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Boudreault J, Lavigne É, Campagna C, Chebana F. Estimating the heat-related mortality and morbidity burden in the province of Quebec, Canada. ENVIRONMENTAL RESEARCH 2024; 257:119347. [PMID: 38844034 DOI: 10.1016/j.envres.2024.119347] [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: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND As climate change increases the frequency and intensity of extreme heat events, there is an urgent need to quantify the heat-related health burden. However, most past studies have focussed on a single health outcome (mainly mortality) or on specific heatwaves, thus providing limited knowledge of the total pressure heat exerts on health services. OBJECTIVES This study aims to quantify the heat-related mortality and morbidity burden for five different health outcomes including all-cause mortality, hospitalizations, emergency department (ED) visits, ambulance transports and calls to a health hotline, using the province of Quebec (Canada) as a case study. METHODS A two-step statistical analysis was employed to estimate regional heat-health relationships using Distributed Lag Non-Linear Models (DLNM) and pooled estimates using a multivariate meta-regression. Heat burden was quantified by attributable fraction (AF) and attributable number (AN) for two temperature ranges: all heat (above the minimum mortality/morbidity temperature) and extreme heat (above the 95th percentile of temperature). RESULTS Higher temperatures were associated with greater risk ratios for all health outcomes studied, but at different levels. Significant AF ranging from 2 to 3% for the all heat effect and 0.4-1.0% for extreme heat were found for all health outcomes, except for hospitalizations that had an AF of 0.1% for both heat exposures. The estimated burden of all heat (and extreme heat) every summer across the province was 470 (200) deaths, 225 (170) hospitalizations, 36 000 (6 200) ED visits, 7 200 (1 500) ambulance transports and 15 000 (3 300) calls to a health hotline, all figures significant. DISCUSSION This new knowledge on the total heat load will help public health authorities to target appropriate actions to reduce its burden now and in the future. The proposed state-of-the-art framework can easily be applied to other regions also experiencing the adverse effects of extreme heat.
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Affiliation(s)
- Jérémie Boudreault
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3.
| | - Éric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON, Canada, K1A 0K9; School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, Canada, G1K 5Z3
| | - Céline Campagna
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3; Department of social and preventive medicine, Laval University, 1050 Av. de la Médecine, Québec, QC, Canada, G1V 0A6
| | - Fateh Chebana
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9
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Park J, Kim A, Bell ML, Kim H, Lee W. Heat and hospital admission via the emergency department for people with intellectual disability, autism, and mental disorders in South Korea: a nationwide, time-stratified, case-crossover study. Lancet Psychiatry 2024; 11:359-367. [PMID: 38631786 DOI: 10.1016/s2215-0366(24)00067-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Given the anticipated increase in ambient temperature due to climate change, the hazardous effects of heat on health have been extensively studied; however, its impact on people with intellectual disability, autism, and mental illness is largely unknown. We aimed to estimate the association between heat and hospitalisation through the emergency department (ED) among people with these mental disorders. METHODS In this nationwide study, we used data from the National Health Insurance Database (NHID) of the National Health Insurance Service, the single universal insurer in South Korea, the claims data for which is based on the ICD-10. We included individuals with identified intellectual disability, autism, and mental disorders (including schizophrenia, bipolar disorder, recurrent depressive disorder, schizoaffective disorder and persistent obsessive-compulsive disorder, Tourette's disorder, and narcolepsy) and we established two control groups of people without these disorders: one including 1 million systematically sampled individuals, and one matched to the cohort based on sex, age, and income group. Data on hospital admission via the ED were obtained from the NHID, including the primary cause of admission and corresponding medical costs, for the warm season (June-September) of the period 2006-2021. We used the Google Earth Engine with the ERA5-Land dataset to collect data on the daily mean temperature. We applied a time-stratified case-crossover design using a distributed lag non-linear model and performed a conditional logistic regression. The risk ratio was estimated as the odds ratio (OR) with calculated odds at the 99th percentile temperature compared with that at the local 75th percentile temperature. We did not include people with lived experience of mental illness in this study. FINDINGS Of the 456 946 people with intellectual disability, autism, or mental disorder in the NHID records, 99 845 were admitted to the ED, including 59 821 (59·9%) males and 40 024 (40·1%) females, and including 29 192 people with intellectual disability, 1428 people with autism, and 69 225 people with mental disorders. We were not able to collect data on ethnicity. The mean age at ED admission was 42·1 years (SD 17·9, range 0-102) for people with intellectual disability, 18·6 years (SD 10·4, range 1-72) for people with autism, and 50·8 years (SD 11·9, range 2-94) for people with mental disorders. The heat OR (odds at the 99th percentile vs 75th percentile of temperature) of ED admission was 1·23 (95% CI 1·11-1·36) for intellectual disability, 1·06 (0·68-1·63) for autism, and 1·20 (1·12-1·29) for mental disorders. People with intellectual disability, female individuals, people living in rural areas, or those with a low-income status were at increased risk of ED admission due to heat. The risk of ED admission due to genitourinary diseases was higher than that from other causes. Annual increase in medical costs attributable to heat among people with intellectual disability, autism, and mental disorders was US$ 224 970 per 100 000 person-years (95% empirical CI 139 784-305 770). INTERPRETATION People with intellectual disability, autism, and mental disorders should be included in groups considered at a high-risk for heat exposure, and heat adaptation policies should be implemented with consideration of these groups and their needs. FUNDING The National Research Foundation of Korea, Korean Ministry of Environment, and Korean Ministry of Education. TRANSLATION For the Korean translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jinah Park
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Ayoung Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven CT, USA
| | - Ho Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea; Institute of Health and 14 Environment, Seoul National University, Seoul, South Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, South Korea.
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Zwolska A, Półrolniczak M, Kolendowicz L. Urban growth's implications on land surface temperature in a medium-sized European city based on LCZ classification. Sci Rep 2024; 14:8308. [PMID: 38594361 PMCID: PMC11004128 DOI: 10.1038/s41598-024-58501-0] [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: 11/29/2023] [Accepted: 03/30/2024] [Indexed: 04/11/2024] Open
Abstract
The study determined the influence of changes in land use and land cover (LULC) on land surface temperature (LST) over a 33-year period based on a medium-sized European city (Poznań, Poland). The LST was estimated from Landsat 5, 8 and Terra (MOD11A2v6) satellites. The local estimation of climate patterns was based on the Local Climate Zones (LCZ) classification utilised with the methodology proposed by the World Urban Database and Access Portal Tools (WUDAPT). Moreover, the Copernicus' imperviousness density product (IMD) was used. Between 2006 and 2018 the area with IMD of 41-100% increased by 6.95 km2, 0-20% decreased by 7.03 km2. The contribution of built-up LCZs increased by 7.4% (19.21 km2) between 1988 and 2021 reaching 13% (34 km2) within open mid-rise LCZ. Due to urbanisation and reforestation, low plants LCZ shrunk by 12.7%. For every 10% increase in IMD, LST increases by up to 0.14 °C. Between 1988 and 2021 the LSTm in specific LCZs rose from 1.52 up to 2.97 °C. As per LST models LCZ change from natural to built-up led up to 1.19 °C LST rise. The increase of the LSTm was registered even when the LCZ remained unchanged.
