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Kenny GP, Tetzlaff EJ, Journeay WS, Henderson SB, O’Connor FK. Indoor overheating: A review of vulnerabilities, causes, and strategies to prevent adverse human health outcomes during extreme heat events. Temperature (Austin) 2024; 11:203-246. [PMID: 39193048 PMCID: PMC11346563 DOI: 10.1080/23328940.2024.2361223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/07/2024] [Accepted: 05/20/2024] [Indexed: 08/29/2024] Open
Abstract
The likelihood of exposure to overheated indoor environments is increasing as climate change is exacerbating the frequency and severity of hot weather and extreme heat events (EHE). Consequently, vulnerable populations will face serious health risks from indoor overheating. While the relationship between EHE and human health has been assessed in relation to outdoor temperature, indoor temperature patterns can vary markedly from those measured outside. This is because the built environment and building characteristics can act as an important modifier of indoor temperatures. In this narrative review, we examine the physiological and behavioral determinants that influence a person's susceptibility to indoor overheating. Further, we explore how the built environment, neighborhood-level factors, and building characteristics can impact exposure to excess heat and we overview how strategies to mitigate building overheating can help reduce heat-related mortality in heat-vulnerable occupants. Finally, we discuss the effectiveness of commonly recommended personal cooling strategies that aim to mitigate dangerous increases in physiological strain during exposure to high indoor temperatures during hot weather or an EHE. As global temperatures continue to rise, the need for a research agenda specifically directed at reducing the likelihood and impact of indoor overheating on human health is paramount. This includes conducting EHE simulation studies to support the development of consensus-based heat mitigation solutions and public health messaging that provides equitable protection to heat-vulnerable people exposed to high indoor temperatures.
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Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - W. Shane Journeay
- Departments of Medicine and Community Health and Epidemiology, Dalhousie Medicine New Brunswick and Dalhousie University, Saint John, NB, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
- Department of Rehabilitative Care, Providence Healthcare-Unity Health Toronto, Toronto, ON, Canada
| | - Sarah B. Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
- National Collaborating Centre for Environmental Health, Vancouver, BC, Canada
| | - Fergus K. O’Connor
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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2
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Yin B, Fang W, Liu L, Guo Y, Ma X, Di Q. Effect of extreme high temperature on cognitive function at different time scales: A national difference-in-differences analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 275:116238. [PMID: 38518609 DOI: 10.1016/j.ecoenv.2024.116238] [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: 12/06/2023] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Mounting evidence has demonstrated that high temperature was associated with adverse health outcomes, especially morbidity and mortality. Nonetheless, the impact of extreme high temperature on cognitive performance, which is the fundamental capacity for interpreting one's surroundings, decision-making, and acquiring new abilities, has not been thoroughly investigated. METHODS We aimed to assess associations between extreme high temperature at different time scales and poor cognitive function. We used longitudinal survey data from the three waves of data from China Family Panel Study, providing an 8-year follow-up of 53,008 participants from China. We assessed temperature and extreme high temperature exposure for each participant based on the residential area and date of cognitive test. We defined the proportion of days/hours above 32 °C as the metric of the exposure to extreme high temperature. Then we used generalized additive model and difference-in-differences approach to explore the associations between extreme high temperature and cognitive function. RESULTS Our results demonstrated that either acute exposure or long-term exposure to extreme high temperature was associated with cognitive decline. At hourly level, 0-1 hour acute exposure to extreme high temperature would induce -0.93 % (95 % CI: -1.46 %, -0.39 %) cognitive change. At annual level, 10 percentage point increase in the hours proportion exceeding 32 °C in the past two years induced -9.87 % (95 % CI: -13.99 %, -5.75 %) cognitive change. Furthermore, subgroup analyses indicated adaptation effect: for the same 10 percentage increase in hours proportion exceeding 32 °C, people in warmer areas had cognitive change of -6.41 % (-11.22 %, -1.61 %), compared with -15.30 % (-21.07 %, -9.53 %) for people in cool areas. CONCLUSION Our results demonstrated that extreme high temperature was associated with reduced cognitive function at hourly, daily and annual levels, warning that people should take better measures to protect the cognitive function in the context of climate change.
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Affiliation(s)
- Bo Yin
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Wen Fang
- Division of Sports Science & Physical Education, Tsinghua University, Beijing 100084, China
| | - Linfeng Liu
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xindong Ma
- Division of Sports Science & Physical Education, Tsinghua University, Beijing 100084, China; IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing 100084, China
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; Institute for Healthy China, Tsinghua University, Beijing 100084, China.
