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Weng Z, Dong Z, Zhao Y, Xu M, Xie Y, Lu F. Cleaner heating policies contribute significantly to health benefits and cost-savings: A case study in Beijing, China. iScience 2024; 27:110249. [PMID: 39027367 PMCID: PMC11254592 DOI: 10.1016/j.isci.2024.110249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/20/2024] [Accepted: 06/07/2024] [Indexed: 07/20/2024] Open
Abstract
Cleaner heating policies aim to reduce air pollution and may bring about health benefits to individuals. Based on a fixed-effect model focusing on Beijing, this study found that after the onset of air pollution, daily clinic visits, hospitalization days, and hospitalization expenses increased several days after the occurrence of air pollution. These hospitalization changes were observed in males and females and three different age groups. A difference-in-differences (DID) model was constructed to identify the influences of cleaner heating policies on health consequences. The study revealed that the policy positively affects health outcomes, with an average decrease of 3.28 thousand clinic visits for all diseases. The total hospitalization days and expenses tend to decrease by 0.22 thousand days and 0.34 million CNY (Chinese Yuan), respectively. Furthermore, implementing the policy significantly reduced the number of daily clinic visits for respiratory diseases, asthma, stroke, diabetes, and chronic obstructive pulmonary diseases (COPDs).
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Affiliation(s)
- Zhixiong Weng
- Institute of Circular Economy, Beijing University of Technology, Beijing 100124, China
| | - Zhaomin Dong
- School of Materials Science and Engineering, Beihang University, Beijing 100191, China
| | - Yi Zhao
- School of Economics and Management, Beihang University, Beijing 100191, China
| | - Meng Xu
- School of Management, Wuhan Institute of Technology, Wuhan 430205, China
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing 100191, China
| | - Feng Lu
- Beijing Municipal Health Commission Information Center, Beijing 100034, China
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2
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Yoo EH, Roberts JE. Differential effects of air pollution exposure on mental health: Historical redlining in New York State. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 948:174516. [PMID: 39009165 DOI: 10.1016/j.scitotenv.2024.174516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024]
Abstract
Growing evidence suggests that ambient air pollution has adverse effects on mental health, yet our understanding of its unequal impact remains limited, especially in areas with historical redlining practices. This study investigates whether the impact of daily fluctuations in ambient air pollutant levels on emergency room (ER) visits for mental disorders (MDs) varies across neighborhoods affected by redlining. Furthermore, we explored how demographic characteristics and ambient temperature may modify the effects of air pollution. To assess the disproportional short-term effects of PM2.5, NO2, and O3 on ER visits across redlining neighborhoods, we used a symmetric bidirectional case-crossover design with a conditional logistic regression model. We analyzed data from 2 million ER visits for MDs between 2005 and 2016 across 17 cities in New York State, where redlining policies were historically implemented. A stratified analysis was performed to examine potential effect modification by individuals' demographic characteristics (sex, age, and race/ethnicity) and ambient temperature. We found that both PM2.5 and NO2 were significantly associated with MD-related ER visits primarily in redlined neighborhoods. Per 10μgm-3 increase in daily PM2.5 and per 10 ppb increase in NO2 concentration were associated with 1.04 % (95 % Confidence Interval (CI): 0.57 %, 1.50 %) and 0.44 % (95 % CI: 0.21 %, 0.67 %) increase in MD-related ER visits in redlined neighborhoods, respectively. We also found significantly greater susceptibility among younger persons (below 18 years old) and adults aged 35-64 among residents in grade C or D, but not in A or B. Furthermore, we found that positive and statistically significant associations between increases in air pollutants (PM2.5 and NO2) and MD-related ER visits exist during medium temperatures (4.90 °C to 21.11 °C), but not in low or high temperature. Exposures to both PM2.5 and NO2 were significantly associated with MD-related ER visits, but these adverse effects were disproportionately pronounced in redlined neighborhoods.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
| | - John E Roberts
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA
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Gupta P, Payra S, Bhatla R, Verma S. WRF-Chem modeling study of heat wave driven ozone over southeast region, India. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 340:122744. [PMID: 37865332 DOI: 10.1016/j.envpol.2023.122744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/03/2023] [Accepted: 10/13/2023] [Indexed: 10/23/2023]
Abstract
Present study examines how ozone concentration changed under heatwave (HW) condition with emphasis on meteorological parameters in respect to non-heatwave (NHW) days. In this perspective, Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) has been used to simulate the surface O3 (SfO3) and maximum temperature (Tmax) during NHW (11th-19th May 2015) and HW days (21st-29th May 2015) over southeast (SE), India. The WRF-Chem simulated meteorological and chemical variables have been evaluated against the ERA5 and CAMS reanalysis dataset. A significant correlation of 55-95% is found for all the meteorological and chemical variables. The influencing parameters shows positive correlation of ozone with temperature, which reaches 75-78 ppbv under HW condition. Day to day trend analysis reveal an increasing pattern of maximum temperature and SfO3 concentration under HW condition. During HW, mixing of ozone-rich air aloft with near-surface air leading a rise in SfO3, as indicated by both ERA5 (with a maximum Planetary Boundary Layer Height (PBLH) of 1000 m) and WRF-Chem simulations (1600 m). Furthermore, the diurnal cycle of SfO3, temperature, PBLH reaches a peak at afternoon, while the other variables like nitrogen oxides (NOx), Relative Humidity (RH) shows a high concentration at night-time. Overall, WRF-Chem model effectively captures the diurnal fluctuations of SfO3, NOx and the meteorological variables during the HW event over the SE, India. Result shows that HW may cause a strong contribution to the rate of increase in SfO3 (22.17%). Thus, it is required to consider contribution of HW driven ozone when developing long-term strategies to mitigate regional ozone pollution.
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Affiliation(s)
- Priyanshu Gupta
- Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Swagata Payra
- Department of Remote Sensing, Birla Institute of Technology Mesra, Ranchi, Jharkhand, India
| | - R Bhatla
- Department of Geophysics, Banaras Hindu University, Varanasi, Uttar Pradesh, India; DST-Mahamana Centre of Excellence in Climate Change Research, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sunita Verma
- Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, Uttar Pradesh, India; DST-Mahamana Centre of Excellence in Climate Change Research, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
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Xu Z, Watzek JT, Phung D, Oberai M, Rutherford S, Bach AJE. Heat, heatwaves, and ambulance service use: a systematic review and meta-analysis of epidemiological evidence. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1523-1542. [PMID: 37495745 PMCID: PMC10457246 DOI: 10.1007/s00484-023-02525-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/01/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
Ambulance data has been reported to be a sensitive indicator of health service use during hot days, but there is no comprehensive summary of the quantitative association between heat and ambulance dispatches. We conducted a systematic review and meta-analysis to retrieve and synthesise evidence published up to 31 August 2022 about the association between heat, prolonged heat (i.e. heatwaves), and the risk of ambulance dispatches. We initially identified 3628 peer-reviewed papers and included 48 papers which satisfied the inclusion criteria. The meta-analyses showed that, for each 5 °C increase in mean temperature, the risk of ambulance dispatches for all causes and for cardiovascular diseases increased by 7% (95% confidence interval (CI): 5%, 10%) and 2% (95% CI: 1%, 3%), respectively, but not for respiratory diseases. The risk of ambulance dispatches increased by 6% (95% CI: 4%, 7%), 7% (95% CI: 5%, 9%), and 18% (95% CI: 12%, 23%) under low-intensity, severe, and extreme heatwaves, respectively. We observed two potential sources of bias in the existing literature: (1) bias in temperature exposure measurement; and (2) bias in the ascertainment of ambulance dispatch causes. This review suggests that heat exposure is associated with an increased risk of ambulance dispatches, and there is a dose-response relationship between heatwave intensity and the risk of ambulance dispatches. For future studies assessing the heat-ambulance association, we recommend that (1) using data on spatially refined gridded temperature that is either very well interpolated or derived from satellite imaging may be an alternative to reduce exposure measurement bias; and (2) linking ambulance data with hospital admission data can be useful to improve health outcome classification.
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Affiliation(s)
- Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
| | - Jessica T Watzek
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Mehak Oberai
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
- Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Aaron J E Bach
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
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Seong K, Jiao J, Mandalapu A. Hourly Associations between Heat Index and Heat-Related Emergency Medical Service (EMS) Calls in Austin-Travis County, Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6853. [PMID: 37835122 PMCID: PMC10572679 DOI: 10.3390/ijerph20196853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023]
Abstract
This paper aims to investigate the following research questions: (1) what are the hourly patterns of heat index and heat-related emergency medical service (EMS) incidents during summertime?; and (2) how do the lagged effects of heat intensity and hourly excess heat (HEH) vary by heat-related symptoms? Using the hourly weather and heat-related EMS call data in Austin-Travis County, Texas, this paper reveals the relationship between heat index patterns on an hourly basis and heat-related health issues and evaluates the immediate health effects of extreme heat events by utilizing a distributed lag non-linear model (DLNM). Delving into the heat index intensity and HEH, our findings suggest that higher heat intensity has immediate, short-term lagged effects on all causes of heat-related EMS incidents, including in cardiovascular, respiratory, neurological, and non-severe cases, while its relative risk (RR) varies by time. HEH also shows a short-term cumulative lagged effect within 5 h in all-cause, cardiovascular, and non-severe symptoms, while there are no statistically significant RRs found for respiratory and neurological cases in the short term. Our findings could be a reference for policymakers when devoting resources, developing extreme heat warning standards, and optimizing local EMS services, providing data-driven evidence for the effective deployment of ambulances.
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Affiliation(s)
- Kijin Seong
- Urban Information Lab, School of Architecture, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Junfeng Jiao
- Urban Information Lab, School of Architecture, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Akhil Mandalapu
- Department of Public Health, The University of Texas at Austin, Austin, TX 78712, USA;
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Herath P, Thatcher M, Jin H, Bai X. Comparing the cooling effectiveness of operationalisable urban surface combination scenarios for summer heat mitigation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 874:162476. [PMID: 36858236 DOI: 10.1016/j.scitotenv.2023.162476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Extreme summer heat in cities exacerbates the vulnerability of urban communities to heatwaves. Vegetative and reflective urban surfaces can help reduce urban heat. This study investigated the impacts of urban trees, green roofs and cool roofs on heat mitigation during average and extreme summer conditions in temperate oceanic Melbourne, Australia. We simulated the city climate using 'The Air Pollution Model' (TAPM) at a 1 km spatial resolution over 10 years, which according to our review of the literature, was the most prolonged period for simulation in Melbourne. During a widespread heatwave event, some of the tested scenarios with combined surface parameters could reduce the extreme values of the energy budget components- sensible heat, latent heat, and storage heat fluxes up to seasonal averages compared to the existing situation for Melbourne (control). The scenario with the highest (reasonable maximum) ground-level vegetation, green roofs, and cool roofs could reduce air temperatures up to 2.4 °C. The simulations suggest that a combined strategy with vegetative and high-albedo surfaces will deliver higher effectiveness with maximum cooling benefits and cost-effectiveness than individual strategies in cities. These results suggest the importance of collaborative strategic planning of urban surfaces to make cities healthier, sustainable, and liveable.
