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Guo J, Xue T, Cao M, Han X, Pan Z, Huang D, Sun W, Mi J, Liu Y, Guan T. Ambient temperature anomalies induce electrocardiogram abnormalities: Findings from a nationwide longitudinal study. ENVIRONMENTAL RESEARCH 2024; 246:117996. [PMID: 38128602 DOI: 10.1016/j.envres.2023.117996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/02/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
Electrocardiogram (ECG) outcomes serve as early manifestations of cardiovascular functional or structural changes. While temperature fluctuation has been demonstrated to be a risk factor for cardiovascular diseases, few epidemiological studies have reported its relationship with ECG outcomes. In this study, we employed temperature anomaly (TA) as an innovative indicator of temperature fluctuation to quantify its detrimental impacts on ECG outcomes. A longitudinal study design was conducted using the repeated ECG records of the China National Stroke Screening Survey from 2013 to 2019. Only individuals undergoing at least two ECG tests were included. The daily temperature was assimilated by combining three kinds of data: in situ observations, satellite remote sensing measurements and weather research forecast simulations. We used generalized estimating equations to control for autocorrelation among repeated records and to estimate the association between TA and the risk of ECG abnormalities. We found 6837 events of ECG abnormalities in 47,286 individuals with 102,030 visits. Each unit increment of TA increased the risk of ECG abnormalities [odds ratio (OR) = 1.009, 95% confidence interval (CI): 1.001-1.017] and the risk of myocardial ischemia (OR = 1.061, 95% CI: 1.012-1.111). Hierarchic analyses presented a similar association of TA with both ECG abnormalities (OR = 1.017, 95% CI: 1.008-1.026) and myocardial ischemia (OR = 1.061, 95%CI: 1.011-1.114) in Northern China, but not in Southern China. The exposure-response relationship was estimated as a U-shaped curve centered at the TA value of zero. Sudden warming tended to increase the risk of ECG abnormalities and myocardial ischemia, and sudden cooling tended to increase the risk of atrial fibrillation. All these detrimental effects of TA could be modified by specific individual characteristics. In summary, ambient temperature fluctuation increased the risk of ECG abnormalities. This result indicated that regular ECG tests could be an early-warning measure for monitoring the adverse health effects of temperature fluctuations.
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Affiliation(s)
- Jian Guo
- State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China; Department of Cardiology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Tao Xue
- Department of Epidemiology and Biostatistics/Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, 100191, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management, Center for Environment and Health, Peking University, Beijing, 100871, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China.
| | - Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Zhaoyang Pan
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Dengmin Huang
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Wei Sun
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Jiarun Mi
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China.
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Li A, Toll M, Bentley R. Mapping social vulnerability indicators to understand the health impacts of climate change: a scoping review. Lancet Planet Health 2023; 7:e925-e937. [PMID: 37940212 DOI: 10.1016/s2542-5196(23)00216-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 11/10/2023]
Abstract
The need to assess and measure how social vulnerability influences the health impacts of climate change has resulted in a rapidly growing body of research literature. To date, there has been no overarching, systematic examination of where this evidence is concentrated and what inferences can be made. This scoping review provides an overview of studies published between 2012 and 2022 on social vulnerability to the negative health effects of climate change. Of the 2115 studies identified from four bibliographic databases (Scopus, Web of Science, PubMed, and CAB Direct), 230 that considered indicators of social vulnerability to climate change impacts on health outcomes were selected for review. Frequency and thematic analyses were conducted to establish the scope of the social vulnerability indicators, climate change impacts, and health conditions studied, and the substantive themes and findings of this research. 113 indicators of social vulnerability covering 15 themes were identified, with a small set of indicators receiving most of the research attention, including age, sex, ethnicity, education, income, poverty, unemployment, access to green and blue spaces, access to health services, social isolation, and population density. The results reveal an undertheorisation and few indicators that conceptualise and operationalise social vulnerability beyond individual sociodemographic characteristics by identifying structural and institutional dimensions of vulnerability, and a preponderance of social vulnerability research in high-income countries. This Review highlights the need for future research, data infrastructure, and policy attention to address structural, institutional, and sociopolitical conditions, which will better support climate resilience and adaptation planning.
