Effects of Increasing Aridity on Ambient Dust and Public Health in the U.S. Southwest Under Climate Change

Dust storms and cardiorespiratory emergency department visits in three Southwestern United States: application of a monitoring-based exposure metric

Climate change is projected to increase the risk of dust storms, particularly in subtropical dryland, including the southwestern US. Research on dust storm's health impacts in the US is limited and hindered by challenges in dust storm identification. This study assesses the potential link between dust storms and cardiorespiratory emergency department (ED) visits in the southwestern US. We acquired data for 2005-2016 from eight IMPROVE (Interagency Monitoring of PROtected Visual Environments) sites in Arizona, California, and Utah. We applied a validated algorithm to identify dust storm days at each site. We acquired patient-level ED visit data from state agencies and ascertained visits for respiratory, cardiovascular, and cause-specific subgroups among patients residing in ZIP codes within 50 km of an IMPROVE site. Using a case-crossover design, we estimated short-term associations of ED visits and dust storms, controlling for temporally varying covariates. During 2005-2016, 40 dust storm days occurred at the eight IMPROVE sites. Mean PM10 and PM2.5 levels were three to six times greater on dust storm days compared to non-dust storm days. Over the study period, there were 2 524 259 respiratory and 2 805 925 cardiovascular ED visits. At lags of 1, 2, and 3 days after a dust storm, we observed 3.7% (95% CI: 1.0%, 7.6%), 4.9% (95% CI: 1.1%, 8.9%), and 5.0% (95% CI: 1.3%, 8.9%) elevated odds of respiratory ED visits compared to non-dust storm days. Estimated associations of dust storm days and cardiovascular disease ED visits were largely consistent with the null. Using a monitoring-based exposure metric, we observed associations among dust storms and respiratory ED visits. The results add to growing evidence of the health threat posed by dust storms. The dust storm metric was limited by lack of daily data; future research should consider information from satellite and numerical models to enhance dust storm characterization.

Climate change and public health in California: A structured review of exposures, vulnerable populations, and adaptation measures

California faces several serious direct and indirect climate exposures that can adversely affect public health, some of which are already occurring. The public health burden now and in the future will depend on atmospheric greenhouse gas concentrations, underlying population vulnerabilities, and adaptation efforts. Here, we present a structured review of recent literature to examine the leading climate risks to public health in California, including extreme heat, extreme precipitation, wildfires, air pollution, and infectious diseases. Comparisons among different climate-health pathways are difficult due to inconsistencies in study design regarding spatial and temporal scales and health outcomes examined. We find, however, that the current public health burden likely affects thousands of Californians each year, depending on the exposure pathway and health outcome. Further, while more evidence exists for direct and indirect proximal health effects that are the focus of this review, distal pathways (e.g., impacts of drought on nutrition) are more uncertain but could add to this burden. We find that climate adaptation measures can provide significant health benefits, particularly in disadvantaged communities. We conclude with priority recommendations for future analyses and solution-driven policy actions.

The influence of long-range transported Saharan dust on the inflammatory potency of ambient PM2.5 and PM10

Although desert dust promotes morbidity and mortality, it is exempt from regulations. Its health effects have been related to its inflammatory properties, which can vary between source regions. It remains unclear which constituents cause this variability. Moreover, whether long-range transported desert dust potentiates the hazardousness of local particulate matter (PM) is still unresolved. We aimed to assess the influence of long-range transported desert dust on the inflammatory potency of PM2.5 and PM10 collected in Cape Verde and to examine associated constituents. During a reference period and two Saharan dust events, 63 PM2.5 and PM10 samples were collected at four sampling stations. The content of water-soluble ions, elements, and organic and elemental carbon was measured in all samples and endotoxins in PM10 samples. The PM-induced release of inflammatory cytokines from differentiated THP-1 macrophages was evaluated. The association of interleukin (IL)-1β release with PM composition was assessed using principal component (PC) regressions. PM2.5 from both dust events and PM10 from one event caused higher IL-1β release than PM from the reference period. PC regressions indicated an inverse relation of IL-1β release with sea spray ions in both size fractions and organic and elemental carbon in PM2.5. The PC with the higher regression coefficient suggested that iron and manganese may contribute to PM2.5-induced IL-1β release. Only during the reference period, endotoxin content strongly differed between sampling stations and correlated with inflammatory potency. Our results demonstrate that long-range transported desert dust amplifies the hazardousness of local air pollution and suggest that, in PM2.5, iron and manganese may be important. Our data indicate that endotoxins are contained in local and long-range transported PM10 but only explain the variability in inflammatory potency of local PM10. The increasing inflammatory potency of respirable and inhalable PM from desert dust events warrants regulatory measures and risk mitigation strategies.