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Affiliation(s)
- Prabhasri Herath
- Fenner School of Environment and Society, Australian National University, Canberra, Australia.
| | - Marcus Thatcher
- CSIRO Marine and Atmospheric Research, Aspendale, Victoria, Australia.
| | - Huidong Jin
- CSIRO Data61, GPO Box 1700, Canberra, ACT 2601, Australia.
| | - Xuemei Bai
- Fenner School of Environment and Society, Australian National University, Canberra, Australia.
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Corvetto JF, Helou AY, Dambach P, Müller T, Sauerborn R. A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1190. [PMID: 36673946 PMCID: PMC9858749 DOI: 10.3390/ijerph20021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.
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Affiliation(s)
- Julia Feriato Corvetto
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ammir Yacoub Helou
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Thomas Müller
- Private Clinic Meiringen, 3860 Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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Braun RA, Hondula DM, Fraser MP. Impact of environmental factors on heat-associated mortalities in an urban desert region. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:2133-2146. [PMID: 36088401 PMCID: PMC9463968 DOI: 10.1007/s00484-022-02346-7] [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: 08/09/2021] [Revised: 06/02/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
The troubling trend of rising heat-associated mortalities in an urban desert region (Maricopa County, AZ, USA) has motivated us to explore the extent to which environmental factors may contribute to increased heat-health risks. Summertime data from 2010 to 2019 were used to construct a suite of models for daily heat-associated mortalities. The best-performing full model included the following predictors, ordered from strongest to weakest influence: daily average air temperature, average of previous 5 days daily average air temperature, year, day of year, average of previous 5 days daily average dew point temperature, average of previous 5 days daily average PM2.5, and daily average PM10. This full model exhibited a 5.39% reduction in mean absolute error in daily heat-associated mortalities as compared to the best-performing model that included only air temperature as an environmental predictor. The extent to which issued and modeled excessive heat warnings (from both the temperature only and full models) corresponded with heat-associated mortalities was also examined. Model hindcasts for 2020 and 2021 showed that the models were able to capture the high number of heat-associated mortalities in 2020, but greatly undercounted the highest yet observed number of heat-associated mortalities in 2021. Results from this study lend insights into environmental factors corresponding to an increased number of heat-associated mortalities and can be used for informing strategies towards reducing heat-health risks. However, as the best-performing model was unable to fully capture the observed number of heat-associated mortalities, continued scrutiny of both environmental and non-environmental factors affecting these observations is needed.
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Affiliation(s)
- Rachel A Braun
- Healthy Urban Environments Initiative, Global Institute of Sustainability and Innovation, Arizona State University, Tempe, AZ, USA.
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - Matthew P Fraser
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA
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Xu E, Li Y, Li T, Li Q. Association between ambient temperature and ambulance dispatch: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:66335-66347. [PMID: 35499723 DOI: 10.1007/s11356-022-20508-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Previous studies have quantified the associations between ambient temperature and dispatch of ambulances, but the conclusions are still controversial. Therefore, a systematic review and meta-analysis were conducted to summarize all the current evidence. A systematic review of published literature was undertaken to characterize the effect of temperature on ambulance dispatch. We completed the literature search by the end of January 5, 2022. The pooled estimates for different temperature exposures were calculated using a random effects model. Differences among temperature pooled estimates were determined using subgroup analysis. This study was registered with PROSPERO under the number CRD42021284434. This is the first meta-analysis investigating the association between temperature and ambulance dispatch. A total of 25 studies were eligible for this study. The overall increased risks of high temperature, expressed as relative risks, were 1.734 (95% CI: 1.481-2.031). Subgroup analysis found that for the study using daily mean temperature, the high temperature increased the risk of ambulance dispatch by 15.2% (RR = 1.152, 95%CI: 1.081-1.228). In the ambulance dispatch of all-cause subgroups, the RR was 1.179 (95% CI: 1.085-1.282). The results also reported a significant association between low temperature and ambulance dispatch (RR = 1.130, 95% CI: 1.052-1.213). In the subgroup, the RR for cardiovascular disease was 1.209 (95% CI: 1.033-1.414), and respiratory disease was 1.126 (95% CI: 1.012-1.253). Sensitivity analysis indicated that the results were robust, and no obvious publication bias was observed. High temperature and low temperature are important factors influencing the dispatch of ambulances. These findings help improve the understanding of temperature effect on ambulance dispatch, demonstrating the need to consider wider surveillance of acute health outcomes in different environments.
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Affiliation(s)
- Er Xu
- Hospital Infection Management Office, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Yanni Li
- Public Health Department, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Tingting Li
- Department of Endocrinology, Rheumatology and Immunology, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Qing Li
- Hospital Infection Management Office, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China.
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing, Anhui, People's Republic of China.
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Ahn J, Bae S, Chung BH, Myong JP, Park MY, Lim YH, Kang MY. Association of summer temperatures and acute kidney injury in South Korea: a case-crossover study. Int J Epidemiol 2022:6661204. [PMID: 35950799 DOI: 10.1093/ije/dyac163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Due to climate change, days with high temperatures are becoming more frequent. Although the effect of high temperature on the kidneys has been reported in research from Central and South America, Oceania, North America and Europe, evidence from Asia is still lacking. This study aimed to examine the association between short-term exposure to high temperatures and acute kidney injury (AKI) in a nationwide study in South Korea. METHODS We used representative sampling data from the 2002-2015 National Health Insurance Service-National Sample Cohort in South Korea to link the daily mean temperatures and AKI cases that occurred in the summer. We used a bidirectional case-crossover study design with 0-7 lag days before the emergency room visit for AKI. In addition, we stratified the data into six income levels to identify the susceptible population. RESULTS A total of 1706 participants were included in this study. The odds ratio (OR) per 1°C increase at 0 lag days was 1.051, and the ORs per 1°C increase at a lag of 2 days were both 1.076. The association between exposure to high temperatures and AKI was slightly greater in the low-income group (OR = 1.088; 95% CI: 1.049-1.128) than in the high-income group (OR = 1.065; 95% CI: 1.026-1.105). CONCLUSIONS In our study, a relationship between exposure to high temperatures and AKI was observed. Precautions should be taken at elevated temperatures to minimize the risk of negative health effects.
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Affiliation(s)
- Joonho Ahn
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Ha Chung
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Min Young Park
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
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Dey C, Dudley M, Knight K, Perkes I. Rising temperatures and suicidal behaviour in children and adolescents. Aust N Z J Psychiatry 2022; 56:729. [PMID: 34388950 DOI: 10.1177/00048674211038848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Cybele Dey
- Department of Psychological Medicine, The Sydney Children's Hospital Network (SCHN), Westmead, NSW, Australia
| | - Michael Dudley
- The South East Sydney Local Health District (SESLHD), UNSW, Randwick, NSW, Australia
| | - Katherine Knight
- Department of Psychological Medicine, The Sydney Children's Hospital Network (SCHN), Westmead, NSW, Australia
| | - Iain Perkes
- Department of Psychological Medicine, The Sydney Children's Hospital Network (SCHN), Westmead, NSW, Australia.,UNSW, Kensington, NSW, Australia
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Understanding current and projected emergency department presentations and associated healthcare costs in a changing thermal climate in Adelaide, South Australia. Occup Environ Med 2022; 79:421-426. [DOI: 10.1136/oemed-2021-107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/18/2022] [Indexed: 11/03/2022]
Abstract
BackgroundExposure to extreme temperatures is associated with increased emergency department (ED) presentations. The resulting burden on health service costs and the potential impact of climate change is largely unknown. This study examines the temperature-EDs/cost relationships in Adelaide, South Australia and how this may be impacted by increasing temperatures.MethodsA time series analysis using a distributed lag nonlinear model was used to explore the exposure–response relationships. The net-attributable, cold-attributable and heat-attributable ED presentations for temperature-related diseases and costs were calculated for the baseline (2014–2017) and future periods (2034–2037 and 2054–2057) under three climate representative concentration pathways (RCPs).ResultsThe baseline heat-attributable ED presentations were estimated to be 3600 (95% empirical CI (eCI) 700 to 6500) with associated cost of $A4.7 million (95% eCI 1.8 to 7.5). Heat-attributable ED presentations and costs were projected to increase during 2030s and 2050s with no change in the cold-attributable burden. Under RCP8.5 and population growth, the increase in heat-attributable burden would be 1.9% (95% eCI 0.8% to 3.0%) for ED presentations and 2.5% (95% eCI 1.3% to 3.7%) for ED costs during 2030s. Under the same conditions, the heat effect is expected to increase by 3.7% (95% eCI 1.7% to 5.6%) for ED presentations and 5.0% (95% eCI 2.6% to 7.1%) for ED costs during 2050s.ConclusionsProjected climate change is likely to increase heat-attributable emergency presentations and the associated costs in Adelaide. Planning health service resources to meet these changes will be necessary as part of broader risk mitigation strategies and public health adaptation actions.
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Yoo EH, Roberts JE, Eum Y, Li X, Konty K. Exposure to urban green space may both promote and harm mental health in socially vulnerable neighborhoods: A neighborhood-scale analysis in New York City. ENVIRONMENTAL RESEARCH 2022; 204:112292. [PMID: 34728238 DOI: 10.1016/j.envres.2021.112292] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/16/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND There is growing evidence that exposure to green space can impact mental health, but these effects may be context dependent. We hypothesized that associations between residential green space and mental health can be modified by social vulnerability. METHOD We conducted an ecological cross-sectional analysis to evaluate the effects of green space exposure on mental disorder related emergency room (ER) visits in New York City at the level of census tract. To objectively represent green space exposure at the neighborhood scale, we calculated three green space exposure metrics, namely proximity to the nearest park, percentage of green space, and visibility of greenness. Using Bayesian hierarchical spatial Poisson regression models, we evaluated neighborhood social vulnerability as a potential modifier of greenness-mental disorder associations, while accounting for the spatially correlated structures. RESULTS We found significant associations between green space exposure (involving both proximity and visibility) and total ER visits for mental disorders in neighborhoods with high social vulnerability, but no significant associations in neighborhoods with low social vulnerability. We also identified specific neighborhoods with particularly high ER utilization for mental disorders. CONCLUSIONS Our findings suggest that exposure to green space is associated with ER visits for mental disorders, but that neighborhood social vulnerability can modify this association. Future research is needed to confirm our finding with longitudinal designs at the level of individuals.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
| | - John E Roberts
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA
| | - Xiaojiang Li
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA, USA
| | - Kevin Konty
- New York City Department of Health & Mental Hygiene, NYC, NY, USA
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14
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Adams J, Brumby S, Kloot K, Baker T, Mohebbi M. High-Heat Days and Presentations to Emergency Departments in Regional Victoria, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042131. [PMID: 35206318 PMCID: PMC8872328 DOI: 10.3390/ijerph19042131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/17/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023]
Abstract
Heat kills more Australians than any other natural disaster. Previous Australian research has identified increases in Emergency Department presentations in capital cities; however, little research has examined the effects of heat in rural/regional locations. This retrospective cohort study aimed to determine if Emergency Department (ED) presentations across the south-west region of Victoria, Australia, increased on high-heat days (1 February 2017 to 31 January 2020) using the Rural Acute Hospital Data Register (RAHDaR). The study also explored differences in presentations between farming towns and non-farming towns. High-heat days were defined as days over the 95th temperature percentile. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes associated with heat-related illness were identified from previous studies. As the region has a large agricultural sector, a framework was developed to identify towns estimated to have 70% or more of the population involved in farming. Overall, there were 61,631 presentations from individuals residing in the nine Local Government Areas. Of these presentations, 3064 (5.0%) were on days of high-heat, and 58,567 (95.0%) were of days of non-high-heat. Unlike previous metropolitan studies, ED presentations in rural south-west Victoria decrease on high-heat days. This decrease was more prominent in the farming cohort; a potential explanation for this may be behavioural adaption.
