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Wang J, Wang P, Liu B, Kinney PL, Huang L, Chen K. Comprehensive evaluation framework for intervention on health effects of ambient temperature. ECO-ENVIRONMENT & HEALTH 2024; 3:154-164. [PMID: 38646097 PMCID: PMC11031729 DOI: 10.1016/j.eehl.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/28/2023] [Accepted: 01/12/2024] [Indexed: 04/23/2024]
Abstract
Despite the existence of many interventions to mitigate or adapt to the health effects of climate change, their effectiveness remains unclear. Here, we introduce the Comprehensive Evaluation Framework for Intervention on Health Effects of Ambient Temperature to evaluate study designs and effects of intervention studies. The framework comprises three types of interventions: proactive, indirect, and direct, and four categories of indicators: classification, methods, scope, and effects. We trialed the framework by an evaluation of existing intervention studies. The evaluation revealed that each intervention has its own applicable characteristics in terms of effectiveness, feasibility, and generalizability scores. We expanded the framework's potential by offering a list of intervention recommendations in different scenarios. Future applications are then explored to establish models of the relationship between study designs and intervention effects, facilitating effective interventions to address the health effects of ambient temperature under climate change.
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Affiliation(s)
- Jiaming Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Peng Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Faculty of Civil Engineering and Mechanics, Jiangsu University, Zhenjiang 212013, China
| | - Beibei Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Patrick L. Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Lei Huang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Center for Public Health Research, Medical School of Nanjing University, Nanjing 210093, China
| | - Kai Chen
- Department of Environmental Health Sciences, Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT 06510, USA
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2
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Metzger A, Baharav Y, Nichols L, Finke M, Saunders B, Mitchell P, Wellenius GA, Baughman McLeod K, Shickman K. Beliefs and behaviors associated with the first named heat wave in Seville Spain 2022. Sci Rep 2024; 14:9055. [PMID: 38643234 PMCID: PMC11032320 DOI: 10.1038/s41598-024-59430-8] [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: 09/05/2023] [Accepted: 04/10/2024] [Indexed: 04/22/2024] Open
Abstract
Heat waves pose a substantial and increasing risk to public health. Heat health early warning systems (HHEWSs) and response plans are increasingly being adopted to alert people to the health risks posed by days of extreme heat and recommend protective behaviors. However, evidence regarding the effectiveness of HHEWSs remains limited. We examined the impact of heat wave naming on heat-related beliefs and behaviors to ascertain the potential effectiveness of heat wave naming as a heat health risk communication and management tool. Specifically, we surveyed members of the public exposed to the proMETEO Sevilla HHEWS messaging campaign which in the summer of 2022 applied a name to heat waves considered to pose the greatest risk to public health. During the heat season we evaluated, the proMETEO Sevilla HHEWS campaign applied a name to one heat wave, heat wave "Zoe". Our analysis of the post-survey of 2022 adults indicated that the 6% of participants who recalled the name Zoe unaided reported greater engagement in heat wave safety behaviors and more positive beliefs about naming heat waves and their local governments' heat wave response. These results provide initial evidence for potential utility in naming heat waves as part of HHEWSs and HAPs.
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Affiliation(s)
| | - Yuval Baharav
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA
| | - Lilly Nichols
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA.
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA.
| | - Megan Finke
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA
| | | | | | - Gregory A Wellenius
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA
| | - Kathy Baughman McLeod
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA
| | - Kurt Shickman
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA
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3
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Notley SR, Mitchell D, Taylor NAS. A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise. Eur J Appl Physiol 2024; 124:1-145. [PMID: 37796292 DOI: 10.1007/s00421-023-05276-3] [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: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 10/06/2023]
Abstract
In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain.
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Affiliation(s)
- Sean R Notley
- Defence Science and Technology Group, Department of Defence, Melbourne, Australia
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
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4
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Wu X, Weinberger KR, Wellenius GA, Dominici F, Braun D. Assessing the causal effects of a stochastic intervention in time series data: are heat alerts effective in preventing deaths and hospitalizations? Biostatistics 2023; 25:57-79. [PMID: 36815555 PMCID: PMC11032723 DOI: 10.1093/biostatistics/kxad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/07/2023] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
The methodological development of this article is motivated by the need to address the following scientific question: does the issuance of heat alerts prevent adverse health effects? Our goal is to address this question within a causal inference framework in the context of time series data. A key challenge is that causal inference methods require the overlap assumption to hold: each unit (i.e., a day) must have a positive probability of receiving the treatment (i.e., issuing a heat alert on that day). In our motivating example, the overlap assumption is often violated: the probability of issuing a heat alert on a cooler day is near zero. To overcome this challenge, we propose a stochastic intervention for time series data which is implemented via an incremental time-varying propensity score (ItvPS). The ItvPS intervention is executed by multiplying the probability of issuing a heat alert on day $t$-conditional on past information up to day $t$-by an odds ratio $\delta_t$. First, we introduce a new class of causal estimands, which relies on the ItvPS intervention. We provide theoretical results to show that these causal estimands can be identified and estimated under a weaker version of the overlap assumption. Second, we propose nonparametric estimators based on the ItvPS and derive an upper bound for the variances of these estimators. Third, we extend this framework to multisite time series using a spatial meta-analysis approach. Fourth, we show that the proposed estimators perform well in terms of bias and root mean squared error via simulations. Finally, we apply our proposed approach to estimate the causal effects of increasing the probability of issuing heat alerts on each warm-season day in reducing deaths and hospitalizations among Medicare enrollees in 2837 US counties.
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Affiliation(s)
- Xiao Wu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA and Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Kate R Weinberger
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Danielle Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA and Department of Data Science, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA
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5
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Thomson TN, Rupasinghe R, Hennessy D, Easton M, Stewart T, Mulvenna V. Population vulnerability to heat: A case-crossover analysis of heat health alerts and hospital morbidity data in Victoria, Australia. Aust N Z J Public Health 2023; 47:100092. [PMID: 37852815 DOI: 10.1016/j.anzjph.2023.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE From 2010 to 2022, the Victorian Department of Health operated a heat health alert system. We explored whether changes to morbidity occurred during or directly after these alerts, and how this differed for certain population groups. METHODS We used a space-time-stratified case-crossover design and conditional logistic regression to examine the associations between heat health alerts and heat-related and all-cause emergency department (ED) presentations and hospital admissions at the state-wide level, with models created for the whole population and subgroups. Data were included for the warm season (November-March) from 2014 to 2021. RESULTS Increases occurred in heat-related ED presentations (OR 1.73, 95% CI: 1.53-1.96) and heat-related hospital admissions (OR 1.23, 95% CI: 1.16-1.30) on days on or after heat health alerts. Effect sizes were largest for those 65 years and older, Aboriginal and Torres Strait Islander people, and those living in the most disadvantaged areas. CONCLUSIONS We confirm that increases in morbidity occurred in Victoria during heat health alerts and describe which population groups are more likely to require healthcare in a hospital. IMPLICATIONS FOR PUBLIC HEALTH These findings can inform responses before and during periods of extreme heat, data-driven adaptation strategies, and the development of heat health surveillance systems.