Continued Rise in Health Burden from Ambient PM2.5 in India under SSP Scenarios Until 2100 despite Decreasing Concentrations

Forecasting alterations in ambient air pollution and the consequent health implications is crucial for safeguarding public health, advancing environmental sustainability, informing economic decision making, and promoting appropriate policy and regulatory action. However, predicting such changes poses a substantial challenge, requiring accurate data, sophisticated modeling methodologies, and a meticulous evaluation of multiple drivers. In this study, we calculate premature deaths due to ambient fine particulate matter (PM2.5) exposure in India from the 2020s (2016-2020) to the 2100s (2095-2100) under four different socioeconomic and climate scenarios (SSPs) based on four CMIP6 models. PM2.5 concentrations decreased in all SSP scenarios except for SSP3-7.0, with the lowest concentration observed in SSP1-2.6. The results indicate an upward trend in the five-year average number of deaths across all scenarios, ranging from 1.01 million in the 2020s to 4.12-5.44 million in the 2100s. Further analysis revealed that the benefits of reducing PM2.5 concentrations under all scenarios are largely mitigated by population aging and growth. These findings underscore the importance of proactive measures and an integrated approach in India to improve atmospheric quality and reduce vulnerability to aging under changing climate conditions.

Saharan dust induces the lung disease-related cytokines granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor

Desert dust exposure is associated with adverse respiratory health effects. Desert dust is a complex pollutant mixtures that includes respirable crystalline and amorphous particles, metals, and microbial constituents. Given the health effects of desert dust and its heterogeneity, as yet unidentified harmful biological pathways may be triggered. Therefore, we exposed human in vitro air-liquid interface co-cultures of alveolar epithelial A549 cells and THP-1 macrophages to Saharan dust (SD). For comparison, we used the known pulmonary toxicant DQ12 quartz dust. Via RNA sequencing, we identified that SD but not DQ12 increased the gene expression of granulocyte-macrophage colony-stimulating factor (GMCSF) and granulocyte colony-stimulating factor (GCSF). These findings were confirmed by quantitative reverse transcriptase PCR. SD dose-dependently upregulated GMCSF and GCSF expression with significant 7 and 9-fold changes, respectively, at the highest tested concentration of 31 µg/cm2. Furthermore, we observed that SD significantly enhanced the secretion of GM-CSF and G-CSF by 2-fold. Both cytokines have previously been associated with lung diseases such as asthma and fibrosis. Hence, we present two molecular messengers that may contribute to the adverse health effects of desert dust and might serve as drug targets for this globally relevant non-anthropogenic air pollutant.

The Social Cost of Ozone-Related Mortality Impacts From Methane Emissions

Atmospheric methane directly affects surface temperatures and indirectly affects ozone, impacting human welfare, the economy, and environment. The social cost of methane (SC-CH4) metric estimates the costs associated with an additional marginal metric ton of emissions. Current SC-CH4 estimates do not consider the indirect impacts associated with ozone production from changes in methane. We use global model simulations and a new BenMAP webtool to estimate respiratory-related deaths associated with increases in ozone from a pulse of methane emissions in 2020. By using an approach consistent with the current SC-CH4 framework, we monetize and discount annual damages back to present day values. We estimate that the methane-ozone mechanism is attributable to 760 (95% CI: 330-1200) respiratory-related deaths per million metric tons of methane globally, for a global net present damage of $1800/mT (95% CI: $760-$2800/Mt CH4; 2% Ramsey discount rate); this would double the current SC-CH4 if included. These physical impacts are consistent with recent studies, but comparing direct costs is challenging. Economic damages are sensitive to uncertainties in the exposure and health risks associated with tropospheric ozone, assumptions about future projections of NOx emissions, socioeconomic conditions, and mortality rates, monetization parameters, and other factors. Our estimates are highly sensitive to uncertainties in ozone health risks. We also develop a reduced form model to test sensitivities to other parameters. The reduced form tool runs with a user-supplied emissions pulse, as well as socioeconomic and precursor projections, enabling future integration of the methane-ozone mechanism into the SC-CH4 modeling framework.

Drought impacts on the electricity system, emissions, and air quality in the western United States

The western United States has experienced severe drought in recent decades, and climate models project increased drought risk in the future. This increased drying could have important implications for the region's interconnected, hydropower-dependent electricity systems. Using power-plant level generation and emissions data from 2001 to 2021, we quantify the impacts of drought on the operation of fossil fuel plants and the associated impacts on greenhouse gas (GHG) emissions, air quality, and human health. We find that under extreme drought, electricity generation from individual fossil fuel plants can increase up to 65% relative to average conditions, mainly due to the need to substitute for reduced hydropower. Over 54% of this drought-induced generation is transboundary, with drought in one electricity region leading to net imports of electricity and thus increased pollutant emissions from power plants in other regions. These drought-induced emission increases have detectable impacts on local air quality, as measured by proximate pollution monitors. We estimate that the monetized costs of excess mortality and GHG emissions from drought-induced fossil generation are 1.2 to 2.5x the reported direct economic costs from lost hydro production and increased demand. Combining climate model estimates of future drying with stylized energy-transition scenarios suggests that these drought-induced impacts are likely to remain large even under aggressive renewables expansion, suggesting that more ambitious and targeted measures are needed to mitigate the emissions and health burden from the electricity sector during drought.