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Affiliation(s)
- Jessie Adams
- National Centre for Farmer Health, Western District Health Service, Hamilton, VIC 3300, Australia;
- Correspondence: ; Tel.: +61-3-5551-8533
| | - Susan Brumby
- National Centre for Farmer Health, Western District Health Service, Hamilton, VIC 3300, Australia;
| | - Kate Kloot
- School of Medicine, Deakin University, Warrnambool, VIC 3280, Australia;
| | - Tim Baker
- Centre for Rural Emergency Medicine, Deakin University, Warrnambool, VIC 3280, Australia;
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia;
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15
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The Thermal Environment of Housing and Its Implications for the Health of Older People in South Australia: A Mixed-Methods Study. ATMOSPHERE 2022. [DOI: 10.3390/atmos13010096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Older people are often over-represented in morbidity and mortality statistics associated with hot and cold weather, despite remaining mostly indoors. The study “Improving thermal environment of housing for older Australians” focused on assessing the relationships between the indoor environment, building characteristics, thermal comfort and perceived health/wellbeing of older South Australians over a study period that included the warmest summer on record. Our findings showed that indoor temperatures in some of the houses reached above 35 °C. With concerns about energy costs, occupants often use adaptive behaviours to achieve thermal comfort instead of using cooling (or heating), although feeling less satisfied with the thermal environment and perceiving health/wellbeing to worsen at above 28 °C (and below 15 °C). Symptoms experienced during hot weather included tiredness, shortness of breath, sleeplessness and dizziness, with coughs and colds, painful joints, shortness of breath and influenza experienced during cold weather. To express the influence of temperature and humidity on perceived health/wellbeing, a Temperature Humidity Health Index (THHI) was developed for this cohort. A health/wellbeing perception of “very good” is achieved between an 18.4 °C and 24.3 °C indoor operative temperature and a 55% relative humidity. The evidence from this research is used to inform guidelines about maintaining home environments to be conducive to the health/wellbeing of older people.
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16
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Liu J, Varghese BM, Hansen A, Borg MA, Zhang Y, Driscoll T, Morgan G, Dear K, Gourley M, Capon A, Bi P. Hot weather as a risk factor for kidney disease outcomes: A systematic review and meta-analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 801:149806. [PMID: 34467930 DOI: 10.1016/j.scitotenv.2021.149806] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The occurrence or exacerbation of kidney disease has been documented as a growing problem associated with hot weather. The implementation of effective prevention measures requires a better understanding of the risk factors that increase susceptibility. To fill gaps in knowledge, this study reviews the current literature on the effects of heat on kidney-disease outcomes (ICD-10 N00-N39), including morbidity and mortality. METHODS Databases were systematically searched for relevant literature published between 1990 and 2020 and the quality of evidence evaluated. We performed random effects meta-analysis to calculate the pooled relative risks (RRs) of the association between high temperatures (and heatwaves) and kidney disease outcomes. We further evaluated vulnerability concerning contextual population characteristics. RESULTS Of 2739 studies identified, 91 were reviewed and 82 of these studies met the criteria for inclusion in a meta-analysis. Findings showed that with a 1 °C increase in temperature, the risk of kidney-related morbidity increased by 1% (RR 1.010; 95% CI: 1.009-1.011), with the greatest risk for urolithiasis. Heatwaves were also associated with increased morbidity with a trend observed with heatwave intensity. During low-intensity heatwaves, there was an increase of 5.9% in morbidity, while during high-intensity heatwaves there was a 7.7% increase. There were greater RRs for males, people aged ≤64 years, and those living in temperate climate zones. Similarly, for every 1 °C temperature increase, there was a 3% (RR 1.031; 95% CI: 1.018-1.045) increase in the risk of kidney-related mortality, which also increased during heatwaves. CONCLUSIONS High temperatures (and heatwaves) are associated with an elevated risk of kidney disease outcomes, particularly urolithiasis. Preventive measures that may minimize risks in vulnerable individuals during hot spells are discussed.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Matthew A Borg
- School of Public Health, The University of Adelaide, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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17
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Constantinou A, Oikonomou S, Konstantinou C, Makris KC. A randomized cross-over trial investigating differences in 24-h personal air and skin temperatures using wearable sensors between two climatologically contrasting settings. Sci Rep 2021; 11:22020. [PMID: 34759278 PMCID: PMC8580978 DOI: 10.1038/s41598-021-01180-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/25/2021] [Indexed: 11/08/2022] Open
Abstract
The influence of elevated air temperatures recorded in various urban microenvironments in adversely impacting biologically relevant disease end points has not yet been extensively tackled. This study is a post hoc analysis of the TEMP pilot trial, a randomized 2 × 2 cross-over trial that examined changes in metabolic and stress hormonal profiles of healthy adults in two settings (urban vs. rural) with distinctly different climatological characteristics during the Mediterranean summer. This analysis aimed to study the association between the 24-h personal air or skin temperature sensor measurements and the diary-based location type (indoors vs. outdoors) in urban (seaside) vs. rural (higher in altitude) microenvironments. Out of 41 eligible participants, a total of 37 participants were included in this post-hoc TEMP trial analysis. Wearable sensors recorded personal air temperature, skin temperature, and activity (as a surrogate marker of physical activity) in each setting, while a time-stamped personal diary recorded the types of indoor or outdoor activities. Temperature peaks during the 24-h sampling period were detected using a peak finding algorithm. Mixed effect logistic regression models were fitted for the odds of participant location (being indoors vs. outdoors) as a function of setting (urban vs. rural) and sensor-based personal temperature data (either raw temperature values or number of temperature peaks). During the study period (July-end of September), median [interquartile range, IQR] personal air temperature in the rural (higher altitude) settings was 1.5 °C lower than that in the urban settings (27.1 °C [25.4, 29.2] vs. 28.6 °C [27.1, 30.5], p < 0.001), being consistent with the Mediterranean climate. Median [IQR] personal air temperature in indoor (micro)environments was lower than those in outdoors (28.0 °C [26.4, 30.3] vs 28.5 °C [26.8, 30.7], p < 0.001). However, median [IQR] skin temperature was higher in indoor (micro)environments vs. outdoors (34.8 °C [34.0, 35.6] and 33.9 °C [32.9, 34.8], p < 0.001) and the number of both personal air and skin temperature peaks was higher indoors compared to outdoors (median [IQR] 3.0 [2.0,4.0] vs 1.0 [1.0,1.3], p < 0.007, for the skin sensors). A significant association between the number of temperature peaks and indoor location types was observed with either the personal air sensor (OR 3.1; 95% CI 1.2-8.2; p = 0.02) or the skin sensor (OR 3.7; 95% CI 1.4-9.9; p = 0.01), suggesting higher number of indoor air temperature fluctuations. Amidst the global climate crisis, more population health studies or personalized medicine approaches that utilize continuous tracking of individual-level air/skin temperatures in both indoor/outdoor locations would be warranted, if we were to better characterize the disease phenotype in response to climate change manifestations.
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Affiliation(s)
- Andria Constantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Stavros Oikonomou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Corina Konstantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
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18
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Wen B, Xu R, Wu Y, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Association between ambient temperature and hospitalization for renal diseases in Brazil during 2000-2015: A nationwide case-crossover study. LANCET REGIONAL HEALTH. AMERICAS 2021; 6:100101. [PMID: 36777886 PMCID: PMC9904055 DOI: 10.1016/j.lana.2021.100101] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022]
Abstract
Background Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to ambient temperature. Methods Daily hospital admission data from 1816 cities in Brazil were collected during 2000 and 2015. A time-stratified case-crossover design was applied to evaluate the association between temperature and renal diseases. Relative risks (RRs), attributable fractions (AFs), and their confidence intervals (CIs) were calculated to estimate the associations and attributable burden. Findings A total of 2,726,886 hospitalizations for renal diseases were recorded during the study period. For every 1°C increase in daily mean temperature, the estimated risk of hospitalization for renal diseases over lag 0-7 days increased by 0·9% (RR = 1·009, 95% CI: 1·008-1·010) at the national level. The associations between temperature and renal diseases were largest at lag 0 days but remained for lag 1-2 days. The risk was more prominent in females, children aged 0-4 years, and the elderly ≥ 80 years. 7·4% (95% CI: 5·2-9·6%) of hospitalizations for renal diseases could be attributable to the increase of temperature, equating to 202,093 (95% CI: 141,554-260,594) cases. Interpretation This nationwide study provides robust evidence that more policies should be developed to prevent heat-related hospitalizations and mitigate climate change. Funding China Scholarship Council, and the Australian National Health and Medical Research Council.
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Affiliation(s)
- Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yao Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia,Corresponding authors: Dr Shanshan Li, and Professor Yuming Guo, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia. Tel: +61 3 9905 6100
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia,Corresponding authors: Dr Shanshan Li, and Professor Yuming Guo, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia. Tel: +61 3 9905 6100
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19
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Yoo EH, Eum Y, Roberts JE, Gao Q, Chen K. Association between extreme temperatures and emergency room visits related to mental disorders: A multi-region time-series study in New York, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 792:148246. [PMID: 34144243 DOI: 10.1016/j.scitotenv.2021.148246] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is growing evidence suggesting that extreme temperatures have an impact on mental disorders. We aimed to explore the effect of extreme temperatures on emergency room (ER) visits for mental health disorders using 2.8 million records from New York State, USA (2009-2016), and to examine potential effect modifications by individuals' age, sex, and race/ethnicity through a stratified analysis to determine if certain populations are more susceptible. METHOD To assess the short-term impact of daily average temperature on ER visits related to mental disorders, we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, as well as long-term and seasonal time trends. We also conducted a meta-analysis to pool the region-specific risk estimates and construct the overall cumulative exposure-response curves for all regions. RESULTS We found positive associations between short-term exposure to extreme heat (27.07 ∘C) and increased ER visits for total mental disorders, as well as substance abuse, mood and anxiety disorders, schizophrenia, and dementia. We did not find any statistically significant difference among any subgroups of the population being more susceptible to extreme heat than any other. CONCLUSIONS Our findings suggest that there is a positive association between short-term exposure to extreme heat and increased ER visits for total mental disorders. This extreme effect was also found across all sub-categories of mental disease, although further research is needed to confirm our finding for specific mental disorders, such as dementia, which accounted for less than 1% of the total mental disorders in this sample.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, NY, USA.
