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Mpakosi A, Cholevas V, Tzouvelekis I, Passos I, Kaliouli-Antonopoulou C, Mironidou-Tzouveleki M. Autoimmune Diseases Following Environmental Disasters: A Narrative Review of the Literature. Healthcare (Basel) 2024; 12:1767. [PMID: 39273791 PMCID: PMC11395540 DOI: 10.3390/healthcare12171767] [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: 07/23/2024] [Revised: 09/02/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Environmental disasters are extreme environmental processes such as earthquakes, volcanic eruptions, landslides, tsunamis, floods, cyclones, storms, wildfires and droughts that are the consequences of the climate crisis due to human intervention in the environment. Their effects on human health have alarmed the global scientific community. Among them, autoimmune diseases, a heterogeneous group of disorders, have increased dramatically in many parts of the world, likely as a result of changes in our exposure to environmental factors. However, only a limited number of studies have attempted to discover and analyze the complex association between environmental disasters and autoimmune diseases. This narrative review has therefore tried to fill this gap. First of all, the activation pathways of autoimmunity after environmental disasters have been analyzed. It has also been shown that wildfires, earthquakes, desert dust storms and volcanic eruptions may damage human health and induce autoimmune responses to inhaled PM2.5, mainly through oxidative stress pathways, increased pro-inflammatory cytokines and epithelial barrier damage. In addition, it has been shown that heat stress, in addition to increasing pro-inflammatory cytokines, may also disrupt the intestinal barrier, thereby increasing its permeability to toxins and pathogens or inducing epigenetic changes. In addition, toxic volcanic elements may accelerate the progressive destruction of myelin, which may potentially trigger multiple sclerosis. The complex and diverse mechanisms by which vector-borne, water-, food-, and rodent-borne diseases that often follow environmental diseases may also trigger autoimmune responses have also been described. In addition, the association between post-disaster stress and the onset or worsening of autoimmune disease has been demonstrated. Given all of the above, the rapid restoration of post-disaster health services to mitigate the flare-up of autoimmune conditions is critical.
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Affiliation(s)
- Alexandra Mpakosi
- Department of Microbiology, General Hospital of Nikaia "Agios Panteleimon", 18454 Piraeus, Greece
| | | | - Ioannis Tzouvelekis
- School of Agricultural Technology, Food Technology and Nutrition, Alexander Technological Educational Institute of Thessaloniki, 57400 Thessaloniki, Greece
| | - Ioannis Passos
- Surgical Department, 219, Mobile Army, Surgical Hospital, 68300 Didymoteicho, Greece
| | | | - Maria Mironidou-Tzouveleki
- Department of Pharmacology, School of Medical, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Montalti M, Fabbri M, Angelini R, Bakken E, Morri M, Tamarri F, Reali C, Soldà G, Silvestrini G, Lenzi J. Syndromic Surveillance in Public Health Emergencies: A Systematic Analysis of Cases Related to Exposure to 2023 Floodwaters in Romagna, Italy. Healthcare (Basel) 2024; 12:1760. [PMID: 39273784 PMCID: PMC11395706 DOI: 10.3390/healthcare12171760] [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: 08/13/2024] [Revised: 09/02/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND In May 2023, Romagna, Italy, faced a devastating flood resulting in 16 fatalities, forced displacement of 26,000 citizens, and significant economic losses. Due to potential water contamination, implementing public health strategies became imperative for the Local Health Authority to mitigate the health consequences, analyze the flood's impact on the local population's health, and detect early anomalies requiring timely public health interventions. METHODS Between June and July 2023, general practitioners who were part of the RespiVirNet surveillance network completed weekly structured forms. These forms collected data on individuals exposed or not to floodwaters and clinical syndromes. Rates per 1000 resident population aged > 14 were stratified by district, week of observation, and symptomatology. Missing data were addressed by imputation using second-order autoregressive modeling. RESULTS An incidence of 3.52 syndromes potentially related to flood water exposure per 1000 individuals (95% CI 2.82-4.35) was estimated. Ravenna, the city most affected by the flood, recorded the highest rate (6.05 per 1000, 95% CI 4.59-7.82). Incidence decreased in the weeks post-event. Anxiety, or trauma and stress symptoms, exhibited higher rates among the exposed, diminishing over weeks. The incidence for the non-exposed (12.76 per 1000, 95% CI 10.55-15.29) showed no significant territorial differences compared to the exposed ones. CONCLUSIONS Syndromic surveillance provided timely information on the flood's health impact, revealing a higher incidence of individual syndromes among the non-exposed. This study contributes to guiding the implementation of future public health preparedness and response strategies for populations facing similar natural disasters.
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Affiliation(s)
- Marco Montalti
- Unit of Hygiene and Public Health Forlì-Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Marco Fabbri
- Unit of Hygiene and Public Health Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Raffaella Angelini
- Unit of Hygiene and Public Health Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Elizabeth Bakken
- Unit of Hygiene and Public Health Rimini, Department of Public Health, Romagna Local Health Authority, 47624 Rimini, Italy
| | - Michela Morri
- Unit of Hygiene and Public Health Rimini, Department of Public Health, Romagna Local Health Authority, 47624 Rimini, Italy
| | - Federica Tamarri
- Unit of Hygiene and Public Health Forlì-Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
| | - Chiara Reali
- Unit of Hygiene and Public Health Forlì-Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
| | - Giorgia Soldà
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
- Unit of Environmental Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Giulia Silvestrini
- Unit of Hygiene and Public Health Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Jacopo Lenzi
- Unit of Hygiene, Public Health, and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
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Rosenzweig B, Montalto FA, Orton P, Kaatz J, Maher N, Kleyman J, Chen Z, Sanderson E, Adhikari N, McPhearson T, Herreros-Cantis P. NPCC4: Climate change and New York City's flood risk. Ann N Y Acad Sci 2024; 1539:127-184. [PMID: 39159317 DOI: 10.1111/nyas.15175] [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] [Indexed: 08/21/2024]
Abstract
This chapter of the New York City Panel on Climate Change 4 (NPCC4) report provides a comprehensive description of the different types of flood hazards (pluvial, fluvial, coastal, groundwater, and compound) facing New York City and provides climatological context that can be utilized, along with climate change projections, to support flood risk management (FRM). Previous NPCC reports documented coastal flood hazards and presented trends in historical and future precipitation and sea level but did not comprehensively assess all the city's flood hazards. Previous NPCC reports also discussed the implications of floods on infrastructure and the city's residents but did not review the impacts of flooding on the city's natural and nature-based systems (NNBSs). This-the NPCC's first report focused on all drivers of flooding-describes and profiles historical examples of each type of flood and summarizes previous and ongoing research regarding exposure, vulnerability, and risk management, including with NNBS and nonstructural measures.
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Affiliation(s)
- Bernice Rosenzweig
- Environmental Science, Sarah Lawrence College, Bronxville, New York, USA
| | - Franco A Montalto
- College of Engineering, Drexel University, Philadelphia, Pennsylvania, USA
- eDesign Dynamics LLC, New York, New York, USA
| | - Philip Orton
- School of Engineering and Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | | | - Nicole Maher
- The Nature Conservancy, Cold Spring Harbor, New York, USA
| | | | - Ziyu Chen
- School of Engineering and Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | | | - Nirajan Adhikari
- College of Engineering, Drexel University, Philadelphia, Pennsylvania, USA
- eDesign Dynamics LLC, New York, New York, USA
| | - Timon McPhearson
- Urban Systems Lab, The New School, New York, New York, USA
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
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Kronen J, Leuchner M, Küpper T. Zika and Chikungunya in Europe 2100 - A GIS based model for risk estimation. Travel Med Infect Dis 2024; 60:102737. [PMID: 38996856 DOI: 10.1016/j.tmaid.2024.102737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 10/27/2023] [Accepted: 07/03/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND The spread of vector-borne infectious diseases is determined, among other things, by temperature. Thus, climate change will have an influence on their global distribution. In the future, Europe will approach the temperature optimum for the transmission of ZIKV and CHIKV. Climate scenarios and climate models can be used to depict future climatic changes and to draw conclusions about future risk areas for vector-borne infectious diseases. METHODS Based on the RCP 4.5 and RCP 8.5 climate scenarios, a geospatial analysis was carried out for the future temperature suitability of ZIKV and CHIKV in Europe. The results were presented in maps and the percentage of the affected areas calculated. RESULTS Due to rising temperatures, the risk areas for transmission of ZIKV and CHIKV spread in both RCP scenarios. For CHIKV transmission, Spain, Portugal, the Mediterranean coast and areas near the Black Sea are mainly affected. Due to high temperatures, large areas throughout Europe are at risk for ZIKV and CHIKV transmission. CONCLUSION Temperature is only one of many factors influencing the spread of vector-borne infectious diseases. Nevertheless, the representation of risk areas on the basis of climate scenarios allows an assessment of future risk development. Monitoring and adaptation strategies are indispensable for coping with and containing possible future autochthonous transmissions and epidemics in Europe.
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Affiliation(s)
- J Kronen
- Physical Geography and Climatology, Institute of Geography, RWTH Aachen University, Aachen, Germany.
| | - M Leuchner
- Physical Geography and Climatology, Institute of Geography, RWTH Aachen University, Aachen, Germany
| | - T Küpper
- Inst. of Occupational, Social & Environmental Medicine, RWTH Aachen University, Aachen, Germany
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Jennings EA, Mall S, Bassil DT, Kahn K. Exposure to Adversity and its Impact on Later Life Cognitive, Mental, and Physical Health. Int J Public Health 2024; 69:1606499. [PMID: 38961855 PMCID: PMC11219567 DOI: 10.3389/ijph.2024.1606499] [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: 08/10/2023] [Accepted: 05/29/2024] [Indexed: 07/05/2024] Open
Abstract
Objectives We aimed to assess later-life health responses to childhood and lifetime adversity in a cohort of rural, Black South African adults. Methods We performed ordinary least squares regression using two waves of data from Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) to estimate a decline in cognitive, mental, and physical health over approximately 3 years. Our analytic sample consisted of 1,993 women and 1,496 men. Results Associations between several types of adversity and health outcomes point to declines in health. At the same time, many adverse experiences are associated with improvements in cognitive, mental, and physical health in later life. The direction of the association varied by type of exposure, health outcome, and gender. Conclusion In populations exposed to many adversities during life, specific adverse experiences may sometimes be associated with greater improvements (and not just greater decline) in health in later life. Further research is needed to unpack the mechanisms at play in these populations.
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Affiliation(s)
- Elyse A. Jennings
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Darina T. Bassil
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Wu Y, Gasevic D, Wen B, Yang Z, Yu P, Zhou G, Zhang Y, Song J, Liu H, Li S, Guo Y. Floods and cause-specific mortality in the UK: a nested case-control study. BMC Med 2024; 22:188. [PMID: 38715068 PMCID: PMC11077877 DOI: 10.1186/s12916-024-03412-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Floods are the most frequent weather-related disaster, causing significant health impacts worldwide. Limited studies have examined the long-term consequences of flooding exposure. METHODS Flood data were retrieved from the Dartmouth Flood Observatory and linked with health data from 499,487 UK Biobank participants. To calculate the annual cumulative flooding exposure, we multiplied the duration and severity of each flood event and then summed these values for each year. We conducted a nested case-control analysis to evaluate the long-term effect of flooding exposure on all-cause and cause-specific mortality. Each case was matched with eight controls. Flooding exposure was modelled using a distributed lag non-linear model to capture its nonlinear and lagged effects. RESULTS The risk of all-cause mortality increased by 6.7% (odds ratio (OR): 1.067, 95% confidence interval (CI): 1.063-1.071) for every unit increase in flood index after confounders had been controlled for. The mortality risk from neurological and mental diseases was negligible in the current year, but strongest in the lag years 3 and 4. By contrast, the risk of mortality from suicide was the strongest in the current year (OR: 1.018, 95% CI: 1.008-1.028), and attenuated to lag year 5. Participants with higher levels of education and household income had a higher estimated risk of death from most causes whereas the risk of suicide-related mortality was higher among participants who were obese, had lower household income, engaged in less physical activity, were non-moderate alcohol consumers, and those living in more deprived areas. CONCLUSIONS Long-term exposure to floods is associated with an increased risk of mortality. The health consequences of flooding exposure would vary across different periods after the event, with different profiles of vulnerable populations identified for different causes of death. These findings contribute to a better understanding of the long-term impacts of flooding exposure.