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Affiliation(s)
- Aleksandra Zwolska
- Department of Meteorology and Climatology, Adam Mickiewicz University in Poznań (Poland), Krygowskiego Str., 10, 61-680, Poznań, Poland.
| | - Marek Półrolniczak
- Department of Meteorology and Climatology, Adam Mickiewicz University in Poznań (Poland), Krygowskiego Str., 10, 61-680, Poznań, Poland
| | - Leszek Kolendowicz
- Department of Meteorology and Climatology, Adam Mickiewicz University in Poznań (Poland), Krygowskiego Str., 10, 61-680, Poznań, Poland
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Xie Y, Zhou Z, Sun Q, Zhao M, Pu J, Li Q, Sun Y, Dai H, Li T. Social-economic transitions and vulnerability to extreme temperature events from 1960 to 2020 in Chinese cities. iScience 2024; 27:109066. [PMID: 38361620 PMCID: PMC10867637 DOI: 10.1016/j.isci.2024.109066] [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: 09/05/2023] [Revised: 12/13/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
Climate change leads to more frequent and intense extreme temperature events, causing a significant number of excess deaths. Using an epidemiological approach, we analyze all-cause deaths related to heatwaves and cold spells in 2,852 Chinese counties from 1960 to 2020. Economic losses associated with these events are determined through the value of statistical life. Findings reveal that cold-related cumulative excess deaths (1,133 thousand) are approximately 2.5 times higher than heat-related deaths, despite an increase in heat-related fatalities in recent decades. Monetized mortality due to heat-related events is estimated at 1,284 billion CNY, while cold-related economic loss is 1,510 billion CNY. Notably, cities located in colder regions experience more heat-related excess deaths, and vice versa. Economic development does not significantly reduce mortality risks to heatwaves across China. This study provides insights into the spatial-temporal heterogeneity of heatwaves and cold spells mortality, essential for policymakers ensuring long-term climate adaptation and sustainability.
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Affiliation(s)
- Yang Xie
- School of Economics and Management, Beihang University, Beijing, China
| | - Ziqiao Zhou
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengdan Zhao
- School of Economics and Management, Beihang University, Beijing, China
| | - Jinlu Pu
- School of Economics and Management, Beihang University, Beijing, China
| | - Qiutong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hancheng Dai
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Chang CJ, Chi CY, Yang HY. Heat exposure and chronic kidney disease: a temporal link in a Taiwanese agricultural county. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1511-1524. [PMID: 37319425 DOI: 10.1080/09603123.2023.2223514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
Heat stress-related kidney injury has drawn public health attention. This study explored the temporal relationships between impaired kidney function and preceding outdoor heat exposure Taiwan. Data of participants collected through a health screening program was used to assess the association between chronic kidney disease (CKD) and average ambient temperature with various time lag structures. A total of 1,243 CKD cases and 38,831 non-CKD participants were included in the study. After adjusting for demographic, socioeconomic, lifestyle factors, and comorbidities, CKD was positively associated with the ambient temperature within 1-9 months. The 9-month average ambient temperature yielded the highest odds ratio of CKD (OR = 1.22; 95% CI = 1.09-1.37). Furthermore, females and farmers were found to be more vulnerable to CKD risk after outdoor heat exposure. These findings suggest that the prevention of heat stress-related kidney injury should consider relevant time frames and focus on vulnerable populations.
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Affiliation(s)
- Che-Jui Chang
- Institute of Occupational and Environmental Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chun-Yi Chi
- Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
| | - Hsiao-Yu Yang
- Institute of Occupational and Environmental Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Population Health and Welfare Research Center, National Taiwan University College of Public Health, Taipei, Taiwan
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Quilty S, Lal A, Honan B, Chateau D, O’Donnell E, Mills J. The Impact of Climate Change on Aeromedical Retrieval Services in Remote Northern Australia: Planning for a Hotter Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:114. [PMID: 38276808 PMCID: PMC10815201 DOI: 10.3390/ijerph21010114] [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: 12/08/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/27/2024]
Abstract
It is known that environmental heat is associated with increased morbidity manifesting as increasing demand on acute care health services including pre-hospital transport and emergency departments. These services play a vital role in emergency care, and in rural and remote locations, where resource capacity is limited, aeromedical and other retrieval services are a vital part of healthcare delivery. There is no research examining how heat impacts remote retrieval service delivery. The Northern Territory (NT) of Australia is characterised by very remote communities with limited acute healthcare capacities and is a region subject to regular extreme tropical heat. In this study, we examine the relationship between aeromedical retrievals and hot weather for all NT retrievals between February 2018 and December 2019. A regression analysis was performed on the number of retrievals by clinical reason for retrieval matched to the temperature on the day of retrieval. There was a statistically significant exposure response relationship with increasing retrievals of obstetric emergencies in hotter weather in the humid climate zone and surgical retrievals in the arid zone. Retrieval services appeared to be at capacity at all times of the year. Given that there are no obstetric services in remote communities and that obstetric emergencies are a higher triage category than other emergencies (i.e., more urgent), such an increase will impede overall retrieval service delivery in hot weather. Increasing surgical retrievals in the arid zone may reflect an increase in soft tissue infections occurring in overcrowded houses in the hotter months of the year. Given that retrieval services are at capacity throughout the year, any increase in demand caused by increasing environmental heat will have broad implications for service delivery as the climate warms. Planning for a hotter future must include building resilient communities by optimising local healthcare capacity and addressing housing and other socioeconomic inequities that amplify heat-related illness.
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Affiliation(s)
- Simon Quilty
- National Centre of Epidemiology and Population Health, Australian National University, Canberra 2600, ACT, Australia; (A.L.); (D.C.)
| | - Aparna Lal
- National Centre of Epidemiology and Population Health, Australian National University, Canberra 2600, ACT, Australia; (A.L.); (D.C.)
| | - Bridget Honan
- Medical Retrieval and Consultation Centre, Alice Springs Hospital, Alice Springs 0870, NT, Australia; (B.H.); (E.O.)
| | - Dan Chateau
- National Centre of Epidemiology and Population Health, Australian National University, Canberra 2600, ACT, Australia; (A.L.); (D.C.)
| | - Elen O’Donnell
- Medical Retrieval and Consultation Centre, Alice Springs Hospital, Alice Springs 0870, NT, Australia; (B.H.); (E.O.)
| | - Jodie Mills
- Careflight Northern Territory, Eaton 0820, NT, Australia;
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7
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Doyle MA. Seasonal patterns in newborns' health: Quantifying the roles of climate, communicable disease, economic and social factors. ECONOMICS AND HUMAN BIOLOGY 2023; 51:101287. [PMID: 37549490 DOI: 10.1016/j.ehb.2023.101287] [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: 02/11/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
Poor health at birth can have long-term consequences for children's development. This paper analyses an important factor associated with health at birth: the time of year that the baby is born, and hence seasonal risks they were exposed to in utero. There are multiple potential explanations for seasonality in newborns' health. Most previous research has examined these in isolation. We therefore do not know which explanations are most important - and hence which policy interventions would most effectively reduce the resulting early-life inequalities. In this paper, I use administrative data to estimate and compare the magnitudes of several seasonal risks, seeking to identify the most important drivers of seasonality in the Northern Territory of Australia, a large territory spanning tropical and arid climates and where newborn health varies dramatically with the seasons. I find that the most important explanations are heat exposure and disease prevalence. Seasonality in food prices and road accessibility have smaller effects on some outcomes. Seasonal fertility patterns, rainfall and humidity do not have statistically significant effects. I conclude that interventions that protect pregnant women from seasonal disease and heat exposure would likely improve newborn health in the Northern Territory, with potential long-term benefits for child development. It is likely that similar impacts would apply in other locations with tropical and arid climates, and that, without action, climate change will accentuate these risks.
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Affiliation(s)
- Mary-Alice Doyle
- Department of Social Policy, London School of Economics, Houghton Street, WC2A 2AE, United Kingdom.
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8
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Fard P, Chung MKJ, Estiri H, Patel CJ. Spatio-temporal interpolation and delineation of extreme heat events in California between 2017 and 2021. ENVIRONMENTAL RESEARCH 2023; 237:116984. [PMID: 37648196 PMCID: PMC10591937 DOI: 10.1016/j.envres.2023.116984] [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: 01/31/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Abstract
Robust spatio-temporal delineation of extreme climate events and accurate identification of areas that are impacted by an event is a prerequisite for identifying population-level and health-related risks. In prior research, attributes such as temperature and humidity have often been linearly assigned to the population of the study unit from the closest weather station. This could result in inaccurate event delineation and biased assessment of extreme heat exposure. We have developed a spatio-temporal model to dynamically delineate boundaries for Extreme Heat Events (EHE) across space and over time, using a relative measure of Apparent Temperature (AT). Our surface interpolation approach offers a higher spatio-temporal resolution compared to the standard nearest-station (NS) assignment method. We show that the proposed approach can provide at least 80.8 percent improvement in identification of areas and populations impacted by EHEs. This improvement in average adjusts the misclassification of about one million Californians per day of an extreme event, who would be either unidentified or misidentified under EHEs between 2017 and 2021.
