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Kapwata T, Abdelatif N, Scovronick N, Gebreslasie MT, Acquaotta F, Wright CY. Identifying heat thresholds for South Africa towards the development of a heat-health warning system. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:381-392. [PMID: 38157021 PMCID: PMC10794383 DOI: 10.1007/s00484-023-02596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
Exposure to heatwaves may result in adverse human health impacts. Heat alerts in South Africa are currently based on defined temperature-fixed threshold values for large towns and cities. However, heat-health warning systems (HHWS) should incorporate metrics that have been shown to be effective predictors of negative heat-related health outcomes. This study contributes to the development of a HHWS for South Africa that can potentially minimize heat-related mortality. Distributed lag nonlinear models (DLNM) were used to assess the association between maximum and minimum temperature and diurnal temperature range (DTR) and population-adjusted mortality during summer months, and the effects were presented as incidence rate ratios (IRR). District-level thresholds for the best predictor from these three metrics were estimated with threshold regression. The mortality dataset contained records of daily registered deaths (n = 8,476,532) from 1997 to 2013 and data for the temperature indices were for the same period. Maximum temperature appeared to be the most statistically significant predictor of all-cause mortality with strong associations observed in 40 out of 52 districts. Maximum temperature was associated with increased risk of mortality in all but three of the districts. Our results also found that heat-related mortality was influenced by regional climate because the spatial distribution of the thresholds varied according to the climate zones across the country. On average, districts located in the hot, arid interior provinces of the Northern Cape and North West experienced some of the highest thresholds compared to districts located in temperate interior or coastal provinces. As the effects of climate change become more significant, population exposure to heat is increasing. Therefore, evidence-based HHWS are required to reduce heat-related mortality and morbidity. The exceedance of the maximum temperature thresholds provided in this study could be used to issue heat alerts as part of effective heat health action plans.
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Affiliation(s)
- Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2028, South Africa.
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa.
| | - Nada Abdelatif
- Biostatistics Research Unit, South African Medical Research Council, Durban, 4001, South Africa
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Michael T Gebreslasie
- School of Agriculture, Earth, and Environmental Sciences, University of KwaZulu-Natal, Durban, 3629, South Africa
| | | | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0084, South Africa
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Chen CF, Lin YT, Lin JY. Field temperature performances of in-use permeable sidewalks and asphalt vehicle roads and the potential impacts on apparent temperature and land surface temperature. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:205. [PMID: 38279028 DOI: 10.1007/s10661-024-12383-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/20/2024] [Indexed: 01/28/2024]
Abstract
Permeable pavements help reduce surface temperatures and have been widely implemented in urban areas. This study utilized an in-use permeable pavement sidewalk in front of a mass rapid transit station in the Taipei city center of Taiwan to determine the actual pavement surface temperature performance. A neighboring asphalt road and impervious pavement were also monitored. With a full year of continuous monitoring, the results showed that the temperature of permeable pavement was 3.7 °C lower than that of impervious pavement and 4.5 °C lower than that of asphalt pavement in the hot season. The frequent rainfall in spring resulted in the smallest temperature differences between the different pavement types. The cooling effects of permeable pavement differed at the different air temperatures. At air temperatures lower than 15 °C, the differences among pavement surface temperatures were noticeable. However, when the air temperature was higher than 35 °C, the surface temperature of permeable pavement was not different from that of impervious pavement and was greater than 55 °C. Field observations were carried out to determine the effects on the apparent temperature and the future surface temperature of climate change scenarios. The results showed that permeable pavement could reduce the average apparent temperature to near the air temperature, and asphalt pavement could increase the apparent temperature by 1.2 °C, assuming that the pavement temperature completely affects the air temperature. With the good prediction ability of the machine learning approach and 15 environmental factors, the preliminary prediction showed the projected surface temperature change in Taipei city in 2033. In the worst-case scenario, the average impervious pavement temperature is as high as 39.12 °C, whereas the average permeable pavement temperature is 32.50 °C.
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Affiliation(s)
- Chi-Feng Chen
- Department of Civil Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - You-Ting Lin
- Department of Civil Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Jen-Yang Lin
- Department of Civil Engineering, National Taipei University of Technology, Taipei, Taiwan.
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Shirinde J, Wichmann J. Temperature modifies the association between air pollution and respiratory disease mortality in Cape Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1122-1131. [PMID: 35581190 DOI: 10.1080/09603123.2022.2076813] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
The aim of this 10-year study was to investigate whether and how temperature modifies the association between daily ambient PM10, NO2, SO2 air pollution and daily respiratory disease mortality in Cape Town. A time-stratified case-crossover epidemiological design was applied. Susceptibility by sex and age groups (15-64 years and ≥65 years) was also investigated. On days with medium Tapp levels, NO2 displayed a stronger association with respiratory mortality than PM10 or SO2. Females appeared to be more susceptible to NO2 at medium Tapp levels to males. The 15-64-year-old age group seemed to be more vulnerable to NO2 and PM10 at medium Tapp levels compared to the elderly (≥65 years). At high Tapp levels, females were more susceptible to PM10. The 15-64-year-old group were more vulnerable to NO2 and SO2. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased air pollution and temperature.
