decoupled from changes in AMT, whereas the latter showed some degree of alignment with extreme heat and cold, suggesting the role of both climatic and non-climatic adaptation drivers. Finally, changes in MMT and cRR varied substantially by sex, age, and ethnicity, exposing disparities in the adaptation capacity of these population groups. Our findings support the need for group-specific interventions and regular monitoring of the health risk to non-optimal temperatures to inform urban public health policies.
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Affiliation(s)
- Aina Roca-Barceló
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Daniela Fecht
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.,Protection Research Unit in Chemical and Radiation Threats and Hazards, Department of Epidemiology and Biostatistics, School of Public Health, National Institute for Health Research Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Monica Pirani
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Frédéric B Piel
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.,Department of Epidemiology and Biostatistics, School of Public Health, National Institute for Health Research Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Adelaide C Nardocci
- Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
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12
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Libonati R, Geirinhas JL, Silva PS, Monteiro Dos Santos D, Rodrigues JA, Russo A, Peres LF, Narcizo L, Gomes MER, Rodrigues AP, DaCamara CC, Pereira JMC, Trigo RM. Drought-heatwave nexus in Brazil and related impacts on health and fires: A comprehensive review. Ann N Y Acad Sci 2022; 1517:44-62. [PMID: 36052446 DOI: 10.1111/nyas.14887] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Climate change is drastically altering the frequency, duration, and severity of compound drought-heatwave (CDHW) episodes, which present a new challenge in environmental and socioeconomic sectors. These threats are of particular importance in low-income regions with growing populations, fragile infrastructure, and threatened ecosystems. This review synthesizes emerging progress in the understanding of CDHW patterns in Brazil while providing insights about the impacts on fire occurrence and public health. Evidence is mounting that heatwaves are becoming increasingly linked with droughts in northeastern and southeastern Brazil, the Amazonia, and the Pantanal. In those regions, recent studies have begun to build a better understanding of the physical mechanisms behind CDHW events, such as the soil moisture-atmosphere coupling, promoted by exceptional atmospheric blocking conditions. Results hint at a synergy between CDHW events and high fire activity in the country over the last decades, with the most recent example being the catastrophic 2020 fires in the Pantanal. Moreover, we show that HWs were responsible for increasing mortality and preterm births during record-breaking droughts in southeastern Brazil. This work paves the way for a more in-depth understanding on CDHW events and their impacts, which is crucial to enhance the adaptive capacity of different Brazilian sectors.
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Affiliation(s)
- Renata Libonati
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Dom Luiz, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.,Forest Research Centre, School of Agriculture, University of Lisbon, Lisbon, Portugal
| | - João L Geirinhas
- Instituto Dom Luiz, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Patrícia S Silva
- Instituto Dom Luiz, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | | | - Julia A Rodrigues
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Russo
- Instituto Dom Luiz, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Leonardo F Peres
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiza Narcizo
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Monique E R Gomes
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andreza P Rodrigues
- Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos C DaCamara
- Instituto Dom Luiz, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - José Miguel C Pereira
- Forest Research Centre, School of Agriculture, University of Lisbon, Lisbon, Portugal.,TERRA Associate Laboratory, Tapada da Ajuda, Portugal
| | - Ricardo M Trigo
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Dom Luiz, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
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13
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Song J, Qin W, Pan R, Yi W, Song S, Cheng J, Su H. A global comprehensive analysis of ambient low temperature and non-communicable diseases burden during 1990-2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:66136-66147. [PMID: 35501439 DOI: 10.1007/s11356-022-20442-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
Climate change and health are inextricably linked, especially the role of ambient temperature. This study aimed to analyze the non-communicable disease (NCD) burden attributable to low temperature globally, regionally, and temporally using data from the Global Burden of Disease (GBD) study 2019. Globally, in 2019, low temperature was responsible for 5.42% DALY and 7.18% death of NCDs, representing the age-standardized disability-adjusted life years (DALY) and death rates (per 100,000 population) of 359.6 (95% uncertainty intervals (UI): 306.09, 416.88) and 21.36 (95% UI:18.26, 24.74). Ischemic heart disease was the first leading cause of DALY and death resulting from low temperature, followed by stroke. However, age-standardized DALY and death rates attributable to low temperature have exhibited wide variability across regions, with the highest in Central Asia and Eastern Europe and the lowest in Caribbean and Western sub-Saharan Africa. During the study period (1990-2019), there has been a significant decrease in the burden of NCDs attributable to low temperature, but progress has been uneven across countries, whereas nations exhibiting high sociodemographic index (SDI) declined more significantly compared with low SDI nations. Notably, three nations, including Uzbekistan, Tajikistan, and Lesotho, had the maximum NCDs burden attributed to low temperature and displayed an upward trend. In conclusion, ambient low temperature contributes to substantial NCD burden with notable geographical variations.
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Affiliation(s)
- Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Wei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Lu'an Center for Disease Control and Prevention, Lu'an, 237000, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China.
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14
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Huang Z, Chan EYY, Wong CS, Zee BCY. Spatiotemporal relationship between temperature and non-accidental mortality: Assessing effect modification by socioeconomic status. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 836:155497. [PMID: 35483463 DOI: 10.1016/j.scitotenv.2022.155497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Most published studies have assessed the overall health impact of temperature by using one-station or multiple-station averaged meteorological and air quality data. Concern has arisen about whether the temperature health impact is homogeneous across the whole territory geographically, since green space and socioeconomic factors may modify the impact. OBJECTIVE This study aims at investigating how small-area mortality is modified by local temperature and other meteorological, air quality, green space, and socioeconomic factors of small geographic units in a subtropical urban setting. METHODS Data on meteorological, air pollutants, and non-accidental mortality count in Hong Kong during 2006-2016 were obtained. Combined with green space and socioeconomic data, spatiotemporal analysis using Generalized Additive Mixed Models was conducted to examine the temperature-mortality relationship, adjusted for seasonality, long-term trend, other meteorological factors, pollutants, socioeconomic characteristics and green space. RESULTS Socioeconomic status was found to modify the temporal temperature-mortality relationship. A J-shape association was identified for most areas in Hong Kong, where a sharp increase of mortality was observed when daily minimum temperature dropped lower than the turning point. However, for people living in the most affluent areas, after the initial increase there was a decrease of mortality for colder days. Besides, when comparing the two spatiotemporal models (i.e. using nearby or central temperature monitoring station), while leaving the other predictors unchanged, this study showed that there was little difference in the overall model performances. CONCLUSION This study indicated that the daily fluctuation of mortality was associated with daily temperature, while the spatial variation of mortality within this city could be explained by the geographical distribution of green space and socioeconomic factors. Since people living in affluent areas were found to be more tolerant of cold temperatures, it would be more efficient to tailor cold temperature health education and warning information for socioeconomically deprived communities.
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Affiliation(s)
- Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong, China; GX Foundation, Hong Kong, China.