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, NY, USA
| | - John E Roberts
- Department of Psychology, State University of New York at Buffalo, NY, USA
| | - Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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20
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Liu J, Varghese BM, Hansen A, Xiang J, Zhang Y, Dear K, Gourley M, Driscoll T, Morgan G, Capon A, Bi P. Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 153:106533. [PMID: 33799230 DOI: 10.1016/j.envint.2021.106533] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mental health is an important public health issue globally. A potential link between heat exposure and mental health outcomes has been recognised in the scientific literature; however, the associations between heat exposure (both high ambient temperatures and heatwaves) and mental health-related mortality and morbidity vary between studies and locations. OBJECTIVE To fill gaps in knowledge, this systematic review aims to summarize the epidemiological evidence and investigate the quantitative effects of high ambient temperatures and heatwaves on mental health-related mortality and morbidity outcomes, while exploring sources of heterogeneity. METHODS A systematic search of peer-reviewed epidemiological studies on heat exposure and mental health outcomes published between January 1990 and November 2020 was conducted using five databases (PubMed, Embase, Scopus, Web of Science and PsycINFO). We included studies that examined the association between high ambient temperatures and/or heatwaves and mental health-related mortality and morbidity (e.g. hospital admissions and emergency department visits) in the general population. A range of mental health conditions were defined using ICD-10 classifications. We performed random effects meta-analysis to summarize the relative risks (RRs) in mental health outcomes per 1 °C increase in temperature, and under different heatwaves definitions. We further evaluated whether variables such as age, sex, socioeconomic status, and climate zone may explain the observed heterogeneity. RESULTS The keyword search yielded 4560 citations from which we identified 53 high temperatures/heatwaves studies that comprised over 1.7 million mental health-related mortality and 1.9 million morbidity cases in total. Our findings suggest associations between heat exposures and a range of mental health-related outcomes. Regarding high temperatures, our meta-analysis of study findings showed that for each 1 °C increase in temperature, the mental health-related mortality and morbidity increased with a RR of 1.022 (95%CI: 1.015-1.029) and 1.009 (95%CI: 1.007-1.015), respectively. The greatest mortality risk was attributed to substance-related mental disorders (RR, 1.046; 95%CI: 0.991-1.101), followed by organic mental disorders (RR, 1.033; 95%CI: 1.020-1.046). A 1 °C temperature rise was also associated with a significant increase in morbidity such as mood disorders, organic mental disorders, schizophrenia, neurotic and anxiety disorders. Findings suggest evidence of vulnerability for populations living in tropical and subtropical climate zones, and for people aged more than 65 years. There were significant moderate and high heterogeneities between effect estimates in overall mortality and morbidity categories, respectively. Lower heterogeneity was noted in some subgroups. The magnitude of the effect estimates for heatwaves varied depending on definitions used. The highest effect estimates for mental health-related morbidity was observed when heatwaves were defined as "mean temperature ≥90th percentile for ≥3 days" (RR, 1.753; 95%CI: 0.567-5.421), and a significant effect was also observed when the definition was "mean temperature ≥95th percentile for ≥3 days", with a RR of 1.064 (95%CI: 1.006-1.123). CONCLUSIONS Our findings support the hypothesis of a positive association between elevated ambient temperatures and/or heatwaves and adverse mental health outcomes. This problem will likely increase with a warming climate, especially in the context of climate change. Further high-quality studies are needed to identify modifying factors of heat impacts.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Australia; School of Public Health, Fujian Medical University, China
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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21
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Yoo EH, Eum Y, Gao Q, Chen K. Effect of extreme temperatures on daily emergency room visits for mental disorders. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:39243-39256. [PMID: 33751353 DOI: 10.1007/s11356-021-12887-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
Relatively few studies investigated the effects of extreme temperatures (both heat and cold) on mental health (ICD-9: 290-319; ICD-10: F00-F99) and the potential effect modifications by individuals' age, sex, and race. We aimed to explore the effect of extreme temperatures of both heat and cold on the emergency room (ER) visits for mental health disorders, and conducted a stratified analysis to identify possible susceptible population in Erie and Niagara counties, NY, USA. To assess the short-term impacts of daily maximum temperature on ER visits related to mental disorders (2009-2015), we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, long-term time trend, and seasonality. We found that there were positive associations between short-term exposure to extreme ambient temperatures and increased ER visits for mental disorders, and the effects can vary by individual factors. We found heat effect (relative risk (RR) = 1.16; 95% confidence intervals (CI), 1.06-1.27) on exacerbated mental disorders became intense in the study region and subgroup of population (the elderly) being more susceptible to extreme heat than any other age group. For extreme cold, we found that there is a substantial delay effect of 14 days (RR = 1.25; 95% CI = 1.08-1.45), which is particularly burdensome to the age group of 50-64 years old and African-Americans. Our findings suggest that there is a positive association between short-term exposure to extreme ambient temperature (heat and cold) and increased ER visits for mental disorders, and the effects vary as a function of individual factors, such as age and race.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA
| | - Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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22
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Qu Y, Zhang W, Ryan I, Deng X, Dong G, Liu X, Lin S. Ambient extreme heat exposure in summer and transitional months and emergency department visits and hospital admissions due to pregnancy complications. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 777:146134. [PMID: 33689898 DOI: 10.1016/j.scitotenv.2021.146134] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Although extreme heat exposure (EHE) was reported to be associated with increased risks of multiple diseases, little is known about the effects of EHE on pregnancy complications. We examined the EHE-pregnancy complications associations by lag days, subtypes, sociodemographic characteristics, and areas in New York State (NYS). We conducted a case-crossover analysis to assess the EHE-pregnancy complications associations in summer (June-August) and transitional months (May and September). All emergency department (ED) visits and hospital admissions due to pregnancy complications (ICD 9 codes: 630-649) from 2005 to 2013 in NYS were included. Daily mean temperature > 90th percentile of the monthly mean temperature in each county was defined as an EHE. We used conditional logistic regression while controlling for other weather factors, air pollutants and holidays to assess the EHE-pregnancy complications associations. EHE was significantly associated with increased ED visits for pregnancy complications in summer (ORs ranged: 1.01-1.04 from lag days 0-5). There was also a significant and stronger association in transitional months (ORs ranged: 1.02-1.06, Lag 0). Furthermore, we found EHE affected multiple subtypes of pregnancy complications, including threatened/spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension (ORs range: 1.13-1.90) during transitional months. A significant concentration response effect between the number of consecutive days of EHE and ED visits in summer (P for trend <0.001), ED visits in September (P for trend =0.03), and hospital admission in May (P for trend<0.001) due to pregnancy complications was observed, respectively. African Americans and residents in lower socioeconomic position (SEP) counties were more susceptible to the effects of EHE. In conclusion, we found an immediate and prolonged effect of EHE on pregnancy complications in summer and a stronger, immediate effect in transitional months. These effects were stronger in African Americans and counties with lower SEP. Earlier warnings regarding extreme heat are recommended to decrease pregnancy complications.
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Affiliation(s)
- Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China; Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Ian Ryan
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Xinlei Deng
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China.
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA.
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Increasing impacts of temperature on hospital admissions, length of stay, and related healthcare costs in the context of climate change in Adelaide, South Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145656. [PMID: 33592481 DOI: 10.1016/j.scitotenv.2021.145656] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND A growing number of studies have investigated the effect of increasing temperatures on morbidity and health service use. However, there is a lack of studies investigating the temperature-attributable cost burden. OBJECTIVES This study examines the relationship of daily mean temperature with hospital admissions, length of hospital stay (LoS), and costs; and estimates the baseline temperature-attributable hospital admissions, and costs and in relation to warmer climate scenarios in Adelaide, South Australia. METHOD A daily time series analysis using distributed lag non-linear models (DLNM) was used to explore exposure-response relationships and to estimate the aggregated burden of hospital admissions for conditions associated with temperatures (i.e. renal diseases, mental health, diabetes, ischaemic heart diseases and heat-related illnesses) as well as the associated LoS and costs, for the baseline period (2010-2015) and different future climate scenarios in Adelaide, South Australia. RESULTS During the six-year baseline period, the overall temperature-attributable hospital admissions, LoS, and associated costs were estimated to be 3915 cases (95% empirical confidence interval (eCI): 235, 7295), 99,766 days (95% eCI: 14,484, 168,457), and AU$159 million (95% eCI: 18.8, 269.0), respectively. A climate scenario consistent with RCP8.5 emissions, and including projected demographic change, is estimated to lead to increases in heat-attributable hospital admissions, LoS, and costs of 2.2% (95% eCI: 0.5, 3.9), 8.4% (95% eCI: 1.1, 14.3), and 7.7% (95% eCI: 0.3, 13.3), respectively by mid-century. CONCLUSIONS There is already a substantial temperature-attributable impact on hospital admissions, LoS, and costs which are estimated to increase due to climate change and an increasing aged population. Unless effective climate and public health interventions are put into action, the costs of treating temperature-related admissions will be high.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia; College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Keith Dear
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Alana Hansen
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Monika Nitschke
- South Australian Department of Health and Wellbeing, Adelaide, South Australia, Australia.
| | - John Nairn
- Australian Bureau of Meteorology, South Australia, Australia.
| | - Ben Scalley
- Metropolitan Communicable Disease Control, Department of Health WA, Perth, Western Australia, Australia.
| | - Alex Xiao
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Michael Tong
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
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24
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Charlson F, Ali S, Benmarhnia T, Pearl M, Massazza A, Augustinavicius J, Scott JG. Climate Change and Mental Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4486. [PMID: 33922573 PMCID: PMC8122895 DOI: 10.3390/ijerph18094486] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 12/28/2022]
Abstract
Climate change is negatively impacting the mental health of populations. This scoping review aims to assess the available literature related to climate change and mental health across the World Health Organisation's (WHO) five global research priorities for protecting human health from climate change. We conducted a scoping review to identify original research studies related to mental health and climate change using online academic databases. We assessed the quality of studies where appropriate assessment tools were available. We identified 120 original studies published between 2001 and 2020. Most studies were quantitative (n = 67), cross-sectional (n = 42), conducted in high-income countries (n = 87), and concerned with the first of the WHO global research priorities-assessing the mental health risks associated with climate change (n = 101). Several climate-related exposures, including heat, humidity, rainfall, drought, wildfires, and floods were associated with psychological distress, worsened mental health, and higher mortality among people with pre-existing mental health conditions, increased psychiatric hospitalisations, and heightened suicide rates. Few studies (n = 19) addressed the other four global research priorities of protecting health from climate change (effective interventions (n = 8); mitigation and adaptation (n = 7); improving decision-support (n = 3); and cost estimations (n = 1)). While climate change and mental health represents a rapidly growing area of research, it needs to accelerate and broaden in scope to respond with evidence-based mitigation and adaptation strategies.
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Affiliation(s)
- Fiona Charlson
- Queensland Centre for Mental Health Research, Queensland Health, Wacol, QLD 4076, Australia; (S.A.); (M.P.); (J.G.S.)
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Institute for Health Metrics and Evaluation, Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Suhailah Ali
- Queensland Centre for Mental Health Research, Queensland Health, Wacol, QLD 4076, Australia; (S.A.); (M.P.); (J.G.S.)
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC, San Diego, CA 92093, USA;
| | - Madeleine Pearl
- Queensland Centre for Mental Health Research, Queensland Health, Wacol, QLD 4076, Australia; (S.A.); (M.P.); (J.G.S.)
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Jura Augustinavicius
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - James G. Scott
- Queensland Centre for Mental Health Research, Queensland Health, Wacol, QLD 4076, Australia; (S.A.); (M.P.); (J.G.S.)
