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Ren N, Huang H, Liu B, Wu C, Xiang J, Zhou Q, Kang S, Zhang X, Jiang Y. Interactive effects of atmospheric oxidising pollutants and heat waves on the risk of residential mortality. Glob Health Action 2024; 17:2313340. [PMID: 38381455 PMCID: PMC10883108 DOI: 10.1080/16549716.2024.2313340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/29/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND The impact of heat waves and atmospheric oxidising pollutants on residential mortality within the framework of global climate change has become increasingly important. OBJECTIVE In this research, the interactive effects of heat waves and oxidising pollutants on the risk of residential mortality in Fuzhou were examined. Methods We collected environmental, meteorological, and residential mortality data in Fuzhou from 1 January 2016, to 31 December 2021. We then applied a generalised additive model, distributed lagged nonlinear model, and bivariate three-dimensional model to investigate the effects and interactions of various atmospheric oxidising pollutants and heat waves on the risk of residential mortality. RESULTS Atmospheric oxidising pollutants increased the risk of residential mortality at lower concentrations, and O3 and Ox were positively associated with a maximum risk of 2.19% (95% CI: 0.74-3.66) and 1.29% (95% CI: 0.51-2.08). The risk of residential mortality increased with increasing temperature, with a strong and long-lasting effect and a maximum cumulative lagged effect of 1.11% (95% CI: 1.01, 1.23). Furthermore, an interaction between atmospheric oxidising pollutants and heat waves may have occurred: the larger effects in the longest cumulative lag time on residential mortality per 10 µg/m3 increase in O3, NO2 and Ox during heat waves compared to non-heat waves were [-3.81% (95% CI: -14.82, 8.63)]; [-0.45% (95% CI: -2.67, 1.81)]; [67.90% (95% CI: 11.55, 152.71)]; 16.37% (95% CI: 2.43, 32.20)]; [-3.00% (95% CI: -20.80, 18.79)]; [-0.30% (95% CI: -3.53, 3.04)]. The risk on heat wave days was significantly higher than that on non-heat wave days and higher than the separate effects of oxidising pollutants and heat waves. CONCLUSIONS Overall, we found some evidence suggesting that heat waves increase the impact of oxidising atmospheric pollutants on residential mortality to some extent.
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Affiliation(s)
- Nan Ren
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Huimin Huang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Baoying Liu
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Chuancheng Wu
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jianjun Xiang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Quan Zhou
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Shuling Kang
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Xiaoyang Zhang
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Yu Jiang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
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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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Dyer GMC, Khomenko S, Adlakha D, Anenberg S, Behnisch M, Boeing G, Esperon-Rodriguez M, Gasparrini A, Khreis H, Kondo MC, Masselot P, McDonald RI, Montana F, Mitchell R, Mueller N, Nawaz MO, Pisoni E, Prieto-Curiel R, Rezaei N, Taubenböck H, Tonne C, Velázquez-Cortés D, Nieuwenhuijsen M. Exploring the nexus of urban form, transport, environment and health in large-scale urban studies: A state-of-the-art scoping review. ENVIRONMENTAL RESEARCH 2024; 257:119324. [PMID: 38844028 DOI: 10.1016/j.envres.2024.119324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art account of large-scale urban health studies is required to shape future research priorities and equity- and evidence-informed policies. OBJECTIVES The purpose of this review was to synthesise evidence from large-scale urban studies focused on the interaction between urban form, transport, environmental exposures, and health. This review sought to determine common methodologies applied, limitations, and future opportunities for improved research practice. METHODS Based on a literature search, 2958 articles were reviewed that covered three themes of: urban form; urban environmental health; and urban indicators. Studies were prioritised for inclusion that analysed at least 90 cities to ensure broad geographic representation and generalisability. Of the initially identified studies, following expert consultation and exclusion criteria, 66 were included. RESULTS The complexity of the urban ecosystem on health was evidenced from the context dependent effects of urban form variables on environmental exposures and health. Compact city designs were generally advantageous for reducing harmful environmental exposure and promoting health, with some exceptions. Methodological heterogeneity was indicative of key urban research challenges; notable limitations included exposure and health data at varied spatial scales and resolutions, limited availability of local-level sociodemographic data, and the lack of consensus on robust methodologies that encompass best research practice. CONCLUSION Future urban environmental health research for evidence-informed urban planning and policies requires a multi-faceted approach. Advances in geospatial and AI-driven techniques and urban indicators offer promising developments; however, there remains a wider call for increased data availability at local-levels, transparent and robust methodologies of large-scale urban studies, and greater exploration of urban health vulnerabilities and inequities.