Climate change and respiratory disease: clinical guidance for healthcare professionals

Climate change is one of the major public health emergencies with already unprecedented impacts on our planet, environment and health. Climate change has already resulted in substantial increases in temperatures globally and more frequent and extreme weather in terms of heatwaves, droughts, dust storms, wildfires, rainstorms and flooding, with prolonged and altered allergen and microbial exposure as well as the introduction of new allergens to certain areas. All these exposures may have a major burden on patients with respiratory conditions, which will pose increasing challenges for respiratory clinicians and other healthcare providers. In addition, complex interactions between these different factors, along with other major environmental risk factors (e.g. air pollution), will exacerbate adverse health effects on the lung. For example, an increase in heat and sunlight in urban areas will lead to increases in ozone exposure among urban populations; effects of very high exposure to smoke and pollution from wildfires will be exacerbated by the accompanying heat and drought; and extreme precipitation events and flooding will increase exposure to humidity and mould indoors. This review aims to bring respiratory healthcare providers up to date with the newest research on the impacts of climate change on respiratory health. Respiratory clinicians and other healthcare providers need to be continually educated about the challenges of this emerging and growing public health problem and be equipped to be the key players in solutions to mitigate the impacts of climate change on patients with respiratory conditions.

Educational aims

To define climate change and describe major related environmental factors that pose a threat to patients with respiratory conditions.To provide an overview of the epidemiological evidence on climate change and respiratory diseases.To explain how climate change interacts with air pollution and other related environmental hazards to pose additional challenges for patients.To outline recommendations to protect the health of patients with respiratory conditions from climate-related environmental hazards in clinical practice.To outline recommendations to clinicians and patients with respiratory conditions on how to contribute to mitigating climate change.

Climate Change and Pregnancy: Risks, Mitigation, Adaptation, and Resilience

Importance

Climate change is affecting the earth, resulting in more extreme temperatures and weather, rising sea levels, more frequent natural disasters, and displacement of populations of plants and animals, including people and insects. These changes affect food and housing security, vector-borne illnesses, and access to clean air and water, all of which influence human health.

Evidence and Results

There are a number of adverse health outcomes linked to heat, air pollution from wildfires, stress from natural disasters, and other elements of climate change. Pregnant people are especially vulnerable to the health harms resulting from climate change, namely, preterm birth, small for gestational age, hypertensive disorders of pregnancy, and other adverse reproductive health and birth outcomes. Strategies to minimize these harms include mitigation and adaptation.

Conclusions and Relevance

Physicians are in a unique position to protect the health of pregnant persons and children by advocating for policy changes that address climate change and providing clinical recommendations for patients to protect themselves from the health impacts of climate hazards.

Mapping of dust source susceptibility by remote sensing and machine learning techniques (case study: Iran-Iraq border)

A dust storm is a major environmental problem affecting many arid regions worldwide. The novel contribution of this study is combining indicators extracted from RS- and statistic-based predictive models to spatial mapping of land susceptibility to dust emissions in a very important dust source area in the borders of Iran and Iraq (Khuzestan province in Iran and Al-Basrah and Maysan provinces in Iraq). In this research, remote sensing (RS) techniques and machine learning techniques, including multivariate adaptive regression spline (MARS), random forest (RF), and logistic regression (LR), were used for dust source identification and susceptibility map preparation. To this end, 152 DSA for the period of 2005-2020 were identified in the study area. Of these DSA data, 70% was assigned to the Dust Source Susceptibility Mapping (DSSM) (training dataset) and 30% to model validation. Consequently, six factors (i.e., soil, lithology, slope, normalized vegetation differential index (NDVI), geomorphology, and land use units) were prepared as DSA's independent and effective variables. The results of all three models indicated that land use had the most impact on DSA. The validation results of these models using the test data showed sub-curves of 0.92, 0.86, and 0.76 for the RF, MARS, and LR models, respectively. Also, results showed that the RF model outperformed MARS (AUC = 0.89) and LR (AUC = 0.78) methods. In all three models, high and very high susceptibility classes generally covered a large percentage of the case study. The highest percentage of dust source points was also in this susceptibility category. Overall, the results of this study can be useful for planners and managers to control and reduce the risk of negative dust consequences.

Industrial Particulate Pollution and Historical Land Use Contribute Metals of Concern to Dust Deposited in Neighborhoods Along the Wasatch Front, UT, USA

The Salt Lake Valley, UT, USA, is proximal to the desiccating Great Salt Lake (GSL). Prior work has found that this lakebed/playa contributes metals-laden dust to snow in the Wasatch and Uinta Mountains. Dust and industrial particulate pollution are also delivered to communities along the Wasatch Front, but their sources, compositions, and fluxes are poorly characterized. In this study, we analyzed the dust deposited in 18 passive samplers positioned near the GSL, in cities in and near the Salt Lake Valley for total dust flux, the <63 µm dust fraction, ⁸⁷Sr/⁸⁶Sr, and trace element geochemistry. We compared spatial patterns in metal flux and abundance with community-level socioeconomic metrics. We observed the highest dust fluxes at sites near the GSL playa. Within the urban corridor, ⁸⁷Sr/⁸⁶Sr and trace element relative abundances suggest that most of the dust to which people are regularly exposed may be fugitive dust from local soil materials. The trace metal content of dust deposited along the Wasatch Front exceeded Environmental Protection Agency screening levels and exhibited enrichment relative to both the upper continental crust and the dust collected adjacent to GSL. Sources of metals to dust deposited along the Wasatch Front may include industrial activities like mining, oil refining, as well as past historical pesticide and herbicide applications. Arsenic and vanadium indicated a statistically significant positive correlation with income, whereas lead, thallium, and nickel exhibited higher concentrations in the least wealthy and least white neighborhoods.

