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Luque-García L, Bataineh S, Al-Bakri J, Abdulla FA, Al-Delaimy WK. The heat-mortality association in Jordan: Effect modification by greenness, population density and urbanization level. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 952:176010. [PMID: 39233083 DOI: 10.1016/j.scitotenv.2024.176010] [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: 06/15/2024] [Revised: 08/10/2024] [Accepted: 09/01/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND The Middle East is one of the most vulnerable regions to the impacts of climate change, yet evidence of the heat-related mortality remains limited in this area. Our present study investigated the heat-mortality association in Jordan and the potential modifying effect of greenness, population density and urbanization level on the association. METHODS For each of the 42 included districts, daily meteorological and mortality data from 2000 to 2020 were obtained for the warmest months (May to September). First, a distributed lag non-linear model was applied to estimate the district level heat-mortality association, then the district specific estimates were pooled using multivariate meta-regression models to obtain an overall estimate. Last, the modifying effect of district level greenness, population density and urbanization level was examined through subgroup analysis. RESULTS When compared to the minimum mortality temperature (MMT, percentile 0th, 22.20 °C), the 99th temperature percentile exhibited a relative risk (RR) of 1.34 (95 % CI 1.23, 1.45). Districts with low greenness had a higher heat-mortality risk (RR 1.39, 95 % CI 1.22, 1.58) when compared to the high greenness (RR 1.28, 95 % CI 1.13, 1.45). While heat-mortality risk did not significantly differ between population density subgroups, highly urbanized districts had a greater heat-mortality risk (RR 1.41, 95 % CI 1.23, 1.62) as compared to ones with low levels of urbanization (RR 1.32, 95 % CI 1.13, 1.55). Districts with high urbanization level had the highest heat-mortality risk if they were further categorized as having low greenness (RR 1.63, 95 % CI 1.30, 2.04). CONCLUSION Exposure to heat was associated with increased mortality risk in Jordan. This risk was higher in districts with low greenness and high urbanization level. As climate change-related heat mortality will be on the rise, early warning systems in highly vulnerable communities in Jordan are required and greening initiatives should be pursued.
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Affiliation(s)
- L Luque-García
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014 Donostia-San Sebastián, Spain; Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga 20700, Spain
| | - S Bataineh
- Civil Engineering Department, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - J Al-Bakri
- Department of Land, Water and Environment, School of Agriculture, The University of Jordan, Amman 11942, Jordan
| | - F A Abdulla
- Civil Engineering Department, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - W K Al-Delaimy
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States.
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Bianco G, Espinoza-Chávez RM, Ashigbie PG, Junio H, Borhani C, Miles-Richardson S, Spector J. Projected impact of climate change on human health in low- and middle-income countries: a systematic review. BMJ Glob Health 2024; 8:e015550. [PMID: 39357915 DOI: 10.1136/bmjgh-2024-015550] [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: 03/08/2024] [Accepted: 08/23/2024] [Indexed: 10/04/2024] Open
Abstract
Low- and middle-income countries (LMICs) contribute relatively little to global carbon emissions but are recognised to be among the most vulnerable parts of the world to health-related consequences of climate change. To help inform resilient health systems and health policy strategies, we sought to systematically analyse published projections of the impact of rising global temperatures and other weather-related events on human health in LMICs. A systematic search involving multiple databases was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies with modelled projections of the future impact of climate change on human health. Qualitative studies, reviews and meta-analyses were excluded. The search yielded more than 2500 articles, of which 70 studies involving 37 countries met criteria for inclusion. China, Brazil and India were the most studied countries while the sub-Saharan African region was represented in only 9% of studies. Forty specific health outcomes were grouped into eight categories. Non-disease-specific temperature-related mortality was the most studied health outcome, followed by neglected tropical infections (predominantly dengue), malaria and cardiovascular diseases. Nearly all health outcomes studied were projected to increase in burden and/or experience a geographic shift in prevalence over the next century due to climate change. Progressively severe climate change scenarios were associated with worse health outcomes. Knowledge gaps identified in this analysis included insufficient studies of various high burden diseases, asymmetric distribution of studies across LMICs and limited use of some climate parameters as independent variables. Findings from this review could be the basis for future research to help inform climate mitigation and adaptation programmes aimed at safeguarding population health in LMICs.
