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Liu T, Shi C, Wei J, Xu R, Li Y, Wang R, Lu W, Liu L, Zhong C, Zhong Z, Zheng Y, Wang T, Hou S, Lv Z, Huang S, Chen G, Zhou Y, Sun H, Liu Y. Extreme temperature events and dementia mortality in Chinese adults: a population-based, case-crossover study. Int J Epidemiol 2024; 53:dyad119. [PMID: 37690069 DOI: 10.1093/ije/dyad119] [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: 02/22/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND The effect of exposure to extreme temperature events (ETEs) on dementia mortality remains largely unknown. We aimed to quantify the association of ETE exposure with dementia mortality. METHODS We conducted a population-based, case-crossover study among 57 791 dementia deaths in Jiangsu province, China, during 2015-20. Daily mean temperatures were extracted from a validated grid dataset at each subject's residential address, and grid-specific exposures to heat wave and cold spell were assessed with a combination of their intensity and duration. We applied conditional logistic regression models to investigate cumulative and lag effects for ETE exposures. RESULTS Exposure to ETE with each of all 24 definitions was associated with an increased odds of dementia mortality, which was higher when exposed to heat wave. Exposure to heat wave (daily mean temperature ≥95th percentile, duration ≥3 days (d); P95_3d) and cold spell (≤5th percentile, duration ≥3 d; P5_3d) was associated with a 75% (95% CI: 61%, 90%) and 30% (19%, 43%) increase in odds of dementia mortality, respectively. Definitions with higher intensity were generally associated with a higher odds of dementia mortality. We estimated that 6.14% of dementia deaths were attributable to exposure to heat wave (P90_2d) and cold spell (P10_2d). No effect modifications were observed by sex or age, except that the association for heat wave was stronger among women. CONCLUSIONS Exposure to both heat wave and cold spell was associated with an increased odds of dementia mortality. Our findings highlight that reducing individual ETE exposures may be helpful in preventing deaths from dementia, especially among women in summer.
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Affiliation(s)
- Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rui Wang
- Luohu District Chronic Disease Hospital, Shenzhen, Guangdong, China
| | - Wenfeng Lu
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Likun Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chenghui Zhong
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zihua Zhong
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tingting Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Sihan Hou
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ziquan Lv
- Central Laboratory, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yun Zhou
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hong Sun
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
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Lo Y, Vosper E, Higgins JP, Howard G. Heat impacts on human health in the Western Pacific Region: an umbrella review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100952. [PMID: 38022710 PMCID: PMC10652124 DOI: 10.1016/j.lanwpc.2023.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Background High temperatures and heatwaves are occurring more frequently and lasting longer because of climate change. A synthesis of existing evidence of heat-related health impacts in the Western Pacific Region (WPR) is lacking. This review addresses this gap. Methods The Scopus and PubMed databases were searched for reviews about heat impacts on mortality, cardiovascular morbidity, respiratory morbidity, dehydration and heat stroke, adverse birth outcomes, and sleep disturbance. The last search was conducted in February 2023 and only publications written in English were included. Primary studies and reviews that did not include specific WPR data were excluded. Data were extracted from 29 reviews. Findings There is strong evidence of heat-related mortality in the WPR, with the evidence concentrating on high-income countries and China. Associations between heat and cardiovascular or respiratory morbidity are not robust. There is evidence of heat-related dehydration and stroke, and preterm and still births in high-income countries in the WPR. Some evidence of sleep disturbance from heat is found for Australia, Japan and China. Interpretation Mortality is by far the most studied and robust health outcome of heat. Future research should focus on morbidity, and lower income countries in continental Asia and Pacific Island States, where there is little review-level evidence. Funding Funded by the World Health Organization WPR Office.
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Affiliation(s)
- Y.T.Eunice Lo
- Cabot Institute for the Environment, University of Bristol, UK
- Elizabeth Blackwell Institute for Health Research, University of Bristol, UK
| | - Emily Vosper
- Cabot Institute for the Environment, University of Bristol, UK
- School of Geographical Sciences, University of Bristol, UK
| | - Julian P.T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Guy Howard
- Cabot Institute for the Environment, University of Bristol, UK
- School of Civil, Aerospace and Design Engineering, University of Bristol, UK
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Hu P, Chang J, Huang Y, Guo M, Lu F, Long Y, Liu H, Yang X, Qi Y, Sun J, Yang Z, Deng Q, Liu J. Nonoptimum Temperatures Are More Closely Associated With Fatal Myocardial Infarction Than With Nonfatal Events. Can J Cardiol 2023; 39:1974-1983. [PMID: 37924969 PMCID: PMC10715678 DOI: 10.1016/j.cjca.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Ambient temperatures trigger hospitalisation, mortality, and emergency department visits for myocardial infarction (MI). However, nonoptimum temperature-related risks of fatal and nonfatal MI have not yet been compared. METHODS From 2007 to 2019, 416,894 MI events (233,071 fatal and 183,823 nonfatal) were identified in Beijing, China. A time-series analysis with a distributed-lag nonlinear model was used to compare the relative and population-attributable risks of fatal and nonfatal MI associated with nonoptimum temperatures. RESULTS The reference was the optimum temperature of 24.3°C. For single-lag effects, cold (-5.2°C) and heat (29.6°C) effects had associations that persisted for more days for fatal MI than for nonfatal MI. For cumulative-lag effects over 0 to 21 days, cold effects were higher for fatal MI (relative risk [RR] 1.99, 95% confidence interval [CI] 1.68-2.35) than for nonfatal MI (RR 1.60, 95% CI 1.32-1.94) with a P value for difference in effect sizes of 0.048. In addition, heat effects were higher for fatal MI (RR 1.33, 95% CI 1.24-1.44) than for nonfatal MI (RR 0.99, 95% CI 0.91-1.08) with a P value for difference in effect sizes of 0.002. The attributable fraction of nonoptimum temperatures was higher for fatal MI (25.6%, 95% CI 19.7%-30.6%) than for nonfatal MI (19.1%, 95% CI 12.1%-25.0%). CONCLUSIONS Fatal MI was more closely associated with nonoptimum temperatures than nonfatal MI, as evidenced by single-lag effects that have associations which persisted for more days, higher cumulative-lag effects, and higher attributable risks for fatal MI. Strategies are needed to mitigate the adverse effects of nonoptimum temperatures.
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Affiliation(s)
- Piaopiao Hu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jie Chang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yulin Huang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Moning Guo
- Beijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, China
| | - Feng Lu
- Beijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, China
| | - Ying Long
- School of Architecture, Tsinghua University, Beijing, China
| | - Huan Liu
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing, China
| | - Xudong Yang
- Departments of Building Science and Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yue Qi
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jiayi Sun
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zhao Yang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qiuju Deng
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Jing Liu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Takada A, Kodera S, Suzuki K, Nemoto M, Egawa R, Takizawa H, Hirata A. Estimation of the number of heat illness patients in eight metropolitan prefectures of Japan: Correlation with ambient temperature and computed thermophysiological responses. Front Public Health 2023; 11:1061135. [PMID: 36875384 PMCID: PMC9982159 DOI: 10.3389/fpubh.2023.1061135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
The number of patients with heat illness transported by ambulance has been gradually increasing due to global warming. In intense heat waves, it is crucial to accurately estimate the number of cases with heat illness for management of medical resources. Ambient temperature is an essential factor with respect to the number of patients with heat illness, although thermophysiological response is a more relevant factor with respect to causing symptoms. In this study, we computed daily maximum core temperature increase and daily total amount of sweating in a test subject using a large-scale, integrated computational method considering the time course of actual ambient conditions as input. The correlation between the number of transported people and their thermophysiological temperature is evaluated in addition to conventional ambient temperature. With the exception of one prefecture, which features a different Köppen climate classification, the number of transported people in the remaining prefectures, with a Köppen climate classification of Cfa, are well estimated using either ambient temperature or computed core temperature increase and daily amount of sweating. For estimation using ambient temperature, an additional two parameters were needed to obtain comparable accuracy. Even using ambient temperature, the number of transported people can be estimated if the parameters are carefully chosen. This finding is practically useful for the management of ambulance allocation on hot days as well as public enlightenment.
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Affiliation(s)
- Akito Takada
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Sachiko Kodera
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Koji Suzuki
- Architecture, Design, Civil Engineering, and Industrial Management Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Mio Nemoto
- Department of Environment Systems, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Ryusuke Egawa
- School of Engineering, Tokyo Denki University, Tokyo, Japan.,Cyberscience Center, Tohoku University, Sendai, Japan
| | | | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan
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Chaseling GK, Morris NB, Ravanelli N. Extreme Heat and Adverse Cardiovascular Outcomes in Australia and New Zealand: What Do We Know? Heart Lung Circ 2023; 32:43-51. [PMID: 36424263 DOI: 10.1016/j.hlc.2022.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 11/23/2022]
Abstract
Extreme heat events are a leading natural hazard risk to human health. Under all future climate change models, extreme heat events will continue to increase in frequency, duration, and intensity. Evidence from previous extreme heat events across the globe demonstrates that adverse cardiovascular events are the leading cause of morbidity and mortality, particularly amongst the elderly and those with pre-existing cardiovascular disease. However, less is understood about the adverse effects of extreme heat amongst specific cardiovascular diseases (i.e., heart failure, dysrhythmias) and demographics (sex, ethnicity, age) within Australia and New Zealand. Furthermore, although Australia has implemented regional and state heat warning systems, most personal heat-health protective advice available in public health policy documents is either insufficient, not grounded in scientific evidence, and/or does not consider clinical factors such as age or co-morbidities. Dissemination of evidence-based recommendations and enhancing community resilience to extreme heat disasters within Australia and New Zealand should be an area of critical focus to reduce the burden and negative health effects associated with extreme heat. This narrative review will focus on five key areas in relation to extreme heat events within Australia and New Zealand: 1) the potential physiological mechanisms that cause adverse cardiovascular outcomes during extreme heat events; 2) how big is the problem within Australia and New Zealand?; 3) what the heat-health response plans are; 4) research knowledge and translation; and, 5) knowledge gaps and areas for future research.
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Affiliation(s)
- Georgia K Chaseling
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; SOLVE-CHD NHMRC Synergy Grant, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Nathan B Morris
- Department of Human Physiology & Nutrition, University of Colorado, Colorado Springs, CO, USA
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Chen Y, Qin X. The Impact of Extreme Temperature Shocks on the Health Status of the Elderly in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15729. [PMID: 36497803 PMCID: PMC9738369 DOI: 10.3390/ijerph192315729] [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: 09/20/2022] [Revised: 11/10/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
With the accelerating process of climate change, long-term exposure to extreme temperatures could threaten individuals' physical health, especially for the vulnerable population. This paper aims to investigate the long-term effects of extreme temperature exposure on the health of the elderly in the context of climate change and aging. Different from most of the existing literature in environmental economics, we define the relative extreme temperature exposure based on the local temperature pattern. By combining a large national household survey and nationwide meteorologic historical data, this study provides empirical evidence that heat exposure days and cold exposure days during the past year both significantly affect the physical health of middle-aged and elderly groups, controlling for city, year, and individual fixed effects. The effect on individual physical health has certain seasonal characteristics and is heterogeneous across populations. Additionally, cooling and heating equipment are effective in alleviating the reverse impact of heat and cold exposure. The estimation is robust and consistent across a variety of temperature measurements and model modifications. Our findings provide evidence of the long-term and accumulative cost of extreme temperature to middle-aged and elderly human capital, contributing to helping the public to better understand the full impact of climate change.