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Affiliation(s)
- Yao Wu
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Guowei Zhou
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Yan Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Jiangning Song
- Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Hong Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Shanshan Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Yuming Guo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Hillin J, Alizadeh B, Li D, Thompson CM, Meyer MA, Zhang Z, Behzadan AH. Designing user-centered decision support systems for climate disasters: What information do communities and rescue responders need during floods? JOURNAL OF EMERGENCY MANAGEMENT (WESTON, MASS.) 2024; 22:71-85. [PMID: 38573731 DOI: 10.5055/jem.0741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Flooding events are the most common natural hazard globally, resulting in vast destruction and loss of life. An effective flood emergency response is necessary to lessen the negative impacts of flood disasters. However, disaster management and response efforts face a complex scenario. Simultaneously, regular citizens attempt to navigate the various sources of information being distributed and determine their best course of action. One thing is evident across all disaster scenarios: having accurate information and clear communication between citizens and rescue personnel is critical. This research aims to identify the diverse needs of two groups, rescue operators and citizens, during flood disaster events by investigating the sources and types of information they rely on and information that would improve their responses in the future. This information can improve the design and implementation of existing and future spatial decision support systems (SDSSs) during flooding events. This research identifies information characteristics crucial for rescue operators and everyday citizens' response and possible evacuation to flooding events by qualitatively coding survey responses from rescue responders and the public. The results show that including local input in SDSS development is crucial for improving higher-resolution flood risk quantification models. Doing so democratizes data collection and analysis, creates transparency and trust between people and governments, and leads to transformative solutions for the broader scientific community.
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Affiliation(s)
- Julia Hillin
- Department of Geography, Texas A&M University, College Station, Texas
| | - Bahareh Alizadeh
- Department of Construction Science, Texas A&M University, College Station, Texas
| | - Diya Li
- Department of Geography, Texas A&M University, College Station, Texas
| | - Courtney M Thompson
- Department of Geography, Texas A&M University, College Station, Texas. ORCID: https://orcid.org/0000-0001-5082-4540
| | - Michelle A Meyer
- Department of Landscape Architecture & Urban Planning, Texas A&M University, College Station, Texas
| | - Zhe Zhang
- Department of Geography, Texas A&M University, College Station, Texas
| | - Amir H Behzadan
- Department of Civil, Environmental, and Architectural Engineering (CEAE), University of Colorado Boulder, Boulder, Colorado
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Wiesehahn LT, Kaifie A. The impact of the 2021 flood on the outpatient care in the North Rhine region, Germany: a cross-sectional study. BMC Public Health 2024; 24:250. [PMID: 38254123 PMCID: PMC10801951 DOI: 10.1186/s12889-023-17279-y] [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: 06/30/2023] [Accepted: 11/21/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND In the summer of 2021, heavy precipitation led to extreme flooding across Western Europe. In Germany, North Rhine-Westphalia and Rhineland-Palatinate were particularly affected. More than 180 people lost their lives, and over 700 were left injured and traumatized. In the North Rhine district alone, more than 120 practices were only able to operate to a limited extent or had to close their practices completely. The aim of this study was to assess the impact of the 2021 flood on the outpatient care in the North Rhine region. METHODS The cross-sectional study was conducted in January 2022 in practices affected by the flood in the North Rhine region. For this purpose, 210 affected practices were identified using a list of the Association of Statutory Health Insurance Physicians for North Rhine (KVNO) and via telephone and/or e-mail. These practices were forwarded a questionnaire that addressed, among other things, the local accessibility of the practices before and after the flood, possibilities of patient care in different premises and received support. RESULTS A total of 103 practices (49.1%) returned the completed questionnaire, of which 1/4 were general practitioners. 97% of the practices reported power failure, more than 50% water supply damage and nearly 40% the loss of patient records. 76% of the participating practices stated that they needed to close their practice at least temporarily. 30 doctors took up patient care in alternative premises. The average number of patients seen by doctors per week before the flood was 206.5. In the first week working in alternative premises, doctors saw an average of 66.2 patients (-50.3%). Especially elderly/geriatric patients and patients with disabilities were identified as particularly vulnerable in terms of access to health care after the flood. CONCLUSIONS The flood had a significant negative impact on outpatient care. We determined not only a high number of closed practices and a large decrease in patient numbers but also differences in patient care assessment depending on the type of alternative premises. To address outpatient care disruptions after extreme weather events more effectively, appropriate measures should be implemented pre-emptively.
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Affiliation(s)
- Luca Theresa Wiesehahn
- Institute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Andrea Kaifie
- Institute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
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Talukder B, Schubert JE, Tofighi M, Likongwe PJ, Choi EY, Mphepo GY, Asgary A, Bunch MJ, Chiotha SS, Matthew R, Sanders BF, Hipel KW, vanLoon GW, Orbinski J. Complex adaptive systems-based framework for modeling the health impacts of climate change. THE JOURNAL OF CLIMATE CHANGE AND HEALTH 2024; 15:100292. [PMID: 38425789 PMCID: PMC10900873 DOI: 10.1016/j.joclim.2023.100292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/01/2023] [Indexed: 03/02/2024]
Abstract
Introduction Climate change is a global phenomenon with far-reaching consequences, and its impact on human health is a growing concern. The intricate interplay of various factors makes it challenging to accurately predict and understand the implications of climate change on human well-being. Conventional methodologies have limitations in comprehensively addressing the complexity and nonlinearity inherent in the relationships between climate change and health outcomes. Objectives The primary objective of this paper is to develop a robust theoretical framework that can effectively analyze and interpret the intricate web of variables influencing the human health impacts of climate change. By doing so, we aim to overcome the limitations of conventional approaches and provide a more nuanced understanding of the complex relationships involved. Furthermore, we seek to explore practical applications of this theoretical framework to enhance our ability to predict, mitigate, and adapt to the diverse health challenges posed by a changing climate. Methods Addressing the challenges outlined in the objectives, this study introduces the Complex Adaptive Systems (CAS) framework, acknowledging its significance in capturing the nuanced dynamics of health effects linked to climate change. The research utilizes a blend of field observations, expert interviews, key informant interviews, and an extensive literature review to shape the development of the CAS framework. Results and discussion The proposed CAS framework categorizes findings into six key sub-systems: ecological services, extreme weather, infectious diseases, food security, disaster risk management, and clinical public health. The study employs agent-based modeling, using causal loop diagrams (CLDs) tailored for each CAS sub-system. A set of identified variables is incorporated into predictive modeling to enhance the understanding of health outcomes within the CAS framework. Through a combination of theoretical development and practical application, this paper aspires to contribute valuable insights to the interdisciplinary field of climate change and health. Integrating agent-based modeling and CLDs enhances the predictive capabilities required for effective health outcome analysis in the context of climate change. Conclusion This paper serves as a valuable resource for policymakers, researchers, and public health professionals by employing a CAS framework to understand and assess the complex network of health impacts associated with climate change. It offers insights into effective strategies for safeguarding human health amidst current and future climate challenges.
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Affiliation(s)
- Byomkesh Talukder
- Department of Global Health, Florida International University, USA
- Dahdaleh Institute for Global Health Research, York University, Canada
| | - Jochen E. Schubert
- Department of Civil and Environmental Engineering, University of California, Irvine, USA
| | - Mohammadali Tofighi
- Dahdaleh Institute for Global Health Research, York University, Canada
- ADERSIM & Disaster & Emergency Management, York University, Canada
| | - Patrick J. Likongwe
- Leadership for Environment and Development Southern and Eastern Africa (LEAD SEA), Malawi
| | - Eunice Y. Choi
- Dahdaleh Institute for Global Health Research, York University, Canada
| | - Gibson Y. Mphepo
- Leadership for Environment and Development Southern and Eastern Africa (LEAD SEA), Malawi
| | - Ali Asgary
- ADERSIM & Disaster & Emergency Management, York University, Canada
| | - Martin J. Bunch
- Faculty of Environmental and Urban Change, York University, Canada
| | - Sosten S. Chiotha
- Leadership for Environment and Development Southern and Eastern Africa (LEAD SEA), Malawi
| | - Richard Matthew
- Department of Urban Planning and Public Policy, University of California, Irvine, USA
| | - Brett F. Sanders
- Department of Civil and Environmental Engineering, University of California, Irvine, USA
- Department of Urban Planning and Public Policy, University of California, Irvine, USA
| | - Keith W. Hipel
- System Engineering Department, Waterloo University, Canada
| | - Gary W. vanLoon
- School of Environmental Studies, Queen's University, Kingston, Canada
| | - James Orbinski
- Dahdaleh Institute for Global Health Research, York University, Canada
- Faculty of Health, York University, Canada
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Augustin J, Andrees V, Czerniejewski A, Dallner R, Schulz CM, Mezger NCS. [The impact of the Ahr Valley flood on the health of the local population - an analysis based on SHI routine data]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:5-13. [PMID: 38193912 PMCID: PMC10776694 DOI: 10.1007/s00103-023-03809-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: 05/03/2023] [Accepted: 11/15/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND In recent decades, Germany has experienced flood events that posed a threat to the health of the local population. However, there is a paucity of studies on the health consequences of these events. Therefore, the aim of the study was to investigate the health consequences of the Ahr Valley flood in 2021. METHODS The data basis of this longitudinal study are nationwide billing data (inpatient/outpatient) of the BKK-Landesverband Nordwest. The study region was Ahrweiler and the study periods were the third quarters of 2020 and 2021. Among other things, prevalence rate ratio tests were used to determine which diagnoses (inpatient/outpatient) were spatially and temporally associated with the flood event on the basis of ICD-10 coding. RESULTS The results show a significant increase in billed services for some diagnosis groups in the inpatient sector. In particular, there was an increase in F diagnoses (mental and behavioural disorders), S diagnoses (injuries) and various diagnosis codes within Z codes (factors influencing health status and leading to healthcare utilisation). In the outpatient sector, a decrease was observed in many diagnosis groups (F and Z diagnoses). CONCLUSION The results of the study showed that the mental health of the local population was particularly affected by the floods. Healthcare was also affected. As floods are expected to become more frequent and severe in the future, measures to protect the population and health infrastructure need to be adapted accordingly.
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Affiliation(s)
- Jobst Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Valerie Andrees
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Deutschland
| | | | | | - Christian M Schulz
- KLUG - Deutsche Allianz Klimawandel und Gesundheit e. V., Berlin, Deutschland
- Medizincampus Oberfranken, Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Deutschland
| | - Nikolaus Christian Simon Mezger
- Centre for Planetary Health Policy, Berlin, Deutschland
- Global Public Health Department, Karolinska Institut, Stockholm, Schweden
- Arbeitsgruppe Globale und Planetare Gesundheit, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Santos-Vega M, Lowe R, Anselin L, Desai V, Vaishnav KG, Naik A, Pascual M. Quantifying climatic and socioeconomic drivers of urban malaria in Surat, India: a statistical spatiotemporal modelling study. Lancet Planet Health 2023; 7:e985-e998. [PMID: 38056969 DOI: 10.1016/s2542-5196(23)00249-8] [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: 11/24/2020] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Cities are becoming increasingly important habitats for mosquito vectors of disease. The pronounced heterogeneity of urban landscapes challenges our understanding of the effects of climate and socioeconomic factors on mosquito-borne disease dynamics at different spatiotemporal scales. Here, we quantify the impact of climatic and socioeconomic factors on urban malaria risk, using an extensive dataset in both space and time for reported Plasmodium falciparum cases in the city of Surat, northwest India. METHODS We analysed 10 years of monthly P falciparum cases resolved at three nested spatial resolutions (seven zones, 32 units, and 478 worker units) with a Bayesian hierarchical mixed model that incorporates the effects of population density, poverty, relative humidity, and temperature, in addition to random effects (structured and unstructured). To reduce dimensionality and avoid correlation of covariates, socioeconomic variables from survey data were summarised into main axes of variation using principal component analysis. With model selection, we identified the main drivers of spatiotemporal variation in malaria incidence rates at each of the three spatial resolutions. We also compared observations to model-fitted cases by quantifying the percentage of predictions within five discrete levels of malaria risk. FINDINGS The spatial variation of urban malaria cases was stationary over time, whereby locations with high and low yearly cases remained largely consistent across years. Local socioeconomic variation could be summarised with three principal components accounting for approximately 80% of the variance. The model that incorporated local temperature and relative humidity together with two of these principal components, largely representing population density and poverty, best explained monthly malaria patterns in models formulated at the three different spatial scales. As model resolution increased, the effect size of humidity decreased, whereas those of temperature and the principal component associated with population density increased. Model predictions accurately captured aggregated total monthly cases for the city; in space-time, they more closely matched observations at the intermediate scale, with around 57% of units estimated to fall in the observed category on average across years. The mean absolute error was lower at the intermediate level, showing that this is the best aggregation level to predict the space-time dynamics of malaria incidence rates across the city with the selected model. INTERPRETATION This statistical modelling framework provides a basis for development of a climate-driven early warning system for urban malaria for the units of Surat, including spatially explicit prediction of malaria risk several weeks to months in advance. Results indicate environmental and socioeconomic covariates for which further measurement at high resolution should lead to model improvement. Advanced warning combined with local surveillance and knowledge of disease hotspots within the city could inform targeted intervention as part of urban malaria elimination efforts. FUNDING US National Institutes of Health.