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Affiliation(s)
- Joyce Shirinde
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Sapari H, Selamat MI, Isa MR, Ismail R, Wan Mahiyuddin WR. The Impact of Heat Waves on Health Care Services in Low- or Middle-Income Countries: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e44702. [PMID: 37843898 PMCID: PMC10616749 DOI: 10.2196/44702] [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: 12/04/2022] [Revised: 06/02/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce. OBJECTIVE This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs. METHODS We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity. RESULTS This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs. CONCLUSIONS The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities. TRIAL REGISTRATION PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44702.
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Affiliation(s)
- Hadita Sapari
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Ikhsan Selamat
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Rodi Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
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Wright CY, Mathee A, Goldstone C, Naidoo N, Kapwata T, Wernecke B, Kunene Z, Millar DA. Developing a Healthy Environment Assessment Tool (HEAT) to Address Heat-Health Vulnerability in South African Towns in a Warming World. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2852. [PMID: 36833550 PMCID: PMC9957206 DOI: 10.3390/ijerph20042852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Prolonged exposure to high temperatures can cause heat-related illnesses and accelerate death, especially in the elderly. We developed a locally-appropriate Healthy Environment Assessment Tool, or 'HEAT' tool, to assess heat-health risks among communities. HEAT was co-developed with stakeholders and practitioners/professionals from the Rustenburg Local Municipality (RLM), a setting in which heat was identified as a risk in an earlier study. Feedback was used to identify vulnerable groups and settings in RLM, consider opportunities and barriers for interventions, and conceptualize a heat-health vulnerability assessment tool for a heat-resilient town. Using information provided by the RLM Integrated Development Plan, the HEAT tool was applied in the form of eight indicators relating to heat-health vulnerability and resilience and areas were evaluated at the ward level. Indicators included population, poverty, education, access to medical facilities, sanitation and basic services, public transport, recreation/community centres, and green spaces. Out of 45 wards situated in the municipality, three were identified as critical risk (red), twenty-eight as medium-high risk (yellow), and six as low risk (green) in relation to heat-health vulnerability. Short-term actions to improve heat health resilience in the community were proposed and partnerships between local government and the community to build heat health resilience were identified.
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Affiliation(s)
- Caradee Y. Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2090, South Africa
- Department of Environmental Health, University of Johannesburg, Johannesburg 2000, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg 2000, South Africa
| | | | - Natasha Naidoo
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
| | - Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2090, South Africa
- Department of Environmental Health, University of Johannesburg, Johannesburg 2000, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Bianca Wernecke
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2090, South Africa
- Department of Environmental Health, University of Johannesburg, Johannesburg 2000, South Africa
| | - Zamantimande Kunene
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2090, South Africa
| | - Danielle A. Millar
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa
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Kapwata T, Gebreslasie MT, Wright CY. An analysis of past and future heatwaves based on a heat-associated mortality threshold: towards a heat health warning system. Environ Health 2022; 21:112. [PMID: 36401226 PMCID: PMC9675182 DOI: 10.1186/s12940-022-00921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Heatwaves can have severe impacts on human health extending from illness to mortality. These health effects are related to not only the physical phenomenon of heat itself but other characteristics such as frequency, intensity, and duration of heatwaves. Therefore, understanding heatwave characteristics is a crucial step in the development of heat-health warning systems (HHWS) that could prevent or reduce negative heat-related health outcomes. However, there are no South African studies that have quantified heatwaves with a threshold that incorporated a temperature metric based on a health outcome. To fill this gap, this study aimed to assess the spatial and temporal distribution and frequency of past (2014 - 2019) and future (period 2020 - 2039) heatwaves across South Africa. Heatwaves were defined using a threshold for diurnal temperature range (DTR) that was found to have measurable impacts on mortality. In the current climate, inland provinces experienced fewer heatwaves of longer duration and greater intensity compared to coastal provinces that experienced heatwaves of lower intensity. The highest frequency of heatwaves occurred during the austral summer accounting for a total of 150 events out of 270 from 2014 to 2019. The heatwave definition applied in this study also identified severe heatwaves across the country during late 2015 to early 2016 which was during the strongest El Niño event ever recorded to date. Record-breaking global temperatures were reported during this period; the North West province in South Africa was the worst affected experiencing heatwaves ranging from 12 to 77 days. Future climate analysis showed increasing trends in heatwave events with the greatest increases (80%-87%) expected to occur during summer months. The number of heatwaves occurring in cooler seasons is expected to increase with more events projected from the winter months of July and August, onwards. The findings of this study show that the identification of provinces and towns that experience intense, long-lasting heatwaves is crucial to inform development and implementation of targeted heat-health adaptation strategies. These findings could also guide authorities to prioritise vulnerable population groups such as the elderly and children living in high-risk areas likely to be affected by heatwaves.
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Affiliation(s)
- Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2028, South Africa.