| | - Chi Shing Wong
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong, China
| | - Benny Chung Ying Zee
- Centre for Clinical Research and Biostatistics (CCRB), The Chinese University of Hong Kong, Hong Kong, China; Office of Research and Knowledge Transfer Services (ORKTS), The Chinese University of Hong Kong, Hong Kong, China
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15
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Dastoorpoor M, Khodadadi N, Masoumi K, Khanjani N, Idani E, Borsi SH, Goudarzi G, Raji H, Sharafkhani R. Physiological equivalent temperature (PET) and non-accidental, cardiovascular and respiratory disease mortality in Ahvaz, Iran. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:2767-2782. [PMID: 34417925 DOI: 10.1007/s10653-021-01063-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
Climate change may be associated with human morbidity and mortality through direct and indirect effects. Ahvaz is one of the hottest cities in the world. The aim of this study was to investigate the relation between physiological Equivalent Temperature (PET) and non-accidental, cardiovascular and respiratory disease mortality in Ahvaz, Iran. Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on death. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted.The results showed that in cold stress [1st percentile of PET (2.7 °C) relative to 25th percentile (11.9 °C)] the risk of total respiratory mortality, respiratory mortality in men, and mortality in people under 65 year olds, significantly decreased in the cumulative lags of 0-2, 0-6 and 0-13; but the risk of respiratory mortality increased in the elderly and in the final lags. In contrast, heat stress [99th percentile of PET (44.9 °C) relative to 75th percentile (43.4 °C)] significantly increased the risk of total cardiovascular mortality (CVD), cardiovascular mortality in men, ischemic heart disease and cerebrovascular disease mortality in lags 0 and 0-2. It seems that high PET values increase the risk of cardiovascular mortality, while low PET values increase respiratory mortality only among the elderly in Ahvaz.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Masoumi
- Department of Emergency Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Esmaeil Idani
- Department of Internal Medicine, School of Medicine, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Borsi
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Gholamreza Goudarzi
- Department of Environmental Health, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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16
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City-level impact of extreme temperatures and mortality in Latin America. Nat Med 2022; 28:1700-1705. [PMID: 35760859 PMCID: PMC9388372 DOI: 10.1038/s41591-022-01872-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/10/2022] [Indexed: 11/08/2022]
Abstract
Climate change and urbanization are rapidly increasing human exposure to extreme ambient temperatures, yet few studies have examined temperature and mortality in Latin America. We conducted a nonlinear, distributed-lag, longitudinal analysis of daily ambient temperatures and mortality among 326 Latin American cities between 2002 and 2015. We observed 15,431,532 deaths among ≈2.9 billion person-years of risk. The excess death fraction of total deaths was 0.67% (95% confidence interval (CI) 0.58-0.74%) for heat-related deaths and 5.09% (95% CI 4.64-5.47%) for cold-related deaths. The relative risk of death was 1.057 (95% CI 1.046-1.067%) per 1 °C higher temperature during extreme heat and 1.034 (95% CI 1.028-1.040%) per 1 °C lower temperature during extreme cold. In Latin American cities, a substantial proportion of deaths is attributable to nonoptimal ambient temperatures. Marginal increases in observed hot temperatures are associated with steep increases in mortality risk. These risks were strongest among older adults and for cardiovascular and respiratory deaths.
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17
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Chesini F, Herrera N, Skansi MDLM, Morinigo CG, Fontán S, Savoy F, Titto ED. Mortality risk during heat waves in the summer 2013-2014 in 18 provinces of Argentina: Ecological study. CIENCIA & SAUDE COLETIVA 2022; 27:2071-2086. [PMID: 35544832 DOI: 10.1590/1413-81232022275.07502021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 07/29/2021] [Indexed: 11/22/2022] Open
Abstract
Increased frequency of heat waves (HWs) is one of the prominent consequences of climate change. Its impact on human health has been mostly reported in the northern hemisphere but has been poorly studied in the southern hemisphere. The aim of this study was to analyze the effects of the HWs waves occurred in the warm season 2013-14 on mortality in the center-north region of Argentina, where 22 million people live. It was carried out an observational study of ecological-type contrasting the mortality occurred during the HWs of the summer 2013-14 with the mortality in the summers 2010-11 to 2012-13, free from HWs. The mortality was analyzed according to the following variables: place of residence, age, sex and cause of death. During the HWs of the summer 2013-14, 1877 (RR=1.23, 95%CI 1.20-1.28) deaths in excess were registered. Moreover, the death risk significantly increased in 13 of the 18 provinces analyzed. The mortality rates by sex revealed heterogeneous behaviour regarding both the time and spatial scale. The death risk increased with age; it was particularly significant in four provinces for the 60-79 years group and in six provinces in people of 80 years and over. The death causes that showed significantly increments were respiratory, cardiovascular, renal diseases and diabetes.
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Affiliation(s)
- Francisco Chesini
- Salud Ambiental, Ministerio de Salud de la Nación. Av. 9 de Julio 1925. C1073ABA Ciudad Autónoma de Buenos Aires Argentina.
| | - Natalia Herrera
- Dirección Central de Monitoreo del Clima, Dirección Nacional de Ciencia e Innovación en Productos y Servicios. Ciudad Autónoma de Buenos Aires Argentina
| | - Maria de Los Milagros Skansi
- Dirección Central de Monitoreo del Clima, Dirección Nacional de Ciencia e Innovación en Productos y Servicios. Ciudad Autónoma de Buenos Aires Argentina
| | - Carolina González Morinigo
- Dirección de Servicios Sectoriales, Dirección Nacional de Pronósticos y Servicios para la Sociedad, Servicio Meteorológico Nacional. Ciudad Autónoma de Buenos Aires Argentina
| | - Silvia Fontán
- Departamento de Ciencias de la Salud, Universidad Nacional de La Matanza. Provincia de Buenos Aires Argentina
| | - Francisco Savoy
- Facultad de Ciencias de la Salud, Universidad Nacional de Entre Ríos. Provincia de Entre Ríos Argentina
| | - Ernesto de Titto
- Salud Ambiental, Ministerio de Salud de la Nación. Av. 9 de Julio 1925. C1073ABA Ciudad Autónoma de Buenos Aires Argentina.
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18
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The influence of soil dry-out on the record-breaking hot 2013/2014 summer in Southeast Brazil. Sci Rep 2022; 12:5836. [PMID: 35393430 PMCID: PMC8991262 DOI: 10.1038/s41598-022-09515-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/21/2022] [Indexed: 11/08/2022] Open
Abstract
The 2013/2014 summer in Southeast Brazil was marked by historical unprecedented compound dry and hot (CDH) conditions with profound socio-economic impacts. The synoptic drivers for this event have already been analyzed, and its occurrence within the context of the increasing trend of CDH conditions in the area evaluated. However, so far, the causes for these record temperatures remain poorly understood. Here, a detailed characterization of the 2013/2014 austral summer season over Southeast Brazil is proposed, emphasizing the role played by land-atmosphere interactions in temperature escalation. We demonstrate that a strong soil moisture-temperature coupling regime promoted record-breaking temperatures levels exceeding almost 5 °C over the previous highest record, and played a key role in triggering an outstanding 'mega-heatwave' that lasted for a period of around 20 days. This pronounced soil desiccation occurred within a current climate change trend defined by drier and hotter conditions in the region. The soil dry-out, coupled with strong radiative processes and low entrainment of cooler air masses through mesoscale sea-breeze circulation processes, led to a water-limited regime and to an enhancement of sensible heat fluxes that, ultimately, resulted in a sharp increase of surface temperatures.
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19
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Jahan S, Cauchi JP, Galdies C, England K, Wraith D. The adverse effect of ambient temperature on respiratory deaths in a high population density area: the case of Malta. Respir Res 2022; 23:299. [PMID: 36316676 PMCID: PMC9623984 DOI: 10.1186/s12931-022-02218-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 09/25/2022] [Indexed: 11/05/2022] Open
Abstract
Background The effect of ambient temperature on respiratory mortality has been consistently observed throughout the world under different climate change scenarios. Countries experiencing greater inter–annual variability in winter temperatures (and may not be lowest winter temperatures) have greater excess winter mortality compared to countries with colder winters. This study investigates the association between temperature and respiratory deaths in Malta which has one of the highest population densities in the world with a climate that is very hot in summer and mild in winter.
Methods Daily number of respiratory deaths (7679 deaths) and meteorological data (daily average temperature, daily average humidity) were obtained from January 1992 to December 2017. The hot and cold effects were estimated at different temperatures using distributed lag non-linear models (DLNM) with a Poisson distribution, controlling for time trend, relative humidity and holidays. The reference temperature (MMT) for the minimum response-exposure relationship was estimated and the harvesting effects of daily temperature (0–27 lag days) were investigated for daily respiratory mortality. Effects were also explored for different age groups, gender and time periods. Results Cooler temperatures (8–15 °C) were significantly related to higher respiratory mortality. At 8.9 °C (1st percentile), the overall effect of daily mean temperature was related to respiratory deaths (RR 2.24, 95%CI 1.10–4.54). These effects were also found for males (95%CI 1.06–7.77) and males across different age groups (Males Over 65 years: RR 4.85, 95%CI 2.02–11.63 vs Males between 16 and 64 years: RR 5.00, 95%CI 2.08–12.03) but not for females. Interestingly, colder temperatures were related to respiratory deaths in the earliest time period (1992–2000), however, no strong cold effect was observed for later periods (2000–2017). In contrast, no heat effect was observed during the study period and across other groups. Conclusions The higher risk for cold-related respiratory mortality observed in this study could be due to greater inter-annual variability in winter temperatures which needs further exploration after adjusting for potential physical and socio-demographic attributes. The study provides useful evidence for policymakers to improve local warning systems, adaptation, and intervention strategies to reduce the impact of cold temperatures. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02218-z.
