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Chen S, Liu D, Huang L, Guo C, Gao X, Xu Z, Yang Z, Chen Y, Li M, Yang J. Global associations between long-term exposure to PM 2.5 constituents and health: A systematic review and meta-analysis of cohort studies. JOURNAL OF HAZARDOUS MATERIALS 2024; 474:134715. [PMID: 38838524 DOI: 10.1016/j.jhazmat.2024.134715] [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: 01/19/2024] [Revised: 05/10/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
Existing studies on the most impactful component remain controversial, hindering the optimization of future air quality standards that concerns particle composition. We aimed to summarize the health risk associated with PM2.5 components and identify those components with the greatest health risk. We performed a meta-analysis to quantify the combined health effects of PM2.5 components, and used the meta-smoothing to produce the pooled concentration-response (C-R) curves. Out of 8954 initial articles, 80 cohort studies met the inclusion criteria, including a total of 198.08 million population. The pooled C-R curves demonstrated approximately J-shaped association between total mortality and exposure to BC, and NO3-, but U-shaped and inverted U-shaped relationship withSO42- and OC, respectively. In addition, this study found that exposure to various elements, including BC,SO42-NO3-, NH4+, Zn, Ni, and Si, were significantly associated with an increased risk of total mortality, with Ni presenting the largest estimate. And exposure to NO3-, Zn, and Si was positively associated with an increased risk of respiratory mortality, while exposure to BC, SO42-, and NO3- showed a positive association with risk of cardiovascular mortality. For health outcome of morbidity, BC was notably associated with a higher incidence of asthma, type 2 diabetes and stroke. Subgroup analysis revealed a higher susceptibility to PM2.5 components in Asia compared to Europe and North America, and females showed a higher vulnerability. Given the significant health effects of PM2.5 components, governments are advised to introduce them in regional monitoring and air quality control guidelines. ENVIRONMENTAL IMPLICATION: PM2.5 is a complex mixture of chemical components from various sources, and each component has unique physicochemical properties and uncertain toxicity, posing significant threat to public health. This study systematically reviewed cohort studies on the association between long-term exposure to 13 PM2.5 components and the risk of morbidity and mortality. And we applied the meta-smoothing approach to establish the pooled concentration-response associations between PM2.5 components and mortality globally. Our findings will provide strong support for PM2.5 components monitoring and the improvement of air quality-related regulations. This will aid in helping to enhance health intervention strategies and mitigating public exposure to detrimental particulate matter.
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Affiliation(s)
- Sujuan Chen
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, China; School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Di Liu
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Lin Huang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Cui Guo
- Department of Urban Planning and Design, Faculty of Architecture, the University of Hong Kong, Hong Kong SAR
| | - Xiaoke Gao
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yu Chen
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Mengmeng Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jun Yang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, China; School of Public Health, Guangzhou Medical University, Guangzhou 511436, China.
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Tiitta I, Cubelo F, McDermott-Levy R, Jaakkola JJK, Kuosmanen L. Climate change integration in nursing education: A scoping review. NURSE EDUCATION TODAY 2024; 139:106210. [PMID: 38643656 DOI: 10.1016/j.nedt.2024.106210] [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: 01/09/2024] [Revised: 03/26/2024] [Accepted: 04/07/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND The environmental impacts of climate change such as extreme weather, affects human physical and mental health; therefore, including climate change and health is important in nursing education. Despite the recognition of the link between climate change and health, this important knowledge has not yet been systematically integrated into nursing curricula, highlighting the need for immediate action to prepare nurses for these emerging human health challenges. OBJECTIVES The objective of this review was to gain an overview of the existing literature exploring climate change in nursing curricula and answer following questions: DESIGN: Scoping review. METHODS A protocol was created and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-SrC). Five data bases were searched: CINAHL, Academic Search Premier, PubMed, Scopus and Cochraine, in addition to databases, grey literature was searched from different sources (reference lists, Google). A total of 1055 articles were derived from the search and 47 articles were included in this review. After selection results from selected studies on educational interventions and climate change education, and opinion pieces were charted, followed by a team review and consensus on the findings. CONCLUSION This review shows the importance of integrating the topic of climate change into nursing curricula. This integration of climate change-related content into nursing curricula is essential for preparing students, not just for their future roles in healthcare, but also their role in policy and climate justice. These results also reflect strong support from students for that integration. But while progress has been made, further research is essential to evaluate the impacts of these teaching strategies on nursing education.
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Affiliation(s)
- Iira Tiitta
- University of Eastern Finland, Department of Nursing Science, Finland.
| | - Floro Cubelo
- University of Eastern Finland, Department of Nursing Science, Finland; Oulu University of Applied Sciences, Finland.
| | - Ruth McDermott-Levy
- Villanova University, M. Louise Fitzpatrick College of Nursing, United States of America.
| | | | - Lauri Kuosmanen
- University of Eastern Finland, Department of Nursing Science, Finland.
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3
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Jones EM, Venkatachalam AM, Ifejika NL. Weathering the storm: Effect of climate change on acute stroke care and stroke rehabilitation. PM R 2024. [PMID: 39016015 DOI: 10.1002/pmrj.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 07/18/2024]
Abstract
Climate change has deleterious effects on stroke recovery, disproportionately affecting populations with increased stroke incidence. These effects start prior to the acute care hospitalization, precipitated by environmental etiologies and are sustained throughout the life course of stroke survivors. Health care practitioners play a critical role in identifying these concerns and mitigating their impact through effective strategies at the patient level, interventions at the community level, and advocacy at the state and federal level. As the experts on improvement in function, quality of life, and the mitigation of disability, physiatrists have the opportunity to lead efforts in this space for stroke survivors and their caregivers.
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Affiliation(s)
- Erica M Jones
- Department of Neurology, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - Nneka L Ifejika
- Department of Neurology, UT Southwestern Medical Center, Dallas, Texas, USA
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
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Bonell A, Ioannou LG, Hirst JE, Flouris A. Understanding the physiological and biological response to ambient heat exposure in pregnancy: protocol for a systematic review and meta-analysis. BMJ Open 2024; 14:e085314. [PMID: 38969375 PMCID: PMC11227802 DOI: 10.1136/bmjopen-2024-085314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/21/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Climate change increases not only the frequency, intensity and duration of extreme heat events but also annual temperatures globally, resulting in many negative health effects, including harmful effects on pregnancy and pregnancy outcomes. As temperatures continue to increase precipitously, there is a growing need to understand the underlying biological pathways of this association. This systematic review will focus on maternal, placental and fetal changes that occur in pregnancy due to environmental heat stress exposure, in order to identify the evidence-based pathways that play a role in this association. METHODS AND ANALYSIS We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search PubMed and Ovid Embase databases from inception using tested and validated search algorithms. Inclusion of any studies that involve pregnant women and have measured environmental heat stress exposure and either maternal, placental or fetal physiological or biochemical changes and are available in English. Modelling studies or those with only animals will be excluded. The risk of bias will be assessed using the Office of Health Assessment and Translation tool. Abstract screening, data extraction and risk of bias assessment will be conducted by two independent reviewers.Environmental parameters will be reported for each study and where possible these will be combined to calculate a heat stress indicator to allow comparison of exposure between studies. A narrative synthesis will be presented following standard guidelines. Where outcome measures have at least two levels of exposure, we will conduct a dose-response meta-analysis should there be at least three studies with the same outcome. A random effects meta-analysis will be conducted where at least three studies give the same outcome. ETHICS AND DISSEMINATION This systematic review and meta-analysis does not require ethical approval. Dissemination will be through peer-reviewed journal publication and presentation at international conferences/interest groups. PROSPERO REGISTRATION NUMBER CRD42024511153.
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Affiliation(s)
- Ana Bonell
- Medical Research Council Unit The Gambia, London School of Hygiene & Tropical Medicine, London, UK
| | - Leonidas G Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Jane Elizabeth Hirst
- The George Institute for Global Health, Imperial College London, London, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Andreas Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
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5
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Lawaczeck L, Rudolph J, Norz V, Tsaur I, Rausch S. The role of planetary health in urologic oncology. Expert Rev Anticancer Ther 2024; 24:513-523. [PMID: 38709157 DOI: 10.1080/14737140.2024.2350631] [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: 01/22/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Climate change and global warming are an omnipresent topic in our daily lives. Planetary health and oncology represent two critical domains within the broader spectrum of healthcare, each addressing distinct yet interconnected aspects of human well-being. We are encouraged to do our part in saving our planet. This should include the decisions we make in our professional life, especially in uro-oncology, as the healthcare sector significantly contributes to environmental pollution. AREAS COVERED There are many aspects that can be addressed in the healthcare sector in general, as there are structural problems in terms of energy consumption, water waste, therapeutic techniques, transportation and drug manufacturing, as well as in uro-oncology specific areas. For example, the use of different surgical techniques, forms of anesthesia and the use of disposable or reusable instruments, each has a different impact on our environment. The literature search was carried out using PubMed, a medical database. EXPERT OPINION We are used to making decisions based on the best outcome for patients without considering the impact that each decision can have on the environment. In the present article, we outline options and choices for a more climate-friendly approach in urologic oncology.
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Affiliation(s)
- Laura Lawaczeck
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Julia Rudolph
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Valentina Norz
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Igor Tsaur
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Steffen Rausch
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
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Hu K, Wang S, Fei F, Song J, Chen F, Zhao Q, Shen Y, Fu J, Zhang Y, Cheng J, Zhong J, Yang X, Wu J. Modifying temperature-related cardiovascular mortality through green-blue space exposure. ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY 2024; 20:100408. [PMID: 38560758 PMCID: PMC10979139 DOI: 10.1016/j.ese.2024.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Green-blue spaces (GBS) are pivotal in mitigating thermal discomfort. However, their management lacks guidelines rooted in epidemiological evidence for specific planning and design. Here we show how various GBS types modify the link between non-optimal temperatures and cardiovascular mortality across different thermal extremes. We merged fine-scale population density and GBS data to create novel GBS exposure index. A case time series approach was employed to analyse temperature-cardiovascular mortality association and the effect modifications of type-specific GBSs across 1085 subdistricts in south-eastern China. Our findings indicate that both green and blue spaces may significantly reduce high-temperature-related cardiovascular mortality risks (e.g., for low (5%) vs. high (95%) level of overall green spaces at 99th vs. minimum mortality temperature (MMT), Ratio of relative risk (RRR) = 1.14 (95% CI: 1.07, 1.21); for overall blue spaces, RRR = 1.20 (95% CI: 1.12, 1.29)), while specific blue space types offer protection against cold temperatures (e.g., for the rivers at 1st vs MMT, RRR = 1.17 (95% CI: 1.07, 1.28)). Notably, forests, parks, nature reserves, street greenery, and lakes are linked with lower heat-related cardiovascular mortality, whereas rivers and coasts mitigate cold-related cardiovascular mortality. Blue spaces provide greater benefits than green spaces. The severity of temperature extremes further amplifies GBS's protective effects. This study enhances our understanding of how type-specific GBS influences health risks associated with non-optimal temperatures, offering valuable insights for integrating GBS into climate adaptation strategies for maximal health benefits.
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Affiliation(s)
- Kejia Hu
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, 310058, China
| | - Shiyi Wang
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Jinglu Song
- Department of Urban Planning and Design, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Feng Chen
- Zhejiang Institute of Meteorological Sciences, Hangzhou, 310008, China
| | - Qi Zhao
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Yujie Shen
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Jingqiao Fu
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Jian Cheng
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Xuchao Yang
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Jiayu Wu
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
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7
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Dimitrova A, Dimitrova A, Mengel M, Gasparrini A, Lotze-Campen H, Gabrysch S. Temperature-related neonatal deaths attributable to climate change in 29 low- and middle-income countries. Nat Commun 2024; 15:5504. [PMID: 38951496 PMCID: PMC11217431 DOI: 10.1038/s41467-024-49890-x] [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: 10/09/2023] [Accepted: 06/19/2024] [Indexed: 07/03/2024] Open
Abstract
Exposure to high and low ambient temperatures increases the risk of neonatal mortality, but the contribution of climate change to temperature-related neonatal deaths is unknown. We use Demographic and Health Survey (DHS) data (n = 40,073) from 29 low- and middle-income countries to estimate the temperature-related burden of neonatal deaths between 2001 and 2019 that is attributable to climate change. We find that across all countries, 4.3% of neonatal deaths were associated with non-optimal temperatures. Climate change was responsible for 32% (range: 19-79%) of heat-related neonatal deaths, while reducing the respective cold-related burden by 30% (range: 10-63%). Climate change has impacted temperature-related neonatal deaths in all study countries, with most pronounced climate-induced losses from increased heat and gains from decreased cold observed in countries in sub-Saharan Africa. Future increases in global mean temperatures are expected to exacerbate the heat-related burden, which calls for ambitious mitigation and adaptation measures to safeguard the health of newborns.
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Affiliation(s)
- Asya Dimitrova
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany.