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Affiliation(s)
- Mauricio Santos-Vega
- Departamento de Ciencias Biológicas and Grupo de Investigación en Biología Matemática y Computacional BIOMAC, Universidad de los Andes, Bogotá, Colombia.
| | - Rachel Lowe
- Barcelona Supercomputing Center, Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain; Centre on Climate Change & Planetary Health and Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Luc Anselin
- Center for Spatial Data Science, University of Chicago, Chicago, IL, USA
| | - Vikas Desai
- Urban Health and Climate Resilience Center of Excellence (UHCRCE), Surat, India
| | - Keshav G Vaishnav
- Vector Borne Diseases Control Department, Surat Municipal Corporation, Surat, India
| | | | - Mercedes Pascual
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA; Department of Biology and Department of Environmental Studies, New York University, NY, USA
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Findlater L, Robin C, Hopgood K, Waite T. Help-seeking following a flooding event: a cross-sectional analysis of adults affected by flooding in England in winter 2013/14. Eur J Public Health 2023; 33:834-840. [PMID: 37328436 PMCID: PMC10567239 DOI: 10.1093/eurpub/ckad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Flooding can cause long-term, significant impacts on mental health in affected populations. We explored help-seeking behaviour of households affected by flooding. METHODS A cross-sectional analysis was conducted on National Study of Flooding and Health data on households flooded in England in winter 2013/14. Participants (Year 1: n = 2006; Year 2: n = 988; Year 3: n = 819) were asked if they sought help from health services and other sources. Logistic regression was conducted to calculate odds ratios (ORs) of help-seeking in flooded and disrupted participants compared to unaffected, adjusted for a priori confounders. RESULTS The odds of seeking help from any source 1 year after flooding were greater for flooded participants [adjusted OR (aOR): 1.71, 95% confidence interval (CI): 1.19-1.45] and those disrupted by flooding (aOR: 1.92, 95% CI: 1.37-2.68) compared to unaffected participants. This continued in the second year (flooded: aOR 6.24, 95% CI: 3.18-13.34; disrupted: aOR: 2.22, 95% CI: 1.14-4.68), and help-seeking remained greater in flooded than unaffected participants in the third year. Flooded and disrupted participants were particularly likely to seek help from informal sources. Help-seeking was more prevalent amongst participants with mental health outcomes, but a notable proportion of individuals with any mental health outcome did not seek help (Year 1: 15.0%; Year 2: 33.3%; Year 3: 40.3%). CONCLUSIONS Flooding is associated with increased demand for formal and informal support, persisting for at least 3 years, and an unmet need for help amongst affected individuals. Our findings should be considered in flood response planning to reduce the long-term adverse health impacts of flooding.
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Affiliation(s)
- L Findlater
- UK Health Security Agency, Bristol, UK
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) on Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
| | - C Robin
- UK Health Security Agency, Bristol, UK
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) on Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
| | - K Hopgood
- UK Health Security Agency, Bristol, UK
| | - T Waite
- Department of Health and Social Care, UK
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Gharaibeh NG, Lee CC(B, Alhalbouni T, Wang F, Lee J, Newman G, Güneralp B, Zandt SV. Quality of Stormwater Infrastructure Systems in Vulnerable Communities: Three Case Studies from Texas. PUBLIC WORKS MANAGEMENT & POLICY 2023; 28:518-536. [PMID: 37719107 PMCID: PMC10503941 DOI: 10.1177/1087724x231164415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
A properly functioning local stormwater drainage system is essential for mitigating flood risks. This study evaluates the quality of roadside drainage channels in three underserved communities in Texas: the Sunnyside neighborhood in Houston (Harris County), a neighborhood in the City of Rockport (Aransas County), and the Hoehn colonia (Hidalgo County). These communities have a history of flooding, are highly socially vulnerable, and rely on roadside ditches as their principal stormwater drainage system for runoff control. Mobile lidar (Light Detection and Ranging) measurements were collected for 6.09 miles of roadside channels in these communities. The raw lidar measurements were processed to evaluate drainage conditions based on the channel's geometric properties, hydraulic capacity, and level of service. The assessment results are linked to a Geographic Information System (GIS) tool for enhanced visualization. Finally, the paper provides insights regarding the quality of stormwater infrastructure in the study communities and discusses their practical implications.
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Affiliation(s)
- Nasir G. Gharaibeh
- Zachry Department of Civil & Environmental Engineering, Texas A&M University, College Station, TX, USA
| | - Cheng-Chun (Barry) Lee
- Zachry Department of Civil & Environmental Engineering, Texas A&M University, College Station, TX, USA
| | - Tariq Alhalbouni
- Zachry Department of Civil & Environmental Engineering, Texas A&M University, College Station, TX, USA
| | - Feiyue Wang
- Zachry Department of Civil & Environmental Engineering, Texas A&M University, College Station, TX, USA
| | - Jessica Lee
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Galen Newman
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Burak Güneralp
- Department of Geography, Texas A&M University, College Station, TX, USA
| | - Shannon Van Zandt
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
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14
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Topluoglu S, Taylan-Ozkan A, Alp E. Impact of wars and natural disasters on emerging and re-emerging infectious diseases. Front Public Health 2023; 11:1215929. [PMID: 37727613 PMCID: PMC10505936 DOI: 10.3389/fpubh.2023.1215929] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/17/2023] [Indexed: 09/21/2023] Open
Abstract
Emerging Infectious Diseases (EIDs) and Re-Emerging Infectious Diseases (REIDs) constitute significant health problems and are becoming of major importance. Up to 75% of EIDs and REIDs have zoonotic origin. Several factors such as the destruction of natural habitats leading humans and animals to live in close proximity, ecological changes due to natural disasters, population migration resulting from war or conflict, interruption or decrease in disease prevention programs, and insufficient vector control applications and sanitation are involved in disease emergence and distribution. War and natural disasters have a great impact on the emergence/re-emergence of diseases in the population. According to a World Bank estimation, two billion people are living in poverty and fragility situations. Wars destroy health systems and infrastructure, curtail existing disease control programs, and cause population movement leading to an increase in exposure to health risks and favor the emergence of infectious diseases. A total of 432 catastrophic cases associated with natural disasters were recorded globally in 2021. Natural disasters increase the risk of EID and REID outbreaks by damaging infrastructure and leading to displacement of populations. A Generic National Action Plan covering risk assessment, mechanism for action, determination of roles and responsibilities of each sector, the establishment of a coordination mechanism, etc. should be developed.
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Affiliation(s)
- Seher Topluoglu
- Provincial Health Directorate of Ankara, Republic of Türkiye Ministry of Health, Ankara, Türkiye
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, Medical Faculty, TOBB University of Economics and Technology, Ankara, Türkiye
| | - Emine Alp
- Department of Clinical Microbiology and Infectious Diseases, Medical Faculty, Ankara Yildirim Beyazit University, Ankara, Türkiye
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Vo MTH, Thonglor R, Moncatar TJR, Han TDT, Tejativaddhana P, Nakamura K. Fear of falling and associated factors among older adults in Southeast Asia: a systematic review. Public Health 2023; 222:215-228. [PMID: 36229238 DOI: 10.1016/j.puhe.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/27/2022] [Accepted: 08/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of this study was to provide a comprehensive overview of the prevalence, measurement scales, related factors and interventions for fear of falling (FOF) among older adults in Southeast Asia. STUDY DESIGN This was a systematic review. METHODS Published research studies on FOF among older adults were searched using the following databases: PubMed, Cochrane Library, Scopus, ASEAN Citation Index, Thai Journal Citation Index, Malaysian Journal Citation Report and Google Scholar. All observational and experimental studies investigating FOF among community-dwelling older adults in Southeast Asia were eligible. A narrative synthesis was used to describe the findings. The Joanna Briggs Institute checklist was used to assess the quality and risk of bias of the included studies. RESULTS A total of 15 observational studies and three experimental studies were included after screening 2112 titles and abstracts. These studies, published between 2011 and 2021, were conducted in Malaysia, Singapore, Thailand and Vietnam. The FOF prevalence ranged from 21.6% to 88.2%. The most commonly used FOF assessment tool was the Falls Efficacy Scale-International. Well-reported related factors of FOF were female sex, advanced age, balance impairment and fall history. All experimental studies utilising single- or multi-component interventions comprised an exercise approach. Limited studies have considered environmental factors. CONCLUSIONS Various related factors of FOF and the interventions implemented were revealed. Public health researchers and policymakers should consider the factors related to FOF in practical FOF intervention and prevention strategies. Further evidence on FOF issues is required to understand the multidimensional characteristics of FOF, specifically the environmental aspects of older adults in Southeast Asia.
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Affiliation(s)
- M T H Vo
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - R Thonglor
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; Faculty of Public Health, Naresuan University, Phitsanulok 65000, Thailand
| | - T J R Moncatar
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - T D T Han
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue 530000, Viet Nam
| | - P Tejativaddhana
- ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - K Nakamura
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; WHO Collaborating Centre for Healthy Cities and Urban Policy Research, Tokyo, Japan.