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa.
| | - Michael T Gebreslasie
- School of Agriculture, Earth, and Environmental Sciences, University of KwaZulu-Natal, Durban, 3629, South Africa
| | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0084, South Africa
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Ogunjo S, Olusola A, Orimoloye I. Association Between Weather Parameters and SARS-CoV-2 Confirmed Cases in Two South African Cities. GEOHEALTH 2022; 6:e2021GH000520. [PMID: 36348988 PMCID: PMC9635841 DOI: 10.1029/2021gh000520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 04/10/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Several approaches have been used in the race against time to mitigate the spread and impact of COVID-19. In this study, we investigated the role of temperature, relative humidity, and particulate matter in the spread of COVID-19 cases within two densely populated cities of South Africa-Pretoria and Cape Town. The role of different levels of COVID-19 restrictions in the air pollution levels, obtained from the Purple Air Network, of the two cities were also considered. Our results suggest that 26.73% and 43.66% reduction in PM2.5 levels were observed in Cape Town and Pretoria respectively for no lockdown (Level 0) to the strictest lockdown level (Level 5). Furthermore, our results showed a significant relationship between particulate matter and COVID-19 in the two cities. Particulate matter was found to be a good predictor, based on the significance of causality test, of COVID-19 cases in Pretoria with a lag of 7 days and more. This suggests that the effect of particulate matter on the number of cases can be felt after 7 days and beyond in Pretoria.
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Affiliation(s)
- Samuel Ogunjo
- Department of PhysicsFederal University of TechnologyAkureNigeria
| | - Adeyemi Olusola
- Faculty of Environmental and Urban ChangeYork UniversityTorontoCanada
- Department of GeographyUniversity of the Free StateBloemfonteinSouth Africa
| | - Israel Orimoloye
- Department of Geography, Faculty of Food and AgricultureThe University of the West Indies, St. Augustine CampusSt. AugustineTrinidad and Tobago
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Sentinel-Based Adaptation of the Local Climate Zones Framework to a South African Context. REMOTE SENSING 2022. [DOI: 10.3390/rs14153594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The LCZ framework has become a widely applied approach to study urban climate. The standard LCZ typology is highly specific when applied to western urban areas but generic in some African cities. We tested the generic nature of the standard typology by taking a two-part approach. First, we applied a single-source WUDAPT-based training input across three urban areas that represent a gradient in South African urbanization (Cape Town, Thohoyandou and East London). Second, we applied a local customized training that accounts for the unique characteristics of the specific area. The LCZ classification was completed using a random forest classifier on a subset of single (SI) and multitemporal (MT) Sentinel 2 imagery. The results show an increase in overall classification accuracy between 17 and 30% for the locally calibrated over the generic standard LCZ framework. The spring season is the best classified of the single-date imagery with the accuracies 7% higher than the least classified season. The multi-date classification accuracy is 13% higher than spring but only 9% higher when a neighborhood function (NF) is applied. For acceptable performance of the LCZ classifier in an African context, the training must be local and customized to the uniqueness of that specific area.
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Zhang F, Zhang X, Zhou G, Zhao G, Zhu S, Zhang X, Xiang N, Zhu W. Is Cold Apparent Temperature Associated With the Hospitalizations for Osteoporotic Fractures in the Central Areas of Wuhan? A Time-Series Study. Front Public Health 2022; 10:835286. [PMID: 35284367 PMCID: PMC8904880 DOI: 10.3389/fpubh.2022.835286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/26/2022] [Indexed: 12/19/2022] Open
Abstract
Osteoporosis is alarming problem due to aggravation of global aging, especially in China. Osteoporotic fracture (OF) is one of the most severe consequents of osteoporosis. Many previous studies found that environmental factors had adverse effects on human health. Cold temperature was associated with OF and bone metabolism in prior observational and experimental researches. However, few studies had been conducted on the acute effect of low temperature and OF. Data on daily meteorological factors and hospitalizations for OF were collected from Wuhan, China, between January 1, 2017 to December 24, 2019. Apparent temperature (AT), comprehensively considered a variety of environmental factors, was calculated by ambient temperature, relative humidity and wind speed. A generalized linear regression model combined with distributed lag non-linear regression model (DLNM) with quasi-Poisson link was used to explore the association between AT and the number of hospitalizations for OF. Subgroup analyses stratified by gender, age and the history of fracture were applied for detecting susceptible people. The exposure-response curve of AT and OF were generally U-shaped with lowest point at 25.8°C. The significant relationship of AT-OF existed only in cold effect (-2.0 vs. 25.8°C) while not in warm effect (37.0 vs. 25.8°C). Statistically significant risks of OF for cold effects were only found in females [RR = 1.12 (95%CI: 1.02, 1.24) at lag 2 day], aged <75 years old [RR = 1.18 (95%CI: 1.04, 1.33) and 1.17 (95%CI: 1.04, 1.33) at lag 2 and 3 days, respectively] and people with history of fracture [RR = 1.39 (95%CI: 1.02, 1.90) and 1.27 (95%CI: 1.05, 1.53) at lag 1 and 2 days, respectively]. The significant associations of AT on OF were only found in cold effect. The females, people aged <75 years and people with history of fracture possibly appeared to be more vulnerable. Public health departments should pay attention to the negative effect of cold AT and take measures in time.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Guangwen Zhou
- Department of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Nan Xiang
- Department of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