The Unintended Benefits of the Conservation Reserve Program for Air Quality

The link between agriculture and air pollution is well-established, as are the benefits of the US Department of Agriculture's Conservation Reserve Program (CRP). However, little research has linked CRP to air quality directly. This study aims to address this gap by modeling the relationship between CRP and fine particulate matter (PM_2.5) concentrations at the county level from 2001 to 2016. Several econometric models are estimated with panel data while controlling for drought, population, and wildfire. Results show that CRP has a statistically significant negative effect on PM_2.5 concentrations. Using estimates from this model, we project an avoided 1,353 deaths, 1,687 deaths, and 3,022 deaths nationally in 2008 relative to three different counterfactual scenarios: all CRP acreage placed under cultivation, increased drought, and a combination of the first two. The value of the avoided mortality is estimated to be $9.5 billion, $11.8 billion, and $21.2 billion, respectively. These findings provide evidence that CRP may generate economic gains in terms of avoided mortality, well above the cost of the program.

Application of Artificial Intelligence Models for Aeolian Dust Prediction at Different Temporal Scales: A Case with Limited Climatic Data

Accurately predicting ambient dust plays a crucial role in air quality management and hazard mitigation. Dust emission is a complex, non-linear response to several climatic variables. This study explores the accuracy of Artificial Intelligence (AI) models: an adaptive-network-based fuzzy inference system (ANFIS) and a multi-layered perceptron artificial neural network (mlp-NN), over the Southwestern United States (SWUS), based on the observed dust data from IMPROVE stations. The ambient fine dust (PM2.5) and coarse dust (PM10) concentrations on monthly and seasonal timescales from 1990–2020 are modeled using average daily maximum wind speed (W), average precipitation (P), and average air temperature (T) available from the North American Regional Reanalysis (NARR) dataset. The model’s performance is measured using correlation (r), root mean square error (RMSE), and percentage bias (% BIAS). The ANFIS model generally performs better than the mlp-NN model in predicting regional dustiness over the SWUS region, with r = 0.77 and 0.83 for monthly and seasonal fine dust, respectively. AI models perform better in predicting regional dustiness on a seasonal timescale than the monthly timescale for both fine dust and coarse dust. AI models better predict fine dust than coarse dust on both monthly and seasonal timescales. Compared to precipitation, air temperature is the more important predictor of regional dustiness on both monthly and seasonal timescales. The relative importance of air temperature is higher on the monthly timescale than the seasonal timescale for PM2.5 and vice versa for PM10. The findings of this study demonstrate that the AI models can predict monthly and seasonal fine and coarse dust, based on the limited climatic data, with good accuracy and with potential implications for research in data sparse regions.

Examining the Relationship between Climate Change and Vibriosis in the United States: Projected Health and Economic Impacts for the 21st Century

BACKGROUND

This paper represents, to our knowledge, the first national-level (United States) estimate of the economic impacts of vibriosis cases as exacerbated by climate change. Vibriosis is an illness contracted through food- and waterborne exposures to various Vibrio species (e.g., nonV. cholerae O1 and O139 serotypes) found in estuarine and marine environments, including within aquatic life, such as shellfish and finfish.

OBJECTIVES

The objective of this study was to project climate-induced changes in vibriosis and associated economic impacts in the United States related to changes in sea surface temperatures (SSTs).

METHODS

For our analysis to identify climate links to vibriosis incidence, we constructed three logistic regression models by Vibrio species, using vibriosis data sourced from the Cholera and Other Vibrio Illness Surveillance system and historical SSTs. We relied on previous estimates of the cost-per-case of vibriosis to estimate future total annual medical costs, lost income from productivity loss, and mortality-related indirect costs throughout the United States. We separately reported results for V. parahaemolyticus, V. vulnificus, V. alginolyticus, and "V. spp.," given the different associated health burden of each.

RESULTS

By 2090, increases in SST are estimated to result in a 51% increase in cases annually relative to the baseline era (centered on 1995) under Representative Concentration Pathway (RCP) 4.5, and a 108% increase under RCP8.5. The cost of these illnesses is projected to reach $5.2 billion annually under RCP4.5, and $7.3 billion annually under RCP8.5, relative to $2.2 billion in the baseline (2018 U.S. dollars), equivalent to 140% and 234% increases respectively.

DISCUSSION

Vibriosis incidence is likely to increase in the United States under moderate and unmitigated climate change scenarios through increases in SST, resulting in a substantial burden of morbidity and mortality, and costing billions of dollars. These costs are mostly attributable to deaths, primarily from exposure to V. vulnificus. Evidence suggests that other factors, including sea surface salinity, may contribute to further increases in vibriosis cases in some regions of the United States and should also be investigated. https://doi.org/10.1289/EHP9999a.

Health and Clinical Impacts of Air Pollution and Linkages with Climate Change

Air Pollution Impacts and Climate Change LinksAs part of the NEJM Group series on climate change, Keswani and colleagues review the linkages between climate change and air pollution and suggest strategies that clinicians may use to mitigate the adverse health impacts of air pollution.

Climate change and global health: A call to more research and more action

There is increasing understanding, globally, that climate change and increased pollution will have a profound and mostly harmful effect on human health. This review brings together international experts to describe both the direct (such as heat waves) and indirect (such as vector-borne disease incidence) health impacts of climate change. These impacts vary depending on vulnerability (i.e., existing diseases) and the international, economic, political, and environmental context. This unique review also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and environmental justice and education. This scholarly resource explores these issues fully, linking them to global health in urban and rural settings in developed and developing countries. The review finishes with a practical discussion of action that health professionals around the world in our field can yet take.