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Affiliation(s)
- Tilda N Thomson
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia; Public Health Division, Victorian Department of Health, Melbourne, Australia.
| | - Rayiky Rupasinghe
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Daneeta Hennessy
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Marion Easton
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Tony Stewart
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Vanora Mulvenna
- Public Health Division, Victorian Department of Health, Melbourne, Australia
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Lung SCC, Liou ML, Yeh JCJ, Hwang JS. A pilot heat-health warning system co-designed for a subtropical city. PLoS One 2023; 18:e0294281. [PMID: 37948468 PMCID: PMC10637700 DOI: 10.1371/journal.pone.0294281] [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: 05/02/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
Significant heat-related casualties underlie the urgency of establishing a heat-health warning system (HHWS). This paper presents an evidence-based pilot HHWS developed for Taipei City, Taiwan, through a co-design process engaging stakeholders. In the co-design process, policy concerns related to biometeorology, epidemiology and public health, and risk communication aspects were identified, with knowledge gaps being filled by subsequent findings. The biometeorological results revealed that Taipei residents were exposed to wet-bulb globe temperature (WBGT) levels of health concern for at least 100 days in 2016. The hot spots and periods identified using WBGT would be missed out if using temperature, underlining the importance of adopting an appropriate heat indicator. Significant increases in heat-related emergency were found in Taipei at WBGT exceeding 36°C with reference-adjusted risk ratio (RaRR) of 2.42, taking 30°C as the reference; and residents aged 0-14 had the highest risk enhancement (RaRR = 7.70). As for risk communication, occurring frequency was evaluated to avoid too frequent warnings, which would numb the public and exhaust resources. After integrating knowledge and reconciling the different preferences and perspectives, the pilot HHWS was co-implemented in 2018 by the science team and Taipei City officials; accompanying responsive measures were formulated for execution by ten city government departments/offices. The results of this pilot served as a useful reference for establishing a nationwide heat-alert app in 2021/2022. The lessons learnt during the interactive co-design processes provide valuable insights for establishing HHWSs worldwide.
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Affiliation(s)
- Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan
- Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan
| | - Ming-Lone Liou
- Graduate Institute of Environmental Engineering, National Taiwan University, Taipei, Taiwan
| | - Jou-Chen Joy Yeh
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan
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7
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Nassikas NJ, Gold DR. Climate change is a health crisis with opportunities for health care action: A focus on health care providers, patients with asthma and allergic immune diseases, and their families and neighbors. J Allergy Clin Immunol 2023; 152:1047-1052. [PMID: 37742937 PMCID: PMC10841871 DOI: 10.1016/j.jaci.2023.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023]
Abstract
Climate change has increased the frequency of extreme weather events and compounded natural disasters. Heat, wildfires, flooding, and pollen are already threatening public health and disproportionately affecting individuals in susceptible situations and vulnerable locations. In this theme issue of the Journal of Allergy and Clinical Immunology, we address what is known and not known about the biologic as well as clinical upstream and downstream effects of climate change on asthma and allergy development and exacerbation. We present potential actions that individuals can take at the family, neighborhood, community, health care system, and national and international levels to build climate resilience and protect their own health and the health and welfare of others. We emphasize the importance of actions and policies that are context specific and just. We emphasize the need for the health care system, which contributes between 3% and 5% of global greenhouse gas emissions, to reduce its carbon footprint and build resiliency. Health care providers play a pivotal role in helping policymakers understand the effects of climate on the health of our patients. There is still a window to avoid the most serious effects of climate change on human health and our planet.
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Affiliation(s)
- Nicholas J Nassikas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Mass.
| | - Diane R Gold
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
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8
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Kiarsi M, Amiresmaili M, Mahmoodi MR, Farahmandnia H, Nakhaee N, Zareiyan A, Aghababaeian H. Heat waves and adaptation: A global systematic review. J Therm Biol 2023; 116:103588. [PMID: 37499408 DOI: 10.1016/j.jtherbio.2023.103588] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/14/2023] [Accepted: 04/23/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Given the increasing trend of global warming and extreme weather conditions, including heat waves and its effects on health, the present study was done to investigate adaptive behaviors of communities in the world for combating heat waves. METHOD ology: In this systematic review, out of 1529 results, 57 relevant and authoritative English papers on adaptation to heat waves hazard were extracted and evaluated using valid keywords from valid databases (PubMed, WOS, EMBASE, and Scopus). In addition, multiple screening steps were done and then, the selected papers were qualitatively assessed. Evaluation results were summarized using an Extraction Table. RESULTS In this paper, the adaptive behaviors for combating heat waves hazard were summarized into 11 categories: Education and awareness raising, Adaptation of critical infrastructure, Governments measures, Health-related measures, Application of early warning system, Protective behaviors in workplace, Physical condition, Adaptive individual behaviors, Design and architecture of the building, Green infrastructure (green cover), and Urban design. CONCLUSION The findings of this study showed that community actions have significant effects on adaptation to heat wave. Therefore, for reducing heat wave-related negative health effects and vulnerability, more attention should be paid to the above-mentioned actions for mitigation, preparation, and responding regarding heat waves. PROSPERO REGISTRATION NUMBER CRD42021257747.
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Affiliation(s)
- Maryam Kiarsi
- Department of Medical Emergencies, Dezful University of Medical Sciences, Dezful, Iran; Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran.
| | - Mohammadreza Amiresmaili
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mohammad Reza Mahmoodi
- Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran; Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Department of Nutrition, Faculty of Public Health, Kerman, Iran.
| | - Hojjat Farahmandnia
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Nouzar Nakhaee
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Health Services Management Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Armin Zareiyan
- Public Health Department, Health in Emergencies and Disasters Department, Nursing Faculty, AJA University of Medical Sciences, Tehran, Iran.
| | - Hamidreza Aghababaeian
- Department of Medical Emergencies, Dezful University of Medical Sciences, Dezful, Iran; Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran.
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NORI‐SARMA AMRUTA, WELLENIUS GREGORYA. Human Health and Well-being in a Warming World. Milbank Q 2023; 101:99-118. [PMID: 37096613 PMCID: PMC10126986 DOI: 10.1111/1468-0009.12608] [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: 06/22/2022] [Revised: 11/01/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points After decades of scientific progress and growth in academic literature, there is a recognition that climate change poses a substantial threat to the health and well-being of individuals and communities both in the United States and globally. Solutions to mitigate and adapt to climate change can have important health cobenefits. A vital component of these policy solutions is that they must also take into consideration historic issues of environmental justice and racism, and implementation of these policies must have a strong equity lens.