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16
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Saberi P, Ming K, Arnold EA, Leddy AM, Weiser SD. Extreme weather events and HIV: development of a conceptual framework through qualitative interviews with people with HIV impacted by the California wildfires and their clinicians. BMC Public Health 2023; 23:950. [PMID: 37231393 DOI: 10.1186/s12889-023-15957-5] [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: 07/22/2022] [Accepted: 05/22/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND People with HIV (PWH) are disproportionately vulnerable to the impacts of wildfires, given the need for frequent access to healthcare systems, higher burden of comorbidities, higher food insecurity, mental and behavioral health challenges, and challenges of living with HIV in a rural area. In this study, we aim to better understand the pathways through which wildfires impact health outcomes among PWH. METHODS From October 2021 through February 2022, we conducted individual semi-structured qualitative interviews with PWH impacted by the Northern California wildfires and clinicians of PWH who were impacted by wildfires. The study aims were to explore the influence of wildfires on the health of PWH and to discuss measures at the individual, clinic, and system levels that helped to mitigate these impacts. RESULTS We interviewed 15 PWH and 7 clinicians. While some PWH felt that surviving the HIV epidemic added to their resilience against wildfires, many felt that the wildfires compounded the HIV-related traumas that they have experienced. Participants outlined five main routes by which wildfires negatively impacted their health: (1) access to healthcare (medications, clinics, clinic staff), (2) mental health (trauma; anxiety, depression, or stress; sleep disturbances; coping strategies), (3) physical health (cardiopulmonary, other co-morbidities), (4) social/economic impacts (housing, finances, community), and (5) nutrition and exercise. The recommendations for future wildfire preparedness were at the (1) individual-level (what to have during evacuation), (2) pharmacy-level (procedural, staffing), and (3) clinic- or county-level (funds and vouchers; case management; mental health services; emergency response planning; other services such as telehealth, home visits, home laboratory testing). CONCLUSIONS Based on our data and prior research, we devised a conceptual framework that acknowledges the impact of wildfires at the community-, household-, and individual-level with implications for physical and mental health outcomes among PWH. These findings and framework can help in developing future interventions, programs, and policies to mitigate the cumulative impacts of extreme weather events on the health of PWH, particularly among individuals living in rural areas. Further studies are needed to examine health system strengthening strategies, innovative methods to improve access to healthcare, and community resilience through disaster preparedness. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Parya Saberi
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Kristin Ming
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Emily A Arnold
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Anna M Leddy
- Division of pulmonary and critical care medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Quinn T, Heath S, Adger WN, Abu M, Butler C, Codjoe SNA, Horvath C, Martinez-Juarez P, Morrissey K, Murphy C, Smith R. Health and wellbeing implications of adaptation to flood risk. AMBIO 2023; 52:952-962. [PMID: 36826747 PMCID: PMC10073375 DOI: 10.1007/s13280-023-01834-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/12/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Adaptation strategies to ameliorate the impacts of climate change are increasing in scale and scope around the world, with interventions becoming a part of daily life for many people. Though the implications of climate impacts for health and wellbeing are well documented, to date, adaptations are largely evaluated by financial cost and their effectiveness in reducing risk. Looking across different forms of adaptation to floods, we use existing literature to develop a typology of key domains of impact arising from interventions that are likely to shape health and wellbeing. We suggest that this typology can be used to assess the health consequences of adaptation interventions more generally and argue that such forms of evaluation will better support the development of sustainable adaptation planning.
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Affiliation(s)
- Tara Quinn
- Irish Climate Analysis and Research Units (ICARUS), Department of Geography, Maynooth University, Maynooth, Co. Kildare Ireland
| | - Stacey Heath
- School of Psychology, The Open University, Walton Hall, Milton Keynes, MK7 6AA UK
| | - W. Neil Adger
- Faculty of Environment, Science and Economy, University of Exeter, Exeter, EX4 4RJ UK
| | - Mumuni Abu
- Regional Institute for Population Studies, University of Ghana, Legon Boundary, Accra, Ghana
| | - Catherine Butler
- Faculty of Environment, Science and Economy, University of Exeter, Exeter, EX4 4RJ UK
| | | | - Csaba Horvath
- Irish Climate Analysis and Research Units (ICARUS), Department of Geography, Maynooth University, Maynooth, Co. Kildare Ireland
| | - Pablo Martinez-Juarez
- Medical School, University of Exeter, Amory Building, Magdalen Road, Exeter, EX1 2LU UK
- Bilbao, Basque Country Spain
| | - Karyn Morrissey
- Sustainability Division, Department of Technology Management and Economics, Technical University of Denmark, Produktionstorvet, 424, 118, 2800 Kgs. Lyngby, Denmark
| | - Conor Murphy
- Irish Climate Analysis and Research Units (ICARUS), Department of Geography, Maynooth University, Maynooth, Co. Kildare Ireland
| | - Richard Smith
- Medical School, University of Exeter, Amory Building, Magdalen Road, Exeter, EX1 2LU UK
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Ramesh B, Callender R, Zaitchik BF, Jagger M, Swarup S, Gohlke JM. Adverse Health Outcomes Following Hurricane Harvey: A Comparison of Remotely-Sensed and Self-Reported Flood Exposure Estimates. GEOHEALTH 2023; 7:e2022GH000710. [PMID: 37091294 PMCID: PMC10120588 DOI: 10.1029/2022gh000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/10/2023] [Accepted: 03/21/2023] [Indexed: 05/03/2023]
Abstract
Remotely sensed inundation may help to rapidly identify areas in need of aid during and following floods. Here we evaluate the utility of daily remotely sensed flood inundation measures and estimate their congruence with self-reported home flooding and health outcomes collected via the Texas Flood Registry (TFR) following Hurricane Harvey. Daily flood inundation for 14 days following the landfall of Hurricane Harvey was acquired from FloodScan. Flood exposure, including number of days flooded and flood depth was assigned to geocoded home addresses of TFR respondents (N = 18,920 from 47 counties). Discordance between remotely-sensed flooding and self-reported home flooding was measured. Modified Poisson regression models were implemented to estimate risk ratios (RRs) for adverse health outcomes following flood exposure, controlling for potential individual level confounders. Respondents whose home was in a flooded area based on remotely-sensed data were more likely to report injury (RR = 1.5, 95% CI: 1.27-1.77), concentration problems (1.36, 95% CI: 1.25-1.49), skin rash (1.31, 95% CI: 1.15-1.48), illness (1.29, 95% CI: 1.17-1.43), headaches (1.09, 95% CI: 1.03-1.16), and runny nose (1.07, 95% CI: 1.03-1.11) compared to respondents whose home was not flooded. Effect sizes were larger when exposure was estimated using respondent-reported home flooding. Near-real time remote sensing-based flood products may help to prioritize areas in need of assistance when on the ground measures are not accessible.
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Affiliation(s)
- Balaji Ramesh
- College of Public HealthThe Ohio State UniversityColumbusOHUSA
| | | | - Benjamin F. Zaitchik
- Department of Earth and Planetary SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | | | - Samarth Swarup
- Biocomplexity InstituteUniversity of VirginiaCharlottesvilleVAUSA
| | - Julia M. Gohlke
- Department of Population Health SciencesVirginia TechBlacksburgVAUSA
- Environmental Defense FundWashingtonDCUSA
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Arnout BA. An epidemiological study of mental health problems related to climate change: A procedural framework for mental health system workers. Work 2023:WOR220040. [PMID: 36710698 DOI: 10.3233/wor-220040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The Arab region has witnessed different biological hazards, including cholera, yellow fever, and the COVID-19 pandemic. In addition, changes in rainfall and increased vegetation cover led to locust outbreaks in Tunisia, Libya, Morocco, and Saudi Arabia. This problem still exists and affects more than 20 countries and concerns indicate food shortages and food insecurity for more than 20 million people. OBJECTIVE This study aimed to detect mental health problems related to climate change in the Arab world. METHODS A cross-sectional descriptive survey was applied to determine the prevalence of mental health problems related to climate change (MHPCC). A random sample consisted of 1080 participants (523 male and 557 female), residents in 18 Arab countries; their ages ranged from 25 to 60 years. The Mental Health Problems related to Climate Change Questionnaire (MHPCCQ) was completed online. RESULTS The results indicated average levels of MHPCC prevalence. The results also revealed no significant statistical differences in the MHPCC due to gender, educational class, and marital status except in climate anxiety; there were statistical differences in favor of married subgroup individuals. At the same time, there are statistically significant differences in the MHPCC due to the residing country variable in favor of Syria, Yemen, Algeria, Libya, and Oman regarding fears, anxiety, alienation, and somatic symptoms. In addition, Tunisia, Bahrain, Sudan, and Iraq were higher in climate depression than the other countries. CONCLUSION The findings shed light on the prevalence of MHPCC in the Arab world and oblige mental health system workers, including policymakers, mental health providers, and departments of psychology in Arab universities, to take urgent action to assess and develop the system for mental health to manage the risks of extreme climate change on the human mental health.
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Affiliation(s)
- Boshra A Arnout
- Department of Psychology, King Khalid University, Abha, Saudi Arabia.,Department of Psychology, Zagazig University, Zagazig, Egypt
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20
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Starkweather KE, Keith MH, Zohora FT, Alam N. Economic impacts and nutritional outcomes of the 2017 floods in Bangladeshi Shodagor fishing families. Am J Hum Biol 2023; 35:e23826. [PMID: 36331095 DOI: 10.1002/ajhb.23826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES As climate change continues to increase the frequency and severity of flooding in Bangladesh and globally, it becomes increasingly critical to understand the pathways through which flooding influences health outcomes, particularly in lower-income and subsistence-based communities. We aim to assess economic pathways that link flooding to nutritional outcomes among Shodagor fishing families in Bangladesh. METHODS We examine longitudinal economic data on kilograms of fish caught, the income earned from those fish, and household food expenditures (as a proxy for dietary intake) from before, during, and after severe flooding in August-September of 2017 to enumerate the impacts of flooding on Shodagor economics and nutrition. We also analyze seasonally collected anthropometric data to model the effects of flooding and household food expenditures on child growth rates and changes to adult body size. RESULTS While Shodagor fishing income declined during the 2017 flooding, food expenditures simultaneously spiked with market inflation, and rice became the predominant expenditure only during and immediately following the flood. Our nutritional models show that children and adults lost more body mass in households that spent more money on rice during the flood. Shodagor children lost an average of 0.36 BMI-for-age z-scores and adults lost an average of 0.32 BMI units during the flooded 2017 rainy season, and these metrics continued to decline across subsequent seasons and did not recover by the end of the study period in 2019. CONCLUSIONS These results show major flood-induced economic impacts that contributed to loss of child and adult body mass among Shodagor fishing families in Bangladesh. More frequent and severe flooding will exacerbate these nutritional insults, and more work is needed to effectively stabilize household nutrition throughout natural disasters and economic hardship.
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Affiliation(s)
- Kathrine E Starkweather
- Department of Anthropology, University of Illinois Chicago, Chicago, Illinois.,Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Monica H Keith
- Department of Anthropology, Vanderbilt University, Nashville, Tennessee, USA
| | - Fatema Tuz Zohora
- Health Systems and Population Studies Division, ICDDR, B, Dhaka, Bangladesh
| | - Nurul Alam
- Health Systems and Population Studies Division, ICDDR, B, Dhaka, Bangladesh
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21
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Rosinger AY. Extreme climatic events and human biology and health: A primer and opportunities for future research. Am J Hum Biol 2023; 35:e23843. [PMID: 36449411 PMCID: PMC9840683 DOI: 10.1002/ajhb.23843] [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: 11/04/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
Extreme climatic events are increasing in frequency, leading to hotter temperatures, flooding, droughts, severe storms, and rising oceans. This special issue brings together a collection of seven articles that describe the impacts of extreme climatic events on a diverse set of human biology and health outcomes. The first two articles cover extreme temperatures extending from extreme heat to cold and changes in winter weather and the respective implications for adverse health events, human environmental limits, well-being, and human adaptability. Next, two articles cover the effects of exposures to extreme storms through an examination of hurricanes and cyclones on stress and birth outcomes. The following two articles describe the effects of extreme flooding events on livelihoods, nutrition, water and food insecurity, diarrheal and respiratory health, and stress. The last article examines the effects of drought on diet and food insecurity. Following a brief review of each extreme climatic event and articles covered in this special issue, I discuss future research opportunities-highlighting domains of climate change and specific research questions that are ripe for biological anthropologists to investigate. I close with a description of interdisciplinary methods to assess climate exposures and human biology outcomes to aid the investigation of the defining question of our time - how climate change will affect human biology and health. Ultimately, climate change is a water, food, and health problem. Human biologists offer a unique perspective for a combination of theoretical, methodological, and applied reasons and thus are in a prime position to contribute to this critical research agenda.
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Affiliation(s)
- Asher Y. Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
- Department of Anthropology, Pennsylvania State University, University Park, PA, USA
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22
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Braam DH. Zoonoses in the margins: environmental displacement and health outcomes in the Indus Delta. Int J Equity Health 2022; 21:189. [PMID: 36581869 PMCID: PMC9800233 DOI: 10.1186/s12939-022-01823-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND It remains unclear how human and animal displacement impacts zoonotic disease risk with little contextualized primary data available. This study investigates zoonotic disease dynamics in populations regularly displaced due to slow onset disasters and annual monsoons in the Indus Delta in Sindh province in southeast Pakistan. METHODS Using a case study methodology, semi-structured key informant interviews and focus group discussions with 35 participants, as well as observational studies were conducted in seven communities in Thatta district. RESULTS Key factors affecting zoonotic disease dynamics in environmental displacement in Thatta identified in the study include disasters and loss of forage, a lack of veterinary and healthcare access, and socio-economic status. Animal and human health are an important consideration in displacement disrupting communities and livelihoods, affecting safety, health, and food security. Displacement results in a poverty spiral whereby the displaced find themselves at continuous peril from poverty and disaster, with zoonotic disease dynamics shifting based on environmental changes, and an expectation of future movement and loss. CONCLUSION The precarious conditions generated through the disruption of communities and livelihoods makes environmentally displaced populations vulnerable to zoonotic disease. To prevent further displacement and disease, broader political economy issues need to be addressed, and comprehensive assistance provided to support sustainable livelihoods.