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Estimation of Mean Radiant Temperature in Urban Canyons Using Google Street View: A Case Study on Seoul. REMOTE SENSING 2022. [DOI: 10.3390/rs14020260] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Extreme heat exposure has severe negative impacts on humans, and the issue is exacerbated by climate change. Estimating spatial heat stress such as mean radiant temperature (MRT) is currently difficult to apply at city scale. This study constructed a method for estimating the MRT of street canyons using Google Street View (GSV) images and investigated its large-scale spatial patterns at street level. We used image segmentation using deep learning to calculate the view factor (VF) and project panorama into fisheye images. We calculated sun paths to estimate MRT using panorama images from Google Street View. This paper shows that regression analysis can be used to validate between estimated short-wave, long-wave radiation and the measurement data at seven field measurements in the clear-sky (0.97 and 0.77, respectively). Additionally, we compared the calculated MRT and land surface temperature (LST) from Landsat 8 on a city scale. As a result of investigating spatial patterns of MRT in Seoul, South Korea, we found that a high MRT of street canyons (>59.4 °C) is mainly distributed in open space areas and compact low-rise density buildings where the sky view factor is 0.6–1.0 and the building view factor (BVF) is 0.35–0.5, or west-east oriented street canyons with an SVF of 0.3–0.55. However, high-density buildings (BVF: 0.4–0.6) or high-density tree areas (Tree View Factor, TVF: 0.6–0.99) showed low MRT (<47.6). The mapped MRT results had a similar spatial distribution to the LST; however, the MRT was lower than the LST in low tree density or low-rise high-density building areas. The method proposed in this study is suitable for a complex urban environment consisting of buildings, trees, and streets. This will help decision makers understand spatial patterns of heat stress at the street level.
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Tapia VL, Vasquez-Apestegui BV, Alcantara-Zapata D, Vu B, Steenland K, Gonzales GF. Association between maximum temperature and PM 2.5 with pregnancy outcomes in Lima, Peru. Environ Epidemiol 2021; 5:e179. [PMID: 34909559 PMCID: PMC8663809 DOI: 10.1097/ee9.0000000000000179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND We have previously documented an inverse relationship between PM2.5 in Lima, Peru, and reproductive outcomes. Here, we investigate the effect of temperature on birth weight, birth weight-Z-score adjusted for gestational age, low birth weight, and preterm birth. We also explore interactions between PM2.5 and temperature. METHODS We studied 123,034 singleton births in three public hospitals of Lima with temperature and PM2.5 during gestation between 2012 and 2016. We used linear, logistic, and Cox regression to estimate associations between temperature during gestation and birth outcomes and explored possible modification of the temperature effect by PM2.5. RESULTS Exposure to maximum temperature in the last trimester was inversely associated with both birth weight [β: -23.7; 95% confidence interval [CI]: -28.0, -19.5] and z-score weight-for-gestational-age (β: -0.024; 95% CI: -0.029, -0.020) with an interquartile range of 5.32 °C. There was also an increased risk of preterm birth with higher temperature (interquartile range) in the first trimester (hazard ratio: 1.04; 95% CI: 1.001, 1.070). The effect of temperature on birthweight was primarily seen at higher PM2.5 levels. There were no statistically significant associations between temperature exposure with low birth weight. CONCLUSIONS Exposition to maximum temperature was associated with lower birth weight and z-score weight-for-gestational-age and higher risk of preterm birth, in accordance with much of the literature. The effects on birth weight were seen only in the third trimester.
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Affiliation(s)
- Vilma L Tapia
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Bertha Vanessa Vasquez-Apestegui
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Diana Alcantara-Zapata
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Bryan Vu
- Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kyle Steenland
- Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Gustavo F Gonzales
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
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Kapwata T, Wright CY, du Preez DJ, Kunene Z, Mathee A, Ikeda T, Landman W, Maharaj R, Sweijd N, Minakawa N, Blesic S. Exploring rural hospital admissions for diarrhoeal disease, malaria, pneumonia, and asthma in relation to temperature, rainfall and air pollution using wavelet transform analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148307. [PMID: 34139502 DOI: 10.1016/j.scitotenv.2021.148307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/10/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Climate variables impact human health and in an era of climate change, there is a pressing need to understand these relationships to best inform how such impacts are likely to change. OBJECTIVES This study sought to investigate time series of daily admissions from two public hospitals in Limpopo province in South Africa with climate variability and air quality. METHODS We used wavelet transform cross-correlation analysis to monitor coincidences in changes of meteorological (temperature and rainfall) and air quality (concentrations of PM2.5 and NO2) variables with admissions to hospitals for gastrointestinal illnesses including diarrhoea, pneumonia-related diagnosis, malaria and asthma cases. We were interested to disentangle meteorological or environmental variables that might be associated with underlying temporal variations of disease prevalence measured through visits to hospitals. RESULTS We found preconditioning of prevalence of pneumonia by changes in air quality and showed that malaria in South Africa is a multivariate event, initiated by co-occurrence of heat and rainfall. We provided new statistical estimates of time delays between the change of weather or air pollution and increase of hospital admissions for pneumonia and malaria that are addition to already known seasonal variations. We found that increase of prevalence of pneumonia follows changes in air quality after a time period of 10 to 15 days, while the increase of incidence of malaria follows the co-occurrence of high temperature and rainfall after a 30-day interval. DISCUSSION Our findings have relevance for early warning system development and climate change adaptation planning to protect human health and well-being.