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10
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Ragettli MS, Saucy A, Flückiger B, Vienneau D, de Hoogh K, Vicedo-Cabrera AM, Schindler C, Röösli M. Explorative Assessment of the Temperature-Mortality Association to Support Health-Based Heat-Warning Thresholds: A National Case-Crossover Study in Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4958. [PMID: 36981871 PMCID: PMC10049426 DOI: 10.3390/ijerph20064958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/24/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Defining health-based thresholds for effective heat warnings is crucial for climate change adaptation strategies. Translating the non-linear function between heat and health effects into an effective threshold for heat warnings to protect the population is a challenge. We present a systematic analysis of heat indicators in relation to mortality. We applied distributed lag non-linear models in an individual-level case-crossover design to assess the effects of heat on mortality in Switzerland during the warm season from 2003 to 2016 for three temperature metrics (daily mean, maximum, and minimum temperature), and various threshold temperatures and heatwave definitions. Individual death records with information on residential address from the Swiss National Cohort were linked to high-resolution temperature estimates from 100 m resolution maps. Moderate (90th percentile) to extreme thresholds (99.5th percentile) of the three temperature metrics implied a significant increase in mortality (5 to 38%) in respect of the median warm-season temperature. Effects of the threshold temperatures on mortality were similar across the seven major regions in Switzerland. Heatwave duration did not modify the effect when considering delayed effects up to 7 days. This nationally representative study, accounting for small-scale exposure variability, suggests that the national heat-warning system should focus on heatwave intensity rather than duration. While a different heat-warning indicator may be appropriate in other countries, our evaluation framework is transferable to any country.
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Affiliation(s)
- Martina S. Ragettli
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Apolline Saucy
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
- Barcelona Institute for Global Health (ISGlobal), 08003 Barcelona, Spain
| | - Benjamin Flückiger
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Ana M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, 3012 Bern, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
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11
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Schmeltz MT, Smith JA, Olmos I, Quintero E. Extreme Heat Governance: A Critical Analysis of Heat Action Plans in California. Am J Public Health 2023; 113:15-19. [PMID: 36516387 PMCID: PMC9755928 DOI: 10.2105/ajph.2022.307117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Michael T Schmeltz
- Michael T. Schmeltz is with the Department of Public Health, California State University, East Bay, Hayward. Jason A. Smith is with the College of Health and Human Development, California State University, Fullerton. Isabella Olmos and Erin Quintero are recent graduates from the Department of Public Health, California State University, East Bay
| | - Jason A Smith
- Michael T. Schmeltz is with the Department of Public Health, California State University, East Bay, Hayward. Jason A. Smith is with the College of Health and Human Development, California State University, Fullerton. Isabella Olmos and Erin Quintero are recent graduates from the Department of Public Health, California State University, East Bay
| | - Isabella Olmos
- Michael T. Schmeltz is with the Department of Public Health, California State University, East Bay, Hayward. Jason A. Smith is with the College of Health and Human Development, California State University, Fullerton. Isabella Olmos and Erin Quintero are recent graduates from the Department of Public Health, California State University, East Bay
| | - Erin Quintero
- Michael T. Schmeltz is with the Department of Public Health, California State University, East Bay, Hayward. Jason A. Smith is with the College of Health and Human Development, California State University, Fullerton. Isabella Olmos and Erin Quintero are recent graduates from the Department of Public Health, California State University, East Bay
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12
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Jacobsen AP, Khiew YC, Duffy E, O'Connell J, Brown E, Auwaerter PG, Blumenthal RS, Schwartz BS, McEvoy JW. Climate change and the prevention of cardiovascular disease. Am J Prev Cardiol 2022; 12:100391. [PMID: 36164332 PMCID: PMC9508346 DOI: 10.1016/j.ajpc.2022.100391] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/27/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022] Open
Abstract
Climate change is a worsening global crisis that will continue negatively impacting population health and well-being unless adaptation and mitigation interventions are rapidly implemented. Climate change-related cardiovascular disease is mediated by air pollution, increased ambient temperatures, vector-borne disease and mental health disorders. Climate change-related cardiovascular disease can be modulated by climate change adaptation; however, this process could result in significant health inequity because persons and populations of lower socioeconomic status have fewer adaptation options. Clear scientific evidence for climate change and its impact on human health have not yet resulted in the national and international impetus and policies necessary to slow climate change. As respected members of society who regularly communicate scientific evidence to patients, clinicians are well-positioned to advocate on the importance of addressing climate change. This narrative review summarizes the links between climate change and cardiovascular health, proposes actionable items clinicians and other healthcare providers can execute both in their personal life and as an advocate of climate policies, and encourages communication of the health impacts of climate change when counseling patients. Our aim is to inspire the reader to invest more time in communicating the most crucial public health issue of the 21st century to their patients.
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Affiliation(s)
- Alan P. Jacobsen
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yii Chun Khiew
- Division of Gastroenterology, Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Eamon Duffy
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - James O'Connell
- Department of Public Health, Health Service Executive West, Galway, Ireland
| | - Evans Brown
- Department of Medicine, Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Paul G. Auwaerter
- Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Brian S. Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - John William McEvoy
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Galway, Ireland
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13
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Adger WN, Barnett J, Heath S, Jarillo S. Climate change affects multiple dimensions of well-being through impacts, information and policy responses. Nat Hum Behav 2022; 6:1465-1473. [DOI: 10.1038/s41562-022-01467-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022]
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14
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Nakamura D, Kinoshita H, Asada K, Arimitsu T, Yasumatsu M, Ishiwata T. Trends in ambulance dispatches related to heat illness from 2010 to 2019: An ecological study. PLoS One 2022; 17:e0275641. [PMID: 36342929 PMCID: PMC9639828 DOI: 10.1371/journal.pone.0275641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/21/2022] [Indexed: 11/09/2022] Open
Abstract
Heatstroke is a serious heat-related illness that can even cause death. Heat alert systems play an important role in reducing the number of patients experiencing heat illness, as they encourage preventive actions such as the use of air conditioning, hydration, or other strategies. However, to date, the Japanese hazard classification has not considered seasonal and regional variations, despite clear differences in meteorological conditions across different regions in Japan. Moreover, several studies have reported a difference in thermoregulation between older and younger adults, implying that the hazard classification should also consider age differences. This study examined the relationship between the number of ambulance dispatches related to heat illness (ADRHI) and the Japanese heat hazard classification from 2010 to 2019, focusing on monthly and regional differences. Data from 47 prefectures during the 10-year period were collected and analyzed. ADRHI and wet bulb globe temperature (WBGT) data were collected from Japan’s Ministry of Internal Affairs and Communications and the Ministry of the Environment Heat Illness Prevention Information website, respectively. The findings showed a significant relationship between ADRHI and WBGTmax (p < 0.05, r = 0.74). ADRHI per 100,000 people showed significant differences across months. The post hoc test detected the first steep increase in ADRHI at a WBGTmax of 23°C than at 22°C in June, and at a WBGTmax of 26°C, 27°C, and 25°C in July, August, and September, respectively. Moreover, the first significant increase in ADRHI per 100,000 people at WBGTmax differed across each region, at a WBGTmax of 24°C in Hokkaido-Tohoku, 25°C in Kanto, Kansai, and Chugoku, 26°C in Chubu, 27°C in Shikoku, and 28°C in Kyushu-Okinawa. Further, Poisson regression analysis revealed that the relative risks differed across each region and month. These results imply that the hazard classification should be adjusted according to region and month in Japan.
