1
|
Sun Y, Zhu S, Wang D, Duan J, Lu H, Yin H, Tan C, Zhang L, Zhao M, Cai W, Wang Y, Hu Y, Tao S, Guan D. Global supply chains amplify economic costs of future extreme heat risk. Nature 2024; 627:797-804. [PMID: 38480894 PMCID: PMC10972753 DOI: 10.1038/s41586-024-07147-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/01/2024] [Indexed: 03/18/2024]
Abstract
Evidence shows a continuing increase in the frequency and severity of global heatwaves1,2, raising concerns about the future impacts of climate change and the associated socioeconomic costs3,4. Here we develop a disaster footprint analytical framework by integrating climate, epidemiological and hybrid input-output and computable general equilibrium global trade models to estimate the midcentury socioeconomic impacts of heat stress. We consider health costs related to heat exposure, the value of heat-induced labour productivity loss and indirect losses due to economic disruptions cascading through supply chains. Here we show that the global annual incremental gross domestic product loss increases exponentially from 0.03 ± 0.01 (SSP 245)-0.05 ± 0.03 (SSP 585) percentage points during 2030-2040 to 0.05 ± 0.01-0.15 ± 0.04 percentage points during 2050-2060. By 2060, the expected global economic losses reach a total of 0.6-4.6% with losses attributed to health loss (37-45%), labour productivity loss (18-37%) and indirect loss (12-43%) under different shared socioeconomic pathways. Small- and medium-sized developing countries suffer disproportionately from higher health loss in South-Central Africa (2.1 to 4.0 times above global average) and labour productivity loss in West Africa and Southeast Asia (2.0-3.3 times above global average). The supply-chain disruption effects are much more widespread with strong hit to those manufacturing-heavy countries such as China and the USA, leading to soaring economic losses of 2.7 ± 0.7% and 1.8 ± 0.5%, respectively.
Collapse
Affiliation(s)
- Yida Sun
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Shupeng Zhu
- Department of Atmospheric Sciences, School of Earth Sciences, Zhejiang University, Hangzhou, China
- Advanced Power and Energy Program, University of California Irvine, Irvine, CA, USA
| | - Daoping Wang
- Department of Geography, King's College London, London, UK
- Centre for Climate Engagement, Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Jianping Duan
- State Key Laboratory of Earth Surface and Ecological Resources, Faculty of Geographical Science, Beijing Normal University, Beijing, China
| | - Hui Lu
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
- Tsinghua University (Department of Earth System Science)-Xi'an Institute of Surveying and Mapping Joint Research Center for Next-Generation Smart Mapping, Beijing, China
| | - Hao Yin
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - Chang Tan
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Lingrui Zhang
- Department of Economics, University of Waterloo, Waterloo, Ontario, Canada
| | - Mengzhen Zhao
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
| | - Wenjia Cai
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Yong Wang
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Yixin Hu
- School of Economics and Management, Southeast University, Nanjing, China
| | - Shu Tao
- College of Urban Environment, Peking University, Beijing, China
| | - Dabo Guan
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China.
- The Bartlett School of Sustainable Construction, University College London, London, UK.
| |
Collapse
|
2
|
Cheng BJ, Li H, Meng K, Li TL, Meng XC, Wang J, Wang C, Jiang N, Sun MJ, Yang LS, Zhu XY, Liu R. Short-term effects of heatwaves on clinical and subclinical cardiovascular indicators in Chinese adults: A distributed lag analysis. ENVIRONMENT INTERNATIONAL 2024; 183:108358. [PMID: 38056095 DOI: 10.1016/j.envint.2023.108358] [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: 07/06/2023] [Revised: 11/11/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023]
Abstract
AIMS Previous studies have related heat waves to morbidity and mortality of cardiovascular diseases; however, potential mechanisms remained limited. Our aims were to investigate the short-term effects of heat waves on a series of clinical/subclinical indicators associated with cardiovascular health. METHODS Our study used 80,574 health examination records from the Health Management Center of Nanjing Zhongda Hospital during the warm seasons of 2019-2021, including 62,128 participants. A total of 11 recognized indicators of cardiovascular risk or injury were assessed. Air pollution and meteorological data were obtained from the Nanjing Ecological Environment Bureau and the China Meteorological Data Network, respectively. Heat waves were defined as a daily average temperature over the 95th percentile for three or more consecutive days from May to September. We used a combination of linear mixed effects models and distributed lag nonlinear models to assess the lagged effects of heat waves on clinical and subclinical cardiovascular indicators. Stratified analyses based on individuals' characteristics, including gender, age, body mass index (BMI), diabetes, and hypertension, were also performed. RESULTS Heat waves were related to significant changes in most indicators, with the magnitude of effects generally peaking at a lag of 0 to 3 days. Moreover, the cumulative percentage changes over lag 0-7 days were -0.82 % to -2.55 % in blood pressure, 1.32 % in heart rate, 0.20 % to 2.66 % in systemic inflammation markers, 0.36 % in a blood viscosity parameter, 9.36 % in homocysteine, and 1.35 % to 3.25 % in injuring myocardial enzymes. Interestingly, females and males showed distinct susceptibilities in different indicators. Stronger effects were also found in participants aged 50 years or over, individuals with abnormal BMI status, and patients with diabetes. CONCLUSION Short-term exposure to heat waves could significantly alter clinical/subclinical cardiovascular indicator profiles, including blood pressure changes, increased heart rate, acute systemic inflammation, elevated blood viscosity, and myocardial injury.
Collapse
Affiliation(s)
- Bei-Jing Cheng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Hui Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Ke Meng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Tian-Lin Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Xing-Chen Meng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Jia Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Chun Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Nan Jiang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Ming-Jun Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Lin-Sheng Yang
- School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Xin-Yi Zhu
- The Affiliated Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, Jiangsu, China
| | - Ran Liu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China.
| |
Collapse
|
3
|
Yang Y, Zhao N. Vulnerability assessment of urban agglomerations to the risk of heat waves in China since the 21st century. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122443. [PMID: 37643676 DOI: 10.1016/j.envpol.2023.122443] [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: 04/19/2023] [Revised: 07/06/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
In the context of global warming, frequent heat wave disasters have seriously threatened the safety of human life and property. The urban agglomeration, as the main region with a high concentration of population and economy, is susceptible to heat weaves due to the existing urban heat island effect. In this study, we investigated the temporal and spatial characteristics of heat waves (heat index, HI) in China from 2000 to 2020 and assess the vulnerability of 19 urban agglomerations to heat waves from the perspective of exposure, sensitivity and adaptability. The results show that: (1) In the past 20 years, the frequency and intensity of HI (greater than 26.67 °C) both showed an upward trend. (2) Shandong Peninsula, Central Henan, Yangtze River Delta, Middle Reaches of Yangtze River, and Mid-southern Liaoning urban agglomerations always maintain a high vulnerability. (3) From 2000 to 2020, the vulnerability of Beijing-Tianjin-Hebei, Yangtze River Delta, Chengdu-Chongqing, Middle reaches of Yangtze River, Guangdong-Fujian-Zhejiang, Harbin-Changchun and Mid-southern Liaoning urban agglomerations were always dominated by exposure. The vulnerability of Shandong Peninsula, Beibu Gulf and Central Henan urban agglomeration has always been dominated by sensitivity. The vulnerability of North Tianshan Mountain, Lanzhou-Xining, Guanzhong and Hu-Bao-E-Yu urban agglomeration has always been dominated by inadequate adaptability. (4) Recently, the factors that contributed most to exposure, sensitivity and adaptability were population density, the proportion of outdoor workers and water supply, with contribution rates of 38%, 55% and 26%, respectively. This study can provide a scientific basis for the rational allocation of resources among urban agglomerations, effectively formulating policies and guiding population migration from high temperature disasters.