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Affiliation(s)
- Gaia Bianco
- Biomedical Research, Novartis, Basel, Switzerland
| | | | - Paul G Ashigbie
- Biomedical Research, Novartis, Cambridge, Massachusetts, USA
| | - Hiyas Junio
- University of the Philippines, Diliman, Philippines
| | - Cameron Borhani
- Global Health and Sustainability, Novartis, Basel, Switzerland
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Albahsahli B, Dimitrova A, Kadri N, Benmarhnia T, Al-Rousan T. Mapping Climate-Related Hazards along Migration Routes: A Mixed Methods Study of Hypertensive Syrian and Iraqi Refugees Resettled in San Diego, California. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:97701. [PMID: 39226182 PMCID: PMC11370993 DOI: 10.1289/ehp14632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 08/14/2024] [Accepted: 08/16/2024] [Indexed: 09/05/2024]
Affiliation(s)
- Behnan Albahsahli
- Herbert Wertheim School of Public Health, University of California, San Diego, California, USA
| | - Anna Dimitrova
- Scripps Institution of Oceanography, University of California, San Diego, California, USA
| | - Nadine Kadri
- Western University of Health Sciences, Pomona, California, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, California, USA
| | - Tala Al-Rousan
- Herbert Wertheim School of Public Health, University of California, San Diego, California, USA
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Ma M, Kouis P, Rudke AP, Athanasiadou M, Scoutellas V, Tymvios F, Nikolaidis K, Koutrakis P, Yiallouros PK, Alahmad B. Projections of mortality attributable to hot ambient temperatures in Cyprus under moderate and extreme climate change scenarios. Int J Hyg Environ Health 2024; 262:114439. [PMID: 39096580 DOI: 10.1016/j.ijheh.2024.114439] [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: 03/01/2024] [Revised: 07/18/2024] [Accepted: 07/31/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Heat-related mortality has become a growing public health concern in light of climate change. However, few studies have quantified the climate-attributable health burden in Cyprus, a recognized climate change hotspot. This study aims to estimate the heat-related mortality in Cyprus for all future decades in the 21st century under moderate (SSP2-4.5) and extreme (SSP5-8.5) climate scenarios. METHODS We applied distributed lag non-linear models to estimate the baseline associations between temperature and mortality from 2004 to 2019 (data obtained from Department of Meteorology of the Ministry of Agriculture, Rural Development and Environment and the Health Monitoring Unit of the Cyprus Ministry of Health). The relationships were then extrapolated to future daily mean temperatures derived from downscaled global climate projections from General Circulation Models. Attributable number of deaths were calculated to determine the excess heat-related health burden compared to the baseline decade of 2000-2009 in the additive scale. The analysis process was repeated for all-cause, cardiovascular, and respiratory mortality and mortality among males, females, and adults younger or older than 65. We assumed a static population and demographic structure, no adaptation to hot temperatures over time, and did not evaluate potential interaction between temperature and humidity. RESULTS Compared to 2000-2009, heat-related total mortality is projected to increase by 2.7% (95% empirical confidence interval: 0.6, 4.0) and 4.75% (2.2, 7.1) by the end of the century in the moderate and extreme climate scenarios, respectively. Cardiovascular disease is expected to be an important cause of heat-related death with projected increases of 3.4% (0.7, 5.1) and 6% (2.6, 9.0) by the end of the century. Reducing carbon emission to the moderate scenario can help avoid 75% of the predicted increase in all-cause heat-related mortality by the end of the century relative to the extreme scenario. CONCLUSIONS Our findings suggest that climate change mitigation and sustainable adaptation strategies are crucial to reduce the anticipated heat-attributable health burden, particularly in Cyprus, where adaptation strategies such as air conditioning is nearing capacity.