- Mental Health Programme, QIMR Berghofer Medical Research Institute, Herston, QLD 4076, Australia
- Metro North Mental Health Service, Herston, QLD 4006, Australia
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Kang Y, Tang H, Jiang L, Wang S, Wang X, Chen Z, Zhang L, Zheng C, Wang Z, Huang G, Gao R. Air temperature variability and high-sensitivity C reactive protein in a general population of China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:141588. [PMID: 32846352 DOI: 10.1016/j.scitotenv.2020.141588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/10/2020] [Accepted: 08/07/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Along with global climate change, the relationship between temperature variability (TV) and cardiovascular hospitalization and deaths have been well established. However, limited studies were conducted to reveal the underlying mechanism for TV-related cardiovascular diseases. OBJECTIVES In the current study, a novel TV calculation, taking account for both interday and intraday TV as well as lag effects, was used to investigate the effect of short-term TV on the level of high-sensitivity C reactive protein (hs-CRP), which is a crucial preclinical predictor for cardiovascular disease (CVD). RESULTS Among the 11,623 Chinese population (46.0% male; mean age 49.8 years), the average hs-CRP was 1.4 mg/ L (standard deviation 1.6 mg/L). Statistical significance between TV and hs-CRP was observed for different TV exposure days (TV01-TV07) in adjusted model, with highest effect for TV06. Specifically, per 1 °C increase in TV06 led to 2.241% (95%CI: 1.552%-2.935%) increase in hs-CRP. Female, obesity and elderly population were more susceptible to TV. The largest mediator for the association of TV and hs-CRP was lipoprotein(a), accounting for 8.68%, followed by smoking status (4.78%), alcohol use (3.95%) and systolic BP (3.20%). CONCLUSION Short-term TV will significantly increase the level of hs-CRP, suggesting hs-CRP to be the potential biologic mechanisms underlying the cardiovascular effects of TV. And more attention should be paid to unstable weather in the global climate change context. Further developing efficient public health policies on climate change may benefit for global heath.
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Affiliation(s)
- Yuting Kang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Haosu Tang
- State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100029, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Linlin Jiang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Su Wang
- State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100029, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102308, China.
| | - Gang Huang
- State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100029, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
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26
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Impact of Extreme Temperatures on Ambulance Dispatches Due to Cardiovascular Causes in North-West Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239001. [PMID: 33287148 PMCID: PMC7729967 DOI: 10.3390/ijerph17239001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/28/2022]
Abstract
Introduction and objectives. The increase in mortality and hospital admissions associated with high and low temperatures is well established. However, less is known about the influence of extreme ambient temperature conditions on cardiovascular ambulance dispatches. This study seeks to evaluate the effects of minimum and maximum daily temperatures on cardiovascular morbidity in the cities of Vigo and A Coruña in North-West Spain, using emergency medical calls during the period 2005–2017. Methods. For the purposes of analysis, we employed a quasi-Poisson time series regression model, within a distributed non-linear lag model by exposure variable and city. The relative risks of cold- and heat-related calls were estimated for each city and temperature model. Results. A total of 70,537 calls were evaluated, most of which were associated with low maximum and minimum temperatures on cold days in both cities. At maximum temperatures, significant cold-related effects were observed at lags of 3–6 days in Vigo and 5–11 days in A Coruña. At minimum temperatures, cold-related effects registered a similar pattern in both cities, with significant relative risks at lags of 4 to 12 days in A Coruña. Heat-related effects did not display a clearly significant pattern. Conclusions. An increase in cardiovascular morbidity is observed with moderately low temperatures without extremes being required to establish an effect. Public health prevention plans and warning systems should consider including moderate temperature range in the prevention of cardiovascular morbidity.
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Urban Overheating and Cooling Potential in Australia: An Evidence-Based Review. CLIMATE 2020. [DOI: 10.3390/cli8110126] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cities in Australia are experiencing unprecedented levels of urban overheating, which has caused a significant impact on the country’s socioeconomic environment. This article provides a comprehensive review on urban overheating, its impact on health, energy, economy, and the heat mitigation potential of a series of strategies in Australia. Existing studies show that the average urban heat island (UHI) intensity ranges from 1.0 °C to 13.0 °C. The magnitude of urban overheating phenomenon in Australia is determined by a combination of UHI effects and dualistic atmospheric circulation systems (cool sea breeze and hot desert winds). The strong relation between multiple characteristics contribute to dramatic fluctuations and high spatiotemporal variabilities in urban overheating. In addition, urban overheating contributes to serious impacts on human health, energy costs, thermal comfort, labour productivity, and social behaviour. Evidence suggest that cool materials, green roofs, vertical gardens, urban greenery, and water-based technologies can significantly alleviate the UHI effect, cool the ambient air, and create thermally balanced cities. Urban greenery, especially trees, has a high potential for mitigation. Trees and hedges can reduce the average maximum UHI by 1.0 °C. The average maximum mitigation performance values of green roofs and green walls are 0.2 °C and 0.1 °C, respectively. Reflective roofs and pavements can reduce the average maximum UHI by 0.3 °C. In dry areas, water has a high cooling potential. The average maximum cooling potential using only one technology is 0.4 °C. When two or more technologies are used at the same time, the average maximum UHI drop is 1.5 °C. The mitigation strategies identified in this article can help the governments and other stakeholders manage urban heating in the natural and built environment, and save health, energy, and economic costs.
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28
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Huang H, Deng X, Yang H, Zhou X, Jia Q. Spatio-Temporal Mechanism Underlying the Effect of Urban Heat Island on Cardiovascular Diseases. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1455-1466. [PMID: 33083322 PMCID: PMC7554388 DOI: 10.18502/ijph.v49i8.3889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: We explored the spatio-temporal characteristics of urban heat island (UHI) effect on cardiovascular diseases (CVDs). Methods: The land surface temperatures (LST) were retrieved from four Landsat remote-sensing images’ data, the temperature data from 95 meteorological stations, and analysis data on CVDs mortality. Based on these data, landscape pattern indexes were used to analyze the pattern-process-function and the mechanism. Results: During 1984–2017, the effects of UHI on CVDs increased, thereby increased the mortality by 28.8%. The affected areas gradually expand from the central area of the city and undergo three evolution stages; the highly affected areas are mainly distributed in central and southern regions, and patches increase in number. The areas and ratio of high-level patches also show an upward tendency, increasing dominance in the overall landscape. Patches of the overall landscape become more complicated in shape, whereas those of high-level ones become less complicated. Concentration degree of the overall landscape decreases gradually with the types of landscapes patches increasing, reaching a rather even space distribution. Conclusion: Increased temperatures exacerbated by UHI lead to increased CVD mortality. As cities expand, the effects of UHI on CVDs increase in terms of both intensity and areas, with the overall landscape in uneven distribution, high-level affected areas in point distribution, and low-level ones in large-area concentration.
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Affiliation(s)
- Huanchun Huang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Xin Deng
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Hailin Yang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Xinhui Zhou
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Qi Jia
- College of Arts and Design, Zhengzhou University of Light Industry, Zhengzhou, China
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29
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Sharifi E, Boland J. Passive activity observation (PAO) method to estimate outdoor thermal adaptation in public space: case studies in Australian cities. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:231-242. [PMID: 29916046 DOI: 10.1007/s00484-018-1570-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 04/20/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
Outdoor thermal comfort is influenced by people's climate expectations, perceptions and adaptation capacity. Varied individual response to comfortable or stressful thermal environments results in a deviation between actual outdoor thermal activity choices and those predicted by thermal comfort indices. This paper presents a passive activity observation (PAO) method for estimating contextual limits of outdoor thermal adaptation. The PAO method determines which thermal environment result in statistically meaningful changes may occur in outdoor activity patterns, and it estimates thresholds of outdoor thermal neutrality and limits of thermal adaptation in public space based on activity observation and microclimate field measurement. Applications of the PAO method have been demonstrated in Adelaide, Melbourne and Sydney, where outdoor activities were analysed against outdoor thermal comfort indices between 2013 and 2014. Adjusted apparent temperature (aAT), adaptive predicted mean vote (aPMV), outdoor standard effective temperature (OUT_SET), physiological equivalent temperature (PET) and universal thermal comfort index (UTCI) are calculated from the PAO data. Using the PAO method, the high threshold of outdoor thermal neutrality was observed between 24 °C for optional activities and 34 °C for necessary activities (UTCI scale). Meanwhile, the ultimate limit of thermal adaptation in uncontrolled public spaces is estimated to be between 28 °C for social activities and 48 °C for necessary activities. Normalised results indicate that city-wide high thresholds for outdoor thermal neutrality vary from 25 °C in Melbourne to 26 °C in Sydney and 30 °C in Adelaide. The PAO method is a relatively fast and localised method for measuring limits of outdoor thermal adaptation and effectively informs urban design and policy making in the context of climate change.
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Affiliation(s)
- Ehsan Sharifi
- School of Architecture and Built Environment, University of Adelaide, Adelaide, Australia.
| | - John Boland
- School of Information Technology and Mathematical Sciences, University of South Australia, Adelaide, Australia
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30
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Bailey E, Fuhrmann C, Runkle J, Stevens S, Brown M, Sugg M. Wearable sensors for personal temperature exposure assessments: A comparative study. ENVIRONMENTAL RESEARCH 2020; 180:108858. [PMID: 31708175 DOI: 10.1016/j.envres.2019.108858] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/20/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Abstract
The impacts of heat on human health has sparked research on different approaches to measure, map, and predict heat exposure at more accurate and precise spatiotemporal scales. Personal heat sensor studies rely on small sensors that can continuously measure ambient temperatures as individuals move through time and space. The comparison between different types of sensors and sensor placements have yet to be fully researched. The objective of this study is to assess the validity of personal ambient temperature sensors. To accomplish this objective, we evaluated the performance of multiple low-cost wearable sensors (HOBOs, iButton Thermochrons, iButton Hygrochrons, and Kestrel DROP D3FW Fire) for measuring ambient temperature in a (1) field exposure study by varying the placement on human subjects and in a (2) field calibration study by co-locating sensors with fixed site weather station monitors. A secondary aim involved investigating consensus between validation metrics that can be used in future sensor comparison studies. Bland-Altman analysis, correlation coefficients, and index of agreement statistics were used to quantify the difference between sensor and weather station ambient temperature measurements. Results demonstrated significant differences in measured temperatures for sensors based on sensor type and placement on participants. Future research should account for the differences in personal ambient temperature readings based on sensor type and placement.
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Affiliation(s)
- Elizabeth Bailey
- Department of Geography & Planning, Appalachian State University, Boone, NC, USA
| | - Christopher Fuhrmann
- Department of Geosciences, Mississippi State University, Mississippi State, MS, USA
| | - Jennifer Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, NC, USA
| | - Scott Stevens
- North Carolina Institute for Climate Studies, North Carolina State University, NC, USA
| | - Michael Brown
- Department of Geosciences, Mississippi State University, Mississippi State, MS, USA
| | - Margaret Sugg
- Department of Geography & Planning, Appalachian State University, Boone, NC, USA.
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31
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Wang Y, Wang A, Zhai J, Tao H, Jiang T, Su B, Yang J, Wang G, Liu Q, Gao C, Kundzewicz ZW, Zhan M, Feng Z, Fischer T. Tens of thousands additional deaths annually in cities of China between 1.5 °C and 2.0 °C warming. Nat Commun 2019; 10:3376. [PMID: 31388009 PMCID: PMC6684802 DOI: 10.1038/s41467-019-11283-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 07/03/2019] [Indexed: 12/16/2022] Open
Abstract
The increase in surface air temperature in China has been faster than the global rate, and more high temperature spells are expected to occur in future. Here we assess the annual heat-related mortality in densely populated cities of China at 1.5 °C and 2.0 °C global warming. For this, the urban population is projected under five SSPs, and 31 GCM runs as well as temperature-mortality relation curves are applied. The annual heat-related mortality is projected to increase from 32.1 per million inhabitants annually in 1986–2005 to 48.8–67.1 per million for the 1.5 °C warming and to 59.2–81.3 per million for the 2.0 °C warming, taking improved adaptation capacity into account. Without improved adaptation capacity, heat-related mortality will increase even stronger. If all 831 million urban inhabitants in China are considered, the additional warming from 1.5 °C to 2 °C will lead to more than 27.9 thousand additional heat-related deaths, annually. Heatwaves are expected to increase under climate change, and so are the associated deaths. Here the authors determine the regional high temperature thresholds for 27 metropolises in China and analyze the changes to heat-related mortality, showing that the additional global-warming temperature increase of 0.5°C, from 1.5°C to 2.0°C, will lead to tens of thousands of additional deaths, annually.