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Affiliation(s)
- Ang Li
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Mathew Toll
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca Bentley
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
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Jurgilevich A, Käyhkö J, Räsänen A, Pörsti S, Lagström H, Käyhkö J, Juhola S. Factors influencing vulnerability to climate change-related health impacts in cities - A conceptual framework. ENVIRONMENT INTERNATIONAL 2023; 173:107837. [PMID: 36921561 DOI: 10.1016/j.envint.2023.107837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/27/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Climate change will have adverse impacts on human health, which are amplified in cities. For these impacts, there are direct, indirect, and deferred pathways. The first category is well-studied, while indirect and deferred impacts are not well-understood. Moreover, the factors moderating the impacts have received little attention, although understanding these factors is critical for adaptation. We developed a conceptual framework that shows the pathways of climate impacts on human health, focusing specifically on the factors of urban environment moderating the emergence and severity of these health impacts. Based on the framework and literature review, we illustrate the mechanisms of direct, indirect, and deferred health impact occurrence and the factors that exacerbate or alleviate the severity of these impacts, thus presenting valuable insights for anticipatory adaptation. We conclude that an integrated systemic approach to preventing health risks from climate change can provide co-benefits for adaptation and address multiple health risks. Such an approach should be mainstreamed horizontally to all sectors of urban planning and should account for the spatiotemporal aspects of policy and planning decisions and city complexity.
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Affiliation(s)
| | - Janina Käyhkö
- University of Helsinki, Environment and Ecosystems Research Programme, Finland
| | | | | | - Hanna Lagström
- University of Turku, Centre for Population Health Research and Turku University Hospital, Finland
| | - Jukka Käyhkö
- University of Turku, Department of Geography and Geology, Finland
| | - Sirkku Juhola
- University of Helsinki, Environment and Ecosystems Research Programme, Finland
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Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol 2022; 14:152-169. [PMID: 35432772 PMCID: PMC8968453 DOI: 10.4330/wjc.v14.i3.152] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/23/2021] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ‘‘U’’ shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth’s climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
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Affiliation(s)
- Maurizio Giuseppe Abrignani
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Alberto Lombardo
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Annabella Braschi
- Department of Internal Medicine, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90100, Italy
| | - Nicolò Renda
- Department of Mental Health, ASP Trapani, Trapani 91100, Italy
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Remigio RV, Turpin R, Raimann JG, Kotanko P, Maddux FW, Sapkota AR, Liang XZ, Puett R, He X, Sapkota A. Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients. ENVIRONMENTAL RESEARCH 2022; 204:112127. [PMID: 34582801 PMCID: PMC8901270 DOI: 10.1016/j.envres.2021.112127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Typical thermoregulatory responses to elevated temperatures among healthy individuals include reduced blood pressure and perspiration. Individuals with end-stage kidney disease (ESKD) are susceptible to systemic fluctuations caused by ambient temperature changes that may increase morbidity and mortality. We investigated whether pre-dialysis systolic blood pressure (preSBP) and interdialytic weight gain (IDWG) can independently mediate the association between ambient temperature, all-cause hospital admissions (ACHA), and all-cause mortality (ACM). METHODS The study population consisted of ESKD patients receiving hemodialysis treatments at Fresenius Medical Care facilities in Philadelphia County, PA, from 2011 to 2019 (n = 1981). Within a time-to-event framework, we estimated the association between daily maximum dry-bulb temperature (TMAX) and, as separate models, ACHA and ACM during warmer calendar months. Clinically measured preSBP and IDWG responses to temperature increases were estimated using linear mixed effect models. We employed the difference (c-c') method to decompose total effect models for ACHA and ACM using preSBP and IDWG as time-dependent mediators. Covariate adjustments for exposure-mediator and total and direct effect models include age, race, ethnicity, blood pressure medication use, treatment location, preSBP, and IDWG. We considered lags up to two days for exposure and 1-day lag for mediator variables (Lag 2-Lag 1) to assure temporality between exposure-outcome models. Sensitivity analyses for 2-day (Lag 2-only) and 1-day (Lag 1-only) lag structures were also conducted. RESULTS Based on Lag 2- Lag 1 temporal ordering, 1 °C increase in daily TMAX was associated with increased hazard of ACHA by 1.4% (adjusted hazard ratio (HR), 1.014; 95% confidence interval, 1.007-1.021) and ACM 7.5% (adjusted HR, 1.075, 1.050-1.100). Short-term lag exposures to 1 °C increase in temperature predicted mean reductions in IDWG and preSBP by 0.013-0.015% and 0.168-0.229 mmHg, respectively. Mediation analysis for ACHA identified significant indirect effects for all three studied pathways (preSBP, IDWG, and preSBP + IDWG) and significant indirect effects for IDWG and conjoined preSBP + IDWG pathways for ACM. Of note, only 1.03% of the association between temperature and ACM was mediated through preSBP. The mechanistic path for IDWG, independent of preSBP, demonstrated inconsistent mediation and, consequently, potential suppression effects in ACHA (-15.5%) and ACM (-6.3%) based on combined pathway models. Proportion mediated estimates from preSBP + IDWG pathways achieved 2.2% and 0.3% in combined pathway analysis for ACHA and ACM outcomes, respectively. Lag 2 discrete-time ACM mediation models exhibited consistent mediation for all three pathways suggesting that 2-day lag in IDWG and preSBP responses can explain 2.11% and 4.41% of total effect association between temperature and mortality, respectively. CONCLUSION We corroborated the previously reported association between ambient temperature, ACHA and ACM. Our results foster the understanding of potential physiological linkages that may explain or suppress temperature-driven hospital admissions and mortality risks. Of note, concomitant changes in preSBP and IDWG may have little intermediary effect when analyzed in combined pathway models. These findings advance our assessment of candidate interventions to reduce the impact of outdoor temperature change on ESKD patients.