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Affiliation(s)
- Georgia M C Dyer
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Sasha Khomenko
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Deepti Adlakha
- Delft University of Technology, Mekelweg 5, 2628, Delft, Netherlands
| | - Susan Anenberg
- Environmental and Occupational Health Department, George Washington University, Milken Institute School of Public Health, 20052, New Hampshire Avenue, Washington, District of Colombia, United States
| | - Martin Behnisch
- Leibniz Institute of Ecological Urban and Regional Development, Weberpl 1, 01217, Dresden, Germany
| | - Geoff Boeing
- University of Southern California, 90007, Los Angeles, United States
| | - Manuel Esperon-Rodriguez
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia; School of Science, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1E 7HT, London, United Kingdom
| | - Haneen Khreis
- MRC Epidemiology Unit, Cambridge University, CB2 0AH, Cambridge, United Kingdom
| | - Michelle C Kondo
- USDA-Forest Service, Northern Research Station, 100 North 20th Street, Ste 205, 19103, Philadelphia, PA, United States
| | - Pierre Masselot
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1E 7HT, London, United Kingdom
| | - Robert I McDonald
- The Nature Conservancy, 4245 North Fairfax Drive Arlington, 22203, Virginia, United States
| | - Federica Montana
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Rich Mitchell
- Institute of Health and Wellbeing, University of Glasgow, 90 Byres Road, Glasgow, G20 0TY, United Kingdom
| | - Natalie Mueller
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - M Omar Nawaz
- Environmental and Occupational Health Department, George Washington University, Milken Institute School of Public Health, 20052, New Hampshire Avenue, Washington, District of Colombia, United States
| | - Enrico Pisoni
- European Commission, Joint Research Centre (JRC), 2749, Ispra, Italy
| | | | - Nazanin Rezaei
- University of California Santa Cruz, 1156 High Street, 95064, California, United States
| | - Hannes Taubenböck
- German Aerospace Centre (DLR), Earth Observation Center (EOC), 82234, Oberpfaffenhofen, Germany; Institute for Geography and Geology, Julius-Maximilians-Universität Würzburg, 97074, Würzburg, Germany
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Daniel Velázquez-Cortés
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain.
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Dadich A, Samaranayake P, Hurriyet H, Elliot C. Process improvement of a paediatric feeding clinic. Heliyon 2024; 10:e23150. [PMID: 38163113 PMCID: PMC10756986 DOI: 10.1016/j.heliyon.2023.e23150] [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: 04/17/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose The purpose of this study is to identify opportunities to improve processes within a paediatric feeding clinic to enhance timely patient access to healthcare through effective and efficient resource use. Design/methodology/approach The study involved three interrelated methods. First, de-identified feeding clinic data, collected over seven years, were analysed to understand patient appointments. Second, clinician workshops and the swim lane method were used to map feeding clinic processes. Third, root cause analysis was conducted to identify bottlenecks and identify improvement opportunities. Findings The results revealed three, poorly connected sub-processes within the feeding clinic - namely: the patient triaging and appointment scheduling or allocation process; the clinic reporting process; and the cancellation and rescheduling process. These sub-processes were poorly connected because of inadequate resources, few standardised processes, and limited coordination between the different processes. Consequently, patient appointments were typically delayed, and patient reports were not always completed in a timely manner. Processes within the paediatric feeding clinic could therefore be improved by using digital tools, patient portals and telehealth, online interventions, an automated appointment confirmation system, and/or an automated transcription of each appointment. Originality/value This is the first published study to apply business process management to a paediatric feeding clinic. By using three methods to clarify opportunities to improve clinic processes, it highlights the potential value of health information technology in this context. This evidence will enable health service managers to ensure that children with feeding difficulties have timely access to appropriate care.
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Affiliation(s)
- Ann Dadich
- School of Business, Western Sydney University, Australia
| | | | - Hilal Hurriyet
- School of Business, Western Sydney University, Australia
| | - Chris Elliot
- Department of Paediatrics, St George Hospital, Australia
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Zhao C, Pan Y, Wu H, Zhu Y. Quantifying the contribution of industrial zones to urban heat islands: Relevance and direct impact. ENVIRONMENTAL RESEARCH 2024; 240:117594. [PMID: 37926229 DOI: 10.1016/j.envres.2023.117594] [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: 08/27/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
Industrial production activities are an important source of urban heat emissions. Quantifying the contribution of industrial zones to urban heat islands (UHIs) is crucial for urban planning and management. However, few studies have explored the quantitative relationship between land surface temperature (LST) and urban industrial zones (UIZs) at the urban scale, especially the direct impact of industrial expansion or contraction on LST. Linyi City, the largest city in Shandong Province, was selected as the study area. This study aims to analyze the spatial-temporal variation in the UIZs in Linyi City from 2013 to 2022, focusing on the quantitative relationship between LST and UIZs. Using remote sensing images, a novel spectral index (called the BCCSI) was constructed to identify factory buildings. The performance of the BCCSI was validated using five existing indices and Google Earth images. Over the past 10 years, the UIZ area of Linyi has increased by 137.16 km2. The UIZs in Linyi are mainly distributed in counties near the urban center, and counties with large UIZ areas are also hotspots for UIZ changes. Moreover, we found that the contraction or expansion of UIZs has obvious effects on LST. After the contraction (or expansion) of UIZs, the LST decreased (or increased) by 0.48 °C (0.39 °C). In addition, we found that there is an exponential relationship between LST and the industrial unit area (P value less than 0.01). This research is valuable for environmental assessment and fine management of industrial cities.