Heavy metal pollution levels, source apportionment and risk assessment in dust storms in key cities in Northwest China

In this study, the potential hazards of heavy metals in dust storms were investigated by collecting dust storm samples, measuring their heavy metal concentrations, and using index evaluation, spatial analysis, positive matrix factorization (PMF) model and risk assessment model. Heavy metals in dust storms were contaminated by anthropogenic sources leading to their concentrations being higher than the background values. The enrichment factors and geoaccumulation indices showed that the heavy metals came from both natural and anthropogenic sources, Cu, Ni, Zn and Pb are strongly influenced by anthropogenic sources. Heavy metals in dust storms were divided into four sources: Cu and Ni were attributed to industrial sources mainly from local mining and metal processing; Cr was mainly contributed by industrial sources related to industrial production such as coal combustion; Pb and Zn were mainly contributed by transportation sources; and Ti, V, Mn, Fe, and As were from natural and agricultural sources. The level of comprehensive ecological risk of heavy metals in dust storms were low, but there were moderate and above risks at individual sites. Both adults and children had the highest carcinogenic and non-carcinogenic risks from the ingestion route, and the risk for children was higher than that for adults.

Time to be nosy: Evaluating the impact of environmental and sociocultural changes on maxillary sinusitis in the Middle Nile Valley (Neolithic to Medieval periods)

OBJECTIVE

To investigate the prevalence of maxillary sinusitis in people who lived in the Middle Nile Valley across different periods, cultures, and environmental conditions.

MATERIALS

481 skeletons from 13 sites, curated at the British Museum, London, were analysed. The sites ranged in date from the Neolithic to Medieval periods (c. 4900 BCE-CE 1500).

METHODS

Bony changes within the maxillary sinuses, associated with sinusitis and oroantral fistulae were systematically recorded according to pre-established criteria.

RESULTS

There were significant differences in the prevalence of maxillary sinusitis between time period/subsistence economy groups. The Neolithic hunter-gatherer/early agricultural group had the lowest prevalence, whilst the urban group demonstrated the highest frequency of the disease.

CONCLUSIONS

Factors involved in the development of maxillary sinusitis are manifold and complex. However, the results indicate that increased aridity in Sudan in later periods and intensification of agricultural practices may have played a role in increasing prevalence of the disease. Urban environments, including crowding, poor sanitation, and industrial air pollution, could also have influenced susceptibility to maxillary sinusitis.

SIGNIFICANCE

Prior to this paper, the impact of arid environments on respiratory health in the past had received little attention despite growing clinical research on the topic. Both arid and urban environments are predicted to expand in the future. This paper provides a deep-time perspective on an issue of increasing concern today.

LIMITATIONS

Poor preservation of skeletons and a lack of archaeological settlement data for some sites.

FUTURE RESEARCH

Investigation of a greater range of populations from different environments/climates.

The role of soils in the regulation of air quality

Soils play a key role in meeting the UN Sustainable Development Goals (SDGs). In this study, we review the contribution of soils to the regulation of air quality, which is one of 'Nature's Contributions to People' identified by the Intergovernmental-Policy Platform on Biodiversity and Ecosystem Services (IPBES). This is particularly relevant for SDG3 (health and well-being) and 11 (sustainable cities and well-being) but also impacts other SDGs. Soils can act as both a source and a sink of air pollutants (and their precursors). In addition, soils support plant growth which plays a major role in regulating air quality. The scale of the soil impacts on air quality range from global (e.g. greenhouse gas fluxes, stratospheric ozone depletion) to local (e.g. odours, particulates, pathogen transport). Harmful emissions from soil can be increased or decreased by anthropogenic activity, while climate change is likely to modify future emissions patterns, both directly and in response to human mitigation and adaption actions. Although soils are not the only source of these pollutants, it is worthwhile managing them to reduce erosion and nutrient losses to maintain soil health so we may continue to benefit from the contributions to good quality of life they provide. This article is part of the theme issue 'The role of soils in delivering Nature's Contributions to People'.

Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review

Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl’s framework for an integrative review. Ninety-eight articles were included in the review from three databases—PubMed, Web of Science, and Scopus—with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.

Detection of a Dust Storm in 2020 by a Multi-Observation Platform over the Northwest China

Dust storms have occurred frequently in northwest China and can dramatically reduce visibility and exacerbate air quality in downwind regions through long-range transport. In order to study the distribution characteristics of dust particles sizes, structures and concentrations in the process of dust storm, especially for the vertical distributions, the multi-observation platform composed of six Lidars and nine aerosol analytical instruments is first used to detect a severe dust storm event, which occurred in Northwest China on 3 May 2020. As a strong weather system process, the dust storm has achieved high intensity and wide range. When the intensity of a dust storm is at its strongest, the ratios of PM2.5 (particulate matter with diameter < 2.5 µm) and PM10 (particulate matter with diameter < 10 µm) (PM2.5/PM10) in cities examined were less than 0.2 and the extinction coefficients became greater than 1 km−1 based on Lidar observations. In addition, the growth rates of PM2.5 were higher than that of PM10. The dust particles mainly concentrated at heights of 2 km, after being transported about 200–300 km, vertical height increased by 1–2 km. Meanwhile, the dust concentration decreased markedly. Furthermore, the depolarization ratio showed that dust in the Tengger Desert was dominated by spherical particles. The linear relationships between 532 nm extinction coefficient and the concentration of PM2.5 and PM10 were found firstly and their R2 were 0.706 to 0.987. Our results could give more information for the physical schemes to simulate dust storms in specific models, which could improve the forecast of dust storms.