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Affiliation(s)
- Pedram Fard
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Ming Kei Jake Chung
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA; School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
| | - Hossein Estiri
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
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Ji JS, Xia Y, Liu L, Zhou W, Chen R, Dong G, Hu Q, Jiang J, Kan H, Li T, Li Y, Liu Q, Liu Y, Long Y, Lv Y, Ma J, Ma Y, Pelin K, Shi X, Tong S, Xie Y, Xu L, Yuan C, Zeng H, Zhao B, Zheng G, Liang W, Chan M, Huang C. China's public health initiatives for climate change adaptation. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100965. [PMID: 38116500 PMCID: PMC10730322 DOI: 10.1016/j.lanwpc.2023.100965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/01/2023] [Accepted: 11/01/2023] [Indexed: 12/21/2023]
Abstract
China's health gains over the past decades face potential reversals if climate change adaptation is not prioritized. China's temperature rise surpasses the global average due to urban heat islands and ecological changes, and demands urgent actions to safeguard public health. Effective adaptation need to consider China's urbanization trends, underlying non-communicable diseases, an aging population, and future pandemic threats. Climate change adaptation initiatives and strategies include urban green space, healthy indoor environments, spatial planning for cities, advance location-specific early warning systems for extreme weather events, and a holistic approach for linking carbon neutrality to health co-benefits. Innovation and technology uptake is a crucial opportunity. China's successful climate adaptation can foster international collaboration regionally and beyond.
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Affiliation(s)
- John S. Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yanjie Xia
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Linxin Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Weiju Zhou
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National School of Public Health, Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Qinghua Hu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jingkun Jiang
- State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National School of Public Health, Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Li
- Public Meteorological Service Centre, China Meteorological Administration, Beijing, China
| | - Qiyong Liu
- National Institute of Infectious Diseases at China, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanxiang Liu
- Public Meteorological Service Centre, China Meteorological Administration, Beijing, China
| | - Ying Long
- School of Architecture, Tsinghua University, Beijing, China
| | - Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jian Ma
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yue Ma
- School of Architecture, Tsinghua University, Beijing, China
| | - Kinay Pelin
- School of Climate Change and Adaptation, University of Prince Edward Island, Prince Edward Island, Canada
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Queensland University of Technology, Brisbane, Australia
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China
| | - Lei Xu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Huatang Zeng
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China
| | - Guangjie Zheng
- State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Margaret Chan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Borg MA, Xiang J, Anikeeva O, Ostendorf B, Varghese B, Dear K, Pisaniello D, Hansen A, Zander K, Sim MR, Bi P. Current and projected heatwave-attributable occupational injuries, illnesses, and associated economic burden in Australia. ENVIRONMENTAL RESEARCH 2023; 236:116852. [PMID: 37558113 DOI: 10.1016/j.envres.2023.116852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/21/2023] [Accepted: 08/06/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION The costs of global warming are substantial. These include expenses from occupational illnesses and injuries (OIIs), which have been associated with increases during heatwaves. This study estimated retrospective and projected future heatwave-attributable OIIs and their costs in Australia. MATERIALS AND METHODS Climate and workers' compensation claims data were extracted from seven Australian capital cities representing OIIs from July 2005 to June 2018. Heatwaves were defined using the Excess Heat Factor. OIIs and associated costs were estimated separately per city and pooled to derive national estimates. Results were projected to 2030 (2016-2045) and 2050 (2036-2065). RESULTS The risk of OIIs and associated costs increased during heatwaves, with the risk increasing during severe and particularly extreme heatwaves. Of all OIIs, 0.13% (95% empirical confidence interval [eCI]: 0.11-0.16%) were heatwave-attributable, equivalent to 120 (95%eCI:70-181) OIIs annually. 0.25% of costs were heatwave-attributable (95%eCI: 0.18-0.34%), equal to $AU4.3 (95%eCI: 1.4-7.4) million annually. Estimates of heatwave-attributable OIIs by 2050, under Representative Concentration Pathway [RCP]4.5 and RCP8.5, were 0.17% (95%eCI: 0.10-0.27%) and 0.23% (95%eCI: 0.13-0.37%), respectively. National costs estimates for 2030 under RCP4.5 and RCP8.5 were 0.13% (95%eCI: 0.27-0.46%) and 0.04% (95%eCI: 0.66-0.60), respectively. These estimates for extreme heatwaves were 0.04% (95%eCI: 0.02-0.06%) and 0.04% (95%eCI: 0.01-0.07), respectively. Cost-AFs in 2050 were, under RCP4.5, 0.127% (95%eCI: 0.27-0.46) for all heatwaves and 0.04% (95%eCI: 0.01-0.09%) for extreme heatwaves. Attributable fractions were approximately similar to baseline when assuming theoretical climate adaptation. DISCUSSION Heatwaves represent notable and preventable portions of preventable OIIs and economic burden. OIIs are likely to increase in the future, and costs during extreme heatwaves in 2030. Workplace and public health policies aimed at heat adaptation can reduce heat-attributable morbidity and costs.
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Affiliation(s)
- Matthew A Borg
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Jianjun Xiang
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia; School of Public Health, Fujian Medical University, 1 Xue Yuan Road, Minhou Campus, Fuzhou, Fujian Province, 350122, China
| | - Olga Anikeeva
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Bertram Ostendorf
- Ecology and Evolutionary Biology, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia
| | - Blesson Varghese
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Keith Dear
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Dino Pisaniello
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Alana Hansen
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Kerstin Zander
- Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, The Alfred Centre, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia.
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Wade R. Climate Change and Healthcare: Creating a Sustainable and Climate-Resilient Health Delivery System. J Healthc Manag 2023; 68:227-238. [PMID: 37410987 DOI: 10.1097/jhm-d-23-00096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Climate change poses global challenges as rising temperatures, recurring natural disasters, and the resulting increase in the prevalence of acute and long-term climate-related diseases threaten the health and safety of populations worldwide. The healthcare sector, one of the largest sources of greenhouse gas emissions globally, both exacerbates and suffers from these effects. As leaders in their local communities and the national economy, hospitals and health systems have a responsibility to not only build climate resilience to withstand disaster events but also implement sustainability initiatives that will reduce the healthcare sector's carbon footprint. A wide variety of initiatives that can meet all financial plans and timelines are available. This discussion focuses on three of the most impactful areas for opportunity: building resilience through community, operating room sustainability, and renewable energy sources.
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Sharma A, Deng L, Wang YC. Estimation of effects of extreme temperature on the risk of hospitalisation in Taiwan. J Epidemiol Community Health 2023; 77:375-383. [PMID: 36944498 DOI: 10.1136/jech-2022-220142] [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: 11/30/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Extreme temperatures are triggering and exacerbating hospital admissions and health burdens; however, it is still understudied. Therefore, we evaluated the effects of the average temperature on overall hospitalisation and the average length of hospital stay. METHODS Daily area-specific age-sex stratified hospitalisation records from 2006 to 2020 were collected from the National Health Research Institutes of Taiwan. The distributed lag non-linear model was used to estimate the area-specific relative risk (RR) and 95% CI associated with daily average temperature. Overall cumulative RR was pooled from area-specific RRs using random effects meta-analysis. Temperature effects of extreme high and low thresholds were also evaluated based on the 99th (32°C) and 5th (14°C) percentiles, respectively. RESULTS Our findings suggested that the elderly (age ≥65 years) are vulnerable to temperature effects, while differential gender effects are not explicit in Taiwan. A higher risk of in-patient visits was seen among the elderly during extreme low temperatures (RR 1.08; 95% CI 1.04 to 1.11) compared with extreme high temperatures (RR 1.07; 95% CI 1.05 to 1.10). Overall, high-temperature extremes increased the risk of hospitalisation with an RR of 1.05 (95% CI 1.03 to 1.07) among the all-age-sex population in Taiwan. Additionally, lag-specific analysis of the study revealed that high-temperature effects on in-patient visits are effective on the same day of exposure, while cold effects occurred after 0-2 days of exposure. The average length of hospital stays can also increase with high-temperature extremes among age group 41-64 years and the elderly. CONCLUSION Public health preparedness should consider the increased load on health facilities and health expenditures during extreme temperatures.