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Affiliation(s)
- Chuanwu Zhao
- State Key Laboratory of Remote Sensing, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China; Key Laboratory of Environmental Change and Natural Disasters of Chinese Ministry of Education, Beijing Normal University, Beijing, 100875, China; Beijing Engineering Research Center for Global Land Remote Sensing Products, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China.
| | - Yaozhong Pan
- State Key Laboratory of Remote Sensing, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China; Key Laboratory of Environmental Change and Natural Disasters of Chinese Ministry of Education, Beijing Normal University, Beijing, 100875, China; Academy of Plateau Science and Sustainability, Qinghai Normal University, Xining, 810016, China.
| | - Hanyi Wu
- State Key Laboratory of Remote Sensing, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China; Key Laboratory of Environmental Change and Natural Disasters of Chinese Ministry of Education, Beijing Normal University, Beijing, 100875, China
| | - Yu Zhu
- State Key Laboratory of Remote Sensing, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China; Key Laboratory of Environmental Change and Natural Disasters of Chinese Ministry of Education, Beijing Normal University, Beijing, 100875, China
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Wu WJ, Hutton J, Zordan R, Ranse J, Crilly J, Tutticci N, English T, Currie J. Review article: Scoping review of the characteristics and outcomes of adults presenting to the emergency department during heatwaves. Emerg Med Australas 2023; 35:903-920. [PMID: 37788821 DOI: 10.1111/1742-6723.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 10/05/2023]
Abstract
As a result of climate change heatwaves are expected to increase in frequency and intensity and will have detrimental impacts on human health globally. EDs are often the critical point of care for acute heat illnesses and other conditions associated with heat exposure. Existing literature has focused on heatwave-related hospitalisation and mortality. This scoping review aimed to identify, evaluate and summarise current literature regarding patient characteristics and outcomes of ED admissions from heatwaves. A scoping review of the literature was conducted using six databases: Medline, EMBASE, EMCARE, CINAHL, PsycINFO, and Scopus, using MeSH terms and keywords related to 'heatwave' and 'Emergency Department'. Articles were included if they were: published in English from January 2000 to August 2021, related to ED, and examined high temperature periods consistent with heatwave criteria. Articles were appraised using the Mixed Methods Appraisal Tool (MMAT). Thirty-one studies were included, mostly from the United States, Australia, and France. The study designs include retrospective case analysis, case-control, and time-series analysis. Eight studies examined known heatwaves, 21 used different criteria to identify heatwave occurrence, and two focused on heat-related illness. The selected articles display a moderate-high quality on MMAT. ED admissions for both heat-related illnesses and other conditions increased during heatwaves, with up to 18.5 times risk increase. The risk was elevated for all population groups, and substantially in the elderly, male patients with certain comorbidities, medications, or lower socioeconomic status. Outcomes including hospitalisation and mortality rates after ED admissions showed positive associations with heatwaves. The heatwaves resulting from climate change will place increasing demands on EDs providing care for increasingly susceptible populations. Significant public heatwave planning across multiple sectors is required to reduce the risk of overwhelming EDs with these patients.
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Affiliation(s)
- Wendy Jingyi Wu
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennie Hutton
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Rachel Zordan
- Education and Learning, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Julia Crilly
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Naomi Tutticci
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Timothy English
- Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Currie
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Feng J, Cao D, Zheng D, Qian ZM, Huang C, Shen H, Liu Y, Liu Q, Sun J, Jiao G, Yang X, McMillin SE, Wang C, Lin H, Zhang X, Zhang S. Cold spells linked with respiratory disease hospitalization, length of hospital stay, and hospital expenses: Exploring cumulative and harvesting effects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:160726. [PMID: 36502973 DOI: 10.1016/j.scitotenv.2022.160726] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies have revealed the relationship between cold spells and morbidity and mortality due to respiratory diseases, while the detrimental effects of cold spells on the length of hospital stay and hospitalization expenses remain largely unknown. METHODS We collected hospitalization data for respiratory diseases in 11 cities of Shanxi, China during 2017-2019. In each case, exposure to meteorological variables and air pollution was estimated by the bilinear interpolation approach and inverse distance weighting method, respectively, and then averaged at the city level. Cold spells were defined as the daily mean temperature below the 10th, 7.5th, or 5th percentiles for at least 2 to 5 consecutive days. We applied distributed lag non-linear models combined with generalized additive models to assess cumulative effects and harvesting effects. RESULTS There were significant associations between cold spells and hospital admissions, length of hospital stay, and hospital expenses for respiratory diseases. Compared with the non-cold spell period, the overall (lag 0-21) cumulative risk of hospitalization for total respiratory diseases was 1.232 (95 % CI: 1.090, 1.394) on cold spell days, and the increased length of hospital stay and hospitalization expenses were 112.793 (95 % CI: 10.755, 214.830) days and 127.568 (95 % CI: 40.513, 214.624) thousand Chinese yuan. The overall cumulative risks of cold spells on total respiratory diseases and pneumonia were statistically significant. We further observed harvesting effects in the associations between cold spells and hospital admission, length of hospital stay, and hospitalization expenses for respiratory diseases. CONCLUSIONS Cumulative cold-spell exposure for up to three weeks is associated with hospitalization, length of hospital stay, and hospital expenses for respiratory diseases. The observed harmful effects of cold spells on respiratory diseases can be partly attributable to harvesting effects.