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Affiliation(s)
- Daisuke Nakamura
- Weathernews Inc., Makuhari Techno Garden, Chiba, Japan
- Rikkyo Research Institute of Wellness, Rikkyo University, Tokyo, Japan
- Physical Fitness Project, Japan Football Association (JFA), Tokyo, Japan
- * E-mail:
| | | | - Kazuo Asada
- Weathernews Inc., Makuhari Techno Garden, Chiba, Japan
| | - Takuma Arimitsu
- Faculty of Health Care, Department of Human Health, Hachinohe Gakuin University, Aomori, Japan
| | - Mikinobu Yasumatsu
- Rikkyo Research Institute of Wellness, Rikkyo University, Tokyo, Japan
- Physical Fitness Project, Japan Football Association (JFA), Tokyo, Japan
- Department of Sport and Wellness, Rikkyo University, Saitama, Japan
| | - Takayuki Ishiwata
- Rikkyo Research Institute of Wellness, Rikkyo University, Tokyo, Japan
- Department of Sport and Wellness, Rikkyo University, Saitama, Japan
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15
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Clemens KK, Ouédraogo AM, Le B, Voogt J, MacDonald M, Stranberg R, Yan JW, Krayenhoff ES, Gilliland J, Forchuk C, Van Uum R, Shariff SZ. Impact of Ontario's Harmonized Heat Warning and Information System on emergency department visits for heat-related illness in Ontario, Canada: a population-based time series analysis. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:686-697. [PMID: 35982292 PMCID: PMC9481795 DOI: 10.17269/s41997-022-00665-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
INTERVENTION Ontario's Harmonized Heat Warning and Information System (HWIS) brings harmonized, regional heat warnings and standard heat-health messaging to provincial public health units prior to periods of extreme heat. RESEARCH QUESTION Was implementation of the harmonized HWIS in May 2016 associated with a reduction in emergency department (ED) visits for heat-related illness in urban locations across Ontario, Canada? METHODS We conducted a population-based interrupted time series analysis from April 30 to September 30, 2012-2018, using administrative health and outdoor temperature data. We used autoregressive integrated moving average models to examine whether ED rates changed following implementation of the harmonized HWIS, adjusted for maximum daily temperature. We also examined whether effects differed in heat-vulnerable groups (≥65 years or <18 years, those with comorbidities, those with a recent history of homelessness), and by heat warning region. RESULTS Over the study period, heat alerts became more frequent in urban areas (6 events triggered between 2013 and 2015 and 14 events between 2016 and 2018 in Toronto, for example). The mean rate of ED visits was 47.5 per 100,000 Ontarians (range 39.7-60.1) per 2-week study interval, with peaks from June to July each year. ED rates were particularly high in those with a recent history of homelessness (mean rate 337.0 per 100,000). Although rates appeared to decline following implementation of HWIS in some subpopulations, the change was not statistically significant at a population level (rate 0.04, 95% CI: -0.03 to 0.1, p=0.278). CONCLUSION In urban areas across Ontario, ED encounters for heat-related illness may have declined in some subpopulations following HWIS, but the change was not statistically significant. Efforts to continually improve HWIS processes are important given our changing Canadian climate.
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Affiliation(s)
- Kristin K Clemens
- Department of Medicine, Western University, London, Ontario, Canada.
- ICES, Toronto, Ontario, Canada.
- St. Joseph's Health Care London, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada.
| | | | | | - James Voogt
- Department of Geography and Environment, Western University, London, Ontario, Canada
| | - Melissa MacDonald
- Environment and Climate Change Canada, Dartmouth, Nova Scotia, Canada
| | - Rebecca Stranberg
- Consumer and Hazardous Products Safety Directorate, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - Justin W Yan
- Division of Emergency Medicine, Western University, London, Ontario, Canada
| | - E Scott Krayenhoff
- School of Environmental Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Jason Gilliland
- Department of Geography and Environment, Western University, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
| | - Cheryl Forchuk
- School of Health Studies, Western University, London, Ontario, Canada
| | - Rafique Van Uum
- Department of Science, University of Toronto, Toronto, Ontario, Canada
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16
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Puvvula J, Abadi AM, Conlon KC, Rennie JJ, Jones H, Bell JE. Evaluating the Sensitivity of Heat Wave Definitions among North Carolina Physiographic Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10108. [PMID: 36011743 PMCID: PMC9408726 DOI: 10.3390/ijerph191610108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Exposure to extreme heat is a known risk factor that is associated with increased heat-related illness (HRI) outcomes. The relevance of heat wave definitions (HWDs) could change across health conditions and geographies due to the heterogenous climate profile. This study compared the sensitivity of 28 HWDs associated with HRI emergency department visits over five summer seasons (2011−2016), stratified by two physiographic regions (Coastal and Piedmont) in North Carolina. The HRI rate ratios associated with heat waves were estimated using the generalized linear regression framework assuming a negative binomial distribution. We compared the Akaike Information Criterion (AIC) values across the HWDs to identify an optimal HWD. In the Coastal region, HWDs based on daily maximum temperature with a threshold > 90th percentile for two or more consecutive days had the optimal model fit. In the Piedmont region, HWD based on the daily minimum temperature with a threshold value > 90th percentile for two or more consecutive days was optimal. The HWDs with optimal model performance included in this study captured moderate and frequent heat episodes compared to the National Weather Service (NWS) heat products. This study compared the HRI morbidity risk associated with epidemiologic-based HWDs and with NWS heat products. Our findings could be used for public health education and suggest recalibrating NWS heat products.
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Affiliation(s)
- Jagadeesh Puvvula
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Azar M. Abadi
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Kathryn C. Conlon
- Department of Public Health Sciences, University of California Davis, One Shields Ave, Davis, CA 95616, USA
| | - Jared J. Rennie
- National Centers for Environmental Information, Asheville, NC 28801, USA
| | - Hunter Jones
- Medical Sciences Interdepartmental Area, Office of Graduate Studies, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Jesse E. Bell
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
- School of Natural Resources, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
- Daugherty Water for Food Global Institute, University of Nebraska, Lincoln, NE 68583, USA
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17
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Dwyer IJ, Barry SJE, Megiddo I, White CJ. Evaluations of heat action plans for reducing the health impacts of extreme heat: methodological developments (2012-2021) and remaining challenges. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1915-1927. [PMID: 35835887 PMCID: PMC9283094 DOI: 10.1007/s00484-022-02326-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/16/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
The recent report of the Intergovernmental Panel on Climate Change is stark in its warnings about the changing climate, including future increases in the frequency and intensity of extremely hot weather. The well-established impacts of extreme heat on human health have led to widespread implementation of national and city-wide heat plans for mitigating such impacts. Evaluations of the effectiveness of some heat plans have been published, with previous reviews highlighting key methodological challenges. This article reviews methods used since and that address those challenges, so helping to set an agenda for improving evaluations of heat plans in terms of their effectiveness in reducing heat-health impacts. We examined the reviews that identified the methodological challenges and systematically searched the literature to find evaluations that had since been conducted. We found 11 evaluations. Their methods help address the key challenge of identifying study control groups and address other challenges to a limited extent. For future evaluations, we recommend: utilising recent evaluation methodologies, such as difference-in-differences quasi-experimental designs where appropriate; cross-agency working to utilise data on morbidity and confounders; adoption of a proposed universal heat index; and greater publication of evaluations. More evaluations should assess morbidity outcomes and be conducted in low- and middle-income countries. Evaluations of heat plans globally should employ robust methodologies, as demonstrated in existing studies and potentially transferrable from other fields. Publication of such evaluations will advance the field and thus help address some of the health challenges resulting from our changing climate.