Estimating PM2.5-related premature mortality and morbidity associated with future wildfire emissions in the western US

Wildfire activity in the western United States (US) has been increasing, a trend that has been correlated with changing patterns of temperature and precipitation associated with climate change. Health effects associated with exposure to wildfire smoke and fine particulate matter (PM_2.5) include short- and long-term premature mortality, hospital admissions, emergency department visits, and other respiratory and cardiovascular incidents. We estimate PM_2.5 exposure and health impacts for the entire continental US from current and future western US wildfire activity projected for a range of future climate scenarios through the 21st century. We use a simulation approach to estimate wildfire activity, area burned, fine particulate emissions, air quality concentrations, health effects, and economic valuation of health effects, using established and novel methodologies. We find that climatic factors increase wildfire pollutant emissions by an average of 0.40% per year over the 2006-2100 period under Representative Concentration Pathway (RCP) 4.5 (lower emissions scenarios) and 0.71% per year for RCP8.5. As a consequence, spatially weighted wildfire PM_2.5 concentrations more than double for some climate model projections by the end of the 21st century. PM_2.5 exposure changes, combined with population projections, result in a wildfire PM2.5-related premature mortality excess burden in the 2090 RCP8.5 scenario that is roughly 3.5 times larger than in the baseline period. The combined effect of increased wildfire activity, population growth, and increase in the valuation of avoided risk of premature mortality over time results in a large increase in total economic impact of wildfire-related PM_2.5 mortality and morbidity in the continental US, from roughly $7 billion per year in the baseline period to roughly $36 billion per year in 2090 for RCP4.5, and $43 billion per year in RCP8.5. The climate effect alone accounts for a roughly 60% increase in wildfire PM2.5-related premature mortality in the RCP8.5 scenario, relative to baseline conditions.

Associations Between Simulated Future Changes in Climate, Air Quality, and Human Health

IMPORTANCE

Future changes in climate are likely to adversely affect human health by affecting concentrations of particulate matter sized less than 2.5 μm (PM2.5) and ozone (O3) in many areas. However, the degree to which these outcomes may be mitigated by reducing air pollutant emissions is not well understood.

OBJECTIVE

To model the associations between future changes in climate, air quality, and human health for 2 climate models and under 2 air pollutant emission scenarios.

DESIGN, SETTING, AND PARTICIPANTS

This modeling study simulated meteorological conditions over the coterminous continental US during a 1995 to 2005 baseline and over the 21st century (2025-2100) by dynamically downscaling representations of a high warming scenario from the Community Earth System Model (CESM) and the Coupled Model version 3 (CM3) global climate models. Using a chemical transport model, PM2.5 and O3 concentrations were simulated under a 2011 air pollutant emission data set and a 2040 projection. The changes in PM2.5 and O3-attributable deaths associated with climate change among the US census-projected population were estimated for 2030, 2050, 2075, and 2095 for each of 2 emission inventories and climate models. Data were analyzed from June 2018 to June 2020.

MAIN OUTCOMES AND MEASURES

The main outcomes were simulated change in summer season means of the maximum daily 8-hour mean O3, annual mean PM2.5, population-weighted exposure, and the number of avoided or incurred deaths associated with these pollutants. Results are reported for 2030, 2050, 2075, and 2095, compared with 2000, for 2 climate models and 2 air pollutant emissions data sets.

RESULTS

The projected increased maximum daily temperatures through 2095 were up to 7.6 °C for the CESM model and 11.8 °C for the CM3 model. Under each climate model scenario by 2095, compared with 2000, an estimated additional 21 000 (95% CI, 14 000-28 000) PM2.5-attributable deaths and 4100 (95% CI, 2200-6000) O3-attributable deaths were projected to occur. These projections decreased to an estimated 15 000 (95% CI, 10 000-20 000) PM2.5-attributable deaths and 640 (95% CI, 340-940) O3-attributable deaths when simulated using a future emission inventory that accounted for reduced anthropogenic emissions.

CONCLUSIONS AND RELEVANCE

These findings suggest that reducing future air pollutant emissions could also reduce the climate-driven increase in deaths associated with air pollution by hundreds to thousands.