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Anna Dimitrova
- Scripps Institution of Oceanography, University of California, San Diego, CA, 92037, USA
| | - Matthias Mengel
- Research Department 3, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Hermann Lotze-Campen
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
- Department of Agricultural Economics, Faculty of Life Sciences, Humboldt University of Berlin, Berlin, Germany
| | - Sabine Gabrysch
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
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8
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Wan K, Hajat S, Doherty RM, Feng Z. Integrating Shared Socioeconomic Pathway-informed adaptation into temperature-related mortality projections under climate change. ENVIRONMENTAL RESEARCH 2024; 251:118731. [PMID: 38492839 DOI: 10.1016/j.envres.2024.118731] [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: 01/16/2024] [Revised: 03/02/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Abstract
The extent to which populations will successfully adapt to continued warming temperatures will be a crucial factor in determining future health burdens. Previous health impact assessments of future temperature-related mortality burdens mostly disregard adaptation or make simplistic assumptions. We apply a novel evidence-based approach to model adaptation that takes into account the fact that adaptation potential is likely to vary at different temperatures. Temporal changes in age-specific mortality risk associated with low and high temperatures were characterised for Scotland between 1974 and 2018 using temperature-specific RR ratios to reflect past changes in adaptive capacity. Three scenarios of future adaption were constructed consistent with the SSPs. These adaptation projections were combined with climate and population projections to estimate the mortality burdens attributable to high (above the 90th percentile of the historical temperature distribution) and low (below the 10th percentile) temperatures up to 2080 under five RCP-SSP scenarios. A decomposition analysis was conducted to attribute the change in the mortality burden into adaptation, climate and population. In 1980-2000, the heat burden (21 deaths/year) was smaller than the colder burden (312 deaths/year). In the 2060-2080 period, the heat burden was projected to be the highest under RCP8.5-SSP5 (1285 deaths/year), and the cold burden was the highest under RCP4.5-SSP4 (320 deaths/year). The net burden was lowest under RCP2.6-SSP1 and highest under RCP8.5-SSP5. Improvements in adaptation was the largest factor reducing the cold burden under RCP2.6-SSP1 whilst temperature increase was the biggest factor contributing to the high heat burdens under RCP8.5-SSP5. Ambient heat will become a more important health determinant than cold in Scotland under all climate change and socio-economic scenarios. Adaptive capacity will not fully counter projected increases in heat deaths, underscoring the need for more ambitious climate mitigation measures for Scotland and elsewhere.
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Affiliation(s)
- Kai Wan
- School of Geosciences, University of Edinburgh, Edinburgh, UK; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth M Doherty
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Zhiqiang Feng
- School of Geosciences, University of Edinburgh, Edinburgh, UK; Scottish Centre for Administrative Data Research, School of Geosciences, University of Edinburgh, Drummond Street, Edinburgh, UK
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9
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Hundessa S, Huang W, Zhao Q, Wu Y, Wen B, Alahmad B, Armstrong B, Gasparrini A, Sera F, Tong S, Madureira J, Kyselý J, Schwartz J, Vicedo-Cabrera AM, Hales S, Johnson A, Li S, Guo Y. Global and Regional Cardiovascular Mortality Attributable to Nonoptimal Temperatures Over Time. J Am Coll Cardiol 2024; 83:2276-2287. [PMID: 38839202 DOI: 10.1016/j.jacc.2024.03.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND The association between nonoptimal temperatures and cardiovascular mortality risk is recognized. However, a comprehensive global assessment of this burden is lacking. OBJECTIVES The goal of this study was to assess global cardiovascular mortality burden attributable to nonoptimal temperatures and investigate spatiotemporal trends. METHODS Using daily cardiovascular deaths and temperature data from 32 countries, a 3-stage analytical approach was applied. First, location-specific temperature-mortality associations were estimated, considering nonlinearity and delayed effects. Second, a multivariate meta-regression model was developed between location-specific effect estimates and 5 meta-predictors. Third, cardiovascular deaths associated with nonoptimal, cold, and hot temperatures for each global grid (55 km × 55 km resolution) were estimated, and temporal trends from 2000 to 2019 were explored. RESULTS Globally, 1,801,513 (95% empirical CI: 1,526,632-2,202,831) annual cardiovascular deaths were associated with nonoptimal temperatures, constituting 8.86% (95% empirical CI: 7.51%-12.32%) of total cardiovascular mortality corresponding to 26 deaths per 100,000 population. Cold-related deaths accounted for 8.20% (95% empirical CI: 6.74%-11.57%), whereas heat-related deaths accounted for 0.66% (95% empirical CI: 0.49%-0.98%). The mortality burden varied significantly across regions, with the highest excess mortality rates observed in Central Asia and Eastern Europe. From 2000 to 2019, cold-related excess death ratios decreased, while heat-related ratios increased, resulting in an overall decline in temperature-related deaths. Southeastern Asia, Sub-Saharan Africa, and Oceania observed the greatest reduction, while Southern Asia experienced an increase. The Americas and several regions in Asia and Europe displayed fluctuating temporal patterns. CONCLUSIONS Nonoptimal temperatures substantially contribute to cardiovascular mortality, with heterogeneous spatiotemporal patterns. Effective mitigation and adaptation strategies are crucial, especially given the increasing heat-related cardiovascular deaths amid climate change.
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Affiliation(s)
- Samuel Hundessa
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Joana Madureira
- Environmental Health Department, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Ana Maria Vicedo-Cabrera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Amanda Johnson
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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10
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Khatana SAM. Climate Change and Cardiovascular Mortality: Will Fewer Cold Days Balance Out More Hot Days? J Am Coll Cardiol 2024; 83:2288-2290. [PMID: 38839203 DOI: 10.1016/j.jacc.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Sameed Ahmed M Khatana
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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11
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Alahmad B, Yuan Q, Achilleos S, Salameh P, Papatheodorou SI, Koutrakis P. Evaluating the temperature-mortality relationship over 16 years in Cyprus. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2024; 74:439-448. [PMID: 38718302 DOI: 10.1080/10962247.2024.2345637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/08/2024] [Indexed: 06/01/2024]
Abstract
In many regions of the world, the relationship between ambient temperature and mortality is well-documented, but little is known about Cyprus, a Mediterranean island country where climate change is progressing faster than the global average. We Examined the association between daily ambient temperature and all-cause mortality risk in Cyprus. We conducted a time-series analysis with quasipoisson distribution and distributed lag non-linear models to investigate the association between temperature and all-cause mortality from 1 January 2004 to 31 December 2019 in five districts in Cyprus. We then performed a meta-analysis to estimate the overall temperature-mortality dose-response relationship in Cyprus. Excess mortality was computed to determine the public health burden caused by extreme temperatures. We did not find evidence of heterogeneity between the five districts (p = 0.47). The pooled results show that for cold effects, comparing the 1st, 2.5th, and 5th percentiles to the optimal temperature (temperature associated with least mortality, 25 ℃), the overall relative risks of mortality were 1.55 (95% CI: 1.32, 1.82), 1.41 (95% CI: 1.21, 1.64), and 1.32 (95% CI: 1.15, 1.52), respectively. For heat effects, the overall relative risks of mortality at the 95th, 97.5th and 99th percentiles were 1.10 (95% CI: 1.04, 1.16), 1.17 (95% CI: 1.07, 1.29), and 1.29 (95% CI: 1.11, 1.5), respectively. The excess mortality attributable to cold days accounted for 8.0 deaths (95% empirical CI: 4.5-10.8) for every 100 deaths, while the excess mortality attributable to heat days accounted for 1.3 deaths (95% empirical CI: 0.7-1.7) for every 100 deaths. The results prompt additional research into environmental risk prevention in this under-studied hot and dry region that could experience disproportionate climate change related exposures.Implications: The quantification of excess mortality attributable to temperature extremes shows an urgent need for targeted public health interventions and climate adaptation strategies in Cyprus and similar regions facing rapid climate change. Future steps should look into subpopulation sensitivity, coping strategies, and adaptive interventions to reduce potential future risks.
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Affiliation(s)
- Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Qinni Yuan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Souzana Achilleos
- School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Pascale Salameh
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Stefania I Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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12
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Cordiner R, Wan K, Hajat S, Macintyre HL. Accounting for adaptation when projecting climate change impacts on health: A review of temperature-related health impacts. ENVIRONMENT INTERNATIONAL 2024; 188:108761. [PMID: 38788417 DOI: 10.1016/j.envint.2024.108761] [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: 01/24/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
Exposure to high and low ambient temperatures can cause harm to human health. Due to global warming, heat-related health effects are likely to increase substantially in future unless populations adapt to living in a warmer world. Adaptation to temperature may occur through physiological acclimatisation, behavioural mechanisms, and planned adaptation. A fundamental step in informing responses to climate change is understanding how adaptation can be appropriately accounted for when estimating future health burdens. Previous studies modelling adaptation have used a variety of methods, and it is often unclear how underlying assumptions of adaptation are made and if they are based on evidence. Consequently, the most appropriate way to quantitatively model adaptation in projections of health impacts is currently unknown. With increasing interest from decisionmakers around implementation of adaptation strategies, it is important to consider the role of adaptation in anticipating future health burdens of climate change. To address this, a literature review using systematic scoping methods was conducted to document the quantitative methods employed by studies projecting future temperature-related health impacts under climate change that also consider adaptation. Approaches employed in studies were coded into methodological categories. Categories were discussed and refined between reviewers during synthesis. Fifty-nine studies were included and grouped into eight methodological categories. Methods of including adaptation in projections have changed over time with more recent studies using a combination of approaches or modelling adaptation based on specific adaptation strategies or socioeconomic conditions. The most common approaches to model adaptation are heat threshold shifts and reductions in the exposure-response slope. Just under 20% of studies were identified as using an intervention-based empirical basis for statistical assumptions. Including adaptation in projections considerably reduced the projected temperature-mortality burden in the future. Researchers should ensure that all future impact assessments include adaptation uncertainty in projections and assumptions are based on empirical evidence.
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Affiliation(s)
- Rhiannon Cordiner
- Centre for Climate and Health Security, UK Health Security Agency, 10 South Colonnade, Canary Wharf, London E14 4PU, England.
| | - Kai Wan
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, England.
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, England.
| | - Helen L Macintyre
- Centre for Climate and Health Security, UK Health Security Agency, 10 South Colonnade, Canary Wharf, London E14 4PU, England; School of Geography Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, England.
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13
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Falchetta G, De Cian E, Sue Wing I, Carr D. Global projections of heat exposure of older adults. Nat Commun 2024; 15:3678. [PMID: 38744815 PMCID: PMC11094092 DOI: 10.1038/s41467-024-47197-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 03/24/2024] [Indexed: 05/16/2024] Open
Abstract
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.
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Affiliation(s)
- Giacomo Falchetta
- CMCC Foundation - Euro-Mediterranean Center on Climate Change, Venice, Italy.
- RFF-CMCC European Institute on Economics and the Environment, Venice, Italy.
- International Institute for Applied Systems Analysis, Laxenburg, Austria.
| | - Enrica De Cian
- CMCC Foundation - Euro-Mediterranean Center on Climate Change, Venice, Italy
- RFF-CMCC European Institute on Economics and the Environment, Venice, Italy
- Department of Economics, Ca' Foscari University, Venice, Italy
| | - Ian Sue Wing
- Department of Earth & Environment, Boston University, Boston, MA, 02215, USA
| | - Deborah Carr
- Department of Sociology, Boston University, Boston, MA, 02215, USA
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Zhou L, Liu C, He C, Lei J, Zhu Y, Gao Y, Xuan J, Kan H, Chen R. Quantification of the Heat-Related Risk and Burden of Hospitalizations for Cause-Specific Injuries and Contribution of Human-Induced Climate Change: A Time-Stratified Case-Crossover Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57005. [PMID: 38752990 PMCID: PMC11098006 DOI: 10.1289/ehp14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/07/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Although ambient temperature has been linked with injury incidence, there have been few nationwide studies to quantify the temperature-related risk and burden of cause-specific injury hospitalizations. Additionally, the impact of human-induced climate change to injury burden remains unknown. OBJECTIVES Our objectives are to examine the associations between ambient temperature and injury hospitalizations from various causes and to quantify the contribution of human-induced warming to the heat-related burden. METHODS We collected injury hospitalization data from a nationwide hospital-based registry in China during 2000-2019. Using a time-stratified case-crossover design, we investigated the associations between daily mean temperature (°C) and cause-specific injury hospitalizations. We also quantified the burden of heat-related injuries under the scenarios with and without anthropogenic forcing, using the Detection and Attribution Model Intercomparison Project to assess the contribution of human-induced warming. RESULTS Our study included a total of 988,087 patients with hospitalization records for injuries. Overall, compared to the temperature at minimum risk of hospitalization (- 12.1 ° C ), the relative risk of hospitalization at extreme hot temperature (30.8°C, 97.5th percentile) was 1.18 [95% confidence interval (CI): 1.14, 1.22], with an approximately linear association between temperature and hospitalization. Vulnerability to heat-related injuries was more pronounced among males, young (< 18 years of age) or middle-aged (45-64 years of age) individuals, and those living in the North. The heat-related attributable fraction increased from 23.2% in the 2000s to 23.6% in the 2010s, with a corresponding increase in the contribution of human-induced change over time. In the 2010s, the heat-related attributable fractions for specific causes of injury ranged from 12.4% to 54.4%, with human-induced change accounting for 6.7% to 10.6% of the burden. DISCUSSION This nationwide study presents new evidence of significant associations between temperature and cause-specific injury hospitalizations in China and highlights the increasing contribution of human-induced warming to the injury burden. https://doi.org/10.1289/EHP14057.