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Affiliation(s)
- Ayushi Sharma
- Department of Environmental Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
- Department of Civil Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
| | - Liwen Deng
- Department of Environmental Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
- Research Center for Environmental Changes, Academia Sinica, Nankang, Taipei, Taiwan
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Zhao J, Zhang Y, Ni Y, He J, Wang J, Li X, Guo Y, Li C, Zhang W, Cui Z. Effect of ambient temperature and other environmental factors on stroke emergency department visits in Beijing: A distributed lag non-linear model. Front Public Health 2022; 10:1034534. [PMID: 36466462 PMCID: PMC9709270 DOI: 10.3389/fpubh.2022.1034534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Most studies have focused on the relationship between ambient temperature and stroke mortality, but studies on the relationship between ambient temperature and stroke occurrence are still limited and inconsistent. Objective This study aimed to analyze the effect of ambient temperature and other environmental factors on emergency stroke visits in Beijing. Methods Our study utilized stroke visit data from the Beijing Red Cross Emergency Medical Center during 2017-2018, and applied a generalized additive model (GAM) as well as a distributed lag non-linear model (DLNM), respectively, regarding the direct, lagged, and cumulative effects of ambient temperature alone and with correction for other environmental factors on stroke occurrence. Results With a total of 26,984 emergency stroke patients in 2017-2018, both cold and hot effects were observed and weakened after correction for other environmental factors. Compared to the reference temperature, in the multi-factor model, extreme cold (-10°C) reached a maximum relative risk (RR) of 1.20 [95% Confidence Interval (CI): 1.09, 1.32] at lag 14 days, and extreme hot (30°C) had a maximum RR of 1.07 (95% CI: 1.04, 1.11) at lag 6 days. The cumulative effect of extreme cold reached a maximum of 2.02 (95% CI: 1.11, 3.67) at lag 0-14 days, whereas the cumulative effect of extreme hot temperature is greatest at lag 0-10 days, but no statistically significant effect was found. In addition, ischemic stroke patients, the elderly, and males were more susceptible to the effects of cold temperature. Conclusions There is a non-linear relationship between ambient temperature and stroke occurrence, with cold temperature having a greater and longer-lasting impact than hot temperature.
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Affiliation(s)
- Jinhua Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Ying Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Junyu He
- Ocean College, Zhejiang University, Zhoushan, China,Ocean Academy, Zhejiang University, Zhoushan, China
| | - Jianping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China,Wenyi Zhang
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China,*Correspondence: Zhuang Cui
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Affiliation(s)
- Cecilia Sorensen
- From the Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University (C.S.), and the Department of Emergency Medicine, Columbia Irving Medical Center (C.S.) - both in New York; and the Department of Emergency Medicine, School of Medicine (J.H.), the Department of Environmental and Occupational Health Sciences, School of Public Health (J.H.), and the Department of Global Health, Schools of Medicine and Public Health (J.H.), University of Washington, Seattle
| | - Jeremy Hess
- From the Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University (C.S.), and the Department of Emergency Medicine, Columbia Irving Medical Center (C.S.) - both in New York; and the Department of Emergency Medicine, School of Medicine (J.H.), the Department of Environmental and Occupational Health Sciences, School of Public Health (J.H.), and the Department of Global Health, Schools of Medicine and Public Health (J.H.), University of Washington, Seattle
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15
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Wu Y, Xu R, Yu W, Wen B, Li S, Guo Y. Economic burden of premature deaths attributable to non-optimum temperatures in Italy: A nationwide time-series analysis from 2015 to 2019. ENVIRONMENTAL RESEARCH 2022; 212:113313. [PMID: 35436452 DOI: 10.1016/j.envres.2022.113313] [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: 01/19/2022] [Revised: 03/21/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Human beings and society are experiencing substantial consequences caused by non-optimum temperatures. However, limited studies have assessed the economic burden of premature deaths attributable to non-optimum temperatures. OBJECTIVES To characterize the association between daily mean temperature and the economic burden of premature deaths. METHODS A total of 3 228 098 deaths were identified from a national mortality dataset in Italy during 2015 and 2019. We used the value of statistical life to quantify the economic losses of premature death. A two-stage time-series analysis was performed to evaluate the economic losses of premature deaths associated with non-optimum temperatures. Attributable burden for non-optimum temperatures compared with minimum risk temperature were estimated. Potential effect modifiers were further explored. RESULTS From 2015 to 2019, the economic loss of premature deaths due to non-optimum temperatures was $525.52 billion (95% CI: $461.84-$580.80 billion), with the attributable fraction of 5.74% (95% CI: 5.04%-6.34%). Attributable economic burden was largely due to moderate cold temperatures ($309.54 billion, 95% CI: $249.49-$357.34 billion). A higher economic burden was observed for people above the age of 65, accounting for 75.97% ($452.42, 95%CI: $406.97-$488.76 billion) of the total economic burden. In particular, higher fractions attributable to heat temperatures were observed for provinces with the lowest level of GDP per capita but the highest level of urbanization. DISCUSSION This study shows a considerable economic burden of premature deaths attributed to non-optimum temperatures. These figures can help inform tailored prevention to tackle the large economic burden imposed by non-optimum temperatures.
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Affiliation(s)
- Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wenhua Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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16
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Anwar A, Hyder S, Bennett R, Younis M. Impact of Environmental Quality on Healthcare Expenditures in Developing Countries: A Panel Data Approach. Healthcare (Basel) 2022; 10:healthcare10091608. [PMID: 36141220 PMCID: PMC9498607 DOI: 10.3390/healthcare10091608] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
Objective: The deterioration in environmental quality has an economic and social cost. The aim of this study is to analyze the impact of environmental factors on health expenditures in developing countries. Method: To analyze the relationship between environmental quality (air pollution and temperature) and health expenditure in thirty-three developing countries, the study uses system generalized method of moments (GMM) using data from 2000 to 2017. Results: The results suggest a positive effect of both air pollution and temperature on health expenditure. However, the effect is highest for government health expenditure, followed by private and total health expenditure in the studied countries. The results further suggest that the impact of environmental factors is greater in higher-income countries when we divide the studied countries into two groups, i.e., higher- and lower-income countries. Conclusion: Our results are interesting and informative for the policy makers to design such policies to attain better environmental quality and social well-being. The increased healthcare expenditures due to increased air pollution and climate change necessitate for an efficient, reliable, affordable and modern energy policy by emphasizing the use of clean and renewable energy in these countries that ensure better health for the masses. Furthermore, a smart and sustainable environmentally friendly economic growth policy is necessary to ensure better health for the masses.
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Affiliation(s)
- Asim Anwar
- Department of Management Sciences, COMSATS University Islamabad, Islamabad 43600, Pakistan
- Correspondence:
| | - Shabir Hyder
- Department of Management Sciences, COMSATS University Islamabad, Islamabad 43600, Pakistan
| | - Russell Bennett
- Department of Health Policy and Management, School of Health Sciences, Jackson State University, Jackson, MS 39217, USA
| | - Mustafa Younis
- Department of Health Policy and Management, School of Health Sciences, Jackson State University, Jackson, MS 39217, USA
- School of Business & Economics, University Putra Malaysia, Serdang 43400, Malaysia
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17
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Affiliation(s)
- C Sorensen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Emergency Medicine, Columbia Irving Medical Center, New York, NY, USA
| | - C Howard
- Cumming School of Medicine, University of Calgary, Calgary, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - P Prabhakaran
- Centre for Environmental Health, Public Health Foundation of India, India
- Centre for Chronic Disease Control, New Delhi, India
| | - G Horton
- School of Medicine and Public Health, University of Newcastle, Australia
| | - R Basu
- Office of Environmental Health Hazard Assessment, Air and Climate Epidemiology Section, Oakland, CA, USA
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Tong M, Wondmagegn B, Xiang J, Hansen A, Dear K, Pisaniello D, Varghese B, Xiao J, Jian L, Scalley B, Nitschke M, Nairn J, Bambrick H, Karnon J, Bi P. Hospitalization Costs of Respiratory Diseases Attributable to Temperature in Australia and Projections for Future Costs in the 2030s and 2050s under Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159706. [PMID: 35955062 PMCID: PMC9368165 DOI: 10.3390/ijerph19159706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 05/06/2023]
Abstract
This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010-2016 were analyzed using distributed non-linear lag models. Future hospitalization costs were estimated based on three predicted climate change scenarios-RCP2.6, RCP4.5 and RCP8.5. The estimated respiratory disease hospitalization costs attributable to ambient temperatures increased from 493.2 million Australian dollars (AUD) in the 2010s to more than AUD 700 million in 2050s in Sydney and from AUD 98.0 million to about AUD 150 million in Perth. The current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1-20.1%) and (5.1-6.6%), respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Limitations of this study should be noted, such as lacking information on individual-level exposures, local air pollution levels, and other behavioral risks, which is common in such ecological studies. Nonetheless, this study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change may result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location.