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Hou K, Xu X. Ambient temperatures associated with reduced cognitive function in older adults in China. Sci Rep 2023; 13:17414. [PMID: 37833389 PMCID: PMC10575877 DOI: 10.1038/s41598-023-44776-2] [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: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 10/15/2023] Open
Abstract
The cognitive function status of older adults determines the social function and living quality of older adults, which is related to the healthy development and stability of the society. However, the impact of high or low ambient temperature on cognitive function in older adults remains unclear. Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we comprehensively assessed the impact of ambient temperature on the cognitive function of older adults in this study. The findings exhibited that for each 1 °C ascent in monthly temperature of high temperature, the examination score of global cognitive function of older adults decreased by 0.48 (95% CI 0.21-0.74), which was greater than that of 0.14 (95% CI 0.06-0.25) for each 1 °C reduction in low temperature. Overall, the detrimental effect of high temperature on cognitive function in older adults was more significant than that of low temperature, including on the five sub-cognitive functions involved. Our research provides vital technical guidance and reference for the health protection and prevention of cognitive function of older adults in specific external environmental conditions under the current climatic variation and temperature rise.
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Affiliation(s)
- Kun Hou
- School of Remote Sensing and Geomatics Engineering, Nanjing University of Information Science and Technology, Nanjing, 210044, China.
| | - Xia Xu
- Jiangsu Province Hydrology and Water Resources Investigation Bureau, Nanjing, 210029, China
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Ostermann T, Anheyer D. "Don't You Understand? It's an Effect of d = 0.09 Between the Groups, Stupid!" Using Common Language Effect Sizes to Improve the Understandability of Study Results. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:452-454. [PMID: 37581575 DOI: 10.1089/jicm.2023.29119.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Affiliation(s)
- Thomas Ostermann
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Dennis Anheyer
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
- Department of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
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The Association of Meteorological Factors with Cognitive Function in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115981. [PMID: 34199578 PMCID: PMC8199712 DOI: 10.3390/ijerph18115981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022]
Abstract
Individual and meteorological factors are associated with cognitive function in older adults. However, how these two factors interact with each other to affect cognitive function in older adults is still unclear. We used mixed effects models to assess the association of individual and meteorological factors with cognitive function among older adults. Individual data in this study were from the database of China Family Panel Studies. A total of 3448 older adults from 25 provinces were included in our analysis. Cognitive functions were measured using a memory test and a logical sequence test. We used the meteorological data in the daily climate dataset of China’s surface international exchange stations, and two meteorological factors (i.e., average temperature and relative humidity) were assessed. The empty model showed significant differences in the cognitive scores of the older adults across different provinces. The results showed a main impact of residence (i.e., urban or rural) and a significant humidity–residence interaction on memory performance in older adults. Specifically, the negative association between humidity and memory performance was more pronounced in urban areas. This study suggested that meteorological factors may, in concert with individual factors, be associated with differences in memory function in older adults.
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Sunshine, temperature and suicidal behaviour in patients treated with antidepressants: an explorative nested case-control study. Sci Rep 2021; 11:10178. [PMID: 33986315 PMCID: PMC8119497 DOI: 10.1038/s41598-021-89499-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/22/2021] [Indexed: 12/14/2022] Open
Abstract
Our aim was to explore if different exposure windows for sunshine or temperature are associated with increased suicidal behaviour among people starting antidepressant treatment. 307 completed and 1674 attempted suicides were included as cases in the conditional logistic regression analyses, while controlling for potential confounders, including season, as well as temperature and hours of sunshine when these variables were not the main exposure variable. Ten controls were matched to each case using risk-set sampling. The role of season, age, and sex was examined with likelihood ratio tests (LRTs) with and without the respective interaction terms and with stratified analyses. There was no overall association between temperature or sunshine with suicidal behaviour. Age was a significant effect modifier for suicide and suicide attempt for both sunshine and temperature exposure. In stratified analyses, an increase of one degree Celsius in the average daily temperature during the last 4 weeks was associated, in the unadjusted model, with a 3% increase in the rate of suicide (p = 0.023) amongst older patients (65+). In the same age group, an increase of 1 h in the average daily sunshine during the last 4 weeks was associated with an 8% increase in the rate of suicide attempt (p = 0.002), while the respective increase for the exposure period of 5–8 weeks was 7% (p = 0.007). An increase of one degree Celsius in the average daily temperature during the last 4 weeks was associated with a 3% increase in the rate of suicide attempt (p = 0.007). These associations did not retain statistical significance in the adjusted models. No associations were found in the other age groups. Our results point to a possible effect modification by age, with higher risk of suicidal behavior associated with an increase in sunshine and temperature found in the older age groups.