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Affiliation(s)
- Lu Zhou
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cheng He
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Jian Lei
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Sen University, Guangzhou, China
| | - Haidong Kan
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- National Center for Children’s Health, Children’s Hospital of Fudan University, Shanghai, China
| | - Renjie Chen
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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15
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Boni Z, Bertel D, Adler V. To stay or not to stay at home? The unintended consequences of public health advice for older adults in the context of Covid-19 and urban heat. Soc Sci Med 2024; 348:116838. [PMID: 38593614 DOI: 10.1016/j.socscimed.2024.116838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024]
Abstract
Stay-at-home advice is one of the most widespread public health solutions to various health risks, including Covid-19 and heat stress. Authorities often direct this recommendation to adults above 65 years old, a group particularly vulnerable to multiple risks. While this advice aims to save lives, when prolonged it also comes with various negative unintended consequences. It increases older adults' isolation and loneliness, which negatively affects their mental and physical health, as well as their wellbeing and quality of life. This article builds on the findings from two European projects that studied, respectively, Covid-19 responses and adaptation to urban heat. First, we analyze the data from semi-structured interviews about Covid-19 responses and their consequences conducted with local experts in Vienna, Austria, in 2021-22. Second, we analyze the data from focus groups on experiencing and adapting to urban heat conducted with older adults in Warsaw, Poland, in 2021. This article demonstrates why stay-at-home advice might be problematic for older adults who live alone and how it leads to their increased isolation and loneliness when it stops being a short-term measure and becomes a prolonged experience. We examine differences and similarities between the two cases to discuss the shortcomings in care for older and frail people. We argue that public health recommendations should consider the issues of temporality, sociality and inequality when re-implementing the stay-at-home advice in the future. We also demonstrate that measures focusing on community wellbeing, instead of thinking only in terms of individual health and responsibility, might be a way to address those issues.
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Affiliation(s)
- Zofia Boni
- Institute of Anthropology and Ethnology, Adam Mickiewicz University in Poznan, ul. Uniwersytetu Poznańskiego 7, 61-614, Poznań, Poland.
| | - Diotima Bertel
- Center for Technology Experience, Austrian Institute of Technology, Giefinggasse 2, 1210, Vienna, Austria
| | - Viktoria Adler
- Media Diversity Institute, 85-87 Bayham Street, London, NW1 0AG, UK
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16
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Zhao Q, Li S, Ye T, Wu Y, Gasparrini A, Tong S, Urban A, Vicedo-Cabrera AM, Tobias A, Armstrong B, Royé D, Lavigne E, de’Donato F, Sera F, Kan H, Schwartz J, Pascal M, Ryti N, Goodman P, Saldiva PHN, Bell ML, Guo Y. Global, regional, and national burden of heatwave-related mortality from 1990 to 2019: A three-stage modelling study. PLoS Med 2024; 21:e1004364. [PMID: 38743771 PMCID: PMC11093289 DOI: 10.1371/journal.pmed.1004364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/20/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The regional disparity of heatwave-related mortality over a long period has not been sufficiently assessed across the globe, impeding the localisation of adaptation planning and risk management towards climate change. We quantified the global mortality burden associated with heatwaves at a spatial resolution of 0.5°×0.5° and the temporal change from 1990 to 2019. METHODS AND FINDINGS We collected data on daily deaths and temperature from 750 locations of 43 countries or regions, and 5 meta-predictors in 0.5°×0.5° resolution across the world. Heatwaves were defined as location-specific daily mean temperature ≥95th percentiles of year-round temperature range with duration ≥2 days. We first estimated the location-specific heatwave-mortality association. Secondly, a multivariate meta-regression was fitted between location-specific associations and 5 meta-predictors, which was in the third stage used with grid cell-specific meta-predictors to predict grid cell-specific association. Heatwave-related excess deaths were calculated for each grid and aggregated. During 1990 to 2019, 0.94% (95% CI: 0.68-1.19) of deaths [i.e., 153,078 cases (95% eCI: 109,950-194,227)] per warm season were estimated to be from heatwaves, accounting for 236 (95% eCI: 170-300) deaths per 10 million residents. The ratio between heatwave-related excess deaths and all premature deaths per warm season remained relatively unchanged over the 30 years, while the number of heatwave-related excess deaths per 10 million residents per warm season declined by 7.2% per decade in comparison to the 30-year average. Locations with the highest heatwave-related death ratio and rate were in Southern and Eastern Europe or areas had polar and alpine climates, and/or their residents had high incomes. The temporal change of heatwave-related mortality burden showed geographic disparities, such that locations with tropical climate or low incomes were observed with the greatest decline. The main limitation of this study was the lack of data from certain regions, e.g., Arabian Peninsula and South Asia. CONCLUSIONS Heatwaves were associated with substantial mortality burden that varied spatiotemporally over the globe in the past 30 years. The findings indicate the potential benefit of governmental actions to enhance health sector adaptation and resilience, accounting for inequalities across communities.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology, School of Public Health/Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- 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
| | - Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Aleš Urban
- Institute of Atmospheric Physics, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Dominic Royé
- Climate Research Foundation (FIC), Madrid, Spain
- Spanish Consortium for Research and Public Health (CIBERESP), Madrid, Spain
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Francesca de’Donato
- Department of Epidemiology, Lazio Regional Health Service, Asl Roma 1, Rome, Italy
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications “G. Parenti”, University of Florence, Florence, Italy
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | | | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut, United States of America
- Korea University, Seoul, South Korea
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Malcolm J, Dodd A, Shaikh M, Cassels-Brown A, Buchan JC. Reducing the carbon footprint of cataract surgery: co-creating solutions with a departmental Delphi process. Eye (Lond) 2024; 38:1349-1354. [PMID: 38155328 PMCID: PMC11076634 DOI: 10.1038/s41433-023-02902-4] [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: 02/07/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Climate change is arguably the greatest threat to global health of the 21st century. Although cataract surgery is a major contributor to global greenhouse gas emissions, recent literature review identified a paucity of evidence-based strategies for improving the environmental impact of cataract services. Our study aimed to assess the effectiveness of a departmental Delphi process for improving cataract services' environmental sustainability. METHODS All members of ophthalmology theatre teams in a UK teaching hospital were invited to participate in a three-stage Delphi process. Team members were surveyed for suggestions for reducing the department's environmental impact. Suggested interventions were refined during a plenary face-to-face discussion and ranked. The highest ranked interventions were combined into a mutually agreed action plan. Data on the economic and environmental cost of cataract services was collected prior to and six months after the Delphi process using the Eyefficiency mobile application. RESULTS Twenty-three interventions were suggested by a range of staff cadres. Interventions were ranked by 24 team members. The 2nd, 4th, 5th, 8th and 11th ranked interventions were combined into an "Eco-packs" project in collaboration with suppliers (Bausch + Lomb), saving 675 kg of waste and 350 kg of CO2 equivalent annually. CONCLUSIONS The Delphi process is an effective method for provoking departmental engagement with the sustainability agenda that we would encourage all ophthalmology departments to consider utilising. The baseline per case CO2 equivalent measured in our department was reproducible and could serve as a maximum benchmark to be improved upon.
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Affiliation(s)
- Jonathan Malcolm
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK.
| | - Amy Dodd
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK
| | - Mohammad Shaikh
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK
| | | | - John C Buchan
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Royal College of Ophthalmologists' National Ophthalmology Database, 18 Stephenson Way, London, NW1 2HD, UK
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18
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Singh N, Areal AT, Breitner S, Zhang S, Agewall S, Schikowski T, Schneider A. Heat and Cardiovascular Mortality: An Epidemiological Perspective. Circ Res 2024; 134:1098-1112. [PMID: 38662866 PMCID: PMC11042530 DOI: 10.1161/circresaha.123.323615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
As global temperatures rise, extreme heat events are projected to become more frequent and intense. Extreme heat causes a wide range of health effects, including an overall increase in morbidity and mortality. It is important to note that while there is sufficient epidemiological evidence for heat-related increases in all-cause mortality, evidence on the association between heat and cause-specific deaths such as cardiovascular disease (CVD) mortality (and its more specific causes) is limited, with inconsistent findings. Existing systematic reviews and meta-analyses of epidemiological studies on heat and CVD mortality have summarized the available evidence. However, the target audience of such reviews is mainly limited to the specific field of environmental epidemiology. This overarching perspective aims to provide health professionals with a comprehensive overview of recent epidemiological evidence of how extreme heat is associated with CVD mortality. The rationale behind this broad perspective is that a better understanding of the effect of extreme heat on CVD mortality will help CVD health professionals optimize their plans to adapt to the changes brought about by climate change and heat events. To policymakers, this perspective would help formulate targeted mitigation, strengthen early warning systems, and develop better adaptation strategies. Despite the heterogeneity in evidence worldwide, due in part to different climatic conditions and population dynamics, there is a clear link between heat and CVD mortality. The risk has often been found to be higher in vulnerable subgroups, including older people, people with preexisting conditions, and the socioeconomically deprived. This perspective also highlights the lack of evidence from low- and middle-income countries and focuses on cause-specific CVD deaths. In addition, the perspective highlights the temporal changes in heat-related CVD deaths as well as the interactive effect of heat with other environmental factors and the potential biological pathways. Importantly, these various aspects of epidemiological studies have never been fully investigated and, therefore, the true extent of the impact of heat on CVD deaths remains largely unknown. Furthermore, this perspective also highlights the research gaps in epidemiological studies and the potential solutions to generate more robust evidence on the future consequences of heat on CVD deaths.
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Affiliation(s)
- Nidhi Singh
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Ashtyn Tracy Areal
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
| | - Siqi Zhang
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Stefan Agewall
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
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Zhu Q, Zhou M, Zare Sakhvidi MJ, Yang S, Chen S, Feng P, Chen Z, Xu Z, Liu Q, Yang J. Projecting heat-related cardiovascular mortality burden attributable to human-induced climate change in China. EBioMedicine 2024; 103:105119. [PMID: 38631093 PMCID: PMC11035030 DOI: 10.1016/j.ebiom.2024.105119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has been found to be particularly vulnerable to climate change and temperature variability. This study aimed to assess the extent to which human-induced climate change contributes to future heat-related CVD burdens. METHODS Daily data on CVD mortality and temperature were collected in 161 Chinese communities from 2007 to 2013. The association between heat and CVD mortality was established using a two-stage time-series design. Under the natural forcing, human-induced, and combined scenarios, we then separately projected excess cause-/age-/region-/education-specific mortality from future high temperature in 2010-2100, assuming no adaptation and population changes. FINDINGS Under shared socioeconomic pathway with natural forcing scenario (SSP2-4.5-nat), heat-related attributable fraction of CVD deaths decreased slightly from 3.3% [95% empirical confidence interval (eCI): 0.3, 5.8] in the 2010s to 2.8% (95% eCI: 0.1, 5.2) in the 2090s, with relative change of -0.4% (95% eCI: -0.8, 0.0). However, for combined natural and human-induced forcings, this estimate would surge to 8.9% (95% eCI: 1.5, 15.7), 14.4% (95% eCI: 1.5, 25.3), 21.3% (95% eCI: -0.6, 39.4), and 28.7% (95% eCI: -3.3, 48.0) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. When excluding the natural forcing, the number of human-induced heat-related CVD deaths would increase from approximately eight thousand (accounting for 31% of total heat-related CVD deaths) in the 2010s to 33,052 (68%), 63,283 (80%), 101,091 (87%), and 141,948 (90%) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. Individuals with stroke, females, the elderly, people living in rural areas, and those with lower education level would exhibit heightened susceptibility to future high temperature. In addition, Southern and Eastern regions of China were expected to experience a faster increase in heat-related attributable fraction of CVD deaths. INTERPRETATION Human activities would significantly amplify the future burden of heat-related CVD. Our study findings suggested that active adaptation and mitigation measures towards future warming could yield substantial health benefits for the patients with CVD. FUNDING National Natural Science Foundation of China.
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Affiliation(s)
- Qiongyu Zhu
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Siru Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Sujuan Chen
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Puyu Feng
- College of Land Science and Technology, China Agricultural University, Beijing, 100193, China
| | | | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Qiyong Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Jun Yang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China.
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20
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Landguth EL, Knudson J, Graham J, Orr A, Coyle EA, Smith P, Semmens EO, Noonan C. Seasonal extreme temperatures and short-term fine particulate matter increases pediatric respiratory healthcare encounters in a sparsely populated region of the intermountain western United States. Environ Health 2024; 23:40. [PMID: 38622704 PMCID: PMC11017546 DOI: 10.1186/s12940-024-01082-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Evaluating while accounting for these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health is becoming more important. METHODS We explored short-term exposure to air pollution on children's respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated healthcare events. The main outcome measure included individual-based address located respiratory-related healthcare visits for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for ages 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis with distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 14 prior-days modified by temperature or season. RESULTS For asthma, increases of 1 µg/m3 in PM2.5 exposure 7-13 days prior a healthcare visit date was associated with increased odds that were magnified during median to colder temperatures and winter periods. For LRTIs, 1 µg/m3 increases during 12 days of cumulative PM2.5 with peak exposure periods between 6-12 days before healthcare visit date was associated with elevated LRTI events, also heightened in median to colder temperatures but no seasonal effect was observed. For URTIs, 1 unit increases during 13 days of cumulative PM2.5 with peak exposure periods between 4-10 days prior event date was associated with greater risk for URTIs visits that were intensified during median to hotter temperatures and spring to summer periods. CONCLUSIONS Delayed, short-term exposure increases of PM2.5 were associated with elevated odds of all three pediatric respiratory healthcare visit categories in a sparsely population area of the inter-Rocky Mountains, USA. PM2.5 in colder temperatures tended to increase instances of asthma and LRTIs, while PM2.5 during hotter periods increased URTIs.