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Affiliation(s)
- Jin Feng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Dawei Cao
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Dashan Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 102200, China; Institute of Healthy China, Tsinghua University, Beijing 102200, China
| | - Huiqing Shen
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Yi Liu
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102200, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, Zhejiang, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing 102200, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing 102200, China
| | - Stephen Edward McMillin
- School of Social Work, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO 63103, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xinri Zhang
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China.
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
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Ruiz-Páez R, Díaz J, López-Bueno JA, Asensio C, Ascaso MS, Saez M, Luna MY, Barceló MA, Navas MA, Linares C. Short-term effects of air pollution and noise on emergency hospital admissions in Madrid and economic assessment. ENVIRONMENTAL RESEARCH 2023; 219:115147. [PMID: 36580986 DOI: 10.1016/j.envres.2022.115147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The aim of this study was to study the effect of air pollution and noise has on the population in Madrid Community (MAR) in the period 2013-2018, and its economic impact. METHODS Time series study analysing emergency hospital admissions in the MAR due to all causes (ICD-10: A00-R99), respiratory causes (ICD-10: J00-J99) and circulatory causes (ICD-10: I00-I99) across the period 2013-2018. The main independent variables were mean daily PM2.5, PM10, NO2, 8-h ozone concentrations, and noise. We controlled for meteorological variables, Public Holidays, seasonality, and the trend and autoregressive nature of the series, and fitted generalised linear models with a Poisson regression link to ascertain the relative risks and attributable risks. In addition, we made an economic assessment of these hospitalisations. RESULTS The following associations were found: NO2 with admissions due to natural (RR: 1.007, 95% CI: 1.004-1.011) and respiratory causes (RR: 1.012, 95% CI: 1.005-1.019); 8-h ozone with admissions due to natural (RR: 1.049, 95% CI: 1.014-1.046) and circulatory causes (RR: 1.088, 95% CI: 1.039-1.140); and diurnal noise (LAeq7-23h) with admissions due to natural (RR: 1.001, 95% CI: 1.001-1.002), respiratory (RR: 1.002, 95% CI: 1.001-1.003) and circulatory causes (RR: 1.003, 95% CI: 1.002-1.005). Every year, a total of 8246 (95% CI: 4580-11,905) natural-cause admissions are attributable to NO2, with an estimated cost of close on €120 million and 5685 (95% CI: 2533-8835) attributed to LAeq7-23h with an estimated cost of close on €82 million. CONCLUSIONS Nitrogen dioxide, ozone and noise are the main pollutants to which a large number of hospitalisations in the MAR are attributed, and are thus responsible for a marked deterioration in population health and high related economic impact.
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Affiliation(s)
| | - J Díaz
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain.
| | | | - C Asensio
- Universidad Politéctnica de Madrid. Grupo de Investigación en Instrumentación y Acústica Aplicada, Ctra. Valencia Km 7, Campus sur, 28031, Madrid, Spain
| | - M S Ascaso
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
| | - M Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M Y Luna
- Meteorological Statal Agency. (AEMET), Madrid, Spain
| | - M A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M A Navas
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
| | - C Linares
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
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9
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Dewi SP, Kasim R, Sutarsa IN, Hunter A, Dykgraaf SH. Effects of climate-related risks and extreme events on health outcomes and health utilization of primary care in rural and remote areas: a scoping review. Fam Pract 2023; 40:486-497. [PMID: 36718099 DOI: 10.1093/fampra/cmac151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Rural populations are at risk of climate-related impacts due to ecological and geographical determinants, potentially leading to greater morbidity and health utilization. They are often highly dependent on primary care services. However, no rural- or primary care specific synthesis of these issues has ever been conducted. This review aimed to identify, characterize, and summarize existing research on the effects of climate-related events on utilization and health outcomes of primary care in rural and remote areas and identify related adaptation strategies used in primary care to climate-related events. METHODS A scoping review following PRISMA-ScR guidelines was conducted, examining peer-reviewed English-language articles published up to 31 October 2022. Eligible papers were empirical studies conducted in primary care settings that involved climate-related events as exposures, and health outcomes or utilization as study outcomes. Two reviewers independently screened and extracted relevant information from selected papers. Data were analysed using content analysis and presented using a narrative approach. RESULTS We screened 693 non-duplicate papers, of those, 60 papers were analysed. Climate-related events were categorized by type, with outcomes described in terms of primary, secondary, and tertiary effects. Disruption of primary care often resulted from shortages in health resources. Primary care may be ill-prepared for climate-related events but has an important role in supporting the development of community. CONCLUSIONS Findings suggest various effects of climate-related events on primary care utilization and health outcomes in rural and remote areas. There is a need to prepare rural and remote primary care service before and after climate-related events.