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Affiliation(s)
- Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa; Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa.
| | - David Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; Laboratoire de l'Atmosphère et des Cyclones (UMR 8105 CNRS, Université de La Réunion, MétéoFrance), 97744 Saint-Denis de La Réunion, France
| | - Zamantimande Kunene
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa; Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg 2028, South Africa; Department of Environmental Health, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | | | - Willem Landman
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; International Research Institute for Climate and Society, The Earth Institute of Columbia University, New York, NY, 10964, USA
| | - Rajendra Maharaj
- Office of Malaria Research, South African Medical Research Council, Durban, South Africa
| | - Neville Sweijd
- Applied Centre for Climate and Earth Systems Science, National Research Foundation, Cape Town, South Africa
| | - Noboru Minakawa
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Suzana Blesic
- Institute for Medical Research, University of Belgrade, Belgrade, Serbia; Center for Participatory Science, Belgrade, Serbia
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Rublee C, Bills C, Theron E, Brysiewicz P, Singh S, Muya I, Smith W, Akpevwe OE, Ali LA, Dauda E, Calvello Hynes E. Outcomes of a Climate Change Workshop at the 2020 African Conference on Emergency Medicine. Afr J Emerg Med 2021; 11:372-377. [PMID: 34367899 PMCID: PMC8326188 DOI: 10.1016/j.afjem.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/15/2021] [Accepted: 05/09/2021] [Indexed: 11/08/2022] Open
Abstract
A changing climate will have demonstrable effects on health and healthcare systems, with specific and disproportionate effects on communities in Africa. Emergency care systems and providers have an opportunity to be at the forefront of efforts to combat the worst health effects from climate change. The 2020 African Conference on Emergency Medicine, under the auspices of the African Federation for Emergency Medicine, convened its first ever workshop on the topic of climate change and human health. Structured as a full day virtual course, the didactic sections were available for both live and asynchronous learning with more than 100 participants enrolled in the course. The workshop introduced the topic of the health effects of climate as they relate to emergency care in Africa and provided a forum to discuss ideas regarding the way forward. Lectures and focused discussions addressed three broad themes related to: health impacts, health care delivery, and advocacy. To our knowledge, this is the first workshop for health professionals to cover topics specific to emergency care, climate change, and health in Africa. The results of this workshop will help to guide future efforts aimed at advancing emergency care approaches in Africa with regard to medical education, research, and policy. African relevance Climate-related extreme weather events are adversely affecting health and health care delivery in African countries. African organisations, cities, and nations have taken positive steps to adapt and build climate resilience. There are opportunities for emergency care professionals and scholars to continue to expand, and lead, climate and health education, research, and policy initiatives on the continent.
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Wright CY, Kapwata T, du Preez DJ, Wernecke B, Garland RM, Nkosi V, Landman WA, Dyson L, Norval M. Major climate change-induced risks to human health in South Africa. ENVIRONMENTAL RESEARCH 2021; 196:110973. [PMID: 33684412 DOI: 10.1016/j.envres.2021.110973] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
There are many climatic changes facing South Africa which already have, or are projected to have, a detrimental impact on human health. Here the risks to health due to several alterations in the climate of South Africa are considered in turn. These include an increase in ambient temperature, causing, for example, a significant rise in morbidity and mortality; heavy rainfall leading to changes in the prevalence and occurrence of vector-borne diseases; drought-associated malnutrition; and exposure to dust storms and air pollution leading to the potential exacerbation of respiratory diseases. Existing initiatives and strategies to prevent or reduce these adverse health impacts are outlined, together with suggestions of what might be required in the future to safeguard the health of the nation. Potential roles for the health and non-health sectors as well as preparedness and capacity development with respect to climate change and health adaptation are considered.
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Affiliation(s)
- Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0001, South Africa; Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa.