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Affiliation(s)
- Erin L Landguth
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Jonathon Knudson
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Jon Graham
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
- Mathematical Sciences, University of Montana, Missoula, USA
| | - Ava Orr
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Emily A Coyle
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Paul Smith
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
- Pediatric Pulmonology, Community Medical Center, Missoula, MT, USA
| | - Erin O Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Curtis Noonan
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
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Yu W, Huang W, Gasparrini A, Sera F, Schneider A, Breitner S, Kyselý J, Schwartz J, Madureira J, Gaio V, Guo YL, Xu R, Chen G, Yang Z, Wen B, Wu Y, Zanobetti A, Kan H, Song J, Li S, Guo Y. Ambient fine particulate matter and daily mortality: a comparative analysis of observed and estimated exposure in 347 cities. Int J Epidemiol 2024; 53:dyae066. [PMID: 38725299 PMCID: PMC11082424 DOI: 10.1093/ije/dyae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 04/13/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Model-estimated air pollution exposure products have been widely used in epidemiological studies to assess the health risks of particulate matter with diameters of ≤2.5 µm (PM2.5). However, few studies have assessed the disparities in health effects between model-estimated and station-observed PM2.5 exposures. METHODS We collected daily all-cause, respiratory and cardiovascular mortality data in 347 cities across 15 countries and regions worldwide based on the Multi-City Multi-Country collaborative research network. The station-observed PM2.5 data were obtained from official monitoring stations. The model-estimated global PM2.5 product was developed using a machine-learning approach. The associations between daily exposure to PM2.5 and mortality were evaluated using a two-stage analytical approach. RESULTS We included 15.8 million all-cause, 1.5 million respiratory and 4.5 million cardiovascular deaths from 2000 to 2018. Short-term exposure to PM2.5 was associated with a relative risk increase (RRI) of mortality from both station-observed and model-estimated exposures. Every 10-μg/m3 increase in the 2-day moving average PM2.5 was associated with overall RRIs of 0.67% (95% CI: 0.49 to 0.85), 0.68% (95% CI: -0.03 to 1.39) and 0.45% (95% CI: 0.08 to 0.82) for all-cause, respiratory, and cardiovascular mortality based on station-observed PM2.5 and RRIs of 0.87% (95% CI: 0.68 to 1.06), 0.81% (95% CI: 0.08 to 1.55) and 0.71% (95% CI: 0.32 to 1.09) based on model-estimated exposure, respectively. CONCLUSIONS Mortality risks associated with daily PM2.5 exposure were consistent for both station-observed and model-estimated exposures, suggesting the reliability and potential applicability of the global PM2.5 product in epidemiological studies.
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Affiliation(s)
- Wenhua Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications ‘G. Parenti’, University of Florence, Florence, Italy
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Jan Kyselý
- Department of Climatology, Institute of Atmospheric Physics, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Vânia Gaio
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisboa, Portugal
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Institute of Environmental and Occupational Health Sciences, NTU College of Public Health, Taipei, Taiwan
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhengyu Yang
- 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
| | - Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Jiangning Song
- Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, 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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Yin P, He C, Chen R, Huang J, Luo Y, Gao X, Xu Y, Ji JS, Cai W, Wei Y, Li H, Zhou M, Kan H. Projection of Mortality Burden Attributable to Nonoptimum Temperature with High Spatial Resolution in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:6226-6235. [PMID: 38557021 DOI: 10.1021/acs.est.3c09162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The updated climate models provide projections at a fine scale, allowing us to estimate health risks due to future warming after accounting for spatial heterogeneity. Here, we utilized an ensemble of high-resolution (25 km) climate simulations and nationwide mortality data from 306 Chinese cities to estimate death anomalies attributable to future warming. Historical estimation (1986-2014) reveals that about 15.5% [95% empirical confidence interval (eCI):13.1%, 17.6%] of deaths are attributable to nonoptimal temperature, of which heat and cold corresponded to attributable fractions of 4.1% (eCI:2.4%, 5.5%) and 11.4% (eCI:10.7%, 12.1%), respectively. Under three climate scenarios (SSP126, SSP245, and SSP585), the national average temperature was projected to increase by 1.45, 2.57, and 4.98 °C by the 2090s, respectively. The corresponding mortality fractions attributable to heat would be 6.5% (eCI:5.2%, 7.7%), 7.9% (eCI:6.3%, 9.4%), and 11.4% (eCI:9.2%, 13.3%). More than half of the attributable deaths due to future warming would occur in north China and cardiovascular mortality would increase more drastically than respiratory mortality. Our study shows that the increased heat-attributable mortality burden would outweigh the decreased cold-attributable burden even under a moderate climate change scenario across China. The results are helpful for national or local policymakers to better address the challenges of future warming.
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Affiliation(s)
- Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Cheng He
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
- Institute of Epidemiology, Helmholtz Zentrum München─German Research Center for Environmental Health (GmbH), Neuherberg 85764, Germany
| | - Renjie Chen
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
| | - Jianbin Huang
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Yong Luo
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Xuejie Gao
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
- Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100017, China
| | - Ying Xu
- National Climate Center, China Meteorological Administration, Beijing 100044, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Wenjia Cai
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai 200032, China
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23
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Yamasaki L, Kamada T, Ng CFS, Takane Y, Nakajima K, Yamaguchi K, Oka K, Honda Y, Kim Y, Hashizume M. Heat-related mortality and ambulance transport after a power outage in the Tokyo metropolitan area. Environ Epidemiol 2024; 8:e292. [PMID: 38617431 PMCID: PMC11008645 DOI: 10.1097/ee9.0000000000000292] [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: 07/09/2023] [Accepted: 01/02/2024] [Indexed: 04/16/2024] Open
Abstract
Background Air conditioners can prevent heat-related illness and mortality, but the increased use of air conditioners may enhance susceptibility to heat-related illnesses during large-scale power failures. Here, we examined the risks of heat-related illness ambulance transport (HIAT) and mortality associated with typhoon-related electricity reduction (ER) in the summer months in the Tokyo metropolitan area. Methods We conducted event study analyses to compare temperature-HIAT and mortality associations before and after the power outage (July to September 2019). To better understand the role of temperature during the power outage, we then examined whether the temperature-HIAT and mortality associations were modified by different power outage levels (0%, 10%, and 20% ER). We computed the ratios of relative risks to compare the risks associated with various ER values to the risks associated without ER. Results We analyzed the data of 14,912 HIAT cases and 74,064 deaths. Overall, 93,200 power outage cases were observed when the typhoon hit. Event study results showed that the incidence rate ratio was 2.01 (95% confidence interval [CI] = 1.42, 2.84) with effects enduring up to 6 days, and 1.11 (95% CI = 1.02, 1.22) for mortality on the first 3 days after the typhoon hit. Comparing 20% to 0% ER, the ratios of relative risks of heat exposure were 2.32 (95% CI = 1.41, 3.82) for HIAT and 0.95 (95% CI = 0.75, 1.22) for mortality. Conclusions A 20% ER was associated with a two-fold greater risk of HIAT because of summer heat during the power outage, but there was little evidence for the association with all-cause mortality.
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Affiliation(s)
- Lisa Yamasaki
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Takuma Kamada
- Osaka School of International Public Policy, Osaka University, Osaka, Japan
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuya Takane
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Ko Nakajima
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Kazuki Yamaguchi
- TEPCO Research Institute, Tokyo Electric Power Company Holdings, Inc, Yokohama, Japan
| | - Kazutaka Oka
- National Institute for Environmental Studies, Ibaraki, Japan
| | - Yasushi Honda
- National Institute for Environmental Studies, Ibaraki, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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24
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Weeding B, Love P, Beyer K, Lucieer A, Remenyi T. High-resolution projections of outdoor thermal stress in the twenty-first century: a Tasmanian case study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:777-793. [PMID: 38427096 DOI: 10.1007/s00484-024-02622-8] [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: 10/21/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 03/02/2024]
Abstract
To adapt to Earth's rapidly changing climate, detailed modelling of thermal stress is needed. Dangerous stress levels are becoming more frequent, longer, and more severe. While traditional measurements of thermal stress have focused on air temperature and humidity, modern measures including radiation and wind speed are becoming widespread. However, projecting such indices has presented a challenging problem, due to the need for appropriate bias correction of multiple variables that vary on hourly timescales. In this paper, we aim to provide a detailed understanding of changing thermal stress patterns incorporating modern measurements, bias correction techniques, and hourly projections to assess the impact of climate change on thermal stress at human scales. To achieve these aims, we conduct a case study of projected thermal stress in central Hobart, Australia for 2040-2059, compared to the historical period 1990-2005. We present the first hourly metre-scale projections of thermal stress driven by multivariate bias-corrected data. We bias correct four variables from six dynamically downscaled General Circulation Models. These outputs drive the Solar and LongWave Environmental Irradiance Geometry model at metre scale, calculating mean radiant temperature and the Universal Thermal Climate Index. We demonstrate that multivariate bias correction can correct means on multiple time scales while accurately preserving mean seasonal trends. Changes in mean air temperature and UTCI by hour of the day and month of the year reveal diurnal and annual patterns in both temporal trends and model agreement. We present plots of future median stress values in the context of historical percentiles, revealing trends and patterns not evident in mean data. Our modelling illustrates a future Hobart that experiences higher and more consistent numbers of hours of heat stress arriving earlier in the year and extending further throughout the day.
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Affiliation(s)
- Ben Weeding
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Sandy Bay, TAS, 7001, Australia.
- Climate Futures Research Group, University of Tasmania, Sandy Bay, TAS, 7001, Australia.
| | - Peter Love
- Climate Futures Research Group, University of Tasmania, Sandy Bay, TAS, 7001, Australia
| | - Kathleen Beyer
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Sandy Bay, TAS, 7001, Australia
- Climate Futures Research Group, University of Tasmania, Sandy Bay, TAS, 7001, Australia
| | - Arko Lucieer
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Sandy Bay, TAS, 7001, Australia
| | - Tom Remenyi
- Acclimatised Pty Ltd, Blackmans Bay, TAS, 7052, Australia
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25
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Stein PJS, Stein MA, Groce N, Kett M, Akyeampong EK, Alford WP, Chakraborty J, Daniels-Mayes S, Eriksen SH, Fracht A, Gallegos L, Grech S, Gurung P, Hans A, Harpur P, Jodoin S, Lord JE, Macanawai SS, McClain-Nhlapo CV, Mezmur BD, Moore RJ, Muñoz Y, Patel V, Pham PN, Quinn G, Sadlier SA, Shachar C, Smith MS, Van Susteren L. Advancing disability-inclusive climate research and action, climate justice, and climate-resilient development. Lancet Planet Health 2024; 8:e242-e255. [PMID: 38580426 DOI: 10.1016/s2542-5196(24)00024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/30/2023] [Accepted: 02/14/2024] [Indexed: 04/07/2024]
Abstract
Globally, more than 1 billion people with disabilities are disproportionately and differentially at risk from the climate crisis. Yet there is a notable absence of climate policy, programming, and research at the intersection of disability and climate change. Advancing climate justice urgently requires accelerated disability-inclusive climate action. We present pivotal research recommendations and guidance to advance disability-inclusive climate research and responses identified by a global interdisciplinary group of experts in disability, climate change, sustainable development, public health, environmental justice, humanitarianism, gender, Indigeneity, mental health, law, and planetary health. Climate-resilient development is a framework for enabling universal sustainable development. Advancing inclusive climate-resilient development requires a disability human rights approach that deepens understanding of how societal choices and actions-characterised by meaningful participation, inclusion, knowledge diversity in decision making, and co-design by and with people with disabilities and their representative organisations-build collective climate resilience benefiting disability communities and society at large while advancing planetary health.