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Affiliation(s)
- Shafkat Jahan
- grid.1024.70000000089150953School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059 Australia
| | - John Paul Cauchi
- grid.1024.70000000089150953School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059 Australia
| | - Charles Galdies
- grid.4462.40000 0001 2176 9482Institute of Earth Systems, University of Malta, Msida, MSD 2080 Malta
| | - Kathleen England
- grid.494361.dDirectorate for Health Information and Research, Ministry for Health, Tal-Pietà, Malta
| | - Darren Wraith
- grid.1024.70000000089150953School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059 Australia
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20
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Máté D, Novotny A, Meyer DF. The Impact of Sustainability Goals on Productivity Growth: The Moderating Role of Global Warming. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111034. [PMID: 34769553 PMCID: PMC8583465 DOI: 10.3390/ijerph182111034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 11/21/2022]
Abstract
The objective of this paper was to gain novel insights into the complex relationships among Sustainable Development Goals (SDGs) in shaping productivity (GDP/capita) growth. Using dynamic panel regressions on data collected in 138 countries between 2000 and 2017, we found that rising temperatures negatively affect growth and mitigate the impact of other SDGs on growth. We also found that CO2 emissions have a U-shaped relationship with growth; life expectancy negatively influences growth (positively moderated by rising temperatures), and food security positively impacts growth (negatively moderated by rising temperatures). This study highlights the difficulty of simultaneously implementing SDGs and elucidates novel research perspectives and policies to decrease the negative impacts of climate change on socio-economic and environmental well-being.
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Affiliation(s)
- Domicián Máté
- Department of Engineering Management and Entrepreneurship, Faculty of Engineering, University of Debrecen, H-4028 Debrecen, Hungary
- College of Business and Economics, University of Johannesburg, Johannesburg 2006, South Africa; (A.N.); (D.F.M.)
- Correspondence: ; Tel.: +36-209915258
| | - Adam Novotny
- College of Business and Economics, University of Johannesburg, Johannesburg 2006, South Africa; (A.N.); (D.F.M.)
- Faculty of Economics and Social Sciences, Eszterházy Károly Catholic University, H-3300 Eger, Hungary
- Business School, Nord University, 8026 Bodø, Norway
| | - Daniel Francois Meyer
- College of Business and Economics, University of Johannesburg, Johannesburg 2006, South Africa; (A.N.); (D.F.M.)
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21
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Petkova EP, Dimitrova LK, Sera F, Gasparrini A. Mortality attributable to heat and cold among the elderly in Sofia, Bulgaria. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:865-872. [PMID: 33416949 DOI: 10.1007/s00484-020-02064-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 05/21/2023]
Abstract
Although a number of epidemiological studies have examined the effects of non-optimal temperatures on mortality in Europe, evidence about the mortality risks associated with exposures to hot and cold temperatures in Bulgaria is scarce. This study provides evidence about mortality attributable to non-optimal temperatures in adults aged 65 and over in Sofia, Bulgaria, between 2000 and 2017. We quantified the relationship between the daily mean temperature and mortality in the total elderly adult population aged 65 and over, among males and females aged 65 and over, as well as individuals aged 65-84 and 85 years or older. We used a distributed lag non-linear model with a 25-day lag to fully capture the effects of both cold and hot temperatures and calculated the fractions of mortality attributable to mild and extreme hot and cold temperatures. Cold temperatures had a greater impact on mortality than hot temperatures during the studied period. Most of the temperature-attributable mortality was due to moderate cold, followed by moderate heat, extreme cold, and extreme heat. The total mortality attributable to non-optimal temperatures was greater among females compared to males and among individuals aged 85 and over compared to those aged 65 to 84. The findings of this study can serve as a foundation for future research and policy development aimed at characterizing and reducing the risks from temperature exposures among vulnerable populations in the country, climate adaptation planning and improved public health preparedness, and response to non-optimal temperatures.
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Affiliation(s)
- Elisaveta P Petkova
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA.
| | - Lyudmila K Dimitrova
- Department of Computer and Information Technology, Prof. Asen Zlatarov University, Burgas, Bulgaria
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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22
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Zhang W, Du G, Xiong L, Liu T, Zheng Z, Yuan Q, Yang J, Wu Y, Zhu R, Hu G. Extreme temperatures and cardiovascular mortality: assessing effect modification by subgroups in Ganzhou, China. Glob Health Action 2021; 14:1965305. [PMID: 34482804 PMCID: PMC8425637 DOI: 10.1080/16549716.2021.1965305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Many people die from cardiovascular diseases each year, and extreme temperatures are regarded as a risk factor for cardiovascular deaths. However, the relationship between temperature and cardiovascular deaths varies in different regions because of population density, demographic inequality, and economic situation, and the evidence in Ganzhou, China is limited and inconclusive. Objective This study aimed to assess extreme temperature-related cardiovascular mortality and identify the potential vulnerable people. Methods After controlling other meteorological measures, air pollution, seasonality, relative humidity, day of the week, and public holidays, we examined temperature-related cardiovascular mortality along 21 lag days by Poisson in Ganzhou, China. Results A J-shaped relationship was observed between mean temperature and cardiovascular mortality. Extremely low temperatures substantially increased the relative risks (RR) of cardiovascular mortality. The effect of cold temperature was delayed by 2–6 days and persisted for 4–10 days. However, the risk of cardiovascular mortality related to extremely high temperatures was not significant (p > 0.05). Subgroup analysis indicated that extremely low temperatures had a stronger association with cardiovascular mortality in people with cerebrovascular diseases (RR: 1.282, 95% confidence interval [CI]: 1.020–1.611), males (RR: 1.492, 95% CI: 1.175–1.896), married people (RR: 1.590, 95% CI: 1.224–2.064), and people above the age of 65 years (RR: 1.641, 95% CI: 1.106–2.434) than in people with ischemic heart disease, females, unmarried people, and the elderly (≥65 years old), respectively. Conclusions The type of cardiovascular disease, sex, age, and marital status modified the effects of extremely low temperatures on the risk of cardiovascular mortality. These findings may help local governments to establish warning systems and precautionary measures to reduce temperature-related cardiovascular mortality.
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Affiliation(s)
- Wei Zhang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gang Du
- Ganzhou Center For Disease Control And Prevention, Ganzhou, Jiangxi, China
| | - Liang Xiong
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Tingting Liu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Zuobing Zheng
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Qiong Yuan
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jiahui Yang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yangna Wu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Rongfei Zhu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gonghua Hu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
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23
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López-Bueno JA, Linares C, Sánchez-Guevara C, Martinez GS, Mirón IJ, Núñez-Peiró M, Valero I, Díaz J. The effect of cold waves on daily mortality in districts in Madrid considering sociodemographic variables. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:142364. [PMID: 33370923 DOI: 10.1016/j.scitotenv.2020.142364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/24/2020] [Accepted: 09/10/2020] [Indexed: 06/12/2023]
Abstract
While there is much research that focuses on the association between cold waves and their impacts on daily mortality at the city level, few analyze the impact related to social context and demographic variables at levels lower than the municipal. The objective of this study was to determine the role of the percentage of people over age 65, income level and percentage of homes without heating in the analysis of the impact of cold waves on daily mortality between January 1, 2010 and December 31, 2013 in different districts of the municipality of Madrid. We calculated Relative Risks (RR) and Attributable Risks (RA) for each of 17 districts to determine correlations between the effect of cold waves and daily mortality due to natural causes (CIEX: A00-R99) using Generalized Linear Models (GLM) of the Poisson family (link log). The pattern of risks obtained by district was analyzed using binomial family models (link logit), considering socioeconomic and demographic variables. In terms of results, an impact of cold on mortality was detected in 9 of the 17 districts analyzed. The analysis of risk patterns revealed that the probability of detecting an impact in a district increases in a statistically significant way (p-value <0.05) with a higher percentage of homes without heating systems and a higher percentage of population over age 65. The results obtained identify the factors that should be considered in public health policies that target the district level to reduce the impact of cold waves.