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Affiliation(s)
- Yanran Chen
- School of Economics, Capital University of Economics and Business, Beijing 100070, China
| | - Xuezheng Qin
- School of Economics, Peking University, Beijing 100871, China
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Fritz M. Temperature and non-communicable diseases: Evidence from Indonesia's primary health care system. HEALTH ECONOMICS 2022; 31:2445-2464. [PMID: 35988141 DOI: 10.1002/hec.4590] [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: 01/03/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Climate change induced rising temperatures will pose a detrimental threat to decent health in the coming decades. Especially at risk are individuals with chronic diseases, since heat can exacerbate a variety of health conditions. In this article, I examine the heat-morbidity relationship in the context of Indonesia, focusing on chronic, non-communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Using a novel dataset from the Indonesian national health insurance scheme Jaminan Kesehatan Nasional/Badan Penyelenggara Jaminan Sosial (BPJS) and linking it with meteorological data on the daily-district level, I estimate the causal effect of high temperatures on the daily number of primary health care visits. The results show that on a hot day all-cause visits and visits with a diagnosis of diabetes and cardiovascular diseases increase by 8%, 25% and 14%, respectively. These increases are permanent and not offset by visit displacement or 'harvesting'. Visits related to respiratory diseases seem not to be affected by high temperatures. I use several climate change scenarios to predict the increase in visits and costs by the end of the century, which all forecast a substantial financial burden for the health care system. These results might have relevance for other middle-income countries with similar climatic conditions.
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Affiliation(s)
- Manuela Fritz
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
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8
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Tong M, Wondmagegn B, Xiang J, Hansen A, Dear K, Pisaniello D, Varghese B, Xiao J, Jian L, Scalley B, Nitschke M, Nairn J, Bambrick H, Karnon J, Bi P. Hospitalization Costs of Respiratory Diseases Attributable to Temperature in Australia and Projections for Future Costs in the 2030s and 2050s under Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159706. [PMID: 35955062 PMCID: PMC9368165 DOI: 10.3390/ijerph19159706] [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: 06/20/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 05/06/2023]
Abstract
This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010-2016 were analyzed using distributed non-linear lag models. Future hospitalization costs were estimated based on three predicted climate change scenarios-RCP2.6, RCP4.5 and RCP8.5. The estimated respiratory disease hospitalization costs attributable to ambient temperatures increased from 493.2 million Australian dollars (AUD) in the 2010s to more than AUD 700 million in 2050s in Sydney and from AUD 98.0 million to about AUD 150 million in Perth. The current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1-20.1%) and (5.1-6.6%), respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Limitations of this study should be noted, such as lacking information on individual-level exposures, local air pollution levels, and other behavioral risks, which is common in such ecological studies. Nonetheless, this study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change may result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location.
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Affiliation(s)
- Michael Tong
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Berhanu Wondmagegn
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Alana Hansen
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Blesson Varghese
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianguo Xiao
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Le Jian
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Benjamin Scalley
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Monika Nitschke
- Department of Health, Government of South Australia, Adelaide, SA 5000, Australia
| | - John Nairn
- Australian Bureau of Meteorology, Adelaide, SA 5000, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QL 4000, Australia
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5001, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
- Correspondence: ; Tel.: +61-8-8313-3583
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9
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Abstract
Rationale: Avoiding excess health damages attributable to climate change is a primary motivator for policy interventions to reduce greenhouse gas emissions. However, the health benefits of climate mitigation, as included in the policy assessment process, have been estimated without much input from health experts. Objectives: In accordance with recommendations from the National Academies in a 2017 report on approaches to update the social cost of greenhouse gases (SC-GHG), an expert panel of 26 health researchers and climate economists gathered for a virtual technical workshop in May 2021 to conduct a systematic review and meta-analysis and recommend improvements to the estimation of health impacts in economic-climate models. Methods: Regionally resolved effect estimates of unit increases in temperature on net all-cause mortality risk were generated through random-effects pooling of studies identified through a systematic review. Results: Effect estimates and associated uncertainties varied by global region, but net increases in mortality risk associated with increased average annual temperatures (ranging from 0.1% to 1.1% per 1°C) were estimated for all global regions. Key recommendations for the development and utilization of health damage modules were provided by the expert panel and included the following: not relying on individual methodologies in estimating health damages; incorporating a broader range of cause-specific mortality impacts; improving the climate parameters available in economic models; accounting for socioeconomic trajectories and adaptation factors when estimating health damages; and carefully considering how air pollution impacts should be incorporated in economic-climate models. Conclusions: This work provides an example of how subject-matter experts can work alongside climate economists in making continued improvements to SC-GHG estimates.
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Understanding current and projected emergency department presentations and associated healthcare costs in a changing thermal climate in Adelaide, South Australia. Occup Environ Med 2022; 79:421-426. [DOI: 10.1136/oemed-2021-107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/18/2022] [Indexed: 11/03/2022]
Abstract
BackgroundExposure to extreme temperatures is associated with increased emergency department (ED) presentations. The resulting burden on health service costs and the potential impact of climate change is largely unknown. This study examines the temperature-EDs/cost relationships in Adelaide, South Australia and how this may be impacted by increasing temperatures.MethodsA time series analysis using a distributed lag nonlinear model was used to explore the exposure–response relationships. The net-attributable, cold-attributable and heat-attributable ED presentations for temperature-related diseases and costs were calculated for the baseline (2014–2017) and future periods (2034–2037 and 2054–2057) under three climate representative concentration pathways (RCPs).ResultsThe baseline heat-attributable ED presentations were estimated to be 3600 (95% empirical CI (eCI) 700 to 6500) with associated cost of $A4.7 million (95% eCI 1.8 to 7.5). Heat-attributable ED presentations and costs were projected to increase during 2030s and 2050s with no change in the cold-attributable burden. Under RCP8.5 and population growth, the increase in heat-attributable burden would be 1.9% (95% eCI 0.8% to 3.0%) for ED presentations and 2.5% (95% eCI 1.3% to 3.7%) for ED costs during 2030s. Under the same conditions, the heat effect is expected to increase by 3.7% (95% eCI 1.7% to 5.6%) for ED presentations and 5.0% (95% eCI 2.6% to 7.1%) for ED costs during 2050s.ConclusionsProjected climate change is likely to increase heat-attributable emergency presentations and the associated costs in Adelaide. Planning health service resources to meet these changes will be necessary as part of broader risk mitigation strategies and public health adaptation actions.
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Alsaiqali M, De Troeyer K, Casas L, Hamdi R, Faes C, Van Pottelbergh G. The Effects of Heatwaves on Human Morbidity in Primary Care Settings: A Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:832. [PMID: 35055653 PMCID: PMC8775418 DOI: 10.3390/ijerph19020832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE This study assesses the potential acute effects of heatwaves on human morbidities in primary care settings. METHODS We performed a time-stratified case-crossover study to assess the acute effects of heatwaves on selected morbidities in primary care settings in Flanders, Belgium, between 2000 and 2015. We used conditional logistic regression models. We assessed the effect of heatwaves on the day of the event (lag 0) and X days earlier (lags 1 to X). The associations are presented as Incidence Density Ratios (IDR). RESULTS We included 22,344 events. Heatwaves are associated with increased heat-related morbidities such as heat stroke IDR 3.93 [2.94-5.26] at lag 0, dehydration IDR 3.93 [2.94-5.26] at lag 1, and orthostatic hypotension IDR 2.06 [1.37-3.10] at lag 1. For cardiovascular morbidities studied, there was only an increased risk of stroke at lag 3 IDR 1.45 [1.04-2.03]. There is no significant association with myocardial ischemia/infarction or arrhythmia. Heatwaves are associated with decreased respiratory infection risk. The IDR for upper respiratory infections is 0.82 [0.78-0.87] lag 1 and lower respiratory infections (LRI) is 0.82 [0.74-0.91] at lag 1. There was no significant effect modification by age or premorbid chronic disease (diabetes, hypertesnsion). CONCLUSION Heatwaves are associated with increased heat-related morbidities and decreased respiratory infection risk. The study of heatwaves' effects in primary care settings helps evaluate the impact of heatwaves on the general population. Primary care settings might be not suitable to study acute life-threatening morbidities.
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Affiliation(s)
- Mahmoud Alsaiqali
- Epidemiology and Social Medicine (ESOC), University of Antwerp, 2610 Antwerp, Belgium;
| | - Katrien De Troeyer
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (K.D.T.); (G.V.P.)
| | - Lidia Casas
- Epidemiology and Social Medicine (ESOC), University of Antwerp, 2610 Antwerp, Belgium;
| | - Rafiq Hamdi
- Royal Meteorological Institute of Belgium, B-1180 Brussels, Belgium;
| | - Christel Faes
- Data Science Institute (DSI), I-BioStat, Hasselt University, BE-3500 Hasselt, Belgium;
| | - Gijs Van Pottelbergh
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (K.D.T.); (G.V.P.)
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12
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Liu J, Varghese BM, Hansen A, Borg MA, Zhang Y, Driscoll T, Morgan G, Dear K, Gourley M, Capon A, Bi P. Hot weather as a risk factor for kidney disease outcomes: A systematic review and meta-analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 801:149806. [PMID: 34467930 DOI: 10.1016/j.scitotenv.2021.149806] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The occurrence or exacerbation of kidney disease has been documented as a growing problem associated with hot weather. The implementation of effective prevention measures requires a better understanding of the risk factors that increase susceptibility. To fill gaps in knowledge, this study reviews the current literature on the effects of heat on kidney-disease outcomes (ICD-10 N00-N39), including morbidity and mortality. METHODS Databases were systematically searched for relevant literature published between 1990 and 2020 and the quality of evidence evaluated. We performed random effects meta-analysis to calculate the pooled relative risks (RRs) of the association between high temperatures (and heatwaves) and kidney disease outcomes. We further evaluated vulnerability concerning contextual population characteristics. RESULTS Of 2739 studies identified, 91 were reviewed and 82 of these studies met the criteria for inclusion in a meta-analysis. Findings showed that with a 1 °C increase in temperature, the risk of kidney-related morbidity increased by 1% (RR 1.010; 95% CI: 1.009-1.011), with the greatest risk for urolithiasis. Heatwaves were also associated with increased morbidity with a trend observed with heatwave intensity. During low-intensity heatwaves, there was an increase of 5.9% in morbidity, while during high-intensity heatwaves there was a 7.7% increase. There were greater RRs for males, people aged ≤64 years, and those living in temperate climate zones. Similarly, for every 1 °C temperature increase, there was a 3% (RR 1.031; 95% CI: 1.018-1.045) increase in the risk of kidney-related mortality, which also increased during heatwaves. CONCLUSIONS High temperatures (and heatwaves) are associated with an elevated risk of kidney disease outcomes, particularly urolithiasis. Preventive measures that may minimize risks in vulnerable individuals during hot spells are discussed.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Matthew A Borg
- School of Public Health, The University of Adelaide, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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13
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Ghada W, Estrella N, Ankerst DP, Menzel A. Universal thermal climate index associations with mortality, hospital admissions, and road accidents in Bavaria. PLoS One 2021; 16:e0259086. [PMID: 34788302 PMCID: PMC8598056 DOI: 10.1371/journal.pone.0259086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
Abstract
When meteorological conditions deviate from the optimal range for human well-being, the risks of illness, injury, and death increase, and such impacts are feared in particular with more frequent and intense extreme weather conditions resulting from climate change. Thermal indices, such as the universal thermal climate index (UTCI), can better assess human weather-related stresses by integrating multiple weather components. This paper quantifies and compares the seasonal and spatial association of UTCI with mortality, morbidity, and road accidents in the federal state of Bavaria, Germany. Linear regression was applied to seasonally associate daily 56 million hospital admissions and 2.5 million death counts (1995-2015) as well as approximately 930,000 road accidents and 1.7 million people injured (2002-2015) with spatially interpolated same day- and lagged- (up to 14 days) average UTCI values. Additional linear regressions were performed stratifying by age, gender, region, and district. UTCI effects were clear in all three health outcomes studied: Increased UTCI resulted in immediate (1-2 days) rises in morbidity and even more strongly in mortality in summer, and lagged (up to 14 days) decreases in fall, winter, and spring. The strongest UTCI effects were found for road accidents where increasing UTCI led to immediate decreases in daily road accidents in winter but pronounced increases in all other seasons. Differences in UTCI effects were observed e.g. between in warmer north-western regions (Franconia, more districts with heat stress-related mortality, but hospital admissions for lung, heart and external reasons decreasing with summer heat stress), the touristic alpine regions in the south (immediate effect of increasing UTCI on road accidents in summer), and the colder south-eastern regions (increasing hospital admissions for lung, heart and external reasons in winter with UTCI). Districts with high percentages of elderly suffered from higher morbidity and mortality, particularly in winter. The influences of UTCI as well as the spatial and temporal patterns of this influence call for improved infrastructure planning and resource allocation in the health sector.