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Affiliation(s)
- Richard V Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA.
| | - Rodman Turpin
- Department of Epidemiology and Biostatistics, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | | | - Peter Kotanko
- Research Division, Renal Research Institute, New York, NY, USA; Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
| | | | - Amy Rebecca Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | - Xin-Zhong Liang
- Department of Atmospheric and Oceanic Sciences, University of Maryland-College Park, College Park, MD, USA
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA
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Hartwig SV, Hacon SDS, Oliveira BFAD, Jacobson LDSV, Sousa RFV, Ignotti E. The effect of ambient temperature on blood pressure of patients undergoing hemodialysis in the Pantanal-Brazil. Heliyon 2021; 7:e07348. [PMID: 34235283 PMCID: PMC8246300 DOI: 10.1016/j.heliyon.2021.e07348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 11/15/2022] Open
Abstract
The objective was to analyze the association of changes in pre-dialysis systolic and diastolic blood pressure with air temperature in a municipality in the Brazilian Pantanal, a tropical climate area. Longitudinal panel study, with analysis of mixed effects models of 133 hemodialysis patients in the city of Cáceres-Mato Grosso in 2014. Air temperature showed an inverse association with pre-dialysis systolic and diastolic blood pressure. With each increase of 1 °C in the mean air temperature, the pre-dialysis systolic blood pressure decreases -0.730mmHg (p ≤ 0.000) and the pre-dialysis diastolic blood pressure decreases -0.280mmHg (p ≤ 0.000). The estimated effect was greater for systolic blood pressure, but both pre-dialysis blood pressure measures are reduced with an increase in lag (up to two days), even when adjusted for relative air humidity. Air temperature is determinant for changes in pre-dialysis systolic and diastolic blood pressure in hemodialysis patients. The temperature effect was greater for systolic blood pressure than for diastolic blood pressure.
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Hvide HK, Johnsen J, Salvanes KG. Parental age and birth defects: a sibling study. Eur J Epidemiol 2021; 36:849-860. [PMID: 33761052 PMCID: PMC8416834 DOI: 10.1007/s10654-021-00734-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
Higher parental age at childbearing has generated much attention as a potential risk factor for birth disorders; however, previous research findings are mixed. Existing studies have exploited variation in parental age across families, which is problematic because families differ not only in parental age but also in genetic and environmental factors. To isolate the effects of parental age, holding many genetic and environmental factors constant, we exploit the variation in parental age within families and compare outcomes for full siblings. The study data were retrieved from the Medical Birth Registry of Norway, which covers the entire population of births in Norway over an extended period (totaling 1.2 million births). Using variation in parental age when siblings were born, we find large and convex effects of increased parental age on the increased risk of birth disorders. To facilitate comparison with the existing literature, we also estimate the effects of parental age using variation in parental age across families and find that the effects are substantially weaker. We conclude that the existing literature may have underestimated the negative effects of parental aging on adverse offspring outcomes.