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Affiliation(s)
- J A López-Bueno
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain
| | - C Linares
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain
| | - C Sánchez-Guevara
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | | | - I J Mirón
- Consejería de Sanidad, Junta de Comunidades de Castilla- La Mancha, Spain
| | - M Núñez-Peiró
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | - I Valero
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | - J Díaz
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain.
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24
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Health effects of heat vulnerability in Rio de Janeiro: a validation model for policy applications. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-03750-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AbstractExtreme heat events can lead to increased risk of heat-related deaths. Furthermore, urban areas are often hotter than their rural surroundings, exacerbating heat waves. Unfortunately, validation is difficult; to our knowledge, most validations, even if they control for temperatures, really only validate a social vulnerability index instead of a heat vulnerability index. Here we investigate how to construct and validate a heat vulnerability index given uncertainty ranges in data for the city of Rio de Janeiro. First, we compare excess deaths of certain types of circulatory diseases during heat waves. Second, we use demographic and environmental data and factor analysis to construct a set of unobserved factors and respective weightings related to heat vulnerability, including a Monte Carlo analysis to represent the uncertainty ranges assigned to the input data. Finally, we use distance to hospital and clinics and their health record data as an instrumental variable to validate our factors. We find that we can validate the Rio de Janeiro heat vulnerability index against excess deaths during heat waves; specifically, we use three types of regressions coupled with difference in difference calculations to show this is indeed a heat vulnerability index as opposed to a social vulnerability index. The factor analysis identifies two factors that contribute to >70% of the variability in the data; one socio-economic factor and one urban form factor. This suggests it is necessary to add a step to existing methods for validation of heat vulnerability indices, that of the difference-in-difference calculation.
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25
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Liu S, Chan EYY, Goggins WB, Huang Z. The Mortality Risk and Socioeconomic Vulnerability Associated with High and Low Temperature in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197326. [PMID: 33036459 PMCID: PMC7579344 DOI: 10.3390/ijerph17197326] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 01/08/2023]
Abstract
(1) Background: The adverse health effect associated with extreme temperature has been extensively reported in the current literature. Some also found that temperature effect may vary among the population with different socioeconomic status (SES), but found inconsistent results. Previous studies on the socioeconomic vulnerability of temperature effect were mainly achieved by multi-city or country analysis, but the large heterogeneity between cities may introduce additional bias to the estimation. The linkage between death registry and census in Hong Kong allows us to perform a city-wide analysis in which the study population shares virtually the same cultural, lifestyle and policy environment. This study aims to examine and compare the high and low temperature on morality in Hong Kong, a city with a subtropical climate and address a key research question of whether the extreme high and low temperature disproportionally affects population with lower SES. (2) Methods: Poisson-generalized additive models and distributed-lagged nonlinear models were used to examine the association between daily mortality and daily mean temperature between 2007–2015 with other meteorological and confounding factors controlled. Death registry was linked with small area census and area-level median household income was used as the proxy for socioeconomic status. (3) Results: 362,957 deaths during the study period were included in the analysis. The minimum mortality temperature was found to be 28.9 °C (82nd percentile). With a subtropical climate, the low temperature has a stronger effect than the high temperature on non-accidental, cardiovascular, respiratory and cancer deaths in Hong Kong. The hot effect was more pronounced in the first few days, while cold effect tended to last up to three weeks. Significant heat effect was only observed in the lower SES groups, whilst the extreme low temperature was associated with significantly higher mortality risk across all SES groups. The older population were susceptible to extreme temperature, especially for cold. (4) Conclusions: This study raised the concern of cold-related health impact in the subtropical region. Compared with high temperature, low temperature may be considered a universal hazard to the entire population in Hong Kong rather than only disproportionally affecting people with lower SES. Future public health policy should reconsider the strategy at both individual and community levels to reduce temperature-related mortality.
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Affiliation(s)
- Sida Liu
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China; (S.L.); (Z.H.)
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Emily Yang Ying Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China; (S.L.); (Z.H.)
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China;
- Correspondence:
| | - William Bernard Goggins
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China; (S.L.); (Z.H.)
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China;
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26
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Wang C, Qi Y, Zhu G. Deep learning for predicting the occurrence of cardiopulmonary diseases in Nanjing, China. CHEMOSPHERE 2020; 257:127176. [PMID: 32497840 DOI: 10.1016/j.chemosphere.2020.127176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 06/11/2023]
Abstract
The efficiency of disease prevention and medical care service necessitated the prediction of incidence. However, predictive accuracy and power were largely impeded in a complex system including multiple environmental stressors and health outcome of which the occurrence might be episodic and irregular in time. In this study, we established four different deep learning (DL) models to capture inherent long-term dependencies in sequences and potential complex relationships among constituents by initiating with the original input into a representation at a higher abstract level. We collected 504,555 and 786,324 hospital outpatient visits of grouped categories of respiratory (RESD) and circulatory system disease (CCD), respectively, in Nanjing from 2013 through 2018. The matched observations in time-series that might pose risk to cardiopulmonary health involved conventional air pollutants concentrations and metrological conditions. The results showed that a well-trained network architecture built upon long short-term memory block and a working day enhancer achieved optimal performance by three quantitative statistics, i.e., 0.879 and 0.902 of Nash-Sutcliffe efficiency, 0.921% and 0.667% of percent bias, and 0.347 and 0.312 of root mean square error-standard deviation ratio for RESD and CCD hospital visits, respectively. We observed the non-linear association of nitrogen dioxide and ambient air temperature with CCD hospital visits. Furthermore, these two environmental stressors were identified as the most sensitive predictive variables, and exerted synergetic effect for two health outcomes, particular in winter season. Our study indicated that high-quality surveillance data of atmospheric environments could provide novel opportunity for anticipating temporal trend of cardiopulmonary health outcomes based on DL model.
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Affiliation(s)
- Ce Wang
- School of Energy and Environment, Southeast University, Nanjing, 210096, China; State Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing, 210096, PR China.
| | - Yi Qi
- School of Architecture and Urban Planning, Nanjing University, No. 22, Hankoulu Road, Nanjing, 210093, PR China.
| | - Guangcan Zhu
- School of Energy and Environment, Southeast University, Nanjing, 210096, China; State Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing, 210096, PR China.
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27
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Silveira IH, Cortes TR, Oliveira BFA, Junger WL. Temperature and cardiovascular mortality in Rio de Janeiro, Brazil: effect modification by individual-level and neighbourhood-level factors. J Epidemiol Community Health 2020; 75:69-75. [PMID: 32863272 DOI: 10.1136/jech-2020-215002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Many factors related to susceptibility or vulnerability to temperature effects on mortality have been proposed in the literature. However, there is limited evidence of effect modification by some individual-level factors such as occupation, colour/race, education level and community-level factors. We investigated the effect modification of the temperature-cardiovascular mortality relationship by individual-level and neighbourhood-level factors in the city of Rio de Janeiro, Brazil. METHODS We used a case-crossover study to estimate the total effect of temperature on cardiovascular mortality in Rio de Janeiro between 2001 and 2018, and the effect modification by individual-level and neighbourhood-level factors. Individual-level factors included sex, age, colour/race, education, and place of death. Neighbourhood-level characteristics included social development index (SDI), income, electricity consumption and demographic change. We used conditional Poisson regression models combined with distributed lag non-linear models, adjusted for humidity and public holidays. RESULTS Our results suggest a higher vulnerability to high temperatures among the elderly, women, non-hospitalised deaths, and people with a lower education level. Vulnerability to low temperatures was higher among the elderly, men, non-white people, and for primary education level. As for neighbourhood-level factors, we identified greater vulnerability to low and high temperatures in places with lower SDI, lower income, lower consumption of electricity, and higher demographic growth. CONCLUSION The effects of temperature on cardiovascular disease mortality in Rio de Janeiro vary according to individual-level and neighbourhood-level factors. These findings are valuable to inform policymakers about the most vulnerable groups and places, in order to develop more effective and equitable public policies.
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Affiliation(s)
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Iranpour S, Khodakarim S, Shahsavani A, Khosravi A, Etemad K. Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran. Epidemiol Health 2020; 42:e2020053. [PMID: 32777886 PMCID: PMC7871149 DOI: 10.4178/epih.e2020053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/18/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide). METHODS Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value. RESULTS We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality. CONCLUSIONS A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.