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Affiliation(s)
- Wael Ghada
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
| | - Nicole Estrella
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
| | - Donna P. Ankerst
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
- Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Annette Menzel
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
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14
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Campbell SL, Remenyi T, Williamson GJ, Rollins D, White CJ, Johnston FH. Ambulance dispatches and heatwaves in Tasmania, Australia: A case-crossover analysis. ENVIRONMENTAL RESEARCH 2021; 202:111655. [PMID: 34252428 DOI: 10.1016/j.envres.2021.111655] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/30/2021] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Climate change is causing an increase in the frequency and severity of heatwave events, with a corresponding negative impact on human health. Health service utilisation during a heatwave is increased, with a greater risk of poor health outcomes identified for specific population groups. In this study, we examined the impact of heatwave events on ambulance dispatches in Tasmania, Australia from 2008 to 2019 to explore health service utilisation and identify the most vulnerable populations at a local level. METHODS We used a time-stratified case-crossover analysis with conditional logistic regression to examine the association between ambulance dispatches and three levels of heatwave events (extreme, severe, and low-intensity). We examined the relationship for the whole study population, and by age, gender, socio-economic advantage and clinical diagnostic group. RESULTS We found that ambulance dispatches increase by 34% (OR 1.34, 95% CI 1.18-1.52) during extreme heatwaves, by 10% (OR 1.10, 95% CI 1.05-1.15) during severe heatwaves and by 4% (OR 1.04, 95% CI 1.02-1.06) during low-intensity heatwaves. We found significant associations for the elderly (over 65), the young (5 and under) and for regions with the greatest socio-economic disadvantage. CONCLUSION Heatwaves were associated with increased demands on ambulance services in Tasmania. In subgroups of people aged over 65 or under 5 years of age, and those from areas of higher disadvantage, we generally observed greater effect sizes than for the population as a whole.
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Affiliation(s)
- Sharon L Campbell
- Menzies Institute for Medical Research, University of Tasmania, 1 Liverpool St, Hobart, Tasmania, 7000, Australia; Public Health Services, Department of Health (Tasmania), 25 Argyle St, Hobart, Tasmania, 7000, Australia.
| | - Tomas Remenyi
- Climate Futures Programme, Geography, Planning and Spatial Sciences, School of Technology, Environments and Design, University of Tasmania, Sandy Bay Campus, Churchill Ave, Hobart, Tasmania, 7001, Australia.
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Sandy Bay Campus, Churchill Ave, Hobart, Tasmania, 7001, Australia.
| | - Dean Rollins
- Climate Futures Programme, Geography, Planning and Spatial Sciences, School of Technology, Environments and Design, University of Tasmania, Sandy Bay Campus, Churchill Ave, Hobart, Tasmania, 7001, Australia.
| | - Christopher J White
- Department of Civil and Environmental Engineering, University of Strathclyde, James Weir Building, 75 Montrose Street, Glasgow, G1 1XJ, United Kingdom.
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, 1 Liverpool St, Hobart, Tasmania, 7000, Australia; Public Health Services, Department of Health (Tasmania), 25 Argyle St, Hobart, Tasmania, 7000, Australia.
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15
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Kegel F, Luo OD, Richer S. The Impact of Extreme Heat Events on Emergency Departments in Canadian Hospitals. Wilderness Environ Med 2021; 32:433-440. [PMID: 34364750 DOI: 10.1016/j.wem.2021.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Mean daily temperatures in Canada rose 1.7°C between 1948 and 2016, and the frequency, severity, and duration of extreme heat events has increased. These events can exacerbate underlying health conditions, bringing patients to emergency departments (EDs). This retrospective analysis assessed the impact of temperature and humidex on ED volume and length of stay (LOS). METHODS LOS is an indicator of ED overcrowding and system performance. Using daily maximum temperatures and humidex values, this study investigated the impact of mean 3-d temperatures and humidex preceding ED presentation on the median and maximum ED LOS and patient volume in 2 community hospitals in Montreal, Quebec, during the summer months of 2016 to 2018. Data were analyzed with 1-way analysis of variance with post hoc Fisher least significant difference tests and Spearman correlation tests. RESULTS The mean maximum temperature and humidex were 26.1°C and 30.4°C, respectively (n=276 d). Mean 3-d temperatures ≥30°C were associated with higher daily ED volumes in both hospitals (138 vs 121, P=0.002 and 132 vs 125, P=0.03) and with increased median LOS at 1 hospital (8.9 vs 7.6 h, P=0.03). Mean 3-d humidex ≥35 was associated with higher daily ED volumes at both hospitals as well (136 vs 123, P=0.01 and 133 vs 125, P=0.009) with an increased median LOS at 1 hospital (8.6 vs 6.9 h, P=0.0001) with humidex values of 25 to 29.9°C. CONCLUSIONS Heat events were associated with increased ED presentations and LOS. This study suggests that a warming climate can impede emergency service provision by increasing the demand for and delaying timely care.
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Affiliation(s)
- Fraser Kegel
- Department of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Owen D Luo
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Signe Richer
- Verdun Hospital, McGill University, Montreal, Quebec, Canada.
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16
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Increasing impacts of temperature on hospital admissions, length of stay, and related healthcare costs in the context of climate change in Adelaide, South Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145656. [PMID: 33592481 DOI: 10.1016/j.scitotenv.2021.145656] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND A growing number of studies have investigated the effect of increasing temperatures on morbidity and health service use. However, there is a lack of studies investigating the temperature-attributable cost burden. OBJECTIVES This study examines the relationship of daily mean temperature with hospital admissions, length of hospital stay (LoS), and costs; and estimates the baseline temperature-attributable hospital admissions, and costs and in relation to warmer climate scenarios in Adelaide, South Australia. METHOD A daily time series analysis using distributed lag non-linear models (DLNM) was used to explore exposure-response relationships and to estimate the aggregated burden of hospital admissions for conditions associated with temperatures (i.e. renal diseases, mental health, diabetes, ischaemic heart diseases and heat-related illnesses) as well as the associated LoS and costs, for the baseline period (2010-2015) and different future climate scenarios in Adelaide, South Australia. RESULTS During the six-year baseline period, the overall temperature-attributable hospital admissions, LoS, and associated costs were estimated to be 3915 cases (95% empirical confidence interval (eCI): 235, 7295), 99,766 days (95% eCI: 14,484, 168,457), and AU$159 million (95% eCI: 18.8, 269.0), respectively. A climate scenario consistent with RCP8.5 emissions, and including projected demographic change, is estimated to lead to increases in heat-attributable hospital admissions, LoS, and costs of 2.2% (95% eCI: 0.5, 3.9), 8.4% (95% eCI: 1.1, 14.3), and 7.7% (95% eCI: 0.3, 13.3), respectively by mid-century. CONCLUSIONS There is already a substantial temperature-attributable impact on hospital admissions, LoS, and costs which are estimated to increase due to climate change and an increasing aged population. Unless effective climate and public health interventions are put into action, the costs of treating temperature-related admissions will be high.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia; College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Keith Dear
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Alana Hansen
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Monika Nitschke
- South Australian Department of Health and Wellbeing, Adelaide, South Australia, Australia.
| | - John Nairn
- Australian Bureau of Meteorology, South Australia, Australia.
| | - Ben Scalley
- Metropolitan Communicable Disease Control, Department of Health WA, Perth, Western Australia, Australia.
| | - Alex Xiao
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Michael Tong
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
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17
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Jiang S, Warren JL, Scovronick N, Moss SE, Darrow LA, Strickland MJ, Newman AJ, Chen Y, Ebelt ST, Chang HH. Using logic regression to characterize extreme heat exposures and their health associations: a time-series study of emergency department visits in Atlanta. BMC Med Res Methodol 2021; 21:87. [PMID: 33902463 PMCID: PMC8077733 DOI: 10.1186/s12874-021-01278-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background Short-term associations between extreme heat events and adverse health outcomes are well-established in epidemiologic studies. However, the use of different exposure definitions across studies has limited our understanding of extreme heat characteristics that are most important for specific health outcomes or subpopulations. Methods Logic regression is a statistical learning method for constructing decision trees based on Boolean combinations of binary predictors. We describe how logic regression can be utilized as a data-driven approach to identify extreme heat exposure definitions using health outcome data. We evaluated the performance of the proposed algorithm in a simulation study, as well as in a 20-year time-series analysis of extreme heat and emergency department visits for 12 outcomes in the Atlanta metropolitan area. Results For the Atlanta case study, our novel application of logic regression identified extreme heat exposure definitions that were associated with several heat-sensitive disease outcomes (e.g., fluid and electrolyte imbalance, renal diseases, ischemic stroke, and hypertension). Exposures were often characterized by extreme apparent minimum temperature or maximum temperature over multiple days. The simulation study also demonstrated that logic regression can successfully identify exposures of different lags and duration structures when statistical power is sufficient. Conclusion Logic regression is a useful tool for identifying important characteristics of extreme heat exposures for adverse health outcomes, which may help improve future heat warning systems and response plans. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01278-x.
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Affiliation(s)
- Shan Jiang
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, USA
| | - Joshua L Warren
- Department of Biostatistics, Yale University, New Haven, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Emory University, Atlanta, USA
| | - Shannon E Moss
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, USA
| | - Lyndsey A Darrow
- School of Community Health Sciences, University of Nevada Reno, Reno, USA
| | | | - Andrew J Newman
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, USA
| | - Yong Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, USA
| | - Stefanie T Ebelt
- Gangarosa Department of Environmental Health, Emory University, Atlanta, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, USA.
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Abstract
Climate change increases the frequency and intensity of heatwaves, causing significant human and material losses every year. Big data, whose volumes are rapidly increasing, are expected to be used for preemptive responses. However, human cognitive abilities are limited, which can lead to ineffective decision making during disaster responses when artificial intelligence-based analysis models are not employed. Existing prediction models have limitations with regard to their validation, and most models focus only on heat-associated deaths. In this study, a random forest model was developed for the weekly prediction of heat-related damages on the basis of four years (2015–2018) of statistical, meteorological, and floating population data from South Korea. The model was evaluated through comparisons with other traditional regression models in terms of mean absolute error, root mean squared error, root mean squared logarithmic error, and coefficient of determination (R2). In a comparative analysis with observed values, the proposed model showed an R2 value of 0.804. The results show that the proposed model outperforms existing models. They also show that the floating population variable collected from mobile global positioning systems contributes more to predictions than the aggregate population variable.