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Affiliation(s)
- Ian J Dwyer
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK.
| | - Sarah J E Barry
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Itamar Megiddo
- Department of Management Science, University of Strathclyde, Glasgow, UK
| | - Christopher J White
- Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow, UK
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18
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Adams QH, Sun Y, Sun S, Wellenius GA. Internet searches and heat-related emergency department visits in the United States. Sci Rep 2022; 12:9031. [PMID: 35641815 PMCID: PMC9156736 DOI: 10.1038/s41598-022-13168-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 05/12/2022] [Indexed: 11/21/2022] Open
Abstract
Emerging research suggests that internet search patterns may provide timely, actionable insights into adverse health impacts from, and behavioral responses to, days of extreme heat, but few studies have evaluated this hypothesis, and none have done so across the United States. We used two-stage distributed lag nonlinear models to quantify the interrelationships between daily maximum ambient temperature, internet search activity as measured by Google Trends, and heat-related emergency department (ED) visits among adults with commercial health insurance in 30 US metropolitan areas during the warm seasons (May to September) from 2016 to 2019. Maximum daily temperature was positively associated with internet searches relevant to heat, and searches were in turn positively associated with heat-related ED visits. Moreover, models combining internet search activity and temperature had better predictive ability for heat-related ED visits compared to models with temperature alone. These results suggest that internet search patterns may be useful as a leading indicator of heat-related illness or stress.
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Affiliation(s)
- Quinn H Adams
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Yuantong Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
- Optum Labs Visiting Scholar, Eden Prairie, MN, USA
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
- Optum Labs Visiting Scholar, Eden Prairie, MN, USA.
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19
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van den Bosch M, Basagaña X, Mudu P, Kendrovski V, Maitre L, Hjertager Krog N, Aasvang GM, Grazuleviciene R, McEachan R, Vrijheid M, Nieuwenhuijsen MJ. Green CURIOCITY: a study protocol for a European birth cohort study analysing childhood heat-related health impacts and protective effects of urban natural environments. BMJ Open 2022; 12:e052537. [PMID: 35074814 PMCID: PMC8788192 DOI: 10.1136/bmjopen-2021-052537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 01/04/2022] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The European climate is getting warmer and the impact on childhood health and development is insufficiently understood. Equally, how heat-related health risks can be reduced through nature-based solutions, such as exposure to urban natural environments, is unknown. Green CURe In Outdoor CITY spaces (Green CURIOCITY) will analyse how heat exposure during pregnancy affects birth outcomes and how long-term heat exposure may influence children's neurodevelopment. We will also investigate if adverse effects can be mitigated by urban natural environments. A final goal is to visualise intraurban patterns of heat vulnerability and assist planning towards healthier cities. METHODS AND ANALYSIS We will use existing data from the Human Early-Life Exposure cohort, which includes information on birth outcomes and neurodevelopment from six European birth cohorts. The cohort is linked to data on prenatal heat exposure and impact on birth outcomes will be analysed with logistic regression models, adjusting for air pollution and noise and sociobehavioural covariates. Similarly, impact of cumulative and immediate heat exposure on neurodevelopmental outcomes at age 5 will be assessed. For both analyses, the potentially moderating impact of natural environments will be quantified. For visualisation, Geographical information systems data will be combined to develop vulnerability maps, demonstrating urban 'hot spots' where the risk of negative impacts of heat is aggravated due to sociodemographic and land use patterns. Finally, geospatial and meteorological data will be used for informing GreenUr, an existing software prototype developed by the WHO Regional Office for Europe to quantify health impacts and augment policy tools for urban green space planning. ETHICS AND DISSEMINATION The protocol was approved by the Comité Ético de Investigación Clínica Parc de Salut MAR, Spain. Findings will be published in peer-reviewed journals and presented at policy events. Through stakeholder engagement, the results will also reach user groups and practitioners.
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Affiliation(s)
- Matilda van den Bosch
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pierpaolo Mudu
- World Health Organization European Centre for Environment and Health, Bonn, Nordrhein-Westfalen, Germany
| | - Vladimir Kendrovski
- World Health Organization European Centre for Environment and Health, Bonn, Nordrhein-Westfalen, Germany
| | - Léa Maitre
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Gunn Marit Aasvang
- Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, Kaunas, Lithuania
| | | | - Martine Vrijheid
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark J Nieuwenhuijsen
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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20
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Weinberger KR, Wu X, Sun S, Spangler KR, Nori-Sarma A, Schwartz J, Requia W, Sabath BM, Braun D, Zanobetti A, Dominici F, Wellenius GA. Heat warnings, mortality, and hospital admissions among older adults in the United States. ENVIRONMENT INTERNATIONAL 2021; 157:106834. [PMID: 34461376 DOI: 10.1016/j.envint.2021.106834] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/22/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Heat warnings are issued in advance of forecast extreme heat events, yet little evidence is available regarding their effectiveness in reducing heat-related illness and death. We estimated the association of heat warnings and advisories (collectively, "alerts") issued by the United States National Weather Service with all-cause mortality and cause-specific hospitalizations among Medicare beneficiaries aged 65 years and older in 2,817 counties, 2006-2016. METHODS In each county, we compared days with heat alerts to days without heat alerts, matched on daily maximum heat index and month. We used conditional Poisson regression models stratified on county, adjusting for year, day of week, federal holidays, and lagged daily maximum heat index. RESULTS We identified a matched non-heat alert day for 92,029 heat alert days in 2,817 counties, or 54.6% of all heat alert days during the study period. Contrary to expectations, heat alerts were not associated with lower risk of mortality (RR: 1.005 [95% CI: 0.997, 1.013]). However, heat alerts were associated with higher risk of hospitalization for fluid and electrolyte disorders (RR: 1.040 [95% CI: 1.015, 1.065]) and heat stroke (RR: 1.094 [95% CI: 1.038, 1.152]). Results were similar in sensitivity analyses additionally adjusting for same-day heat index, ozone, and PM2.5. CONCLUSIONS Our results suggest that heat alerts are not associated with lower risk of mortality but may be associated with higher rates of hospitalization for fluid and electrolyte disorders and heat stroke, potentially suggesting that heat alerts lead more individuals to seek or access care.