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Affiliation(s)
- Mingyue Ma
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, USA.
| | - Panayiotis Kouis
- Respiratory Physiology Laboratory, Medical School, University of Cyprus, Cyprus
| | - Anderson Paulo Rudke
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Brazil
| | | | | | - Filippos Tymvios
- Department of Meteorology, Cyprus Ministry of Agriculture, Rural Development and Environment, Cyprus
| | - Kleanthis Nikolaidis
- Department of Meteorology, Cyprus Ministry of Agriculture, Rural Development and Environment, Cyprus
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, USA
| | | | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, USA; Dasman Diabetes Institute, Kuwait City, Kuwait
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Ullah S, Aldossary A, Ullah W, Al-Ghamdi SG. Augmented human thermal discomfort in urban centers of the Arabian Peninsula. Sci Rep 2024; 14:3974. [PMID: 38368465 PMCID: PMC10874419 DOI: 10.1038/s41598-024-54766-7] [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: 11/01/2023] [Accepted: 02/16/2024] [Indexed: 02/19/2024] Open
Abstract
Anthropogenic climate change has amplified human thermal discomfort in urban environments. Despite the considerable risks posed to public health, there is a lack of comprehensive research, evaluating the spatiotemporal changes in human thermal discomfort and its characteristics in hot-hyper arid regions, such as the Arabian Peninsula (AP). The current study analyzes spatiotemporal changes in human thermal discomfort categories and their characteristics in AP, using the newly developed high-resolution gridded ERA5-HEAT (Human thErmAl comforT) dataset for the period 1979-2022. In addition, the study assesses the interplay between the Universal Thermal Climate Index (UTCI) and El Niño-Southern Oscillation (ENSO) indices for the study period. The results reveal a significant increase in human thermal discomfort and its characteristics, with higher spatial variability in the AP region. The major urban centers in the southwestern, central, and southeastern parts of AP have experienced significant increases in human thermal discomfort (0.4-0.8 °C), with higher frequency and intensity of thermal stress during the study period. The temporal distribution demonstrates a linear increase in UTCI indices and their frequencies and intensities, particularly from 1998 onward, signifying a transition towards a hotter climate characterized by frequent, intense, and prolonged heat stress conditions. Moreover, the UTCI and ENSO indices exhibit a dipole pattern of correlation with a positive (negative) pattern in the southwestern (eastern parts) of AP. The study's findings suggest that policymakers and urban planners need to prioritize public health and well-being in AP's urban areas, especially for vulnerable groups, by implementing climate change adaptation and mitigation strategies, and carefully designing future cities to mitigate the effects of heat stress.
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Affiliation(s)
- Safi Ullah
- Environmental Science and Engineering Program, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), 23955-6900, Thuwal, Saudi Arabia
- KAUST Climate and Livability Initiative, King Abdullah University of Science and Technology (KAUST), 23955-6900, Thuwal, Saudi Arabia
| | - Abdullah Aldossary
- KAUST Climate and Livability Initiative, King Abdullah University of Science and Technology (KAUST), 23955-6900, Thuwal, Saudi Arabia
- School of Computer, Data and Information Sciences, University of Wisconsin-Madison, Madison, WI, 53715-1007, USA
| | - Waheed Ullah
- Defense and Security, Rabdan Academy, 114646, Abu Dhabi, United Arab Emirates
| | - Sami G Al-Ghamdi
- Environmental Science and Engineering Program, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), 23955-6900, Thuwal, Saudi Arabia.
- KAUST Climate and Livability Initiative, King Abdullah University of Science and Technology (KAUST), 23955-6900, Thuwal, Saudi Arabia.