Collapse
Affiliation(s)
- Yang Yang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Na Zhao
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China; Jiangsu Center for Collaborative Innovation in Geographic Information Resource Development and Application, Nanjing, 210023, China.
| |
Collapse
|
4
|
Ning X, Li Y, Gao G, Zhang Y, Qin Y. Temporal and spatial characteristics of high temperatures, heat waves, and population distribution risk in China from 1951 to 2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:96629-96646. [PMID: 37578588 DOI: 10.1007/s11356-023-28955-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
Understanding the relationships between high temperatures (HT) and heat waves (HW) is vital for enhancing human health, especially in areas with dense population. This paper analyzes the temporal and spatial characteristics of different HT and HW intensities, their spatial influence, and the population distribution risk at different HW intensities for 844 meteorological stations between 1951 and 2019. The results indicate that (1) HT and extreme temperature (ET) days are symmetrically distributed along the Huhuanyong Line, from southeast to northwest China. The times, days, and accumulated temperatures of HW, the times, days, and accumulated temperature of strong heat waves (SHW), and the times, days, and accumulated temperature of extreme heat waves (EHW) were distributed similarly; (2) with the increase in high temperatures or heat waves from HT to ET or from HW to SHW, the proportion of stations with an upward trend was always greater in China, while stations with a downward trend were mainly located in the North China Plain and Huai River Basin. For HW, SHW, and EHW, the increasing range of times and days were less than the accumulated temperatures; (3) between 1990 and 2019, there was an expansion of the HW and SHW distribution area with an annual average of more than 10 days, and the EHW distribution area with an annual average of more than 3 days. Moreover, the number of people exposed to HW, SHW, and EHW also increased during this period; and (4) considering the population distribution characteristics and the regional HT and HW characteristics, society needs to form regional adaptation actions for different HT and HW intensities.
Collapse
Affiliation(s)
- Xiaoju Ning
- School of Resources and Environment, Henan University of Economics and Law, Zhengzhou, 450046, China
- Academician Laboratory for Urban and Rural Spatial Data Mining of Henan Province, Henan University of Economics and Law, Zhengzhou, 450046, China
| | - Yuanzheng Li
- School of Resources and Environment, Henan University of Economics and Law, Zhengzhou, 450046, China
- Academician Laboratory for Urban and Rural Spatial Data Mining of Henan Province, Henan University of Economics and Law, Zhengzhou, 450046, China
| | - Genghe Gao
- School of Resources and Environment, Henan University of Economics and Law, Zhengzhou, 450046, China
- Academician Laboratory for Urban and Rural Spatial Data Mining of Henan Province, Henan University of Economics and Law, Zhengzhou, 450046, China
| | - Yan Zhang
- Ecological Economy Research Center, Qiong Tai Normal University, Haikou, 570228, China
| | - Yaochen Qin
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education & College of Geography and Environmental Science, Henan University, Kaifeng, 475004, China.
- Key Research Institute of Yellow River Civilization and Sustainable Development & Collaborative Innovation Center on Yellow River Civilization jointly built by Henan Province and Ministry of Education, Henan University, Kaifeng, 475001, China.
| |
Collapse
|
5
|
Liang L, Yu L, Wang Z. Identifying the dominant impact factors and their contributions to heatwave events over mainland China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 848:157527. [PMID: 35931164 DOI: 10.1016/j.scitotenv.2022.157527] [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: 04/19/2022] [Revised: 07/09/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
The heatwave frequency and intensity have significantly changed as the climate warms and human activities increase, which poses a potential risk to human society. However, the impact factors that determine the change of heatwave events remain unclear. Here, we estimated the heatwave events based on data from 2474 in-suit gauges during 1960-2018 at daily scale in China. Besides, we explored possible drivers and their contributions to the change of heatwave based on correlation analysis, multiple linear regression (MLR), and random forest (RF) in different subregions of China. The results show that the temporal changes of all heatwave metrics exhibit significant differences between the period 1960-1984 and the period 1985-2019. Spatially, the heatwave frequency and duration significant increase in the southern China (S), eastern arid region (EA), northeastern China (NE), Qinghai-Tibet region (QT) and western arid and semi-arid region (WAS). The occurrence of the first heatwave event in a year tends to be earlier in S, NE, EA, WAS, and QT than before. Based on the regression modelling and RF, human activities play an important role in heatwave intensity in all subregions of China. For heatwave frequency, urbanization generate a dominant influence in NE, EA, and QT, with relative contributions (RC) ranging from 32.8 % to 38.9 %. Long-term climate change exerts the dominant influence in C, N, and S. Moreover, the first day of the yearly heatwave event (HWT) in NE is significantly influenced by climate change, with RC of 33.9 % for temperature variation (TEM). Our findings could provide critical information for understanding the causes of heatwave across different regions of China in the context of rapid urbanization and climate change.
Collapse
Affiliation(s)
- Liaofeng Liang
- Key Laboratory of Water Cycle and Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 101400, China
| | - Linfei Yu
- Key Laboratory of Water Cycle and Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 101400, China
| | - Zhonggen Wang
- Key Laboratory of Water Cycle and Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; National Institute of Natural Hazards, Ministry of Emergency Management of China, Beijing 100085, China.
| |
Collapse
|
6
|
Yu H, Lu N, Fu B, Zhang L, Wang M, Tian H. Hotspots, co-occurrence, and shifts of compound and cascading extreme climate events in Eurasian drylands. ENVIRONMENT INTERNATIONAL 2022; 169:107509. [PMID: 36108499 DOI: 10.1016/j.envint.2022.107509] [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: 05/19/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Eurasian drylands are the regions that are most vulnerable to climate change. Climate extremes have caused enormous or even devastating impacts on ecosystems and the social economy in this region, and the compound climate extremes (com_CEs, two or more extreme events occurring simultaneously) and cascading climate extremes (cas_CEs, two or more extreme events occurring successively) have exacerbated these problems. However, little is known about the occurrence patterns of com_CEs and cas_CEs in the Eurasian drylands. Based on the ERA5 reanalysis data range from 1979 to 2020, we improved the methodology for the extraction of co-occurrence events and identified high-frequency types, their hotspots, and occurrence rhythms (seasonally and annually) in Eurasian drylands. Our results showed that com_CEs and cas_CEs have high similarities in the types and spatial hotspots of extreme events; however, the former has a wider geographical and spatial distribution, and the latter has a longer duration. Specifically, co-occurring drought and heatwave events (DH) frequently appear in South Asia and western mid-latitude regions during summer, while in the winter, high latitude regions should be alert to the co-occurrence of drought and low-temperature events (DT). Central Asia and the Mongolian Plateau regions are prone to frequent drought and wind events (DW), and wind and high precipitation events (WP) in the spring and autumn. We have noticed that mid-latitude may suffer from extreme events that have never occurred before, such as com_DH being scattered sporadically in the first two decades and suddenly surging in West Asia and East Asia after the year 2000, and com_DT migrating from high-latitude areas such as the Arctic Ocean coast to mid-latitudes. Our results contribute to understanding hotspots of co-occurring CEs in Eurasian drylands, where more efforts will be needed in the future, especially in mid-latitudes which may suffer extreme climate events that have never occurred before.
Collapse
Affiliation(s)
- Huiqian Yu
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Nan Lu
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Bojie Fu
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China; Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
| | - Lu Zhang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Mengyu Wang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hanqin Tian
- Schiller Institute for Integrated Science and Society, Department of Earth and Environmental Sciences, Boston College, Chestnut Hill, MA 02467, USA
| |
Collapse
|
7
|
Zhang X, Long Q, Kun D, Yang D, Lei L. Comprehensive Risk Assessment of Typical High-Temperature Cities in Various Provinces in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074292. [PMID: 35409974 PMCID: PMC8998455 DOI: 10.3390/ijerph19074292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023]
Abstract
Global climate change results in an increased risk of high urban temperatures, making it crucial to conduct a comprehensive assessment of the high-temperature risk of urban areas. Based on the data of 194 meteorological stations in China from 1986 to 2015 and statistical yearbooks and statistical bulletins from 2015, we used GIS technology and mathematical statistics to evaluate high-temperature spatial and temporal characteristics, high-temperature risk, and high-temperature vulnerability of 31 cities across China. Over the past 30 years, most Chinese cities experienced 5–8 significant oscillation cycles of high-temperature days. A 15-year interval analysis of high-temperature characteristics found that 87% of the cities had an average of 5.44 more high-temperature days in the 15-year period from 2001 to 2015 compared to the period from 1986 to 2000. We developed five high-temperature risk levels and six vulnerability levels. Against the background of a warming climate, we discuss risk mitigation strategies and the importance of early warning systems.
Collapse
Affiliation(s)
- Xueru Zhang
- School of Public Administration, Hebei University of Economics and Business, Shijiazhuang 050061, China; (D.K.); (L.L.)