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Affiliation(s)
- Dorien H Braam
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Madingley Road, CB3 0ES, Cambridge, UK.
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Evaluating the Prevalence and Correlates of Major Depressive Disorder Among Residents of Fort McMurray, Canada, One Year After a Devastating Flood. Disaster Med Public Health Prep 2022; 17:e271. [PMID: 36537001 DOI: 10.1017/dmp.2022.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study assessed the prevalence and correlates of depression following the April 2020 flooding in Fort McMurray. METHODOLOGY A cross-sectional study design. Questionnaires were self-administered through an anonymous, online survey. Data collected included sociodemographics, flooding-related variables, clinical information, and likely major depressive disorder (MDD) using PHQ-9 scoring. Data were analyzed using descriptive statistics, the chi-square test, and logistic regression at P = < 0.05. RESULTS Of the 186 respondents who completed the survey, 85.5% (159) of the respondents were females, 14.5% (27) were males, 52.7% (98) were above 40 years of age, and 94% (175) were employed. The prevalence of mild to severe depression among the respondents was 53.7% (75). Respondents who reported that they are unemployed are 12 times more likely to have a moderate to severe depression (OR = 12.16; 95% CI: 1.08-136.26). Respondents who had previously received a mental health diagnosis of MDD are five times more likely to have moderate to severe depression (OR = 5.306; 95% CI: 1.84-15.27). CONCLUSION This study suggests that flooding could impact the psychosocial and mental health of affected people. There is a need to reassess the existing guidelines on emergency planning for flooding to reduce its impacts on mental health and identify where research can support future evidence-based guidelines.
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Fritz M. Temperature and non-communicable diseases: Evidence from Indonesia's primary health care system. HEALTH ECONOMICS 2022; 31:2445-2464. [PMID: 35988141 DOI: 10.1002/hec.4590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Climate change induced rising temperatures will pose a detrimental threat to decent health in the coming decades. Especially at risk are individuals with chronic diseases, since heat can exacerbate a variety of health conditions. In this article, I examine the heat-morbidity relationship in the context of Indonesia, focusing on chronic, non-communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Using a novel dataset from the Indonesian national health insurance scheme Jaminan Kesehatan Nasional/Badan Penyelenggara Jaminan Sosial (BPJS) and linking it with meteorological data on the daily-district level, I estimate the causal effect of high temperatures on the daily number of primary health care visits. The results show that on a hot day all-cause visits and visits with a diagnosis of diabetes and cardiovascular diseases increase by 8%, 25% and 14%, respectively. These increases are permanent and not offset by visit displacement or 'harvesting'. Visits related to respiratory diseases seem not to be affected by high temperatures. I use several climate change scenarios to predict the increase in visits and costs by the end of the century, which all forecast a substantial financial burden for the health care system. These results might have relevance for other middle-income countries with similar climatic conditions.
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Affiliation(s)
- Manuela Fritz
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
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How does flooding affect the nutritional status of children in floodplain regions? A cross-sectional study from Assam, India. PROCEEDINGS OF THE INDIAN NATIONAL SCIENCE ACADEMY 2022. [DOI: 10.1007/s43538-022-00128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ahmadi C, Karampourian A, Samarghandi MR. Explain the challenges of evacuation in floods based on the views of citizens and executive managers. Heliyon 2022; 8:e10759. [PMID: 36193530 PMCID: PMC9525901 DOI: 10.1016/j.heliyon.2022.e10759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/20/2022] [Accepted: 09/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background Flood is one of the natural hazards that causes a lot of human and financial losses. Emergency evacuation in the response phase is necessary to reduce damage. The present study was conducted to explain the challenges related to evacuation in floods based on the views of citizens and executive managers. Materials and methods In this study, a qualitative research method with a contractual content analysis approach was used. 27 participants including 10 citizens and 17 executive managers were included in the study by purposive sampling. Semi-structured interviews were used to collect data. In order to have confidence the validity of the results, rigor was certified by using the guidelines suggested by Guba and Lincoln for making trustworthiness. The duration of the interview was between 45 min and 60 min. The interviews were handwritten by line-by-line content analysis and then analyzed. Results Data analysis led to the extraction of 6 main categories with 14 sub-categories including: lack of primary warning system (with 2 sub-categories, lack of national early warning system and lack of attention to early warning), insufficient resources (with 4 sub-categories, lack of equipment, lack of manpower Human resources, inadequate allocation of financial resources and lack of information resources), problems related to unpreparedness (having 2 sub-categories, lack of pre-determined program and lack of attention to public education), problems related to emergency housing (having 2 sub-categories, lack of housing program and lack of attention to indigenous culture in housing), lack of risk perception (has 2 sub-categories of people's belief in floods and officials' belief in flood) and problems related to lack of coordination (has 2 sub-categories of internal disharmony and external disharmony). Conclusion To increase evacuation, it is necessary to identify the relevant challenges. Establishing an early warning system and evacuation plan, supply of resources, and increase risk perception and coordination can increase the speed of evacuation and reduce the financial and human losses caused by floods.
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Affiliation(s)
| | - Arezou Karampourian
- Urology and Nephrology Research Center, Chronic Diseases (Home Care) Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Samarghandi
- Department of Environmental Health, School of Health, Health Sciences Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
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Abass K, Gyasi RM, Katey D, Frempong F, Garsonu EK. Flood exposure and psychological distress among Ghanaian adults in flood-prone settings. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 835:155481. [PMID: 35490804 DOI: 10.1016/j.scitotenv.2022.155481] [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: 10/17/2021] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
Urban floods have long-term mental health implications, yet this subject remains largely neglected in flood-related studies. This paper examines the psychological distress (PD) of adults exposed to floods in Ghana. Cross-sectional data involving 767 flood-prone community-dwelling household heads aged ≥20 years were analyzed [mean = 47.3 years (SD = 13.7); males = 61.4%]. We used the Exposure to Flood-related Events Scale, and PD was assessed with the Kessler Psychological Distress Scale (K10). Ordinary Least Squares (OLS) regressions evaluated crude and adjusted associations of flood exposure with PD. The mean scores of PD (37[SD = 8]) and exposure to flood events (6[SD = 3]) significantly varied by age and sex (p < .05). After full adjustment for potential confounders, exposure to flood events was significantly and positively associated with PD index in the total sample (β = 0.030; p < .005), among male participants (β = 0.019; p < .05) and female participants (β = 0.048; p < .001). Furthermore, age-wise analysis revealed significant association of flood exposure with PD in young adults (β = 0.033; p < .001) but not in older adults (β = 0.048; p = .062). Exposure to floods increased the risk of PD. Policy and public health efforts to manage PD should include selective flood reduction interventions, including land use regulations and sustained public education.
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Affiliation(s)
- Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya.
| | - Daniel Katey
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Foster Frempong
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Emmanuel Kofi Garsonu
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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Mavrouli M, Mavroulis S, Lekkas E, Tsakris A. Infectious Diseases Associated with Hydrometeorological Hazards in Europe: Disaster Risk Reduction in the Context of the Climate Crisis and the Ongoing COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10206. [PMID: 36011854 PMCID: PMC9408126 DOI: 10.3390/ijerph191610206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/07/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Hydrometeorological hazards comprise a wide range of events, mainly floods, storms, droughts, and temperature extremes. Floods account for the majority of the related disasters in both developed and developing countries. Flooding alters the natural balance of the environment and frequently establish a favorable habitat for pathogens and vectors to thrive. Diseases caused by pathogens that require vehicle transmission from host to host (waterborne) or a host/vector as part of their life cycle (vector-borne) are those most likely to be affected by flooding. Considering the most notable recent destructive floods events of July 2021 that affected several Central Europe countries, we conducted a systematic literature review in order to identify documented sporadic cases and outbreaks of infectious diseases in humans in Europe, where hydrometeorological hazards, mainly floods, were thought to have been involved. The occurrence of water-, rodent-, and vector-borne diseases in several European countries is highlighted, as flooding and the harsh post-flood conditions favor their emergence and transmission. In this context, strategies for prevention and management of infectious disease outbreaks in flood-prone and flood-affected areas are also proposed and comprise pre- and post-flood prevention measures, pre- and post-outbreak prevention measures, as well as mitigation actions when an infectious disease outbreak finally occurs. Emphasis is also placed on the collision of floods, flood-related infectious disease outbreaks, and the evolving COVID-19 pandemic, which may result in unprecedented multi-hazard conditions and requires a multi-hazard approach for the effective disaster management and risk reduction.
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Affiliation(s)
- Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Spyridon Mavroulis
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
| | - Efthymios Lekkas
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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LaMontagne MG, Zhang Y, Guillen GJ, Gentry TJ, Allen MS. Hurricane Harvey Impacts on Water Quality and Microbial Communities in Houston, TX Waterbodies. Front Microbiol 2022; 13:875234. [PMID: 35774461 PMCID: PMC9239555 DOI: 10.3389/fmicb.2022.875234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022] Open
Abstract
Extreme weather events can temporarily alter the structure of coastal systems and generate floodwaters that are contaminated with fecal indicator bacteria (FIB); however, every coastal system is unique, so identification of trends and commonalities in these episodic events is challenging. To improve our understanding of the resilience of coastal systems to the disturbance of extreme weather events, we monitored water quality, FIB at three stations within Clear Lake, an estuary between Houston and Galveston, and three stations in bayous that feed into the estuary. Water samples were collected immediately before and after Hurricane Harvey (HH) and then throughout the fall of 2017. FIB levels were monitored by culturing E. coli and Enterococci. Microbial community structure was profiled by high throughput sequencing of PCR-amplified 16S rRNA gene fragments. Water quality and FIB data were also compared to historical data for these water body segments. Before HH, salinity within Clear Lake ranged from 9 to 11 practical salinity units (PSU). Immediately after the storm, salinity dropped to < 1 PSU and then gradually increased to historical levels over 2 months. Dissolved inorganic nutrient levels were also relatively low immediately after HH and returned, within a couple of months, to historical levels. FIB levels were elevated immediately after the storm; however, after 1 week, E. coli levels had decreased to what would be acceptable levels for freshwater. Enterococci levels collected several weeks after the storm were within the range of historical levels. Microbial community structure shifted from a system dominated by Cyanobacteria sp. before HH to a system dominated by Proteobacteria and Bacteroidetes immediately after. Several sequences observed only in floodwater showed similarity to sequences previously reported for samples collected following Hurricane Irene. These changes in beta diversity corresponded to salinity and nitrate/nitrite concentrations. Differential abundance analysis of metabolic pathways, predicted from 16S sequences, suggested that pathways associated with virulence and antibiotic resistance were elevated in floodwater. Overall, these results suggest that floodwater generated from these extreme events may have high levels of fecal contamination, antibiotic resistant bacteria and bacteria rarely observed in other systems.