| | - Thandi Kapwata
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2094, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2094, South Africa
| | - David Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; Laboratoire de l'Atmosphère et des Cyclones (UMR 8105 CNRS, Université de La Réunion, Météo France), 97744, Saint-Denis de La Réunion, France
| | - Bianca Wernecke
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2094, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2094, South Africa
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; Climate and Air Quality Modelling Research Group, Council for Scientific and Industrial Research, Pretoria, 0001, South Africa; Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2531, South Africa
| | - Vusumuzi Nkosi
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2094, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2094, South Africa; School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa
| | - Willem A Landman
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; International Research Institute for Climate and Society, The Earth Institute of Columbia University, New York, NY, 10964, USA
| | - Liesl Dyson
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa
| | - Mary Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK
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Opoku SK, Filho WL, Hubert F, Adejumo O. Climate Change and Health Preparedness in Africa: Analysing Trends in Six African Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094672. [PMID: 33925753 PMCID: PMC8124714 DOI: 10.3390/ijerph18094672] [Citation(s) in RCA: 194] [Impact Index Per Article: 64.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 11/23/2022]
Abstract
Climate change is a global problem, which affects the various geographical regions at different levels. It is also associated with a wide range of human health problems, which pose a burden to health systems, especially in regions such as Africa. Indeed, across the African continent public health systems are under severe pressure, partly due to their fragile socioeconomic conditions. This paper reports on a cross-sectional study in six African countries (Ghana, Nigeria, South Africa, Namibia, Ethiopia, and Kenya) aimed at assessing their vulnerabilities to climate change, focusing on its impacts on human health. The study evaluated the levels of information, knowledge, and perceptions of public health professionals. It also examined the health systems’ preparedness to cope with these health hazards, the available resources, and those needed to build resilience to the country’s vulnerable population, as perceived by health professionals. The results revealed that 63.1% of the total respondents reported that climate change had been extensively experienced in the past years, while 32% claimed that the sampled countries had experienced them to some extent. Nigerian respondents recorded the highest levels (67.7%), followed by Kenya with 66.6%. South Africa had the lowest level of impact as perceived by the respondents (50.0%) when compared with the other sampled countries. All respondents from Ghana and Namibia reported that health problems caused by climate change are common in the two countries. As perceived by the health professionals, the inadequate resources reiterate the need for infrastructural resources, medical equipment, emergency response resources, and technical support. The study’s recommendations include the need to improve current policies at all levels (i.e., national, regional, and local) on climate change and public health and to strengthen health professionals’ skills. Improving the basic knowledge of health institutions to better respond to a changing climate is also recommended. The study provides valuable insights which may be helpful to other nations in Sub-Saharan Africa.
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Affiliation(s)
- Samuel Kwasi Opoku
- Research and Transfer Centre “Sustainable Development and Climate Change Management”, Hamburg University of Applied Sciences, Ulmenliet 20, D-21033 Hamburg, Germany; (S.K.O.); (F.H.)
| | - Walter Leal Filho
- Research and Transfer Centre “Sustainable Development and Climate Change Management”, Hamburg University of Applied Sciences, Ulmenliet 20, D-21033 Hamburg, Germany; (S.K.O.); (F.H.)
- Correspondence:
| | - Fudjumdjum Hubert
- Research and Transfer Centre “Sustainable Development and Climate Change Management”, Hamburg University of Applied Sciences, Ulmenliet 20, D-21033 Hamburg, Germany; (S.K.O.); (F.H.)
| | - Oluwabunmi Adejumo
- Institute for Entrepreneurship and Development Studies, Obafemi Awolowo University, Ile-Ife 220282, Osun State, Nigeria;
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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.
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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
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Chen X, Qiu B, Zou Q, Qiu T, Li R, Truong A, Qi Y, Liu T, Han L, Liu T, Chang J, Sun Q, Zhu Y, Xu D. Source specific PM 2.5 associated with heart rate variability in the elderly with coronary heart disease: A community-based panel study. CHEMOSPHERE 2020; 260:127399. [PMID: 32668362 DOI: 10.1016/j.chemosphere.2020.127399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
There is increasingly concern that PM2.5 constituents play a significant role in PM2.5-related cardiovascular outcomes. However, little is known about the associations between specific constituents of PM2.5 and risk for cardiovascular health. To evaluate the exposure to specific chemicals of PM2.5 from various sources and their cardiac effects, a longitudinal investigation was conducted with four repeated measurements of elderly participants' HRV and PM2.5 species in urban Beijing. Multiple chemicals in PM2.5 (metals, ions and PAHs) were characterized for PM2.5 source apportionment and personalized exposure assessment. Five sources were finally identified with specific chemicals as the indicators: oil combustion (1.1%, V & PAHs), secondary particle (11.3%, SO42- & NO3-), vehicle emission (1.2%, Pd), construction dust (28.7%, Mg & Ca), and coal combustion (57.7%, Se & As). As observed, each IQR increase in exposure to oil combustion (V), vehicle emission (Pd), and coal combustion (Se) significantly decreased rMSSD by 13.1% (95% CI: -25.3%, -1.0%), 27.4% (95% CI: -42.9%, -7.6%) and 24.7% (95% CI: -39.2%, -6.9%), respectively, while those of PM2.5 mass with decreases of rMSSD by 11.1% (95% CI: -19.6%, -1.9%) at lag 0. Elevated exposures to specific sources/constituents of PM2.5 disrupt cardiac autonomic function in elderly and have more adverse effects than PM2.5 mass. In the stratified analysis, medication and gender modify the associations of specific chemicals from variable sources with HRV. The findings of this study provide evidence on the roles of influential constituents of ambient air PM2.5 and their sources in terms of their adverse cardiovascular health effects.