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Affiliation(s)
- Sari Puspa Dewi
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia.,Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Rosny Kasim
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia
| | - I Nyoman Sutarsa
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia.,Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - Arnagretta Hunter
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Sally Hall Dykgraaf
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia
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10
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Huang Y, Song H, Cheng Y, Bi P, Li Y, Yao X. Heatwave and urinary hospital admissions in China: Disease burden and associated economic loss, 2014 to 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159565. [PMID: 36265638 DOI: 10.1016/j.scitotenv.2022.159565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/15/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Many studies have shown that heatwaves are associated with an increased prevalence of urinary diseases. However, few national studies have been undertaken in China, and none have considered the associated economic losses. Such information would be useful for health authorities and medical service providers to improve their policy-making and medical resource allocation decisions. OBJECTIVES To explore the association between heatwaves and hospital admissions for urinary diseases and assess the related medical costs and indirect economic losses in China from 2014 to 2019. METHODS Daily meteorological and hospital admission data from 2014 to 2019 were collected from 23 study sites with different climatic characteristics in China. We assessed the heatwave-hospitalization associations and evaluated the location-specific attributable fractions (AFs) of urinary-related hospital admissions due to heatwaves by using a time-stratified case-crossover method with a distributed lag nonlinear model. We then pooled the AFs in a meta-analysis and estimated the national excess disease burden and associated economic losses. We also performed stratified analyses by sex, age, climate zone, and urinary disease subtype. RESULTS A significant association between heatwaves and urinary-related hospital admissions was found with a relative risk of 1.090 (95 % confidence interval (CI): 1.050, 1.132). The pooled AF was 8.27 % (95%CI: 4.77 %, 11.63 %), indicating that heatwaves during the warm season (May to September) caused 248,364 urinary-related hospital admissions per year, with 2.42 (95%CI: 1.35, 3.45) billion CNY in economic losses, including 2.23 (95%CI: 1.29, 3.14) billion in direct losses and 0.19 (95%CI, 0.06, 0.31) billion in indirect losses, males, people aged 15-64 years, residents of temperate continental climate zones, and patients with urolithiasis were at higher risk. CONCLUSION Tailored community health campaigns should be developed and implemented to reduce the adverse health effects and economic losses of heatwave-related urinary diseases, especially in the context of climate change.
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Affiliation(s)
- Yushu Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hejia Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, South Australia, Australia
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoyuan Yao
- 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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11
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Xu H, Zhuang CC, Guan X, He X, Wang T, Wu R, Zhang Q, Huang W. Associations of climate variability driven by El Niño-southern oscillation with excess mortality and related medical costs in Chinese elderly. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158196. [PMID: 35995158 DOI: 10.1016/j.scitotenv.2022.158196] [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: 06/10/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Climate variability driven by El Niño-Southern Oscillation (ENSO) is a significant public health concern in parallel with global population aging; however, its role in healthy aging is less studied. We examined the longitudinal impacts of ENSO exposure on excess mortality and related medical costs in the elderly from 23 provinces of China. A total of 27,533 non-accidental all-cause deaths were recorded in 30,763 participants during 1998-2018. We found that both low and high levels of ENSO metrics over lags of 0-12 months were associated with increased mortality risks. Specifically, comparing the 10th percentile (-1.8) and 90th percentile (2.0) multivariate El Niño index (MEI) levels to the reference level with the minimum effect of MEI exposure, the risk of mortality was 1.87 (95 % confidence interval [CI], 1.75, 2.00) and 4.89 (95 % CI, 4.36, 5.49), respectively. ENSO exposure was also positively related to medical costs. Further, the associations were stronger among drinkers, lower-income participants, and those with higher blood pressure and heart rate measured at the most recent follow-ups. Our results suggested that ENSO exposure was capable of heightening mortality risks and medical burden among older elderly adults, highlighting that climate variability driven by ENSO could be a crucial determinant of healthy aging.