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Affiliation(s)
- Michael Tong
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Berhanu Wondmagegn
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Alana Hansen
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Blesson Varghese
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianguo Xiao
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Le Jian
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Benjamin Scalley
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Monika Nitschke
- Department of Health, Government of South Australia, Adelaide, SA 5000, Australia
| | - John Nairn
- Australian Bureau of Meteorology, Adelaide, SA 5000, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QL 4000, Australia
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5001, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
- Correspondence: ; Tel.: +61-8-8313-3583
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Strathearn M, Osborne NJ, Selvey LA. Impact of low-intensity heat events on mortality and morbidity in regions with hot, humid summers: a scoping literature review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1013-1029. [PMID: 35059818 PMCID: PMC9042961 DOI: 10.1007/s00484-022-02243-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 05/05/2023]
Abstract
The objective of this study is to determine the impacts of low-intensity heat on human health in regions with hot, humid summers. Current literature has highlighted an increase in mortality and morbidity rates during significant heat events. While the impacts on high-intensity events are established, the impacts on low-intensity events, particularly in regions with hot, humid summers, are less clear. A scoping review was conducted searching three databases (PubMed, EMBASE, Web of Science) using key terms based on the inclusion criteria. We included papers that investigated the direct human health impacts of low-intensity heat events (single day or heatwaves) in regions with hot, humid summers in middle- and high-income countries. We excluded papers written in languages other than English. Of the 600 publications identified, 33 met the inclusion criteria. Findings suggest that low-intensity heatwaves can increase all-cause non-accidental, cardiovascular-, respiratory- and diabetes-related mortality, in regions experiencing hot, humid summers. Impacts of low-intensity heatwaves on morbidity are less clear, with research predominantly focusing on hospitalisation rates with a range of outcomes. Few studies investigating the impact of low-intensity heat events on emergency department presentations and ambulance dispatches were found. However, the data from a limited number of studies suggest that both of these outcome measures increase during low-intensity heat events. Low-intensity heat events may increase mortality. There is insufficient evidence of a causal effect of low-intensity heat events on increasing morbidity for a firm conclusion. Further research on the impact of low-intensity heat on morbidity and mortality using consistent parameters is warranted.
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Affiliation(s)
- Melanie Strathearn
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Nicholas J Osborne
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Linda A Selvey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia.
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Understanding current and projected emergency department presentations and associated healthcare costs in a changing thermal climate in Adelaide, South Australia. Occup Environ Med 2022; 79:421-426. [DOI: 10.1136/oemed-2021-107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/18/2022] [Indexed: 11/03/2022]
Abstract
BackgroundExposure to extreme temperatures is associated with increased emergency department (ED) presentations. The resulting burden on health service costs and the potential impact of climate change is largely unknown. This study examines the temperature-EDs/cost relationships in Adelaide, South Australia and how this may be impacted by increasing temperatures.MethodsA time series analysis using a distributed lag nonlinear model was used to explore the exposure–response relationships. The net-attributable, cold-attributable and heat-attributable ED presentations for temperature-related diseases and costs were calculated for the baseline (2014–2017) and future periods (2034–2037 and 2054–2057) under three climate representative concentration pathways (RCPs).ResultsThe baseline heat-attributable ED presentations were estimated to be 3600 (95% empirical CI (eCI) 700 to 6500) with associated cost of $A4.7 million (95% eCI 1.8 to 7.5). Heat-attributable ED presentations and costs were projected to increase during 2030s and 2050s with no change in the cold-attributable burden. Under RCP8.5 and population growth, the increase in heat-attributable burden would be 1.9% (95% eCI 0.8% to 3.0%) for ED presentations and 2.5% (95% eCI 1.3% to 3.7%) for ED costs during 2030s. Under the same conditions, the heat effect is expected to increase by 3.7% (95% eCI 1.7% to 5.6%) for ED presentations and 5.0% (95% eCI 2.6% to 7.1%) for ED costs during 2050s.ConclusionsProjected climate change is likely to increase heat-attributable emergency presentations and the associated costs in Adelaide. Planning health service resources to meet these changes will be necessary as part of broader risk mitigation strategies and public health adaptation actions.
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Yan M, Xie Y, Zhu H, Ban J, Gong J, Li T. The exceptional heatwaves of 2017 and all-cause mortality: An assessment of nationwide health and economic impacts in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152371. [PMID: 34919930 DOI: 10.1016/j.scitotenv.2021.152371] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Heatwaves with unprecedented conditions have devastating health impacts. The summer of 2017 saw unusual heat in China and other regions on earth. Although epidemiologic evidence is clear for elevated mortality risks of heatwaves, the economic impacts due to heatwave-associated mortality remain poorly characterized. Hence, this study systematically assessed the mortality and economic impacts of the 2017 exceptional heatwaves in China. We first used the generalized linear mixed-effect model with Poisson distribution to examine the mortality risks of the 2017 heatwaves in 91 Chinese counties. Further, we calculated the excess deaths attributable to heatwaves in 2852 counties. Finally, we evaluated the city- and province-level death-related economic burden of the 2017 heatwaves based on the value of statistical life (VSL). We found that the 2017 exceptional heatwaves had a statistically significant association (relative risk was 1.23, 95% confidence interval 1.14-1.32) with all-cause mortality across 91 Chinese counties. Nationwide, a total of 16,299 all-cause deaths that occurred in 2017 were attributable to the exceptional heatwaves, resulting in an overall death-related economic loss of 61,304 million RMB as valued by VSL. Given that extraordinary heatwaves are projected to be more frequent under global climate change, our findings could enhance the current understanding of heatwaves' health and economic impacts and add valuable insights in projection studies of estimating the future health burden of heatwaves.
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Affiliation(s)
- Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China; Future Cities Lab, Beihang University, China
| | - Huanhuan Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology and State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Adélaïde L, Chanel O, Pascal M. Health effects from heat waves in France: an economic evaluation. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:119-131. [PMID: 34304326 PMCID: PMC8310615 DOI: 10.1007/s10198-021-01357-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/13/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND Scarcity of data on the health impacts and associated economic costs of heat waves may limit the will to invest in adaptation measures. We assessed the economic impact associated with mortality, morbidity, and loss of well-being during heat waves in France between 2015 and 2019. METHODS Health indicators monitored by the French national heat wave plan were used to estimate excess visits to emergency rooms and outpatient clinics and hospitalizations for heat-related causes. Total excess mortality and years of life loss were considered, as well as the size of the population that experienced restricted activity. A cost-of-illness and willingness-to-pay approach was used to account for associated costs. RESULTS Between 2015 and 2019, the economic impact of selected health effects of heat waves amounts to €25.5 billion, mainly in mortality (€23.2 billion), minor restricted activity days (€2.3 billion), and morbidity (€0.031 billion). CONCLUSION The results highlight a significant economic burden on the French health system and the population. A better understanding of the economic impacts of climate change on health is required to alert decision-makers to the urgency of mitigation and to support concrete adaptation actions.