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Urban Overheating and Cooling Potential in Australia: An Evidence-Based Review. CLIMATE 2020. [DOI: 10.3390/cli8110126] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cities in Australia are experiencing unprecedented levels of urban overheating, which has caused a significant impact on the country’s socioeconomic environment. This article provides a comprehensive review on urban overheating, its impact on health, energy, economy, and the heat mitigation potential of a series of strategies in Australia. Existing studies show that the average urban heat island (UHI) intensity ranges from 1.0 °C to 13.0 °C. The magnitude of urban overheating phenomenon in Australia is determined by a combination of UHI effects and dualistic atmospheric circulation systems (cool sea breeze and hot desert winds). The strong relation between multiple characteristics contribute to dramatic fluctuations and high spatiotemporal variabilities in urban overheating. In addition, urban overheating contributes to serious impacts on human health, energy costs, thermal comfort, labour productivity, and social behaviour. Evidence suggest that cool materials, green roofs, vertical gardens, urban greenery, and water-based technologies can significantly alleviate the UHI effect, cool the ambient air, and create thermally balanced cities. Urban greenery, especially trees, has a high potential for mitigation. Trees and hedges can reduce the average maximum UHI by 1.0 °C. The average maximum mitigation performance values of green roofs and green walls are 0.2 °C and 0.1 °C, respectively. Reflective roofs and pavements can reduce the average maximum UHI by 0.3 °C. In dry areas, water has a high cooling potential. The average maximum cooling potential using only one technology is 0.4 °C. When two or more technologies are used at the same time, the average maximum UHI drop is 1.5 °C. The mitigation strategies identified in this article can help the governments and other stakeholders manage urban heating in the natural and built environment, and save health, energy, and economic costs.
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20
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Dutta A, Bhattacharya S, Ak K, Pati S, Swain S, Nanda L. At which temperature do the deleterious effects of ambient heat "kick-in" to affect all-cause mortality? An exploration of this threshold from an eastern Indian city. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:187-197. [PMID: 30855980 DOI: 10.1080/09603123.2019.1587389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
Despite experiencing hot weathers, limited studies from India explored relationships between ambient heat and health. We studied associations between heat and all-cause mortality to estimate heat threshold(s) affecting health, and examine other affecting dimensions. We conducted time-series analysis with daily maximum temperature and all-cause mortality data of Bhubaneswar city (March-July, 2007-2017), and explored their interactions. Mortality risks rose when daily maximum temperatures were >36.2°C (lower threshold), and even more when >40.5°C (upper threshold). Every degree above36.2°C increased the mortality risk by 2% (mortality rate ratio: 1.02; 95% CI 1.01, 1.03). The effects of maximum temperature increased on days when minimum temperatures were >25.6°C (median). The effect of heat was immediate and lasted for 0-1 day with no lagged effect. Two temperature thresholds with varying mortality risks provided an opportunity for a graded heat warning system. The accentuation of the deleterious effects of heat by the higher minimum temperature calls for its inclusion in the heat warning system in future.
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Affiliation(s)
- Ambarish Dutta
- Indian Institute of Public Health, Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
- School of Public Health, Kalinga Institute of Industrial Technology deemed to be University, Bhubaneswar, India
| | - Shreeporna Bhattacharya
- Indian Institute of Public Health, Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
| | - Kavitha Ak
- School of Public Health, Kalinga Institute of Industrial Technology deemed to be University, Bhubaneswar, India
| | - Sanghamitra Pati
- Regional Medical Research Centre Indian Council of Medical Research, Bhubaneswar, India
| | | | - Lipika Nanda
- Indian Institute of Public Health, Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
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21
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Davis RE, Hondula DM, Sharif H. Examining the diurnal temperature range enigma: why is human health related to the daily change in temperature? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:397-407. [PMID: 31720855 DOI: 10.1007/s00484-019-01825-8] [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: 07/23/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 05/09/2023]
Abstract
An increasing number of epidemiological studies are finding statistical evidence that diurnal temperature range (DTR) is positively correlated to human morbidity and mortality despite the lack of clear clinical understanding. We examine a 14-year daily time series of emergency department (ED) admissions to the University of Virginia Medical Center in Charlottesville, Virginia, relative to long-term climate records from the Charlottesville/Albemarle County Airport weather station and the Spatial Synoptic Classification. DTR has a consistent strong positive correlation (r ~ 0.5) with maximum temperature in all months but only a weak, negative correlation (r ~- 0.1) with minimum temperature except in late summer (r ~- 0.4). Warm season DTR is highest on dry air mass days with low dew point temperatures. Cool season DTR is unrelated to morning temperature. Using a distributed lag non-linear model with an emphasis on DTR and its seasonal variation, after stratifying the models by season, we find that ED visits are linked to extreme cold events (cold days and nights) and high DTR in the cold season. In the warm season, ED visits are also linked to high DTR, but these are cool, dry, and pleasant days. The existing confusion regarding interpretation of DTR impacts on health might be rectified through a more careful analysis of the underlying physical factors that drive variations in DTR over the course of a year.
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Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, P.O. Box 400123, Charlottesville, VA, 22904-4123, USA.
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, 85281, USA
| | - Humna Sharif
- Department of Environmental Sciences, University of Virginia, P.O. Box 400123, Charlottesville, VA, 22904-4123, USA
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Regional Temperature-Sensitive Diseases and Attributable Fractions in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010184. [PMID: 31888051 PMCID: PMC6982219 DOI: 10.3390/ijerph17010184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/23/2019] [Accepted: 12/25/2019] [Indexed: 12/12/2022]
Abstract
Few studies have been carried out to systematically screen regional temperature-sensitive diseases. This study was aimed at systematically and comprehensively screening both high- and low-temperature-sensitive diseases by using mortality data from 17 study sites in China located in temperate and subtropical climate zones. The distributed lag nonlinear model (DLNM) was applied to quantify the association between extreme temperature and mortality to screen temperature-sensitive diseases from 18 kinds of diseases of eight disease systems. The attributable fractions (AFs) of sensitive diseases were calculated to assess the mortality burden attributable to high and low temperatures. A total of 1,380,713 records of all-cause deaths were involved. The results indicate that injuries, nervous, circulatory and respiratory diseases are sensitive to heat, with the attributable fraction accounting for 6.5%, 4.2%, 3.9% and 1.85%, respectively. Respiratory and circulatory diseases are sensitive to cold temperature, with the attributable fraction accounting for 13.3% and 11.8%, respectively. Most of the high- and low-temperature-sensitive diseases seem to have higher relative risk in study sites located in subtropical zones than in temperate zones. However, the attributable fractions for mortality of heat-related injuries were higher in temperate zones. The results of this research provide epidemiological evidence of the relative burden of mortality across two climate zones in China.
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23
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Xu X, Li J, Gao J, Liu K, Liu Q. Effective analysis of a community-based intervention during heat waves to improve knowledge, attitude and practice in a population in Licheng District, Jinan City, China. J Public Health (Oxf) 2019; 40:573-581. [PMID: 28977506 DOI: 10.1093/pubmed/fdx121] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Indexed: 01/21/2023] Open
Abstract
Background Intervention strategies that focus on coping with continuous heat wave threats have been implemented in many countries. Despite these efforts, we still lack evidence concerning intervention efficacy. A Heat Wave Intervention Program (HWIP) that impacts knowledge, attitude and practice (KAP) was designed, and its effectiveness during heat waves was evaluated. Methods A stratified two-stage probability proportion to size sampling method was employed to analyze an intervention group and a control group. Two cross-sectional surveys, which included questions about heat waves in 2014 and 2015, were analyzed using difference-in-difference (DID) analysis. Results Mean KAP scores among participants with different demographic characteristics in the intervention group were higher in 2015 than those in 2014. Further analysis by DID found that implementing interventions was positively associated with knowledge (ß = 0.387, P < 0.001) and attitude (ß = 0.166, P < 0.01). Conclusion Intervention measures can significantly promote levels of knowledge and attitude. However, as the practice level, most of the sub-groups showed no significant differences for net values between in the intervention group and control group. A cost-benefit analysis was suggested as future work to check the effectiveness of the program. Therefore, further improvement measures should be targeted towards the populations to enable them to effectively cope with the heat waves.
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Affiliation(s)
- Xin Xu
- Department of Dentistry, Affiliated Hospital, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Jing Li
- Public Health Department of Weifang Medical University, Weifang, Shandong Province, PR China.,State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jinghong Gao
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Keke Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
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Varghese BM, Barnett AG, Hansen AL, Bi P, Heyworth JS, Sim MR, Hanson-Easey S, Nitschke M, Rowett S, Pisaniello DL. Geographical variation in risk of work-related injuries and illnesses associated with ambient temperatures: A multi-city case-crossover study in Australia, 2005-2016. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 687:898-906. [PMID: 31412493 DOI: 10.1016/j.scitotenv.2019.06.098] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/17/2019] [Accepted: 06/06/2019] [Indexed: 05/14/2023]
Abstract
BACKGROUND The thermal working environment can have direct and in-direct effects on health and safety. Ambient temperatures have been associated with an increased risk of occupational injuries but it is unknown how the relationship can vary by weather, location and climate. OBJECTIVES To examine the relationship between ambient temperatures and work-related injury and illness compensation claims in three Australian cities: Melbourne and Perth (temperate climate) and Brisbane (subtropical climate) in order to determine how hot and cold weather influences the risk of occupational injury in Australia. METHODS Workers' compensation claims from each city for the period 2005 to 2016 were merged with local daily weather data. A time-stratified case-crossover design combined with a distributed lag non-linear model was used to quantify the impacts of daily maximum temperature (Tmax) on the risk of work-related injuries and illnesses. RESULTS Compared to the median maximum temperature (Tmax), extremely hot temperatures (99th percentile) were associated with a 14% (95%CI: 3-25%) increase in total workers' compensation claims in Melbourne, but there were no observed effects in Brisbane or Perth, with the exception of traumatic injuries that increased by 17% (95%CI: 3-35%) during extreme heat in Perth. For extremely low temperatures (1st percentile), there was a protective effect in Brisbane (RR 0.89; 95%CI: 0.81-0.98), while no effects were observed in Melbourne or Perth. CONCLUSION The relationship between injury and ambient temperature appears to be variable depending on location and climate. In general, work-related injuries and illnesses appear to be more common at higher temperatures than lower temperatures. Adopting adaptation and prevention measures could reduce the social and economic burden of injury, and formulating effective measures for dealing with high temperatures should be prioritised given the predicted increase in the frequency and intensity of hot weather.
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Affiliation(s)
- Blesson M Varghese
- The University of Adelaide, School of Public Health, Adelaide, Australia
| | - Adrian G Barnett
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Alana L Hansen
- The University of Adelaide, School of Public Health, Adelaide, Australia
| | - Peng Bi
- The University of Adelaide, School of Public Health, Adelaide, Australia
| | - Jane S Heyworth
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, The Alfred Centre, Monash University, Melbourne, Victoria, Australia
| | - Scott Hanson-Easey
- The University of Adelaide, School of Public Health, Adelaide, Australia
| | - Monika Nitschke
- Department for Health and Wellbeing, Government of South Australia, 11 Hindmarsh Square, Adelaide, SA 5000, Australia
| | - Shelley Rowett
- SafeWork SA, Government of South Australia, 33 Richmond Road, Keswick, SA 5035, Australia
| | - Dino L Pisaniello
- The University of Adelaide, School of Public Health, Adelaide, Australia.
