The global need for smart heat-health warning systems

A study on the monitoring of heatwaves and bivariate frequency analysis based on mortality risk assessment in Wuhan, China

The increasingly frequent occurrence of urban heatwaves has become a significant threat to human health. To quantitatively analyze changes in heatwave characteristics and to investigate the return periods of future heatwaves in Wuhan City, China, this study extracted 9 heatwave definitions and divided them into 3 mortality risk levels to identify and analyze historical observations and future projections of heatwaves. The copula functions were employed to derive the joint distribution of heatwave severity and duration and to analyze the co-occurrence return periods. The results demonstrate the following. (1) As the concentration of greenhouse gas emissions increases, the severity of heatwaves intensifies, and the occurrence of heatwaves increases significantly; moreover, a longer duration of heatwaves correlated with higher risk levels in each emission scenario. (2) Increasing concentrations of greenhouse gas emissions result in significantly shorter heatwave co-occurrence return periods at each level of risk. (3) In the 3 risk levels under each emission scenario, the co-occurrence return periods for heatwaves become longer as heatwave severity intensifies and duration increases. Under the influence of climate change, regional-specific early warning systems for heatwaves are necessary and crucial for policymakers to reduce heat-related mortality risks in the population, especially among vulnerable groups.

Comprehensive evaluation framework for intervention on health effects of ambient temperature

Despite the existence of many interventions to mitigate or adapt to the health effects of climate change, their effectiveness remains unclear. Here, we introduce the Comprehensive Evaluation Framework for Intervention on Health Effects of Ambient Temperature to evaluate study designs and effects of intervention studies. The framework comprises three types of interventions: proactive, indirect, and direct, and four categories of indicators: classification, methods, scope, and effects. We trialed the framework by an evaluation of existing intervention studies. The evaluation revealed that each intervention has its own applicable characteristics in terms of effectiveness, feasibility, and generalizability scores. We expanded the framework's potential by offering a list of intervention recommendations in different scenarios. Future applications are then explored to establish models of the relationship between study designs and intervention effects, facilitating effective interventions to address the health effects of ambient temperature under climate change.

Global projections of heat exposure of older adults

The global population is aging at the same time as heat exposures are increasing due to climate change. Age structure, and its biological and socio-economic drivers, determine populations' vulnerability to high temperatures. Here we combine age-stratified demographic projections with downscaled temperature projections to mid-century and find that chronic exposure to heat doubles across all warming scenarios. Moreover, >23% of the global population aged 69+ will inhabit climates whose 95th percentile of daily maximum temperature exceeds the critical threshold of 37.5 °C, compared with 14% today, exposing an additional 177-246 million older adults to dangerous acute heat. Effects are most severe in Asia and Africa, which also have the lowest adaptive capacity. Our results facilitate regional heat risk assessments and inform public health decision-making.

Spatiotemporal characteristics and influencing factors for joint events of air pollution wave and cold wave in China

Climate change triggered more environmental extremes. The joint events of air pollution wave and cold wave showed higher health risks than independent events, but little evidence is available for the spatiotemporal features of their co-occurrence. To better understand and forecast the joint events, a method framework was developed in this study. The temporal trend and spatial distribution of count and duration for joint events were measured at each grid cell (0.5°×0.5°) by integrating the PM2.5 air pollution wave and cold wave. The generalized linear mixed model was used to screen influencing variables that took into account socioeconomic characteristics, meteorological variables, and annual PM2.5 levels. During 2000 and 2018, the average annual count of joint events was 4.1 ± 6.8 days and the average duration ranged from 1.0 to 9.7 days. High spatial heterogeneity was observed throughout China, with a significant increase in joint events observed in Xinjiang area (the largest province in China). The most average count of joint events was observed in Henan province (one of the most populous provinces), while the longest duration was in Chongqing (a municipality, one of the megacities). Areas with higher PM2.5 levels, prolonged air pollution wave, and cold wave durations would experience more joint events. These findings can assist China in locating vulnerable areas and establishing effective local early warning systems. The method framework offers broader perspectives on mitigating health risks associated with extreme events in other countries and regions.

Multilevel interventions as climate change adaptation response to protect maternal and child health: a scoping review protocol

INTRODUCTION

Growing evidence suggests that climate change-related extreme weather events adversely impact maternal and child health (MCH) outcomes, which requires effective, sustainable and culturally appropriate interventions at individual, community and policy levels to minimise these impacts. This scoping review proposes to map the evidence available on the type, characteristics and outcomes of multilevel interventions implemented as adaptational strategies to protect MCH from the possible adverse effects of climate change.

METHODS

The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings.

ETHICS AND DISSEMINATION

Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.

Evaluating the Applicability and Health Benefits of the Graded Heat Health Risk Early Warning Model - Jinan City, Shandong Province, China, 2022

What is already known about this topic?

The heat health early warning model serves as an effective strategy for reducing health risks related to heatwaves and improving population adaptability. Several high-income countries have taken the lead in conducting research and implementing measures aimed at safeguarding their populations.

What is added by this report?

The graded heat health risk early warning model (GHREWM) in Jinan City has demonstrated efficacy in safeguarding males, females, individuals aged above 75 years, and those with cardiopulmonary diseases. During the summer of 2022, the warning stage of GHREWM contributed to the prevention of 10.9 deaths per million individuals, concurrently averting health-related economic losses estimated at approximately 227 million Chinese Yuan (CNY).

What are the implications for public health practice?

The GHREWM has the potential to enhance cities' adaptability to climate change. It is crucial to incorporate additional adverse health endpoint data in the development of early warning models, as this will improve their applicability and protective efficacy.

Diabetes and climate change: current evidence and implications for people with diabetes, clinicians and policy stakeholders

Climate change will be a major challenge for the world's health systems in the coming decades. Elevated temperatures and increasing frequencies of heat waves, wildfires, heavy precipitation and other weather extremes can affect health in many ways, especially if chronic diseases are already present. Impaired responses to heat stress, including compromised vasodilation and sweating, diabetes-related comorbidities, insulin resistance and chronic low-grade inflammation make people with diabetes particularly vulnerable to environmental risk factors, such as extreme weather events and air pollution. Additionally, multiple pathogens show an increased rate of transmission under conditions of climate change and people with diabetes have an altered immune system, which increases the risk for a worse course of infectious diseases. In this review, we summarise recent studies on the impact of climate-change-associated risk for people with diabetes and discuss which individuals may be specifically prone to these risk conditions due to their clinical features. Knowledge of such high-risk groups will help to develop and implement tailored prevention and management strategies to mitigate the detrimental effect of climate change on the health of people with diabetes.