Economic Valuation of Coccidioidomycosis (Valley Fever) Projections in the United States in Response to Climate Change

Coccidioidomycosis, or valley fever, is an infectious fungal disease currently endemic to the southwestern United States. Symptoms of valley fever range in severity from flu-like illness to severe morbidity and mortality. Warming temperatures and changes in precipitation patterns may cause the area of endemicity to expand northward throughout the western United States, putting more people at risk for contracting valley fever. This may increase the health and economic burdens from this disease. We developed an approach to describe the relationship between climate conditions and valley fever incidence using historical data and generated projections of future incidence in response to both climate change and population trends using the Climate Change Impacts and Risk Analysis (CIRA) framework developed by the U.S. Environmental Protection Agency. We also developed a method to estimate economic impacts of valley fever that is based on case counts. For our 2000-15 baseline time period, we estimated annual medical costs, lost income, and economic welfare losses for valley fever in the United States were $400,000 per case, and the annual average total cost was $3.9 billion per year. For a high greenhouse gas emission scenario and accounting for population growth, we found that total annual costs for valley fever may increase up to 164% by year 2050 and up to 380% by 2090. By the end of the twenty-first century, valley fever may cost $620,000 per case and the annual average total cost may reach $18.5 billion per year. This work contributes to the broader effort to monetize climate change-attributable damages in the United States.

Synergistic health effects of air pollution, temperature, and pollen exposure: a systematic review of epidemiological evidence

BACKGROUND

Exposure to heat, air pollution, and pollen are associated with health outcomes, including cardiovascular and respiratory disease. Studies assessing the health impacts of climate change have considered increased exposure to these risk factors separately, though they may be increasing simultaneously for some populations and may act synergistically on health. Our objective is to systematically review epidemiological evidence for interactive effects of multiple exposures to heat, air pollution, and pollen on human health.

METHODS

We systematically searched electronic literature databases (last search, April 29, 2019) for studies reporting quantitative measurements of associations between at least two of the exposures and mortality from any cause and cardiovascular and respiratory morbidity and mortality specifically. Following the Navigation Guide systematic review methodology, we evaluated the risk of bias of individual studies and the overall quality and strength of evidence.

RESULTS

We found 56 studies that met the inclusion criteria. Of these, six measured air pollution, heat, and pollen; 39 measured air pollution and heat; 10 measured air pollution and pollen; and one measured heat and pollen. Nearly all studies were at risk of bias from exposure assessment error. However, consistent exposure-response across studies led us to conclude that there is overall moderate quality and sufficient evidence for synergistic effects of heat and air pollution. We concluded that there is overall low quality and limited evidence for synergistic effects from simultaneous exposure to (1) air pollution, pollen, and heat; and (2) air pollution and pollen. With only one study, we were unable to assess the evidence for synergistic effects of heat and pollen.

CONCLUSIONS

If synergistic effects between heat and air pollution are confirmed with additional research, the health impacts from climate change-driven increases in air pollution and heat exposure may be larger than previously estimated in studies that consider these risk factors individually.

How will air quality effects on human health, crops and ecosystems change in the future?

Future air quality will be driven by changes in air pollutant emissions, but also changes in climate. Here, we review the recent literature on future air quality scenarios and projected changes in effects on human health, crops and ecosystems. While there is overlap in the scenarios and models used for future projections of air quality and climate effects on human health and crops, similar efforts have not been widely conducted for ecosystems. Few studies have conducted joint assessments across more than one sector. Improvements in future air quality effects on human health are seen in emission reduction scenarios that are more ambitious than current legislation. Larger impacts result from changing particulate matter (PM) abundances than ozone burdens. Future global health burdens are dominated by changes in the Asian region. Expected future reductions in ozone outside of Asia will allow for increased crop production. Reductions in PM, although associated with much higher uncertainty, could offset some of this benefit. The responses of ecosystems to air pollution and climate change are long-term, complex, and interactive, and vary widely across biomes and over space and time. Air quality and climate policy should be linked or at least considered holistically, and managed as a multi-media problem. This article is part of a discussion meeting issue 'Air quality, past present and future'.

Associations Between Dust Storms and Intensive Care Unit Admissions in the United States, 2000-2015

Anthropogenic climate change is influencing the incidence of dust storms and associated human exposure to coarse particulate matter (PM2.5-10) in the United States. Studies have found adverse health consequences related to dust exposure. These consequences include respiratory disease exacerbations and premature mortality, resulting in increased health care utilization. However, the impact of dust storms on critical care demand has not been studied in the United States. We seek to quantify the relationship between dust storms and surges in critical care demand by investigating the association between dust storms and intensive care unit (ICU) admissions at nearby hospitals from 2000 to 2015. ICU data were acquired from Premier, Inc. and encompass 15-20% of all ICU admissions in the United States. Dust storm, meteorology, and air pollutant data were downloaded from the U.S. National Weather Service, the U.S. National Climatic Data Center, and the U.S. Environmental Protection Agency websites, respectively. Associations between ICU admission and dust storms, controlling for temperature, dew point temperature, ambient PM2.5 and ozone, as well as seasonally varying confounders, were estimated using a distributed lag conditional Poisson model with overdispersion. We found a 4.8% (95% CI: 0.4, 9.4; p = 0.033) increase in total ICU admissions on the day of the dust storm (Lag 0) and a 9.2% (95% CI: 1.8, 17.0; p = 0.013) and 7.5% (95% CI: 0.3, 15.2; p = 0.040) increase in respiratory admissions at Lags 0 and 5. North American dust storms are associated with increases in same day and lagged demand for critical care services at nearby hospitals.