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25
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Campbell SL, Remenyi TA, Williamson GJ, White CJ, Johnston FH. The Value of Local Heatwave Impact Assessment: A Case-Crossover Analysis of Hospital Emergency Department Presentations in Tasmania, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193715. [PMID: 31581630 PMCID: PMC6801666 DOI: 10.3390/ijerph16193715] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022]
Abstract
Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events on hospital emergency department (ED) presentations in the two most populous regions of Tasmania, Australia, from 2008–2016. Using conditional logistic regression, we analyzed the relationship between ED presentations and severe/extreme heatwaves for the whole population, specific demographics including age, gender and socio-economic advantage, and diagnostic conditions that are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05, 95% CI 1.01–1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03–1.24) for children 15 years and under, and by 19% (OR 1.19, 95% CI 1.04–1.36) for children 5 years and under. A less precise association in the same direction was found for those over 65 years. For diagnostic subgroups, non-significant increases in ED presentations were observed for asthma, diabetes, hypertension, and atrial fibrillation. These findings may assist ED surge capacity planning and public health preparedness and response activities for heatwave events in Tasmania, highlighting the importance of using local research to inform local practice.
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Affiliation(s)
- Sharon L Campbell
- Menzies Institute for Medical Research, University of Tasmania, 1 Liverpool St, Hobart, Tasmania 7000, Australia.
- Public Health Services, Department of Health (Tasmania), 25 Argyle St, Hobart, Tasmania 7000, Australia.
| | - Tomas A Remenyi
- Antarctic Climate and Ecosystems Cooperative Research Centre, University of Tasmania, 20 Castray Esplanade, Hobart, Tasmania 7000, Australia.
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania 7001, Australia.
| | - Christopher J White
- Antarctic Climate and Ecosystems Cooperative Research Centre, University of Tasmania, 20 Castray Esplanade, Hobart, Tasmania 7000, Australia.
- Department of Civil and Environmental Engineering, University of Strathclyde, James Weir Building, 75 Montrose Street, Glasgow G1 1XJ, UK.
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, 1 Liverpool St, Hobart, Tasmania 7000, Australia.
- Public Health Services, Department of Health (Tasmania), 25 Argyle St, Hobart, Tasmania 7000, Australia.
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26
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Varghese BM, Barnett AG, Hansen AL, Bi P, Nairn J, Rowett S, Nitschke M, Hanson-Easey S, Heyworth JS, Sim MR, Pisaniello DL. Characterising the impact of heatwaves on work-related injuries and illnesses in three Australian cities using a standard heatwave definition- Excess Heat Factor (EHF). JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:821-830. [PMID: 30988389 DOI: 10.1038/s41370-019-0138-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/07/2019] [Accepted: 03/04/2019] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND AIMS Heatwaves have potential health and safety implications for many workers, and heatwaves are predicted to increase in frequency and intensity with climate change. There is currently a lack of comparative evidence for the effects of heatwaves on workers' health and safety in different climates (sub-tropical and temperate). This study examined the relationship between heatwave severity (as defined by the Excess Heat Factor) and workers' compensation claims, to define impacts and identify workers at higher risk. METHODS Workers' compensation claims data from Australian cities with temperate (Melbourne and Perth) and subtropical (Brisbane) climates for the years 2006-2016 were analysed in relation to heatwave severity categories (low and moderate/high severity) using time-stratified case-crossover models. RESULTS Consistent impacts of heatwaves were observed in each city with either a protective or null effect during heatwaves of low-intensity while claims increased during moderate/high-severity heatwaves compared with non-heatwave days. The highest effect during moderate/high-severity heatwaves was in Brisbane (RR 1.45, 95% CI: 1.42-1.48). Vulnerable worker subgroups identified across the three cities included: males, workers aged under 34 years, apprentice/trainee workers, labour hire workers, those employed in medium and heavy strength occupations, and workers from outdoor and indoor industrial sectors. CONCLUSION These findings show that work-related injuries and illnesses increase during moderate/high-severity heatwaves in both sub-tropical and temperate climates. Heatwave forecasts should signal the need for heightened heat awareness and preventive measures to minimise the risks to workers.
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Affiliation(s)
- Blesson M Varghese
- The University of Adelaide, School of Public Health, Adelaide, SA, Australia
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Alana L Hansen
- The University of Adelaide, School of Public Health, Adelaide, SA, Australia
| | - Peng Bi
- The University of Adelaide, School of Public Health, Adelaide, SA, Australia
| | - John Nairn
- Australian Bureau of Meteorology, Adelaide, SA, Australia
- The University of Adelaide, School of Biological Science, Adelaide, SA, Australia
| | - Shelley Rowett
- SafeWork SA, Government of South Australia, 33 Richmond Road, Keswick, SA, 5035, Australia
| | - Monika Nitschke
- Department for Health and Ageing, Government of South Australia, 11 Hindmarsh Square, Adelaide, SA, 5000, Australia
| | - Scott Hanson-Easey
- The University of Adelaide, School of Public Health, Adelaide, SA, Australia
| | - Jane S Heyworth
- School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, The Alfred Centre, Monash University, Melbourne, VIC, Australia
| | - Dino L Pisaniello
- The University of Adelaide, School of Public Health, Adelaide, SA, Australia.
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27
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Patel D, Jian L, Xiao J, Jansz J, Yun G, Lin T, Robertson A. Joint effects of heatwaves and air quality on ambulance services for vulnerable populations in Perth, western Australia. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 252:532-542. [PMID: 31170565 DOI: 10.1016/j.envpol.2019.05.125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
As the frequency, intensity, and duration of heatwaves increases, emergency health serviceutilization, including ambulance service, has correspondingly increased across the world. The negative effects of air pollution on health complicate these adverse health effects. This research work is the first known study to analyze the joint effects of heatwaves and air quality on the ambulance service in Western Australia (WA). The main objective is to investigate the potential joint effects of heatwaves and air quality on the ambulance service for vulnerable populations in the Perth metropolitan area. A time series design was used. Daily data on ambulance callouts, temperature and air pollutants (CO, SO2, NO2, O3, PM10 and PM2.5) were collected for the Perth metropolitan area, WA from 2006 to 2015. Poisson regression modeling was used to assess the association between heatwaves, air quality, and ambulance callouts. Risk assessments on age, gender, socio-economic status (SES), and joint effects between heatwaves and air quality on ambulance callouts were conducted. The ambulance callout rate was higher during heatwave days (14.20/100,000/day) compared to non-heatwave days (13.95/100,000/day) with a rate ratio of 1.017 (95% confidence interval 1.012, 1.023). The ambulance callout rate was higher in males, people over 60 years old, people with low SES, and those living in coastal areas during period of heatwaves. Exposure to CO, SO2, O3 and PM2.5 increased risk on ambulance callouts and exposure to NO2 showed joint effect with heatwave and increased risk of ambulance callouts by 3% after adjustment of all other risk factors. Ambulance callouts are an important indicator for evaluating heatwave-related emergency morbidity in WA. As the median concentrations of air pollutants in WA were lower than the Australian National Standards, the interactive effects of heatwaves and air quality on ambulance service need to be further examined, especially when air pollutants exceed the standards.
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Affiliation(s)
- Dimpalben Patel
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Le Jian
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia; School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Jianguo Xiao
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Janis Jansz
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Grace Yun
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Ting Lin
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Andrew Robertson
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
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28
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Kim JH, Ryoo HW, Moon S, Jang TC, Jin SC, Mun YH, Do BS, Lee SB, Kim JY. Determining the correlation between outdoor heatstroke incidence and climate elements in Daegu metropolitan city. Yeungnam Univ J Med 2019; 36:241-248. [PMID: 31620639 PMCID: PMC6784657 DOI: 10.12701/yujm.2019.00248] [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: 04/25/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 11/06/2022] Open
Abstract
Background Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS). Methods We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression. Results Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102-3.017). The most suitable cutoff point for MHI by Youden's index was 30.0°C (sensitivity, 77.4%; specificity, 73.7%). Conclusion Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was 30.0°C.
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Affiliation(s)
- Jung Ho Kim
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sungbae Moon
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae Chang Jang
- Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Sang Chan Jin
- Department of Emergency Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - You Ho Mun
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Soo Do
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sam Beom Lee
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jong-yeon Kim
- Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
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29
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Ragettli MS, Vicedo-Cabrera AM, Flückiger B, Röösli M. Impact of the warm summer 2015 on emergency hospital admissions in Switzerland. Environ Health 2019; 18:66. [PMID: 31412877 PMCID: PMC6694501 DOI: 10.1186/s12940-019-0507-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/12/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND Only a few studies have examined the impact of a particular heat event on morbidity. The aim of this study was to evaluate the impact of the warm summer 2015 on emergency hospital admissions (EHA) in Switzerland. The summer 2015 ranks as the second hottest after 2003 in the history of temperature observation in Switzerland. METHODS Daily counts of EHA for various disease categories during summer 2015 were analyzed in relation to previous summers in Switzerland. Excess EHA for non-external causes during summer 2015 (June-August) were estimated by age group, gender, geographic region and disease category by comparing observed and expected cases. The latter were predicted from strata-specific quasi-Poisson regression models fitted to the daily counts of EHA for years 2012-2014. RESULTS Over the three summer months in 2015, an estimated 2.4% (95% confidence interval [CI] 1.6-3.2%) increase in EHA (non-external causes) occurred corresponding to 2,768 excess cases. Highest excess EHA estimates were found in the warmest regions (Ticino [8.4%, 95% CI 5.1-11.7%] and the Lake Geneva region [4.8%, 95% CI 3.0-6.7%]) and among the elderly population aged ≥75 years (5.1%, 95% CI 3.7-6.5%). Increased EHA during days with most extreme temperatures were observed for influenza and pneumonia, certain infectious diseases and diseases of the genitourinary system. CONCLUSIONS Summer 2015 had a considerable impact on EHA in Switzerland. The daily number of EHA mainly increased due to diseases not commonly linked to heat-related mortality. No excess morbidity was found for cardiovascular and most respiratory diseases. This suggests that current public health interventions should be reevaluated to prevent both heat-related illness and deaths.
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Affiliation(s)
- Martina S Ragettli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Ana M Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Benjamin Flückiger
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
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30
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Wang Y, Wang A, Zhai J, Tao H, Jiang T, Su B, Yang J, Wang G, Liu Q, Gao C, Kundzewicz ZW, Zhan M, Feng Z, Fischer T. Tens of thousands additional deaths annually in cities of China between 1.5 °C and 2.0 °C warming. Nat Commun 2019; 10:3376. [PMID: 31388009 PMCID: PMC6684802 DOI: 10.1038/s41467-019-11283-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 07/03/2019] [Indexed: 12/16/2022] Open
Abstract
The increase in surface air temperature in China has been faster than the global rate, and more high temperature spells are expected to occur in future. Here we assess the annual heat-related mortality in densely populated cities of China at 1.5 °C and 2.0 °C global warming. For this, the urban population is projected under five SSPs, and 31 GCM runs as well as temperature-mortality relation curves are applied. The annual heat-related mortality is projected to increase from 32.1 per million inhabitants annually in 1986–2005 to 48.8–67.1 per million for the 1.5 °C warming and to 59.2–81.3 per million for the 2.0 °C warming, taking improved adaptation capacity into account. Without improved adaptation capacity, heat-related mortality will increase even stronger. If all 831 million urban inhabitants in China are considered, the additional warming from 1.5 °C to 2 °C will lead to more than 27.9 thousand additional heat-related deaths, annually. Heatwaves are expected to increase under climate change, and so are the associated deaths. Here the authors determine the regional high temperature thresholds for 27 metropolises in China and analyze the changes to heat-related mortality, showing that the additional global-warming temperature increase of 0.5°C, from 1.5°C to 2.0°C, will lead to tens of thousands of additional deaths, annually.