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Affiliation(s)
- Penelope J S Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Michael Ashley Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA.
| | - Nora Groce
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; International Disability Research Centre, University College London, London, UK
| | - Maria Kett
- International Disability Research Centre, University College London, London, UK
| | - Emmanuel K Akyeampong
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Willliam P Alford
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Jayajit Chakraborty
- Bren School of Environmental Science and Management, University of California-Santa Barbara, Santa Barbara, CA, USA
| | | | - Siri H Eriksen
- Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Anne Fracht
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Luis Gallegos
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; The United Nations Institute for Training and Research, Quito, Ecuador
| | - Shaun Grech
- Community Based Inclusive Development Initiative, CBM, Bensheim, Germany
| | - Pratima Gurung
- National Indigenous Disabled Women Association Nepal, Kusunti, Nepal
| | - Asha Hans
- School of Women's Studies, Utkal University, Bhubaneswar, India
| | - Paul Harpur
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; TC Beirne School of Law, University of Queensland, Brisbane, QLD, Australia
| | | | - Janet E Lord
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Center for International and Comparative Law, University of Baltimore, Baltimore, MD, USA
| | | | | | | | - Rhonda J Moore
- All of US Research Program, National Institutes of Health, Washington, DC, USA
| | | | - Vikram Patel
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA
| | - Phuong N Pham
- Harvard Humanitarian Initiative, Cambridge, MA, USA; Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Gerard Quinn
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Faculty of Law, University of Galway, Galway, Ireland
| | | | - Carmel Shachar
- Health Law and Policy Clinic at the Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, MA, USA
| | - Matthew S Smith
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Lise Van Susteren
- Department of Psychiatry and Behavorial Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Xiao L, Wang Q, Ni H, Xu T, Cai X, Dai T, Wang L, Song C, Li Y, Li F, Meng T, Sheng H, Yu X, Zeng Q, Guo P, Zhang X. Effects of temperature anomaly on sperm quality: A multi-center study of 33,234 men. Heliyon 2024; 10:e26765. [PMID: 38434420 PMCID: PMC10907732 DOI: 10.1016/j.heliyon.2024.e26765] [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: 06/30/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Backgrounds Global fertility rates continue to decline and sperm quality is a prime factor affecting male fertility. Both extreme cold and heat have been demonstrated to be associated with decreased sperm quality, but no epidemiological studies have considered human adaptation to long-term temperature. Our aim was to conduct a multi-center retrospective cohort study to investigate exposure-response relationship between temperature anomaly (TA) that deviate from long-term climate patterns and sperm quality. Methods A total of 78,952 semen samples measured in 33,234 donors from 6 provincial human sperm banks in China were collected. This study considered heat and cold acclimatization to prolonged exposure in humans and explored the exposure-response relationship between TAs and sperm quality parameters (sperm concentrations, sperm count, progressive motility, progressive sperm count, total motility and total motile sperm count) during the hot and cold seasons, respectively. Linear mixed models and generalized linear models were built separately for specific centers to pool in a meta-analysis to obtain the pooled effect of TA on sperm quality, considering repeated measurements data structure and spatial heterogeneity. Results We identified an inverted U-shaped exposure-response relationship between TA and sperm quality during the hot season. Significant negative effect of anomalous cold on sperm quality during the hot season was found after additional adjustment for Body mass index, marital status and childbearing history. The heat-related TA in hot season was significantly negatively associated with sperm concentration, progressive sperm count and total motile sperm count (all P-values<0.05). After adjusting the relative humidity, the cold-related TA in cold season was negatively associated with the sperm total motility (P-values<0.05). Conclusions Our results suggest both heat-related and cold-related TAs are associated with decreased sperm quality. The findings highlight the importance of reducing exposure to anomalous temperatures to protect male fertility.
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Affiliation(s)
- Lina Xiao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Qiling Wang
- National Health Commission Key Laboratory of Male Reproduction and Genetics, Guangzhou, China
- Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), China
| | - Haobo Ni
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Ting Xu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Xiaoyan Cai
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Tingting Dai
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Lingxi Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Chunying Song
- Human Sperm Bank, The Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China
| | - Yushan Li
- Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fuping Li
- Human Sperm Bank, The Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Tianqing Meng
- Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Human Sperm Bank, Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiqiang Sheng
- Human Sperm Bank, The Zhejiang Provincial Maternal and Child and Reproductive Health Care Center, Hangzhou, China
| | - Xiaolin Yu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Qinghui Zeng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Xinzong Zhang
- National Health Commission Key Laboratory of Male Reproduction and Genetics, Guangzhou, China
- Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), China
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27
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Deshayes TA, Sodabi DGA, Dubord M, Gagnon D. Shifting focus: Time to look beyond the classic physiological adaptations associated with human heat acclimation. Exp Physiol 2024; 109:335-349. [PMID: 37885125 PMCID: PMC10988689 DOI: 10.1113/ep091207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Planet Earth is warming at an unprecedented rate and our future is now assured to be shaped by the consequences of more frequent hot days and extreme heat. Humans will need to adapt both behaviorally and physiologically to thrive in a hotter climate. From a physiological perspective, countless studies have shown that human heat acclimation increases thermoeffector output (i.e., sweating and skin blood flow) and lowers cardiovascular strain (i.e., heart rate) during heat stress. However, the mechanisms mediating these adaptations remain understudied. Furthermore, several possible benefits of heat acclimation for other systems and functions involved in maintaining health and performance during heat stress remain to be elucidated. This review summarizes recent advances in human heat acclimation, with emphasis on recent studies that (1) advanced our understanding of the mechanisms mediating improved thermoeffector output and (2) investigated adaptations that go beyond those classically associated with heat acclimation. We highlight that these studies have contributed to a better understanding of the integrated physiological responses underlying human heat acclimation while leaving key unanswered questions that will need to be addressed in the future.
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Affiliation(s)
- Thomas A. Deshayes
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Dèwanou Gilles Arnaud Sodabi
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Marianne Dubord
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Daniel Gagnon
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
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28
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Boretti A. Revisiting Masselot et al. (2023): assessing the share of excess mortality linked to cold and hot weather in Europe. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:527-533. [PMID: 38085338 DOI: 10.1007/s00484-023-02598-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/18/2023] [Accepted: 12/07/2023] [Indexed: 02/15/2024]
Abstract
While a considerable focus has been placed on excess fatalities during hot weather, a reanalysis of European data reveals that excess mortality attributed to cold weather is significantly more pronounced, surpassing that linked to hot weather by an order of magnitude. These ratios are noteworthy: 56.32 for the United Kingdom, 43.56 for Northern Europe, 8.49 for Western Europe, 12.41 for Eastern Europe, 5.50 for Southern Europe, and an overall ratio of 10.09 for Europe as a whole. These ratios of cold to hot excess deaths indicate a significant disparity in the number of excess deaths caused by cold weather compared to those caused by hot weather. This significant difference underscores the greater health risks and vulnerabilities associated with cold weather.
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Affiliation(s)
- Alberto Boretti
- Melbourne Institute of Technology, 288 Latrobe Street, Melbourne, VIC, 3000, Australia.
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29
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Chen K, de Schrijver E, Sivaraj S, Sera F, Scovronick N, Jiang L, Roye D, Lavigne E, Kyselý J, Urban A, Schneider A, Huber V, Madureira J, Mistry MN, Cvijanovic I, Gasparrini A, Vicedo-Cabrera AM. Impact of population aging on future temperature-related mortality at different global warming levels. Nat Commun 2024; 15:1796. [PMID: 38413648 PMCID: PMC10899213 DOI: 10.1038/s41467-024-45901-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 02/07/2024] [Indexed: 02/29/2024] Open
Abstract
Older adults are generally amongst the most vulnerable to heat and cold. While temperature-related health impacts are projected to increase with global warming, the influence of population aging on these trends remains unclear. Here we show that at 1.5 °C, 2 °C, and 3 °C of global warming, heat-related mortality in 800 locations across 50 countries/areas will increase by 0.5%, 1.0%, and 2.5%, respectively; among which 1 in 5 to 1 in 4 heat-related deaths can be attributed to population aging. Despite a projected decrease in cold-related mortality due to progressive warming alone, population aging will mostly counteract this trend, leading to a net increase in cold-related mortality by 0.1%-0.4% at 1.5-3 °C global warming. Our findings indicate that population aging constitutes a crucial driver for future heat- and cold-related deaths, with increasing mortality burden for both heat and cold due to the aging population.
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Affiliation(s)
- Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA.
| | - Evan de Schrijver
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Sidharth Sivaraj
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Noah Scovronick
- Gangarosa Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Leiwen Jiang
- Asian Demographic Research Institute, Shanghai University, Shanghai, China
- Population Council, New York, NY, USA
| | - Dominic Roye
- Climate Research Foundation (FIC), Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Eric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Chair of Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Joana Madureira
- Department of Enviromental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Malcolm N Mistry
- Environment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Ivana Cvijanovic
- ISGlobal - Barcelona Institute for Global Health, Barcelona, Spain
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
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30
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Orlov A, Schleypen J, Aunan K, Sillmann J, Gasparrini A, Mistry MN. A better integration of health and economic impact assessments of climate change. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2024; 19:031004. [PMID: 38476251 PMCID: PMC7615732 DOI: 10.1088/1748-9326/ad29a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Climate change could lead to high economic burden for individuals (i.e. low income and high prices). While economic conditions are important determinants of climate change vulnerability, environmental epidemiological studies focus primarily on the direct impact of temperature on morbidity and mortality without accounting for climate-induced impacts on the economy. More integrated approaches are needed to provide comprehensive assessments of climate-induced direct and indirect impacts on health. This paper provides some perspectives on how epidemiological and economic impact assessments could be better integrated. We argue that accounting for the economic repercussions of climate change on people's health and, vice versa, the consequences of health effects on the economy could provide more realistic scenario projections and could be more useful for adaptation policy.
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Affiliation(s)
- Anton Orlov
- CICERO Center for International Climate Research, Oslo, Norway
| | | | - Kristin Aunan
- CICERO Center for International Climate Research, Oslo, Norway
| | - Jana Sillmann
- CICERO Center for International Climate Research, Oslo, Norway
- Sustainability and Climate Risks, University of Hamburg, Hamburg, Germany
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Malcolm N Mistry
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Economics, Ca’ Foscari University of Venice, Venice, Italy
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31
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Walkowiak MP, Walkowiak D, Walkowiak J. Exploring the paradoxical nature of cold temperature mortality in Europe. Sci Rep 2024; 14:3181. [PMID: 38326605 PMCID: PMC10850168 DOI: 10.1038/s41598-024-53675-z] [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: 10/03/2023] [Accepted: 02/03/2024] [Indexed: 02/09/2024] Open
Abstract
While low winter temperatures are associated with increased mortality, this phenomenon has been suggested to be most severe in regions with seemingly mild winters. The study aimed to establish a temperature-based formula that could elucidate the previously ambiguous regional differences in vulnerability to low temperature. European weekly mortality data (2000-2019) were matched with meteorological data to determine for each region vulnerability to temperature decrease and the optimal temperature with lowest mortality. Regression models were developed to generalize and explain these findings considering regional temperature characteristics. Optimal temperature could be predicted based on local average summer temperature (R2 = 85.6%). Regional vulnerability to temperature decrease could be explained by combination of winter and summer temperatures (R2 = 86.1%). Regions with warm winters and cold summers showed the highest vulnerability to decrease of temperature during winter. Contrary to theories about economic disparities Eastern Europe exhibited resistance comparable to Scandinavia. The southern edges of Europe demonstrated serious low temperature vulnerability to decreased temperatures, even if temperature was relatively high around 20 °C. This suggests that the observed connection primarily reflects the modulation of the length of respiratory virus infection seasons by climate conditions, counterbalanced by varying levels of acquired immunity and the presence of heatwaves eliminating the most frail individuals. Thus, relatively low vulnerability and a flat mortality cycle in countries with harsh climates paradoxically imply the presence of threats throughout the whole year.
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Affiliation(s)
- Marcin Piotr Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Święcickiego 6, 60-781, Poznań, Poland.
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland
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32
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Janoš T, Ballester J, Čupr P, Achebak H. Countrywide analysis of heat- and cold-related mortality trends in the Czech Republic: growing inequalities under recent climate warming. Int J Epidemiol 2024; 53:dyad141. [PMID: 37857363 PMCID: PMC10859142 DOI: 10.1093/ije/dyad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Only little is known about trends in temperature-mortality associations among the most vulnerable subgroups, especially in the areas of central and eastern Europe, which are considered major climatic hotspots in terms of heatwave exposure. Thus, we aimed to assess trends in temperature-related mortality in the Czech Republic by sex, age and cause of death, and to quantify the temporal evolution of possible inequalities. METHODS We collected daily time series of all-cause (1987-2019) and cause-specific (1994-2019) mortality by sex and age category, and population-weighted daily mean 2-metre temperatures for each region of the Czech Republic. We applied a quasi-Poisson regression model to estimate the trends in region-specific temperature-mortality associations, with distributed lag non-linear models and multivariate random-effects meta-analysis to derive average associations across the country. We then calculated mortality attributable to non-optimal temperatures and implemented the indicator of sex- and age-dependent inequalities. RESULTS We observed a similar risk of mortality due to cold temperatures for men and women. Conversely, for warm temperatures, a higher risk was observed for women. Results by age showed a clear pattern of increasing risk due to non-optimum temperatures with increasing age category. The relative risk (RR) related to cold was considerably attenuated in most of the studied subgroups during the study period, whereas an increase in the RR associated with heat was seen in the overall population, in women, in the age category 90+ years and with respect to respiratory causes. Moreover, underlying sex- and age-dependent inequalities experienced substantial growth. CONCLUSIONS Our findings suggest ongoing adaptation to cold temperatures. Mal/adaptation to hot temperatures occurred unequally among population subgroups and resulted in growing inequalities between the sexes and among age categories.