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Affiliation(s)
- Yanjun Wang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Anqian Wang
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jianqing Zhai
- National Climate Center, China Meteorological Administration, Beijing, 100081, China
| | - Hui Tao
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China
| | - Tong Jiang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China.
| | - Buda Su
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China
| | - Guojie Wang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Chao Gao
- Faculty of Architectural, Civil Engineering and Environment, Ningbo University, Ningbo, 31511, China
| | - Zbigniew W Kundzewicz
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China.,Institute for Agricultural and Forest Environment, Polish Academy of Sciences, Poznan, Poland
| | | | - Zhiqiang Feng
- School of Geosciences, University of Edinburgh, Edinburgh, EH8 9XP, UK
| | - Thomas Fischer
- Department of Geosciences, Eberhard Karls University, Tübingen, 72070, Germany.
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32
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Patel D, Jian L, Xiao J, Jansz J, Yun G, Robertson A. Joint effect of heatwaves and air quality on emergency department attendances for vulnerable population in Perth, Western Australia, 2006 to 2015. ENVIRONMENTAL RESEARCH 2019; 174:80-87. [PMID: 31054525 DOI: 10.1016/j.envres.2019.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/14/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND As global warming and the frequency and intensity of heatwaves increases, health service utilization, including emergency department attendances (EDA) have correspondingly increased across the world. The impact of air quality on health adds to the complexity of the effects. Potential joint effects between heatwaves and air quality on EDA have been rarely reported in the literature, prompting this study. OBJECTIVES To investigate the potential joint effect of heatwaves and air quality on the EDA for vulnerable populations in the Perth metropolitan area, Western Australia. METHODS A time series design was used. Daily data on EDA, heatwaves (excess heat factor>0) and air pollutants (CO, SO2, NO2, O3, PM10 and PM2.5) were collected for Perth, Western Australia from 2006 to 2015. Poisson regression modelling was used to assess the associations between heatwaves, air quality, and EDA. Risk assessments on age, gender, Aboriginality, socio-economic status (SES), and joint effect between heatwaves and air quality on EDA were conducted. RESULTS The EDA rate was higher in heatwave days (77.86/100,000/day) compared with non-heatwave days (73.90/100,000/day) with rate ratio of 1.053 (95% confidence interval 1.048, 1.058). The EDA rate was higher in males, people older than 60 years or younger than 15 years, Aboriginal people, and people with low SES. Exposure to CO, SO2, O3 and PM2.5 increased risk on EDA and exposure to PM2.5 showed joint effect with heatwave and increased risk of EDA by 6.6% after adjustment of all other risk factors. CONCLUSIONS EDA is an important indicator to evaluate heatwave related morbidity for emergency medical service as EDA rate increased during heatwaves with relative high concentrations of air pollutants. As all air pollutants measured in the study were lower than the Australian National Standards, the joint effect of heatwaves and air quality needs to be further examined when it exceeds the standards.
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Affiliation(s)
- Dimpalben Patel
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia; School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Jianguo Xiao
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Janis Jansz
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Grace Yun
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Andrew Robertson
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
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Occurrence and Coupling of Heat and Ozone Events and Their Relation to Mortality Rates in Berlin, Germany, between 2000 and 2014. ATMOSPHERE 2019. [DOI: 10.3390/atmos10060348] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Episodes of hot weather and poor air quality pose significant consequences for public health. In this study, these episodes are addressed by applying the observational data of daily air temperature and ozone concentrations in an event-based risk assessment approach in order to detect individual heat and ozone events, as well as events of their co-occurrence in Berlin, Germany, in the years 2000 to 2014. Various threshold values are explored so as to identify these events and to search for the appropriate regressions between the threshold exceedances and mortality rates. The events are further analyzed in terms of their event-specific mortality rates and their temporal occurrences. The results reveal that at least 40% of all heat events during the study period are accompanied by increased ozone concentrations in Berlin, particularly the most intense and longest heat events. While ozone events alone are only weakly associated with increased mortality rates, elevated ozone concentrations during heat events are found to amplify mortality rates. We conclude that elevated air temperatures during heat events are one major driver for increased mortality rates in Berlin, but simultaneously occurring elevated ozone concentrations act as an additional stressor, leading to an increased risk for the regional population.
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Borg M, Nitschke M, Williams S, McDonald S, Nairn J, Bi P. Using the excess heat factor to indicate heatwave-related urinary disease: a case study in Adelaide, South Australia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:435-447. [PMID: 30687904 DOI: 10.1007/s00484-019-01674-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016-1.076), urolithiasis (IRR 1.106, 95% 1.046-1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258-1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048-1.133) and AKI (IRR 1.335, 95% CI 1.204-1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.
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Affiliation(s)
- Matthew Borg
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Monika Nitschke
- SA Health, Government of South Australia, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Stephen McDonald
- The Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - John Nairn
- South Australian State Office, Bureau of Meteorology, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia.
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Wondmagegn BY, Xiang J, Williams S, Pisaniello D, Bi P. What do we know about the healthcare costs of extreme heat exposure? A comprehensive literature review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 657:608-618. [PMID: 30677927 DOI: 10.1016/j.scitotenv.2018.11.479] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/23/2018] [Accepted: 11/30/2018] [Indexed: 05/04/2023]
Abstract
Exposure to extreme heat can lead to a range of heat-related illnesses, exacerbate pre-existing health conditions and cause increased demand on the healthcare system. A projected increase in temperature may lead to greater healthcare expenditure, however, at present the costs of heat-related healthcare utilization is under-researched. This study aims to review the literature on heat-related costs for the healthcare system with a focus on ED visits, hospitalization, and ambulance call-outs. PubMed, Scopus, and Embase were used to search relevant literature from database inception to December 2017 and limited to human studies and English language. After screening, a total of ten papers were identified for final inclusion. In general, the healthcare costs of heat extremes have been poorly investigated in developed countries and not reported in developing countries where the largest heat-vulnerable populations reside. Studies showed that exposure to extreme heat was causing a substantial economic burden on healthcare systems. Females, the elderly, low-income families, and ethnic minorities had the highest healthcare costs on a range of health services utilization. Although a few studies have estimated heat healthcare costs, none of them quantified the temperature-healthcare cost relationship. There is a need to systematically examine heat-attributable costs for the healthcare system in the context of climate change to better inform heat-related policy making, target interventions and resource allocation.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia; College of Health and Medical Sciences, Haramaya University, Ethiopia, P.O. Box 138, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
| | - Susan Williams
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
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Cheng YT, Lung SCC, Hwang JS. New approach to identifying proper thresholds for a heat warning system using health risk increments. ENVIRONMENTAL RESEARCH 2019; 170:282-292. [PMID: 30599292 PMCID: PMC7126132 DOI: 10.1016/j.envres.2018.12.059] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/12/2018] [Accepted: 12/24/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND A critical adaptation strategy for reducing heat-related health risk under climate change is to establish a heat warning system with a proper threshold that requires evaluation of heat-health relationships using empirical data. OBJECTIVES This work presents a new approach to selecting proper health-based thresholds for a heat warning system which are different from thresholds of heat-health relationship. METHODS The proposed approach examined heat-health relationships through analyzing 15 years of health records with a modified generalized additive model (GAM), compared risk ratio increments (RRIs) of threshold candidates against a reference, assessed frequency of days above these candidates, and presented results graphically for easy communication. The candidate with the maximum RRI and proper occurring frequency is potentially the best threshold. Three heat indicators, including wet-bulb globe temperature (WBGT), temperature (T), and apparent temperature (AT), as well as three health outcomes, including all-cause mortality, heat-related hospital admissions, and heat-related emergency visits were evaluated. RESULTS Risk ratios for all three health outcomes showed a consistent rising trend with increasing threshold candidates for all three heat indicators among different age and gender groups. WBGT had the most obvious increasing trend of RRIs with the three health outcomes. The maximum RRI was observed in heat-related emergency visits (242%), followed by heat-related hospital admissions (73%), and all-cause mortality (9%). The RRIs assessed for the three health outcomes pointed to the same thresholds, 33.0 °C, 34.0 °C, and 37.5 °C for WBGT, T, and AT, respectively. The number of days above these thresholds and for warning to be issued ranged between 0 and 7 days during 2000-2014. DISCUSSION This study demonstrated a new approach to determining heat-warning thresholds with different heat indicators and health outcomes. The proposed approach provides a straightforward, feasible, and flexible scientific tool that assists the authorities around the world in selecting a proper threshold for a heat warning system.
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Affiliation(s)
- Yu-Ting Cheng
- Research Center for Environmental Changes, Academia Sinica, Taipei 115, Taiwan
| | - Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei 115, Taiwan; Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan; Institute of Environmental Health, National Taiwan University, Taipei, Taiwan.
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Kim E, Kim H, Kim YC, Lee JP. Association between extreme temperature and kidney disease in South Korea, 2003-2013: Stratified by sex and age groups. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 642:800-808. [PMID: 29920466 DOI: 10.1016/j.scitotenv.2018.06.055] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/15/2018] [Accepted: 06/05/2018] [Indexed: 05/27/2023]
Abstract
Weather conditions due to climate change affect the health directly and indirectly. Previous studies have shown associations with temperature, heat wave, and cold spell, and these do not only result in mortality from cardiovascular disease, respiratory disease, etc., but also in morbidity. This study aimed to quantify the relative risk for hospital admissions related to ambient temperature for genitourinary system diseases, which are representative of metabolic disease. We conducted a nationwide retrospective cohort study using claims data generated by medical services for diseases of the urinary system. The data was based on medical claims data from 16 districts in South Korea, to the nationwide level between 2003 and 2013. A total of 1,255,671 hospital admissions through the emergency department because of diseases of the genitourinary system were reported within the study period. The overall cumulative relative risk at the 99th percentile vs. the minimum morbidity percentile for renal diseases was 1.252 (95% confidence interval 1.211 to 1.294) in Seoul, 1.252 (1.21 to 1.296) in Busan, 1.236 (1.196 to 1.276) in Daegu, 1.237(1.197 to 1.279) in Gwangju, and 1.258 (1.218 to 1.299) in Gyeonggi-do, 1.278 (1.211 to 1.349) in Chungcheongbuk-do, 1.291 (1.235 to 1.35) in Gyeongsangnam-do. In the group of men over 65 years, the overall cumulative RR was high and statistically significant in acute kidney injury (AKI). But we could not find the effect of high temperature for chronic kidney disease (CKD). The association were rather opposite, but not statistically significant. Our nationwide study not only demonstrates relative risk considering lag effects associated with ambient temperature and trends in hospital admissions through the emergency department for genitourinary disorders but also observed differences among disease groups.