- Collaborative Innovation Center of Urban-Rural Integration Development, Hebei University of Economics and Business, Shijiazhuang 050061, China
- Correspondence:
| | - Qiuyue Long
- Chongqing Cybercity Sci-Tech Co., Ltd., Chongqing 401121, China;
| | - Dong Kun
- School of Public Administration, Hebei University of Economics and Business, Shijiazhuang 050061, China; (D.K.); (L.L.)
| | - Dazhi Yang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China;
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Liu Lei
- School of Public Administration, Hebei University of Economics and Business, Shijiazhuang 050061, China; (D.K.); (L.L.)
| |
Collapse
|
8
|
Dong Y, Ren Z, Fu Y, Hu N, Guo Y, Jia G, He X. Decrease in the residents' accessibility of summer cooling services due to green space loss in Chinese cities. ENVIRONMENT INTERNATIONAL 2022; 158:107002. [PMID: 34991262 DOI: 10.1016/j.envint.2021.107002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/28/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
Urban green spaces (UGSs) reduce the surrounding temperature and create cooling areas as a buffer between people and high temperatures, thus helping residents adapt to the warming climate. However, the accessibility of UGS cooling services to the residents of cities remains largely unknown, which hinders decision-making regarding the formulation of climate adaptation and urban greening schemes. In the present study, we estimated the number of residents who accessed UGSs for cooling by analyzing the annual changes in such cooling areas during summer across 315 Chinese cities from 2003 to 2015. Approximately 93.3% of the cities showed significant decreasing trends (p < 0.05) of the total UGS area; as such the UGS coverage dropped from 12.23 ± 0.32% in 2003 to 7.69 ± 0.22% in 2015. Consequently, with the prevalent loss of UGS, the coverage of cooling spaces decreased from 32.55 ± 0.76% in 2003 to 24.39 ± 0.60% in 2015. This has formed a spatial mismatch between the growing urban population and the remaining UGSs. Accordingly, the number of residents of areas outside these cooling spaces increased by 4.23 million per year. In particular, the shortage of cooling services was more significant in cities with < 20,000 USD gross domestic product per capita and < 5 million residents than in the rest of the cities. To minimize the adverse impacts of increasing temperatures, focused greening plans are warranted, specifically in underdeveloped cities.
Collapse
Affiliation(s)
- Yulin Dong
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhibin Ren
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yao Fu
- School of Geography and Engineering of Land Resources, Yuxi Normal University, Yuxi 653100, China
| | - Nanlin Hu
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yujie Guo
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Guangliang Jia
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China; Key Laboratory of Forest Ecology and Management, Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang 110016, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xingyuan He
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China; Key Laboratory of Forest Ecology and Management, Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang 110016, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| |
Collapse
|
9
|
Spatial and Temporal Variation Characteristics of Heatwaves in Recent Decades over China. REMOTE SENSING 2021. [DOI: 10.3390/rs13193824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Global warming and rapid socioeconomic development increased the risk of regional and global disasters. Particularly in China, annual heatwaves (HWs) caused many fatalities and substantial property damage, with an increasing trend. Therefore, it is of great scientific value and practical importance to analyze the spatiotemporal changes of HW in China for the sustainable development of regional socioeconomic and disaster risk management. In this study, based on gridded maximum temperature product and specific humidity dataset, an HW evaluation algorithm, considering the impact of humidity on the human body and the characteristics of HW in China, was employed to generate daily HW state at light, moderate, and severe levels for the period 1979–2018. Consequently, the regional differences at three HW levels were revealed, and the changing trend of HW onset, termination, and duration in each subregion was analyzed. The results show that in the three levels, the frequency and duration of HW in China had a significant increasing trend, generally characterized by the advancement of HW onset and the postponement of HW termination. The HW influence at light, moderate and severe levels decreased gradually, with the light level occurring the earliest and terminating the latest. Among the seven subregions, the largest HW frequency happened to be mainly in XJ (Xinjiang), SC (Southern China), and NC (Northern China), while the variations of HW onset and termination had noticeable regional differences at the three levels. The findings presented in this study can provide the essential scientific and technological support for national and regional disaster prevention mitigation and adaptation to extreme climate events.
Collapse
|
10
|
Faye M, Dème A, Diongue AK, Diouf I. Impact of different heat wave definitions on daily mortality in Bandafassi, Senegal. PLoS One 2021; 16:e0249199. [PMID: 33819272 PMCID: PMC8021182 DOI: 10.1371/journal.pone.0249199] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 03/12/2021] [Indexed: 11/19/2022] Open
Abstract
Objective The aim of this study is to find the most suitable heat wave definition among 15 different ones and to evaluate its impact on total, age-, and gender-specific mortality for Bandafassi, Senegal. Methods Daily weather station data were obtained from Kedougou situated at 17 km from Bandafassi from 1973 to 2012. Poisson generalized additive model (GAM) and distributed lag non-linear model (DLNM) are used to investigate the effect of heat wave on mortality and to evaluate the nonlinear association of heat wave definitions at different lag days, respectively. Results Heat wave definitions, based on three or more consecutive days with both daily minimum and maximum temperatures greater than the 90th percentile, provided the best model fit. A statistically significant increase in the relative risk (RRs 1.4 (95% Confidence Interval (CI): 1.2–1.6), 1.7 (95% CI: 1.5–1.9), 1.21 (95% CI: 1.08–1.3), 1.2 (95% CI: 1.04–1.5), 1.5 (95% CI: 1.3–1.8), 1.4 (95% CI: 1.2–1.5), 1.5 (95% CI: 1.07–1.6), and 1.5 (95% CI: 1.3–1.8)) of total mortality was observed for eight definitions. By using the definition based on the 90th percentile of minimum and maximum temperature with a 3-day duration, we also found that females and people aged ≥ 55 years old were at higher risks than males and other different age groups to heat wave related mortality. Conclusion The impact of heat waves was associated with total-, age-, gender-mortality. These results are expected to be useful for decision makers who conceive of public health policies in Senegal and elsewhere. Climate parameters, including temperatures and humidity, could be used to forecast heat wave risks as an early warning system in the area where we conduct this research. More broadly, our findings should be highly beneficial to climate services, researchers, clinicians, end-users and decision-makers.
Collapse
Affiliation(s)
- Mbaye Faye
- LERSTAD—UFR Sciences Appliquées et de Technologies, Université Gaston Berger de Saint-Louis, Saint-Louis, Sénégal
- * E-mail:
| | - Abdoulaye Dème
- LSAO—UFR Sciences Appliquées et de Technologies, Université Gaston Berger de Saint-Louis, Saint-Louis, Sénégal
| | - Abdou Kâ Diongue
- LERSTAD—UFR Sciences Appliquées et de Technologies, Université Gaston Berger de Saint-Louis, Saint-Louis, Sénégal
| | - Ibrahima Diouf
- NOAA Center for Weather and Climate Prediction Climate Prediction Center College Park, Maryland, United States of America
| |
Collapse
|
11
|
Pan R, Wang Q, Yi W, Wei Q, Cheng J, Su H. Temporal trends of the association between extreme temperatures and hospitalisations for schizophrenia in Hefei, China from 2005 to 2014. Occup Environ Med 2021; 78:oemed-2020-107181. [PMID: 33737328 DOI: 10.1136/oemed-2020-107181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/06/2021] [Accepted: 02/03/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We aimed to examine the temporal trends of the association between extreme temperature and schizophrenia (SCZ) hospitalisations in Hefei, China. METHODS We collected time-series data on SCZ hospitalisations for 10 years (2005-2014), with a total of 36 607 cases registered. We used quasi-Poisson regression and distributed lag non-linear model (DLNM) to assess the association between extreme temperature (cold and heat) and SCZ hospitalisations. A time-varying DLNM was then used to explore the temporal trends of the association between extreme temperature and SCZ hospitalisations in different periods. Subgroup analyses were conducted by age (0-39 and 40+ years) and gender, respectively. RESULTS We found that extreme cold and heat significantly increased the risk of SCZ hospitalisations (cold: 1st percentile of temperature 1.19 (95% CI 1.04 to 1.37) and 2.5th percentile of temperature 1.16 (95% CI 1.03 to 1.31); heat: 97.5th percentile of temperature 1.37 (95% CI 1.13 to 1.66) and 99th percentile of temperature 1.38 (95% CI 1.13 to 1.69)). We found a slightly decreasing trend in heat-related SCZ hospitalisations and a sharp increasing trend in cold effects from 2005 to 2014. However, the risk of heat-related hospitalisation has been rising since 2008. Stratified analyses showed that age and gender had different modification effects on temporal trends. CONCLUSIONS The findings highlight that as temperatures rise the body's adaptability to high temperatures may be accompanied by more threats from extreme cold. The burden of cold-related SCZ hospitalisations may increase in the future.