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Affiliation(s)
- Lucie Adélaïde
- Santé publique France (SpF), 12, rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Olivier Chanel
- Aix-Marseille Univ, CNRS, AMSE, 5 boulevard Maurice Bourdet CS50498, 13205, Marseille Cedex 01, France.
| | - Mathilde Pascal
- Santé publique France (SpF), 12, rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
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Impact of Heat Waves on Hospitalisation and Mortality in Nursing Homes: A Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010697. [PMID: 34682444 PMCID: PMC8536121 DOI: 10.3390/ijerph182010697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 01/01/2023]
Abstract
Climate change leads to more days with extremely hot temperatures. Previous analyses of heat waves have documented a short-term rise in mortality. The results on the relationship between high temperatures and hospitalisations, especially in vulnerable patients admitted to nursing homes, are inconsistent. The objective of this research was to examine the discrepancy between heat-related mortality and morbidity in nursing homes. A time-stratified case-crossover study about the impact of heat waves on mortality and hospitalisations between 1 January 2013 and 31 December 2017 was conducted in 10 nursing homes over 5 years in Flanders, Belgium. In this study, the events were deaths and hospitalisations. We selected our control days during the same month as the events and matched them by day of the week. Heat waves were the exposure. Conditional logistic regression models were applied. The associations were reported as odds ratios at lag 0, 1, 2, and 3 and their 95% confidence intervals. In the investigated time period, 3048 hospitalisations took place and 1888 residents died. The conditional logistic regression showed that odds ratios of mortality and hospitalisations during heat waves were 1.61 (95% confidence interval 1.10–2.37) and 0.96 (95% confidence interval 0.67–1.36), respectively, at lag 0. Therefore, the increase in mortality during heat waves was statistically significant, but no significant changes in hospitalisations were obtained. Our result suggests that heat waves have an adverse effect on mortality in Flemish nursing homes but have no significant effect on the number of hospitalisations.
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Qu Y, Zhang W, Ryan I, Deng X, Dong G, Liu X, Lin S. Ambient extreme heat exposure in summer and transitional months and emergency department visits and hospital admissions due to pregnancy complications. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 777:146134. [PMID: 33689898 DOI: 10.1016/j.scitotenv.2021.146134] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Although extreme heat exposure (EHE) was reported to be associated with increased risks of multiple diseases, little is known about the effects of EHE on pregnancy complications. We examined the EHE-pregnancy complications associations by lag days, subtypes, sociodemographic characteristics, and areas in New York State (NYS). We conducted a case-crossover analysis to assess the EHE-pregnancy complications associations in summer (June-August) and transitional months (May and September). All emergency department (ED) visits and hospital admissions due to pregnancy complications (ICD 9 codes: 630-649) from 2005 to 2013 in NYS were included. Daily mean temperature > 90th percentile of the monthly mean temperature in each county was defined as an EHE. We used conditional logistic regression while controlling for other weather factors, air pollutants and holidays to assess the EHE-pregnancy complications associations. EHE was significantly associated with increased ED visits for pregnancy complications in summer (ORs ranged: 1.01-1.04 from lag days 0-5). There was also a significant and stronger association in transitional months (ORs ranged: 1.02-1.06, Lag 0). Furthermore, we found EHE affected multiple subtypes of pregnancy complications, including threatened/spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension (ORs range: 1.13-1.90) during transitional months. A significant concentration response effect between the number of consecutive days of EHE and ED visits in summer (P for trend <0.001), ED visits in September (P for trend =0.03), and hospital admission in May (P for trend<0.001) due to pregnancy complications was observed, respectively. African Americans and residents in lower socioeconomic position (SEP) counties were more susceptible to the effects of EHE. In conclusion, we found an immediate and prolonged effect of EHE on pregnancy complications in summer and a stronger, immediate effect in transitional months. These effects were stronger in African Americans and counties with lower SEP. Earlier warnings regarding extreme heat are recommended to decrease pregnancy complications.
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Affiliation(s)
- Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China; Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Ian Ryan
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Xinlei Deng
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China.
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA.
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Increasing impacts of temperature on hospital admissions, length of stay, and related healthcare costs in the context of climate change in Adelaide, South Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145656. [PMID: 33592481 DOI: 10.1016/j.scitotenv.2021.145656] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND A growing number of studies have investigated the effect of increasing temperatures on morbidity and health service use. However, there is a lack of studies investigating the temperature-attributable cost burden. OBJECTIVES This study examines the relationship of daily mean temperature with hospital admissions, length of hospital stay (LoS), and costs; and estimates the baseline temperature-attributable hospital admissions, and costs and in relation to warmer climate scenarios in Adelaide, South Australia. METHOD A daily time series analysis using distributed lag non-linear models (DLNM) was used to explore exposure-response relationships and to estimate the aggregated burden of hospital admissions for conditions associated with temperatures (i.e. renal diseases, mental health, diabetes, ischaemic heart diseases and heat-related illnesses) as well as the associated LoS and costs, for the baseline period (2010-2015) and different future climate scenarios in Adelaide, South Australia. RESULTS During the six-year baseline period, the overall temperature-attributable hospital admissions, LoS, and associated costs were estimated to be 3915 cases (95% empirical confidence interval (eCI): 235, 7295), 99,766 days (95% eCI: 14,484, 168,457), and AU$159 million (95% eCI: 18.8, 269.0), respectively. A climate scenario consistent with RCP8.5 emissions, and including projected demographic change, is estimated to lead to increases in heat-attributable hospital admissions, LoS, and costs of 2.2% (95% eCI: 0.5, 3.9), 8.4% (95% eCI: 1.1, 14.3), and 7.7% (95% eCI: 0.3, 13.3), respectively by mid-century. CONCLUSIONS There is already a substantial temperature-attributable impact on hospital admissions, LoS, and costs which are estimated to increase due to climate change and an increasing aged population. Unless effective climate and public health interventions are put into action, the costs of treating temperature-related admissions will be high.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia; College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Keith Dear
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Alana Hansen
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Monika Nitschke
- South Australian Department of Health and Wellbeing, Adelaide, South Australia, Australia.
| | - John Nairn
- Australian Bureau of Meteorology, South Australia, Australia.
| | - Ben Scalley
- Metropolitan Communicable Disease Control, Department of Health WA, Perth, Western Australia, Australia.
| | - Alex Xiao
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Michael Tong
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
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26
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Wang Y, Liu Y, Ye D, Li N, Bi P, Tong S, Wang Y, Cheng Y, Li Y, Yao X. Temperatures and health costs of emergency department visits: A multisite time series study in China. ENVIRONMENTAL RESEARCH 2021; 197:111023. [PMID: 33745933 DOI: 10.1016/j.envres.2021.111023] [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: 01/12/2021] [Revised: 02/26/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Evidence is limited regarding the association between temperatures and health costs. OBJECTIVES We tried to investigate the association between temperatures and emergency department visits (EDVs) costs in China. METHODS Daily data on EDVs costs, weather, air pollution were collected from 17 sites in China during 2014-2018. A quasi-Poisson generalized additive regression with distributed lag nonlinear model was applied to assess the temperature-EDVs cost association. Random-effect meta-analysis was used to pool the estimates from each site. Attributable fractions and national attributable EDVs costs due to heat and cold were calculated. RESULTS Relative risk (RR) due to extreme heat over 0-7 lag days was 1.14 [95% confidence intervals (CI): 1.08-1.19] and 1.11 (95% CI: 1.07-1.16) for EDVs examination (including treatment) and medicine cost, respectively. People aged 18-44 and those with genitourinary diseases were at higher risk from heat. 0.72% of examination cost and 0.57% of medicine cost were attributed to extreme heat, costing 274 million Chinese Yuan annually. Moderate heat had lower RR but higher attributable fraction of EDVs costs. Exposure to extreme cold over 0-21 lag days increased the risk of medicine cost for people aged 18-44 [RR: 1.30 (95% CI: 1.10-1.55)] and those with respiratory diseases [RR: 1.56 (95% CI: 1.14-2.14)], but had non-statistically significant attributable fraction of the total EDVs cost. CONCLUSIONS Exposure to heat and cold resulted in remarkable health costs. More resources and preparedness are needed to tackle such a challenge as our climate is rapidly changing.
