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Mendrinos A, O'Brien J, Davis M, Baldwin A, Zaitchik BF, Britton A, Mwanja I, Gohlke JM. Association between summertime emergency department visits and maximum daily heat index in rural and non-rural areas of Virginia (2015-2022). THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 948:174753. [PMID: 39025140 DOI: 10.1016/j.scitotenv.2024.174753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 06/09/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
There is growing evidence that high ambient temperatures are associated with a range of adverse health outcomes. Further evidence suggests differences in rural versus non-rural populations' vulnerability to heat-related adverse health outcomes. The current project aims to 1) refine estimated associations between maximum daily heat index (HI) and emergency department (ED) visits in regions of Virginia, and 2) compare associations between maximum daily HI and ED visits in rural versus non-rural areas of Virginia and within those areas, for persons 65 years of age and older versus those younger than 65 years. Our study utilized 16,873,213 healthcare visits from Virginia facilities reporting to the Virginia Department of Health syndromic surveillance system between May and September 2015-2022. Federal Office of Rural Health Policy defined rural areas were assigned to patient home ZIP code. The estimated daily maximum HI at which ED visits begin to rise varies between 25 °C and 33 °C across climate zones and regions of Virginia. Across all regions, estimated ED visits attributable to days with maximum HI above 25.7 °C were higher in rural areas (3.7%, 95% CI: 3.5%, 3.9%) versus in non-rural areas (3.1%, 95% CIs: 3.0%, 3.2%). Patients aged 0-64 years had a higher estimated heat attributable fraction of ED visits (4.2%, 95% CI: 4.0%, 4.3%) than patients 65 years and older (3.1%, 95% CI: 2.9%, 3.4%). Rural patients older than 65 have a higher estimated fraction of heat attributable ED visits (2.7%, 95% CI: 2.2%, 3.1%) compared to non-rural patients 65 years and older (1.5%, 95% CI: 1.3%, 1.8%). State-level syndromic surveillance data can be used to optimize heat warning messaging based on expected changes in healthcare visits given a set of meteorological variables, and can be further refined based on climate, rurality and age.
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Affiliation(s)
- Antonia Mendrinos
- Department of Population Health Sciences, Virginia Polytechnic and State University, Blacksburg, VA, USA
| | - Janice O'Brien
- Department of Population Health Sciences, Virginia Polytechnic and State University, Blacksburg, VA, USA
| | - Meredith Davis
- Office of Epidemiology, Virginia Department of Health, Richmond, VA, USA
| | - Alexandra Baldwin
- Office of Epidemiology, Virginia Department of Health, Richmond, VA, USA
| | - Benjamin F Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Annie Britton
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Immaculata Mwanja
- Geospatial Data Services, University Libraries, Virginia Polytechnic and State University, Blacksburg, VA, USA
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Polytechnic and State University, Blacksburg, VA, USA.
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Boudreault J, Lavigne É, Campagna C, Chebana F. Estimating the heat-related mortality and morbidity burden in the province of Quebec, Canada. ENVIRONMENTAL RESEARCH 2024; 257:119347. [PMID: 38844034 DOI: 10.1016/j.envres.2024.119347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND As climate change increases the frequency and intensity of extreme heat events, there is an urgent need to quantify the heat-related health burden. However, most past studies have focussed on a single health outcome (mainly mortality) or on specific heatwaves, thus providing limited knowledge of the total pressure heat exerts on health services. OBJECTIVES This study aims to quantify the heat-related mortality and morbidity burden for five different health outcomes including all-cause mortality, hospitalizations, emergency department (ED) visits, ambulance transports and calls to a health hotline, using the province of Quebec (Canada) as a case study. METHODS A two-step statistical analysis was employed to estimate regional heat-health relationships using Distributed Lag Non-Linear Models (DLNM) and pooled estimates using a multivariate meta-regression. Heat burden was quantified by attributable fraction (AF) and attributable number (AN) for two temperature ranges: all heat (above the minimum mortality/morbidity temperature) and extreme heat (above the 95th percentile of temperature). RESULTS Higher temperatures were associated with greater risk ratios for all health outcomes studied, but at different levels. Significant AF ranging from 2 to 3% for the all heat effect and 0.4-1.0% for extreme heat were found for all health outcomes, except for hospitalizations that had an AF of 0.1% for both heat exposures. The estimated burden of all heat (and extreme heat) every summer across the province was 470 (200) deaths, 225 (170) hospitalizations, 36 000 (6 200) ED visits, 7 200 (1 500) ambulance transports and 15 000 (3 300) calls to a health hotline, all figures significant. DISCUSSION This new knowledge on the total heat load will help public health authorities to target appropriate actions to reduce its burden now and in the future. The proposed state-of-the-art framework can easily be applied to other regions also experiencing the adverse effects of extreme heat.
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Affiliation(s)
- Jérémie Boudreault
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3.
| | - Éric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON, Canada, K1A 0K9; School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, Canada, G1K 5Z3
| | - Céline Campagna
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3; Department of social and preventive medicine, Laval University, 1050 Av. de la Médecine, Québec, QC, Canada, G1V 0A6
| | - Fateh Chebana
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9
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Dyer GMC, Khomenko S, Adlakha D, Anenberg S, Behnisch M, Boeing G, Esperon-Rodriguez M, Gasparrini A, Khreis H, Kondo MC, Masselot P, McDonald RI, Montana F, Mitchell R, Mueller N, Nawaz MO, Pisoni E, Prieto-Curiel R, Rezaei N, Taubenböck H, Tonne C, Velázquez-Cortés D, Nieuwenhuijsen M. Exploring the nexus of urban form, transport, environment and health in large-scale urban studies: A state-of-the-art scoping review. ENVIRONMENTAL RESEARCH 2024; 257:119324. [PMID: 38844028 DOI: 10.1016/j.envres.2024.119324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art account of large-scale urban health studies is required to shape future research priorities and equity- and evidence-informed policies. OBJECTIVES The purpose of this review was to synthesise evidence from large-scale urban studies focused on the interaction between urban form, transport, environmental exposures, and health. This review sought to determine common methodologies applied, limitations, and future opportunities for improved research practice. METHODS Based on a literature search, 2958 articles were reviewed that covered three themes of: urban form; urban environmental health; and urban indicators. Studies were prioritised for inclusion that analysed at least 90 cities to ensure broad geographic representation and generalisability. Of the initially identified studies, following expert consultation and exclusion criteria, 66 were included. RESULTS The complexity of the urban ecosystem on health was evidenced from the context dependent effects of urban form variables on environmental exposures and health. Compact city designs were generally advantageous for reducing harmful environmental exposure and promoting health, with some exceptions. Methodological heterogeneity was indicative of key urban research challenges; notable limitations included exposure and health data at varied spatial scales and resolutions, limited availability of local-level sociodemographic data, and the lack of consensus on robust methodologies that encompass best research practice. CONCLUSION Future urban environmental health research for evidence-informed urban planning and policies requires a multi-faceted approach. Advances in geospatial and AI-driven techniques and urban indicators offer promising developments; however, there remains a wider call for increased data availability at local-levels, transparent and robust methodologies of large-scale urban studies, and greater exploration of urban health vulnerabilities and inequities.
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Affiliation(s)
- Georgia M C Dyer
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Sasha Khomenko
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Deepti Adlakha
- Delft University of Technology, Mekelweg 5, 2628, Delft, Netherlands
| | - Susan Anenberg
- Environmental and Occupational Health Department, George Washington University, Milken Institute School of Public Health, 20052, New Hampshire Avenue, Washington, District of Colombia, United States
| | - Martin Behnisch
- Leibniz Institute of Ecological Urban and Regional Development, Weberpl 1, 01217, Dresden, Germany
| | - Geoff Boeing
- University of Southern California, 90007, Los Angeles, United States
| | - Manuel Esperon-Rodriguez
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia; School of Science, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1E 7HT, London, United Kingdom
| | - Haneen Khreis
- MRC Epidemiology Unit, Cambridge University, CB2 0AH, Cambridge, United Kingdom
| | - Michelle C Kondo
- USDA-Forest Service, Northern Research Station, 100 North 20th Street, Ste 205, 19103, Philadelphia, PA, United States
| | - Pierre Masselot
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1E 7HT, London, United Kingdom
| | - Robert I McDonald
- The Nature Conservancy, 4245 North Fairfax Drive Arlington, 22203, Virginia, United States
| | - Federica Montana
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Rich Mitchell
- Institute of Health and Wellbeing, University of Glasgow, 90 Byres Road, Glasgow, G20 0TY, United Kingdom
| | - Natalie Mueller
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - M Omar Nawaz
- Environmental and Occupational Health Department, George Washington University, Milken Institute School of Public Health, 20052, New Hampshire Avenue, Washington, District of Colombia, United States
| | - Enrico Pisoni
- European Commission, Joint Research Centre (JRC), 2749, Ispra, Italy
| | | | - Nazanin Rezaei
- University of California Santa Cruz, 1156 High Street, 95064, California, United States
| | - Hannes Taubenböck
- German Aerospace Centre (DLR), Earth Observation Center (EOC), 82234, Oberpfaffenhofen, Germany; Institute for Geography and Geology, Julius-Maximilians-Universität Würzburg, 97074, Würzburg, Germany
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Daniel Velázquez-Cortés
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain.
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Coppes T, Hazen ACM, Zwart DLM, Koster ES, van Gelder T, Bouvy ML. Characteristics and preventability of medication-related admissions for acute kidney injury and dehydration in elderly patients. Eur J Clin Pharmacol 2024; 80:1355-1362. [PMID: 38831143 PMCID: PMC11303467 DOI: 10.1007/s00228-024-03704-7] [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: 11/03/2023] [Accepted: 05/24/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Patients with impaired renal function using medication that affects glomerular filtration rate are at increased risk of developing acute kidney injury (AKI) leading to hospital admissions. The risk increases during periods of dehydration due to diarrhoea, vomiting or fever (so-called "sick days"), or high environmental temperatures (heat wave). This study aims to gain insight into the characteristics and preventability of medication-related admissions for AKI and dehydration in elderly patients. METHODS Retrospective case series study in patients aged ≥ 65 years with admission for acute kidney injury, dehydration or electrolyte imbalance related to dehydration that was defined as medication-related. General practitioner's (GP) patient records including medication history and hospital discharge letters were available. For each admission, patient and admission characteristics were collected to review the patient journey. A case-by-case assessment of preventability of hospital admissions was performed. RESULTS In total, 75 admissions were included. Most prevalent comorbidities were hypertension, diabetes, and known impaired renal function. Diuretics and RAS-inhibitors were the most prevalent medication combination. Eighty percent of patients experienced non-acute onset of symptoms and 60% had contacted their GP within 2 weeks prior to admission. Around 40% (n = 29) of admissions were considered potentially preventable if pharmacotherapy had been timely and adequately adjusted. CONCLUSION A substantial proportion of patients admitted with AKI or dehydration experience non-acute onset of symptoms and had contacted their GP within 2 weeks prior to admission. Timely adjusting of medication in these patients could have potentially prevented a considerable number of admissions.