Collapse
Affiliation(s)
- Rubing Pan
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Qizhi Wang
- Chinese Academy of Agricultural Sciences, Haidian District, Beijing, China
| | - Weizhuo Yi
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Qiannan Wei
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Jian Cheng
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Hong Su
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| |
Collapse
|
12
|
Liu X, Tian Z, Sun L, Liu J, Wu W, Xu H, Sun L, Wang C. Mitigating heat-related mortality risk in Shanghai, China: system dynamics modeling simulations. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2020; 42:3171-3184. [PMID: 32350804 PMCID: PMC7518989 DOI: 10.1007/s10653-020-00556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
Numerous studies in epidemiology, meteorology, and climate change research have demonstrated a significant association between abnormal ambient temperature and mortality. However, there is a shortage of research attention to a systematic assessment of potential mitigation measures which could effectively reduce the heat-related morbidity and mortality risks. This study first illustrates a conceptualization of a systems analysis version of urban framework for climate service (UFCS). It then constructs a system dynamics (SD) model for the UFCS and employs this model to quantify the impacts of heat waves on public health system in Shanghai and to evaluate the performances of two mitigation measures in the context of a real heat wave event in July 2013 in the city. Simulation results show that in comparison with the baseline without mitigation measures, if the hospital system could prepare 20% of beds available for emergency response to heat waves once receiving the warning in advance, the number of daily deaths could be reduced by 40-60 (15.8-19.5%) on the 2 days of day 7 and day 8; if increasing the minimum living allowance of 790 RMB/month in 2013 by 20%, the number of daily deaths could be reduced by 50-70 (17.7-21.9%) on the 2 days of day 8 and day 12. This tool can help policy makers systematically evaluate adaptation and mitigation options based on performance assessment, thus strengthening urban resilience to changing climate.
Collapse
Affiliation(s)
- Xiaochen Liu
- Shanghai Climate Center, Shanghai Meteorological Services, Shanghai, 200030 China
- Key Laboratory of Cities’ Mitigation and Adaptation to Climate Change in Shanghai, Shanghai, 200092 China
| | - Zhan Tian
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Laixiang Sun
- Department of Geographical Sciences, University of Maryland, College Park, MD 20742 USA
- School of Finance and Management, SOAS University of London, Russell Square, London, WC1H 0XG UK
- International Institute for Applied Systems Analysis (IIASA), 2361 Laxenburg, Austria
| | - Junguo Liu
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Wei Wu
- Shanghai Climate Center, Shanghai Meteorological Services, Shanghai, 200030 China
- Key Laboratory of Cities’ Mitigation and Adaptation to Climate Change in Shanghai, Shanghai, 200092 China
| | - Hanqing Xu
- Key Laboratory of Geographic Information Science (Ministry of Education), East China Normal University, Shanghai, 200241 China
| | - Landong Sun
- Shanghai Climate Center, Shanghai Meteorological Services, Shanghai, 200030 China
- Key Laboratory of Cities’ Mitigation and Adaptation to Climate Change in Shanghai, Shanghai, 200092 China
| | - Chunfang Wang
- Shanghai Center of Disease Prevention and Control, Shanghai, 200336 China
| |
Collapse
|
13
|
Abstract
Many cities are experiencing persistent risk in China due to frequent extreme weather events. Some extreme weather events, such as extreme heat hazard, have seriously threatened human health and socio-economic development in cities. There is an urgent need to measure the degree of extreme heat risk and identify cites with the highest levels of extreme heat risk. In this study, we presented a risk assessment framework of extreme heat and considered risk as a combination of hazard, exposure, and vulnerability. Based on these three dimensions, we selected relevant variables from historical meteorological data (1960–2016) and socioeconomic statistics in 2016, establishing an indicator system of extreme heat risk evaluation. Finally, we developed an extreme heat risk index to quantify the levels of extreme heat risk of 296 prefecture-level cities in China and revealed the spatial pattern of extreme heat risk in China in 2016 and their dominant factors. The results show that (1) cities with high levels of extreme heat hazard are mainly located in the south of China, especially in the southeast of China; (2) the spatial distribution of the extreme heat risk index shows obvious agglomeration characteristics; (3) the spatial distribution of the extreme heat risk is still mostly controlled by natural geographical conditions such as climate and topography; (4) among the four types of hazard-dominated, exposure-dominated, vulnerability-dominated, and low risk cities, the number of vulnerability-dominated cities is the largest. The results of this study can provide support for the risk management of extreme heat disasters and the formation of targeted countermeasures in China.
Collapse
|
14
|
Spatial Characteristics of Heat Extremes in South Korea from the Climatological Mean Perspective. ATMOSPHERE 2020. [DOI: 10.3390/atmos11030250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated the spatial characteristics of heat extremes in South Korea from the climatological mean perspective. A heat extreme was defined as a day when the daily maximum temperature was higher than 33 °C. According to our analyses, the eastern area of the Sobaek and Taebaek mountain ranges (hereafter called the eastern district) is significantly more exposed to heat extremes compared to other areas. The onset date and total number of days of annual heat extremes in the eastern district are approximately 13 days earlier and 3 days higher than those in the western district on average, respectively. Likewise, the annual mean of daily maximum temperatures during heat extreme days are approximately 0.25 °C higher. This larger exposure to heat extremes in the eastern district appears to be attributable to the Föhn phenomenon, which is likely induced by the dominant southwesterly monsoon during the early-to-peak summer. In contrast, differences in the ending dates of annual heat extremes are not noticeable between the eastern and western districts, when the southerly winds are dominant. Our analyses suggest that heat extremes in South Korea cannot be understood by a simple function of latitude, but in conjunction with atmospheric physical processes.
Collapse
|
15
|
Xu X, Li J, Gao J, Liu K, Liu Q. Effective analysis of a community-based intervention during heat waves to improve knowledge, attitude and practice in a population in Licheng District, Jinan City, China. J Public Health (Oxf) 2019; 40:573-581. [PMID: 28977506 DOI: 10.1093/pubmed/fdx121] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Indexed: 01/21/2023] Open
Abstract
Background Intervention strategies that focus on coping with continuous heat wave threats have been implemented in many countries. Despite these efforts, we still lack evidence concerning intervention efficacy. A Heat Wave Intervention Program (HWIP) that impacts knowledge, attitude and practice (KAP) was designed, and its effectiveness during heat waves was evaluated. Methods A stratified two-stage probability proportion to size sampling method was employed to analyze an intervention group and a control group. Two cross-sectional surveys, which included questions about heat waves in 2014 and 2015, were analyzed using difference-in-difference (DID) analysis. Results Mean KAP scores among participants with different demographic characteristics in the intervention group were higher in 2015 than those in 2014. Further analysis by DID found that implementing interventions was positively associated with knowledge (ß = 0.387, P < 0.001) and attitude (ß = 0.166, P < 0.01). Conclusion Intervention measures can significantly promote levels of knowledge and attitude. However, as the practice level, most of the sub-groups showed no significant differences for net values between in the intervention group and control group. A cost-benefit analysis was suggested as future work to check the effectiveness of the program. Therefore, further improvement measures should be targeted towards the populations to enable them to effectively cope with the heat waves.