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Tian X, Fang Z, Liu W. Decreased humidity improves cognitive performance at extreme high indoor temperature. INDOOR AIR 2021; 31:608-627. [PMID: 33012043 DOI: 10.1111/ina.12755] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/17/2020] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Abstract
In this study, we examined the cognitive performance of subtropically acclimatized subjects at an extreme high indoor temperature and the effect of decreased humidity on the cognitive performance at the high temperature. Forty-eight healthy subjects experienced the three exposure conditions: 26°C/relative humidity (RH) 70%, 39°C/RH50%, and 39°C/RH70% in a climate chamber. During 140-minute-long exposures to each thermal condition, they were required to perform cognitive tests that assess the perception, spatial orientation, concentration, memory, and thinking abilities. Meanwhile, their heart rate, core temperature, skin temperature, blood pressure, and body weight were measured and subjective responses, that is, thermal comfort, perceived air quality, and acute health symptoms were investigated. At the relative humidity of 70%, increasing indoor temperature from 26°C to 39°C caused a significant decrease in the accuracy of these cognitive tests. However, when the relative humidity decreased from 70% to 50% at 39°C, the accuracy of the cognitive tests increased significantly. Accordingly, the physiological and subjective responses of the subjects changed significantly with the changes in indoor temperature and humidity, which provided a basis to the variation in the cognitive performance. These results indicated that decreasing indoor humidity at extreme high temperature could improve the impaired cognitive performance.
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Affiliation(s)
- Xiaoyu Tian
- School of Energy Science & Engineering, Central South University, Changsha, Hunan, China
| | - Zhaosong Fang
- School of Civil Engineering, Guangzhou University, Guangzhou, Guangdong, China
| | - Weiwei Liu
- School of Energy Science & Engineering, Central South University, Changsha, Hunan, China
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Skirrow C, Cashdollar N, Granger K, Jennings S, Baker E, Barnett J, Cormack F. Test-retest reliability on the Cambridge Neuropsychological Test Automated Battery: Comment on Karlsen et al. (2020). APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:889-892. [PMID: 33406910 DOI: 10.1080/23279095.2020.1860987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Test-retest reliability is essential to the development and validation of psychometric tools. Here we respond to the article by Karlsen et al. (Applied Neuropsychology: Adult, 2020), reporting test-retest reliability on the Cambridge Neuropsychological Test Automated Battery (CANTAB), with results that are in keeping with prior research on CANTAB and the broader cognitive assessment literature. However, after adopting a high threshold for adequate test-retest reliability, the authors report inadequate reliability for many measures. In this commentary we provide examples of stable, trait-like constructs which we would expect to remain highly consistent across longer time periods, and contrast these with measures which show acute within-subject change in response to contextual or psychological factors. Measures characterized by greater true within-subject variability typically have lower test-retest reliability, requiring adequate powering in research examining group differences and longitudinal change. However, these measures remain sensitive to important clinical and functional outcomes. Setting arbitrarily elevated test-retest reliability thresholds for test adoption in cognitive research limits the pool of available tools and precludes the adoption of many well-established tests showing consistent contextual, diagnostic, and treatment sensitivity. Overall, test-retest reliability must be balanced with other theoretical and practical considerations in study design, including test relevance and sensitivity.
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Affiliation(s)
- Caroline Skirrow
- Cambridge Cognition, Cambridge, UK.,School of Psychological Science, University of Bristol, Bristol, UK
| | - Nathan Cashdollar
- Cambridge Cognition, Cambridge, UK.,Cambridge Cognition, Cambridge, MA, USA
| | | | | | | | - Jennifer Barnett
- Cambridge Cognition, Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Francesca Cormack
- Cambridge Cognition, Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
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Gasparetto T, Nesseler C. Diverse Effects of Thermal Conditions on Performance of Marathon Runners. Front Psychol 2020; 11:1438. [PMID: 32719639 PMCID: PMC7350124 DOI: 10.3389/fpsyg.2020.01438] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/28/2020] [Indexed: 01/01/2023] Open
Abstract
Heat exposure affects human performance in many ways. Both physiological (i.e., glycogen sparing, oxygen uptake, thermoregulation) and biomechanical mechanisms (i.e., contact time, knee flexion, muscle activity) are affected, hence reducing performance. However, the exposure affects persons differently. Not all athletes necessarily experience an identical thermal condition similarly, and this point has been overlooked to date. We analyzed endurance performances of the top 1000 runners for every year during the last 12 New York City Marathons. Thermal conditions were estimated with wet-bulb globe temperature (WBGT) and universal thermal climate index (UTCI). Under identical thermal exposure, the fastest runners experienced a larger decline in performance than the slower ones. The empirical evidence offered here not only shows that thermal conditions affect runners differently, but also that some groups might consistently suffer more than others. Further research may inspect other factors that could be affected by thermal conditions, as pacing and race strategy.