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Affiliation(s)
- Tristan Coppes
- Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Ankie C M Hazen
- Department of General Practice & Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Dorien L M Zwart
- Department of General Practice & Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ellen S Koster
- Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Teun van Gelder
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Marcel L Bouvy
- Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
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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] [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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Fedeli U, Barbiellini Amidei C, Tacconelli E, Carrara E. Sepsis-related mortality: long-term trends in Northeastern Italy, including pandemic years. Infect Dis (Lond) 2024; 56:624-631. [PMID: 38607235 DOI: 10.1080/23744235.2024.2340728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Global estimates of sepsis mortality are based on multiple causes of death (MCOD, any mention of the condition on death certificates); however, MCOD data are sparse and mainly referring to the pre-pandemic period. OBJECTIVES To investigate recent trends in sepsis-related mortality, associated sites of infection, and comorbidities in Veneto (Northeastern Italy). METHODS Mortality records from 2008 to 2022 were extracted, and sepsis-related mortality was assessed based both on the underlying cause of death (UCOD) and on MCOD. The average annual percent change in age-standardised rates was estimated by join point regression through the whole study period. MCOD records were investigated to retrieve infection sites and comorbidities. RESULTS Sepsis was mentioned in 63,479 death certificates, growing from 4.9% out of all deaths in 2008 to 12.9% in 2022. Age-standardised mortality rates increased yearly by 8.2% (95%CI 2.1-14.7%) based on the UCOD and by 5.9% (95%CI 5.3-6.5%) based on MCOD. Sharp peaks in monthly mortality were observed in correspondence with flu epidemics, COVID-19 pandemic waves, and periods of extreme heat. The percentage of sepsis-related deaths associated to urinary tract infections, and with mention of neurodegenerative disorders and chronic kidney disease increased over time. CONCLUSION Raised awareness of physicians, ageing of the population, spread of antimicrobial resistance further fuelled by the COVID-19 pandemic are among reasons of increasing sepsis-related mortality in Italy. Continuous monitoring of sepsis by means of MCOD data and other surveillance tools is warranted.
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Affiliation(s)
- Ugo Fedeli
- Epidemiological Department, Azienda Zero, Padova, Italy
| | | | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Elena Carrara
- Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
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Crespo-Miguel R, Ordóñez C, García-Herrera R, Schnell JL, Turnock ST. Large-scale ozone episodes in Europe: Decreasing sizes in the last decades but diverging changes in the future. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 949:175071. [PMID: 39079641 DOI: 10.1016/j.scitotenv.2024.175071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/04/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024]
Abstract
Episodes of high near-surface ozone concentrations tend to cover large areas for several days. They are strongly dependent on meteorology, precursor emissions, and the ambient photochemical conditions. This study introduces a new pseudo-Lagrangian algorithm that identifies the spatiotemporal patterns of episodes, allowing for a good characterization of their areal extent and an assessment of their drivers. The algorithm has been used to identify ozone episodes in Europe from April to September over the last twenty years (2003-2022) in the Copernicus Atmosphere Monitoring Service (CAMS) reanalysis as well as in the historical simulation (1950-2014) and four shared socio-economic pathways (SSPs, spanning 2015-2100) of three Earth system models (UKESM1-0-LL, EC-Earth3-AerChem and GFDL-ESM4). While the total number of episodes has increased in recent years, the frequency of large episodes has decreased following European precursor emission reductions. The analysis of the 100 largest episodes shows that they tend to occur in Northern Europe during spring and in the center and south of the continent from June onwards. Most of the top 10 episodes occurred in the first years of the century and were associated with high temperatures, enhanced solar radiation, and anticyclonic conditions. Despite the decrease in large episodes in recent years, there is uncertainty regarding future European episodes. Episodes of reduced size are found for SSPs with weak greenhouse forcing and low precursor emissions, whereas episode sizes increase in scenarios with high methane concentrations and enhanced radiative forcing, even exceeding the maximum historical size. However, the three models project episodes of different sizes for any given scenario, probably associated with their differing warming trends and the varying level of complexity in the implementation of processes. These results point to the need to implement both effective climate and air quality policies to address the ozone air pollution problem in Europe in a warming climate.
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Affiliation(s)
- Rodrigo Crespo-Miguel
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, Madrid, Spain.
| | - Carlos Ordóñez
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, Madrid, Spain.
| | - Ricardo García-Herrera
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, Madrid, Spain; Instituto de Geociencias (IGEO), Consejo Superior de Investigaciones Científicas-Universidad Complutense de Madrid (CSIC-UCM), Madrid, Spain.
| | - Jordan L Schnell
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, United States of America; NOAA Global Systems Laboratory, Boulder, CO, United States of America.
| | - Steven T Turnock
- Met Office Hadley Centre, Exeter, United Kingdom; University of Leeds, Met Office Strategic (LUMOS) Research Group, University of Leeds, Leeds, United Kingdom.
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Shaban M, Amer FGM, Shaban MM. The impact of nursing sustainable prevention program on heat strain among agricultural elderly workers in the context of climate change. Geriatr Nurs 2024; 58:215-224. [PMID: 38838403 DOI: 10.1016/j.gerinurse.2024.05.021] [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: 01/10/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND This study assesses a geriatric nursing-led sustainable heat prevention program for elderly agricultural workers. It targets those aged 60 and above, addressing the heightened risk of heat strain in the era of climate change. METHODS A community-based quasi-experimental design involved 120 elderly agricultural workers, divided into intervention and control groups. The program, spanning three months, included education on hydration, rest, protective clothing, and recognition of heat-related illnesses. RESULTS The intervention led by geriatric nursing professionals showed significant improvements in heat strain metrics. The Heat Strain Score Index (HSSI) and the Observational-Perceptual Heat Strain Risk Assessment (OPHSRA) Index indicated increased safety levels and reduced risk categories among participants. CONCLUSIONS The study demonstrates the effectiveness of a geriatric nursing-led, tailored prevention program in reducing heat strain among elderly agricultural workers. It highlights the crucial role of nursing in adapting healthcare practices to the challenges posed by climate change. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT06192069 retrospectively registered.
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Barry H, Iglesies-Grau J, Chaseling GK, Paul J, Gosselin C, D'Oliviera-Sousa C, Juneau M, Harel F, Kaiser D, Pelletier-Galarneau M, Gagnon D. The Effect of Heat Exposure on Myocardial Blood Flow and Cardiovascular Function. Ann Intern Med 2024; 177:901-910. [PMID: 38857500 DOI: 10.7326/m24-3504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Heat extremes are associated with greater risk for cardiovascular death. The pathophysiologic mechanisms mediating this association are unknown. OBJECTIVE To quantify the myocardial blood flow (MBF) requirements of heat exposure. DESIGN Experimental study. (ClinicalTrials.gov: NCT04549974). SETTING Laboratory-based. PARTICIPANTS 61 participants, comprising 20 healthy young adults (mean age, 28 years), 21 healthy older adults (mean age, 67 years), and 20 older adults with coronary artery disease (CAD) (mean age, 70 years). INTERVENTION Participants were heated until their core temperature increased 1.5 °C; MBF was measured before heat exposure and at every increase of 0.5 °C in core temperature. MEASUREMENTS The primary outcome was MBF measured by positron emission tomography-computed tomography. Secondary outcomes included heart rate, blood pressure, and body weight change. RESULTS At a core temperature increase of 1.5 °C, MBF increased in healthy young adults (change, 0.8 mL/min/g [95% CI, 0.5 to 1.0 mL/min/g]), healthy older adults (change, 0.7 mL/min/g [CI, 0.5 to 0.9 mL/min/g]), and older adults with CAD (change, 0.6 mL/min/g [CI, 0.3 to 0.8 mL/min/g]). This represented a 2.08-fold (CI, 1.75- to 2.41-fold), 1.79-fold (CI, 1.59- to 1.98-fold), and 1.64-fold (CI, 1.41- to 1.87-fold) change, respectively, from preexposure values. Imaging evidence of asymptomatic heat-induced myocardial ischemia was seen in 7 adults with CAD (35%) in post hoc analyses. LIMITATIONS In this laboratory-based study, heating was limited to about 100 minutes and participants were restricted in movement and fluid intake. Participants refrained from strenuous exercise and smoking; stopped alcohol and caffeine intake; and withheld β-blockers, calcium-channel blockers, and nitroglycerin before heating. CONCLUSION Heat exposure that increases core temperature by 1.5 °C nearly doubles MBF. Changes in MBF did not differ by age or presence of CAD, but some older adults with CAD may experience asymptomatic myocardial ischemia. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research.
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Affiliation(s)
- Hadiatou Barry
- Montreal Heart Institute and Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada (H.B.)
| | - Josep Iglesies-Grau
- Montreal Heart Institute and Department of Medicine, Université de Montréal, Montreal, Quebec, Canada (J.I.)
| | - Georgia K Chaseling
- Engagement and Co-Design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (G.K.C.)
| | - Jade Paul
- Montreal Heart Institute, Montreal, Quebec, Canada (J.P., C.G., M.J.)
| | - Camila Gosselin
- Montreal Heart Institute, Montreal, Quebec, Canada (J.P., C.G., M.J.)
| | - Caroline D'Oliviera-Sousa
- Department of Medical Imaging, Montreal Heart Institute, Montreal, Quebec, Canada (C.D., F.H., M.P.)
| | - Martin Juneau
- Montreal Heart Institute, Montreal, Quebec, Canada (J.P., C.G., M.J.)
| | - Francois Harel
- Department of Medical Imaging, Montreal Heart Institute, Montreal, Quebec, Canada (C.D., F.H., M.P.)
| | - David Kaiser
- Direction de Santé Publique du Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada (D.K.)
| | | | - Daniel Gagnon
- Montreal Heart Institute and School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada (D.G.)
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10
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Cottle RM, Fisher KG, Leach OK, Wolf ST, Kenney WL. Critical environmental core temperature limits and heart rate thresholds across the adult age span (PSU HEAT Project). J Appl Physiol (1985) 2024; 137:145-153. [PMID: 38813613 DOI: 10.1152/japplphysiol.00117.2024] [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: 02/14/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024] Open
Abstract
The frequency, duration, and severity of extreme heat events have increased and are projected to continue to increase throughout the next century. As a result, there is an increased risk of excessive heat- and cardiovascular-related morbidity and mortality during these extreme heat events. Therefore, the purposes of this investigation were to establish 1) critical environmental core temperature (Tc) limits for middle-aged adults (MA), 2) environmental thresholds that cause heart rate (HR) to progressively rise in MA and older (O) adults, and 3) examine critical environmental Tc limits and HR environmental thresholds across the adult age span. Thirty-three young (Y) (15 F; 23 ± 3 yr), 28 MA (17 F; 51 ± 6 yr), and 31 O (16 F; 70 ± 3 yr) subjects were exposed to progressive heat stress in an environmental chamber in a warm-humid (WH, 34-36°C, 50-90% rh) and a hot-dry (HD, 38°C-52°C, <30% rh) environment while exercising at a low metabolic rate reflecting activities of daily living (∼1.8 METs). In both environments, there was a main effect of age on the critical environmental Tc limit and environmental HR thresholds (main effect of age all P < 0.001). Across the lifespan, critical environmental Tc and HR thresholds decline linearly with age in HD environments (R2 ≥ 0.3) and curvilinearly in WH environments (R2 ≥ 0.4). These data support an age-associated shift in critical environmental Tc limits and HR thresholds toward lower environmental conditions and can be used to develop evidence-based safety guidelines to minimize future heat-related morbidity and mortality across the adult age span.NEW & NOTEWORTHY This study is the first to identify critical environmental core temperature and heart rate thresholds across the adult age spectrum. In addition, our data demonstrate that the rate of decline in Tc and HR limits with age is environmental-dependent. These findings provide strong empirical data for the development of safety guidelines and policy decisions to mitigate excessive heat- and cardiovascular-related morbidity and mortality for impending heat events.