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Affiliation(s)
- Yanjun Wang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Anqian Wang
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jianqing Zhai
- National Climate Center, China Meteorological Administration, Beijing, 100081, China
| | - Hui Tao
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China
| | - Tong Jiang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China.
| | - Buda Su
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China
| | - Guojie Wang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Chao Gao
- Faculty of Architectural, Civil Engineering and Environment, Ningbo University, Ningbo, 31511, China
| | - Zbigniew W Kundzewicz
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China.,Institute for Agricultural and Forest Environment, Polish Academy of Sciences, Poznan, Poland
| | | | - Zhiqiang Feng
- School of Geosciences, University of Edinburgh, Edinburgh, EH8 9XP, UK
| | - Thomas Fischer
- Department of Geosciences, Eberhard Karls University, Tübingen, 72070, Germany.
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31
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Patel D, Jian L, Xiao J, Jansz J, Yun G, Robertson A. Joint effect of heatwaves and air quality on emergency department attendances for vulnerable population in Perth, Western Australia, 2006 to 2015. ENVIRONMENTAL RESEARCH 2019; 174:80-87. [PMID: 31054525 DOI: 10.1016/j.envres.2019.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/14/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND As global warming and the frequency and intensity of heatwaves increases, health service utilization, including emergency department attendances (EDA) have correspondingly increased across the world. The impact of air quality on health adds to the complexity of the effects. Potential joint effects between heatwaves and air quality on EDA have been rarely reported in the literature, prompting this study. OBJECTIVES To investigate the potential joint effect of heatwaves and air quality on the EDA for vulnerable populations in the Perth metropolitan area, Western Australia. METHODS A time series design was used. Daily data on EDA, heatwaves (excess heat factor>0) and air pollutants (CO, SO2, NO2, O3, PM10 and PM2.5) were collected for Perth, Western Australia from 2006 to 2015. Poisson regression modelling was used to assess the associations between heatwaves, air quality, and EDA. Risk assessments on age, gender, Aboriginality, socio-economic status (SES), and joint effect between heatwaves and air quality on EDA were conducted. RESULTS The EDA rate was higher in heatwave days (77.86/100,000/day) compared with non-heatwave days (73.90/100,000/day) with rate ratio of 1.053 (95% confidence interval 1.048, 1.058). The EDA rate was higher in males, people older than 60 years or younger than 15 years, Aboriginal people, and people with low SES. Exposure to CO, SO2, O3 and PM2.5 increased risk on EDA and exposure to PM2.5 showed joint effect with heatwave and increased risk of EDA by 6.6% after adjustment of all other risk factors. CONCLUSIONS EDA is an important indicator to evaluate heatwave related morbidity for emergency medical service as EDA rate increased during heatwaves with relative high concentrations of air pollutants. As all air pollutants measured in the study were lower than the Australian National Standards, the joint effect of heatwaves and air quality needs to be further examined when it exceeds the standards.
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Affiliation(s)
- Dimpalben Patel
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia; School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Jianguo Xiao
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Janis Jansz
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Grace Yun
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Andrew Robertson
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
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Cui L, Geng X, Ding T, Tang J, Xu J, Zhai J. Impact of ambient temperature on hospital admissions for cardiovascular disease in Hefei City, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:723-734. [PMID: 30852664 DOI: 10.1007/s00484-019-01687-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 05/21/2023]
Abstract
Many studies have quantified the hospitalization risk for cardiovascular disease (CVD) caused by temperature, but the results of most studies are not consistent. In this study, we evaluate the effect of temperature on CVD hospitalizations. We use a quasi-Poisson regression with a distributed-lag nonlinear model (DLNM) to evaluate the effect of temperature on CVD hospitalizations between July 1, 2015, and October 31, 2017, in Hefei City, China. We found that the cold effect and heat effect of temperature can impact CVD hospital admissions. Compared with the 25th percentile of temperature (10.3 °C), the cumulative relative risk (RR) of extremely low temperature (first percentile of temperature, 0.075 °C) over lags 0-27 days was 0.616 (95% CI 0.423-0.891), and the cumulative RR of moderate low temperature (10th percentile of temperature, 5.16 °C) was 1.081 (95% CI 1.019-1.147) over lags 0-7 days. Compared with the 75th percentile of temperature (25.6 °C), the cumulative RR of extremely high temperature (99th percentile of temperature, 33.7 °C) was 1.078 (95% CI 0.752-1.547) over lags 0-27 days, and the cumulative RR of moderate-high temperature (90th percentile of temperature, 29.0 °C) was 1.015 (95% CI 0.988-1.043) over lag 0 day. In the subgroup, the < 65-year group and male were more susceptible to low temperature; however, the ≥ 65-year group and female were more vulnerable to high temperature. The high temperature's impact on CVD hospital admissions was found to be more obvious in female and the ≥ 65-year group compared to male and the < 65-year group. However, the < 65-year group and men are more sensitive to low temperature.
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Affiliation(s)
- Longjiang Cui
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Xiya Geng
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Tao Ding
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jing Tang
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jixiang Xu
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jinxia Zhai
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
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Perceptions of, and Practices for Coping with, Heat Exposure among Male Arab Pilgrims to the Hajj, 1436. Prehosp Disaster Med 2019; 34:161-174. [PMID: 30968815 DOI: 10.1017/s1049023x19000025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The problems associated with exposure to excessive heat are a key health concern throughout the world, and are likely to become increasingly important as Earth's climate warms. Heat exposure is particularly problematic when large groups of people gather, but there is relatively little literature on the subject. Islam requires all adherents who are able to undertake a pilgrimage to Mecca (Saudi Arabia), known as the Hajj. This can result in huge numbers of pilgrims travelling to Mecca in the summer months, during which the temperatures can be very high, and to undertake physically demanding activities. OBJECTIVE The aim of this study was to identify the perception level of heat-related health issues and the coping behaviors adopted by pilgrims in the face of excessive heat exposure. METHODS A cross-sectional study was conducted in Mecca, Saudi Arabia among male Arab pilgrims performing Hajj of the Islamic calendar year 1436 (Summer 2015). Sample was divided into two strata: domestic pilgrims and international Arabs. A total of 14 camps were selected randomly, seven from each stratum. A total of 412 participants completed the questionnaire. RESULTS Mean age was 43.48 (SD = 13.42) years. Majority of pilgrims had never performed Hajj before (68.2%). Almost 89.5% among pilgrims more than 40 years of age had more water intake compared to only 76.5% for people under 40 years. Only 7.3% of educated people used to go out at noon time, and almost two-fold of pilgrims with lower educational level did so (15.4%). Approximately 51.8% among those who were aware of Mecca's weather used cotton clothes, compared to 36.0% among pilgrims unaware of Mecca's weather. CONCLUSION This study reveals the extent of pilgrims' understanding of, and abilities to cope with, excessive heat and also suggests coping strategies and options for improved understanding of heat-related health issues world-wide.Al Mayahi ZK, Ali Kabbash I. Perceptions of, and practices for coping with, heat exposure among male Arab pilgrims to the Hajj, 1436. Prehosp Disaster Med. 2019;34(2):161-174.
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Wang Y, Song Q, Du Y, Wang J, Zhou J, Du Z, Li T. A random forest model to predict heatstroke occurrence for heatwave in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 650:3048-3053. [PMID: 30373081 DOI: 10.1016/j.scitotenv.2018.09.369] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/08/2018] [Accepted: 09/30/2018] [Indexed: 06/08/2023]
Abstract
Extreme heat events have recently become more frequent and represent an increasing risk of damage to public health. However, the existing prediction of heatwave related health effects has limited representativeness and verification. Our study addressed the prediction of heatstroke occurrences based on three years' data of typical cities of hot temperature in China, and examined the importance ranks of model parameters including meteorological and socioeconomic status (SES) factors. The results show that meteorological factors contributed the most to model estimation of the parameters evaluated, and SES parameters, such as the search index, were also important indicators of heatstroke prediction. The model had a satisfying performance compared to traditional linear regression models. The model established in our study can be further applied to extreme weather-related impact research and reduce economic loss due to public health expenses.
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Affiliation(s)
- Yanwen Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qingqing Song
- Peking University School of Public Health, Beijing 100191, China
| | - Yanjun Du
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jiaonan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jinhui Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Zonghao Du
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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Zhao Q, Li S, Coelho MSZS, Saldiva PHN, Hu K, Arblaster JM, Nicholls N, Huxley RR, Abramson MJ, Guo Y. Geographic, Demographic, and Temporal Variations in the Association between Heat Exposure and Hospitalization in Brazil: A Nationwide Study between 2000 and 2015. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:17001. [PMID: 30620212 PMCID: PMC6371650 DOI: 10.1289/ehp3889] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Limited evidence is available regarding the association between heat exposure and morbidity in Brazil and how the effect of heat exposure on health outcomes may change over time. OBJECTIVES This study sought to quantify the geographic, demographic and temporal variations in the heat–hospitalization association in Brazil from 2000–2015. METHODS Data on hospitalization and meteorological conditions were collected from 1,814 cities during the 2000–2015 hot seasons. Quasi-Poisson regression with constrained lag model was applied to examine city-specific estimates, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, 10 age groups, and 11 cause categories. Meta-regression was used to examine the temporal change in estimates of heat effect from 2000 to 2015. RESULTS For every 5°C increase in daily mean temperature during the 2000–2015 hot seasons, the estimated risk of hospitalization over lag 0-7 d rose by 4.0% [95% confidence interval (CI): 3.7%, 4.3%] nationwide. Estimated 6.2% [95% empirical CI (eCI): 3.3%, 9.1%] of hospitalizations were attributable to heat exposure, equating to 132 cases (95% eCI: 69%, 192%) per 100,000 residents. The attributable rate was greatest in children [Formula: see text] and was highest for hospitalizations due to infectious and parasitic diseases. Women of reproductive age and those [Formula: see text] had higher heat burden than men. The attributable burden was greatest for cities in the central west and the inland of the northeast; lowest in the north and eastern coast. Over the 16-y period, the estimated heat effects declined insignificantly at the national level. CONCLUSIONS In Brazil's hot seasons, 6% of hospitalizations were estimated to be attributed to heat exposure. As there was no evidence indicating that thermal adaptation had occurred at the national level, the burden of hospitalization associated with heat exposure in Brazil is likely to increase in the context of global warming. https://doi.org/10.1289/EHP3889.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Paulo H N Saldiva
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan, China
| | - Julie M Arblaster
- School of Earth, Atmosphere and Environment, Monash University, Melbourne, Australia
- Centre of Excellence for Climate Extremes, Australian Research Council, Sydney, Australia
| | - Neville Nicholls
- School of Earth, Atmosphere and Environment, Monash University, Melbourne, Australia
| | - Rachel R Huxley
- College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Abstract
Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of the heat wave experienced in Izmir province of Turkey on mortality.During a 9-day period between 17th and 25th June 2016 (study period), air temperature values were higher than the seasonal norms in Izmir, Turkey. In this cross-sectional study, nontraumatic admissions and in-hospital mortality rates were compared this historical interval of the extreme heat wave with the same period of the previous year and the other 21 days of June 2016.The average air temperature between 17th and 25th June 2016, was higher than the average air temperature of the previous year's same period and the average air temperature from the other 21 days of June 2016 (27.8 ± 3.6 °C, (24.5 ± 1.9°C, 24.1 ± 2.1°C, respectively) (P <.01)During the study period, the mean number of ED visits and mortality rates were significantly higher than the previous year's same period (320 ± 30/day vs 269 ± 27/day, [P <.01], and 1.6% vs 0.7%, [P <.01]).Although the admission rate was similar between the study period and the other 21 days of June 2016 (320 ± 30/day vs 310 ± 32/ day, [P = .445]); in-hospital mortality rate was significantly higher during study period (1.6% vs 0.7%, [P <.01]).During the extreme heat waves, ED admissions and in-hospital mortality rates are increased. Precautions should be addressed for adaptation of people to extreme hot weather.