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Affiliation(s)
- Tomáš Janoš
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | | | - Pavel Čupr
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Hicham Achebak
- ISGlobal, Barcelona, Spain
- Inserm, France Cohortes, Paris, France
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Gao Y, Huang W, Zhao Q, Ryti N, Armstrong B, Gasparrini A, Tong S, Pascal M, Urban A, Zeka A, Lavigne E, Madureira J, Goodman P, Huber V, Forsberg B, Kyselý J, Sera F, Guo Y, Li S. Global, regional, and national burden of mortality associated with cold spells during 2000-19: a three-stage modelling study. Lancet Planet Health 2024; 8:e108-e116. [PMID: 38331527 DOI: 10.1016/s2542-5196(23)00277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Exposure to cold spells is associated with mortality. However, little is known about the global mortality burden of cold spells. METHODS A three-stage meta-analytical method was used to estimate the global mortality burden associated with cold spells by means of a time series dataset of 1960 locations across 59 countries (or regions). First, we fitted the location-specific, cold spell-related mortality associations using a quasi-Poisson regression with a distributed lag non-linear model with a lag period of up to 21 days. Second, we built a multivariate meta-regression model between location-specific associations and seven predictors. Finally, we predicted the global grid-specific cold spell-related mortality associations during 2000-19 using the fitted meta-regression model and the yearly grid-specific meta-predictors. We calculated the annual excess deaths, excess death ratio (excess deaths per 1000 deaths), and excess death rate (excess deaths per 100 000 population) due to cold spells for each grid across the world. FINDINGS Globally, 205 932 (95% empirical CI [eCI] 162 692-250 337) excess deaths, representing 3·81 (95% eCI 2·93-4·71) excess deaths per 1000 deaths (excess death ratio), and 3·03 (2·33-3·75) excess deaths per 100 000 population (excess death rate) were associated with cold spells per year between 2000 and 2019. The annual average global excess death ratio in 2016-19 increased by 0·12 percentage points and the excess death rate in 2016-19 increased by 0·18 percentage points, compared with those in 2000-03. The mortality burden varied geographically. The excess death ratio and rate were highest in Europe, whereas these indicators were lowest in Africa. Temperate climates had higher excess death ratio and rate associated with cold spells than other climate zones. INTERPRETATION Cold spells are associated with substantial mortality burden around the world with geographically varying patterns. Although the number of cold spells has on average been decreasing since year 2000, the public health threat of cold spells remains substantial. The findings indicate an urgency of taking local and regional measures to protect the public from the mortality burdens of cold spells. FUNDING Australian Research Council, Australian National Health and Medical Research Council, EU's Horizon 2020 Project Exhaustion.
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Affiliation(s)
- Yuan Gao
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Qi Zhao
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ben Armstrong
- 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 & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | - Aleš Urban
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - Ariana Zeka
- Institute for the Environment, Brunel University London, London, UK
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ONT, Canada; Air Health Science Division, Health Canada, Ottawa, ONT, Canada
| | - Joana Madureira
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain; EPIUnit-Instituto de Saude Publica, Universidade do Porto, Porto, Portugal
| | | | - Veronika Huber
- The Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians University, Munich, Munich, Germany
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Jan Kyselý
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Yuming Guo
- 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.
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34
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Madaniyazi L, Armstrong B, Tobias A, Mistry MN, Bell ML, Urban A, Kyselý J, Ryti N, Cvijanovic I, Ng CFS, Roye D, Vicedo-Cabrera AM, Tong S, Lavigne E, Íñiguez C, da Silva SDNP, Madureira J, Jaakkola JJK, Sera F, Honda Y, Gasparrini A, Hashizume M. Seasonality of mortality under climate change: a multicountry projection study. Lancet Planet Health 2024; 8:e86-e94. [PMID: 38331534 DOI: 10.1016/s2542-5196(23)00269-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Climate change can directly impact temperature-related excess deaths and might subsequently change the seasonal variation in mortality. In this study, we aimed to provide a systematic and comprehensive assessment of potential future changes in the seasonal variation, or seasonality, of mortality across different climate zones. METHODS In this modelling study, we collected daily time series of mean temperature and mortality (all causes or non-external causes only) via the Multi-Country Multi-City Collaborative (MCC) Research Network. These data were collected during overlapping periods, spanning from Jan 1, 1969 to Dec 31, 2020. We projected daily mortality from Jan 1, 2000 to Dec 31, 2099, under four climate change scenarios corresponding to increasing emissions (Shared Socioeconomic Pathways [SSP] scenarios SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). We compared the seasonality in projected mortality between decades by its shape, timings (the day-of-year) of minimum (trough) and maximum (peak) mortality, and sizes (peak-to-trough ratio and attributable fraction). Attributable fraction was used to measure the burden of seasonality of mortality. The results were summarised by climate zones. FINDINGS The MCC dataset included 126 809 537 deaths from 707 locations within 43 countries or areas. After excluding the only two polar locations (both high-altitude locations in Peru) from climatic zone assessments, we analysed 126 766 164 deaths in 705 locations aggregated in four climate zones (tropical, arid, temperate, and continental). From the 2000s to the 2090s, our projections showed an increase in mortality during the warm seasons and a decrease in mortality during the cold seasons, albeit with mortality remaining high during the cold seasons, under all four SSP scenarios in the arid, temperate, and continental zones. The magnitude of this changing pattern was more pronounced under the high-emission scenarios (SSP3-7.0 and SSP5-8.5), substantially altering the shape of seasonality of mortality and, under the highest emission scenario (SSP5-8.5), shifting the mortality peak from cold seasons to warm seasons in arid, temperate, and continental zones, and increasing the size of seasonality in all zones except the arid zone by the end of the century. In the 2090s compared with the 2000s, the change in peak-to-trough ratio (relative scale) ranged from 0·96 to 1·11, and the change in attributable fraction ranged from 0·002% to 0·06% under the SSP5-8.5 (highest emission) scenario. INTERPRETATION A warming climate can substantially change the seasonality of mortality in the future. Our projections suggest that health-care systems should consider preparing for a potentially increased demand during warm seasons and sustained high demand during cold seasons, particularly in regions characterised by arid, temperate, and continental climates. FUNDING The Environment Research and Technology Development Fund of the Environmental Restoration and Conservation Agency, provided by the Ministry of the Environment of Japan.
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Affiliation(s)
- Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Malcolm N Mistry
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Carmen Íñiguez
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Statistics and Computational Research, Universitat de València, València, Spain
| | | | - Joana Madureira
- Environmental Health Department, National Institute of Health, Porto, Portugal; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Finnish Meteorological Institute, Helsinki, Finland
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Masahiro Hashizume
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Kandula S, Keyes KM, Yaari R, Shaman J. Excess Mortality in the United States, 2020-21: County-level Estimates for Population Groups and Associations with Social Vulnerability. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.14.24301290. [PMID: 38293208 PMCID: PMC10827264 DOI: 10.1101/2024.01.14.24301290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
To assess the excess mortality burden of Covid-19 in the United States, we estimated sex, age and race stratified all-cause excess deaths in each county of the US during 2020 and 2021. Using spatial Bayesian models trained on all recorded deaths between 2003-2019, we estimated 463,187 (95% uncertainty interval (UI): 426,139 - 497,526) excess deaths during 2020, and 544,105 (95% UI: 492,202 - 592,959) excess deaths during 2021 nationally, with considerable geographical heterogeneity. Excess mortality rate (EMR) nearly doubled for each 10-year increase in age and was consistently higher among men than women. EMR in the Black population was 1.5 times that of the White population nationally and as high as 3.8 times in some states. Among the 25-54 year population excess mortality was highest in the American Indian/Alaskan Native (AI/AN) population among the four racial groups studied, and in a few states was as high as 6 times that of the White population. Strong association of EMR with county-level social vulnerability was estimated, including positive associations with prevalence of disability (standardized effect: 40.6 excess deaths per 100,000), older population (37.6), poverty (23.6), and unemployment (18.5), whereas population density (-50), higher education (-38.6), and income (-35.4) were protective. Together, these estimates provide a more reliable and comprehensive understanding of the mortality burden of the pandemic in the US thus far. They suggest that Covid-19 amplified social and racial disparities. Short-term measures to protect more vulnerable groups in future Covid-19 waves and systemic corrective steps to address long-term societal inequities are necessary.
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Affiliation(s)
- Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY
| | | | - Rami Yaari
- Department of Environmental Health Sciences, Columbia University, New York, NY
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY
- Columbia Climate School, Columbia University, New York, NY
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36
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Choi HM, Heo S, Bell ML. The effect modification of greenspace and impervious surface on the heat-mortality association: Differences by the dissimilarity index. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168074. [PMID: 37898198 PMCID: PMC10841598 DOI: 10.1016/j.scitotenv.2023.168074] [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: 06/27/2023] [Revised: 09/26/2023] [Accepted: 10/21/2023] [Indexed: 10/30/2023]
Abstract
Recent studies have shown that heat-mortality risk differs by level of greenspace and impervious surface. However, these studies do not consider both green spaces and impervious surfaces simultaneously, and further did not fully consider community- and individual-level characteristics. In this study we explored the effect modification of greenspace and impervious surface on the association between heat and mortality and how it differs by race/ethnicity dissimilarity index levels in North Carolina, USA. We aggregated datasets for greenspace, impervious surface estimates, temperature, and mortality for 1275 census tracts for North Carolina, USA, for 2000 to 2016 for 5 warm months (May to September). We used distributed lag non-linear models to estimate the heat-mortality relationship in each census tract. Heat-mortality relative risk (RR) was higher for census tracts with low greenspace than high greenspace (RR comparing risk at 99th temperature and minimum mortality temperature: 1.08 (1.02, 1.15) for low greenspace and 0.97 (0.87, 1.08) for high greenspace). Heat-mortality RR was higher for tracts with high impervious surface than low impervious surface (1.04 (1.00, 1.09) for high impervious surface and 0.94 (0.84, 1.05) for low impervious surface). Census tracts with high dissimilarity value and low greenspace had the highest heat-mortality risk compared to the tracts with high dissimilarity value with and high greenspace (1.13 (1.02, 1.24) for high dissimilarity index and 0.97 (0.86, 1.09) for low dissimilarity index). Communities with low greenspace or high impervious surfaces had higher heat-mortality associations, and this effect modification was higher for high race/ethnicity dissimilarity regions.
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Affiliation(s)
| | - Seulkee Heo
- School of the Environment, Yale University, New Haven, CT, USA
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
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Deshpande A, Scovronick N, Clasen TF, Waller L, Wang J, Aravindalochanan V, Balakrishnan K, Puttaswamy N, Peel J, Pillarisetti A. Heat Exposure among Adult Women in Rural Tamil Nadu, India. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:315-322. [PMID: 38153962 PMCID: PMC10785747 DOI: 10.1021/acs.est.3c03461] [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: 05/07/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023]
Abstract
Exposure to heat is associated with a substantial burden of disease and is an emerging issue in the context of climate change. Heat is of particular concern in India, which is one of the world's hottest countries and also most populous, where relatively little is known about personal heat exposure, particularly in rural areas. Here, we leverage data collected as part of a randomized controlled trial to describe personal temperature exposures of adult women (40-79 years of age) in rural Tamil Nadu. We also characterize measurement error in heat exposure assessment by comparing personal exposure measurements to the nearest ambient monitoring stations and to commonly used modeled temperature data products. We find that temperatures differ across individuals in the same area on the same day, sometimes by more than 5 °C within the same hour, and that some individuals experience sharp increases in heat exposure in the early morning or evening, potentially a result of cooking with solid fuels. We find somewhat stronger correlations between the personal exposure measurements and the modeled products than with ambient monitors. We did not find evidence of systematic biases, which indicates that adjusting for discrepancies between different exposure measurement methods is not straightforward.
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Affiliation(s)
- Aniruddha Deshpande
- Department
of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Noah Scovronick
- Gangarosa
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Thomas F. Clasen
- Gangarosa
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Lance Waller
- Department
of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Jiantong Wang
- Department
of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | | | - Kalpana Balakrishnan
- Sri
Ramachandra Institute of Higher Education and Research, Chennai 600116, India
| | - Naveen Puttaswamy
- Sri
Ramachandra Institute of Higher Education and Research, Chennai 600116, India
| | - Jennifer Peel
- Department
of Epidemiology, Colorado State University, Aurora, Colorado 80523, United States
| | - Ajay Pillarisetti
- Division
of Environmental Health Sciences, University
of California Berkeley, Berkeley, California 94720, United States
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Choudhary RK, Joshi P, Ghosh S, Ganguly D, Balakrishnan K, Singh N, Mall RK, Kumar A, Dey S. Excess Mortality Risk Due to Heat Stress in Different Climatic Zones of India. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:342-351. [PMID: 38151765 DOI: 10.1021/acs.est.3c05218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
India is at a high risk of heat stress-induced health impacts and economic losses owing to its tropical climate, high population density, and inadequate adaptive planning. The health impacts of heat stress across climate zones in India have not been adequately explored. Here, we examine and report the vulnerability to heat stress in India using 42 years (1979-2020) of meteorological data from ERA-5 and developed climate-zone-specific percentile-based human comfort class thresholds. We found that the heat stress is usually 1-4 °C higher on heatwave (HW) days than on nonheatwave (NHW) days. However, the stress on NHW days remains considerable and cannot be neglected. We then showed the association of a newly formulated India heat index (IHI) with daily all-cause mortality in three cities - Delhi (semiarid), Varanasi (humid subtropical), and Chennai (tropical wet and dry), using a semiparametric quasi-Poisson regression model, adjusted for nonlinear confounding effects of time and PM2.5. The all-cause mortality risk was enhanced by 8.1% (95% confidence interval, CI: 6.0-10.3), 5.9% (4.6-7.2), and 8.0% (1.7-14.2) during "sweltering" days in Varanasi, Delhi, and Chennai, respectively, relative to "comfortable" days. Across four age groups, the impact was more severe in Varanasi (ranging from a 3.2 to 7.5% increase in mortality risk for a unit rise in IHI) than in Delhi (2.6-4.2% higher risk) and Chennai (0.9-5.7% higher risk). We observed a 3-6 days lag effect of heat stress on mortality in these cities. Our results reveal heterogeneity in heat stress impact across diverse climate zones in India and call for developing an early warning system keeping in mind these regional variations.