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Affiliation(s)
- Hans K Hvide
- University of Bergen, Bergen, Norway. .,CEPR, London, UK. .,University of Aberdeen, Aberdeen, UK.
| | | | - Kjell G Salvanes
- CEPR, London, UK.,FAIR, Bergen, Norway.,Norwegian School of Economics, Bergen, Norway.,IZA, Bergen, Norway.,HCEO, Bergen, Norway
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Chen X, Qiu B, Zou Q, Qiu T, Li R, Truong A, Qi Y, Liu T, Han L, Liu T, Chang J, Sun Q, Zhu Y, Xu D. Source specific PM 2.5 associated with heart rate variability in the elderly with coronary heart disease: A community-based panel study. CHEMOSPHERE 2020; 260:127399. [PMID: 32668362 DOI: 10.1016/j.chemosphere.2020.127399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
There is increasingly concern that PM2.5 constituents play a significant role in PM2.5-related cardiovascular outcomes. However, little is known about the associations between specific constituents of PM2.5 and risk for cardiovascular health. To evaluate the exposure to specific chemicals of PM2.5 from various sources and their cardiac effects, a longitudinal investigation was conducted with four repeated measurements of elderly participants' HRV and PM2.5 species in urban Beijing. Multiple chemicals in PM2.5 (metals, ions and PAHs) were characterized for PM2.5 source apportionment and personalized exposure assessment. Five sources were finally identified with specific chemicals as the indicators: oil combustion (1.1%, V & PAHs), secondary particle (11.3%, SO42- & NO3-), vehicle emission (1.2%, Pd), construction dust (28.7%, Mg & Ca), and coal combustion (57.7%, Se & As). As observed, each IQR increase in exposure to oil combustion (V), vehicle emission (Pd), and coal combustion (Se) significantly decreased rMSSD by 13.1% (95% CI: -25.3%, -1.0%), 27.4% (95% CI: -42.9%, -7.6%) and 24.7% (95% CI: -39.2%, -6.9%), respectively, while those of PM2.5 mass with decreases of rMSSD by 11.1% (95% CI: -19.6%, -1.9%) at lag 0. Elevated exposures to specific sources/constituents of PM2.5 disrupt cardiac autonomic function in elderly and have more adverse effects than PM2.5 mass. In the stratified analysis, medication and gender modify the associations of specific chemicals from variable sources with HRV. The findings of this study provide evidence on the roles of influential constituents of ambient air PM2.5 and their sources in terms of their adverse cardiovascular health effects.
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Affiliation(s)
- Xi Chen
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Qiu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China
| | - Qinpei Zou
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Tian Qiu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Runkui Li
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China; State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Ashley Truong
- Brown University School of Public Health, Providence, RI, USA
| | - Yanmin Qi
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China
| | - Tao Liu
- Civil Aviation General Hospital, Beijing, China
| | - Limin Han
- Civil Aviation General Hospital, Beijing, China
| | - Tiebing Liu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China
| | - Junrui Chang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ying Zhu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Dongqun Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Earth Observation Data Supporting Non-Communicable Disease Research: A Review. REMOTE SENSING 2020. [DOI: 10.3390/rs12162541] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A disease is non-communicable when it is not transferred from one person to another. Typical examples include all types of cancer, diabetes, stroke, or allergies, as well as mental diseases. Non-communicable diseases have at least two things in common—environmental impact and chronicity. These diseases are often associated with reduced quality of life, a higher rate of premature deaths, and negative impacts on a countries’ economy due to healthcare costs and missing work force. Additionally, they affect the individual’s immune system, which increases susceptibility toward communicable diseases, such as the flu or other viral and bacterial infections. Thus, mitigating the effects of non-communicable diseases is one of the most pressing issues of modern medicine, healthcare, and governments in general. Apart from the predisposition toward such diseases (the genome), their occurrence is associated with environmental parameters that people are exposed to (the exposome). Exposure to stressors such as bad air or water quality, noise, extreme heat, or an overall unnatural surrounding all impact the susceptibility to non-communicable diseases. In the identification of such environmental parameters, geoinformation products derived from Earth Observation data acquired by satellites play an increasingly important role. In this paper, we present a review on the joint use of Earth Observation data and public health data for research on non-communicable diseases. We analyzed 146 articles from peer-reviewed journals (Impact Factor ≥ 2) from all over the world that included Earth Observation data and public health data for their assessments. Our results show that this field of synergistic geohealth analyses is still relatively young, with most studies published within the last five years and within national boundaries. While the contribution of Earth Observation, and especially remote sensing-derived geoinformation products on land surface dynamics is on the rise, there is still a huge potential for transdisciplinary integration into studies. We see the necessity for future research and advocate for the increased incorporation of thematically profound remote sensing products with high spatial and temporal resolution into the mapping of exposomes and thus the vulnerability and resilience assessment of a population regarding non-communicable diseases.