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Affiliation(s)
- Rachel M Cottle
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Center for Healthy Aging, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Kat G Fisher
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Center for Healthy Aging, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Olivia K Leach
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - S Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - W Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Center for Healthy Aging, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, United States
- Graduate Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania, United States
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11
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van Daalen KR, Tonne C, Semenza JC, Rocklöv J, Markandya A, Dasandi N, Jankin S, Achebak H, Ballester J, Bechara H, Beck TM, Callaghan MW, Carvalho BM, Chambers J, Pradas MC, Courtenay O, Dasgupta S, Eckelman MJ, Farooq Z, Fransson P, Gallo E, Gasparyan O, Gonzalez-Reviriego N, Hamilton I, Hänninen R, Hatfield C, He K, Kazmierczak A, Kendrovski V, Kennard H, Kiesewetter G, Kouznetsov R, Kriit HK, Llabrés-Brustenga A, Lloyd SJ, Batista ML, Maia C, Martinez-Urtaza J, Mi Z, Milà C, Minx JC, Nieuwenhuijsen M, Palamarchuk J, Pantera DK, Quijal-Zamorano M, Rafaj P, Robinson EJZ, Sánchez-Valdivia N, Scamman D, Schmoll O, Sewe MO, Sherman JD, Singh P, Sirotkina E, Sjödin H, Sofiev M, Solaraju-Murali B, Springmann M, Treskova M, Triñanes J, Vanuytrecht E, Wagner F, Walawender M, Warnecke L, Zhang R, Romanello M, Antó JM, Nilsson M, Lowe R. The 2024 Europe report of the Lancet Countdown on health and climate change: unprecedented warming demands unprecedented action. Lancet Public Health 2024; 9:e495-e522. [PMID: 38749451 PMCID: PMC11209670 DOI: 10.1016/s2468-2667(24)00055-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 06/30/2024]
Affiliation(s)
- Kim R van Daalen
- Barcelona Supercomputing Center (BSC), Barcelona, Spain; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jan C Semenza
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Joacim Rocklöv
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany; Interdisciplinary Center of Scientific Computing, Heidelberg University, Heidelberg, Germany; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Niheer Dasandi
- School of Government, University of Birmingham, Birmingham, UK
| | - Slava Jankin
- School of Government, University of Birmingham, Birmingham, UK
| | - Hicham Achebak
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Institut National de la Santé et de la Recherche Médicale (Inserm), Paris, France
| | - Joan Ballester
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | | | - Thessa M Beck
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Max W Callaghan
- Mercator Research Institute on Global Commons and Climate Change (MCC), Berlin, Germany
| | | | - Jonathan Chambers
- Energy Efficiency Group, Institute for Environmental Sciences (ISE), University of Geneva, Geneva, Switzerland
| | - Marta Cirah Pradas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Orin Courtenay
- The Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, UK
| | - Shouro Dasgupta
- Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy; Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Sciences, London, UK
| | - Matthew J Eckelman
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Zia Farooq
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Peter Fransson
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany; Interdisciplinary Center of Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Elisa Gallo
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Olga Gasparyan
- Department of Political Science, Florida State University, Tallahassee, FL, USA
| | - Nube Gonzalez-Reviriego
- Barcelona Supercomputing Center (BSC), Barcelona, Spain; European Centre for Medium-Range Weather Forecast (ECMWF), Bonn, Germany
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Risto Hänninen
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - Charles Hatfield
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany; Heidelberg Institute for Geoinformation Technology (HeiGIT), Heidelberg University, Heidelberg, Germany
| | - Kehan He
- The Bartlett School of Sustainable Construction, University College London, London, UK
| | | | - Vladimir Kendrovski
- European Centre for Environment and Health, WHO Regional Office for Europe, Bonn, Germany
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | - Gregor Kiesewetter
- Pollution Management Research Group, Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | | | - Hedi Katre Kriit
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany; Interdisciplinary Center of Scientific Computing, Heidelberg University, Heidelberg, Germany
| | | | - Simon J Lloyd
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Martín Lotto Batista
- Barcelona Supercomputing Center (BSC), Barcelona, Spain; Medical School of Hannover, Hannover, Germany
| | - Carla Maia
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, UNL, Lisboa, Portugal
| | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Zhifu Mi
- The Bartlett School of Sustainable Construction, University College London, London, UK
| | - Carles Milà
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jan C Minx
- Mercator Research Institute on Global Commons and Climate Change (MCC), Berlin, Germany
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | | | - Marcos Quijal-Zamorano
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Peter Rafaj
- Pollution Management Research Group, Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Elizabeth J Z Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Sciences, London, UK
| | | | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | - Oliver Schmoll
- European Centre for Environment and Health, WHO Regional Office for Europe, Bonn, Germany
| | | | - Jodi D Sherman
- Yale University School of Medicine, Yale University, New Haven, CT, USA
| | - Pratik Singh
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Elena Sirotkina
- Department of Political Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Henrik Sjödin
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | | | - Marco Springmann
- Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK; Environmental Change Institute, University of Oxford, Oxford, UK
| | - Marina Treskova
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany; Interdisciplinary Center of Scientific Computing, Heidelberg University, Heidelberg, Germany; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Joaquin Triñanes
- Department of Electronics and Computer Science, Universidade de Santiago de Compostela, Santiago, Spain
| | | | - Fabian Wagner
- The Bartlett School of Sustainable Construction, University College London, London, UK
| | - Maria Walawender
- Institute for Global Health, University College London, London, UK
| | | | - Ran Zhang
- University of Mannheim, Mannheim, Germany
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - Josep M Antó
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Rachel Lowe
- Barcelona Supercomputing Center (BSC), Barcelona, Spain; Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
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12
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Wilkinson A, Woodcock A. High-quality and low-carbon asthma care go hand in hand. Eur Respir J 2024; 64:2400638. [PMID: 38991725 DOI: 10.1183/13993003.00638-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 07/13/2024]
Affiliation(s)
- Alexander Wilkinson
- East and North Hertfordshire NHS Trust, Respiratory Department, Lister Hospital, Stevenage, UK
| | - Ashley Woodcock
- The University of Manchester, Division of Infection, Immunity and Respiratory Medicine, Manchester, UK
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13
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Sarchosoglou A, Couto JG, Khine R, O'Donovan T, Pisoni V, Bajinskis A, England A. A European Federation of Radiographer Societies (EFRS) position statement on sustainability for the radiography profession. Radiography (Lond) 2024; 30 Suppl 1:19-22. [PMID: 38848653 DOI: 10.1016/j.radi.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Affiliation(s)
- A Sarchosoglou
- European Federation of Radiographers Societies (EFRS), Portugal; Radiation Oncology Department, General Oncological Hospital of Kifisia "Oi Agioi Anargyroi", Athens, Greece; Department of Biomedical Sciences, Radiology & Radiotherapy Sector, University of West Attica, Athens, Greece.
| | - J G Couto
- European Federation of Radiographers Societies (EFRS), Portugal; Radiography Department, University of Malta, Malta
| | - R Khine
- European Federation of Radiographers Societies (EFRS), Portugal; Institute of Health Sciences Education (IHSE), Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - T O'Donovan
- European Federation of Radiographers Societies (EFRS), Portugal; Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - V Pisoni
- European Federation of Radiographers Societies (EFRS), Portugal; Radiation Oncology Department, Fondazione IRCCS San Gerardo dei Tintori, Monza MB, Italy; School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - A Bajinskis
- European Federation of Radiographers Societies (EFRS), Portugal; University of Latvia, Latvia
| | - A England
- European Federation of Radiographers Societies (EFRS), Portugal; Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
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14
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Yezli S, Ehaideb S, Yassin Y, Alotaibi B, Bouchama A. Escalating climate-related health risks for Hajj pilgrims to Mecca. J Travel Med 2024; 31:taae042. [PMID: 38457640 PMCID: PMC11149718 DOI: 10.1093/jtm/taae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/02/2024] [Accepted: 03/07/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Global temperatures are on the rise, leading to more frequent and severe heatwaves with associated health risks. Heat-related illnesses (HRIs) are an increasing threat for travellers to hot climate destinations. This study was designed to elucidate the interplay between increasing ambient temperatures, incidence of HRIs and the effectiveness of mitigation strategies during the annual Hajj mass gathering over a 40-year period. METHODS An observational study was conducted utilizing historical records spanning four decades of meteorological data, and the rates of heat stroke (HS) and heat exhaustion (HE) during the Hajj pilgrimage in Mecca, Saudi Arabia. With an annual population exceeding 2 million participants from over 180 countries, the study analysed temporal variations in weather conditions over two distinct Hajj hot cycles and correlated it with the occurrence of HS and HE. The effectiveness of deployed mitigation measures in alleviating health vulnerabilities between the two cycles was also assessed. RESULTS Throughout the study period, average dry and wet bulb temperatures in Mecca escalated by 0.4°C (Mann-Kendall P < 0.0001) and 0.2°C (Mann-Kendall P = 0.25) per decade, respectively. Both temperatures were strongly correlated with the incidence of HS and HE (P < 0.001). Despite the intensifying heat, the mitigation strategies including individual, structural and community measures were associated with a substantial 74.6% reduction in HS cases and a 47.6% decrease in case fatality rate. CONCLUSION The study underscores the escalating climate-related health risks in Mecca over the study period. The mitigation measures' efficacy in such a globally representative setting emphasizes the findings' generalizability and the importance of refining public health interventions in the face of rising temperatures.
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Affiliation(s)
- Saber Yezli
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia
| | - Salleh Ehaideb
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Yara Yassin
- Federation of Saudi Chambers Institute, Federation of Saudi Chambers, Riyadh 12711, Saudi Arabia
| | | | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
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15
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Meade RD, Akerman AP, Notley SR, Kirby NV, Sigal RJ, Kenny GP. Exploring the contribution of inter-individual factors to the development of physiological heat strain in older adults exposed to simulated indoor overheating. Appl Physiol Nutr Metab 2024. [PMID: 38830263 DOI: 10.1139/apnm-2024-0135] [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: 06/05/2024]
Abstract
Older adults are at elevated risk of heat-related mortality due to age-associated declines in thermoregulatory and cardiovascular function. However, the inter-individual factors that exacerbate physiological heat strain during heat exposure remain unclear, making it challenging to identify more heat-vulnerable subgroups. We therefore explored factors contributing to inter-individual variability in physiological responses of older adults exposed to simulated hot weather. Thirty-seven older adults (61-80 years, 16 females) rested for 8 h in 31 and 36 °C (45% relative humidity). Core (rectal) temperature, heart rate (HR), HR variability, mean arterial pressure (MAP), and cardiac autonomic responses to standing were measured at baseline and end-exposure. Bootstrapped least absolute shrinkage and selection operator regression was used to evaluate whether variation in these responses was related to type 2 diabetes (T2D, n = 10), hypertension (n = 18), age, sex, body morphology, habitual physical activity levels, and/or heat-acclimatization. T2D was identified as a predictor of end-exposure HR (with vs. without: 13 beats/min (bootstrap 95% confidence interval: 6, 23)), seated MAP (-7 mmHg (-18, 1)), and the systolic pressure response to standing (20 mmHg (4, 36)). HR was also influenced by sex (female vs. male: 8 beats/min (1, 16)). No other predictors were identified. The inter-individual factors explored did not meaningfully contribute to the variation in body temperature responses in older adults exposed to simulated indoor overheating. By contrast, cardiovascular responses were exacerbated in females and individuals with T2D. These findings improve understanding of how inter-individual differences contribute to heat-induced physiological strain in older persons.