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Affiliation(s)
- Michael G. LaMontagne
- Department of Biology and Biotechnology, University of Houston – Clear Lake, Houston, TX, United States
| | - Yan Zhang
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - George J. Guillen
- Department of Biology and Biotechnology, University of Houston – Clear Lake, Houston, TX, United States
| | - Terry J. Gentry
- Department of Soil and Crop Sciences, Texas A&M University, College Station, TX, United States
| | - Michael S. Allen
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX, United States
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Days of Flooding Associated with Increased Risk of Influenza. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:8777594. [PMID: 35692665 PMCID: PMC9187473 DOI: 10.1155/2022/8777594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/10/2022] [Indexed: 11/18/2022]
Abstract
Influenza typically causes mild infection but can lead to severe outcomes for those with compromised lung health. Flooding, a seasonal problem in Iowa, can expose many Iowans to molds and allergens shown to alter lung inflammation, leading to asthma attacks and decreased viral clearance. Based on this, the hypothesis for this research was that there would be geographically specific positive associations in locations with flooding with influenza diagnosis. An ecological study was performed using influenza diagnoses and positive influenza polymerase chain reaction tests from a de-identified large private insurance database and Iowa State Hygienic Lab. After adjustment for multiple confounding factors, Poisson regression analysis resulted in a consistent 1% associated increase in influenza diagnoses per day above flood stage (95% confidence interval: 1.00–1.04). This relationship remained after removal of the 2009–2010 influenza pandemic year. There was no associated risk between flooding and influenza-like illness as a nonspecific diagnosis. Associated risks between flooding and increased influenza diagnoses were geographically specific, with the greatest risk in the most densely populated areas. This study indicates that populations who live, work, or volunteer in flooded environments should consider preventative measures to avoid environmental exposures to mitigate illness from influenza in the following year.
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Yari A, Zarezadeh Y, Rahimiforoushani A, Ardalan A, Boubakran MS, Bidarpoor F, Ostadtaghizadeh A. Scale Development and Psychometric Evaluation of a Questionnaire for Measuring the Risk Factors for Death in Floods. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2022; 20:521-533. [PMID: 35669828 PMCID: PMC9163268 DOI: 10.1007/s40201-022-00798-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/14/2022] [Indexed: 06/15/2023]
Abstract
Purpose Determination of the causes of flood-related deaths is the precondition for effective interventions aimed at the reduction of such deaths. There is a gap in the design and the development of a valid and reliable instrument for measuring underlying factors of death in the flood. Methods This study was carried out in two phases. In the first phase, item pool generation and questionnaire design were carried out through systematic review of literature and qualitative study. the initial questionnaire was divided into two parts of objective and subjective factors. In the second phase, the psychometric evaluation of the questionnaire included face, content, and construct validity in the subjective part. The reliability was also evaluated by calculating test-retest intraclass correlation coefficient and Cronbach's alpha. Exploratory factor analysis (EFA) was used for the data collected from 369 individuals in the flood-affected communities experiencing flood deaths. Data analysis was performed in SPSS version 23. Results In the EFA, 33 items and seven dimensions were extracted that explained 57.82% of the variance of influential factors in flood death, including the cognition of the flood (four items), general knowledge (four items), public beliefs (four items), risk perception (nine items), attitude (five items), prevention (five items), and social norms (two items). The internal consistency of the instrument using Cronbach's alpha coefficient was 0.92. Finally, in order to perform the stability test, the Pearson correlation coefficient was calculated for all questions. This was above .05 and acceptable. Conclusions According to the results, the factors affecting flood death questionnaire (FAFDQ) could be used to make decisions, identify groups at risk of flood-related deaths, and implement flood-related death-reduction interventions. Indeed, these measures have led to the development of a comprehensive and reliable questionnaire for measuring the factors affecting flood deaths.
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Affiliation(s)
- Arezoo Yari
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Health in Emergencies and Disasters, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Climate Change and Health, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Yadolah Zarezadeh
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Rahimiforoushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ali Ardalan
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Farzam Bidarpoor
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Ostadtaghizadeh
- Department of Climate Change and Health, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, IR Iran
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
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Posttraumatic Stress Symptoms, Physical Illness, and Social Adjustment Among Disaster Victims. Disaster Med Public Health Prep 2022; 17:e195. [PMID: 35593424 DOI: 10.1017/dmp.2022.89] [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: 02/08/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder is one of the most studied outcomes after a disaster. Posttraumatic stress symptoms (PTSS) are maladaptive and disabling and can severely impair affected individuals' psychosocial functioning and quality of life. Consequently, the objective of this research is to investigate the prevalence of PTSS and physical illness among disaster victims. METHODS We analyzed disaster victims' survey data in South Korea 1 year after a natural disaster (n = 1659). Then, we performed multivariable comparisons of social and work adjustments between individuals with PTSS and individuals with physical illness to examine the association between PTSS and functional impairment. RESULTS Individuals with PTSS had a significant association with work and social maladjustments whether or not they had a physical illness; PTSS (+) physical illness (-) group (OR: 1.18, CI: 1.12-1.26, P < 0.001) and PTSS (+) physical illness (+) group (OR: 1.16, CI: 1.08-1.23, P < 0.001). Interestingly, this association was not significant in the group that exclusively presented physical illness. CONCLUSIONS Our results suggest that PTSS might be a critical factor in social maladjustment during the post-disaster period. Subsequently, an assessment of disaster victims' PTSS would help ensure effective medical and governmental approaches to assist disaster victims.
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Flood Hazard Mapping and Flood Preparedness Literacy of the Elderly Population Residing in Bangkok, Thailand. WATER 2022. [DOI: 10.3390/w14081268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This research aimed at assessing flood hazard areas and flood literacy of the elderly population in Bangkok, Thailand and analyzing their flood preparedness through SWOT analysis. Expert interviews and a community survey were conducted. Using the analytic hierarchy process (AHP) and GIS technique, the results indicated that land-use, drainage density, and annual maximum rainfall were the most heavily weighted factors in flood hazard mapping in Bangkok. About half (50.32%) of Bangkok’s total area was defined as high flood hazard area. A total of 736 questionnaires were distributed in flood-prone areas and in the areas with the highest percentage of elderly population. The results of both SWOT and survey analysis found that many senior citizens have low digital and media literacy and limited experience in using information technology for flood preparedness. Lack of integration of disaster risk reduction and aging population policy, ineffective warning system, and lack of access to disaster preparedness training were the key barriers in reducing vulnerability to flood hazard. The survey revealed that the majority of elderly respondents (75%) have neither used online applications for their flood hazard management both before and during flood disaster nor shared/communicated information via online platforms. Some respondents (13%) used Facebook and Line applications to obtain information before a flood event. Very few of the elderly respondents (<2%) accessed the national/provincial web-based platform to find out flood-related information. Almost all respondents, especially who are living in high-risk flood zones, had never participated in the community training of flood preparedness and management. Therefore, effective strategies in enhancing social engagement of the elderly and their literacy skills in flood risk preparedness and management are urgently needed.
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Developing a large-scale dataset of flood fatalities for territories in the Euro-Mediterranean region, FFEM-DB. Sci Data 2022; 9:166. [PMID: 35414083 PMCID: PMC9005609 DOI: 10.1038/s41597-022-01273-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/23/2022] [Indexed: 11/09/2022] Open
Abstract
This data paper describes the multinational Database of Flood Fatalities from the Euro-Mediterranean region FFEM-DB that hosts data of 2,875 flood fatalities from 12 territories (nine of which represent entire countries) in Europe and the broader Mediterranean region from 1980 to 2020. The FFEM-DB database provides data on fatalities' profiles, location, and contributing circumstances, allowing researchers and flood risk managers to explore demographic, behavioral, and situational factors, as well as environmental features of flood-related mortality. The standardized data collection and classification methodology enable comparison between regions beyond administrative boundaries. The FFEM-DB is expandable, regularly updated, publicly available, and with anonymized data. The key advantages of the FFEM-DB compared to existing datasets containing flood fatalities are its high level of detail, data accuracy, record completeness, and the large sample size from an extended area.
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Kim M, Kienast Y, Hatt JK, Kirby AE, Konstantinidis KT. Metagenomics indicate that public health risk may be higher from flooding following dry versus rainy periods. ENVIRONMENTAL MICROBIOLOGY REPORTS 2022; 14:265-273. [PMID: 35112509 DOI: 10.1111/1758-2229.13047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
Urban floodwater could lead to significant risk for public and environmental health from mobilization of microbial pathogens and overflow of wastewater treatment systems. Here, we attempted to assess this risk by obtaining metagenomic profiles of antibiotic resistance genes (ARGs), virulence factors (VFs) and pathogens present in floodwater samples collected in urban Atlanta, GA that were categorized in two distinct groups: floods that occurred after periods of drought and those after regular (seasonal) rain events. Even though no major (known) pathogens were present at the limit of detection of our sequencing effort (~3 Gbp/sample), we observed that floodwaters after drought showed a 2.5-fold higher abundance of both ARGs and VFs compared to floodwater after rainy days. These differences were mainly derived by several novel species of the Pseudomonas genus, which were more dominant in the former versus the latter samples and carried several genes to cope with osmotic stress in addition to ARGs and VFs. These results revealed that there are previously undescribed species that become mobilized after flooding events in the Southeast US urban settings and could represent an increased public health risk, especially after periods of drought, which warrants further attention.
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Affiliation(s)
- Minjae Kim
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA
| | - Yvonne Kienast
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Janet K Hatt
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA
| | - Amy E Kirby
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Konstantinos T Konstantinidis
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA
- School of Biological Sciences, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA
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A High-Resolution Earth Observations and Machine Learning-Based Approach to Forecast Waterborne Disease Risk in Post-Disaster Settings. CLIMATE 2022. [DOI: 10.3390/cli10040048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Responding to infrastructural damage in the aftermath of natural disasters at a national, regional, and local level poses a significant challenge. Damage to road networks, clean water supply, and sanitation infrastructures, as well as social amenities like schools and hospitals, exacerbates the circumstances. As safe water sources are destroyed or mixed with contaminated water during a disaster, the risk of a waterborne disease outbreak is elevated in those disaster-affected locations. A country such as Haiti, where a large quantity of the population is deprived of safe water and basic sanitation facilities, would suffer more in post-disaster scenarios. Early warning of waterborne diseases like cholera would be of great help for humanitarian aid, and the management of disease outbreak perspectives. The challenging task in disease forecasting is to identify the suitable variables that would better predict a potential outbreak. In this study, we developed five (5) models including a machine learning approach, to identify and determine the impact of the environmental and social variables that play a significant role in post-disaster cholera outbreaks. We implemented the model setup with cholera outbreak data in Haiti after the landfall of Hurricane Matthew in October 2016. Our results demonstrate that adding high-resolution data in combination with appropriate social and environmental variables is helpful for better cholera forecasting in a post-disaster scenario. In addition, using a machine learning approach in combination with existing statistical or mechanistic models provides important insights into the selection of variables and identification of cholera risk hotspots, which can address the shortcomings of existing approaches.
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Charles KJ, Howard G, Villalobos Prats E, Gruber J, Alam S, Alamgir ASM, Baidya M, Flora MS, Haque F, Hassan SMQ, Islam S, Lazaro A, Lwetoijera DW, Mahmud SG, Mahmud ZH, Matwewe F, Pasa K, Rahman M, Reza AAS, Selimuzzaman M, Sharif AR, Sharma S, Thomas JM, Campbell-Lendrum D. Infrastructure alone cannot ensure resilience to weather events in drinking water supplies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 813:151876. [PMID: 34826465 DOI: 10.1016/j.scitotenv.2021.151876] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 06/13/2023]
Abstract
Climate resilient water supplies are those that provide access to drinking water that is sustained through seasons and through extreme events, and where good water quality is also sustained. While surface and groundwater quality are widely understood to vary with rainfall, there is a gap in the evidence on the impact of weather and extremes in rainfall and temperature on drinking water quality, and the role of changes in water system management. A three-country (Bangladesh, Nepal and Tanzania) observational field study tracked 2353 households clustered around 685 water sources across seven different geographies over 14 months. Water quality (E. coli) data was modelled using GEE to account for clustering effects and repeated measures at households. All types of infrastructure were vulnerable to changes in weather, with differences varying between geographies; protected boreholes provided the greatest protection at the point of collection (PoC). Water quality at the point of use (PoU) was vulnerable to changes in weather, through changes in PoC water quality as well as changes in management behaviours, such as safe storage, treatment and cleaning. This is the first study to demonstrate the impact of rainfall and temperature extremes on water quality at the PoC, and the role that weather has on PoU water quality via management behaviours. Climate resilience for water supplies needs to consider the infrastructure as well as the management decisions that are taking place at a community and household level.