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Affiliation(s)
- Nese Colak Oray
- Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova
| | - Deniz Oray
- Izmir Medicalpark Hospital, Department of Emergency Medicine, Karsiyaka, İzmir, Turkey
| | - Ersin Aksay
- Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova
| | - Ridvan Atilla
- Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova
| | - Basak Bayram
- Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova
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Kloog I, Novack L, Erez O, Just AC, Raz R. Associations between ambient air temperature, low birth weight and small for gestational age in term neonates in southern Israel. Environ Health 2018; 17:76. [PMID: 30413171 PMCID: PMC6234799 DOI: 10.1186/s12940-018-0420-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/25/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND The increase in ambient temperatures (Ta) and emissions of greenhouse gases over the last century has focused attention on the effects of ambient temperatures on health outcomes. We aimed to investigate the association between Ta and the clinical measures of term low birth weight (tLBW) and small for gestational age (SGA) in singleton term infants using a decade of regional hospital data in southern Israel. METHODS We linked all births in Soroka University Medical Center in the southern district of Israel insured by Clalit Health Services with pregnancy Ta estimated by our novel hybrid spatio-temporally resolved prediction model. Logistic regression generalized additive models and general linear models were used, with either tLBW or SGA as the dependent variable, modeling entire pregnancy and trimester-specific Ta adjusting for seasonality, time trend, particulate matter, maternal age, gravidity, parity, ethnicity, sex, poverty index and population density. RESULTS The study population included 56,141 singleton term newborns, with 1716 (3.1%) cases of tLBW and 8634 (15.4%) cases of SGA. The average and the median Ta across the entire pregnancy were 19.9 (SD: 1.77, range: 14.6-24.9) degrees centigrade. The lowest Ta quartile (Ta = < 18.5) was associated with higher risk of tLBW (odds ratio = 1.33, 95%CI 1.11-1.58) while the highest Ta quartile (Ta > =21.3) was not significantly associated with tLBW (odds ratio = 1.17, 95%CI 0.99-1.38), in comparison to the two intermediate quartiles. When analyzing SGA as the dependent variable, the lowest Ta quartile was associated with significantly higher risk of SGA (odds ratio = 1.18, 95%CI 1.09-1.29) while the highest quartile was associated with significantly lower risk of SGA (odds ratio = 0.91, 95%CI 0.84-0.99) in comparison to the two intermediate quartiles. CONCLUSIONS Our findings suggest that lower pregnancy Ta may increase the risk of tLBW and SGA, and higher pregnancy Ta may decrease the risk of SGA in singleton term infants in southern Israel.
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Affiliation(s)
- Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B, 653 Beer Sheva, Israel
| | - Lena Novack
- Department of Public Health, Ben-Gurion University of the Negev, P.O.B, 653 Beer Sheva, Israel
| | - Offer Erez
- Department of Gynecology and Obstetrics, Soroka medical center, Beer Sheva, Israel
| | - Allan C. Just
- Department of Preventive Medicine, Icahn School of Medicine at Mt Sinai, New York, NY USA
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, Faculty of medicine, the Hebrew University of Jerusalem, Jerusalem, Israel
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Raei E, Nikoo MR, AghaKouchak A, Mazdiyasni O, Sadegh M. GHWR, a multi-method global heatwave and warm-spell record and toolbox. Sci Data 2018; 5:180206. [PMID: 30376556 PMCID: PMC6207177 DOI: 10.1038/sdata.2018.206] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/07/2018] [Indexed: 11/18/2022] Open
Abstract
Heatwaves are extended periods of unusually high temperatures with significant societal and environmental impacts. Despite their significance, there is not a generalized definition for heatwaves. In this paper, we introduce a multi-method global heatwave and warm-spell data record and analysis toolbox (named GHWR). In addition to a comprehensive long-term global data record of heatwaves, GHWR allows processing and extracting heatwave records for any location efficiently. We use traditional constant temperature threshold methods, as well as spatially and temporally localized threshold approaches to identify heatwaves. GHWR includes binary (0/1) occurrence records of heatwaves/warm-spells, and annual summary files with detailed information on their frequency, duration, magnitude and amplitude. GHWR also introduces the standardized heat index (SHI) as a generalized statistical metric to identify heatwave/warm-spells. SHI has direct association with the probability distribution function of long-term daily temperatures for any given calendar day and spatial grid. Finally, GHWR offers a unique opportunity for users to select the type of heatwave/warm-spell information from a plethora of methods based on their needs and applications.
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Ahmadalipour A, Moradkhani H. Escalating heat-stress mortality risk due to global warming in the Middle East and North Africa (MENA). ENVIRONMENT INTERNATIONAL 2018; 117:215-225. [PMID: 29763817 DOI: 10.1016/j.envint.2018.05.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/04/2018] [Accepted: 05/06/2018] [Indexed: 06/08/2023]
Abstract
Climate change will substantially exacerbate extreme temperature and heatwaves. The impacts will be more intense across the Middle East and North Africa (MENA), a region mostly characterized by hot and arid climate, already intolerable for human beings in many parts. In this study, daily climate data from 17 fine-resolution Regional Climate Models (RCMs) are acquired to calculate wet-bulb temperature and investigate the mortality risk for people aged over 65 years caused by excessive heat stress across the MENA region. Spatially adaptive temperature thresholds are implemented for quantifying the mortality risk, and the analysis is conducted for the historical period of 1951-2005 and two future scenarios of RCP4.5 and RCP8.5 during the 2006-2100 period. Results show that the mortality risk will increase in distant future to 8-20 times higher than that of the historical period if no climate change mitigation is implemented. The coastal regions of the Red sea, Persian Gulf, and Mediterranean Sea indicate substantial increase in mortality risk. Nonetheless, the risk ratio will be limited to 3-7 times if global warming is limited to 2 °C. Climate change planning and adaptation is imperative for mitigating heat-related mortality risk across the region.
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Affiliation(s)
- Ali Ahmadalipour
- Center for Complex Hydrosystems Research, Department of Civil, Construction, and Environmental Engineering, The University of Alabama, Tuscaloosa, AL 35487, United States.
| | - Hamid Moradkhani
- Center for Complex Hydrosystems Research, Department of Civil, Construction, and Environmental Engineering, The University of Alabama, Tuscaloosa, AL 35487, United States
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The Impact of Heat Waves on Emergency Department Admissions in Charlottesville, Virginia, U.S.A. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071436. [PMID: 29986505 PMCID: PMC6068980 DOI: 10.3390/ijerph15071436] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 11/24/2022]
Abstract
Heat waves have been linked to increases in emergency-related morbidity, but more research is needed on the demographic and disease-specific aspects of these morbidities. Using a case-crossover approach, over 700,000 daily emergency department hospital admissions in Charlottesville, Virginia, U.S.A. from 2005–2016 are compared between warm season heat wave and non-heat wave periods. Heat waves are defined based on the exceedance, for at least three consecutive days, of two apparent temperature thresholds (35 °C and 37 °C) that account for 3 and 6% of the period of record. Total admissions and admissions for whites, blacks, males, females, and 20–49 years old are significantly elevated during heat waves, as are admissions related to a variety of diagnostic categories, including diabetes, pregnancy complications, and injuries and poisoning. Evidence that heat waves raise emergency department admissions across numerous demographic and disease categories suggests that heat exerts comorbidity influences that extend beyond the more well-studied direct relationships such as heat strokes and cardiac arrest.
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Effects on Public Health of Heat Waves to Improve the Urban Quality of Life. SUSTAINABILITY 2018. [DOI: 10.3390/su10041082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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What Can We Learn about Workplace Heat Stress Management from a Safety Regulator Complaints Database? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030459. [PMID: 29509710 PMCID: PMC5877004 DOI: 10.3390/ijerph15030459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 11/16/2022]
Abstract
Heat exposure can be a health hazard for many Australian workers in both outdoor and indoor situations. With many heat-related incidents left unreported, it is often difficult to determine the underlying causal factors. This study aims to provide insights into perceptions of potentially unsafe or uncomfortably hot working conditions that can affect occupational health and safety using information provided by the public and workers to the safety regulator in South Australia (SafeWork SA). Details of complaints regarding heat exposure to the regulator's "Help Centre" were assembled in a dataset and the textual data analysed thematically. The findings showed that the majority of calls relate to indoor work environments such as kitchens, factories, and warehouses. The main themes identified were work environment, health effects, and organisational issues. Impacts of hot working conditions ranged from discomfort to serious heat-related illnesses. Poor management practices and inflexibility of supervisors featured strongly amongst callers' concerns. With temperatures predicted to increase and energy prices escalating, this timely study, using naturalistic data, highlights accounts of hot working conditions that can compromise workers' health and safety and the need for suitable measures to prevent heat stress. These could include risk assessments to assess the likelihood of heat stress in workplaces where excessively hot conditions prevail.
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The Impact of Urban Design Descriptors on Outdoor Thermal Environment: A Literature Review. ENERGIES 2017. [DOI: 10.3390/en10122151] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Li J, Xu X, Yang J, Liu Z, Xu L, Gao J, Liu X, Wu H, Wang J, Yu J, Jiang B, Liu Q. Ambient high temperature and mortality in Jinan, China: A study of heat thresholds and vulnerable populations. ENVIRONMENTAL RESEARCH 2017; 156:657-664. [PMID: 28463825 DOI: 10.1016/j.envres.2017.04.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 04/17/2017] [Accepted: 04/18/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Understanding the health consequences of continuously rising temperatures-as is projected for China-is important in terms of developing heat-health adaptation and intervention programs. This study aimed to examine the association between mortality and daily maximum (Tmax), mean (Tmean), and minimum (Tmin) temperatures in warmer months; to explore threshold temperatures; and to identify optimal heat indicators and vulnerable populations. METHODS Daily data on temperature and mortality were obtained for the period 2007-2013. Heat thresholds for condition-specific mortality were estimated using an observed/expected analysis. We used a generalised additive model with a quasi-Poisson distribution to examine the association between mortality and Tmax/Tmin/Tmean values higher than the threshold values, after adjustment for covariates. RESULTS Tmax/Tmean/Tmin thresholds were 32/28/24°C for non-accidental deaths; 32/28/24°C for cardiovascular deaths; 35/31/26°C for respiratory deaths; and 34/31/28°C for diabetes-related deaths. For each 1°C increase in Tmax/Tmean/Tmin above the threshold, the mortality risk of non-accidental-, cardiovascular-, respiratory, and diabetes-related death increased by 2.8/5.3/4.8%, 4.1/7.2/6.6%, 6.6/25.3/14.7%, and 13.3/30.5/47.6%, respectively. Thresholds for mortality differed according to health condition when stratified by sex, age, and education level. For non-accidental deaths, effects were significant in individuals aged ≥65 years (relative risk=1.038, 95% confidence interval: 1.026-1.050), but not for those ≤64 years. For most outcomes, women and people ≥65 years were more vulnerable. CONCLUSION High temperature significantly increases the risk of mortality in the population of Jinan, China. Climate change with rising temperatures may bring about the situation worse. Public health programs should be improved and implemented to prevent and reduce health risks during hot days, especially for the identified vulnerable groups.
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Affiliation(s)
- Jing Li
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China; State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China; Center for Climate Change and Health, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China
| | - Xin Xu
- Department of Dentistry, Affiliated Hospital, Weifang Medical University, Weifang 261031, Shandong Province, PR China
| | - Jun Yang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Zhidong Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China
| | - Lei Xu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jinghong Gao
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Xiaobo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Haixia Wu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jun Wang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jieqiong Yu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China; Center for Climate Change and Health, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China.
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China; Center for Climate Change and Health, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China.