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Affiliation(s)
- Ejin Kim
- Graduate School of Public Health, Seoul National University, Republic of Korea
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Republic of Korea.
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Zhan ZY, Yu YM, Qian J, Song YF, Chen PY, Ou CQ. Effects of ambient temperature on ambulance emergency call-outs in the subtropical city of Shenzhen, China. PLoS One 2018; 13:e0207187. [PMID: 30419000 PMCID: PMC6231653 DOI: 10.1371/journal.pone.0207187] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 10/26/2018] [Indexed: 12/17/2022] Open
Abstract
The associations between meteorological factors and mortality have been well documented worldwide, but limited evidence is available for the non-fatal health impacts of ambient temperature, particularly there are few population-based investigations on the impacts of emergency ambulance dispatches in Asia. In this study, based on 809,906 ambulance emergency call-outs (AECOs) for the total population from 2010-2016 in the subtropical city of Shenzhen, China, a Poisson regression combined with a distributed lag nonlinear model was used to simultaneously assess the nonlinear and lag effects of daily mean temperature on AECOs. Stratified analyses by age and sex were performed to identify vulnerable subpopulations. A U-shaped relationship was found between temperature and AECOs. Cold effects were delayed and persisted for 3-4 weeks, with a cumulative relative risk (RR) and 95% confidence interval (CI) of 1.23 (1.10-1.38) and 1.25 (1.16-1.35) over lag 0-28 when comparing the 1st and 5th percentile of the temperature distribution to the optimal (i.e. minimum AECOs) temperature, respectively. Hot effects were immediate and diminished quickly in 5 days, with an increase of 19% (RR = 1.19, 95%CI: 1.14-1.23) and 21% (RR = 1.21, 95%CI: 1.16-1.26) in AECOs over lag 0-5 when comparing the 95th and 99th percentile of temperature to the optimal temperature. Children and the elderly were more vulnerable to cold effects. The youth and middle-aged people suffered more from high temperature. The effects of temperature were similar between males and females. In summary, significant increases were observed in the frequency of AECOs during cold and hot days, and the weather-associated increases in AECOs are different among age groups. This information has valuable implications in ambulance demand prediction and service provision planning.
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Affiliation(s)
- Zhi-Ying Zhan
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yi-Min Yu
- Shenzhen Center for Prehospital Care, Shenzhen, China
- The People's Hospital of Longhua, Shenzhen, China
| | - Jun Qian
- Department of Mathematics and Physics, School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Yun-Feng Song
- Intensive Care Unit, Guangdong No.2 Provincial People’s Hospital, Guangzhou, China
| | - Ping-Yan Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- * E-mail:
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Liu Y, Hoppe BO, Convertino M. Threshold Evaluation of Emergency Risk Communication for Health Risks Related to Hazardous Ambient Temperature. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:2208-2221. [PMID: 29637591 DOI: 10.1111/risa.12998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/25/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
Emergency risk communication (ERC) programs that activate when the ambient temperature is expected to cross certain extreme thresholds are widely used to manage relevant public health risks. In practice, however, the effectiveness of these thresholds has rarely been examined. The goal of this study is to test if the activation criteria based on extreme temperature thresholds, both cold and heat, capture elevated health risks for all-cause and cause-specific mortality and morbidity in the Minneapolis-St. Paul Metropolitan Area. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson generalized linear model is used to derive the exposure-response functions between daily maximum heat index and mortality (1998-2014) and morbidity (emergency department visits; 2007-2014). Specific causes considered include cardiovascular, respiratory, renal diseases, and diabetes. Six extreme temperature thresholds, corresponding to 1st-3rd and 97th-99th percentiles of local exposure history, are examined. All six extreme temperature thresholds capture significantly increased relative risks for all-cause mortality and morbidity. However, the cause-specific analyses reveal heterogeneity. Extreme cold thresholds capture increased mortality and morbidity risks for cardiovascular and respiratory diseases and extreme heat thresholds for renal disease. Percentile-based extreme temperature thresholds are appropriate for initiating ERC targeting the general population. Tailoring ERC by specific causes may protect some but not all individuals with health conditions exacerbated by hazardous ambient temperature exposure.
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Affiliation(s)
- Yang Liu
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Brenda O Hoppe
- Department of Health, Environmental Health Division, Minnesota, St. Paul, MN, USA
| | - Matteo Convertino
- Complexity Group, Division of Frontier Science & Media and Network Technologies, Laboratory of Information Communication Networks, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
- Global Station for Big Data and Cybersecurity, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
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Cheng J, Zhang Y, Zhang W, Xu Z, Bambrick H, Hu W, Tong S. Assessment of heat- and cold-related emergency department visits in cities of China and Australia: Population vulnerability and attributable burden. ENVIRONMENTAL RESEARCH 2018; 166:610-619. [PMID: 29982149 DOI: 10.1016/j.envres.2018.06.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND Non-optimal ambient temperature has detrimental impacts on mortality worldwide, but little is known about the difference in population vulnerability to non-optimal temperature and temperature-related morbidity burden between developing and developed countries. OBJECTIVES We estimated and compared the associations of emergency department visits (EDV) with non-optimal temperature in terms of risk trigger temperature, the average slope of exposure-risk function and attributable risk in 12 cities from China and Australia. METHODS We modelled the associations of EDV with heat during warm season and with cold during cold season, separately, using generalized additive model. Population vulnerability within a given region was quantified with multiple risk trigger points including minimum risk temperature, increasing risk temperature and excessive risk temperature, and average coefficient of exposure-risk function. Fraction of EDV attributable to heat and cold was also calculated. RESULTS We found large between- and within-country contrasts in the identified multiple risk trigger temperatures, with higher heat and cold trigger points, except excessive risk temperature, observed in Australia than in China. Heat was associated with a relative risk (RR) of 1.009 [95% confidence interval (CI):1.007, 1.011] in China, which accounted for 5.9% of EDV. Higher RR of heat was observed in Australia (1.014, 95% CI: 1.010, 1.018), responsible for 4.0% of EDV. For cold effects, the RR was similar between two countries, but the attributable fraction was higher in China (9.6%) than in Australia (1.5%). CONCLUSIONS Exposure to heat and cold had adverse but divergent impacts on EDV in China and Australia. Further mitigation policy efforts incorporating region-specific population vulnerability to temperature impacts are necessary in both countries.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Wenyi Zhang
- Center for Disease Surveillance of PLA, Institute of Disease Control and Prevention of PLA, Beijing, China
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China; School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia.
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The Impact of Heat Waves on Emergency Department Admissions in Charlottesville, Virginia, U.S.A. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071436. [PMID: 29986505 PMCID: PMC6068980 DOI: 10.3390/ijerph15071436] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 11/24/2022]
Abstract
Heat waves have been linked to increases in emergency-related morbidity, but more research is needed on the demographic and disease-specific aspects of these morbidities. Using a case-crossover approach, over 700,000 daily emergency department hospital admissions in Charlottesville, Virginia, U.S.A. from 2005–2016 are compared between warm season heat wave and non-heat wave periods. Heat waves are defined based on the exceedance, for at least three consecutive days, of two apparent temperature thresholds (35 °C and 37 °C) that account for 3 and 6% of the period of record. Total admissions and admissions for whites, blacks, males, females, and 20–49 years old are significantly elevated during heat waves, as are admissions related to a variety of diagnostic categories, including diabetes, pregnancy complications, and injuries and poisoning. Evidence that heat waves raise emergency department admissions across numerous demographic and disease categories suggests that heat exerts comorbidity influences that extend beyond the more well-studied direct relationships such as heat strokes and cardiac arrest.
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Kenny GP, Flouris AD, Yagouti A, Notley SR. Towards establishing evidence-based guidelines on maximum indoor temperatures during hot weather in temperate continental climates. Temperature (Austin) 2018; 6:11-36. [PMID: 30906809 PMCID: PMC6422495 DOI: 10.1080/23328940.2018.1456257] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/15/2018] [Indexed: 11/09/2022] Open
Abstract
Rising environmental temperatures represent a major threat to human health. The activation of heat advisories using evidence-based thresholds for high-risk outdoor ambient temperatures have been shown to be an effective strategy to save lives during hot weather. However, although the relationship between weather and human health has been widely defined by outdoor temperature, corresponding increases in indoor temperature during heat events can also be harmful to health especially in vulnerable populations. In this review, we discuss our current understanding of the relationship between outdoor temperature and human health and examine how human health can also be adversely influenced by high indoor temperatures during heat events. Our assessment of the existing literature revealed a high degree of variability in what can be considered an acceptable indoor temperature because there are differences in how different groups of people may respond physiologically and behaviorally to the same living environment. Finally, we demonstrate that both non-physiological (e.g., geographical location, urban density, building design) and physiological (e.g., sex, age, fitness, state of health) factors must be considered when defining an indoor temperature threshold for preserving human health in a warming global climate.
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Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | | | - Sean R. Notley
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040754. [PMID: 29662001 PMCID: PMC5923796 DOI: 10.3390/ijerph15040754] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/06/2018] [Accepted: 04/12/2018] [Indexed: 11/16/2022]
Abstract
Background: Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods: Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air pollutants, adjusted for seasonal trend, long-term trend, day-of-week, and holiday. Analyses were stratified by disease class, gender and age-group. Results: 44,600 admissions were included in the analysis. Temperature was positively associated with overall mental-disorder hospitalizations (cumulative relative risk at 28 °C vs. 19.4 °C (interquartile range, lag 0-2 days) = 1.09 (95% confidence interval 1.03, 1.15)), with the strongest effect among the elderly (≥75 years old). Transient mental disorders due to conditions classified elsewhere and episodic mood disorders also showed strong positive associations with temperature. Conclusion: This study found a positive temperature-mental-disorder admissions association in a warm subtropical region and the association was most prominent among older people. With the dual effect of global warming and an aging population, targeted strategies should be designed to lower the disease burden.
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What Can We Learn about Workplace Heat Stress Management from a Safety Regulator Complaints Database? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030459. [PMID: 29509710 PMCID: PMC5877004 DOI: 10.3390/ijerph15030459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 11/16/2022]
Abstract
Heat exposure can be a health hazard for many Australian workers in both outdoor and indoor situations. With many heat-related incidents left unreported, it is often difficult to determine the underlying causal factors. This study aims to provide insights into perceptions of potentially unsafe or uncomfortably hot working conditions that can affect occupational health and safety using information provided by the public and workers to the safety regulator in South Australia (SafeWork SA). Details of complaints regarding heat exposure to the regulator's "Help Centre" were assembled in a dataset and the textual data analysed thematically. The findings showed that the majority of calls relate to indoor work environments such as kitchens, factories, and warehouses. The main themes identified were work environment, health effects, and organisational issues. Impacts of hot working conditions ranged from discomfort to serious heat-related illnesses. Poor management practices and inflexibility of supervisors featured strongly amongst callers' concerns. With temperatures predicted to increase and energy prices escalating, this timely study, using naturalistic data, highlights accounts of hot working conditions that can compromise workers' health and safety and the need for suitable measures to prevent heat stress. These could include risk assessments to assess the likelihood of heat stress in workplaces where excessively hot conditions prevail.