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Affiliation(s)
- Katrina J Charles
- School of Geography and the Environment, University of Oxford, South Parks Rd, Oxford, UK.
| | - Guy Howard
- Department of Civil Engineering and Cabot Institute of the Environment, University of Bristol, University Walk, Bristol BS8 1TR, UK.
| | | | - Joshua Gruber
- Center for Effective Global Action, University of California, Berkeley, Berkeley, CA, United States of America.
| | - Sadekul Alam
- Bangladesh Meteorological Department, Bangladesh
| | - A S M Alamgir
- Institute of Epidemiology Disease Control And Research (IEDCR), Bangladesh
| | | | | | - Farhana Haque
- Institute of Epidemiology Disease Control And Research (IEDCR), Bangladesh
| | | | | | | | | | | | | | | | | | - Mahmudur Rahman
- Institute of Epidemiology Disease Control And Research (IEDCR), Bangladesh
| | | | - M Selimuzzaman
- Institute of Epidemiology Disease Control And Research (IEDCR), Bangladesh
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Ramesh B, Jagger MA, Zaitchik BF, Kolivras KN, Swarup S, Yang B, Corpuz BG, Gohlke JM. Estimating changes in emergency department visits associated with floods caused by Tropical Storm Imelda using satellite observations and syndromic surveillance. Health Place 2022; 74:102757. [DOI: 10.1016/j.healthplace.2022.102757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/10/2022] [Accepted: 01/24/2022] [Indexed: 11/27/2022]
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Modeling and Risk Analysis of Dam-Break Flooding in a Semi-Arid Montane Watershed: A Case Study of the Yabous Dam, Northeastern Algeria. WATER 2022. [DOI: 10.3390/w14050767] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The risk related to embankment dam breaches needs to be evaluated in order to prepare emergency action plans. The physical and hydrodynamic parameters of the flood wave generated from the dam failure event correspond to various breach parameters, such as width, slope, and formation time. This study aimed to simulate the dam breach failure scenario of the Yabous dam (northeast Algeria) and analyze its influence on the related areas (urban and natural environments) downstream of the dam. The simulation was completed using the sensitivity analysis method to assess the impact of breach parameters and flooding on the dam break scenario. The flood wave propagation associated with the dam break was simulated using the one-dimensional HEC-RAS hydraulic model. This study applied a sensitivity analysis of three breach parameters (slope, width, and formation time) on five sites selected downstream of the embankment dam. The simulation showed that the maximum flow of the flood wave recorded at the level of the breach was 8768 m3/s, which gradually attenuated along the river course to reach 1972.7 m3/s at about 8.5 km downstream the dam. This study established the map of flood risk areas that illustrated zones threatened by the flooding wave triggered by the dam failure due to extreme rainfall events. The sensitivity analysis showed that flood wave flow, height, and width revealed positive and similar changes for the increases in adjustments (±25% and ±50%) of breach width and slope in the five sites. However, flood wave parameters of breach formation time showed significant trends that changed in the opposite direction compared to breach slope and width. Meanwhile, the adjustments (±25% and ±50%) of the flood hydrograph did not significantly influence the flood parameters downstream of the dam. In the present study, the HEC-RAS 1-D modeling demonstrated effectiveness in simulating the propagation of flood waves downstream of the dam in the event of dam failure and highlighted the impact of the breach parameters and the flood hydrographical pattern on flood wave parameters.
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Effectiveness Evaluation of a Primary School-Based Intervention against Heatwaves in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052532. [PMID: 35270225 PMCID: PMC8909389 DOI: 10.3390/ijerph19052532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 01/25/2022] [Accepted: 02/05/2022] [Indexed: 11/23/2022]
Abstract
Background: Evidence of the effectiveness of intervention against extreme heat remains unclear, especially among children, one of the vulnerable populations. This study aimed to evaluate the effectiveness of a primary school-based intervention program against heatwave and climate change in China to provide evidence for development of policies for adaptation to climate change. Methods: Two primary schools in Dongtai City, Jiangsu Province, China, were randomly selected as intervention and control schools (CTR registration number: ChiCTR2200056005). Health education was conducted at the intervention school to raise students’ awareness and capability to respond to extreme heat during May to September in 2017. Knowledge, attitude, and practice (KAP) of students and their parents at both schools were investigated by questionnaire surveys before and after intervention. The changes in KAP scores after intervention were evaluated using multivariable difference-in-difference (DID) analysis, controlling for age, sex, etc. Results: The scores of knowledge, attitude, and practice of students and their parents increased by 19.9% (95%CI: 16.3%, 23.6%) and 22.5% (95%CI: 17.8%, 27.1%); 9.60% (95%CI: 5.35%, 13.9%) and 7.22% (95%CI: 0.96%, 13.5%); and 9.94% (95%CI: 8.26%, 18.3%) and 5.22% (95%CI: 0.73%, 9.71%), respectively, after intervention. The KAP score changes of boys were slightly higher than those of girls. Older students had higher score changes than younger students. For parents, the higher the education level, the greater the score change, and change in scores was greater in females than in males. All the health education activities in the program were significantly correlated with the changes in KAP scores of primary school students after intervention, especially those curricula with interesting activities and experiential learning approaches. Conclusions: Heat and health education program in primary school was an effective approach to improve cognition and behavior for both students and their parents to better adapt to heatwaves and climate change. The successful experience can be generalized to respond to the increasing extreme weather/climate events in the context of climate change, such as heatwaves, and other emergent occasions or public health education, such as the control and prevention of COVID-19.
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Abstract
PURPOSE OF REVIEW Tropical cyclones impact human health, sometimes catastrophically. Epidemiological research characterizes these health impacts and uncovers pathways between storm hazards and health, helping to mitigate the health impacts of future storms. These studies, however, require researchers to identify people and areas exposed to tropical cyclones, which is often challenging. Here we review approaches, tools, and data products that can be useful in this exposure assessment. RECENT FINDINGS Epidemiological studies have used various operational measures to characterize exposure to tropical cyclones, including measures of physical hazards (e.g., wind, rain, flooding), measures related to human impacts (e.g., damage, stressors from the storm), and proxy measures of distance from the storm's central track. The choice of metric depends on the research question asked by the study, but there are numerous resources available that can help in capturing any of these metrics of exposure. Each has strengths and weaknesses that may influence their utility for a specific study. Here we have highlighted key tools and data products that can be useful for exposure assessment for tropical cyclone epidemiology. These results can guide epidemiologists as they design studies to explore how tropical cyclones influence human health.
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Suhr F, Steinert JI. Epidemiology of floods in sub-Saharan Africa: a systematic review of health outcomes. BMC Public Health 2022; 22:268. [PMID: 35144560 PMCID: PMC8830087 DOI: 10.1186/s12889-022-12584-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/17/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Floods have affected 2.3 billion people worldwide in the last 20 years, and are associated with a wide range of negative health outcomes. Climate change is projected to increase the number of people exposed to floods due to more variable precipitation and rising sea levels. Vulnerability to floods is highly dependent on economic wellbeing and other societal factors. Therefore, this systematic review synthesizes the evidence on health effects of flood exposure among the population of sub-Saharan Africa. METHODS We systematically searched two databases, Web of Science and PubMed, to find published articles. We included studies that (1) were published in English from 2010 onwards, (2) presented associations between flood exposure and health indicators, (3) focused on sub-Saharan Africa, and (4) relied on a controlled study design, such as cohort studies, case-control studies, cross-sectional studies, or quasi-experimental approaches with a suitable comparator, for instance individuals who were not exposed to or affected by floods or individuals prior to experiencing a flood. RESULTS Out of 2306 screened records, ten studies met our eligibility criteria. We included studies that reported the impact of floods on water-borne diseases (n = 1), vector-borne diseases (n = 8) and zoonotic diseases (n = 1). Five of the ten studies assessed the connection between flood exposure and malaria. One of these five evaluated the impact of flood exposure on malaria co-infections. The five non-malaria studies focused on cholera, scabies, taeniasis, Rhodesian sleeping sickness, alphaviruses and flaviviruses. Nine of the ten studies reported significant increases in disease susceptibility after flood exposure. CONCLUSION The majority of included studies of the aftermath of floods pointed to an increased risk of infection with cholera, scabies, taeniasis, Rhodesian sleeping sickness, malaria, alphaviruses and flaviviruses. However, long-term health effects, specifically on mental health, non-communicable diseases and pregnancy, remain understudied. Further research is urgently needed to improve our understanding of the health risks associated with floods, which will inform public policies to prevent and reduce flood-related health risks.
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Affiliation(s)
- Friederike Suhr
- School of Social Sciences and Technology, Technical University of Munich, Richard-Wagner Str. 1, 80333, Munich, Germany.
| | - Janina Isabel Steinert
- School of Social Sciences and Technology, Technical University of Munich, Richard-Wagner Str. 1, 80333, Munich, Germany
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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Mora C, McKenzie T, Gaw IM, Dean JM, von Hammerstein H, Knudson TA, Setter RO, Smith CZ, Webster KM, Patz JA, Franklin EC. Over half of known human pathogenic diseases can be aggravated by climate change. NATURE CLIMATE CHANGE 2022; 12:869-875. [PMID: 35968032 PMCID: PMC9362357 DOI: 10.1038/s41558-022-01426-1] [Citation(s) in RCA: 210] [Impact Index Per Article: 105.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/22/2022] [Indexed: 05/14/2023]
Abstract
It is relatively well accepted that climate change can affect human pathogenic diseases; however, the full extent of this risk remains poorly quantified. Here we carried out a systematic search for empirical examples about the impacts of ten climatic hazards sensitive to greenhouse gas (GHG) emissions on each known human pathogenic disease. We found that 58% (that is, 218 out of 375) of infectious diseases confronted by humanity worldwide have been at some point aggravated by climatic hazards; 16% were at times diminished. Empirical cases revealed 1,006 unique pathways in which climatic hazards, via different transmission types, led to pathogenic diseases. The human pathogenic diseases and transmission pathways aggravated by climatic hazards are too numerous for comprehensive societal adaptations, highlighting the urgent need to work at the source of the problem: reducing GHG emissions.
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Affiliation(s)
- Camilo Mora
- Department of Geography and Environment, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Tristan McKenzie
- Department of Earth Sciences, School of Ocean and Earth Science and Technology, University of Hawaiʻi at Mānoa, Honolulu, HI USA
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Isabella M. Gaw
- Marine Biology Graduate Program, School of Life Sciences, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Jacqueline M. Dean
- Department of Geography and Environment, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Hannah von Hammerstein
- Department of Geography and Environment, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Tabatha A. Knudson
- Department of Geography and Environment, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Renee O. Setter
- Department of Geography and Environment, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Charlotte Z. Smith
- Department of Natural Resources and Environmental Management, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Kira M. Webster
- Department of Geography and Environment, University of Hawaiʻi at Mānoa, Honolulu, HI USA
| | - Jonathan A. Patz
- Nelson Institute & Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI USA
| | - Erik C. Franklin
- Department of Geography and Environment, University of Hawaiʻi at Mānoa, Honolulu, HI USA
- Hawaiʻi Institute of Marine Biology, School of Ocean and Earth Science and Technology, University of Hawaiʻi at Mānoa, Kaneohe, HI USA
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Owusu E, Shalaby R, Eboreime E, Nkire N, Lawal MA, Agyapong B, Pazderka H, Obuobi-Donkor G, Adu MK, Mao W, Oluwasina F, Agyapong VIO. Prevalence and Determinants of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray 12 Months Following the 2020 Flooding. Front Psychiatry 2022; 13:844907. [PMID: 35815045 PMCID: PMC9263447 DOI: 10.3389/fpsyt.2022.844907] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/06/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The flood in Fort McMurray (FMM) which occurred between April 26 and May 2, 2020, is known to have displaced an estimated population of 1,500 people, and destroyed or damaged about 1,230 buildings. In all, it is estimated to have caused about $228 million in losses. OBJECTIVE This study aims to identify the prevalence and determinants of likely Generalized Anxiety disorder (GAD) in among respondents 12-months after the 2020 flooding. METHODS Data for the study were collected through a cross-sectional survey sent through REDCap and hosted online from the 24th of April to the 2nd of June 2021. The self-administered questionnaire was emailed to respondents using community, government, school, and occupational platforms. Demographic, flooding-related variables, and clinical data were collected. A validated instrument, the GAD-7 was used to collect information on likely GAD. Consent was implied by completing the survey forms, and the University of Alberta Health Research Ethics Committee approved the study. RESULTS Of the 249 residents surveyed, 74.7% (186) respondents completed the online survey, 81.6% (80) were above 40 years, 71% (132) were in a relationship, 85.5% (159) were females, and 94.1% (175) were employed. The prevalence of likely GAD was 42.5% in our study. Predictors of likely GAD among respondents included positive employment status (OR = 30.70; 95% C.I. 2.183-423.093), prior diagnosis of depression (OR = 3.30; 95% C.I. 1.157-9.43), and the perceived need to have mental health counseling (OR = 6.28; 95% C.I. 2.553-15.45). CONCLUSION This study showed that there was an increased magnitude of moderate to high anxiety symptoms among respondents following the natural disaster particularly the flood in 2020. The predictors of likely GAD include positive employment status, history of depression diagnosis, and the need to have mental health counseling. Policymakers may mitigate the rise of anxiety after flooding in vulnerable areas by addressing these and other factors.