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Affiliation(s)
- Kate R Weinberger
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada.
| | - Xiao Wu
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Shengzhi Sun
- Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Keith R Spangler
- Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Amruta Nori-Sarma
- Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Joel Schwartz
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Weeberb Requia
- School of Public Policy and Government, Fundação Getúlio Vargas, Brasilia, SGAN (Setor de Grandes Áreas Norte) Quadra 602 - Módulos A, B e C - Asa Norte, Brasilia, DF 70830-051, Brasil
| | - Benjamin M Sabath
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Danielle Braun
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Data Science, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA
| | - Antonella Zanobetti
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Francesca Dominici
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Gregory A Wellenius
- Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
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21
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Abstract
Shilu Tong and colleagues describe the health consequences of extreme urban heat and the priorities for action and research to mitigate the harms
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Affiliation(s)
- Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- Centre of Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Jason Prior
- Institute for Sustainable Futures, University of Technology, Sydney, Australia
| | | | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Patrick Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
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22
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Jay O, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Ebi KL. Reducing the health effects of hot weather and heat extremes: from personal cooling strategies to green cities. Lancet 2021; 398:709-724. [PMID: 34419206 DOI: 10.1016/s0140-6736(21)01209-5] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 12/19/2020] [Accepted: 05/20/2021] [Indexed: 01/01/2023]
Abstract
Heat extremes (ie, heatwaves) already have a serious impact on human health, with ageing, poverty, and chronic illnesses as aggravating factors. As the global community seeks to contend with even hotter weather in the future as a consequence of global climate change, there is a pressing need to better understand the most effective prevention and response measures that can be implemented, particularly in low-resource settings. In this Series paper, we describe how a future reliance on air conditioning is unsustainable and further marginalises the communities most vulnerable to the heat. We then show that a more holistic understanding of the thermal environment at the landscape and urban, building, and individual scales supports the identification of numerous sustainable opportunities to keep people cooler. We summarise the benefits (eg, effectiveness) and limitations of each identified cooling strategy, and recommend optimal interventions for settings such as aged care homes, slums, workplaces, mass gatherings, refugee camps, and playing sport. The integration of this information into well communicated heat action plans with robust surveillance and monitoring is essential for reducing the adverse health consequences of current and future extreme heat.
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Affiliation(s)
- Ollie Jay
- Thermal Ergonomics Laboratory, The University of Sydney, Sydney, NSW, Australia; Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia; Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
| | - Anthony Capon
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia
| | - Peter Berry
- Faculty of Environment, University of Waterloo, ON, Canada
| | - Carolyn Broderick
- School of Medical Sciences, UNSW Medicine, Sydney, UNSW, Australia; The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Richard de Dear
- Indoor Environmental Quality Laboratory, School of Architecture, Design, and Planning, The University of Sydney, Sydney, NSW, Australia
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - R Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Wei Ma
- School of Public Health, Shandong University, Jinan, China; Climate Change and Health Center, Shandong University, Jinan, China
| | - Arunima Malik
- School of Physics, Faculty of Science, ISA, The University of Sydney, Sydney, NSW, Australia; Discipline of Accounting, Business School, The University of Sydney, Sydney, NSW, Australia
| | - Nathan B Morris
- Thermal Ergonomics Laboratory, The University of Sydney, Sydney, NSW, Australia; Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Sonia I Seneviratne
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, AZ, USA
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, WA, USA
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23
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Sahib S, Sharma A, Muresanu DF, Zhang Z, Li C, Tian ZR, Buzoianu AD, Lafuente JV, Castellani RJ, Nozari A, Patnaik R, Menon PK, Wiklund L, Sharma HS. Nanodelivery of traditional Chinese Gingko Biloba extract EGb-761 and bilobalide BN-52021 induces superior neuroprotective effects on pathophysiology of heat stroke. PROGRESS IN BRAIN RESEARCH 2021; 265:249-315. [PMID: 34560923 DOI: 10.1016/bs.pbr.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Military personnel often exposed to high summer heat are vulnerable to heat stroke (HS) resulting in abnormal brain function and mental anomalies. There are reasons to believe that leakage of the blood-brain barrier (BBB) due to hyperthermia and development of brain edema could result in brain pathology. Thus, exploration of suitable therapeutic strategies is needed to induce neuroprotection in HS. Extracts of Gingko Biloba (EGb-761) is traditionally used in a variety of mental disorders in Chinese traditional medicine since ages. In this chapter, effects of TiO2 nanowired EGb-761 and BN-52021 delivery to treat brain pathologies in HS is discussed based on our own investigations. We observed that TiO2 nanowired delivery of EGb-761 or TiO2 BN-52021 is able to attenuate more that 80% reduction in the brain pathology in HS as compared to conventional drug delivery. The functional outcome after HS is also significantly improved by nanowired delivery of EGb-761 and BN-52021. These observations are the first to suggest that nanowired delivery of EGb-761 and BN-52021 has superior therapeutic effects in HS not reported earlier. The clinical significance in relation to the military medicine is discussed.
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Affiliation(s)
- Seaab Sahib
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
| | - Dafin F Muresanu
- Department of Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania; "RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Zhiqiang Zhang
- Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Yuexiu, Guangzhou, China
| | - Cong Li
- Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Yuexiu, Guangzhou, China
| | - Z Ryan Tian
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Anca D Buzoianu
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - José Vicente Lafuente
- LaNCE, Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Rudy J Castellani
- Department of Pathology, University of Maryland, Baltimore, MD, United States
| | - Ala Nozari
- Anesthesiology & Intensive Care, Massachusetts General Hospital, Boston, MA, United States
| | - Ranjana Patnaik
- Department of Biomaterials, School of Biomedical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, India
| | - Preeti K Menon
- Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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Science Policy to Advance a Climate Change and Health Research Agenda in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157868. [PMID: 34360159 PMCID: PMC8345657 DOI: 10.3390/ijerph18157868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 01/27/2023]
Abstract
Climate change is thought to be one of the greatest public health threats of the 21st century and there has been a tremendous growth in the published literature describing the health implications of climate change over the last decade. Yet, there remain several critical knowledge gaps in this field. Closing these gaps is crucial to developing effective interventions to minimize the health risks from climate change. In this commentary, we discuss policy trends that have influenced the advancement of climate change and health research in the United States context. We then enumerate specific knowledge gaps that could be addressed by policies to advance scientific research. Finally, we describe tools and methods that have not yet been fully integrated into the field, but hold promise for advancing the science. Prioritizing this advancement offers the potential to improve public health-related policies on climate change.
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Woodward A, Ebi KL, Hess JJ. Commentary: Responding to hazardous heat: think climate not weather. Int J Epidemiol 2021; 49:1823-1825. [PMID: 33147619 DOI: 10.1093/ije/dyaa194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Kristie L Ebi
- Department of Global Health, University of Washington, USA
| | - Jeremy J Hess
- Department of Global Health, University of Washington, USA
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McElroy S, Schwarz L, Green H, Corcos I, Guirguis K, Gershunov A, Benmarhnia T. Defining heat waves and extreme heat events using sub-regional meteorological data to maximize benefits of early warning systems to population health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 721:137678. [PMID: 32197289 DOI: 10.1016/j.scitotenv.2020.137678] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/14/2020] [Accepted: 03/01/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Extreme heat events have been consistently associated with an increased risk of hospitalization for various hospital diagnoses. Classifying heat events is particularly relevant for identifying the criteria to activate early warning systems. Heat event classifications may also differ due to heterogeneity in climates among different geographic regions, which may occur at a small scale. Using local meteorological data, we identified heat waves and extreme heat events that were associated with the highest burden of excess hospitalizations within the County of San Diego and quantified discrepancies using county-level meteorological criteria. METHODS Eighteen event classifications were created using various combinations of temperature metric, percentile, and duration for both county-level and climate zone level meteorological data within San Diego County. Propensity score matching and Poisson regressions were utilized to ascertain the association between heat wave exposure and risk of hospitalization for heat-related illness and dehydration for the 1999-2013 period. We estimated both relative and absolute risks for each heat event classification in order to identify optimal definitions of heat waves and extreme heat events for the whole city and in each climate zone to target health impacts. RESULTS Heat-related illness differs vastly by level (county or zone-specific), definition, and risk measure. We found the county-level definitions to be systematically biased when compared to climate zone definitions with the largest discrepancy of 56 attributable hospitalizations. The relative and attributable risks were often minimally correlated, which exemplified that relative risks alone are not adequate to optimize heat waves definitions. CONCLUSIONS Definitions based on county-level defined thresholds do not provide an accurate picture of the observed health effects and will fail to maximize the potential effectiveness of heat warning systems. Absolute rather than relative risks are a more appropriate measure to define the set of criteria to activate early warnings systems and thus maximize public health benefits.