Projections of Ambient Temperature- and Air Pollution-Related Mortality Burden Under Combined Climate Change and Population Aging Scenarios: a Review

PURPOSE OF REVIEW

Climate change will affect mortality associated with both ambient temperature and air pollution. Because older adults have elevated vulnerability to both non-optimal ambient temperature (heat and cold) and air pollution, population aging can amplify future population vulnerability to these stressors through increasing the number of vulnerable older adults. We aimed to review recent evidence on projections of temperature- or air pollution-related mortality burden (i.e., number of deaths) under combined climate change and population aging scenarios, with a focus on evaluating the role of population aging in assessing these health impacts of climate change. We included studies published between 2014 and 2019 with age-specific population projections.

RECENT FINDINGS

We reviewed 16 temperature projection studies and 15 air pollution projection studies. Nine of the temperature studies and four of the air pollution studies took population aging into account by performing age-stratified analyses that utilized age-specific relationships between temperature or air pollution exposures and mortality (i.e., age-specific exposure-response functions (ERFs)). Population aging amplifies the projected mortality burden of temperature and air pollution under a warming climate. Compared with a constant population scenario, population aging scenarios lead to less reduction or even increases in cold-related mortality burden, resulting in substantial net increases in future overall (heat and cold) temperature-related mortality burden. There is strong evidence suggesting that to accurately assess the future temperature- and air pollution-related mortality burden of climate change, investigators need to account for the amplifying effect of population aging. Thus, all future studies should incorporate age-specific population size projections and age-specific ERFs into their analyses. These studies would benefit from refinement of age-specific ERF estimates.

New Approaches to Identifying and Reducing the Global Burden of Disease From Pollution

Pollution from multiple sources causes significant disease and death worldwide. Some sources are legacy, such as heavy metals accumulated in soils, and some are current, such as particulate matter. Because the global burden of disease from pollution is so high, it is important to identify legacy and current sources and to develop and implement effective techniques to reduce human exposure. But many limitations exist in our understanding of the distribution and transport processes of pollutants themselves, as well as the complicated overprint of human behavior and susceptibility. New approaches are being developed to identify and eliminate pollution in multiple environments. Community-scale detection of geogenic arsenic and fluoride in Bangladesh is helping to map the distribution of these harmful elements in drinking water. Biosensors such as bees and their honey are being used to measure heavy metal contamination in cities such as Vancouver and Sydney. Drone-based remote sensors are being used to map metal hot spots in soils from former mining regions in Zambia and Mozambique. The explosion of low-cost air monitors has allowed researchers to build dense air quality sensing networks to capture ephemeral and local releases of harmful materials, building on other developments in personal exposure sensing. And citizen science is helping communities without adequate resources measure their own environments and in this way gain agency in controlling local pollution exposure sources and/or alerting authorities to environmental hazards. The future of GeoHealth will depend on building on these developments and others to protect a growing population from multiple pollution exposure risks.

Estimating the Health-Related Costs of 10 Climate-Sensitive U.S. Events During 2012

Climate change threatens human health, but there remains a lack of evidence on the economic toll of climate-sensitive public health impacts. We characterize human mortality and morbidity costs associated with 10 climate-sensitive case study events spanning 11 US states in 2012: wildfires in Colorado and Washington, ozone air pollution in Nevada, extreme heat in Wisconsin, infectious disease outbreaks of tick-borne Lyme disease in Michigan and mosquito-borne West Nile virus in Texas, extreme weather in Ohio, impacts of Hurricane Sandy in New Jersey and New York, allergenic oak pollen in North Carolina, and harmful algal blooms on the Florida coast. Applying a consistent economic valuation approach to published studies and state estimates, we estimate total health-related costs from 917 deaths, 20,568 hospitalizations, and 17,857 emergency department visits of $10.0 billion in 2018 dollars, with a sensitivity range of $2.7-24.6 billion. Our estimates indicate that the financial burden of deaths, hospitalizations, emergency department visits, and associated medical care is a key dimension of the overall economic impact of climate-sensitive events. We found that mortality costs (i.e., the value of a statistical life) of $8.4 billion exceeded morbidity costs and lost wages ($1.6 billion combined). By better characterizing health damages in economic terms, this work helps to shed light on the burden climate-sensitive events already place on U.S. public health each year. In doing so, we provide a conceptual framework for broader estimation of climate-sensitive health-related costs. The high health-related costs associated with climate-sensitive events highlight the importance of actions to mitigate climate change and adapt to its unavoidable impacts.

Monitoring the impact of desert dust outbreaks for air quality for health studies

We review the major features of desert dust outbreaks that are relevant to the assessment of dust impacts upon human health. Our ultimate goal is to provide scientific guidance for the acquisition of relevant population exposure information for epidemiological studies tackling the short and long term health effects of desert dust. We first describe the source regions and the typical levels of dust particles in regions close and far away from the source areas, along with their size, composition, and bio-aerosol load. We then describe the processes by which dust may become mixed with anthropogenic particulate matter (PM) and/or alter its load in receptor areas. Short term health effects are found during desert dust episodes in different regions of the world, but in a number of cases the results differ when it comes to associate the effects to the bulk PM, the desert dust-PM, or non-desert dust-PM. These differences are likely due to the different monitoring strategies applied in the epidemiological studies, and to the differences on atmospheric and emission (natural and anthropogenic) patterns of desert dust around the world. We finally propose methods to allow the discrimination of health effects by PM fraction during dust outbreaks, and a strategy to implement desert dust alert and monitoring systems for health studies and air quality management.