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Affiliation(s)
- Thadeu Gasparetto
- Department of Management, National Research University Higher School of Economics, Saint Petersburg, Russia
| | - Cornel Nesseler
- Business School, Norwegian University of Science and Technology, Trondheim, Norway
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10
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Zhu M, Liu W, Wargocki P. Changes in EEG signals during the cognitive activity at varying air temperature and relative humidity. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:285-298. [PMID: 31235789 DOI: 10.1038/s41370-019-0154-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/04/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
In this study, we examined changes in EEG signals during the cognitive activity at different air temperatures and relative humidities (RH). Thirty-two healthy young people acclimatized to the subtropical climate of Changsha, China, were recruited as subjects. They experienced four air temperature levels (26, 30, 33, and 37 °C) and two relative humidity levels (50 and 70%) in a climate chamber. During 175 min-long exposures to each thermal condition, they performed cognitive tasks and their EEG signals were measured. Relative humidity of 70% and increased temperature at this relative humidity significantly increased the relative power of δ-band and significantly decreased relative power of θ-band, α-band, and β-band. This may suggest that subjects were more sleepy but less drowsy, and it was more difficult for them to think clearly. At the same time, subjective evaluations indicated that they could be less alert and it was harder for them to think. However, no changes in performance of tasks measuring cognitive abilities were observed. It remains therefore unclear whether EEG can be a credible marker of changes in cognitive activity as a result of changes in indoor environmental quality in buildings and the future experiments should closely examine this issue.
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Affiliation(s)
- Minghui Zhu
- School of Energy Science & Engineering, Central South University, Changsha, Hunan, China
| | - Weiwei Liu
- School of Energy Science & Engineering, Central South University, Changsha, Hunan, China.
| | - Pawel Wargocki
- Technical University of Denmark, Kongens Lyngby, Denmark
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Zhang N, Du S, Tang Z, Zheng M, Ma G. Effect of Water Supplementation on Cognitive Performances and Mood among Male College Students in Cangzhou, China: Study Protocol of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090966. [PMID: 32962317 PMCID: PMC5615503 DOI: 10.3390/ijerph14090966] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/27/2022]
Abstract
Introduction: Water accounts for about 75% of brain mass. Cognitive performances and mood may be impaired by hypohydration and improved by water supplementation. Two surveys conducted in China demonstrated that a large proportion of adults and children drank less fluid than the amounts recommended by the Chinese Nutrition Society. The association between hypohydration and cognitive performance has not been reported in China. The purpose of this study is to explore the effect of water supplementation on cognitive performances and mood among male college students in Cangzhou, China. Methods and Analysis: A randomized controlled trial is designed to test the hypothesis. A total of 68 male college students aged 18–25 years will be recruited and randomly assigned into water-supplementation group (WS group, n = 34) and no water-supplementation group (NW group, n = 34) after an overnight fasting, i.e., without eating foods and drinking fluid for 12 h. The first morning urine will be collected to determine urine osmolality on the water supplementation day. Cognitive performances and mood will be performed before water supplementation by researchers with questionnaire. Subjects in the WS group will drink 400 mL purified water within 5 min, while those in NW group will not drink any fluid. One hour later, urine will be collected and urine osmolality, cognitive performances and mood will be measured again. Mixed model of repeated measures ANOVA will be used to investigate the effect of water supplementation on cognitive performances. The study would provide information about the benefit of water supplementation on cognitive performances. Ethics and Dissemination: The study protocol is reviewed and approved by the Ethical Review Committee of the Chinese Nutrition Society. Ethical approval project identification code is CNS-2015-001. Results will be published according to the CONSORT statement and will be reported in peer-reviewed journals. Trial registration: Chinese clinical trial registry. Identifier: ChiCTR-IOR-15007020. Registry name “The effect of hydration on cognitive performance”.
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Affiliation(s)
- Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Hai Dian District, Beijing 100191, China;
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Hai Dian District, Beijing 100191, China
| | - Songming Du
- Chinese Nutrition Society, 6 Guang An Men Nei Street, Xi Cheng District, Beijing 100053, China;
| | - Zhenchuang Tang
- Institute of Food and Nutrition Development, Ministry of Agriculture, 12 Zhong Guan Cun Nan Street, Hai Dian District, Beijing 100081, China;
| | - Mengqi Zheng
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nan Wei Road, Xi Chen District, Beijing 100050, China;
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Hai Dian District, Beijing 100191, China;
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Hai Dian District, Beijing 100191, China
- Correspondence: ; Tel.: +86-10-8280-5266
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