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Affiliation(s)
- Sara McElroy
- School of Public Health, San Diego State University, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Lara Schwarz
- School of Public Health, San Diego State University, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Hunter Green
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Isabel Corcos
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Kristen Guirguis
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Alexander Gershunov
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
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27
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Williams AA, Allen JG, Catalano PJ, Buonocore JJ, Spengler JD. The Influence of Heat on Daily Police, Medical, and Fire Dispatches in Boston, Massachusetts: Relative Risk and Time-Series Analyses. Am J Public Health 2020; 110:662-668. [PMID: 32191522 PMCID: PMC7144447 DOI: 10.2105/ajph.2019.305563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To examine the impact of extreme heat on emergency services in Boston, MA.Methods. We conducted relative risk and time series analyses of 911 dispatches of the Boston Police Department (BPD), Boston Emergency Medical Services (BEMS), and Boston Fire Department (BFD) from November 2010 to April 2014 to assess the impact of extreme heat on emergency services.Results. During the warm season, there were 2% (95% confidence interval [CI] = 0%, 5%) more BPD dispatches, 9% (95% CI = 7%, 12%) more BEMS dispatches, and 10% (95% CI = 5%, 15%) more BFD dispatches on days when the maximum temperature was 90°F or higher, which remained consistent when we considered multiple days of heat. A 10°F increase in daily maximum temperature, from 80° to 90°F, resulted in 1.016, 1.017, and 1.002 times the expected number of daily BPD, BEMS, and BFD dispatch calls, on average, after adjustment for other predictors.Conclusions. The burden of extreme heat on local emergency medical and police services may be agency-wide, and impacts on fire departments have not been previously documented.Public Health Implications. It is important to account for the societal burden of extreme heat impacts to most effectively inform climate change adaptation strategies and planning.
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Affiliation(s)
- Augusta A Williams
- Augusta A. Williams, Joseph G. Allen, and John D. Spengler are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA. Paul J. Catalano is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, and the Department of Data Sciences, Dana-Farber Cancer Institute, Boston. Augusta A. Williams and Jonathan J. Buonocore are with the Harvard T. H. Chan School of Public Health Center for Climate, Health, and the Global Environment, Boston
| | - Joseph G Allen
- Augusta A. Williams, Joseph G. Allen, and John D. Spengler are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA. Paul J. Catalano is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, and the Department of Data Sciences, Dana-Farber Cancer Institute, Boston. Augusta A. Williams and Jonathan J. Buonocore are with the Harvard T. H. Chan School of Public Health Center for Climate, Health, and the Global Environment, Boston
| | - Paul J Catalano
- Augusta A. Williams, Joseph G. Allen, and John D. Spengler are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA. Paul J. Catalano is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, and the Department of Data Sciences, Dana-Farber Cancer Institute, Boston. Augusta A. Williams and Jonathan J. Buonocore are with the Harvard T. H. Chan School of Public Health Center for Climate, Health, and the Global Environment, Boston
| | - Jonathan J Buonocore
- Augusta A. Williams, Joseph G. Allen, and John D. Spengler are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA. Paul J. Catalano is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, and the Department of Data Sciences, Dana-Farber Cancer Institute, Boston. Augusta A. Williams and Jonathan J. Buonocore are with the Harvard T. H. Chan School of Public Health Center for Climate, Health, and the Global Environment, Boston
| | - John D Spengler
- Augusta A. Williams, Joseph G. Allen, and John D. Spengler are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA. Paul J. Catalano is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, and the Department of Data Sciences, Dana-Farber Cancer Institute, Boston. Augusta A. Williams and Jonathan J. Buonocore are with the Harvard T. H. Chan School of Public Health Center for Climate, Health, and the Global Environment, Boston
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Kodera S, Nishimura T, Rashed EA, Hasegawa K, Takeuchi I, Egawa R, Hirata A. Estimation of heat-related morbidity from weather data: A computational study in three prefectures of Japan over 2013-2018. ENVIRONMENT INTERNATIONAL 2019; 130:104907. [PMID: 31203028 DOI: 10.1016/j.envint.2019.104907] [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: 03/29/2019] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 06/09/2023]
Abstract
In recent years, the rates of heat-related morbidity and mortality have begun to increase with the increase in global warming; in this context, it is noteworthy that the number of patients transported by ambulance in heat-related cases in Japan reached 95,137 in 2018. The estimation of heat-related morbidity forms a key factor in proposing and implementing suitable intervention strategies and ambulance availability and arrangements. Heat-related morbidity is known to be fairly correlated to metrics related to ambient conditions, thus necessitating the exploration of new metrics to more accurately estimate morbidity. In this study, we use an integrated computational technique relating to thermodynamics and thermoregulation to estimate daily peak core temperature elevation and daily water loss, which are linked to heat-related illnesses, from weather data of three different prefectures in Japan (Tokyo, Osaka, and Aichi). The correlations of the computed core temperature elevation and water loss as well as conventional ambient conditions are investigated in terms of number of patients suffering from heat-related illnesses transported by ambulance from 2013 to 2018. The estimated water loss per the proposed computation yields better correlation with the number of patients transported by ambulance. In particular, the weight-sum daily water loss for two to three successive days is found to be an important metric for predicting the number of patients transported by ambulance. For the same ambient conditions, morbidity is found to decrease to 0.4 owing to heat adaption at the end of summer (60 days) as compared with that at the end of the rainy season. Thus, the weighted sum of water loss and daily average ambient temperature for successive days can be used as better metrics than conventional weather data for the application of intervention strategies and planning of ambulance arrangements for heat-related morbidity.
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Affiliation(s)
- Sachiko Kodera
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Taku Nishimura
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Essam A Rashed
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; Department of Computer Science, Faculty of Informatics & Computer Science, The British University in Egypt, Cairo 11837, Egypt; Department of Mathematics, Faculty of Science, Suez Canal University, Ismailia 41522, Egypt
| | - Kazuma Hasegawa
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Ichiro Takeuchi
- Department of Computer Science, Nagoya Institute of Technology, Nagoya 466-8555, Japan; Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya 466-8555, Japan; Frontier Research Institute for Information Science, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Ryusuke Egawa
- Cyberscience Center, Tohoku University, Sendai 980-8578, Japan
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya 466-8555, Japan; Frontier Research Institute for Information Science, Nagoya Institute of Technology, Nagoya 466-8555, Japan.