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Nassikas NJ, Gold DR. Climate change is a health crisis with opportunities for health care action: A focus on health care providers, patients with asthma and allergic immune diseases, and their families and neighbors. J Allergy Clin Immunol 2023; 152:1047-1052. [PMID: 37742937 PMCID: PMC10841871 DOI: 10.1016/j.jaci.2023.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023]
Abstract
Climate change has increased the frequency of extreme weather events and compounded natural disasters. Heat, wildfires, flooding, and pollen are already threatening public health and disproportionately affecting individuals in susceptible situations and vulnerable locations. In this theme issue of the Journal of Allergy and Clinical Immunology, we address what is known and not known about the biologic as well as clinical upstream and downstream effects of climate change on asthma and allergy development and exacerbation. We present potential actions that individuals can take at the family, neighborhood, community, health care system, and national and international levels to build climate resilience and protect their own health and the health and welfare of others. We emphasize the importance of actions and policies that are context specific and just. We emphasize the need for the health care system, which contributes between 3% and 5% of global greenhouse gas emissions, to reduce its carbon footprint and build resiliency. Health care providers play a pivotal role in helping policymakers understand the effects of climate on the health of our patients. There is still a window to avoid the most serious effects of climate change on human health and our planet.
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Affiliation(s)
- Nicholas J Nassikas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Mass.
| | - Diane R Gold
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
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Albahsahli B, Dimitrova A, Kadri N, Benmarhnia T, Rousan TA. Implications of climate-related disasters on refugees' health: A case study of resettled Syrian and Iraqi refugees in San Diego, California. RESEARCH SQUARE 2023:rs.3.rs-3392999. [PMID: 37886471 PMCID: PMC10602067 DOI: 10.21203/rs.3.rs-3392999/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Background Climate change disproportionately harms people of color and low-income communities. Despite their unprecedented numbers, being constantly on the move, and suffering extreme social vulnerability, almost nothing is known about the impact of climate change on the health of refugees. This study uses state-of-the-art mixed methods to examine the differential susceptibility of climate-sensitive exposures and environmental exposures among refugees and their links to perceived health after resettlement. Methods Arabic-speaking refugees (N=67) from Iraq and Syria previously diagnosed with hypertension who resettled in California were recruited from a community center. Semi-structured interviews were conducted to explore participant's understanding of the impact of climate on health. Survey data were collected to inquire regarding participant's refugee journeys prior to resettlement in the US. Survey data on climate-related disasters was retrospectively geo-referenced through the Emergency Events Database (EM-DAT). Qualitative data was analyzed using inductive thematic analysis. Results All participants stayed in at least one temporary resettlement country during their migration journey and 12% has stayed in refugee camps. The most popular resettlement sites were Turkey (most disaster-prone in the region due to frequent floods and earthquakes) and Jordan (one of the most extreme water-scarce globally). Participants reported harsh weather conditions during their migratory journeys including extreme cold in Turkey and extreme heat in Jordan. Many participants noted their exposure to dust throughout their travels, and an inability to deal with harsh weather conditions due to financial insecurity. Participants did not link their diagnosis of hypertension to their experience of extreme weather and would only link it to their exposure to stress from war. Participants did note poorer mental health due to poor weather conditions and a challenge adjusting to the climate conditions in different countries. Few participants reported residing in a refugee camp and described it as ill-equipped for the challenges of climate hazards. Conclusion This study reveals the links between structural drivers of climate change and health inequities for refugee populations. Refugees are highly vulnerable to climate-sensitive exposures but remain not fully aware of the potential links between these exposures and health. Learnings from this study will inform clinical and public health interventions, and policies to close the climate gap without leaving this vulnerable population behind.
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Affiliation(s)
- Behnan Albahsahli
- Herbert Wertheim School of Public Health, University of California, San Diego, USA
| | - Anna Dimitrova
- Scripps Institution of Oceanography, University of California, San Diego, USA
| | - Nadine Kadri
- Western University of Health Sciences, Pomona, California, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, USA
| | - Tala Al Rousan
- Herbert Wertheim School of Public Health, University of California, San Diego, USA
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Schmidt S. Precision Public Health Opportunity: Heat-Associated Mortality Greater among Pilgrims during Hajj. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:64001. [PMID: 37267062 DOI: 10.1289/ehp13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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