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Affiliation(s)
- Sohrab Iranpour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Shahsavani
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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29
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Geirinhas JL, Russo A, Libonati R, Trigo RM, Castro LCO, Peres LF, Magalhães MDAFM, Nunes B. Heat-related mortality at the beginning of the twenty-first century in Rio de Janeiro, Brazil. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1319-1332. [PMID: 32314060 DOI: 10.1007/s00484-020-01908-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/16/2020] [Accepted: 03/26/2020] [Indexed: 05/24/2023]
Abstract
Temperature record-breaking events, such as the observed more intense, longer-lasting, and more frequent heat waves, pose a new global challenge to health sectors worldwide. These threats are of particular interest in low-income regions with limited investments in public health and a growing urban population, such as Brazil. Here, we apply a comprehensive interdisciplinary climate-health approach, including meteorological data and a daily mortality record from the Brazilian Health System from 2000 to 2015, covering 21 cities over the Metropolitan Region of Rio de Janeiro. The percentage of absolute mortality increase due to summer extreme temperatures is estimated using a negative binomial regression modeling approach and maximum/minimum temperature-derived indexes as covariates. Moreover, this study assesses the vulnerability to thermal stress for different age groups and both genders and thoroughly analyzes four extremely intense heat waves during 2010 and 2012 regarding their impacts on the population. Results showed that the highest absolute mortality values during heat-related events were linked to circulatory illnesses. However, the highest excess of mortality was related to diabetes, particularly for women within the elderly age groups. Moreover, results indicate that accumulated heat stress conditions during consecutive days preferentially preceded by persistent periods of moderate-temperature, lead to higher excess mortality rather than sporadic single hot days. This work may provide directions in human health policies related to extreme climate events in large tropical metropolitan areas from developing countries, contributing to altering the historically based purely reactive response.
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Affiliation(s)
- João L Geirinhas
- Instituto Dom Luiz (IDL), Faculdade de Ciências, Universidade de Lisboa, 1749-016, Lisbon, Portugal.
| | - Ana Russo
- Instituto Dom Luiz (IDL), Faculdade de Ciências, Universidade de Lisboa, 1749-016, Lisbon, Portugal
| | - Renata Libonati
- Instituto Dom Luiz (IDL), Faculdade de Ciências, Universidade de Lisboa, 1749-016, Lisbon, Portugal
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-916, Brazil
- Centro de Estudos Florestais, Universidade de Lisboa, 1349-017, Lisbon, Portugal
| | - Ricardo M Trigo
- Instituto Dom Luiz (IDL), Faculdade de Ciências, Universidade de Lisboa, 1749-016, Lisbon, Portugal
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-916, Brazil
| | - Lucas C O Castro
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-916, Brazil
| | - Leonardo F Peres
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-916, Brazil
- Instituto Português do Mar e da Atmosfera (IPMA), 1749-077, Lisbon, Portugal
| | - Mônica de Avelar F M Magalhães
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Baltazar Nunes
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
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Elevated chronic bronchitis diagnosis risk among women in a local emergency department patient population associated with the 2012 heatwave and drought in Douglas county, NE USA. Heart Lung 2020; 49:934-939. [PMID: 32522416 DOI: 10.1016/j.hrtlng.2020.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/20/2020] [Accepted: 03/26/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Concerns about global climate change force local public health agencies to assess potential local disease risk. OBJECTIVE Determine if risk of an emergency department chronic bronchitis diagnosis in Douglas County, NE, was higher during the 2012 heatwave compared to the same calendar period in 2011. METHODS Retrospective, observational, case-control design selecting subjects from 2011 and 2012 emergency department (ED) admissions. Risk was estimated by conditional logistic regression. RESULTS The odds of an ED chronic bronchitis diagnosis among females was 3.77 (95% CI =1.37-10.21) times higher during the 2012 risk period compared to females admitted to the ED during the 2011 risk period. Chronic bronchitis ED diagnosis odds were 1.05 (95%CI=1.04 - 1.06) times higher for each year of age. ED, gender, and race modified the risk (i.e., effect). The overall chronic bronchitis ED risk estimate was 1.61 (95%CI=0.81 - 3.21) times higher during the 2012 risk period compared to the 2011 risk period. The mean ambient absolute humidity upon admission was 11.44 gr/m3 (95%CI; 10.40 - 12.47) among chronic bronchitis cases and 12.67 gr/m3 (95%CI; 12.63 - 12.71) among controls. CONCLUSION The odds of ED chronic bronchitis diagnosis was higher among female subjects admitted during the 2012 risk period compared to females admitted during the 2011 risk period. Age also increased chronic bronchitis ED diagnosis risk among 2012 risk period admissions compared to 2011 risk period admissions.
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Numerical Simulation of Local Climate Zone Cooling Achieved through Modification of Trees, Albedo and Green Roofs—A Case Study of Changsha, China. SUSTAINABILITY 2020. [DOI: 10.3390/su12072752] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
By exploring the cooling potential of tree quantity, ground albedo, green roofs and their combinations in local climate zone (LCZ)-4, LCZ-5, and LCZ-6, this study focuses on the optimum cooling level that can be achieved in open residential regions in Changsha. It designs and models 39 scenarios by integrating in situ measurement and ENVI-met numerical simulation and further compares cooling effects of various combinations of the cooling factors. The results show that (1) an increased number of trees and higher albedo are more effective compared to green roofs in reducing summer potential temperatures at street level (2 m high) in three LCZs. Negative correlations are observed in the pedestrian air temperature with trees and ground albedo; (2) the effects of cooling factors vary among different LCZ classes, with the increased 60% more trees leading to lower outdoor temperatures for LCZ-4 (0.28 °C), LCZ-5 (0.39 °C), and LCZ-6 (0.54 °C), while higher albedo of asphalt surface (increased by 0.4) is more effective in LCZ-4 (reaches to 0.68 °C) 14:00, compare to LCZ-5 (0.49 °C) and LCZ-6 (0.38 °C); (3) applying combined cooling methods can provoke air temperature reduction (up to 0.96 °C), especially when higher levels of tree quantities (increased by 60%) are coupled with cool ground materials (albedo increased by 0.4). The results can contribute useful information for improving thermal environment in existing residential regions and future residential planning.
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The Association between Air Temperature and Mortality in Two Brazilian Health Regions. CLIMATE 2020. [DOI: 10.3390/cli8010016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Air temperature, both cold and hot, has impacts on mortality and morbidities, which are exacerbated by poor health service and protection responses, particularly in under-developed countries. This study was designed to analyze the effects of air temperature on the risk of deaths for all and specific causes in two regions of Brazil (Florianopolis and Recife), between 2005 and 2014. The association between temperature and mortality was performed through the fitting of a quasi-Poisson non-linear lag distributed model. The association between air temperature and mortality was identified for both regions. The results showed that temperature exerted influence on both general mortality indicators and specific causes, with hot and cold temperatures bringing different impacts to the studied regions. Cerebrovascular and cardiovascular deaths were more sensitive to cold temperatures for Florianopolis and Recife, respectively. Based on the application of the very-well documented state-of-the-art methodology, it was possible to conclude that there was evidence that extreme air temperature influenced general and specific deaths. These results highlighted the importance of consolidating evidence and research in tropical countries such as Brazil as a way of understanding climate change and its impacts on health indicators.
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Silveira IH, Oliveira BFA, Cortes TR, Junger WL. The effect of ambient temperature on cardiovascular mortality in 27 Brazilian cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 691:996-1004. [PMID: 31326821 DOI: 10.1016/j.scitotenv.2019.06.493] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/17/2019] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is limited evidence on the relationship between temperature and cardiovascular mortality in middle and low-income countries, particularly in Latin America. In this study, we investigated the total effect of temperature on cardiovascular mortality in 27 Brazilian cities, and the effect modification by geographic, socioeconomic, demographic and infrastructure characteristics within cities. METHODS In the city-specific analysis, we used time-series analyses to estimate the relationship between mean temperature and daily cardiovascular mortality using quasi-Poisson generalized linear models combined with distributed lag non-linear models. In the second stage, a meta-analysis was used to pool the effects of temperature on cardiovascular mortality for Brazil and its five regions (Central-West, North, Northeast, South, and Southeast). We used a meta-regression to examine the effect modification of city-specific geographic, socioeconomic, demographic and infrastructure-related variables. RESULTS The risks associated with temperature varied across the locations. Higher cardiovascular mortality was associated with low and high temperatures in most of the cities, Brazil and the Central-West, North, South, and Southeast regions. The overall relative risk (RR) for Brazil was 1.26 (95% confidence interval [CI]: 1.17-1.35) for the 1st percentile of temperature and 1.07 (95% CI: 1.01-1.13) for the 99th percentile of temperature versus the 79th percentile (27.7 °C), where RR was lowest. The temperature range was the variable that best explained the variation in effects among the cities, with greater effects in locations having a broader range. CONCLUSIONS The results indicate effects of low and high temperatures on the risk of cardiovascular mortality in most of Brazil's capital cities, besides a pooled effect for Brazil and the Central-West, North, South, and Southeast regions. These findings can help inform public policies addressing the health impact of temperature extremes, especially in the context of climate change.