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Gao H, Lan L, Yang C, Wang J, Zhao Y. The Threshold Temperature and Lag Effects on Daily Excess Mortality in Harbin, China: A Time Series Analysis. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:85-95. [PMID: 28432370 PMCID: PMC6679615 DOI: 10.15171/ijoem.2017.979] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/17/2017] [Indexed: 01/08/2023]
Abstract
Background: A large number of studies have reported the relationship between ambient temperature and mortality. However, few studies have focused on the effects of high temperatures on cardio-cerebrovascular diseases mortality (CCVDM) and their acute events (ACCVDM). Objective: To assess the threshold temperature and time lag effects on daily excess mortality in Harbin, China. Methods: A generalized additive model (GAM) with a Poisson distribution was used to investigate the relative risk of mortality for each 1 °C increase above the threshold temperature and their time lag effects in Harbin, China. Results: High temperature threshold was 26 °C in Harbin. Heat effects were immediate and lasted for 0–6 and 0–4 days for CCVDM and ACCVDM, respectively. The acute cardiovascular disease mortality (ACVDM) seemed to be more sensitive to temperature than cardiovascular disease mortality (CVDM) with higher death risk and shorter time lag effects. The lag effects lasted longer for cerebrovascular disease mortality (CBDM) than CVDM; so did ACBDM compared to ACVDM. Conclusion: Hot temperatures increased CCVDM and ACCVDM in Harbin, China. Public health intervention strategies for hot temperatures adaptation should be concerned.
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Affiliation(s)
- Hanlu Gao
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China.,Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, China
| | - Li Lan
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China
| | - Chao Yang
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China.
| | - Jian Wang
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China
| | - Yashuang Zhao
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, China.
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Xiao J, Spicer T, Jian L, Yun GY, Shao C, Nairn J, Fawcett RJB, Robertson A, Weeramanthri TS. Variation in Population Vulnerability to Heat Wave in Western Australia. Front Public Health 2017; 5:64. [PMID: 28421177 PMCID: PMC5376557 DOI: 10.3389/fpubh.2017.00064] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
Heat waves (HWs) have killed more people in Australia than all other natural hazards combined. Climate change is expected to increase the frequency, duration, and intensity of HWs and leads to a doubling of heat-related deaths over the next 40 years. Despite being a significant public health issue, HWs do not attract the same level of attention from researchers, policy makers, and emergency management agencies compared to other natural hazards. The purpose of the study was to identify risk factors that might lead to population vulnerability to HW in Western Australia (WA). HW vulnerability and resilience among the population of the state of WA were investigated by using time series analysis. The health impacts of HWs were assessed by comparing the associations between hospital emergency department (ED) presentations, hospital admissions and mortality data, and intensities of HW. Risk factors including age, gender, socioeconomic status (SES), remoteness, and geographical locations were examined to determine whether certain population groups were more at risk of adverse health impacts due to extreme heat. We found that hospital admissions due to heat-related conditions and kidney diseases, and overall ED attendances, were sensitive indicators of HW. Children aged 14 years or less and those aged 60 years or over were identified as the most vulnerable populations to HWs as shown in ED attendance data. Females had more ED attendances and hospital admissions due to kidney diseases; while males had more heat-related hospital admissions than females. There were significant dose–response relationships between HW intensity and SES, remoteness, and health service usage. The more disadvantaged and remotely located the population, the higher the health service usage during HWs. Our study also found that some population groups and locations were resilient to extreme heat. We produced a mapping tool, which indicated geographic areas throughout WA with various vulnerability and resilience levels to HW. The findings from this study will allow local government, community service organizations, and agencies in health, housing, and education to better identify and understand the degree of vulnerability to HW throughout the state, better target preparatory strategies, and allocate limited resources to those most in need.
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Affiliation(s)
- Jianguo Xiao
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Tony Spicer
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Le Jian
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Public Health, Curtin University, Perth, WA, Australia
| | - Grace Yajuan Yun
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Changying Shao
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - John Nairn
- Australian Bureau of Meteorology, Adelaide, SA, Australia
| | | | - Andrew Robertson
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
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Zhang Y, Nitschke M, Krackowizer A, Dear K, Pisaniello D, Weinstein P, Tucker G, Shakib S, Bi P. Risk factors for deaths during the 2009 heat wave in Adelaide, Australia: a matched case-control study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:35-47. [PMID: 27221967 DOI: 10.1007/s00484-016-1189-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 03/18/2016] [Accepted: 05/08/2016] [Indexed: 05/24/2023]
Abstract
The extreme heat wave in Australia in 2009 resulted in significantly increased number of daily deaths. The circumstances that lead to deaths during extreme heat have not been explored before in Australia. This study aims to identify the individual and community risk factors for deaths during this extreme heat wave in Adelaide. A matched case-control study was conducted. Cases were those who died in the Adelaide metropolitan area during the heat wave period. For each case, two community controls were randomly selected, matched by age and gender. Face-to-face or telephone interviews were conducted to collect data of demographic information, living environment, social support, health status and behavioural changes during the heat wave. Descriptive analysis, as well as simple and multiple conditional logistic regressions were performed. In total, 82 deaths and 164 matched community controls were included in the analysis, with a median age of 77.5 (range 26.6-100.7). The multiple logistic regression model indicated that, compared with controls, the risk of death during the heat wave was significantly increased for people living alone (AOR = 42.31, 95 % CI 2.3, 792.8) or having existing chronic heart disease (AOR = 22.4, 95 % CI 1.7, 303.0). In addition, having air conditioning in bedrooms (AOR = 0.004, 95 % CI 0.00006, 0.28) and participating in social activities more than once a week (AOR = 0.011, 95 % CI 0.0004, 0.29) indicated significant protective effects. We have identified factors that could significantly impact on the likelihood of deaths during heat waves. Our findings could assist in the development of future intervention programs and policies to reduce mortality associated with a warmer climate.
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Affiliation(s)
- Ying Zhang
- School of Public Health, China Studies Centre, University of Sydney, Sydney, NSW, Australia.
| | - Monika Nitschke
- South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia
| | - Antoinette Krackowizer
- School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Keith Dear
- Global Health Institute, Duke University and Duke Kunshan University, Kunshan, China
| | - Dino Pisaniello
- School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Philip Weinstein
- School of Biological Sciences, University of Adelaide, Adelaide, Australia
| | - Graeme Tucker
- South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia
| | - Sepehr Shakib
- Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, Australia
| | - Peng Bi
- School of Population Health, University of Adelaide, Adelaide, South Australia, Australia.
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48
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Hot of Not: Physiological versus Meteorological Heatwaves-Support for a Mean Temperature Threshold. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080753. [PMID: 27472348 PMCID: PMC4997439 DOI: 10.3390/ijerph13080753] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 11/17/2022]
Abstract
The aim of this study was to determine whether a revised heat warning threshold provides an enhanced predictive tool for increases in Emergency Department heat-related presentations in Canberra, Australia. All Emergency Department triage records containing the word “heat”, as well as those diagnosing a heat related illness for the summer periods 2013/2014, 2014/2015, and 2015/2016 were searched. Then a medical record review was conducted to confirm that the patient’s presentation was related to environmental heat, which was defined by the final clinical diagnosis, presentation complaint and details of the patient’s treatment. Researchers then compared this presentation data, to a mean threshold formula. The mean threshold formula included the past three consecutive daily mean temperatures and the last measured temperature upon presentation. This formula was designed to take into account the variance of night-time lows, with concurrent daily ambient temperatures, and was used to determine whether there was a correlation between heat-related presentations and increasing mean temperatures. Heat-related presentations appeared to occur when the mean threshold temperature reached 25 °C (77 °F), with significant increases when the mean threshold reached 30 °C (86 °F). These results confirm that a mean temperature of 30 °C corresponds to a relevant local public health heat-related threat.
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Boschat G, Simmonds I, Purich A, Cowan T, Pezza AB. On the use of composite analyses to form physical hypotheses: An example from heat wave - SST associations. Sci Rep 2016; 6:29599. [PMID: 27412238 PMCID: PMC4944154 DOI: 10.1038/srep29599] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/22/2016] [Indexed: 11/09/2022] Open
Abstract
This paper highlights some caveats in using composite analyses to form physical hypotheses on the associations between environmental variables. This is illustrated using a specific example, namely the apparent links between heat waves (HWs) and sea surface temperatures (SSTs). In this case study, a composite analysis is performed to show the large-scale and regional SST conditions observed during summer HWs in Perth, southwest Australia. Composite results initially point to the importance of the subtropical South Indian Ocean, where physically coherent SST dipole anomalies appear to form a necessary condition for HWs to develop across southwest Australia. However, sensitivity tests based on pattern correlation analyses indicate that the vast majority of days when the identified SST pattern appears are overwhelmingly not associated with observed HWs, which suggests that this is definitely not a sufficient condition for HW development. Very similar findings are obtained from the analyses of 15 coupled climate model simulations. The results presented here have pertinent implications and applications for other climate case studies, and highlight the importance of applying comprehensive statistical approaches before making physical inferences on apparent climate associations.
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Affiliation(s)
- Ghyslaine Boschat
- School of Earth Sciences, The University of Melbourne, Victoria, Australia.,Australian Research Council's Centre of Excellence for Climate System Science, Australia
| | - Ian Simmonds
- School of Earth Sciences, The University of Melbourne, Victoria, Australia
| | - Ariaan Purich
- CSIRO Oceans and Atmosphere, Aspendale, Victoria, Australia
| | - Tim Cowan
- School of Geosciences, University of Edinburgh, Edinburgh, United Kingdom
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Sun S, Tian L, Qiu H, Chan KP, Tsang H, Tang R, Lee RSY, Thach TQ, Wong CM. The influence of pre-existing health conditions on short-term mortality risks of temperature: Evidence from a prospective Chinese elderly cohort in Hong Kong. ENVIRONMENTAL RESEARCH 2016; 148:7-14. [PMID: 26994463 DOI: 10.1016/j.envres.2016.03.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/22/2016] [Accepted: 03/08/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Both cold and hot temperatures are associated with adverse health outcomes. Less is known about the role of pre-existing medical conditions to confer individual's susceptibility to temperature extremes. METHODS We studied 66,820 subjects aged ≥65 who were enrolled and interviewed in all the 18 Elderly Health Centers of Department of Health, Hong Kong from 1998 to 2001, and followed up for 10-13 years. The distributed lag nonlinear model (DLNM) combined with a nested case-control study design was applied to estimate the nonlinear and delayed effects of cold or hot temperature on all natural mortality among subjects with different pre-existing diseases. RESULTS The relative risk of all natural mortality associated with a decrease of temperature from 25th percentile (19.5°C) to 1st percentile (11.3°C) over 0-21 lag days for participants who reported to have an active disease at the baseline was 2.21 (95% confidence interval (CI): 1.19, 4.10) for diabetes mellitus (DM), 1.59 (1.12, 2.26) for circulatory system diseases (CSD), and 1.23 (0.53, 2.84) for chronic obstructive pulmonary disease (COPD), whereas 1.04 (0.59, 1.85) for non-disease group (NDG). Compared with NDG, elders with COPD had excess risk of mortality associated with thermal stress attributable to hot temperature, while elders with DM and CSD were vulnerable to both hot and cold temperatures. CONCLUSIONS Elders with pre-existing health conditions were more vulnerable to excess mortality risk to hot and/or cold temperature. Preventative measures should target on elders with chronic health problems.
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Affiliation(s)
- Shengzhi Sun
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Hong Qiu
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - King-Pan Chan
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Hilda Tsang
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Robert Tang
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Ruby Siu-Yin Lee
- Elderly Health Service, Department of Health, Hong Kong SAR, China
| | - Thuan-Quoc Thach
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Chit-Ming Wong
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China.
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