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Affiliation(s)
- Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine, Beijing 100191, China
| | - Castiel Chen Zhuang
- Peking University School of Economics, Beijing 100871, China; Department of Economics, University of Washington, Seattle, WA 98195, USA.
| | - Xinpeng Guan
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine, Beijing 100191, China
| | - Xinghou He
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine, Beijing 100191, China
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine, Beijing 100191, China
| | - Rongshan Wu
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Qinghong Zhang
- Department of Atmospheric and Oceanic Sciences, School of Physics, Peking University, Beijing 100871, China
| | - Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine, Beijing 100191, China
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12
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Adnan MSG, Dewan A, Botje D, Shahid S, Hassan QK. Vulnerability of Australia to heatwaves: A systematic review on influencing factors, impacts, and mitigation options. ENVIRONMENTAL RESEARCH 2022; 213:113703. [PMID: 35716815 DOI: 10.1016/j.envres.2022.113703] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/04/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Heatwaves have received major attention globally due to their detrimental effects on human health and the environment. The frequency, duration, and severity of heatwaves have increased recently due to changes in climatic conditions, anthropogenic forcing, and rapid urbanization. Australia is highly vulnerable to this hazard. Although there have been an increasing number of studies conducted in Australia related to the heatwave phenomena, a systematic review of heatwave vulnerability has rarely been reported in the literature. OBJECTIVES This study aims to provide a systematic and overarching review of the different components of heatwave vulnerability (e.g., exposure, sensitivity, and adaptive capacity) in Australia. METHODS A systematic review was conducted using the PRISMA protocol. Peer-reviewed English language articles published between January 2000 and December 2021 were selected using a combination of search keywords in Web of Science, Scopus, and PubMed. Articles were critically analyzed based on three specific heatwave vulnerability components: exposure, sensitivity, and adaptive capacity. RESULTS AND DISCUSSION A total of 107 articles meeting all search criteria were chosen. Although there has been an increasing trend of heat-related studies in Australia, most of these studies have concentrated on exposure and adaptive capacity components. Evidence suggests that the frequency, severity, and duration of heatwaves in Australian cities has been increasing, and that this is likely to continue under current climate change scenarios. This study noted that heatwave vulnerability is associated with geographical and climatic factors, space, time, socioeconomic and demographic factors, as well as the physiological condition of people. Various heat mitigation and adaptation measures implemented around the globe have proven to be efficient in reducing the impacts of heatwaves. CONCLUSION This study provides increased clarity regarding the various drivers of heatwave vulnerability in Australia. Such knowledge is crucial in informing extreme heat adaptation and mitigation planning.
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Affiliation(s)
- Mohammed Sarfaraz Gani Adnan
- Department of Urban and Regional Planning, Chittagong University of Engineering and Technology (CUET), Chittagong, 4319, Bangladesh; Environmental Change Institute, School of Geography and the Environment, University of Oxford, OX1 3QY, United Kingdom.
| | - Ashraf Dewan
- School of Earth and Planetary Sciences, Curtin University, Perth, WA, 6102, Australia
| | - Dirk Botje
- School of Earth and Planetary Sciences, Curtin University, Perth, WA, 6102, Australia
| | - Shamsuddin Shahid
- Department of Hydraulics & Hydrology, Faculty of Civil Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia
| | - Quazi K Hassan
- Department of Geomatics Engineering, University of Calgary, 2500 University Drive NW, Calgary Alberta, T2N 1N4, Canada
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13
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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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14
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Fatima SH, Rothmore P, Giles LC, Bi P. Outdoor ambient temperatures and occupational injuries and illnesses: Are there risk differences in various regions within a city? THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 826:153945. [PMID: 35189241 DOI: 10.1016/j.scitotenv.2022.153945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 06/14/2023]
Abstract
Increased risk of occupational injuries and illnesses (OI) is associated with hot ambient temperatures. However, the existing evidence of risk estimation is limited to large regions at the city or provincial scales. For effective and localized occupational health risk management, spatio-temporal analysis should be carried out at the intra-city level to identify high-risk areas within cities. This study examined the exposure-response relationship between ambient temperatures and OI at the intra-city scale in Greater Adelaide, Australia. Vulnerable groups of workers, in terms of workers' characteristics, the nature of their work, and workplace characteristics were identified. Further, the projected risk of OI was quantified in various climate change scenarios. The temperature-OI association was estimated using a time-series study design combined with Distributed Lag Non-linear Models. Daily workers' compensation claims (2005-2018) were merged with 5 km gridded meteorological data of maximum temperature (°C) at Statistical Area Level 3 in Greater Adelaide. Region-wise subgroup analyses were conducted to identify vulnerable groups of workers. Future projections (2006-2100) were conducted using downscaled climate projections and the risk was quantified using log-linear extrapolation. The analyses were performed in R 4.1.0. The overall OI risk was 16.7% (95%CI: 10.8-23.0) at moderate heat (90th percentile) and increased to 25.0% (95%CI: 16.4-34.2) at extreme heat (99th percentile). Northern Adelaide had a higher risk of OI for all types of workers at moderate heat, while western regions had a high risk for indoor industries. Southern and eastern regions had a higher OI risk for males, older workers, and outdoor industries at extreme heat. The projected risk of OI is estimated to increase from 20.8% (95%CI: -0.2-46.3) in 2010s to 22.9% (95%CI: -8.0-64.1) by 2050s. Spatio-temporal risk assessment at the intra-city scale can help us identify high-risk areas, where targeted interventions can be efficiently employed to reduce the socio-economic burden of OI.