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Affiliation(s)
- Ismael Henrique Silveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil.
| | - Beatriz Fátima Alves Oliveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Washington Leite Junger
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
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Chesini F, Abrutzky R, Titto ED. [Mortality from heat waves in the city of Buenos Aires, Argentina (2005-2015)]. CAD SAUDE PUBLICA 2019; 35:e00165218. [PMID: 31508697 DOI: 10.1590/0102-311x00165218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 04/15/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze mortality during heat waves in the city of Buenos Aires, Argentina, in 2005-2015. We used a time series design with generalized additive models, linking mortality to days of heat waves throughout the period, and to days of the heat wave in 2013, the longest wave since 1906, controlling for time variables, mean temperature, and humidity. Risk of death from natural causes increased by 14% (RR = 1.140; 95%CI: 1.108-1.173) during heat waves when compared to the other days in the hot season. The increase occurred in both sexes and in all age groups, and individuals under 15 years of age were more affected (RR = 1.167; 95%CI: 1.019-1.335) as were those over 84 years (RR = 1.201; 95%CI: 1.098-1.313). The heat wave in December 2013 showed an increase of 43% (RR = 1.428; 95%CI: 1.399-1.457) in total daily deaths, increasing to 51% in individuals over 84 years (RR = 1.515; 95%CI: 1.372-1.674) and 65% (RR = 1.647; 95%CI: 1.367-1.986) for renal causes. We conclude that heat waves pose a significant risk of death, differing according to sex and age in the population of Buenos Aires.
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Affiliation(s)
| | - Rosana Abrutzky
- Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina
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Moraes SLD, Almendra R, Santana P, Galvani E. [Meteorological variables and air pollution and their association with hospitalizations due to respiratory diseases in children: a case study in São Paulo, Brazil]. CAD SAUDE PUBLICA 2019; 35:e00101418. [PMID: 31365700 DOI: 10.1590/0102-311x00101418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 01/28/2019] [Indexed: 12/21/2022] Open
Abstract
Urban climate changes, excessive air pollution, and increasing social inequalities have become determinant factors in the high risk of hospitalizations due to respiratory diseases. The current study thus aimed to understand how meteorological factors (air temperature, relative humidity, and precipitation) and air pollution (particulate matter with aerodynamic diameter less than 10µm - PM10) are related to hospitalizations due to respiratory diseases in children in 14 districts in the city of São Paulo, Brazil. The combination of generalized linear models with a negative binomial distribution and distributed lag non-linear model (DLNM) were used as the statistical method to analyze the relationship between hospitalizations, climatic factors, and pollution from 2003 to 2013. The results show statistically significant association with high relative risk between mean air temperature (17.5ºC to 21ºC, for the total analyzed), relative humidity (84% to 98% for females), precipitation (0mm to 2.3mm for the total and both sexes and > 120mm for females), and PM10 (> 35µg/m³ for the total and for females). These results showed that environmental factors contribute to the high risk of hospitalizations.
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Affiliation(s)
- Sara Lopes de Moraes
- Faculdade de Filosofia, Letras e Ciências Humanas, Universidade de São Paulo, São Paulo, Brasil
| | | | | | - Emerson Galvani
- Faculdade de Filosofia, Letras e Ciências Humanas, Universidade de São Paulo, São Paulo, Brasil
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The Use of a Quasi-Experimental Study on the Mortality Effect of a Heat Wave Warning System in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122245. [PMID: 31242672 PMCID: PMC6617315 DOI: 10.3390/ijerph16122245] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 12/31/2022]
Abstract
Many cities and countries have implemented heat wave warning systems to combat the health effects of extreme heat. Little is known about whether these systems actually reduce heat-related morbidity and mortality. We examined the effectiveness of heat wave alerts and health plans in reducing the mortality risk of heat waves in Korea by utilizing the discrepancy between the alerts and the monitored temperature. A difference-in-differences analysis combined with propensity score weighting was used. Mortality, weather monitoring, and heat wave alert announcement data were collected for 7 major cities during 2009–2014. Results showed evidence of risk reduction among people aged 19–64 without education (−0.144 deaths/1,000,000 people, 95% CI: −0.227, −0.061) and children aged 0–19 (−0.555 deaths/1,000,000 people, 95% CI: −0.993, −0.117). Decreased cardiovascular and respiratory mortality was found in several subgroups including single persons, widowed people, blue-collar workers, people with no education or the highest level of education (university or higher). No evidence was found for decreased all-cause mortality in the population (1.687 deaths/1,000,000 people per day; 95% CI: 1.118, 2.255). In conclusion, heat wave alerts may reduce mortality for several causes and subpopulations of age and socio-economic status. Further work needs to examine the pathways through which the alerts impact subpopulations differently.
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McDonald RI, Kroeger T, Zhang P, Hamel P. The Value of US Urban Tree Cover for Reducing Heat-Related Health Impacts and Electricity Consumption. Ecosystems 2019. [DOI: 10.1007/s10021-019-00395-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Green H, Bailey J, Schwarz L, Vanos J, Ebi K, Benmarhnia T. Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research. ENVIRONMENTAL RESEARCH 2019; 171:80-91. [PMID: 30660921 DOI: 10.1016/j.envres.2019.01.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 05/13/2023]
Abstract
Heat waves and high air temperature are associated with increased morbidity and mortality. However, the majority of research conducted on this topic is focused on high income areas of the world. Although heat waves have the most severe impacts on vulnerable populations, relatively few studies have studied their impacts in low and middle income countries (LMICs). The aim of this paper is to review the existing evidence in the literature on the impact of heat on human health in LMICs. We identified peer-reviewed epidemiologic studies published in English between January 1980 and August 2018 investigating potential associations between high ambient temperature or heat waves and mortality or morbidity. We selected studies according to the following criteria: quantitative studies that used primary and/or secondary data and report effect estimates where ambient temperature or heat waves are the main exposure of interest in relation to human morbidity or mortality within LMICs. Of the total 146 studies selected, eighty-two were conducted in China, nine in other countries of East Asia and the Pacific, twelve in South Asia, ten in Sub-Saharan Africa, eight in the Middle East and North Africa, and seven in each of Latin America and Europe. The majority of studies (92.9%) found positive associations between heat and human morbidity/mortality. Additionally, while outcome variables and study design differed greatly, most utilized a time-series study design and examined overall heath related morbidity/mortality impacts in an entire population, although it is notable that the selected studies generally found that the elderly, women, and individuals within the low socioeconomic brackets were the most vulnerable to the effects of high temperature. By highlighting the existing evidence on the impact of extreme heat on health in LMICs, we hope to determine data needs and help direct future studies in addressing this knowledge gap. The focus on LMICs is justified by the lack of studies and data studying the health burden of higher temperatures in these regions even though LMICs have a lower capacity to adapt to high temperatures and thus an increased risk.