Collapse
Affiliation(s)
- Xin Xu
- Department of Dentistry, Affiliated Hospital, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Jing Li
- Public Health Department of Weifang Medical University, Weifang, Shandong Province, PR China.,State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Jinghong Gao
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Keke Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China
| |
Collapse
|
16
|
Cheng J, Xu Z, Bambrick H, Prescott V, Wang N, Zhang Y, Su H, Tong S, Hu W. Cardiorespiratory effects of heatwaves: A systematic review and meta-analysis of global epidemiological evidence. ENVIRONMENTAL RESEARCH 2019; 177:108610. [PMID: 31376629 DOI: 10.1016/j.envres.2019.108610] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Heatwaves affect human health and global heatwave-related disease burden will continue to rise as climate change proceeds, but the effects of heatwaves on cardiovascular and respiratory diseases have not yet been investigated globally and nationally. OBJECTIVES This systematic review and meta-analysis aim to quantify heatwave effects on four major health outcomes: cardiovascular and respiratory morbidity and mortality. METHODS We searched PubMed, Scopus, Embase, and Web of Science for relevant studies from database inception to November 2018. Categories of morbidity included hospital admissions, emergency department visits, and ambulance attendances/call-outs. A random-effects meta-analysis model was used to pool previous estimates of heatwave effects on mortality and morbidity due to cardiovascular and respiratory diseases. Subgroup analyses by gender, age, and disease cause were conducted. Sensitivity analyses were performed by the categories of morbidity, heatwave definitions, study design, and using a leave-one-out cross validation approach. This study is registered with PROSPERO (number: CRD42018101964). RESULTS We identified 54 studies conducted in 20 countries. In total, there were significant associations between heatwaves and cardiovascular mortality (risk estimates (RE): 1.149, 95% confidence interval (CI): 1.090, 1.210) and respiratory mortality (RE: 1.183, 95%CI: 1.092, 1.282), but the magnitude of these associations varied across countries and studies. Heatwaves appeared to be marginally associated with cardiovascular and respiratory morbidities (RE: 0.999, 95%CI: 0.996, 1.002, p-value = 0.61 for cardiovascular morbidity; RE: 1.043, 95%CI: 0.995, 1.093; p-value = 0.08 for respiratory morbidity). For mortality, significant associations were observed for the elderly, ischemic heart disease, stroke, heart failure, and chronic obstructive pulmonary disease. Sensitivity analyses suggested that these findings were robust. CONCLUSION Mortality of cardiovascular and respiratory diseases appeared to be more vulnerable to heatwaves in comparison to morbidity. Considering high heterogeneity detected between studies and limited investigations into subpopulations, more research are required to provide a clearer picture of how heatwaves affect cardiovascular and respiratory diseases in different settings.
Collapse
Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - 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
| | | | - Ning Wang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Yuzhou Zhang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Anhui, China; School of Public Health and Social Work, 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.
| |
Collapse
|
17
|
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.
Collapse
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.
| |
Collapse
|
18
|
Chan EYY, Ho JY, Hung HHY, Liu S, Lam HCY. Health impact of climate change in cities of middle-income countries: the case of China. Br Med Bull 2019; 130:5-24. [PMID: 31070715 PMCID: PMC6587073 DOI: 10.1093/bmb/ldz011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 01/31/2019] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND This review examines the human health impact of climate change in China. Through reviewing available research findings under four major climate change phenomena, namely extreme temperature, altered rainfall pattern, rise of sea level and extreme weather events, relevant implications for other middle-income population with similar contexts will be synthesized. SOURCES OF DATA Sources of data included bilingual peer-reviewed articles published between 2000 and 2018 in PubMed, Google Scholar and China Academic Journals Full-text Database. AREAS OF AGREEMENT The impact of temperature on mortality outcomes was the most extensively studied, with the strongest cause-specific mortality risks between temperature and cardiovascular and respiratory mortality. The geographical focuses of the studies indicated variations in health risks and impacts of different climate change phenomena across the country. AREAS OF CONTROVERSY While rainfall-related studies predominantly focus on its impact on infectious and vector-borne diseases, consistent associations were not often found. GROWING POINTS Mental health outcomes of climate change had been gaining increasing attention, particularly in the context of extreme weather events. The number of projection studies on the long-term impact had been growing. AREAS TIMELY FOR DEVELOPING RESEARCH The lack of studies on the health implications of rising sea levels and on comorbidity and injury outcomes warrants immediate attention. Evidence is needed to understand health impacts on vulnerable populations living in growing urbanized cities and urban enclaves, in particular migrant workers. Location-specific climate-health outcome thresholds (such as temperature-mortality threshold) will be needed to support evidence-based clinical management plans and health impact mitigation strategies to protect vulnerable communities.
Collapse
Affiliation(s)
- Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- François-Xavier Bagnoud Center for Health & Human Rights, Harvard University, Boston, MA, USA
| | - Janice Y Ho
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Heidi H Y Hung
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sida Liu
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly C Y Lam
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
19
|
Ban J, Shi W, Cui L, Liu X, Jiang C, Han L, Wang R, Li T. Health-risk perception and its mediating effect on protective behavioral adaptation to heat waves. ENVIRONMENTAL RESEARCH 2019; 172:27-33. [PMID: 30769186 DOI: 10.1016/j.envres.2019.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/27/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
Ensuring spontaneously adjusting behaviors of the public in their daily life in response to heat waves is an important aspect of successful public health intervention under climate change. However, the current response behavior guidance released by the government is insufficient because of the limited understanding of public perceptions of heat-related risk and the motivating factors for the public's diverse adaptive behaviors. Here, we conducted a survey on the behavioral adaptations of 3065 urban residents in response to heat waves in Jinan, which is a typical city suffering from a hot climate. We provided evidence on the current state of residents' perception of heat waves and the mechanism of how risk perception mediates individual behavioral intentions upon exposure to high ambient temperatures. We found that the mediating effects of risk perception varied significantly with respect to different types of adaptive behaviors. Concern behaviors appeared be motivated completely by the mediating effects of perceived concern (b = 0.45, p < 0.01 for concerns about health guidelines; b = 0.36, p < 0.01 for concerns about the weather forecast) and severity (b = 0.11, p < 0.01 for concerns about health guidelines), while outdoor activity could be consciously adjusted according to temperature changes without those mediating effects (p > 0.05). Indoor cooling behaviors and transportation behaviors are partially mediated by risk perception (b = -0.04, p < 0.01; b = 0.08, p < 0.01; b = 0.08, p < 0.01 for indoor fan usage, use of air-conditioned buses, and use of private cars, respectively). The conclusions could help determine more targeted and detailed interventions to enhance public behavioral adjustments, including participation in adaption to and emergency preparedness for extreme temperature under the ongoing climate changes.
Collapse
Affiliation(s)
- Jie Ban
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wanying Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liangliang Cui
- Jinan Center for Disease Control and Prevention, Jinan 250021, China
| | - Xia Liu
- Center for Disease Prevention and Control of Changqing District, Jinan 250300, China
| | - Chao Jiang
- Center for Disease Prevention and Control of Central District, Jinan 250001, China
| | - Lianyu Han
- Center for Disease Prevention and Control of Licheng District, Jinan 250100, China
| | - Rui Wang
- Jinan Center for Disease Control and Prevention, Jinan 250021, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
20
|
Spatial Assessment of Urban Climate Change Vulnerability during Different Urbanization Phases. SUSTAINABILITY 2019. [DOI: 10.3390/su11082406] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In urban areas, concentrated populations and societal changes intensify the influence of climate change. However, few studies have focused on vulnerability to climate-related risks on the scale of a single urban area. Against this backdrop, we reconstructed a spatial vulnerability framework based on the drivers-pressures-state-impact-response (DPSIR) model to reflect the complex interactions between urbanization and climate change and to integrate the natural and socio-economic factors of urban areas into this framework. Furthermore, to explore the relationship between rapid urbanization and climate change, we studied data from two years that represented different stages of urbanization. The results showed that the index framework was able to reconcile these two concepts to reflect the complex interactions between urbanization and climate change. The assessment results indicate that the overall degree of climate change vulnerability exhibits a generally increasing and dispersing trend after rapid urbanization. The increasing trend is influenced by an increase in low-vulnerability areas, and the dispersing trend is influenced by anthropogenic activities caused by rapid urbanization. The changes are reflected in the following observations: 1. The suburbs are affected by their own natural environmental characteristics and rapid urbanization; the vulnerability level has risen in most areas but has declined in certain inland areas. 2. High-vulnerability regions show minor changes during this stage due to the lasting impact of climate change. Finally, the main environmental problems faced by high-vulnerability areas are discussed based on existing research.