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Affiliation(s)
- Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Ashley P Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Nathalie V Kirby
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Ronald J Sigal
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, AB, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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16
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Laitano O, Mündel T, Bouchama A. There's a seat at the table for all! Converging disciplines toward understanding and mitigating heat-related mortality. J Appl Physiol (1985) 2024; 136:1344-1345. [PMID: 38836541 DOI: 10.1152/japplphysiol.00276.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 06/06/2024] Open
Affiliation(s)
- Orlando Laitano
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Toby Mündel
- Department of Kinesiology, Brock University, Ontario, Canada
| | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
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17
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Vecellio DJ, Vanos JK. Aligning thermal physiology and biometeorological research for heat adaptation and resilience in a changing climate. J Appl Physiol (1985) 2024; 136:1322-1328. [PMID: 38385187 DOI: 10.1152/japplphysiol.00098.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024] Open
Affiliation(s)
- Daniel J Vecellio
- Center for Healthy Aging, Pennsylvania State University, University Park, Pennsylvania, United States
- Virginia Climate Center, George Mason University, Fairfax, Virginia, United States
| | - Jennifer K Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona, United States
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18
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Beard S, Hall EJ, Bradbury J, Carter AJ, Gilbert S, O'Neill DG. Epidemiology of heat-related illness in dogs under UK emergency veterinary care in 2022. Vet Rec 2024; 194:e4153. [PMID: 38783549 DOI: 10.1002/vetr.4153] [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: 01/24/2024] [Revised: 03/22/2024] [Accepted: 04/05/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Dogs are exposed to increasing environmental risk for developing heat-related illness (HRI), with 2022 recorded as the hottest year to date in the UK and most of Europe. METHODS This study used VetCompass data to report the incidence risk, event fatality rate and canine risk factors for HRI in dogs presenting to Vets Now emergency care practices in the UK during 2022. RESULTS From the clinical records of 167,751 dogs under care at Vets Now emergency clinics in 2022, 384 HRI events were identified. The 2022 incidence risk of HRI within the Vets Now caseload was 0.23% (95% confidence interval [CI]: 0.21%‒0.25%), with an event fatality rate of 26.56% (95% CI: 21.66%-32.25%). Multivariable analysis identified breed, age and sex/neuter status as risk factors for HRI. Brachycephalic dogs had 4.21 times the odds of HRI compared to mesocephalic dogs (95% CI: 3.22‒5.49, p < 0.001). LIMITATIONS The clinical data used in this study were not primarily recorded for research and had some substantial levels of missing data (especially patient bodyweight). CONCLUSION In order to protect canine welfare, improved long-term mitigation strategies are urgently needed to minimise HRI risk and associated fatality in UK dogs.
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Affiliation(s)
- Sian Beard
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
| | - Emily J Hall
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Jude Bradbury
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Anne J Carter
- Department of Animal and Veterinary Sciences, Scottish Rural Colleges, Dumfries, UK
| | | | - Dan G O'Neill
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
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19
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Junck L, Saad A, Andrews B. Neurology and climate change. Lancet Neurol 2024; 23:552-553. [PMID: 38760086 DOI: 10.1016/s1474-4422(24)00144-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Larry Junck
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
| | - Ali Saad
- Climate & Health Program, University of Colorado, Denver, CO, USA; Centura Health Physicians Group-Neuroscience and Spine, Denver, CO, USA
| | - Bret Andrews
- Department of Neurology, Kaiser-Permanente Health, Oakland, CA, USA
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20
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McClure ES, Ranapurwala SI, Nocera M, Richardson DB. Heat-related fatalities in North Carolina 1999-2017. Am J Ind Med 2024; 67:551-555. [PMID: 38624268 DOI: 10.1002/ajim.23587] [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: 01/02/2024] [Revised: 03/05/2024] [Accepted: 04/06/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES Research shows the highest rates of occupational heat-related fatalities among farm laborers and among Black and Hispanic workers in North Carolina (NC). The Hispanic population and workforce in NC have grown substantially in the past 20 years. We describe the epidemiology of heat-related fatal injuries in the general population and among workers in NC. METHODS We reviewed North Carolina death records and records of the North Carolina Office of the Chief Medical Examiner to identify heat-related deaths (primary International Classification of Diseases, Tenth Revision diagnosis code: X30 or T67.0-T67.9) that occurred between January 1, 1999, and December 31, 2017. Decedent age, sex, race, and ethnicity were extracted from both the death certificate and the medical examiner's report as well as determinations of whether the death occurred at work. RESULTS In NC between 1999 and 2017, there were 225 deaths from heat-related injuries, and 25 occurred at work. The rates of occupational heat-related deaths were highest among males, workers of Hispanic ethnicity, workers of Black, multiple, or unknown race, and in workers aged 55-64. The highest rate of occupational heat-related deaths occurred in the agricultural industry. CONCLUSIONS Since the last report (2001), the number of heat-related fatalities has increased, but fewer were identified as workplace fatalities. Rates of occupational heat-related deaths are highest among Hispanic workers. NC residents identifying as Black are disproportionately burdened by heat-related fatalities in general, with a wider apparent disparity in occupational deaths.
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Affiliation(s)
- Elizabeth S McClure
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shabbar I Ranapurwala
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Maryalice Nocera
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David B Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California, USA
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21
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McAlister S, Luyckx VA, Viecelli AK. Cutting back on low-value health care practices supports sustainable kidney care. Kidney Int 2024; 105:1178-1185. [PMID: 38513999 DOI: 10.1016/j.kint.2023.12.022] [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: 09/24/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 03/23/2024]
Abstract
July 2023 marked the hottest month on record, underscoring the urgent need for action on climate change. The imperative to reduce carbon emissions extends to all sectors, including health care, with it being responsible for 5.5% of global emissions. In decarbonizing health care, although much attention has focused on greening health care infrastructure and procurement, less attention has focused on reducing emissions through demand-side management. An important key element of this is reducing low-value care, given that ≈20% of global health care expenditure is considered low value. "Value" in health care, however, is subjective and dependent on how health outcomes are regarded. This review, therefore, examines the 3 main value perspectives specific to health care. Clinical effectiveness defines low-value care as interventions that offer little to no benefit or have a risk of harm exceeding benefits. Cost-effectiveness compares health outcomes versus costs compared with an alternative treatment. In this case, low-value care is care greater than a societal willingness to pay for an additional unit of health (quality-adjusted life year). Last, community perspectives emphasize the value of shared decision-making and patient-centered care. These values sit within broader societal values of ethics and equity. Any reduction in low-value care should, therefore, also consider patient autonomy, societal value perspectives and opportunity costs, and equity. Deimplementing entrenched low-value care practices without unnecessarily compromising ethics and equity will require tailored strategies, education, and transparency.
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Affiliation(s)
- Scott McAlister
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Valerie A Luyckx
- Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Andrea K Viecelli
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Australasian Kidney Trials Network, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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22
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Wootton E, Grossmann M, Warren AM. Dysnatremia in a changing climate: A global systematic review of the association between serum sodium and ambient temperature. Clin Endocrinol (Oxf) 2024; 100:527-541. [PMID: 38634410 DOI: 10.1111/cen.15052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE Both hyponatremia and hypernatremia have been reported to occur more frequently with higher ambient temperatures, although the underlying mechanisms are not well understood. Global temperatures are rising due to climate change, which may impact the incidence of dysnatremia worldwide. We aimed to identify, collate and critically appraise studies analyzing the relationship between climate measures (outdoor temperature, humidity) and serum sodium concentrations. DESIGN Systematic review, reported in accordance with PRISMA guidelines. METHODS MEDLINE and Embase were searched with relevant key terms. Studies assessing the effect on serum sodium measurement of elevated temperature or humidity versus a comparator were included. RESULTS Of 1466 potentially relevant studies, 34 met inclusion criteria, originating from 23 countries spanning all inhabited continents. The majority (30 of 34, 88%) reported a significant association between outdoor temperature and dysnatremia, predominantly lower serum sodium with increased ambient temperature. Humidity had a less consistent effect. Individuals aged above 65 years, children, those taking diuretics and antidepressants, those with chronic renal impairment or those undertaking physical exertion had increased vulnerability to heat-associated dysnatremia. The risk of bias was assessed to be high in all but four studies. CONCLUSIONS Higher ambient temperature is consistently associated with an increased incidence of hyponatremia. We infer that hyponatremia presentations are likely to rise with increasing global temperatures and the frequency of extreme heat events secondary to climate change. Evidence-based public health messages, clinician education and reduction in fossil fuel consumption are necessary to reduce the expected burden on healthcare services worldwide.
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Affiliation(s)
| | - Mathis Grossmann
- Department of Endocrinology, Austin Health, Melbourne, Australia
- Department of Medicine, the University of Melbourne, Melbourne, Australia
| | - Annabelle M Warren
- Department of Endocrinology, Austin Health, Melbourne, Australia
- Department of Medicine, the University of Melbourne, Melbourne, Australia
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23
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Benavides FG, Utzet M, Serra C, Delano P, García-Gómez M, Ayala A, Delclós J, Ronda E, García V, García AM. [Health and well-being of healthcare workers: employment and working conditions beyond the pandemic]. GACETA SANITARIA 2024; 38 Suppl 1:102378. [PMID: 38806390 DOI: 10.1016/j.gaceta.2024.102378] [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: 09/01/2023] [Revised: 12/27/2023] [Accepted: 02/16/2024] [Indexed: 05/30/2024]
Abstract
Healthcare workers are people who work in health activities, whether or not they have direct contact with citizens. Currently, around 1.3 million people (70% women) work in healthcare activities in Spain. This represents around 10% of the active population, having increased by 33% since 2008, especially the number of women, which has doubled. Healthcare organizations, especially hospitals, are extremely complex workplaces, with precarious working and employment conditions, especially in more hierarchical occupations, exposing healthcare workers to numerous occupational hazards, mainly from ergonomic and psychosocial conditions. These causes frequent musculoskeletal and mental disorders, highlighting burnout, which is estimated at 40% in some services such as intensive care units. This high morbidity is reflected in a high frequency of absences due to illness, around 9% after the pandemic. The pandemic, and its consequences in the last three years, has put extreme pressure on the health system and has clearly shown its deficiencies in relation to working and employment conditions. The hundreds of occupational health professionals, technicians and healthcare workers, who are part of the structures of health organizations, constitute very valuable resources to increase the resilience of the NHS. We recommend the strengthening in resources and institutionally of the occupational health services of health centers and the creation of an Observatory of working, employment and health conditions in the National Health Service, as an instrument for monitoring changes and proposing solutions.