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Affiliation(s)
- Hunter Green
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA
| | - Jennifer Bailey
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Jennifer Vanos
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
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Feng W, Li H, Wang S, Van Halm-Lutterodt N, An J, Liu Y, Liu M, Wang X, Guo X. Short-term PM 10 and emergency department admissions for selective cardiovascular and respiratory diseases in Beijing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 657:213-221. [PMID: 30543969 DOI: 10.1016/j.scitotenv.2018.12.066] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/05/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Few studies have explored PM10's connection with specific respiratory and cardiovascular emergency department admissions (EDAs). This study aimed to examine the overall effects of PM10 on EDAs for cardiovascular and respiratory diseases, including specifically, cerebrovascular events (CVE), ischemic heart disease (IHD), arrhythmia, heart failure (HF), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), chronic obstructive pulmonary disease (COPD) and asthma. METHODS We collected daily data for EDAs from the 10 largest hospitals in Beijing, between January 2013 and December 2013 as well as daily measurements of PM10 from 17 stations in Beijing. The generalized-additive model was utilized to evaluate the associations between daily PM10 and cardio-pulmonary disease admissions. Differences in gender, age, and season groups were also examined by models. Relative risks (RR) with 95% confidence interval (CI) were calculated based on subtype, age, gender and seasonal groups. In all, there were approximately 56,212 cardiovascular and 92,464 respiratory emergency admissions presented in this study. RESULTS The largest estimate effects in EDAs of total cardiovascular disease, CVE, IHD, total respiratory diseases, URTI, LRTI and COPD were found for PM10 at day 4 (accumulative) moving average, were 0.29% (95% CI:0.12%, 0.46%), 0.36% (95% CI:0.11%, 0.61%), 0.68% (95% CI:0.25%, 1.10%), 0.34% (95% CI:0.22%, 0.47%), 0.35% (95% CI:0.18%, 0.51%), 0.34% (95% CI:0.14%, 0.55%), 2.75% (95% CI:1.38%, 4.12%) respectively. In two-pollutant models and full-pollutant model modified confounding factors, the positive correlation remained unchanged. The elderly (age ≥ 65 years) and male subjects were more susceptible to specific respiratory diseases. PM10's impact on EDAs for HF was found higher during the hot season however, EDAs for COPD peaked during the cold season. CONCLUSION The study markedly informed that PM10 pollution was strongly associated with EDAs for cardio-pulmonary diseases. The effects of PM10 pollution on COPD and heart failure EDAs were clearly determined by seasonal-temperatures.
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Affiliation(s)
- Wei Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shuo Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Nicholas Van Halm-Lutterodt
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Orthopaedics and Neurosurgery, Keck Medical Center of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Ji An
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yue Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Mengyang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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Yin Q, Wang J, Su J, Wei Z. A new method to estimate the temperature-CVD mortality relationship. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:8895-8901. [PMID: 30715716 DOI: 10.1007/s11356-019-04247-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
Few detailed, individual-focused studies have researched the added effect of temperature on cardiovascular disease (CVD), particularly in China. Moreover, no prior studies have explored the exposure-response relationship among all populations and different sub-sociodemographic groups. A distributed lag nonlinear model (DLNM) was applied to evaluate the adverse health effects of temperature on CVD mortality for all populations and different sub-sociodemographic groups (by age, sex, educational level, living arrangement, and occupation) in Beijing. Based on the exposure-response relationships, firstly, we proposed a new model (COCKTAIL, Code Of Climate Key To An Ill) for revealing the split-and-merge relationships of the temperature-CVD mortality curve. This method could be used to apply the CVD deaths in a studied area to forecast the exposure-response relationships in the same area in the future. Secondly, this is the most detailed study to analyze the relationship between temperature and CVD mortality for different subgroups among the existing researches for developed and developing countries. We found that the cold temperature (at - 14 °C) was the risk factor for people with low socioeconomic status, especially for single people (including unmarried, divorced, and widowed), for indoor workers, and for people with low education, compared with the minimum mortality temperature, with a cumulative increase of 3.9 (80%CI, 2.9-5.4), 3.8 (80%CI, 2.8-5.1), and 4.5 (80%CI, 3.1-6.3) times respectively. Meanwhile, the hot temperature (at 35 °C) was the risk factor for CVD death, with a cumulative increase of 2.6 (80%CI, 2.0-3.4) for females, and 3.1 (80%CI, 2.4-4.2) for single people. The varying CVD vulnerability in terms of CVD mortality among various groups may assist governments in preparing health resources and taking measures to prevent or reduce temperature-related deaths.
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Affiliation(s)
- Qian Yin
- State Key Laboratory of Resources and Environmental Information System, Chinese Academy of Sciences, Institute of Geographic Sciences and Nature Resources Research, A11, Datun Road, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Chinese Academy of Sciences, Institute of Geographic Sciences and Nature Resources Research, A11, Datun Road, Beijing, China.
- The University of Chinese Academy of Sciences, Beijing, China.
| | - Jianting Su
- Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Beijing Research Center for Preventive Medicine, Beijing, China
| | - Zaihua Wei
- Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Beijing Research Center for Preventive Medicine, Beijing, China
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Geirinhas JL, Trigo RM, Libonati R, Castro LCO, Sousa PM, Coelho CAS, Peres LF, Magalhães MDAFM. Characterizing the atmospheric conditions during the 2010 heatwave in Rio de Janeiro marked by excessive mortality rates. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 650:796-808. [PMID: 30308855 DOI: 10.1016/j.scitotenv.2018.09.060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 06/08/2023]
Abstract
Global temperatures have increased considerably over the last decades, directly impacting the number, intensity and duration of extreme events such as heat waves. Climate model projections accounting for anthropogenic factors indicate that deadly mega-heat waves are likely to become more frequent in the future. Although the atmospheric features and social-economic related impacts of heat waves have already been documented in various regions around the world, for other highly populated regions, such as the Metropolitan Region of Rio de Janeiro (MRRJ), a similar objective assessment is still needed. Heat waves directly impact the public health sector and particularly the less wealthy and elderly population groups. During February 2010, an elevated mortality peak occurred during a 8-day period (from 2 to 9 Feb 2010) characterized as a heat wave episode in MRRJ. A total excess of 737 deaths was recorded with the elderly group registering the highest mortality incidence. During this heat wave period, a quasi-stationary anticyclonic anomaly forced in altitude by a Rossby wave train was established over the south Brazilian coast. At the surface, the meteorological scenario from January 2010 to the heat wave period was marked by clear sky conditions, large precipitation deficits, and enhanced diabatic heating. During the heat wave period, warm and dry air masses were advected from interior regions towards the MRRJ, exacerbating temperature conditions by pronounced subsidence and adiabatic heating mechanisms. All these conditions contributed to pronounced positive temperature anomalies, reinforced by land-atmosphere feedbacks.
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Affiliation(s)
- João L Geirinhas
- Instituto Dom Luiz, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa, Portugal.
| | - Ricardo M Trigo
- Instituto Dom Luiz, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa, Portugal
| | - Renata Libonati
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Lisboa, Portugal
| | - Lucas C O Castro
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Pedro M Sousa
- Instituto Dom Luiz, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa, Portugal
| | - Caio A S Coelho
- Centro de Previsão de Tempo e Estudos Climáticos (CPTEC), Instituto Nacional de Pesquisas Espaciais (INPE), Cachoeira Paulista, SP, Brazil
| | - Leonardo F Peres
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Instituto Português do Mar e da Atmosfera (IPMA), Lisboa, Portugal
| | - Mônica de Avelar F M Magalhães
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
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Zhan ZY, Yu YM, Qian J, Song YF, Chen PY, Ou CQ. Effects of ambient temperature on ambulance emergency call-outs in the subtropical city of Shenzhen, China. PLoS One 2018; 13:e0207187. [PMID: 30419000 PMCID: PMC6231653 DOI: 10.1371/journal.pone.0207187] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 10/26/2018] [Indexed: 12/17/2022] Open
Abstract
The associations between meteorological factors and mortality have been well documented worldwide, but limited evidence is available for the non-fatal health impacts of ambient temperature, particularly there are few population-based investigations on the impacts of emergency ambulance dispatches in Asia. In this study, based on 809,906 ambulance emergency call-outs (AECOs) for the total population from 2010-2016 in the subtropical city of Shenzhen, China, a Poisson regression combined with a distributed lag nonlinear model was used to simultaneously assess the nonlinear and lag effects of daily mean temperature on AECOs. Stratified analyses by age and sex were performed to identify vulnerable subpopulations. A U-shaped relationship was found between temperature and AECOs. Cold effects were delayed and persisted for 3-4 weeks, with a cumulative relative risk (RR) and 95% confidence interval (CI) of 1.23 (1.10-1.38) and 1.25 (1.16-1.35) over lag 0-28 when comparing the 1st and 5th percentile of the temperature distribution to the optimal (i.e. minimum AECOs) temperature, respectively. Hot effects were immediate and diminished quickly in 5 days, with an increase of 19% (RR = 1.19, 95%CI: 1.14-1.23) and 21% (RR = 1.21, 95%CI: 1.16-1.26) in AECOs over lag 0-5 when comparing the 95th and 99th percentile of temperature to the optimal temperature. Children and the elderly were more vulnerable to cold effects. The youth and middle-aged people suffered more from high temperature. The effects of temperature were similar between males and females. In summary, significant increases were observed in the frequency of AECOs during cold and hot days, and the weather-associated increases in AECOs are different among age groups. This information has valuable implications in ambulance demand prediction and service provision planning.