Collapse
|
21
|
Zhang A, Hu W, Li J, Wei R, Lin J, Ma W. Impact of heatwaves on daily outpatient visits of respiratory disease: A time-stratified case-crossover study. ENVIRONMENTAL RESEARCH 2019; 169:196-205. [PMID: 30466013 DOI: 10.1016/j.envres.2018.10.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/20/2018] [Accepted: 10/27/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES This study aims to estimate the impact of heatwaves from July 2010 to October 2012 on daily outpatient visits for respiratory disease (RD) in Cangnan, China and identify vulnerable populations. METHODS The definition of heatwave was a period at least 3 consecutive days with maximum temperature exceeding 35 °C in this study. A time-stratified case-crossover design was conducted to examine the relationship between heatwaves and outpatient visits for RD. Patient data for the period from 2010 to 2012 were collected from the Third People's Hospital of Cangnan and daily meteorological data for the same period were collected from the China Meteorological Data Service Center. Data regarding the air pollution index (API), a composite indicator of air pollution, were collected from the Data Center of the Chinese Ministry of Environmental Protection. RD were identified based on the 10th revision International Classification of Diseases (ICD-10) codes (J00-J99). A conditional Poisson regression model was applied to examine the heatwave-RD association using the Relative Risk (RR) while adjusting for meteorological and air pollution factors including temperature, rainfall, wind speed, pressure, humidity, sunshine hours and API. RESULTS During the study period, 4 heatwaves occurred and a total of 1732 outpatient visits for RD were reported. Heatwaves increased the frequency of RD outpatient visits and the highest RR of total RD was 1.155% and 95% Confidence Intervals (95% CI) was 1.084-1.232 at Lag 0. For subcategories, heatwaves increased the risk of infectious RD (Lag 0: RR =1.182, 95% CI: 1.106-1.263) and decreased the risk of non-infectious RD ((Lag 6: RR =0.750, 95% CI: 0.568-0.990). Moreover, heatwaves showed adverse effects on acute upper respiratory infection (Lag 0: RR =1.306, 95% CI: 1.177-1.450). The RR of outpatient visits for RD was statistically significant in females (Lag 0: RR =1.161, 95% CI: 1.046-1.298), males (Lag 4: RR =1.161, 95% CI: 1.096-1.261), young people aged 4-17 years (Lag 0: RR =1.741, 95% CI: 1.524-1.990) and elders aged 65 years or older (Lag 5: RR =1.412, 95% CI: 1.111-1.794) during heatwaves. CONCLUSIONS Heatwaves had a significant harmful impact on daily outpatient visits for RD in Cangnan, especially for vulnerable population identified. These results can be used not only to strengthen the health education and protection of these vulnerable populations, but also to assist relevant organizations with developing intervention programmes and improving disease prevention and community care.
Collapse
Affiliation(s)
- Anran Zhang
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| | - Wenqi Hu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China
| | - Jiawei Li
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| | - Ran Wei
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| | - Junfen Lin
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, PR China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China; Shandong University Climate Change and Health Center, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| |
Collapse
|
22
|
Park J, Kim J. Defining heatwave thresholds using an inductive machine learning approach. PLoS One 2018; 13:e0206872. [PMID: 30403743 PMCID: PMC6221332 DOI: 10.1371/journal.pone.0206872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/22/2018] [Indexed: 11/18/2022] Open
Abstract
Establishing appropriate heatwave thresholds is important in reducing adverse human health consequences as it enables a more effective heatwave warning system and response plan. This paper defined such thresholds by focusing on the non-linear relationship between heatwave outcomes and meteorological variables as part of an inductive approach. Daily data on emergency department visitors who were diagnosed with heat illnesses and information on 19 meteorological variables were obtained for the years 2011 to 2016 from relevant government agencies. A Multivariate Adaptive Regression Splines (MARS) analysis was performed to explore points (referred to as “knots”) where the behaviour of the variables rapidly changed. For all emergency department visitors, two thresholds (a maximum daily temperature ≥ 32.58°C for 2 consecutive days and a heat index ≥ 79.64) were selected based on the dramatic rise of morbidity at these points. Nonetheless, visitors, who included children and outside workers diagnosed in the early summer season, were reported as being sensitive to heatwaves at lower thresholds. The average daytime temperature (from noon to 6 PM) was determined to represent an alternative threshold for heatwaves. The findings have implications for exploring complex heatwave-morbidity relationships and for developing appropriate intervention strategies to prevent and mitigate the health impact of heatwaves.
Collapse
Affiliation(s)
- Juhyeon Park
- School of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Jeongseob Kim
- School of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
- * E-mail:
| |
Collapse
|
23
|
Raei E, Nikoo MR, AghaKouchak A, Mazdiyasni O, Sadegh M. GHWR, a multi-method global heatwave and warm-spell record and toolbox. Sci Data 2018; 5:180206. [PMID: 30376556 PMCID: PMC6207177 DOI: 10.1038/sdata.2018.206] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/07/2018] [Indexed: 11/18/2022] Open
Abstract
Heatwaves are extended periods of unusually high temperatures with significant societal and environmental impacts. Despite their significance, there is not a generalized definition for heatwaves. In this paper, we introduce a multi-method global heatwave and warm-spell data record and analysis toolbox (named GHWR). In addition to a comprehensive long-term global data record of heatwaves, GHWR allows processing and extracting heatwave records for any location efficiently. We use traditional constant temperature threshold methods, as well as spatially and temporally localized threshold approaches to identify heatwaves. GHWR includes binary (0/1) occurrence records of heatwaves/warm-spells, and annual summary files with detailed information on their frequency, duration, magnitude and amplitude. GHWR also introduces the standardized heat index (SHI) as a generalized statistical metric to identify heatwave/warm-spells. SHI has direct association with the probability distribution function of long-term daily temperatures for any given calendar day and spatial grid. Finally, GHWR offers a unique opportunity for users to select the type of heatwave/warm-spell information from a plethora of methods based on their needs and applications.
Collapse
|
24
|
Xu Z, Cheng J, Hu W, Tong S. Heatwave and health events: A systematic evaluation of different temperature indicators, heatwave intensities and durations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 630:679-689. [PMID: 29494976 DOI: 10.1016/j.scitotenv.2018.02.268] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 05/21/2023]
Abstract
OBJECTIVES Temperature observation time and type influenced the assessment of heat impact on mortality, and different health events may have different temperature thresholds beyond which these health events increase substantially. This study aimed to investigate whether temperature observation time and type influenced the assessment of heatwave impact on morbidity, to assess how heatwave duration modified heatwave impact on morbidity, and to examine whether there was a consistent temperature threshold beyond which five different types of health events increased sharply. METHODS Minutely air temperature data in Brisbane, Australia, were collected and converted into five daily temperature indicators observed at different time points or calculated using different approaches. Twenty-nine heatwave definitions for each temperature indicator were used to examine the effects of heatwaves on five health events (i.e., ambulance service uses, emergency department attendances (EDAs), hospitalizations, possible EDAs of heat and/or dehydration, and possible hospitalizations of heat and/or dehydration) by quasi-Poisson models. RESULTS Mean temperature was slightly better than maximum temperature in predicting heatwave impact on morbidity (P<0.05), and no appreciable difference in model performance was observed amongst different mean temperature indicators. Two-day-duration heatwaves were more detrimental than longer-lasting heatwaves when heatwave intensity was not high, and 97th percentile appeared to be a consistent temperature threshold for most heatwave-related health events (P<0.05). CONCLUSIONS It seems desirable in the development of heatwave definition and early warning systems to use mean temperature as an exposure indicator, and to adopt the 97th percentile of temperature as the trigger in Brisbane. Health sectors need to better prepare for short-lasting heatwaves.
Collapse
Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.
| | - Jian Cheng
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Shilu Tong
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China.
| |
Collapse
|
25
|
Lin Y, Hu W, Xu J, Luo Z, Ye X, Yan C, Liu Z, Tong S. Association between temperature and maternal stress during pregnancy. ENVIRONMENTAL RESEARCH 2017; 158:421-430. [PMID: 28689033 DOI: 10.1016/j.envres.2017.06.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 06/09/2017] [Accepted: 06/27/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Maternal psychological stress during pregnancy has essentially been conceptualized as a teratogen. However, little is known about the effect of temperature on maternal stress during pregnancy. The aim of this study is to investigate the relationship between temperature and maternal stress during pregnancy. METHODS In 2010, a total of 1931 eligible pregnant women were enrolled across Shanghai from four prenatal-care clinics during their mid-to-late pregnancy. Maternal life-event stress and emotional stress levels during pregnancy were assessed by the "Life Event Scale for Pregnant Women" (LESPW) and "Symptom Checklist-90-Revised Scale" (SCL-90-R), respectively. Exposure to ambient temperature was evaluated based on daily regional average in different moving average and lag days. The generalized estimating equations were used to evaluate the relationship between daily average temperature/temperature difference and maternal stress. RESULTS After adjusting for relevant confounders, an U-shaped relationship was observed between daily average temperature and maternal Global-Severity-Index (GSI) of the SCL-90-R. Cumulative exposures to extremely low temperatures (< P5, 1.4-10.5℃, lag 0-1 days, 0-2 days and 0-5 days) and extremely high temperatures (≥ P95, 31.2-34.1℃, lag 0-1 days and 0-2 days), and acute exposures to extremely low (lag day 0, 1, 2 and 3) and high (lag day 0, 1) temperatures, all induced higher risks of high GSI (the highest tertile), compared to the risk induced by exposed to an optimal temperature range (20-25℃) (P< 0.05). Increased temperature difference was associated with high maternal GSI (P< 0.05). However, non-significant associations were observed between daily average temperatures/temperature differences and maternal log-transferred LESPW scores. CONCLUSIONS Cumulative and acute exposures to extremely low/high temperatures may both induce emotional stress during pregnancy.