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Affiliation(s)
- Fernando G Benavides
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
| | - Mireia Utzet
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Consol Serra
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Pia Delano
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | | | - Amaia Ayala
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Jordi Delclós
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; School of Public Health, The University of Texas Health Science Center at Houston, Texas, United States of America
| | - Elena Ronda
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Salud Pública, Universidad de Alicante, Sant Joan d'Alacant, AlicanteEspaña
| | - Vega García
- Departamento de Salud Pública, Universidad de Alicante, Sant Joan d'Alacant, AlicanteEspaña; Servicio Navarro de Salud - Osasunbidea, Gobierno de Navarra, Pamplona, España
| | - Ana María García
- Centre d'Investigació en Salut Laboral, Universitat Pompeu Fabra - Hospital del Mar, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Salud Pública, Universidad de Valencia, Valencia, España
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24
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Pinho-Gomes AC, Woodward M. The association between gender equality and climate adaptation across the globe. BMC Public Health 2024; 24:1394. [PMID: 38790000 PMCID: PMC11127422 DOI: 10.1186/s12889-024-18880-5] [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: 07/14/2023] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Climate change has a disproportionate impact on women in comparison to men, and women have a key role to play in climate adaptation. However, evidence is lacking on how gender inequalities may be associated with climate vulnerability and ability to respond at country level. METHODS This ecological study investigated the association between climate adaptation, measured by the Notre Dame Global Adaptation Initiative Country Index (ND-GAIN), and gender equality, measured by the Global Gender Gap Index (GGGI) developed by the World Economic Forum and the Gender Inequality Index (GII) developed by the United Nations. Simple linear regression was used to estimate the associations between the indices and their subdomains for 146 countries. RESULTS There was an approximately linear association between the GGGI and climate adaptation. Each 1% increase in gender equality was associated with a 0.6% increase in the ND-GAIN score (the slope was 0.59, with a 95% confidence interval [0.33 to 0.84]). This was driven by a negative association between gender equality and vulnerability (-0.41 [-0.62 to -0.20]), and a positive association between gender equality and readiness (0.77 [0.44 to 1.10]). The strongest associations between gender equality and climate adaptation were observed for the education domain of the GGGI. There was a strong negative linear association between the GII and climate adaptation, which explained most (86%) of the between-country variation in climate adaptation. Each 1% increase in gender inequality was associated with a 0.5% decrease in the ND-GAIN score (-0.54 [-0.57 to -0.50]). The association between gender inequality and readiness was stronger than the association with vulnerability (0.41 [0.37 to 0.44] for vulnerability versus - 0.67 [-0.72 to -0.61] for readiness). CONCLUSIONS Gender inequality, measured broadly across different domains of life, is associated with climate adaptation at country level, both in terms of vulnerability to impact and readiness to respond.
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Affiliation(s)
- Ana-Catarina Pinho-Gomes
- The George Institute for Global Health, Imperial College London, Scale Space, 58 Wood Lane, London, W12 7RZ, UK.
- Institute for Global Health, University College London, London, UK.
| | - Mark Woodward
- The George Institute for Global Health, Imperial College London, Scale Space, 58 Wood Lane, London, W12 7RZ, UK
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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25
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Lo YTE, Mitchell DM, Gasparrini A. Compound mortality impacts from extreme temperatures and the COVID-19 pandemic. Nat Commun 2024; 15:4289. [PMID: 38782899 PMCID: PMC11116452 DOI: 10.1038/s41467-024-48207-2] [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: 01/15/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Extreme weather and coronavirus-type pandemics are both leading global health concerns. Until now, no study has quantified the compound health consequences of the co-occurrence of them. We estimate the mortality attributable to extreme heat and cold events, which dominate the UK health burden from weather hazards, in England and Wales in the period 2020-2022, during which the COVID-19 pandemic peaked in terms of mortality. We show that temperature-related mortality exceeded COVID-19 mortality by 8% in South West England. Combined, extreme temperatures and COVID-19 led to 19 (95% confidence interval: 16-22 in North West England) to 24 (95% confidence interval: 20-29 in Wales) excess deaths per 100,000 population during heatwaves, and 80 (95% confidence interval: 75-86 in Yorkshire and the Humber) to 127 (95% confidence interval: 123-132 in East of England) excess deaths per 100,000 population during cold snaps. These numbers are at least ~2 times higher than the previous decade. Society must increase preparedness for compound health crises such as extreme weather coinciding with pandemics.
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Affiliation(s)
- Y T Eunice Lo
- Cabot Institute for the Environment, University of Bristol, Bristol, UK.
- Elizabeth Blackwell Institute for Health Research, University of Bristol, Bristol, UK.
| | - Dann M Mitchell
- Cabot Institute for the Environment, University of Bristol, Bristol, UK
- School of Geographical Sciences, University of Bristol, Bristol, UK
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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26
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Zhu Q, Ye P, Wang Y, Duan L, He G, Er Y, Jin Y, Ji C, Hu J, Deng X, Ma W, Liu T. Heatwaves increase road traffic injury morbidity risk and burden in China and its provinces. ENVIRONMENT INTERNATIONAL 2024; 188:108760. [PMID: 38788419 DOI: 10.1016/j.envint.2024.108760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/08/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
Previous studies have demonstrated health impacts of climate change, but evidence on heatwaves' associations with road traffic injury (RTI) is limited. In this study, individual information of RTI cases in May-September during 2006-2021 in China were obtained from the National Injury Surveillance System. Daily maximum temperatures (TMmax) during 2006-2021 were collected from the ERA-5 reanalysis, and the projected daily TMmax during 2020-2099 were obtained from the latest Coupled Model Intercomparison Project Phase 6 Shared Socioeconomic Pathways scenarios (SSPs). We used a time-stratified case-crossover analysis to investigate the association between short-term exposure (lag01 days) to heatwaves (exceeding the 92.5th percentile of daily TMmax for ≥ three consecutive days) and RTI, and to project heatwave-related RTI until 2099 across China. Finally, a total of 1 031 082 RTI cases were included in the analyses. Compared with non-heatwaves, the risks of RTI increased by 3.61 % during heatwaves. Greater associations were found in people aged 15-64 years, in people with transportation occupation, for non-motor traffic vehicle injuries, for severe RTI cases, and in Western China particularly in Qinghai province. We projected substantial increases in attributable fraction (AF) of heatwave-related RTI in the future, particularly in Western and Southwest China. The national average increase in AF (per decade) during 2020s-2090s was 0.036 % for SSP1-2.6 scenario, and 0.267 % for SSP5-8.5 scenario. This study provided evidence on the associations of heatwaves with RTI, and the heatwave-related RTI will substantially increase in the future.
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Affiliation(s)
- Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China
| | - Pengpeng Ye
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yuan Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yuliang Er
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Ye Jin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Cuirong Ji
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Xiao Deng
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
| | - Tao Liu
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China.
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27
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Shetty D. A lack of quality statistics is hiding the real heatwave death toll. BMJ 2024; 385:q1052. [PMID: 38744464 DOI: 10.1136/bmj.q1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
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28
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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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29
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Xi D, Liu L, Zhang M, Huang C, Burkart KG, Ebi K, Zeng Y, Ji JS. Risk factors associated with heatwave mortality in Chinese adults over 65 years. Nat Med 2024; 30:1489-1498. [PMID: 38528168 DOI: 10.1038/s41591-024-02880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/22/2024] [Indexed: 03/27/2024]
Abstract
Aging populations are susceptible to heat-related mortality because of physiological factors and comorbidities. However, the understanding of individual vulnerabilities in the aging population is incomplete. In the Chinese Longitudinal Healthy Longevity Survey, we assessed daily heatwave exposure individually for 13,527 participants (median age = 89 years) and 3,249 summer mortalities during follow-up from 2008 to 2018. The mortality risk during heatwave days according to relative temperature is approximately doubled (hazard ratio (HR) range = 1.78-1.98). We found that heatwave mortality risks were increased for individuals with functional declines in mobility (HR range = 2.32-3.20), dependency in activities of daily living (HR range = 2.22-3.27), cognitive impairment (HR = 2.22) and social isolation reflected by having nobody to ask for help during difficulties (HR range = 2.14-10.21). Contrary to current understanding, older age was not predictive of heatwave mortality risk after accounting for individual functional declines; no statistical differences were detected according to sex. Beyond age as a risk factor, our findings emphasize that functional aging is an underlying factor in enhancing heatwave resilience. Assessment of functional decline and implementing care strategies are crucial for targeted prevention of mortality during heatwaves.
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Affiliation(s)
- Di Xi
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Linxin Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Min Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Katrin G Burkart
- Institute for Health Metric and Evaluation, University of Washington, Seattle, WA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
- Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, USA
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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30
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Achebak H, Rey G, Chen ZY, Lloyd SJ, Quijal-Zamorano M, Méndez-Turrubiates RF, Ballester J. Heat Exposure and Cause-Specific Hospital Admissions in Spain: A Nationwide Cross-Sectional Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57009. [PMID: 38775486 PMCID: PMC11110655 DOI: 10.1289/ehp13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 03/20/2024] [Accepted: 04/02/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND More frequent and intense exposure to extreme heat conditions poses a serious threat to public health. However, evidence on the association between heat and specific diagnoses of morbidity is still limited. We aimed to comprehensively assess the short-term association between cause-specific hospital admissions and high temperature, including the added effect of temperature variability and heat waves and the effect modification by humidity and air pollution. METHODS We used data on cause-specific hospital admissions, weather (i.e., temperature and relative humidity), and air pollution [i.e., fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), fine particulate matter with aerodynamic diameter ≤ 10 μ m (PM 10 ), NO 2 , and ozone (O 3 )] for 48 provinces in mainland Spain and the Balearic Islands between 1 January 2006 and 31 December 2019. The statistical analysis was performed for the summer season (June-September) and consisted of two steps. We first applied quasi-Poisson generalized linear regression models in combination with distributed lag nonlinear models (DLNM) to estimate province-specific temperature-morbidity associations, which were then pooled through multilevel univariate/multivariate random-effect meta-analysis. RESULTS High temperature had a generalized impact on cause-specific hospitalizations, while the added effect of temperature variability [i.e., diurnal temperature range (DTR)] and heat waves was limited to a reduced number of diagnoses. The strongest impact of heat was observed for metabolic disorders and obesity [relative risk (RR) = 1.978; 95% empirical confidence interval (eCI): 1.772, 2.208], followed by renal failure (1.777; 95% eCI: 1.629, 1.939), urinary tract infection (1.746; 95% eCI: 1.578, 1.933), sepsis (1.543; 95% eCI: 1.387, 1.718), urolithiasis (1.490; 95% eCI: 1.338, 1.658), and poisoning by drugs and nonmedicinal substances (1.470; 95% eCI: 1.298, 1.665). We also found differences by sex (depending on the diagnosis of hospitalization) and age (very young children and the elderly were more at risk). Humidity played a role in the association of heat with hospitalizations from acute bronchitis and bronchiolitis and diseases of the muscular system and connective tissue, which were higher in dry days. Moreover, heat-related effects were exacerbated on high pollution days for metabolic disorders and obesity (PM 2.5 ) and diabetes (PM 10 , O 3 ). DISCUSSION Short-term exposure to heat was found to be associated with new diagnoses (e.g., metabolic diseases and obesity, blood diseases, acute bronchitis and bronchiolitis, muscular and connective tissue diseases, poisoning by drugs and nonmedicinal substances, complications of surgical and medical care, and symptoms, signs, and ill-defined conditions) and previously identified diagnoses of hospital admissions. The characterization of the vulnerability to heat can help improve clinical and public health practices to reduce the health risks posed by a warming planet. https://doi.org/10.1289/EHP13254.