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Affiliation(s)
- Zhi-Ying Zhan
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yi-Min Yu
- Shenzhen Center for Prehospital Care, Shenzhen, China
- The People's Hospital of Longhua, Shenzhen, China
| | - Jun Qian
- Department of Mathematics and Physics, School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Yun-Feng Song
- Intensive Care Unit, Guangdong No.2 Provincial People’s Hospital, Guangzhou, China
| | - Ping-Yan Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- * E-mail:
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Odhiambo Sewe M, Bunker A, Ingole V, Egondi T, Oudin Åström D, Hondula DM, Rocklöv J, Schumann B. Estimated Effect of Temperature on Years of Life Lost: A Retrospective Time-Series Study of Low-, Middle-, and High-Income Regions. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:017004. [PMID: 29342452 PMCID: PMC6014689 DOI: 10.1289/ehp1745] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 05/16/2023]
Abstract
BACKGROUND Numerous studies have reported a strong association between temperature and mortality. Additional insights can be gained from investigating the effects of temperature on years of life lost (YLL), considering the life expectancy at the time of death. OBJECTIVES The goal of this work was to assess the association between temperature and YLL at seven low-, middle-, and high-income sites. METHODS We obtained meteorological and population data for at least nine years from four Health and Demographic Surveillance Sites in Kenya (western Kenya, Nairobi), Burkina Faso (Nouna), and India (Vadu), as well as data from cities in the United States (Philadelphia, Phoenix) and Sweden (Stockholm). A distributed lag nonlinear model was used to estimate the association of daily maximum temperature and daily YLL, lagged 0-14 d. The reference value was set for each site at the temperature with the lowest YLL. RESULTS Generally, YLL increased with higher temperature, starting day 0. In Nouna, the hottest location, with a minimum YLL temperature at the first percentile, YLL increased consistently with higher temperatures. In Vadu, YLL increased in association with heat, whereas in Nairobi, YLL increased in association with both low and high temperatures. Associations with cold and heat were evident for Phoenix (stronger for heat), Stockholm, and Philadelphia (both stronger for cold). Patterns of associations with mortality were generally similar to those with YLL. CONCLUSIONS Both high and low temperatures are associated with YLL in high-, middle-, and low-income countries. Policy guidance and health adaptation measures might be improved with more comprehensive indicators of the health burden of high and low temperatures such as YLL. https://doi.org/10.1289/EHP1745.
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Affiliation(s)
- Maquins Odhiambo Sewe
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
- KEMRI Centre for Global Health Research , Kisumu, Kenya
- Graduate School in Population Dynamics and Public Policy , Umeå University , Umeå, Sweden
| | - Aditi Bunker
- Network Aging Research, University of Heidelberg , Heidelberg, Germany
- Heidelberg Institute of Public Health , University of Heidelberg , Heidelberg, Germany
- Centre de Recherche en Santé de Nouna , Nouna, Burkina Faso
| | - Vijendra Ingole
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
- Graduate School in Population Dynamics and Public Policy , Umeå University , Umeå, Sweden
- Vadu Rural Health Program, KEM Hospital Research Centre , Pune, India
| | - Thaddaeus Egondi
- African Population and Health Research Center , Nairobi, Kenya
- Center for Research in Therapeutic Sciences (CREATES) , Strathmore University , Nairobi, Kenya
| | - Daniel Oudin Åström
- Department of Clinical Science, Center for Primary Health Care Research, Lund University , Malmö , Sweden
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University , Umeå , Sweden
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona USA
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
| | - Barbara Schumann
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
- Centre for Demographic and Ageing Research , Umeå University , Umeå, Sweden
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Son JY, Lane KJ, Lee JT, Bell ML. Urban vegetation and heat-related mortality in Seoul, Korea. ENVIRONMENTAL RESEARCH 2016; 151:728-733. [PMID: 27644031 PMCID: PMC5071166 DOI: 10.1016/j.envres.2016.09.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/23/2016] [Accepted: 09/04/2016] [Indexed: 05/21/2023]
Abstract
Urban areas are particularly vulnerable to heat-related health outcomes. Simultaneous trends of climate change and urbanization may increase the urban heat-related health burden. We investigated the effects of urban vegetation on heat-related mortality, and evaluated whether different levels of vegetation and individuals' characteristics affect the temperature-mortality associations within Seoul, Korea 2000-2009. We used Normalized Difference Vegetation Index (NDVI) to assess the urban vegetation within Seoul. We applied an overdispersed Poisson generalized linear model with interaction term between temperature and indicator of NDVI group (categorized in 3 levels) to assess the effect modification of the temperature-mortality association by urban vegetation. We conducted stratified analysis to explore whether associations are affected by individual characteristics of sex and age. The association between total mortality and a 1°C increase in temperature above the 90th percentile (25.1°C) (the "heat effect") was the highest for gus with low NDVI. The heat effect was a 4.1% (95% confidence interval (CI) 2.3, 5.9%), 3.0% (95% CI 0.2, 5.9%), and 2.2% (95% CI -0.5, 5.0%) increase in mortality risk for low, medium, and high NDVI group, respectively. Estimated risks showed similar effects by sex and age. Our findings suggest a higher mortality effect of high temperature in areas with lower vegetation in Seoul, Korea.
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Affiliation(s)
- Ji-Young Son
- School of Forestry & Environmental Studies, Yale University, CT, USA
| | - Kevin J Lane
- School of Forestry & Environmental Studies, Yale University, CT, USA
| | - Jong-Tae Lee
- Department of Environmental Health, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Michelle L Bell
- School of Forestry & Environmental Studies, Yale University, CT, USA.
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Bidassey-Manilal S, Wright CY, Engelbrecht JC, Albers PN, Garland RM, Matooane M. Students' Perceived Heat-Health Symptoms Increased with Warmer Classroom Temperatures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E566. [PMID: 27338423 PMCID: PMC4924023 DOI: 10.3390/ijerph13060566] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/23/2016] [Accepted: 05/31/2016] [Indexed: 12/18/2022]
Abstract
Temperatures in Africa are expected to increase by the end of the century. Heat-related health impacts and perceived health symptoms are potentially a problem, especially in public schools with limited resources. Students (n = 252) aged ~14-18 years from eight high schools completed an hourly heat-health symptom log over 5 days. Data loggers measured indoor classroom temperatures. A high proportion of students felt tired (97.2%), had low concentration (96.8%) and felt sleepy (94.1%) during at least one hour on any day. There were statistically significant correlations, when controlling for school cluster effect and time of day, between indoor temperatures ≥32 °C and students who felt tired and found it hard to breathe. Consistently higher indoor classroom temperatures were observed in classrooms constructed of prefabricated asbestos sheeting with corrugated iron roof and converted shipping container compared to brick classrooms. Longitudinal studies in multiple seasons and different classroom building types are needed.
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Affiliation(s)
- Shalin Bidassey-Manilal
- Department of Environmental Health, Tshwane University of Technology, Pretoria 0001, South Africa.
| | - Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council, 1 Soutpansberg Road, Pretoria 0001, South Africa.
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa.
| | - Jacobus C Engelbrecht
- Department of Environmental Health, Tshwane University of Technology, Pretoria 0001, South Africa.
| | - Patricia N Albers
- Environment and Health Research Unit, South African Medical Research Council, 1 Soutpansberg Road, Pretoria 0001, South Africa.
| | - Rebecca M Garland
- Natural Resources and the Environment, Council for Scientific and Industrial Research, Pretoria 0001, South Africa.
- Climatology Research Group, North West University, Potchefstroom 2520, South Africa.
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