Collapse
Affiliation(s)
- Yanfen Lin
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Wenjing Hu
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jian Xu
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Zhongcheng Luo
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Xiaofang Ye
- Shanghai Key Laboratory of Meteorology and Health, Shanghai 200135, China
| | - Chonghuai Yan
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Zhiwei Liu
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia
| |
Collapse
|
26
|
Zhang Y, Feng R, Wu R, Zhong P, Tan X, Wu K, Ma L. Global climate change: impact of heat waves under different definitions on daily mortality in Wuhan, China. Glob Health Res Policy 2017; 2:10. [PMID: 29202078 PMCID: PMC5683448 DOI: 10.1186/s41256-017-0030-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background There was no consistent definition for heat wave worldwide, while a limited number of studies have compared the mortality effect of heat wave as defined differently. This paper aimed to provide epidemiological evidence for policy makers to determine the most appropriate definition for local heat wave warning systems. Methods We developed 45 heat wave definitions (HWs) combining temperature indicators and temperature thresholds with durations. We then assessed the impact of heat waves under various definitions on non-accidental mortality in hot season (May–September) in Wuhan, China during 2003–2010. Results Heat waves defined by HW14 (daily mean temperature ≥ 99.0th percentile and duration ≥ 3 days) had the best predictive ability in assessing the mortality effects of heat wave with the relative risk of 1.63 (95% CI: 1.43, 1.89) for total mortality. The group-specific mortality risk using official heat wave definition of Chinese Meteorological Administration was much smaller than that using HW14. We also found that women, and the elderly (age ≥ 65) were more susceptible to heat wave effects which were stronger and longer lasting. Conclusion These findings suggest that region specific heat wave definitions are crucial and necessary for developing efficient local heat warning systems and for providing evidence for policy makers to protect the vulnerable population. Electronic supplementary material The online version of this article (doi:10.1186/s41256-017-0030-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Renjie Feng
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Ran Wu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Peirong Zhong
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Xiaodong Tan
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Kai Wu
- Jiang'an District Center for Disease Control and Prevention, 3 Chezhan Road, Jiang'an District, Wuhan, 430014 China
| | - Lu Ma
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| |
Collapse
|
27
|
Effect of Indoor Temperature on Physical Performance in Older Adults during Days with Normal Temperature and Heat Waves. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020186. [PMID: 28216585 PMCID: PMC5334740 DOI: 10.3390/ijerph14020186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 01/02/2023]
Abstract
Indoor temperature is relevant with regard to mortality and heat-related self-perceived health problems. The aim of this study was to describe the association between indoor temperature and physical performance in older adults. Eighty-one older adults (84% women, mean age 80.9 years, standard deviation 6.53) were visited every four weeks from May to October 2015 and additionally during two heat waves in July and August 2015. Indoor temperature, habitual gait speed, chair-rise performance and balance were assessed. Baseline assessment of gait speed was used to create two subgroups (lower versus higher gait speed) based on frailty criteria. The strongest effect of increasing temperature on habitual gait speed was observed in the subgroup of adults with higher gait speed (−0.087 m/s per increase of 10 °C; 95% confidence interval (CI): −0.136; −0.038). The strongest effects on timed chair-rise and balance performance were observed in the subgroup of adults with lower gait speed (2.03 s per increase of 10 °C (95% CI: 0.79; 3.28) and −3.92 s per increase of 10 °C (95% CI: −7.31; −0.52), respectively). Comparing results of physical performance in absentia of a heat wave and during a heat wave, habitual gait speed was negatively affected by heat in the total group and subgroup of adults with higher gait speed, chair-rise performance was negatively affected in all groups and balance was not affected. The study provides arguments for exercise interventions in general for older adults, because a better physical fitness might alleviate impediments of physical capacity and might provide resources for adequate adaptation in older adults during heat stress.
Collapse
|
28
|
Kang SH, Oh IY, Heo J, Lee H, Kim J, Lim WH, Cho Y, Choi EK, Yi SM, Sang DS, Kim H, Youn TJ, Chae IH, Oh S. Heat, heat waves, and out-of-hospital cardiac arrest. Int J Cardiol 2016; 221:232-7. [PMID: 27404681 DOI: 10.1016/j.ijcard.2016.07.071] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 07/04/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Cardiac arrest is one of the common presentations of cardiovascular disorders and a leading cause of death. There are limited data on the relationship between out-of-hospital cardiac arrest (OHCA) and ambient temperatures, specifically extreme heat. This study investigated how heat and heat waves affect the occurrence of OHCA. METHODS Seven major cities in Korea with more than 1 million residents were included in this study. A heat wave was defined as a daily mean temperature above the 98th percentile of the yearly distribution for at least two consecutive days. RESULTS A total of 50,318 OHCAs of presumed cardiac origin were identified from the nationwide emergency medical service database between 2006 and 2013. Ambient temperature and OHCA had a J-shaped relationship with a trough at 28°C. Heat waves were shown to be associated with a 14-% increase in the risk of OHCA. Adverse effects were apparent from the beginning of each heat wave period and slightly increased during its continuation. Excess OHCA events during heat waves occurred between 3PM and 5PM. Subgroup analysis showed that those 65years or older were significantly more susceptible to heat waves. CONCLUSIONS Ambient temperature and OHCA had a J-shaped relationship. The risk of OHCA was significantly increased with heat waves. Excess OHCA events primarily occurred during the afternoon when the temperature was high. We found that the elderly were more susceptible to the deleterious effects of heat waves.
Collapse
Affiliation(s)
- Si-Hyuck Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Il-Young Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jongbae Heo
- Department of Environmental Health and Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hyewon Lee
- Department of Biostatistics and Epidemiology, Graduate School of Public Health & Asian Institute of Energy, Environment, and Sustainability, Seoul National University, Republic of Korea
| | - Jungeun Kim
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Woo-Hyun Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea
| | - Youngjin Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Muk Yi
- Department of Environmental Health and Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Do Shin Sang
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ho Kim
- Department of Biostatistics and Epidemiology, Graduate School of Public Health & Asian Institute of Energy, Environment, and Sustainability, Seoul National University, Republic of Korea
| | - Tae-Jin Youn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - In-Ho Chae
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seil Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
| |
Collapse
|
29
|
Xu Z, FitzGerald G, Guo Y, Jalaludin B, Tong S. Impact of heatwave on mortality under different heatwave definitions: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2016; 89-90:193-203. [PMID: 26878285 DOI: 10.1016/j.envint.2016.02.007] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 05/21/2023]
Abstract
Heatwave effects on human health and wellbeing is a great public health concern, especially in the context of climate change. However, no universally consistent heatwave definition is available. A systematic review and meta-analysis was conducted to assess the heatwave definitions used in the literature published up to 1st April 2015 by searching five databases (PubMed, ProQuest, ScienceDirect, Scopus, and Web of Science). Random-effects models were used to pool the effects of heatwave on total and cardiorespiratory mortality by different heatwave definitions. Existing evidence suggests a significant impact of heatwave on mortality, but the magnitude of the effect estimates varies under different heatwave definitions. Heatwave-related mortality risks increased by 4% (using "mean temperatures ≥95th percentile for ≥2days" as a heatwave definition), 3% (mean temperatures ≥98th percentile for ≥2days), 7% (mean temperatures ≥99th percentile for ≥2days) and 16% (mean temperatures ≥97th percentile for ≥5days). Heatwave intensity plays a relatively more important role than duration in determining heatwave-related deaths. Heatwaves significantly increase mortality across the globe, but the effect estimates vary with the definition of heatwaves. City- or region-specific heat health early warning systems based on identified local heatwave definitions may be optimal for protecting and preventing people from the adverse impacts of future heatwaves.