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Affiliation(s)
- Hicham Achebak
- Inserm, France Cohortes, Paris, France
- ISGlobal, Barcelona, Spain
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Janson D, Grewe HA, Nickl J, Hannemann L. [Hot weather and health risks in the focus of the Hessian health authorities : Inspection and consultation of residential care and nursing facilities since 2004]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:578-586. [PMID: 38639816 PMCID: PMC11093794 DOI: 10.1007/s00103-024-03845-1] [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: 09/15/2023] [Accepted: 01/29/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND AND AIMS Heat extremes are associated with considerable health risks, especially for vulnerable groups. To counteract these risks, public health policy calls for protective measures to be linked to heat warnings. Such links do not generally exist in Germany, with the exception of the heat inspections and consultations carried out by the Hessian health authorities since 2004. The aims of this work were to identify the structures and processes of the Hessian heat inspections and heat consultations and to derive findings for acute response to heat in residential care and nursing facilities. METHODS We conducted 14 qualitative, semi-structured interviews with experts from the Hessian health authorities as well as with managers of residential care and nursing facilities. The analysis of the interview protocols was carried out using content-structuring qualitative content analysis. In addition, documents from the supervisory authority were analyzed. RESULTS Every year, up to 370 heat inspections are carried out in the approximately 2500 inpatient facilities in Hesse. They are either integrated into already planned inspections or carried out separately; they focus on preventive and acute measures. In principle, heat protection can be easily integrated into the daily routine of residential health facilities. High staff turnover and lack of resources pose challenges. DISCUSSION Inspections and consultations on heat management raise awareness of hot weather health risks and support the establishment of preventive measures. The Hessian system is a suitable orientation for other federal states.
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Affiliation(s)
- Debora Janson
- Deutsches Krankenhausinstitut, Düsseldorf, Deutschland
| | | | - Johanna Nickl
- Schule für Pflegeberufe, Städtisches Klinikum Lüneburg, Lüneburg, Deutschland
| | - Laura Hannemann
- GKV-Bündnis für Gesundheit in Bayern, München, Deutschland
- Geschäftsstelle Gesundheitsregion Plus im Landkreis Dachau, Dachau, Deutschland
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Kephart JL, Okoye SM. Tackling heat-related mortality in aging populations. Nat Med 2024; 30:1247-1248. [PMID: 38589604 DOI: 10.1038/s41591-024-02919-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Josiah L Kephart
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Safiyyah M Okoye
- Department of Graduate Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Bernhardt JM, Amiri A. Application of the socioecological model to mitigate risks of heat illness. Nurs Outlook 2024; 72:102150. [PMID: 38442464 DOI: 10.1016/j.outlook.2024.102150] [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: 11/29/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND The socio-ecological model (SEM) is a widely used framework that can be applied to heat-related illness (HRI) in the context of multiple influencing factors that exist in society. Leaders and policymakers must intervene to mitigate the deleterious effects of climate change on those at risk. PURPOSE The purpose is to introduce the SEM as a framework to address the complex factors contributing to the impact of excess heat. METHODS Conceived through the SEM, the compounding and cumulative impact of excess heat resulting in HRI is operationalized. DISCUSSION The SEM provides a structure for understanding the complex nature of climate change and HRI and proposed interventions. The prevention of HRI is dependent on actions, related to practice, education, research, and advocacy across multiple levels of the SEM. The SEM has the potential to target HRI at all levels of society to reduce the harm of excess heat.
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Affiliation(s)
- Jean M Bernhardt
- School of Nursing, MGH Institute of Health Professions, Charlestown, MA.
| | - Azita Amiri
- College of Nursing, The University of Alabama Huntsville, Huntsville, AL
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Yao P, Zhang B, Yang R, Ma X, Zhang X, Wu T, Li B. Assessment of the combined vulnerability to droughts and heatwaves in Shandong Province in summer from 2000 to 2018. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:464. [PMID: 38647697 DOI: 10.1007/s10661-024-12637-8] [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: 10/30/2023] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
Droughts and heat waves exhibit synergistic effects and are among the world's most costly disasters. To explore the spatiotemporal differences and formation mechanisms of the combined vulnerability to droughts and heat waves in Shandong Province over the past 20 years, a vulnerability scoping diagram (VSD) model with three dimensions-exposure, sensitivity, and adaptability-was constructed to assess and compare the combined vulnerability to high-temperature and drought events, considering economic and social conditions. The results showed that (1) over the past 20 years, heat waves and droughts have increased in Shandong Province. The number of high-temperature events significantly increased in the west and decreased along the eastern coast, and drought change was characterized by an increase in the south and a decrease in the north. (2) The combined exposure to summer droughts and heat waves in Shandong Province showed a significant increasing trend (P < 0.05) at a rate of approximately 0.072/10a; the combined sensitivity significantly decreased (P < 0.05) at a rate of approximately 0.137/10a, and the combined adaptability continued to increase at a rate of approximately 0.481/10a. (3) The combined vulnerability to summer droughts and heat waves in the western inland area of Shandong Province was high and gradually decreased toward the southeastern coast. The overall decrease trend was nonsignificant with a decrease of approximately 0.126/10a, and the decline rate decreased from northwest to southeast, in which Laiwu, Yantai, Jinan, and Zibo cities exhibited a significant decreasing trend (P < 0.05). Although the compound vulnerability of Shandong Province has decreased insignificantly, the frequency of combined drought and heat wave events has increased, and the combined vulnerability will increase in the future.
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Affiliation(s)
- Ping Yao
- Key Laboratory of Terrestrial Ecological Remediation in Jining City, School of Geography and Tourism, Qufu Normal University, Rizhao, 276826, China
| | - Baohuan Zhang
- Department of College English Teaching, Qufu Normal University, Rizhao, 276826, China.
| | - Ruihan Yang
- Key Laboratory of Terrestrial Ecological Remediation in Jining City, School of Geography and Tourism, Qufu Normal University, Rizhao, 276826, China
| | - Xiaonuo Ma
- Key Laboratory of Terrestrial Ecological Remediation in Jining City, School of Geography and Tourism, Qufu Normal University, Rizhao, 276826, China
| | - Xiangning Zhang
- Key Laboratory of Terrestrial Ecological Remediation in Jining City, School of Geography and Tourism, Qufu Normal University, Rizhao, 276826, China
| | - Tianxiao Wu
- Key Laboratory of Terrestrial Ecological Remediation in Jining City, School of Geography and Tourism, Qufu Normal University, Rizhao, 276826, China
| | - Baofu Li
- Key Laboratory of Terrestrial Ecological Remediation in Jining City, School of Geography and Tourism, Qufu Normal University, Rizhao, 276826, China.
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Aznarez C, Kumar S, Marquez-Torres A, Pascual U, Baró F. Ecosystem service mismatches evidence inequalities in urban heat vulnerability. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 922:171215. [PMID: 38428611 DOI: 10.1016/j.scitotenv.2024.171215] [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: 11/22/2023] [Revised: 01/23/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
Exposure to heat poses a pressing challenge in cities, with uneven health and environmental impacts across the urban fabric. To assess disparities in heat vulnerability and its environmental justice implications, we model supply-demand mismatches for the ecosystem service (ES) urban temperature regulation. We integrated remote sensing, health, and socio-demographic data with Artificial Intelligence for Environment and Sustainability (ARIES) and geographical information system tools. We computed composite indicators at the census tract level for urban cooling supply, and vulnerability to heat as a measure of demand. We do so in the context of the mid-size city of Vitoria-Gasteiz, Basque Country (Europe). We mapped relative mismatches after identifying and analysed their relationship with socio-demographic and health factors. Our findings show disparities in heat vulnerability, with increased exposure observed among socio-economically disadvantaged communities, the elderly, and people with health issues. Areas associated with higher income levels show lower ES mismatches, indicating higher temperature regulation supply and reduced heat vulnerability. The results point at the need for nature-based heat mitigation interventions that especially focus on the more socio-economically disadvantaged communities.
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Affiliation(s)
- Celina Aznarez
- Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain; Basque Centre for Climate Change (BC3), Leioa, Spain.
| | | | | | - Unai Pascual
- Basque Centre for Climate Change (BC3), Leioa, Spain; Basque Foundation for Science, Ikerbasque, Bilbao, Spain
| | - Francesc Baró
- Department of Geography, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Department of Sociology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Metzger A, Baharav Y, Nichols L, Finke M, Saunders B, Mitchell P, Wellenius GA, Baughman McLeod K, Shickman K. Beliefs and behaviors associated with the first named heat wave in Seville Spain 2022. Sci Rep 2024; 14:9055. [PMID: 38643234 PMCID: PMC11032320 DOI: 10.1038/s41598-024-59430-8] [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: 09/05/2023] [Accepted: 04/10/2024] [Indexed: 04/22/2024] Open
Abstract
Heat waves pose a substantial and increasing risk to public health. Heat health early warning systems (HHEWSs) and response plans are increasingly being adopted to alert people to the health risks posed by days of extreme heat and recommend protective behaviors. However, evidence regarding the effectiveness of HHEWSs remains limited. We examined the impact of heat wave naming on heat-related beliefs and behaviors to ascertain the potential effectiveness of heat wave naming as a heat health risk communication and management tool. Specifically, we surveyed members of the public exposed to the proMETEO Sevilla HHEWS messaging campaign which in the summer of 2022 applied a name to heat waves considered to pose the greatest risk to public health. During the heat season we evaluated, the proMETEO Sevilla HHEWS campaign applied a name to one heat wave, heat wave "Zoe". Our analysis of the post-survey of 2022 adults indicated that the 6% of participants who recalled the name Zoe unaided reported greater engagement in heat wave safety behaviors and more positive beliefs about naming heat waves and their local governments' heat wave response. These results provide initial evidence for potential utility in naming heat waves as part of HHEWSs and HAPs.
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Affiliation(s)
| | - Yuval Baharav
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA
| | - Lilly Nichols
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA.
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA.
| | - Megan Finke
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA
| | | | | | - Gregory A Wellenius
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA
| | - Kathy Baughman McLeod
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA
| | - Kurt Shickman
- Adrienne Arsht-Rockefeller Foundation Resilience Center at the Atlantic Council, Washington, DC, USA
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Chowdhury S, Hänninen R, Sofiev M, Aunan K. Fires as a source of annual ambient PM 2.5 exposure and chronic health impacts in Europe. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 922:171314. [PMID: 38423313 DOI: 10.1016/j.scitotenv.2024.171314] [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: 10/26/2023] [Revised: 01/29/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Chronic exposure to ambient PM2.5 is the largest environmental health risk in Europe. We used a chemical transport model and recent exposure response functions to simulate ambient PM2.5, contribution from fires and related health impacts over Europe from 1990 to 2019. Our estimation indicates that the excess death burden from exposure to ambient PM2.5 declined across Europe at a rate of 10,000 deaths per year, from 0.57 million (95 % confidence intervals: 0.44-0.75 million) in 1990 to 0.28 million (0.19-0.42 million) in the specified period. Among these excess deaths, approximately 99 % were among adults, while only around 1 % occurred among children. Our findings reveal a steady increase in fire mortality fractions (excess deaths from fires per 1000 deaths from ambient PM2.5) from 2 in 1990 to 13 in 2019. Notably, countries in Eastern Europe exhibited significantly higher fire mortality fractions and experienced more pronounced increases compared to those in Western and Central Europe. We performed sensitivity analyses by considering fire PM2.5 to be more toxic as compared to other sources, as indicated by recent studies. By considering fire PM2.5 to be more toxic than other PM2.5 sources results in an increased relative contribution of fires to excess deaths, reaching 2.5-13 % in 2019. Our results indicate the requirement of larger mitigation and adaptation efforts and more sustainable forest management policies to avert the rising health burden from fires.