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Affiliation(s)
- Yu Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dianxiu Ye
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Na Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Yan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yibin Cheng
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yonghong Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoyuan Yao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Borg MA, Xiang J, Anikeeva O, Pisaniello D, Hansen A, Zander K, Dear K, Sim MR, Bi P. Occupational heat stress and economic burden: A review of global evidence. ENVIRONMENTAL RESEARCH 2021; 195:110781. [PMID: 33516686 DOI: 10.1016/j.envres.2021.110781] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 11/22/2020] [Accepted: 01/19/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND The adverse effects of heat on workers' health and work productivity are well documented. However, the resultant economic consequences and productivity loss are less understood. This review aims to summarize the retrospective and potential future economic burden of workplace heat exposure in the context of climate change. METHODS Literature was searched from database inception to October 2020 using Embase, PubMed, and Scopus. Articles were limited to original human studies investigating costs from occupational heat stress in English. RESULTS Twenty studies met criteria for inclusion. Eighteen studies estimated costs secondary to heat-induced labor productivity loss. Predicted global costs from lost worktime, in US$, were 280 billion in 1995, 311 billion in 2010 (≈0.5% of GDP), 2.4-2.5 trillion in 2030 (>1% of GDP) and up to 4.0% of GDP by 2100. Three studies estimated heat-related healthcare expenses from occupational injuries with averaged annual costs (US$) exceeding 1 million in Spain, 1 million in Guangzhou, China and 250,000 in Adelaide, Australia. Low- and middle-income countries and countries with warmer climates had greater losses as a proportion of GDP. Greater costs per worker were observed in outdoor industries, medium-sized businesses, amongst males, and workers aged 25-44 years. CONCLUSIONS The estimated global economic burden of occupational heat stress is substantial. Climate change adaptation and mitigation strategies should be implemented to likely minimize future costs. Further research exploring the relationship between occupational heat stress and related expenses from lost productivity, decreased work efficiency and healthcare, and costs stratified by demographic factors, is warranted. Key messages. The estimated retrospective and future economic burden from occupational heat stress is large. Responding to climate change is crucial to minimize this burden. Analyzing heat-attributable occupational costs may guide the development of workplace heat management policies and practices as part of global warming strategies.
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Affiliation(s)
- Matthew A Borg
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Jianjun Xiang
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Olga Anikeeva
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Dino Pisaniello
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Alana Hansen
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Kerstin Zander
- Northern Institute, Charles Darwin University, Darwin, NT, 0909, Australia.
| | - Keith Dear
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, The Alfred Centre, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Peng Bi
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
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Rublee C, Dresser C, Giudice C, Lemery J, Sorensen C. Evidence-Based Heatstroke Management in the Emergency Department. West J Emerg Med 2021; 22:186-195. [PMID: 33856299 PMCID: PMC7972371 DOI: 10.5811/westjem.2020.11.49007] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/20/2020] [Indexed: 11/14/2022] Open
Abstract
Introduction Climate change is causing an increase in the frequency and intensity of extreme heat events, which disproportionately impact the health of vulnerable populations. Heatstroke, the most serious heat-related illness, is a medical emergency that causes multiorgan failure and death without intervention. Rapid recognition and aggressive early treatment are essential to reduce morbidity and mortality. The objective of this study was to evaluate current standards of care for the emergent management of heatstroke and propose an evidence-based algorithm to expedite care. Methods We systematically searched PubMed, Embase, and key journals, and reviewed bibliographies. Original research articles, including case studies, were selected if they specifically addressed the recognition and management of heatstroke in any prehospital, emergency department (ED), or intensive care unit population. Reviewers evaluated study quality and abstracted information regarding demographics, scenario, management, and outcome. Results In total, 63 articles met full inclusion criteria after full-text review and were included for analysis. Three key themes identified during the qualitative review process included recognition, rapid cooling, and supportive care. Rapid recognition and expedited external or internal cooling methods coupled with multidisciplinary management were associated with improved outcomes. Delays in care are associated with adverse outcomes. We found no current scalable ED alert process to expedite early goal-directed therapies. Conclusion Given the increased risk of exposure to heat waves and the time-sensitivity of the condition, EDs and healthcare systems should adopt processes for rapid recognition and management of heatstroke. This study proposes an evidence-based prehospital and ED heat alert pathway to improve early diagnosis and resource mobilization. We also provide an evidence-based treatment pathway to facilitate efficient patient cooling. It is hoped that this protocol will improve care and help healthcare systems adapt to changing environmental conditions.
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Affiliation(s)
- Caitlin Rublee
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Caleb Dresser
- Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts
| | - Catharina Giudice
- Los Angeles County and University of Southern California, Department of Emergency Medicine, Los Angeles, California
| | - Jay Lemery
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Cecilia Sorensen
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
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Morabito M, Messeri A, Crisci A, Pratali L, Bonafede M, Marinaccio A. Heat warning and public and workers' health at the time of COVID-19 pandemic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 738:140347. [PMID: 32570084 PMCID: PMC7301811 DOI: 10.1016/j.scitotenv.2020.140347] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 05/09/2023]
Abstract
The humanity is currently facing the COVID-19 pandemic challenge, the largest global health emergency after the Second World War. During summer months, many countries in the northern hemisphere will also have to counteract an imminent seasonal phenomenon, the management of extreme heat events. The novelty this year concerns that the world population will have to deal with a new situation that foresees the application of specific measures, including adjunctive personal protective equipment (i.e. facemasks and gloves), in order to reduce the potential transmission of the SARS-CoV-2 virus. These measures should help to decrease the risk of the infection transmission but will also represent an aggravating factor to counteract the heat effects on the population health both at occupational and environmental level. The use of a specific heat health warning system with personalized information based on individual, behavioural and environmental characteristics represents a necessary strategy to help a fast adaptation of the population at a time where the priority is to live avoiding SARS-CoV-2 infection.
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Affiliation(s)
- Marco Morabito
- Institute of BioEconomy, National Research Council, Florence, Italy; Centre of Bioclimatology, University of Florence, Florence, Italy.