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Affiliation(s)
- Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Nnamdi Nkire
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Mobolaji A Lawal
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Medard K Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Sharma S, Kumar V, Saruchi. Community approach toward disaster resilience. COGNITIVE DATA MODELS FOR SUSTAINABLE ENVIRONMENT 2022. [PMCID: PMC9307421 DOI: 10.1016/b978-0-12-824038-0.00003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The novel coronavirus pandemic has currently emerged as the world's worst disaster in history whose nature of cause is still under debate. Community in the current study refers to group of people subjected to common risks or threats and with the capacity to recognize disruptive events. Disaster sociologists have a common consensus that these communities should be directly involved in planning and preparing for response to disaster, mitigating effects, thus reducing its risk through Community-based Disaster Management (CBDM) strategy. A community approach can help in assessing levels of disaster risk in advance and also enhances the social capacity of preparedness, response, and recovery. In the current study, analysis of such programs and strategies are presented in which community participates in disaster resilience. Various case studies of disaster risk management policies are adapted by Asian countries. Role of faith-based organizations working for disaster management and mitigation is discussed in the present study.
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Edney JM, Kovats S, Filippi V, Nakstad B. A systematic review of hot weather impacts on infant feeding practices in low-and middle-income countries. Front Pediatr 2022; 10:930348. [PMID: 36147803 PMCID: PMC9485728 DOI: 10.3389/fped.2022.930348] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increased rates of exclusive breastfeeding could significantly improve infant survival in low- and middle-income countries. There is a concern that increased hot weather due to climate change may increase rates of supplemental feeding due to infants requiring fluids, or the perception that infants are dehydrated. OBJECTIVE To understand how hot weather conditions may impact infant feeding practices by identifying and appraising evidence that exclusively breastfed infants can maintain hydration levels under hot weather conditions, and by examining available literature on infant feeding practices in hot weather. METHODS Systematic review of published studies that met inclusion criteria in MEDLINE, EMBASE, Global Health and Web of Science databases. The quality of included studies was appraised against predetermined criteria and relevant data extracted to produce a narrative synthesis of results. RESULTS Eighteen studies were identified. There is no evidence among studies of infant hydration that infants under the age of 6months require supplementary food or fluids in hot weather conditions. In some settings, healthcare providers and relatives continue to advise water supplementation in hot weather or during the warm seasons. Cultural practices, socio-economic status, and other locally specific factors also affect infant feeding practices and may be affected by weather and seasonal changes themselves. CONCLUSION Interventions to discourage water/other fluid supplementation in breastfeeding infants below 6 months are needed, especially in low-middle income countries. Families and healthcare providers should be advised that exclusive breastfeeding (EBF) is recommended even in hot conditions.
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Affiliation(s)
- Jessica M Edney
- Centre on Climate Change and Planetary Health, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Veronique Filippi
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Britt Nakstad
- Division of Paediatrics and Adolescence Medicine, Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
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Yang X, Xiong W, Huang T, He J. Meteorological and social conditions contribute to infectious diarrhea in China. Sci Rep 2021; 11:23374. [PMID: 34862400 PMCID: PMC8642416 DOI: 10.1038/s41598-021-00932-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/20/2021] [Indexed: 11/09/2022] Open
Abstract
Infectious diarrhea in China showed a significant pattern. Many researchers have tried to reveal the drivers, yet usually only meteorological factors were taken into consideration. Furthermore, the diarrheal data they analyzed were incomplete and the algorithms they exploited were inefficient of adapting realistic relationships. Here, we investigate the impacts of meteorological and social factors on the number of infectious diarrhea cases in China. A machine learning algorithm called the Random Forest is utilized. Our results demonstrate that nearly half of infectious diarrhea occurred among children under 5 years old. Generally speaking, increasing temperature or relative humidity leads to increased cases of infectious diarrhea in China. Nevertheless, people from different age groups or different regions own different sensitivities to meteorological factors. The weight of feces that are harmfully treated could be a possible reason for infectious diarrhea of the elderly as well as children under 5 years old. These findings indicate that infectious diarrhea prevention for children under 5 years old remains a primary task in China. Personalized prevention countermeasures ought to be provided to different age groups and different regions. It is essential to bring the weight of feces that are harmfully treated to the forefront when considering infectious diarrhea prevention.
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Affiliation(s)
- Xiang Yang
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China
| | - Weifeng Xiong
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China
| | - Tianyao Huang
- grid.12527.330000 0001 0662 3178Tsinghua University, Haidian District, Beijing, 100084 China
| | - Juan He
- Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.
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Ramadan AMH, Ataallah AG. Are climate change and mental health correlated? Gen Psychiatr 2021; 34:e100648. [PMID: 34825128 PMCID: PMC8578975 DOI: 10.1136/gpsych-2021-100648] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/19/2021] [Indexed: 12/16/2022] Open
Abstract
Climate change is one of the biggest challenges of our time and is likely to affect human beings in substantial ways. Recently, researchers started paying more attention to the changes in climate and their subsequent impact on the social, environmental and economic determinants of health, and the role they play in causing or exacerbating mental health problems. The effects of climate change-related events on mental well-being could be classified into direct and indirect effects. The direct effects of climate change mostly occur after acute weather events and include post-traumatic stress disorder, anxiety, substance abuse disorder, depression and even suicidal ideation. The indirect effects include economic losses, displacement and forced migration, competition over scarce resources and collective violence. The risk factors for developing those mental health issues include young age, female gender, low socioeconomic status, loss or injury of a loved one, being a member of immigrant groups or indigenous people, pre-existing mental illness and inadequate social support. However, in some individuals, especially those undisturbed by any directly observable effects of climate change, abstract awareness and acknowledgement of the ongoing climate crisis can induce negative emotions that can be intense enough to cause mental health illness. Coping strategies should be provided to the affected communities to protect their mental health from collapse in the face of climate disasters. Awareness of the mental health impacts of climate change should be raised, especially in the high-risk groups. Social and global attention to the climate crisis and its detrimental effects on mental health are crucial. This paper was written with the aim of trying to understand the currently, scientifically proven impact of climate change-related disasters on mental health and understanding the different methods of solving the problem at the corporate level, by trying to decrease greenhouse gas emissions to zero, and at the individual level by learning how to cope with the impacts of those disasters.
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Affiliation(s)
| | - Ahmed G Ataallah
- Department of Psychiatry, Mansoura University Faculty of Medicine, Mansoura, Egypt
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From the One Health Perspective: Schistosomiasis Japonica and Flooding. Pathogens 2021; 10:pathogens10121538. [PMID: 34959493 PMCID: PMC8709050 DOI: 10.3390/pathogens10121538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 01/09/2023] Open
Abstract
Schistosomiasis is a water-borne parasitic disease distributed worldwide, while schistosomiasis japonica localizes in the People’s Republic of China, the Philippines, and a few regions of Indonesia. Although significant achievements have been obtained in these endemic countries, great challenges still exist to reach the elimination of schistosomiasis japonica, as the occurrence of flooding can lead to several adverse consequences on the prevalence of schistosomiasis. This review summarizes the influence of flooding on the transmission of schistosomiasis japonica and interventions responding to the adverse impacts from the One Health perspective in human beings, animals, and the environment. For human and animals, behavioral changes and the damage of water conservancy and sanitary facilities will increase the intensity of water contact. For the environment, the density of Oncomelania snails significantly increases from the third year after flooding, and the snail habitats can be enlarged due to active and passive diffusion. With more water contact of human and other reservoir hosts, and larger snail habitats with higher density of living snails, the transmission risk of schistosomiasis increases under the influence of flooding. With the agenda set for global schistosomiasis elimination, interventions from the One Health perspective are put forward to respond to the impacts of increased flooding. For human beings, conducting health education to increase the consciousness of self-protection, preventive chemotherapy for high-risk populations, supply of safe water, early case finding, timely reporting, and treating cases will protect people from infection and prevent the outbreak of schistosomiasis. For animals, culling susceptible domestic animals, herding livestock in snail-free areas, treating livestock with infection or at high risk of infection, harmless treatment of animal feces to avoid water contamination, and monitoring the infection status of wild animals in flooding areas are important to cut off the transmission chain from the resources. For the environment, early warning of flooding, setting up warning signs and killing cercaria in risk areas during and post flooding, reconstructing damaged water conservancy facilities, developing hygiene and sanitary facilities, conducting snail surveys, using molluscicide, and predicting areas with high risk of schistosomiasis transmission after flooding all contribute to reducing the transmission risk of schistosomiasis. These strategies need the cooperation of the ministry of health, meteorological administration, water resources, agriculture, and forestry to achieve the goal of minimizing the impact of flooding on the transmission of schistosomiasis. In conclusion, flooding is one of the important factors affecting the transmission of schistosomiasis japonica. Multi-sectoral cooperation is needed to effectively prevent and control the adverse impacts of flooding on human beings, animals, and the environment.
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Berens AS, Palmer T, Dutton ND, Lavery A, Moore M. Using search-constrained inverse distance weight modeling for near real-time riverine flood modeling: Harris County, Texas, USA before, during, and after Hurricane Harvey. NATURAL HAZARDS (DORDRECHT, NETHERLANDS) 2021; 105:277-292. [PMID: 34092916 PMCID: PMC8173697 DOI: 10.1007/s11069-020-04309-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 09/05/2020] [Indexed: 06/12/2023]
Abstract
Flooding poses a serious public health hazard throughout the world. Flood modeling is an important tool for emergency preparedness and response, but some common methods require a high degree of expertise or may be unworkable due to poor data quality or data availability issues. The conceptually simple method of inverse distance weight modeling offers an alternative. Using stream gauges as inputs, this study interpolated stream elevation via inverse distance weight modeling under 15 different model input parameter scenarios for Harris County, Texas, USA, from August 25th to September 15th, 2017 (before, during, and after Hurricane Harvey inundated the county). A digital elevation model was used to identify areas where modeled stream elevation exceeded ground elevation, indicating flooding. Imagery and observed high water marks were used to validate the models' outputs. There was a high degree of agreement (between 79 and 88%) between imagery and model outputs of parameterizations visually validated. Quantitative validations based on high water marks were also positive, with a Nash-Sutcliffe efficiency of in excess of .6 for all parameterizations relative to a Nash-Sutcliffe efficiency of the benchmark of 0.56. Inverse distance weight modeling offers a simple, accurate method for first-order estimations of riverine flooding in near real-time using readily available data, and outputs are robust to some alterations to input parameters.
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Affiliation(s)
- Andrew S. Berens
- Geospatial Research, Analysis, and Services Program (GRASP), Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, USA
| | - Tess Palmer
- Geospatial Research, Analysis, and Services Program (GRASP), Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, USA
| | - Nina D. Dutton
- Geospatial Research, Analysis, and Services Program (GRASP), Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, USA
| | - Amy Lavery
- Geospatial Research, Analysis, and Services Program (GRASP), Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, USA
| | - Mark Moore
- Harris County Flood Control District, Houston, TX, USA
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