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Affiliation(s)
| | | | | | - Kristin Aunan
- CICERO Center for International Climate Research, Oslo, Norway
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Zonnefeld AG, Cui CY, Tsitsipatis D, Piao Y, Fan J, Mazan-Mamczarz K, Xue Y, Indig FE, De S, Gorospe M. Characterization of age-associated gene expression changes in mouse sweat glands. Aging (Albany NY) 2024; 16:6717-6730. [PMID: 38637019 PMCID: PMC11087089 DOI: 10.18632/aging.205776] [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: 12/18/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
Evaporation of sweat on the skin surface is the major mechanism for dissipating heat in humans. The secretory capacity of sweat glands (SWGs) declines during aging, leading to heat intolerance in the elderly, but the mechanisms responsible for this decline are poorly understood. We investigated the molecular changes accompanying SWG aging in mice, where sweat tests confirmed a significant reduction of active SWGs in old mice relative to young mice. We first identified SWG-enriched mRNAs by comparing the skin transcriptome of Eda mutant Tabby male mice, which lack SWGs, with that of wild-type control mice by RNA-sequencing analysis. This comparison revealed 171 mRNAs enriched in SWGs, including 47 mRNAs encoding 'core secretory' proteins such as transcription factors, ion channels, ion transporters, and trans-synaptic signaling proteins. Among these, 28 SWG-enriched mRNAs showed significantly altered abundance in the aged male footpad skin, and 11 of them, including Foxa1, Best2, Chrm3, and Foxc1 mRNAs, were found in the 'core secretory' category. Consistent with the changes in mRNA expression levels, immunohistology revealed that higher numbers of secretory cells from old SWGs express the transcription factor FOXC1, the protein product of Foxc1 mRNA. In sum, our study identified mRNAs enriched in SWGs, including those that encode core secretory proteins, and altered abundance of these mRNAs and proteins with aging in mouse SWGs.
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Affiliation(s)
- Alexandra G. Zonnefeld
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Chang-Yi Cui
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Dimitrios Tsitsipatis
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Yulan Piao
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Jinshui Fan
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Krystyna Mazan-Mamczarz
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Yutong Xue
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Fred E. Indig
- Confocal Imaging Core Facility, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Supriyo De
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Myriam Gorospe
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
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Quijal-Zamorano M, Martinez-Beneito MA, Ballester J, Marí-Dell’Olmo M. Spatial Bayesian distributed lag non-linear models (SB-DLNM) for small-area exposure-lag-response epidemiological modelling. Int J Epidemiol 2024; 53:dyae061. [PMID: 38641428 PMCID: PMC11031409 DOI: 10.1093/ije/dyae061] [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: 07/21/2023] [Accepted: 04/10/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Distributed lag non-linear models (DLNMs) are the reference framework for modelling lagged non-linear associations. They are usually used in large-scale multi-location studies. Attempts to study these associations in small areas either did not include the lagged non-linear effects, did not allow for geographically-varying risks or downscaled risks from larger spatial units through socioeconomic and physical meta-predictors when the estimation of the risks was not feasible due to low statistical power. METHODS Here we proposed spatial Bayesian DLNMs (SB-DLNMs) as a new framework for the estimation of reliable small-area lagged non-linear associations, and demonstrated the methodology for the case study of the temperature-mortality relationship in the 73 neighbourhoods of the city of Barcelona. We generalized location-independent DLNMs to the Bayesian framework (B-DLNMs), and extended them to SB-DLNMs by incorporating spatial models in a single-stage approach that accounts for the spatial dependence between risks. RESULTS The results of the case study highlighted the benefits of incorporating the spatial component for small-area analysis. Estimates obtained from independent B-DLNMs were unstable and unreliable, particularly in neighbourhoods with very low numbers of deaths. SB-DLNMs addressed these instabilities by incorporating spatial dependencies, resulting in more plausible and coherent estimates and revealing hidden spatial patterns. In addition, the Bayesian framework enriches the range of estimates and tests that can be used in both large- and small-area studies. CONCLUSIONS SB-DLNMs account for spatial structures in the risk associations across small areas. By modelling spatial differences, SB-DLNMs facilitate the direct estimation of non-linear exposure-response lagged associations at the small-area level, even in areas with as few as 19 deaths. The manuscript includes an illustrative code to reproduce the results, and to facilitate the implementation of other case studies by other researchers.
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Affiliation(s)
| | - Miguel A Martinez-Beneito
- Departament d’Estadística i Investigaciò Operativa, Universitat de València, Burjassot, Valencia, Spain
| | | | - Marc Marí-Dell’Olmo
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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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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Ye T, Guo Y, Huang W, Zhang Y, Abramson MJ, Li S. Heat Exposure, Preterm Birth, and the Role of Greenness in Australia. JAMA Pediatr 2024; 178:376-383. [PMID: 38407915 PMCID: PMC10897824 DOI: 10.1001/jamapediatrics.2024.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/21/2023] [Indexed: 02/27/2024]
Abstract
Importance Preterm birth (PTB) is associated with adverse health outcomes. The outcomes of heat exposure during pregnancy and the moderating association of greenness with PTB remain understudied. Objective To investigate associations between heat exposure, greenness, and PTB, as well as interactions between these factors. Design, Setting, and Participants Included in this cohort study were births occurring in Sydney, New South Wales, Australia, between 2000 and 2020, retrieved from New South Wales Midwives Data Collection. Participants with incomplete or missing data on their residential address or those who resided outside of New South Wales during their pregnancy were excluded. Data were analyzed from March to October 2023. Exposures Greenness measured using normalized difference vegetation index (NDVI) and tree cover derived from satellite images. Daily extreme heat and nighttime extreme heat were defined as above the 95th percentile of community- and trimester-specific daily mean temperatures and nighttime temperatures. Main Outcomes and Measures Logistic regression models estimated the independent association of extreme heat with PTB, adjusting for individual- and area-level covariates, season of conception, and long-term trend. An interaction term between extreme heat exposure and greenness was included to explore potential modification. With a significant interaction observed, the number of preventable heat-associated PTBs that were associated with greenness was estimated. Results A total of 1 225 722 births (median [IQR] age, 39 [38-40] weeks; 631 005 male [51.5%]) were included in the analysis, including 63 144 PTBs (median [IQR] age, 35 [34-36] weeks; 34 822 male [55.1%]). Compared with those without heat exposure, exposure to daily extreme heat and nighttime extreme heat in the third trimester was associated with increased risks of PTB, with an adjusted odds ratio (OR) of 1.61 (95% CI, 1.55-1.67) and 1.51 (95% CI, 1.46-1.56]), respectively (PTB rates: exposed, 4615 of 61 338 [7.5%] vs unexposed, 56 440 of 1 162 295 [4.9%] for daily extreme heat and 4332 of 61 337 [7.1%] vs 56 723 of 1 162 296 [4.9%] for nighttime extreme heat). Disparities in associations between extreme heat exposure and PTB were observed, with lower odds of PTB among pregnant individuals residing in greener areas. The associations between extreme heat exposure and PTB could be mitigated significantly by higher greenness. Improving NDVI and tree cover could reduce daily extreme heat-associated PTB by 13.7% (95% CI, 2.3%-15.1%) and 20.9% (95% CI, 5.8%-31.5%), respectively. For nighttime extreme heat-associated PTB, reductions were 13.0% (0.2%-15.4%) and 17.2% (4.1%-27.0%), respectively. Conclusions and Relevance Results of this large birth cohort study suggest that extreme heat exposure was adversely associated with PTB, with greenness playing a moderating role. Increasing greenness levels in residential communities could prevent heat-associated PTBs. These findings emphasize the importance of integrating heat mitigation strategies and improving green space in urban planning and public health interventions.
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Affiliation(s)
- Tingting Ye
- 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
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yiwen Zhang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael J. Abramson
- 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
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Pallubinsky H, Blondin DP, Jay O. A double-edged sword: risks and benefits of heat for human health. Trends Endocrinol Metab 2024; 35:277-279. [PMID: 38593784 DOI: 10.1016/j.tem.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 04/11/2024]
Abstract
Extreme heat events will become more frequent and intense across the globe. In this science and society article we summarize how heat affects our body and discuss the associated health threats, but also the potential health benefits of heat exposure. Moreover, we provide practical suggestions for sustainable and health-oriented strategies to cope with heat.
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Affiliation(s)
- Hannah Pallubinsky
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211KL Maastricht, The Netherlands; Healthy Living Spaces Laboratory, Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
| | - Denis P Blondin
- Faculty of Medicine and Health Sciences, Department of Medicine, Division of Neurology, Université de Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada; Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec J1H 5N4, Canada
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Hou X, Kong S, Xiang R. Extreme high temperatures and corporate low-carbon actions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 925:171704. [PMID: 38492586 DOI: 10.1016/j.scitotenv.2024.171704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/27/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Abstract
Greenhouse gas emissions are considered the culprit of extreme high temperatures, and low-carbon transformation has become a global consensus. The low-carbon action by enterprises is an inevitable choice if they are to adapt to economic and social needs. Green innovation is an important measure for enterprises to respond to the challenges of low-carbon transformation. This study mainly discusses the causal relationship between extreme high temperatures and green innovation of enterprises. Using China's industrial enterprise database, we construct county-annual panel data from 2000 to 2013. Results show that extreme high temperatures improve the level of green innovation of enterprises. After a series of robustness tests, the results remain. Mechanism analysis shows that extreme high temperatures increase the environmental concerns of the government, the public, and society, thus strengthening government regulation, public participation, and social supervision as well as encouraging enterprises to carry out green innovation. Our heterogeneous analysis shows that in the eastern region with a high level of legal system and economic development, it is easier to promote green innovation for enterprises. In addition, large-scale enterprises are more willing to carry out green innovation after experiencing a heat wave.
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Affiliation(s)
- Xiaojuan Hou
- School of Economics and Management, China University of Geosciences, Beijing 100083, China
| | - Shuning Kong
- School of Applied Economics, Renmin University of China, Beijing 100872, China.
| | - Ruojun Xiang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.
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Kumar P, Debele SE, Khalili S, Halios CH, Sahani J, Aghamohammadi N, Andrade MDF, Athanassiadou M, Bhui K, Calvillo N, Cao SJ, Coulon F, Edmondson JL, Fletcher D, Dias de Freitas E, Guo H, Hort MC, Katti M, Kjeldsen TR, Lehmann S, Locosselli GM, Malham SK, Morawska L, Parajuli R, Rogers CD, Yao R, Wang F, Wenk J, Jones L. Urban heat mitigation by green and blue infrastructure: Drivers, effectiveness, and future needs. Innovation (N Y) 2024; 5:100588. [PMID: 38440259 PMCID: PMC10909648 DOI: 10.1016/j.xinn.2024.100588] [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: 08/07/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
The combination of urbanization and global warming leads to urban overheating and compounds the frequency and intensity of extreme heat events due to climate change. Yet, the risk of urban overheating can be mitigated by urban green-blue-grey infrastructure (GBGI), such as parks, wetlands, and engineered greening, which have the potential to effectively reduce summer air temperatures. Despite many reviews, the evidence bases on quantified GBGI cooling benefits remains partial and the practical recommendations for implementation are unclear. This systematic literature review synthesizes the evidence base for heat mitigation and related co-benefits, identifies knowledge gaps, and proposes recommendations for their implementation to maximize their benefits. After screening 27,486 papers, 202 were reviewed, based on 51 GBGI types categorized under 10 main divisions. Certain GBGI (green walls, parks, street trees) have been well researched for their urban cooling capabilities. However, several other GBGI have received negligible (zoological garden, golf course, estuary) or minimal (private garden, allotment) attention. The most efficient air cooling was observed in botanical gardens (5.0 ± 3.5°C), wetlands (4.9 ± 3.2°C), green walls (4.1 ± 4.2°C), street trees (3.8 ± 3.1°C), and vegetated balconies (3.8 ± 2.7°C). Under changing climate conditions (2070-2100) with consideration of RCP8.5, there is a shift in climate subtypes, either within the same climate zone (e.g., Dfa to Dfb and Cfb to Cfa) or across other climate zones (e.g., Dfb [continental warm-summer humid] to BSk [dry, cold semi-arid] and Cwa [temperate] to Am [tropical]). These shifts may result in lower efficiency for the current GBGI in the future. Given the importance of multiple services, it is crucial to balance their functionality, cooling performance, and other related co-benefits when planning for the future GBGI. This global GBGI heat mitigation inventory can assist policymakers and urban planners in prioritizing effective interventions to reduce the risk of urban overheating, filling research gaps, and promoting community resilience.