| | - Alessandro Messeri
- Centre of Bioclimatology, University of Florence, Florence, Italy; Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
| | - Alfonso Crisci
- Institute of BioEconomy, National Research Council, Florence, Italy
| | - Lorenza Pratali
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, National Institute for Insurance against Accidents at Work, Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, National Institute for Insurance against Accidents at Work, Rome, Italy
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Xu R, Zhao Q, Coelho MSZS, Saldiva PHN, Abramson MJ, Li S, Guo Y. Socioeconomic level and associations between heat exposure and all-cause and cause-specific hospitalization in 1,814 Brazilian cities: A nationwide case-crossover study. PLoS Med 2020; 17:e1003369. [PMID: 33031393 PMCID: PMC7544074 DOI: 10.1371/journal.pmed.1003369] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 09/03/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Heat exposure, which will increase with global warming, has been linked to increased risk of a range of types of cause-specific hospitalizations. However, little is known about socioeconomic disparities in vulnerability to heat. We aimed to evaluate whether there were socioeconomic disparities in vulnerability to heat-related all-cause and cause-specific hospitalization among Brazilian cities. METHODS AND FINDINGS We collected daily hospitalization and weather data in the hot season (city-specific 4 adjacent hottest months each year) during 2000-2015 from 1,814 Brazilian cities covering 78.4% of the Brazilian population. A time-stratified case-crossover design modeled by quasi-Poisson regression and a distributed lag model was used to estimate city-specific heat-hospitalization association. Then meta-analysis was used to synthesize city-specific estimates according to different socioeconomic quartiles or levels. We included 49 million hospitalizations (58.5% female; median [interquartile range] age: 33.3 [19.8-55.7] years). For cities of lower middle income (LMI), upper middle income (UMI), and high income (HI) according to the World Bank's classification, every 5°C increase in daily mean temperature during the hot season was associated with a 5.1% (95% CI 4.4%-5.7%, P < 0.001), 3.7% (3.3%-4.0%, P < 0.001), and 2.6% (1.7%-3.4%, P < 0.001) increase in all-cause hospitalization, respectively. The inter-city socioeconomic disparities in the association were strongest for children and adolescents (0-19 years) (increased all-cause hospitalization risk with every 5°C increase [95% CI]: 9.9% [8.7%-11.1%], P < 0.001, in LMI cities versus 5.2% [4.1%-6.3%], P < 0.001, in HI cities). The disparities were particularly evident for hospitalization due to certain diseases, including ischemic heart disease (increase in cause-specific hospitalization risk with every 5°C increase [95% CI]: 5.6% [-0.2% to 11.8%], P = 0.060, in LMI cities versus 0.5% [-2.1% to 3.1%], P = 0.717, in HI cities), asthma (3.7% [0.3%-7.1%], P = 0.031, versus -6.4% [-12.1% to -0.3%], P = 0.041), pneumonia (8.0% [5.6%-10.4%], P < 0.001, versus 3.8% [1.1%-6.5%], P = 0.005), renal diseases (9.6% [6.2%-13.1%], P < 0.001, versus 4.9% [1.8%-8.0%], P = 0.002), mental health conditions (17.2% [8.4%-26.8%], P < 0.001, versus 5.5% [-1.4% to 13.0%], P = 0.121), and neoplasms (3.1% [0.7%-5.5%], P = 0.011, versus -0.1% [-2.1% to 2.0%], P = 0.939). The disparities were similar when stratifying the cities by other socioeconomic indicators (urbanization rate, literacy rate, and household income). The main limitations were lack of data on personal exposure to temperature, and that our city-level analysis did not assess intra-city or individual-level socioeconomic disparities and could not exclude confounding effects of some unmeasured variables. CONCLUSIONS Less developed cities displayed stronger associations between heat exposure and all-cause hospitalizations and certain types of cause-specific hospitalizations in Brazil. This may exacerbate the existing geographical health and socioeconomic inequalities under a changing climate.
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Affiliation(s)
- Rongbin Xu
- School of Public Health and Management, Binzhou Medical University, Yantai, China
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Qi Zhao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | - Michael J. Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Management, Binzhou Medical University, Yantai, China
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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31
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Wang Y, Liu Y, Ye D, Li N, Bi P, Tong S, Wang Y, Cheng Y, Li Y, Yao X. High temperatures and emergency department visits in 18 sites with different climatic characteristics in China: Risk assessment and attributable fraction identification. ENVIRONMENT INTERNATIONAL 2020; 136:105486. [PMID: 31991239 DOI: 10.1016/j.envint.2020.105486] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/20/2019] [Accepted: 01/11/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Health impacts of high temperatures on hospital emergency department visits (EDVs) have been less reported, especially from developing countries. OBJECTIVES To investigate high temperature-EDVs relationship in various regions with different climatic characteristics, to explore the regional differences, to identify vulnerable populations, and to provide scientific evidence for climate change adaptation strategies in China. METHODS Daily data on weather, air pollution and EDVs were collected from 18 sites in China from June to August during 2014-2017. A quasi-Poisson generalized additive regression model was applied to examine the high temperature-EDVs relationship in each site. Site-specific risks of EDVs were pooled using a random effect meta-analysis model. Stratified analyses were performed by gender, age-groups, cause-specific EDVs and regions. Attributable fractions of EDVs due to high temperatures were calculated in different regions. RESULTS 1 °C increase in daily mean temperature was associated with 1.07% (95% CI, 0.46-1.67%) increase in EDVs across all study regions. The negative health effects from high temperatures were worse for the people living in southern China, in subtropical monsoon climate zone or in counties, with percentage change of 1.96% (95% CI, 0.92-3.02%), 1.35% (95% CI, 0.95-1.76%) and 1.41% (95% CI, 0.48-2.34%), respectively. People under 18 were more vulnerable to high temperatures. Exposure to high temperatures increased EDVs risks from endocrine, respiratory, and digestive diseases and injury. The attributable fraction due to high temperatures was 8.64% for overall EDVs, 11.70% for the people living in southern China, 10.80% for people living in subtropical monsoon climate zone and 12.65% for the county population. CONCLUSIONS Exposure to high temperatures resulted in extra burden to China's already overloaded hospital emergency departments. More resources are needed to meet increasing demands and effective preventative measurements are warranted to tackle such a challenge. Further studies should pay more attention to both heat and cold-related EDVs risks and socioeconomic cost for better climate change adaptation.
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Affiliation(s)
- Yu Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dianxiu Ye
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Na Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Yan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yibin Cheng
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yonghong Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoyuan Yao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Park CY, Yoon EJ, Lee DK, Thorne JH. Integrating four radiant heat load mitigation strategies is an efficient intervention to improve human health in urban environments. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 698:134259. [PMID: 31514036 DOI: 10.1016/j.scitotenv.2019.134259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
Increasing heat in urban areas raises heat-related health risks. Green infrastructure and managing surface albedo can reduce the radiation exposure of pedestrians. However, selecting options among various radiant fluxes mitigation strategies is challenging, particularly due to potential interactions among options such as planting vegetation or changing surface albedos. We used a multi-strategies model for determining optimal design combinations for reducing mean radiant temperature (MRT) in urban environments across a range of costs and benefits. The solutions are developed by a non-dominated sorting genetic algorithm II (NSGA II) with a MRT simulator. We selected four MRT reduction strategies: tree planting, grass planting, albedo reduction of building walls, and albedo reduction of sidewalks. Model test results for a simulated street canyon show a wide range of optimal alternative plans considering the combination effects of the four strategies. While previous studies have focused on single options to reduce heat load, we found benefits were higher by using a combination of these strategies, which can provide synergistic benefits. These results provide useful information for decision makers confronting real world problems such as heat related mortality. Thermal-friendly design methods and green infrastructure will help the urban environment become sustainable and improve human health and well-being.
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Affiliation(s)
- Chae Yeon Park
- Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Eun Joo Yoon
- Center for Social and Environmental Systems Research, National Institute for Environmental Studies, 305-8506, 16-2 Onogawa, Tsukuba, Ibaraki, Japan
| | - Dong Kun Lee
- Research Institute of Agriculture Life Science, Seoul National University, Seoul 08826, Republic of Korea; Dept. of Landscape Architecture & Rural System Engineering, College of Agriculture Life Sciences, Seoul National University, Seoul 08826, Republic of Korea.
| | - James H Thorne
- Dept. of Environmental Science and Policy, University of California, One Shields Ave, Davis, CA 95616, United States of America
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Heat Health Prevention Measures and Adaptation in Older Populations-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224370. [PMID: 31717424 PMCID: PMC6888447 DOI: 10.3390/ijerph16224370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/29/2019] [Accepted: 11/06/2019] [Indexed: 11/25/2022]
Abstract
The population of older people is increasing at a rapid rate, with those 80 years and older set to triple by 2050. This systematic review aimed to examine older people’s perceptions and behaviours against existing heatwaves prevention measures and systematically categorize and analyse those measures using the Ottawa charter for health promotion framework. Peer-reviewed published literature between 22nd September 2006 and 24th April 2018 was retrieved, according to the PRISMA guidelines, from five different databases. Eighteen articles were finally included. There is a lack of published studies from developing countries. Results were categorized and analysed using the Ottawa charter five action areas. Mitigation strategies from current heat action plans are discussed and gaps are highlighted. A lack of systematic evaluation of heat action plans efficacy was identified. Older people are not demonstrating all recommended preventative measures during heatwaves. Support personnel and health professionals are not being pro-active enough in facilitating prevention of adverse effects from heatwaves. Governments are beginning to implement policy changes, but other recommended support measures outlined in the Ottawa charter are still lacking, and hence require further action. Linkage between specific components of heat action plans and outcomes cannot be ascertained; therefore, more systematic evaluation is needed.
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Abstract
Minimising the health harms of climate change and optimising universal health coverage will only be achieved through an integrated agenda and aligned solutions, say Renee Salas and Ashish Jha
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