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Affiliation(s)
- Xi Chen
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Qiu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China
| | - Qinpei Zou
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Tian Qiu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Runkui Li
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China; State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Ashley Truong
- Brown University School of Public Health, Providence, RI, USA
| | - Yanmin Qi
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China
| | - Tao Liu
- Civil Aviation General Hospital, Beijing, China
| | - Limin Han
- Civil Aviation General Hospital, Beijing, China
| | - Tiebing Liu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China
| | - Junrui Chang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ying Zhu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Dongqun Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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18
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Lokotola CL, Wright CY, Wichmann J. Temperature as a modifier of the effects of air pollution on cardiovascular disease hospital admissions in Cape Town, South Africa. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:16677-16685. [PMID: 32133609 DOI: 10.1007/s11356-020-07938-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 01/29/2020] [Indexed: 05/20/2023]
Abstract
Climate change and air pollution are two independent risk factors to cardiovascular diseases (CVD). Few studies investigated their interaction and potential effect modification of one another in developing countries. Individual level CVD hospital admission (ICD10: I00-I99) data for 1 January 2011 to 31 October 2016 were obtained from seven private hospitals in Cape Town. NO2, SO2, PM10, temperature and relative humidity data were obtained from the South African Weather Services and the City of Cape Town. A case-crossover epidemiological study design and conditional logistic regression model were applied. Various cut-off values were applied to classify cold and warm days. In total, 54,818 CVD hospital admissions were included in the study. In general, on warm and cold days the 15-64 years old group was more at risk for CVD hospitalization with increasing air pollution levels compared to all ages combined or the ≥ 65 years old group. Females appeared to be more at risk than males with increasing PM10 levels. In contrast, males were more vulnerable to the effects of NO2 and SO2 than females. The study showed the modification effect of temperature on air pollution associated with CVD hospital admissions. The consideration of such interaction will help in policy making and public health interventions dealing with climate change-related health risks.
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Affiliation(s)
- Christian L Lokotola
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Caradee Y Wright
- South African Medical Research Council, Pretoria, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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Krummenauer L, Prahl BF, Costa L, Holsten A, Walther C, Kropp JP. Global drivers of minimum mortality temperatures in cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 695:133560. [PMID: 31422334 DOI: 10.1016/j.scitotenv.2019.07.366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/02/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
Human mortality shows a pronounced temperature dependence. The minimum mortality temperature (MMT) as a characteristic point of the temperature-mortality relationship is influenced by many factors. As MMT estimates are based on case studies, they are sporadic, limited to data-rich regions, and their drivers have not yet been clearly identified across case studies. This impedes the elaboration of spatially comprehensive impact studies on heat-related mortality and hampers the temporal transfer required to assess climate change impacts. Using 400 MMTs from cities, we systematically establish a generalised model that is able to estimate MMTs (in daily apparent temperature) for cities, based on a set of climatic, topographic and socio-economic drivers. A sigmoid model prevailed against alternative model setups due to having the lowest Akaike Information Criterion (AICc) and the smallest RMSE. We find the long-term climate, the elevation, and the socio-economy to be relevant drivers of our MMT sample within the non-linear parametric regression model. A first model application estimated MMTs for 599 European cities (>100 000 inhabitants) and reveals a pronounced decrease in MMTs (27.8-16 °C) from southern to northern cities. Disruptions of this pattern across regions of similar mean temperatures can be explained by socio-economic standards as noted for central eastern Europe. Our alternative method allows to approximate MMTs independently from the availability of daily mortality records. For the first time, a quantification of climatic and non-climatic MMT drivers has been achieved, which allows to consider changes in socio-economic conditions and climate. This work contributes to the comparability among MMTs beyond location-specific and regional limits and, hence, towards a spatially comprehensive impact assessment for heat-related mortality.
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Affiliation(s)
| | - Boris F Prahl
- Potsdam Institute for Climate Impact Research, Potsdam, Germany; Carbon Delta, Zurich, Switzerland
| | - Luís Costa
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Anne Holsten
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Carsten Walther
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Jürgen P Kropp
- Potsdam Institute for Climate Impact Research, Potsdam, Germany; University of Potsdam, Institute for Environmental Science and Geography, Potsdam, Germany
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20
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Chersich MF, Wright CY. Climate change adaptation in South Africa: a case study on the role of the health sector. Global Health 2019; 15:22. [PMID: 30890178 PMCID: PMC6423888 DOI: 10.1186/s12992-019-0466-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/12/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Globally, the response to climate change is gradually gaining momentum as the impacts of climate change unfold. In South Africa, it is increasingly apparent that delays in responding to climate change over the past decades have jeopardized human life and livelihoods. While slow progress with mitigation, especially in the energy sector, has garnered much attention, focus is now shifting to developing plans and systems to adapt to the impacts of climate change. METHODS We applied systematic review methods to assess progress with climate change adaptation in the health sector in South Africa. This case study provides useful lessons which could be applied in other countries in the African region, or globally. We reviewed the literature indexed in PubMed and Web of Science, together with relevant grey literature. We included articles describing adaptation interventions to reduce the impact of climate change on health in South Africa. All study designs were eligible. Data from included articles and grey literature were summed thematically. RESULTS Of the 820 publications screened, 21 were included, together with an additional xx papers. Very few studies presented findings of an intervention or used high-quality research designs. Several policy frameworks for climate change have been developed at national and local government levels. These, however, pay little attention to health concerns and the specific needs of vulnerable groups. Systems for forecasting extreme weather, and tracking malaria and other infections appear well established. Yet, there is little evidence about the country's preparedness for extreme weather events, or the ability of the already strained health system to respond to these events. Seemingly, few adaptation measures have taken place in occupational and other settings. To date, little attention has been given to climate change in training curricula for health workers. CONCLUSIONS Overall, the volume and quality of research is disappointing, and disproportionate to the threat posed by climate change in South Africa. This is surprising given that the requisite expertise for policy advocacy, identifying effective interventions and implementing systems-based approaches rests within the health sector. More effective use of data, a traditional strength of health professionals, could support adaptation and promote accountability of the state. With increased health-sector leadership, climate change could be reframed as predominately a health issue, one necessitating an urgent, adequately-resourced response. Such a shift in South Africa, but also beyond the country, may play a key role in accelerating climate change adaptation and mitigation.