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Affiliation(s)
- Prashant Kumar
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
- Institute for Sustainability, University of Surrey, Guildford GU2 7XH, Surrey, UK
- School of Architecture, Southeast University, 2 Sipailou, Nanjing 210096, China
| | - Sisay E. Debele
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Soheila Khalili
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Christos H. Halios
- School of Built Environment, University of Reading, Whiteknights, Reading RG6 6BU, UK
| | - Jeetendra Sahani
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Nasrin Aghamohammadi
- School Design and the Built Environment, Curtin University Sustainability Policy Institute, Kent St, Bentley 6102, Western Australia
- Harry Butler Institute, Murdoch University, Murdoch 6150, Western Australia
| | - Maria de Fatima Andrade
- Atmospheric Sciences Department, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of Sao Paulo, Sao Paulo 05508-090, Brazil
| | | | - Kamaldeep Bhui
- Department of Psychiatry and Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, Oxford, UK
| | - Nerea Calvillo
- Centre for Interdisciplinary Methodologies, University of Warwick, Warwick, UK
| | - Shi-Jie Cao
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
- School of Architecture, Southeast University, 2 Sipailou, Nanjing 210096, China
| | - Frederic Coulon
- Cranfield University, School of Water, Environment and Energy, Cranfield MK43 0AL, UK
| | - Jill L. Edmondson
- Plants, Photosynthesis, Soil Cluster, School of Biosciences, University of Sheffield, Sheffield S10 2TN, UK
| | - David Fletcher
- UK Centre for Ecology & Hydrology, Environment Centre Wales, Deiniol Road, Bangor LL57 2UW, UK
| | - Edmilson Dias de Freitas
- Atmospheric Sciences Department, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of Sao Paulo, Sao Paulo 05508-090, Brazil
| | - Hai Guo
- Air Quality Studies, Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Madhusudan Katti
- Department of Forestry and Environmental Resources, Faculty Excellence Program for Leadership in Public Science, North Carolina State University, Chancellor, Raleigh, NC 27695, USA
| | - Thomas Rodding Kjeldsen
- Departments of Architecture & Civil Engineering, and Chemical Engineering, University of Bath, Bath BA2 7AY, UK
| | - Steffen Lehmann
- School of Architecture, University of Nevada, Las Vegas, NV 89154, USA
| | - Giuliano Maselli Locosselli
- Department of Tropical Ecosystems Functioning, Center of Nuclear Energy in Agriculture, University of São Paulo, Piracicaba 13416-000, Sao Paulo, Brazil
| | - Shelagh K. Malham
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5 AB, UK
| | - Lidia Morawska
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
- International Laboratory for Air Quality and Health, Science and Engineering Faculty, Queensland University of Science and Technology, QLD, Australia
| | - Rajan Parajuli
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
| | - Christopher D.F. Rogers
- Department of Civil Engineering, School of Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Runming Yao
- School of Built Environment, University of Reading, Whiteknights, Reading RG6 6BU, UK
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, School of the Civil Engineering, Chongqing University, Chongqing, China
| | - Fang Wang
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing 210008, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jannis Wenk
- Departments of Architecture & Civil Engineering, and Chemical Engineering, University of Bath, Bath BA2 7AY, UK
| | - Laurence Jones
- UK Centre for Ecology & Hydrology, Environment Centre Wales, Deiniol Road, Bangor LL57 2UW, UK
- Liverpool Hope University, Department of Geography and Environmental Science, Hope Park, Liverpool L16 9JD, UK
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45
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Sobel A. Are we all doomed? How to cope with the daunting uncertainties of climate change. Nature 2024; 627:483-485. [PMID: 38499678 DOI: 10.1038/d41586-024-00790-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
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46
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Barletta JF, Palmieri TL, Toomey SA, Harrod CG, Murthy S, Bailey H. Management of Heat-Related Illness and Injury in the ICU: A Concise Definitive Review. Crit Care Med 2024; 52:362-375. [PMID: 38240487 DOI: 10.1097/ccm.0000000000006170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVES The increasing frequency of extreme heat events has led to a growing number of heat-related injuries and illnesses in ICUs. The objective of this review was to summarize and critically appraise evidence for the management of heat-related illnesses and injuries for critical care multiprofessionals. DATA SOURCES Ovid Medline, Embase, Cochrane Clinical Trials Register, Cumulative Index to Nursing and Allied Health Literature, and ClinicalTrials.gov databases were searched from inception through August 2023 for studies reporting on heat-related injury and illness in the setting of the ICU. STUDY SELECTION English-language systematic reviews, narrative reviews, meta-analyses, randomized clinical trials, and observational studies were prioritized for review. Bibliographies from retrieved articles were scanned for articles that may have been missed. DATA EXTRACTION Data regarding study methodology, patient population, management strategy, and clinical outcomes were qualitatively assessed. DATA SYNTHESIS Several risk factors and prognostic indicators for patients diagnosed with heat-related illness and injury have been identified and reported in the literature. Effective management of these patients has included various cooling methods and fluid replenishment. Drug therapy is not effective. Multiple organ dysfunction, neurologic injury, and disseminated intravascular coagulation are common complications of heat stroke and must be managed accordingly. Burn injury from contact with hot surfaces or pavement can occur, requiring careful evaluation and possible excision and grafting in severe cases. CONCLUSIONS The prevalence of heat-related illness and injury is increasing, and rapid initiation of appropriate therapies is necessary to optimize outcomes. Additional research is needed to identify effective methods and strategies to achieve rapid cooling, the role of immunomodulators and anticoagulant medications, the use of biomarkers to identify organ failure, and the role of artificial intelligence and precision medicine.
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Affiliation(s)
- Jeffrey F Barletta
- Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale Campus, AZ
| | - Tina L Palmieri
- Burn Division, Department of Surgery, Shriners Hospitals for Children Northern California, Sacramento, CA
| | - Shari A Toomey
- Respiratory Department/Sleep Center, Carilion Clinic Children's Hospital, Roanoke, VA
| | | | - Srinivas Murthy
- Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada
| | - Heatherlee Bailey
- Department of Emergency Medicine, Durham Veterans Affairs Medical Center, Durham, NC
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Fedeli U, Danieli G, Barbiellini Amidei C, Casotto V. Increasing Parkinson's disease related mortality through the pandemic and beyond: An update. Parkinsonism Relat Disord 2024; 120:105992. [PMID: 38198927 DOI: 10.1016/j.parkreldis.2024.105992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Affiliation(s)
- Ugo Fedeli
- Epidemiological Department, Azienda Zero, Veneto Region, Italy.
| | - Giacomo Danieli
- Epidemiological Department, Azienda Zero, Veneto Region, Italy
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Deng L, Chen X, Ma P, Wu Y, Okoye CO, Du D, Deng Q. The combined effect of oxidative stress and TRPV1 on temperature-induced asthma: Evidence in a mouse model. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123313. [PMID: 38185356 DOI: 10.1016/j.envpol.2024.123313] [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: 10/20/2023] [Revised: 12/17/2023] [Accepted: 01/04/2024] [Indexed: 01/09/2024]
Abstract
Temperature is one of the possible activators for asthma. As global warming continues, the health hazard of high temperatures is increasing. It is unclear, nevertheless, how high temperatures affect asthma. The research aims to examine how asthma is affected by high temperatures and underlying molecular mechanisms. The BALB/c mice were adopted in a model of asthma. The mice were exposed at 24 °C, 38 °C and 40 °C for 4h on weekdays from day 1 to day 30. After the experiment, the lung function was measured in vivo, and then serum protein, pulmonary inflammation and immunohistochemistry assay was assessed in vitro. As the temperature increased from 24 °C to 40 °C, there was a significant increase in serum protein, while there is no discernible difference in serum protein of OVA-sIgE and OVA-sIgG between the OVA (38 °C) group and OVA (24 °C) group. The immunohistochemistry assay showed a change in the pro-inflammatory cytokines. The histopathological analysis exhibited the change of airway structure after high-temperature exposure, especially for exposure at 40 °C. The results of signals protein showed a remarkable rise of TRPV1 for OVA+40 °C. Our results revealed that high temperatures may make asthmatic airway dysfunction severe, and the higher the temperature, the more serious asthma. The oxidative stress and TRPV1 receptor can be a potential drug target for asthma. It will provide a new tool for precision medicine in asthma.
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Affiliation(s)
- Linjing Deng
- School of Emergency Management, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China.
| | - Xunfeng Chen
- Biofuels Institute of Jiangsu university, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China
| | - Ping Ma
- Laboratory of Environment-Immunological and Neurological Diseases, Hubei University of Science and Technology, Xianning, 437100, China
| | - Yang Wu
- Laboratory of Environment-Immunological and Neurological Diseases, Hubei University of Science and Technology, Xianning, 437100, China
| | - Charles Obinwanne Okoye
- School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China; Department of Zoology & Environmental Biology, University of Nigeria, Nsukka, 410001, Nigeria
| | - Daolin Du
- School of Emergency Management, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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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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50
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Kang Y, Baek I, Park J. Assessing heatwave effects on disabled persons in South Korea. Sci Rep 2024; 14:3459. [PMID: 38342943 PMCID: PMC10859370 DOI: 10.1038/s41598-024-54015-x] [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: 10/10/2023] [Accepted: 02/07/2024] [Indexed: 02/13/2024] Open
Abstract
This study investigated the risk of heatwaves for people with disabilities and other socioeconomic attributes using Health Care Bigdata in South Korea. The Health Care Bigdata provides detailed information on heat-related illness (HRI) patients in 2011-2020 from seven major cities. We employed the Distributed Lag Nonlinear Model (DLNM) to measure heat waves' relative risk. Our findings are four-fold. First, the relative risk (RR) of disabled people was 5.075 (95% confidence interval 4.476-5.674), significantly surpassing that of non-disabled people, 3.296 (2.517-4.075). Second, among various personal characteristics studied, disability influenced RR the most, exceeding impacts from elderly (4.457: 3.748-5.166), low-income (3.909: 3.004-4.813), and outdoor (4.052: 2.940-5.164). Third, the disabled young group (5.305: 4.414-6.195) was more vulnerable than the non-disabled elderly group (4.287: 3.576-4.999). Lastly, no significant difference in relative risk was observed between the mild (4.413: 3.855-4.971) and severe disabled groups (4.013: 3.121-4.905).
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Affiliation(s)
- Yeji Kang
- Kongju National University, 56 Gongjudaehak-Ro, Gongju, 32588, South Korea
| | - Ingul Baek
- Kongju National University, 56 Gongjudaehak-Ro, Gongju, 32588, South Korea
| | - Jongchul Park
- Kongju National University, 56 Gongjudaehak-Ro, Gongju, 32588, South Korea.
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