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Borg M, Bi P, Nitschke M, Williams S, McDonald S. The impact of daily temperature on renal disease incidence: an ecological study. Environ Health 2017; 16:114. [PMID: 29078794 PMCID: PMC5659014 DOI: 10.1186/s12940-017-0331-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/12/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND Extremely high temperatures over many consecutive days have been linked to an increase in renal disease in several cities. This is becoming increasingly relevant with heatwaves becoming longer, more intense, and more frequent with climate change. This study aimed to extend the known relationship between daily temperature and kidney disease to include the incidence of eight temperature-prone specific renal disease categories - total renal disease, urolithiasis, renal failure, acute kidney injury (AKI), chronic kidney disease (CKD), urinary tract infections (UTIs), lower urinary tract infections (LUTIs) and pyelonephritis. METHODS Daily data was acquired for maximum, minimum and average temperature over the period of 1 July 2003 to 31 March 2014 during the warm season (October to March) in Adelaide, South Australia. Data for daily admissions to all metropolitan hospitals for renal disease, including 83,519 emergency department admissions and 42,957 inpatient admissions, was also obtained. Renal outcomes were analyzed using time-stratified negative binomial regression models, with the results aggregated by day. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated for associations between the number of admissions and daily temperature. RESULTS Increases in daily temperature per 1 °C were associated with an increased incidence for all renal disease categories except for pyelonephritis. Minimum temperature was associated with the greatest increase in renal disease followed by average temperature and then maximum temperature. A 1°C increase in daily minimum temperature was associated with an increase in daily emergency department admissions for AKI (IRR 1.037, 95% CI: 1.026-1.048), renal failure (IRR 1.030, 95% CI: 1.022-1.039), CKD (IRR 1.017, 95% CI: 1.001-1.033) urolithiasis (IRR 1.015, 95% CI: 1.010-1.020), total renal disease (IRR 1.009, 95% CI: 1.006-1.011), UTIs (IRR 1.004, 95% CI: 1.000-1.007) and LUTIs (IRR 1.003, 95% CI: 1.000-1.006). CONCLUSIONS An increased frequency of renal disease, including urolithiasis, acute kidney injury and urinary tract infections, is predicted with increasing temperatures from climate change. These results have clinical and public health implications for the management of renal diseases and demand tailored health services. Future research is warranted to analyze individual renal diseases with more comprehensive information regarding renal risk factors, and studies examining mortality for specific renal diseases.
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Affiliation(s)
- Matthew Borg
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Monika Nitschke
- SA Health, Government of South Australia, Adelaide, South Australia Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Stephen McDonald
- The Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia Australia
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Li J, Xu X, Yang J, Liu Z, Xu L, Gao J, Liu X, Wu H, Wang J, Yu J, Jiang B, Liu Q. Ambient high temperature and mortality in Jinan, China: A study of heat thresholds and vulnerable populations. ENVIRONMENTAL RESEARCH 2017; 156:657-664. [PMID: 28463825 DOI: 10.1016/j.envres.2017.04.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 04/17/2017] [Accepted: 04/18/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Understanding the health consequences of continuously rising temperatures-as is projected for China-is important in terms of developing heat-health adaptation and intervention programs. This study aimed to examine the association between mortality and daily maximum (Tmax), mean (Tmean), and minimum (Tmin) temperatures in warmer months; to explore threshold temperatures; and to identify optimal heat indicators and vulnerable populations. METHODS Daily data on temperature and mortality were obtained for the period 2007-2013. Heat thresholds for condition-specific mortality were estimated using an observed/expected analysis. We used a generalised additive model with a quasi-Poisson distribution to examine the association between mortality and Tmax/Tmin/Tmean values higher than the threshold values, after adjustment for covariates. RESULTS Tmax/Tmean/Tmin thresholds were 32/28/24°C for non-accidental deaths; 32/28/24°C for cardiovascular deaths; 35/31/26°C for respiratory deaths; and 34/31/28°C for diabetes-related deaths. For each 1°C increase in Tmax/Tmean/Tmin above the threshold, the mortality risk of non-accidental-, cardiovascular-, respiratory, and diabetes-related death increased by 2.8/5.3/4.8%, 4.1/7.2/6.6%, 6.6/25.3/14.7%, and 13.3/30.5/47.6%, respectively. Thresholds for mortality differed according to health condition when stratified by sex, age, and education level. For non-accidental deaths, effects were significant in individuals aged ≥65 years (relative risk=1.038, 95% confidence interval: 1.026-1.050), but not for those ≤64 years. For most outcomes, women and people ≥65 years were more vulnerable. CONCLUSION High temperature significantly increases the risk of mortality in the population of Jinan, China. Climate change with rising temperatures may bring about the situation worse. Public health programs should be improved and implemented to prevent and reduce health risks during hot days, especially for the identified vulnerable groups.
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Affiliation(s)
- Jing Li
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China; State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China; Center for Climate Change and Health, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China
| | - Xin Xu
- Department of Dentistry, Affiliated Hospital, Weifang Medical University, Weifang 261031, Shandong Province, PR China
| | - Jun Yang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Zhidong Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China
| | - Lei Xu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jinghong Gao
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Xiaobo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Haixia Wu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jun Wang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jieqiong Yu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China; Center for Climate Change and Health, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China.
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China; Center for Climate Change and Health, School of Public Health, Shandong University, Jinan City, Shandong Province, PR China.
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Navi M, Hansen A, Nitschke M, Hanson-Easey S, Pisaniello D. Developing Health-Related Indicators of Climate Change: Australian Stakeholder Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050552. [PMID: 28531155 PMCID: PMC5452002 DOI: 10.3390/ijerph14050552] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/15/2017] [Accepted: 05/15/2017] [Indexed: 11/16/2022]
Abstract
Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders’ perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions.
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Affiliation(s)
- Maryam Navi
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Alana Hansen
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Monika Nitschke
- South Australia Department for Health and Ageing, Level 1, Citi Centre Building, 11 Hindmarsh Square, Adelaide, SA 5005, Australia.
| | - Scott Hanson-Easey
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
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Harduar Morano L, Watkins S. Evaluation of Diagnostic Codes in Morbidity and Mortality Data Sources for Heat-Related Illness Surveillance. Public Health Rep 2017; 132:326-335. [PMID: 28379784 PMCID: PMC5415256 DOI: 10.1177/0033354917699826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to identify patients with heat-related illness (HRI) using codes for heat-related injury diagnosis and external cause of injury in 3 administrative data sets: emergency department (ED) visit records, hospital discharge records, and death certificates. METHODS We obtained data on ED visits, hospitalizations, and deaths for Florida residents for May 1 through October 31, 2005-2012. To identify patients with HRI, we used codes from the International Classification of Diseases, Ninth Revision, Clinical Modification ( ICD-9-CM) to search data on ED visits and hospitalizations and codes from the International Classification of Diseases, Tenth Revision ( ICD-10) to search data on deaths. We stratified the results by data source and whether the HRI was work related. RESULTS We identified 23 981 ED visits, 4816 hospitalizations, and 140 deaths in patients with non-work-related HRI and 2979 ED visits, 415 hospitalizations, and 23 deaths in patients with work-related HRI. The most common diagnosis codes among patients were for severe HRI (heat exhaustion or heatstroke). The proportion of patients with a severe HRI diagnosis increased with data source severity. If ICD-9-CM code E900.1 and ICD-10 code W92 (excessive heat of man-made origin) were used as exclusion criteria for HRI, 5.0% of patients with non-work-related deaths, 3.0% of patients with work-related ED visits, and 1.7% of patients with work-related hospitalizations would have been removed. CONCLUSIONS Using multiple data sources and all diagnosis fields may improve the sensitivity of HRI surveillance. Future studies should evaluate the impact of converting ICD-9-CM to ICD-10-CM codes on HRI surveillance of ED visits and hospitalizations.
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Affiliation(s)
- Laurel Harduar Morano
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sharon Watkins
- Bureau of Epidemiology, Pennsylvania Department of Health, Harrisburg, PA, USA
- Public Health Research Unit, Florida Department of Health, Tallahassee, FL, USA
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Onozuka D, Hagihara A. Spatiotemporal variation in heat-related out-of-hospital cardiac arrest during the summer in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 583:401-407. [PMID: 28117163 DOI: 10.1016/j.scitotenv.2017.01.081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/13/2017] [Accepted: 01/13/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although several studies have reported the impacts of extremely high temperature on cardiovascular diseases, few studies have investigated the spatiotemporal variation in the incidence of out-of-hospital cardiac arrest (OHCA) due to extremely high temperature in Japan. METHODS Daily OHCA data from 2005 to 2014 were acquired from all 47 prefectures of Japan. We used time-series Poisson regression analysis combined with a distributed lag non-linear model to assess the temporal variability in the effects of extremely high temperature on OHCA incidence in each prefecture, adjusted for time trends. Spatial variability in the relationships between extremely high temperature and OHCA between prefectures was estimated using a multivariate random-effects meta-analysis. RESULTS We analyzed 166,496 OHCA cases of presumed cardiac origin occurring during the summer (June to September) that met the inclusion criteria. The minimum morbidity percentile (MMP) was the 51st percentile of temperature during the summer in Japan. The overall cumulative relative risk at the 99th percentile vs. the MMP over lags 0-10days was 1.21 (95% CI: 1.12-1.31). There was also a strong low temperature effect during the summer periods. No substantial difference in spatial or temporal variability was observed over the study period. CONCLUSIONS Our study demonstrated spatiotemporal homogeneity in the risk of OHCA during periods of extremely high temperature between 2005 and 2014 in Japan. Our findings suggest that public health strategies for OHCA due to extremely high temperatures should be finely adjusted and should particularly account for the unchanging risk during the summer.
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Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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Zander KK, Moss SA, Garnett ST. Drivers of self-reported heat stress in the Australian labour force. ENVIRONMENTAL RESEARCH 2017; 152:272-279. [PMID: 27816864 DOI: 10.1016/j.envres.2016.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/25/2016] [Indexed: 06/06/2023]
Abstract
Heat stress causes reductions in well-being and health. As average annual temperatures increase, heat stress is expected to affect more people. While most research on heat stress has explored how exposure to heat affects functioning of the human organism, stress from heat can be manifest long before clinical symptoms are evident, with profound effects on behavior. Here we add to the little research conducted on these subclinical effects of environmental heat using results from an Australian-wide cross-sectional study of nearly 2000 respondents on their self-reported level of heat stress. Slightly less than half (47%) of the respondents perceived themselves as at least sometimes, often or very often stressed by heat during the previous 12 months. Health status and smoking behavior had the expected impact on self-reported perceived heat stress. There were also regional differences with people living in South Australia, Victoria and New South Wales most likely to have reported to have felt heat stressed. People generally worried about climate change, who had been influenced by recent heat waves and who thought there was a relationship between climate change and health were also more likely to have been heat stressed. Surprisingly average maximum temperatures did not significantly explain heat stress but stress was greater among people who perceived the day of the survey as hotter than usual. Currently heat stress indices are largely based on monitoring the environment and physical limitations to people coping with heat. Our results suggest that psychological perceptions of heat need to be considered when predicting how people will be affected by heat under climate change and when developing heat relief and climate change adaptation plans, at work, at home or in public spaces. We further conclude that the perception of temperature and heat stress complements measures that assess heat exposure and heat strain.
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Affiliation(s)
- Kerstin K Zander
- Northern Institute, Charles Darwin University, Darwin, Northern Territory, Australia.
| | - Simon A Moss
- School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Stephen T Garnett
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Darwin, Northern Territory, Australia
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