Collapse
Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Gerard FitzGerald
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Yuming Guo
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Bin Jalaludin
- Health People and Places Unit, South Western Sydney Local Health District, New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia
| | - Shilu Tong
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| |
Collapse
|
30
|
Witt C, Schubert AJ, Jehn M, Holzgreve A, Liebers U, Endlicher W, Scherer D. The Effects of Climate Change on Patients With Chronic Lung Disease. A Systematic Literature Review. DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 112:878-83. [PMID: 26900154 PMCID: PMC4736555 DOI: 10.3238/arztebl.2015.0878] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ever since higher overall mortality rates due to heat stress were reported during the European heat waves of 2003 and 2006, the relation between heat waves and disease-specific events has been an object of scientific study. The effects of heat waves on the morbidity and mortality of persons with chronic lung disease remain unclear. METHODS We conducted a systematic search using PubMed, the Cochrane Library, and Google Advanced Search to identify relevant studies published between 1990 and 2015. The reference lists of the primarily included articles were searched for further pertinent articles. All articles were selected according to the PRISMA guidelines. The heat-wave-related relative excess mortality was descriptively expressed as a mean daily rate ratio ([incidence 1]/[incidence 2]), and the cumulative excess risk (CER) was expressed in percent. RESULTS 33 studies with evaluable raw data concerning the effect of heat waves on patients with chronic lung disease (chronic obstructive pulmonary disease, bronchial asthma, pulmonary arterial hypertension, and idiopathic pulmonary fibrosis) were analyzed in this review. By deriving statistics from the overall data set, we arrived at the conclusion that future heat waves will-with at least 90% probability-result in a mean daily excess mortality (expressed as a rate ratio) of at least 1.018, and-with 50% probability-in a mean daily excess mortality of at least 1.028. These figures correspond, respectively, to 1.8% and 2.8% rises in the daily risk of death. CONCLUSION Heat waves significantly increase morbidity and mortality in patients with chronic lung disease. The argument that the excess mortality during heat waves is compensated for by a decrease in mortality in the subsequent weeks/months (mortality displacement) should not be used as an excuse for delay in implementing adaptive strategies to protect lung patients from this risk to their health.
Collapse
Affiliation(s)
- Christian Witt
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
- These authors share first authorship
| | - André Jean Schubert
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
- These authors share first authorship
| | - Melissa Jehn
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
| | | | - Uta Liebers
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
| | - Wilfried Endlicher
- Geography Department, Humboldt-Universität zu Berlin; on behalf of the KLIMZUG Research Group, Berlin
| | - Dieter Scherer
- Department of Ecology, Technische Universität Berlin; on behalf of the UCaSH Research Unit, Berlin
| |
Collapse
|
31
|
The Construction and Validation of the Heat Vulnerability Index, a Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7220-34. [PMID: 26132476 PMCID: PMC4515652 DOI: 10.3390/ijerph120707220] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 06/03/2015] [Accepted: 06/16/2015] [Indexed: 12/23/2022]
Abstract
The occurrence of extreme heat and its adverse effects will be exacerbated with the trend of global warming. An increasing number of researchers have been working on aggregating multiple heat-related indicators to create composite indices for heat vulnerability assessments and have visualized the vulnerability through geographic information systems to provide references for reducing the adverse effects of extreme heat more effectively. This review includes 15 studies concerning heat vulnerability assessment. We have studied the indicators utilized and the methods adopted in these studies for the construction of the heat vulnerability index (HVI) and then further reviewed some of the studies that validated the HVI. We concluded that the HVI is useful for targeting the intervention of heat risk, and that heat-related health outcomes could be used to validate and optimize the HVI. In the future, more studies should be conducted to provide references for the selection of heat-related indicators and the determination of weight values of these indicators in the development of the HVI. Studies concerning the application of the HVI are also needed.
Collapse
|
32
|
Ma W, Zeng W, Zhou M, Wang L, Rutherford S, Lin H, Liu T, Zhang Y, Xiao J, Zhang Y, Wang X, Gu X, Chu C. The short-term effect of heat waves on mortality and its modifiers in China: an analysis from 66 communities. ENVIRONMENT INTERNATIONAL 2015; 75:103-9. [PMID: 25461419 DOI: 10.1016/j.envint.2014.11.004] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/24/2014] [Accepted: 11/11/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Many studies have reported increased mortality risk associated with heat waves. However, few have assessed the health impacts at a nation scale in a developing country. This study examines the mortality effects of heat waves in China and explores whether the effects are modified by individual-level and community-level characteristics. METHODS Daily mortality and meteorological variables from 66 Chinese communities were collected for the period 2006-2011. Heat waves were defined as ≥2 consecutive days with mean temperature ≥95th percentile of the year-round community-specific distribution. The community-specific mortality effects of heat waves were first estimated using a Distributed Lag Non-linear Model (DLNM), adjusting for potential confounders. To investigate effect modification by individual characteristics (age, gender, cause of death, education level or place of death), separate DLNM models were further fitted. Potential effect modification by community characteristics was examined using a meta-regression analysis. RESULTS A total of 5.0% (95% confidence intervals (CI): 2.9%-7.2%) excess deaths were associated with heat waves in 66 Chinese communities, with the highest excess deaths in north China (6.0%, 95% CI: 1%-11.3%), followed by east China (5.2%, 95% CI: 0.4%-10.2%) and south China (4.5%, 95% CI: 1.4%-7.6%). Our results indicate that individual characteristics significantly modified heat waves effects in China, with greater effects on cardiovascular mortality, cerebrovascular mortality, respiratory mortality, the elderly, females, the population dying outside of a hospital and those with a higher education attainment. Heat wave mortality effects were also more pronounced for those living in urban cities or densely populated communities. CONCLUSION Heat waves significantly increased mortality risk in China with apparent spatial heterogeneity, which was modified by some individual-level and community-level factors. Our findings suggest adaptation plans that target vulnerable populations in susceptible communities during heat wave events should be developed to reduce health risks.
Collapse
Affiliation(s)
- Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; Center for Environment and Population Health, Griffith University, Brisbane 4111, Australia
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Lijun Wang
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Shannon Rutherford
- Center for Environment and Population Health, Griffith University, Brisbane 4111, Australia
| | - Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Yewu Zhang
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xiaofeng Wang
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xin Gu
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Cordia Chu
- Center for Environment and Population Health, Griffith University, Brisbane 4111, Australia
| |
Collapse
|
33
|
Stotz A, Rapp K, Oksa J, Skelton DA, Beyer N, Klenk J, Becker C, Lindemann U. Effect of a brief heat exposure on blood pressure and physical performance of older women living in the community-a pilot-study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:12623-31. [PMID: 25489997 PMCID: PMC4276636 DOI: 10.3390/ijerph111212623] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/17/2014] [Accepted: 11/28/2014] [Indexed: 11/16/2022]
Abstract
Global climate change is affecting health and mortality, particularly in vulnerable populations. High ambient temperatures decrease blood pressure (BP) in young and middle aged adults and may lead to orthostatic hypotension, increasing the risk of falls in older adults. The aim of this study was to evaluate the feasibility of a test protocol to investigate BP response and aerobic capacity of older adults in a hot indoor environment. BP response and aerobic capacity were assessed in 26 community-dwelling older women (median age 75.5 years) at a room temperature of either 20 °C or 30 °C. The protocol was well tolerated by all participants. In the 30 °C condition systolic and diastolic BP (median difference 10 and 8 mmHg, respectively) and distance walked in 6 min (median difference 29.3 m) were lower than in the 20 °C condition (all p < 0.01). Systolic BP decreased after standing up from a lying position in the 30 °C (17.4 mmHg) and 20 °C (14.2 mmHg) condition (both p < 0.001). In conclusion, the protocol is feasible in this cohort and should be repeated in older adults with poor physical performance and impaired cardio-vascular response mechanisms. Furthermore, aerobic capacity was reduced after exposure to hot environmental temperatures, which should be considered when recommending exercise to older people during the summer months.
Collapse
Affiliation(s)
- Anja Stotz
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.
| | - Kilian Rapp
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.
| | - Juha Oksa
- Physical Work Capacity Team, Finnish Institute of Occupational Health, 90220 Oulu, Finland.
| | - Dawn A Skelton
- Institute of Applied Health Research, Glasgow Caledonian University, Scotland, G4 0BA, UK.
| | - Nina Beyer
- Musculoskeletal Rehabilitation Research Unit, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, 2400 NV Copenhagen, Denmark.
| | - Jochen Klenk
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.
| | - Clemens Becker
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.
| | - Ulrich Lindemann
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.
| |
Collapse
|