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Affiliation(s)
- Syeda Hira Fatima
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Paul Rothmore
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lynne C Giles
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
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de Schrijver E, Bundo M, Ragettli MS, Sera F, Gasparrini A, Franco OH, Vicedo-Cabrera AM. Nationwide Analysis of the Heat- and Cold-Related Mortality Trends in Switzerland between 1969 and 2017: The Role of Population Aging. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:37001. [PMID: 35262415 PMCID: PMC8906252 DOI: 10.1289/ehp9835] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Because older adults are particularly vulnerable to nonoptimal temperatures, it is expected that the progressive population aging will amplify the health burden attributable to heat and cold due to climate change in future decades. However, limited evidence exists on the contribution of population aging on historical temperature-mortality trends. OBJECTIVES We aimed to a) assess trends in heat- and cold-related mortality in Switzerland between 1969 and 2017 and b) to quantify the contribution of population aging to the observed patterns. METHODS We collected daily time series of all-cause mortality by age group (<65, 65-79, and 80 y and older) and mean temperature for each Swiss municipality (1969-2017). We performed a two-stage time-series analysis with distributed lag nonlinear models and multivariate longitudinal meta-regression to obtain temperature-mortality associations by canton, decade, and age group. We then calculated the corresponding excess mortality attributable to nonoptimal temperatures and compared it to the estimates obtained in a hypothetical scenario of no population aging. RESULTS Between 1969 and 2017, heat- and cold-related mortality represented 0.28% [95% confidence interval (CI): 0.18, 0.37] and 8.91% (95% CI: 7.46, 10.21) of total mortality, which corresponded to 2.4 and 77 deaths per 100,000 people annually, respectively. Although mortality rates for heat slightly increased over time, annual number of deaths substantially raised up from 74 (12;125) to 181 (39;307) between 1969-78 and 2009-17, mostly driven by the ≥80-y-old age group. Cold-related mortality rates decreased across all ages, but annual cold-related deaths still increased among the ≥80, due to the increase in the population at risk. We estimated that heat- and cold-related deaths would have been 52.7% and 44.6% lower, respectively, in the most recent decade in the absence of population aging. DISCUSSION Our findings suggest that a substantial proportion of historical temperature-related impacts can be attributed to population aging. We found that population aging has attenuated the decrease in cold-related mortality and amplified heat-related mortality. https://doi.org/10.1289/EHP9835.
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Affiliation(s)
- Evan de Schrijver
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Graduate school of Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Marvin Bundo
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Graduate school of Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Martina S. Ragettli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Francesco Sera
- Department of Statistics, Informatics, Applications, University of Florence, Florence, Italy
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Ana M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
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16
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Cao D, Zheng D, Qian ZM, Shen H, Liu Y, Liu Q, Sun J, Zhang S, Jiao G, Yang X, Vaughn MG, Wang C, Zhang X, Lin H. Ambient sulfur dioxide and hospital expenditures and length of hospital stay for respiratory diseases: A multicity study in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 229:113082. [PMID: 34929503 DOI: 10.1016/j.ecoenv.2021.113082] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ambient sulfur dioxide (SO2) has been associated with morbidity and mortality of respiratory diseases, however, its effect on length of hospital stays (LOS) and cost for these diagnoses remain unclear. METHODS We collected hospital admission information for respiratory diseases from all 11 cities in the Shanxi Province of China during 2017-2019. We assessed individual-level exposure by using an inverse distance weighting approach based on geocoded residential addresses. A generalized additive model was built to delineate city-specific effects of SO2 on hospitalization, hospital expenditure, and length of hospital stay for respiratory diseases. The overall effects were obtained by random-effects meta-analysis. We further estimated the respiratory burden attributable to SO2 by comparing different reference concentrations. RESULTS We observed significant effects of SO2 exposure on respiratory diseases. At the provincial level, each 10 μg/m3 increase in SO2 on lag03 was associated with a 0.63% (95% CI: 0.14-0.11) increase in hospital admission, an increase of 4.56 days (95% CI: 1.16-7.95) of hospital stay, and 3647.97 renminbi (RMB, Chinese money) (95% CI: 1091.05-6204.90) in hospital cost. We estimated about 6.13 (95% CI: 1.33-11.10) thousand hospital admissions, 65.77 million RMB (95% CI: 19.67-111.87) in hospital expenditure, and 82.13 (95% CI: 20.87-143.40) thousand days of hospital stay could have potentially been avoided had the daily SO2 concentrations been reduced to WHO's reference concentration (40 µg/m3). Variable values in correspondence with this reference concentration could reduce the hospital cost and LOS of each case by 52.67 RMB (95% CI: 15.75-89.59) and 0.07 days (95% CI: 0.02-0.117). CONCLUSION This study provides evidence that short-term ambient SO2 exposure is an important risk factor of respiratory diseases, indicating that continually tightening policies to reduce SO2 levels could effectively reduce respiratory disease burden in Shanxi Province.