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Affiliation(s)
- Rohit Kumar Choudhary
- Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, Delhi 110016, India
- Swami Shraddhanand College, University of Delhi, Delhi 110036, India
| | - Pallavi Joshi
- Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, Delhi 110016, India
| | - Santu Ghosh
- St. John's Medical College, Bengaluru 560034, India
| | - Dilip Ganguly
- Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, Delhi 110016, India
| | - Kalpana Balakrishnan
- SRU-ICMR Centre for Advanced Research on Air Quality, Climate and Health Department of Environmental Health Engineering, Faculty of Public Health, Sri Ramachandra Institute for Higher Education and Research, Chennai 600116, India
| | - Nidhi Singh
- IUF - Leibniz Research Institute for Environmental Medicine, 103045 Düsseldorf, Germany
| | - Rajesh Kumar Mall
- DST-Mahamana Centre of Excellence in Climate Change Research, Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi 221005, India
- Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi 221005, India
| | - Alok Kumar
- Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, Delhi 110016, India
| | - Sagnik Dey
- Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, Delhi 110016, India
- Centre of Excellence for Research on Clean Air, Indian Institute of Technology Delhi, Delhi 110016, India
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Liang C, Yuan J, Tang X, Kan H, Cai W, Chen J. The influence of humid heat on morbidity of megacity Shanghai in China. ENVIRONMENT INTERNATIONAL 2024; 183:108424. [PMID: 38219539 DOI: 10.1016/j.envint.2024.108424] [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: 08/25/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Increased attention has been paid to humid-heat extremes as they are projected to increase in both frequency and intensity. However, it remains unclear how compound extremes of heat and humidity affects morbidity when the climate is projected to continue warming in the future, in particular for a megacity with a large population. METHODS We chose the Wet-Bulb Globe Temperature (WBGT) index as the metric to characterize the humid-heat exposure. The historical associations between daily outpatient visits and daily mean WBGT was established using a Distributed Lag Non-linear Model (DLNM) during the warm season (June to September) from 2013 to 2015 in Shanghai, a prominent megacity of China. Future morbidity burden related to the combined effect of high temperature and humidity were projected under four greenhouse gases (GHGs) emission scenarios (SSP126, SSP245, SSP370 and SSP585). RESULTS The humid-heat weather was significantly associated with a higher risk of outpatient visits in Shanghai than the high-temperature conditions. Relative to the baseline period (2010-2019), the morbidity burden due to humid-heat weather was projected to increase 4.4 % (95 % confidence interval (CI): 1.1 %-10.1 %) even under the strict emission control scenario (SSP126) by 2100. Under the high-GHGs emission scenario (SSP585), this burden was projected to be 25.4 % (95 % CI: 15.8 %-38.4 %), which is 10.1 % (95 % CI: 6.5 %-15.8 %) more than that due to high-temperature weather. Our results also indicate that humid-hot nights could cause large morbidity risks under high-GHGs emission scenarios particularly in heat-sensible diseases such as the respiratory and cardiovascular disease by the end of this century. CONCLUSIONS Humid heat exposures significantly increased the all-cause morbidity risk in the megacity Shanghai, especially in humid-hot nights. Our findings suggest that the combined effect of elevated temperature and humidity is projected to have more substantial impact on health compared to high temperature alone in a warming climate.
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Affiliation(s)
- Chen Liang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China.
| | - Xu Tang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Haidong Kan
- IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Wenjia Cai
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China
| | - Jianmin Chen
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
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Muccione V, Biesbroek R, Harper S, Haasnoot M. Towards a more integrated research framework for heat-related health risks and adaptation. Lancet Planet Health 2024; 8:e61-e67. [PMID: 38199725 DOI: 10.1016/s2542-5196(23)00254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/10/2023] [Accepted: 11/02/2023] [Indexed: 01/12/2024]
Abstract
Advances in research on current and projected heat-related risks from climate change and the associated responses have rapidly developed over the past decade. Modelling architectures of climate impacts and heat-related health risks have become increasingly sophisticated alongside a growing number of experiments and socioeconomic studies, and possible options for heat-related health adaptation are increasingly being catalogued and assessed. However, despite this progress, these efforts often remain isolated streams of research, substantially hampering our ability to contribute to evidence-informed decision making on responding to heat-related health risks. We argue that the integration of scientific efforts towards more holistic research is urgently needed to tackle fragmented evidence and identify crucial knowledge gaps, so that health research can better anticipate and respond to heat-related health risks in the context of a changing climate. In this Personal View, we outline six building blocks, each constituting a research stream, but each needed as part of a more integrated research framework-namely, projected heat-related health risks; adaptation options; the feasibility and effectiveness of adaptation; synergies, trade-offs, and co-benefits of adaptation; adaptation limits and residual risks; and adaptation pathways. We outline their respective importance and discuss their benefits for health-related research and policy.
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Affiliation(s)
- Veruska Muccione
- Department of Geography, University of Zurich, Zurich, Switzerland; Swiss Federal Research Institute WSL, Birmensdorf, Switzerland.
| | - Robbert Biesbroek
- Public Administration and Policy Group, Wageningen University, Wageningen, Netherlands
| | - Sherilee Harper
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Marjolijn Haasnoot
- Deltares, Delft, Netherlands; Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
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Gao Y, Liu Y, He J, Zhang Y, Wang T, Wu L, Sun N, Fang T, Mao H, Tang NJ, Chen X. Effects of heat waves and cold spells on blood parameters: a cohort study of blood donors in Tianjin, China. Environ Health Prev Med 2024; 29:25. [PMID: 38658361 PMCID: PMC11058483 DOI: 10.1265/ehpm.24-00023] [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: 01/29/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND With the increasing occurrence of extreme temperature events due to climate change, the attention has been predominantly focused on the effects of heat waves and cold spells on morbidity and mortality. However, the influence of these temperature extremes on blood parameters has been overlooked. METHODS We conducted a cohort study involving 2,752 adult blood donors in Tianjin, China, between January 18, 2013, and June 25, 2021. The generalized additive mixed model was used to investigate the effects and lagged effects of heat waves and cold spells on six blood parameters of blood donors, including alanine aminotransferase (ALT), white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HB), hematocrit (HCT), and platelet count (PLT). Subgroup analyses were stratified by sex, age, and BMI. RESULTS Heat waves and cold spells are associated with changes in blood parameters, particularly HB and PLT. Heat waves increased HB and PLT, while cold spells increased HB and decreased PLT. The effect of heat waves is greater than that of cold spells. The largest effect of heat waves on HB and PLT occurred at lag1 with 2.6 g/L (95% CI: 1.76 to 3.45) and lag7 with 9.71 × 10^9/L (95% CI: 6.26 to 13.17), respectively, while the largest effect of cold spells on HB and PLT occurred at lag0 with 1.02 g/L (95% CI: 0.71 to 1.33) and lag2 with -3.85 × 10^9/L (95% CI: -5.00 to -2.70), respectively. In subgroup analysis, the effect of cold spells on ALT was greater in the 40-49 age group. CONCLUSION We indicated that heat waves and cold spells can impact hemoglobin and platelet counts in the human body. These findings provide evidence linking heat waves or cold spells to diseases and may reduce health risks caused by extreme temperature events.
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Affiliation(s)
- Yutong Gao
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Sciences and Engineering, Nankai University, Tianjin 300071, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Yifan Liu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Jiayu He
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Yin Zhang
- Tianjin Blood Center, 424 Huanghe Road, Tianjin 300110, China
| | - Ting Wang
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Sciences and Engineering, Nankai University, Tianjin 300071, China
| | - Lin Wu
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Sciences and Engineering, Nankai University, Tianjin 300071, China
| | - Naixiu Sun
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Sciences and Engineering, Nankai University, Tianjin 300071, China
| | - Tiange Fang
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Sciences and Engineering, Nankai University, Tianjin 300071, China
| | - Hongjun Mao
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Sciences and Engineering, Nankai University, Tianjin 300071, China
| | - Nai-jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
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Lo Y, Vosper E, Higgins JP, Howard G. Heat impacts on human health in the Western Pacific Region: an umbrella review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100952. [PMID: 38022710 PMCID: PMC10652124 DOI: 10.1016/j.lanwpc.2023.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Background High temperatures and heatwaves are occurring more frequently and lasting longer because of climate change. A synthesis of existing evidence of heat-related health impacts in the Western Pacific Region (WPR) is lacking. This review addresses this gap. Methods The Scopus and PubMed databases were searched for reviews about heat impacts on mortality, cardiovascular morbidity, respiratory morbidity, dehydration and heat stroke, adverse birth outcomes, and sleep disturbance. The last search was conducted in February 2023 and only publications written in English were included. Primary studies and reviews that did not include specific WPR data were excluded. Data were extracted from 29 reviews. Findings There is strong evidence of heat-related mortality in the WPR, with the evidence concentrating on high-income countries and China. Associations between heat and cardiovascular or respiratory morbidity are not robust. There is evidence of heat-related dehydration and stroke, and preterm and still births in high-income countries in the WPR. Some evidence of sleep disturbance from heat is found for Australia, Japan and China. Interpretation Mortality is by far the most studied and robust health outcome of heat. Future research should focus on morbidity, and lower income countries in continental Asia and Pacific Island States, where there is little review-level evidence. Funding Funded by the World Health Organization WPR Office.
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Affiliation(s)
- Y.T.Eunice Lo
- Cabot Institute for the Environment, University of Bristol, UK
- Elizabeth Blackwell Institute for Health Research, University of Bristol, UK
| | - Emily Vosper
- Cabot Institute for the Environment, University of Bristol, UK
- School of Geographical Sciences, University of Bristol, UK
| | - Julian P.T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Guy Howard
- Cabot Institute for the Environment, University of Bristol, UK
- School of Civil, Aerospace and Design Engineering, University of Bristol, UK
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Wennman H, Partonen T. Impacts of temperature and solar radiation changes in northern Europe on key population health behaviors: a scoping review of reviews. Scand J Public Health 2023:14034948231216909. [PMID: 38142291 DOI: 10.1177/14034948231216909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023]
Abstract
AIM Climate change threatens health directly as well as indirectly through impacts on health-related behaviors. Physical activity, nutrition and sleep are key health-related behaviors for population health. We aimed at elucidating the impacts of climate change which emerge gradually on these three key health-related behaviors, particularly focusing on scenarios and projections relevant to people living in the northern Europe. METHODS We conducted a systematic literature search in three different databases in January 2023 to identify English language review articles summarizing the effects of climate change on either physical activity, nutrition, sleep, or their combination. RESULTS We identified 15 review articles on the topic. Data on climate change impacts on nutrition and sleep were sparse, and those on physical activity were heterogeneous. The climate in northern Europe will become warmer and sunnier in summer as well as warmer and darker in winter, which will probably increase the level of physical activity, but decrease the consumption of fruits and vegetables, as well as increase the occurrence of sleep disturbances in a population. CONCLUSIONS The anticipated changes in physical activity, nutrition and sleep driven by climate change influence population health and call for grass-roots action plans for adaptation.
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Affiliation(s)
- Heini Wennman
- Equality Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Timo Partonen
- Equality Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
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Hsu CY, Wong PY, Chern YR, Lung SCC, Wu CD. Evaluating long-term and high spatiotemporal resolution of wet-bulb globe temperature through land-use based machine learning model. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023:10.1038/s41370-023-00630-1. [PMID: 38104232 DOI: 10.1038/s41370-023-00630-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The increase in global temperature and urban warming has led to the exacerbation of heatwaves, which negatively affect human health and cause long-term loss of work productivity. Therefore, a global assessment in temperature variation is essential. OBJECTIVE This paper is the first of its kind to propose land-use based spatial machine learning (LBSM) models for predicting highly spatial-temporal variations of wet-bulb globe temperature (WBGT), which is a heat stress indicator used to assess thermal comfort in indoor and outdoor environments, specifically for the main island of Taiwan. METHODS To develop spatiotemporal prediction models for both the working period and noon period, we calculated the WBGT of each weather station from 2001 to 2019 using temperature, humidity, and solar radiation data. These WBGT estimations were then used as the dependent variable for developing the spatiotemporal prediction models. To enhance model performance, we used innovative approaches that combined SHapley Additive exPlanations (SHAP) values for the selection of non-linear variables, along with machine learning algorithms for model development. RESULTS When incorporating temperature along with other land-use/land cover predictor variables, the performance of LBSM models was excellent, with an R2 value of up to 0.99. The LBSM models explained 98% and 99% of the spatial-temporal variations in WBGT for the working and noon periods, respectively, within the complete models. In the temperature-excluded models, the explained variances were 94% and 96% for the working and noon periods, respectively. IMPACT WBGT is a common method used by many organizations to access the impact of heat stress on human beings. However, limited studies have mentioned the association between WBGT and health impacts due to the absence of spatiotemporal databases. This study develops a new approach using land-use-based spatial machine learning (LBSM) models to better predict the fine spatial-temporal WBGT levels, with a 50-m × 50-m grid resolution for both working time and noontime. Our proposed methodology could be used in future studies aimed at evaluating the potential long-term loss of work productivity due to the effects of global warming or urban heat island.
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Affiliation(s)
- Chin-Yu Hsu
- Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan
- Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, New Taipei City, Taiwan
| | - Pei-Yi Wong
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Yinq-Rong Chern
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan
- Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan.
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
- Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Tainan, Taiwan.