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The Use of a Quasi-Experimental Study on the Mortality Effect of a Heat Wave Warning System in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122245. [PMID: 31242672 PMCID: PMC6617315 DOI: 10.3390/ijerph16122245] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 12/31/2022]
Abstract
Many cities and countries have implemented heat wave warning systems to combat the health effects of extreme heat. Little is known about whether these systems actually reduce heat-related morbidity and mortality. We examined the effectiveness of heat wave alerts and health plans in reducing the mortality risk of heat waves in Korea by utilizing the discrepancy between the alerts and the monitored temperature. A difference-in-differences analysis combined with propensity score weighting was used. Mortality, weather monitoring, and heat wave alert announcement data were collected for 7 major cities during 2009–2014. Results showed evidence of risk reduction among people aged 19–64 without education (−0.144 deaths/1,000,000 people, 95% CI: −0.227, −0.061) and children aged 0–19 (−0.555 deaths/1,000,000 people, 95% CI: −0.993, −0.117). Decreased cardiovascular and respiratory mortality was found in several subgroups including single persons, widowed people, blue-collar workers, people with no education or the highest level of education (university or higher). No evidence was found for decreased all-cause mortality in the population (1.687 deaths/1,000,000 people per day; 95% CI: 1.118, 2.255). In conclusion, heat wave alerts may reduce mortality for several causes and subpopulations of age and socio-economic status. Further work needs to examine the pathways through which the alerts impact subpopulations differently.
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Ban J, Shi W, Cui L, Liu X, Jiang C, Han L, Wang R, Li T. Health-risk perception and its mediating effect on protective behavioral adaptation to heat waves. ENVIRONMENTAL RESEARCH 2019; 172:27-33. [PMID: 30769186 DOI: 10.1016/j.envres.2019.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/27/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
Ensuring spontaneously adjusting behaviors of the public in their daily life in response to heat waves is an important aspect of successful public health intervention under climate change. However, the current response behavior guidance released by the government is insufficient because of the limited understanding of public perceptions of heat-related risk and the motivating factors for the public's diverse adaptive behaviors. Here, we conducted a survey on the behavioral adaptations of 3065 urban residents in response to heat waves in Jinan, which is a typical city suffering from a hot climate. We provided evidence on the current state of residents' perception of heat waves and the mechanism of how risk perception mediates individual behavioral intentions upon exposure to high ambient temperatures. We found that the mediating effects of risk perception varied significantly with respect to different types of adaptive behaviors. Concern behaviors appeared be motivated completely by the mediating effects of perceived concern (b = 0.45, p < 0.01 for concerns about health guidelines; b = 0.36, p < 0.01 for concerns about the weather forecast) and severity (b = 0.11, p < 0.01 for concerns about health guidelines), while outdoor activity could be consciously adjusted according to temperature changes without those mediating effects (p > 0.05). Indoor cooling behaviors and transportation behaviors are partially mediated by risk perception (b = -0.04, p < 0.01; b = 0.08, p < 0.01; b = 0.08, p < 0.01 for indoor fan usage, use of air-conditioned buses, and use of private cars, respectively). The conclusions could help determine more targeted and detailed interventions to enhance public behavioral adjustments, including participation in adaption to and emergency preparedness for extreme temperature under the ongoing climate changes.
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Affiliation(s)
- Jie Ban
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wanying Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liangliang Cui
- Jinan Center for Disease Control and Prevention, Jinan 250021, China
| | - Xia Liu
- Center for Disease Prevention and Control of Changqing District, Jinan 250300, China
| | - Chao Jiang
- Center for Disease Prevention and Control of Central District, Jinan 250001, China
| | - Lianyu Han
- Center for Disease Prevention and Control of Licheng District, Jinan 250100, China
| | - Rui Wang
- Jinan Center for Disease Control and Prevention, Jinan 250021, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Anderson GB, Barnes EA, Bell ML, Dominici F. The Future of Climate Epidemiology: Opportunities for Advancing Health Research in the Context of Climate Change. Am J Epidemiol 2019; 188:866-872. [PMID: 30877291 DOI: 10.1093/aje/kwz034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 12/14/2022] Open
Abstract
In the coming decades, climate change is expected to dramatically affect communities worldwide, altering the patterns of many ambient exposures and disasters, including extreme temperatures, heat waves, wildfires, droughts, and floods. These exposures, in turn, can affect risks for a variety of human diseases and health outcomes. Climate epidemiology plays an important role in informing policy related to climate change and its threats to public health. Climate epidemiology leverages deep, integrated collaborations between epidemiologists and climate scientists to understand the current and potential future impacts of climate-related exposures on human health. A variety of recent and ongoing developments in climate science are creating new avenues for epidemiologic contributions. Here, we discuss the contributions of climate epidemiology and describe some key current research directions, including research to better characterize uncertainty in climate health projections. We end by outlining 3 developing areas of climate science that are creating opportunities for high-impact epidemiologic advances in the near future: 1) climate attribution studies, 2) subseasonal to seasonal forecasts, and 3) decadal predictions.
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Affiliation(s)
- G Brooke Anderson
- Department of Environmental & Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Elizabeth A Barnes
- Department of Atmospheric Science, Colorado State University, Fort Collins, Colorado
| | - Michelle L Bell
- School of Forestry & Environmental Studies, New Haven, Connecticut
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Martínez-Solanas È, Basagaña X. Temporal changes in temperature-related mortality in Spain and effect of the implementation of a Heat Health Prevention Plan. ENVIRONMENTAL RESEARCH 2019; 169:102-113. [PMID: 30447497 DOI: 10.1016/j.envres.2018.11.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 05/16/2023]
Abstract
Exposure to extreme ambient temperatures has been widely described to increase mortality. Exploring changes in susceptibility to temperatures over time can provide useful information for policy planning and can provide insights on the effectiveness of health preventive plans. The aims of this study were i) to compare changes in temperature-related mortality in Spain during a 20-year period and ii) to assess whether the number of actions implemented in each region as part of a Heat Health Prevention Plan (HHPP) was associated with the temporal changes in heat-related mortality. Daily counts of deaths and daily maximum temperature were obtained for each Spanish province (1993-2013). We used time-varying distributed lag non-linear models to estimate the relationship between temperature and mortality. We compared the risk of death due to extreme temperatures (cold and heat) in the two periods (1993-2002 and 2004-2013), assuming a constant temperature distribution and different temperature-mortality function. Results were reported as mortality attributable fraction (%) (AF). Overall, there was a decrease in mortality attributable to temperature in period 2, more remarkable for extreme cold (from 1.01% to 0.52%), while for moderate heat there was an increase (from 0.38% to 1.21%). Provinces with more actions implemented in their HHPP showed stronger decreases in mortality attributable to extreme heat. Other variables (e.g. average temperature) could explain this association. The highest mortality-AF reductions were detected among the elderly, in mortality for cardiovascular causes and in towns with high socioeconomic vulnerability. Our results suggest that the implementation of the Spanish HHPP could help reduce heat-related mortality.
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Affiliation(s)
- Èrica Martínez-Solanas
- ISGlobal, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
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