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Affiliation(s)
- Dawei Cao
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dashan Zheng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Huiqing Shen
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yi Liu
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Shiyu Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing, China
| | - Michael G Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO 631034, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xinri Zhang
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Hualiang Lin
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.
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17
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Williams S, Nitschke M, Wondmagegn BY, Tong M, Xiang J, Hansen A, Nairn J, Karnon J, Bi P. Evaluating cost benefits from a heat health warning system in Adelaide, South Australia. Aust N Z J Public Health 2021; 46:149-154. [PMID: 34939708 DOI: 10.1111/1753-6405.13194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/01/2021] [Accepted: 11/01/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To examine the cost benefits of a heat health warning system (HHWS) in South Australia. METHODS Information from key agencies was used to estimate the costs associated with the South Australian HHWS, including for three targeted public health interventions. Health cost savings were estimated based on previously reported HHWS-attributable reductions in hospital and emergency department (ED) admissions and ambulance callouts. RESULTS The estimated cost for a one-week activation of the HHWS was AU$593,000. Activation costs compare favourably with the potential costs averted through HHWS-attributable reductions in hospital admissions and ambulance callouts with an estimated benefit-cost ratio of 2.0-3.3. CONCLUSIONS On the basis of estimated cost benefit, the South Australian HHWS is a no-regret public health response to heatwaves. Implications for public health: As global temperatures rise there are likely to be significant health impacts from more frequent and intense heatwaves. This study indicates that HHWSs incorporating targeted supports for vulnerable groups are likely to be cost-effective public health interventions.
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Affiliation(s)
- Susan Williams
- School of Public Health, The University of Adelaide, Adelaide, South Australia
| | - Monika Nitschke
- South Australian Department for Health and Wellbeing, Adelaide, South Australia
| | | | - Michael Tong
- School of Public Health, The University of Adelaide, Adelaide, South Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, South Australia
| | - Alana Hansen
- School of Public Health, The University of Adelaide, Adelaide, South Australia
| | - John Nairn
- South Australian Bureau of Meteorology, Adelaide, South Australia
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia
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18
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Cao D, Li D, Wu Y, Qian ZM, Liu Y, Liu Q, Sun J, Guo Y, Zhang S, Jiao G, Yang X, Wang C, McMillin SE, Zhang X, Lin H. Ambient PM 2.5 exposure and hospital cost and length of hospital stay for respiratory diseases in 11 cities in Shanxi Province, China. Thorax 2021; 76:thoraxjnl-2020-215838. [PMID: 34088786 DOI: 10.1136/thoraxjnl-2020-215838] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 04/09/2021] [Accepted: 05/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Few studies have examined the effects of ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) on hospital cost and length of hospital stay for respiratory diseases in China. METHODS We estimated ambient air pollution exposure for respiratory cases through inverse distance-weighted averages of air monitoring stations based on their residential address and averaged at the city level. We used generalised additive models to quantify city-specific associations in 11 cities in Shanxi and a meta-analysis to estimate the overall effects. We further estimated respiratory burden attributable to PM2.5 using the standards of WHO (25 µg/m3) and China (75 µg/m3) as reference. RESULTS Each 10 µg/m3 increase in lag03 PM2.5 corresponded to 0.53% (95% CI: 0.33% to 0.73%) increase in respiratory hospitalisation, an increment of 3.75 thousand RMB (95% CI: 1.84 to 5.670) in hospital cost and 4.13 days (95% CI: 2.51 to 5.75) in length of hospital stay. About 9.7 thousand respiratory hospitalisations, 132 million RMB in hospital cost and 145 thousand days of hospital stay could be attributable to PM2.5 exposures using WHO's guideline as reference. We estimated that 193 RMB (95% CI: 95 to 292) in hospital cost and 0.21 days (95% CI: 0.13 to 0.30) in hospital stay could be potentially avoidable for an average respiratory case. CONCLUSION Significant respiratory burden could be attributable to PM2.5 exposures in Shanxi Province, China. The results need to be factored into impact assessment of air pollution policies to provide a more complete indication of the burden addressed by the policies.
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Affiliation(s)
- Dawei Cao
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dongyan Li
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Yi Liu
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Xinri Zhang
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
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