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Fonseca-Rodríguez O, Adams RE, Sheridan SC, Schumann B. Projection of extreme heat- and cold-related mortality in Sweden based on the spatial synoptic classification. ENVIRONMENTAL RESEARCH 2023; 239:117359. [PMID: 37863163 DOI: 10.1016/j.envres.2023.117359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/30/2023] [Accepted: 10/07/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Climate change is projected to result in increased heat events and decreased cold events. This will substantially impact human health, particularly when compounded with demographic change. This study employed the Spatial Synoptic Classification (SSC) to categorize daily weather into one of seven types. Here we estimated future mortality due to extremely hot and cold weather types under different climate change scenarios for one southern (Stockholm) and one northern (Jämtland) Swedish region. METHODS Time-series Poisson regression with distributed lags was used to assess the relationship between extremely hot and cold weather events and daily deaths in the population above 65 years, with cumulative effects (6 days in summer, 28 days in winter), 1991 to 2014. A global climate model (MPI-M-MPI-ESM-LR) and two climate change scenarios (RCP 4.5 and 8.5) were used to project the occurrence of hot and cold days from 2031 to 2070. Place-specific projected mortality was calculated to derive attributable numbers and attributable fractions (AF) of heat- and cold-related deaths. RESULTS In Stockholm, for the RCP 4.5 scenario, the mean number of annual deaths attributed to heat increased from 48.7 (CI 32.2-64.2; AF = 0.68%) in 2031-2040 to 90.2 (56.7-120.5; AF = 0.97%) in 2061-2070, respectively. For RCP 8.5, heat-related deaths increased more drastically from 52.1 (33.6-69.7; AF = 0.72%) to 126.4 (68.7-175.8; AF = 1.36%) between the first and the last decade. Cold-related deaths slightly increased over the projected period in both scenarios. In Jämtland, projections showed a small decrease in cold-related deaths but no change in heat-related mortality. CONCLUSIONS In rural northern region of Sweden, a decrease of cold-related deaths represents the dominant trend. In urban southern locations, on the other hand, an increase of heat-related mortality is to be expected. With an increasing elderly population, heat-related mortality will outweigh cold-related mortality at least under the RCP 8.5 scenario, requiring societal adaptation measures.
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Affiliation(s)
- Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87 Umeå, Sweden.
| | - Ryan E Adams
- Department of Geography, Kent State University, Kent, OH 44242, USA
| | - Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH 44242, USA
| | - Barbara Schumann
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87 Umeå, Sweden; Department of Health and Caring Sciences, Linnaeus University, 391 82 Kalmar, Sweden
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Kim S, Byun G, Lee JT. Association between non-optimal temperature and cardiovascular hospitalization and its temporal variation at the intersection of disability. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166874. [PMID: 37683874 DOI: 10.1016/j.scitotenv.2023.166874] [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: 06/19/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND While previous research has identified populations susceptible to non-optimal temperatures, disability has been largely overlooked. Given the growing number of persons with disabilities (PwD) and their social and health disadvantages, understanding how disability intersects with temperature-related health effects is crucial. This study aimed to investigate the associations between non-optimal temperatures and cardiovascular disease (CVD) hospitalization and examine how these associations vary over time considering the existence of disability. METHODS We used the National Health Insurance Service-National Sample Cohort to investigate the association between non-optimal temperatures and CVD hospitalization in South Korea, 2002-2019. We obtained daily mean temperature from the Korea Meteorological Administration's automated synoptic observing system. We applied a space-time-stratified case-crossover design using a conditional quasi-Poisson regression with a distributed lag non-linear model, adjusting for relative humidity, wind speed, and public holidays. We examined temporal variations in temperature-CVD hospitalization associations using a time window approach. All analyses used the minimum hospitalization temperature (20.0 °C) as reference and were stratified by disability status. RESULTS The cumulative exposure-response curve in persons without disabilities showed a J-shape with a relative risk (RR) of 1.07 (95 % confidence interval [CI]: 0.99, 1.15) at extreme heat (99th percentile) and 1.09 (95 % CI: 0.97, 1.23) at extreme cold (1st percentile). The cumulative exposure-response curve in PwD showed an M-shape with the highest RR at chill (1.22 [95 % CI: 1.13, 1.32]) and moderate cold temperature (1.11 [95 % CI: 1.01, 1.21]), defined as the 30th and 5th percentiles, respectively. The impacts of heat and cold decreased over time for persons without disabilities but increased for PwD. CONCLUSIONS Our study found differential temperature-related impacts on CVD hospitalization based on disability status, and PwD were maladapted to heat and cold over time. This suggests the importance of considering disability when investigating temperature-related health disparity and adopting disability-inclusive adaptation strategies.
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Affiliation(s)
- Sera Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea
| | - Garam Byun
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea; School of the Environment, Yale University, New Haven, CT 06511, USA
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea; School of Health Policy and Management, College of Health Sciences, Korea University, Seoul 02841, Republic of Korea.
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Yin P, Gao Y, Chen R, Liu W, He C, Hao J, Zhou M, Kan H. Temperature-related death burden of various neurodegenerative diseases under climate warming: a nationwide modelling study. Nat Commun 2023; 14:8236. [PMID: 38086884 PMCID: PMC10716387 DOI: 10.1038/s41467-023-44066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Limited knowledge exists regarding the ramifications of climate warming on death burden from neurodegenerative diseases. Here, we conducted a nationwide, individual-level, case-crossover study between 2013 and 2019 to investigate the effects of non-optimal temperatures on various neurodegenerative diseases and to predict the potential death burden under different climate change scenarios. Our findings reveal that both low and high temperatures are linked to increased risks of neurodegenerative diseases death. We project that heat-related neurodegenerative disease deaths would increase, while cold-related deaths would decrease. This is characterized by a steeper slope in the high-emission scenario, but a less pronounced trend in the scenarios involving mitigation strategies. Furthermore, we predict that the net changes in attributable death would increase after the mid-21st century, especially under the unrestricted-emission scenario. These results highlight the urgent need for effective climate and public health policies to address the growing challenges of neurodegenerative diseases associated with global warming.
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Affiliation(s)
- Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Wei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cheng He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Junwei Hao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
- National Center for Neurological Disorders, Beijing, China.
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
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Liu J, Varghese BM, Hansen A, Dear K, Morgan G, Driscoll T, Zhang Y, Gourley M, Capon A, Bi P. Projection of high temperature-related burden of kidney disease in Australia under different climate change, population and adaptation scenarios: population-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100916. [PMID: 37867620 PMCID: PMC10587708 DOI: 10.1016/j.lanwpc.2023.100916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023]
Abstract
Background The dual impacts of a warming climate and population ageing lead to an increasing kidney disease prevalence, highlighting the importance of quantifying the burden of kidney disease (BoKD) attributable to high temperature, yet studies on this subject are limited. The study aims to quantify the BoKD attributable to high temperatures in Australia across all states and territories, and project future BoKD under climatic, population and adaptation scenarios. Methods Data on disability-adjusted-life-years (DALYs) due to kidney disease, including years of life lost (YLL), and years lived with disability (YLD), were collected during 2003-2018 (baseline) across all states and territories in Australia. The temperature-response association was estimated using a meta-regression model. Future temperature projections were calculated using eight downscaled climate models to estimate changes in attributable BoKD centred around 2030s and 2050s, under two greenhouse gas emissions scenarios (RCP4.5 and RCP8.5), while considering changes in population size and age structure, and human adaptation to climate change. Findings Over the baseline (2003-2018), high-temperature contributed to 2.7% (Standard Deviation: 0.4%) of the observed BoKD in Australia. The future population attributable fraction and the attributable BoKD, projected using RCP4.5 and RCP8.5, showed a gradually increasing trend when assuming no human adaptation. Future projections were most strongly influenced by the population change, with the high temperature-related BoKD increasing by 18.4-67.4% compared to the baseline under constant population and by 100.2-291.2% when accounting for changes in population size and age structure. However, when human adaptation was adopted (from no to partial to full), the high temperature-related BoKD became smaller. Interpretation It is expected that increasing high temperature exposure will substantially contribute to higher BoKD across Australia, underscoring the urgent need for public health interventions to mitigate the negative health impacts of a warming climate on BoKD. Funding Australian Research Council Discovery Program.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia
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Ju Y, Dronova I, Rodriguez DA, Bakhtsiyarava M, Farah I. Recent greening may curb urban warming in Latin American cities of better economic conditions. LANDSCAPE AND URBAN PLANNING 2023; 240:None. [PMID: 38046954 PMCID: PMC10570748 DOI: 10.1016/j.landurbplan.2023.104896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/04/2023] [Accepted: 09/13/2023] [Indexed: 12/05/2023]
Abstract
Rising temperatures have profound impacts on the well-being of urban residents. However, factors explaining the temporal variability of urban thermal environment, or urban warming, remain insufficiently understood, especially in the Global South. Addressing this gap, we studied the relationship between city-level economic conditions and urban warming, and how urban green space mediated this relationship, focusing on 359 major Latin American cities between 2001 and 2022. While effect sizes varied by economic and temperature measures used, we found that better economic conditions were associated with lower baseline greenness in 2011, which contributed to faster warming. There was modest evidence that this faster warming associated with lower baseline greenness and improved economic conditions was partially offset by cooling from recent greening (2001-2022) in cities of better economic conditions. This offset was more evident in arid cities. Together, these findings provide insights into the urban warming mechanism manifested through the effect of economic conditions on urban green space, for Latin American cities and other high-density cities transforming in a similar context.
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Affiliation(s)
- Yang Ju
- School of Architecture and Urban Planning, Nanjing University, Rm. 810, Jianliang Bldg., No. 22 Hankou Rd., Nanjing, China
| | - Iryna Dronova
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, USA
- Department of Landscape Architecture and Environmental Planning, University of California, Berkeley, USA
| | - Daniel A. Rodriguez
- Department of City and Regional Planning, University of California, Berkeley, USA
- Institute of Transportation Studies, University of California, Berkeley, USA
| | - Maryia Bakhtsiyarava
- Institute of Urban and Regional Development, University of California, Berkeley, USA
| | - Irene Farah
- Department of City and Regional Planning, University of California, Berkeley, USA
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Kivimäki M, Batty GD, Pentti J, Suomi J, Nyberg ST, Merikanto J, Nordling K, Ervasti J, Suominen SB, Partanen AI, Stenholm S, Käyhkö J, Vahtera J. Climate Change, Summer Temperature, and Heat-Related Mortality in Finland: Multicohort Study with Projections for a Sustainable vs. Fossil-Fueled Future to 2050. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127020. [PMID: 38150315 PMCID: PMC10752417 DOI: 10.1289/ehp12080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Climate change scenarios illustrate various pathways in terms of global warming ranging from "sustainable development" (Shared Socioeconomic Pathway SSP1-1.9), the best-case scenario, to 'fossil-fueled development' (SSP5-8.5), the worst-case scenario. OBJECTIVES We examined the extent to which increase in daily average urban summer temperature is associated with future cause-specific mortality and projected heat-related mortality burden for the current warming trend and these two scenarios. METHODS We did an observational cohort study of 363,754 participants living in six cities in Finland. Using residential addresses, participants were linked to daily temperature records and electronic death records from national registries during summers (1 May to 30 September) 2000 to 2018. For each day of observation, heat index (average daily air temperature weighted by humidity) for the preceding 7 d was calculated for participants' residential area using a geographic grid at a spatial resolution of 1 km × 1 km . We examined associations of the summer heat index with risk of death by cause for all participants adjusting for a wide range of individual-level covariates and in subsidiary analyses using case-crossover design, computed the related period population attributable fraction (PAF), and projected change in PAF from summers 2000-2018 compared with those in 2030-2050. RESULTS During a cohort total exposure period of 582,111,979 summer days (3,880,746 person-summers), we recorded 4,094 deaths, including 949 from cardiovascular disease. The multivariable-adjusted rate ratio (RR) for high (≥ 21 ° C ) vs. reference (14 - 15 ° C ) heat index was 1.70 (95% CI: 1.28, 2.27) for cardiovascular mortality, but it did not reach statistical significance for noncardiovascular deaths, RR = 1.14 (95% CI: 0.96, 1.36), a finding replicated in case-crossover analysis. According to projections for 2030-2050, PAF of summertime cardiovascular mortality attributable to high heat will be 4.4% (1.8%-7.3%) under the sustainable development scenario, but 7.6% (3.2%-12.3%) under the fossil-fueled development scenario. In the six cities, the estimated annual number of summertime heat-related cardiovascular deaths under the two scenarios will be 174 and 298 for a total population of 1,759,468 people. DISCUSSION The increase in average urban summer temperature will raise heat-related cardiovascular mortality burden. The estimated magnitude of this burden is > 1.5 times greater if future climate change is driven by fossil fuels rather than sustainable development. https://doi.org/10.1289/EHP12080.
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Affiliation(s)
- Mika Kivimäki
- University College London (UCL) Brain Sciences, UCL, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - G. David Batty
- University College London (UCL) Brain Sciences, UCL, London, UK
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
| | - Juuso Suomi
- Department of Geography and Geology, UTU, Turku, Finland
| | - Solja T. Nyberg
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Kalle Nordling
- Finnish Meteorological Institute, Helsinki, Finland
- Centre for International Climate and Environmental Research, Oslo, Norway
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Sakari B. Suominen
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Turku University Hospital, Turku, Finland
- School of Health Science, University of Skövde, Skövde, Sweden
| | | | - Sari Stenholm
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
| | - Jukka Käyhkö
- Department of Geography and Geology, UTU, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
- Turku University Hospital, Turku, Finland
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