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Affiliation(s)
- Matthew F Chersich
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council and Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
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Chersich MF, Wright CY, Venter F, Rees H, Scorgie F, Erasmus B. Impacts of Climate Change on Health and Wellbeing in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1884. [PMID: 30200277 PMCID: PMC6164733 DOI: 10.3390/ijerph15091884] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/17/2018] [Accepted: 08/24/2018] [Indexed: 11/17/2022]
Abstract
Given its associated burden of disease, climate change in South Africa could be reframed as predominately a health issue, one necessitating an urgent health-sector response. The growing impact of climate change has major implications for South Africa, especially for the numerous vulnerable groups in the country. We systematically reviewed the literature by searching PubMed and Web of Science. Of the 820 papers screened, 34 were identified that assessed the impacts of climate change on health in the country. Most papers covered effects of heat on health or on infectious diseases (20/34; 59%). We found that extreme weather events are the most noticeable effects to date, especially droughts in the Western Cape, but rises in vector-borne diseases are gaining prominence. Climate aberration is also linked in myriad ways with outbreaks of food and waterborne diseases, and possibly with the recent Listeria epidemic. The potential impacts of climate change on mental health may compound the multiple social stressors that already beset the populace. Climate change heightens the pre-existing vulnerabilities of women, fishing communities, rural subsistence farmers and those living in informal settlements. Further gender disparities, eco-migration and social disruptions may undermine the prevention-but also treatment-of HIV. Our findings suggest that focused research and effective use of surveillance data are required to monitor climate change's impacts; traditional strengths of the country's health sector. The health sector, hitherto a fringe player, should assume a greater leadership role in promoting policies that protect the public's health, address inequities and advance the country's commitments to climate change accords.
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Affiliation(s)
- Matthew F Chersich
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.
| | - Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council and Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, Hatfield, Private Bag X200028, South Africa.
| | - Francois Venter
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.
| | - Helen Rees
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.
| | - Fiona Scorgie
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.
| | - Barend Erasmus
- Global Change Institute, University of the Witwatersrand, Johannesburg 2000, South Africa.
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Scovronick N, Sera F, Acquaotta F, Garzena D, Fratianni S, Wright CY, Gasparrini A. The association between ambient temperature and mortality in South Africa: A time-series analysis. ENVIRONMENTAL RESEARCH 2018; 161:229-235. [PMID: 29161655 PMCID: PMC5773242 DOI: 10.1016/j.envres.2017.11.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 09/07/2017] [Accepted: 11/01/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND There is an extensive literature describing temperature-mortality associations in developed regions, but research from developing countries, and Africa in particular, is limited. METHODS We conducted a time-series analysis using daily temperature data and a national dataset of all 8.8 million recorded deaths in South Africa between 1997 and 2013. Mortality and temperature data were linked at the district municipality level and relationships were estimated with a distributed lag non-linear model with 21 days of lag, and pooled in a multivariate meta-analysis. RESULTS We found an association between daily maximum temperature and mortality. The relative risk for all-age all-cause mortality on very cold and hot days (1st and 99th percentile of the temperature distribution) was 1.14 (1.10,1.17) and 1.06 (1.03,1.09), respectively, when compared to the minimum mortality temperature. This "U" shaped relationship was evident for every age and cause group investigated, except among 25-44 year olds. The strongest associations were in the youngest (< 5) and oldest (> 64) age groups and for cardiorespiratory causes. Heat effects occurred immediately after exposure but diminished quickly whereas cold effects were delayed but persistent. Overall, 3.4% of deaths (~ 290,000) in South Africa were attributable to non-optimum temperatures over the study period. We also present results for the 52 district municipalities individually. CONCLUSIONS An assessment of the largest-ever dataset for analyzing temperature-mortality associations in (South) Africa indicates mortality burdens associated with cold and heat, and identifies the young and elderly as particularly vulnerable.
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Affiliation(s)
- Noah Scovronick
- Woodrow Wilson School, Princeton University, Princeton, NJ 08544, USA.
| | - Francesco Sera
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | | | - Diego Garzena
- Department of Earth Sciences, University of Turin, Turin 10124, Italy
| | - Simona Fratianni
- Department of Earth Sciences, University of Turin, Turin 10124, Italy
| | - Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council and Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
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