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Limaye VS, Max W, Constible J, Knowlton K. Estimating the Health-Related Costs of 10 Climate-Sensitive U.S. Events During 2012. GEOHEALTH 2019; 3:245-265. [PMID: 32159045 PMCID: PMC7007172 DOI: 10.1029/2019gh000202] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/30/2019] [Accepted: 07/25/2019] [Indexed: 05/14/2023]
Abstract
Climate change threatens human health, but there remains a lack of evidence on the economic toll of climate-sensitive public health impacts. We characterize human mortality and morbidity costs associated with 10 climate-sensitive case study events spanning 11 US states in 2012: wildfires in Colorado and Washington, ozone air pollution in Nevada, extreme heat in Wisconsin, infectious disease outbreaks of tick-borne Lyme disease in Michigan and mosquito-borne West Nile virus in Texas, extreme weather in Ohio, impacts of Hurricane Sandy in New Jersey and New York, allergenic oak pollen in North Carolina, and harmful algal blooms on the Florida coast. Applying a consistent economic valuation approach to published studies and state estimates, we estimate total health-related costs from 917 deaths, 20,568 hospitalizations, and 17,857 emergency department visits of $10.0 billion in 2018 dollars, with a sensitivity range of $2.7-24.6 billion. Our estimates indicate that the financial burden of deaths, hospitalizations, emergency department visits, and associated medical care is a key dimension of the overall economic impact of climate-sensitive events. We found that mortality costs (i.e., the value of a statistical life) of $8.4 billion exceeded morbidity costs and lost wages ($1.6 billion combined). By better characterizing health damages in economic terms, this work helps to shed light on the burden climate-sensitive events already place on U.S. public health each year. In doing so, we provide a conceptual framework for broader estimation of climate-sensitive health-related costs. The high health-related costs associated with climate-sensitive events highlight the importance of actions to mitigate climate change and adapt to its unavoidable impacts.
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Affiliation(s)
| | - Wendy Max
- Institute for Health & AgingUniversity of CaliforniaSan FranciscoCAUSA
| | | | - Kim Knowlton
- Natural Resources Defense CouncilNew YorkNYUSA
- Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
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Remigio RV, Jiang C, Raimann J, Kotanko P, Usvyat L, Maddux FW, Kinney P, Sapkota A. Association of Extreme Heat Events With Hospital Admission or Mortality Among Patients With End-Stage Renal Disease. JAMA Netw Open 2019; 2:e198904. [PMID: 31397862 PMCID: PMC6692691 DOI: 10.1001/jamanetworkopen.2019.8904] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 12/11/2022] Open
Abstract
Importance Extreme heat events (EHEs) are increasing in frequency, duration, and intensity, and this trend is projected to continue as part of ongoing climate change. There is a paucity of data regarding how EHEs may affect highly vulnerable populations, such as patients with end-stage renal disease (ESRD). Such data are needed to inform ESRD patient management guidelines in a changing climate. Objectives To investigate the association between EHEs and the risk of hospital admission or mortality among patients with ESRD and further characterize how this risk may vary among races/ethnicities or patients with preexisting comorbidities. Design, Setting, and Participants This study used hospital admission and mortality records of patients with ESRD who underwent hemodialysis treatment at Fresenius Kidney Care clinics in Boston, Massachusetts; Philadelphia, Pennsylvania; or New York, New York, from January 1, 2001, to December 31, 2012. Data were analyzed using a time-stratified case-crossover design with conditional Poisson regression to investigate associations between EHEs and risk of hospital admission or mortality among patients with ESRD. Data were analyzed from July 1, 2017, to March 31, 2019. Exposures Calendar day- and location-specific 95th-percentile maximum temperature thresholds were calculated using daily meteorological data from 1960 to 1989. These thresholds were used to identify EHEs in each of the 3 cities during the study. Main Outcomes and Measures Daily all-cause hospital admission and all-cause mortality among patients with ESRD. Results The study included 7445 patients with ESRD (mean [SD] age, 61.1 [14.1] years; 4283 [57.5%] men), among whom 2953 deaths (39.7%) and 44 941 hospital admissions (mean [SD], 6.0 [7.5] per patient) were recorded. Extreme heat events were associated with increased risk of same-day hospital admission (rate ratio [RR], 1.27; 95% CI, 1.13-1.43) and same-day mortality (RR, 1.31; 95% CI, 1.01-1.70) among patients with ESRD. There was some heterogeneity in risk, with patients in Boston showing statistically significant increased risk for hospital admission (RR, 1.15; 95% CI, 1.00-1.31) and mortality (RR, 1.45; 95% CI, 1.04-2.02) associated with cumulative exposure to EHEs, while such risk was absent among patients with ESRD in Philadelphia. While increases in risks were similar among non-Hispanic black and non-Hispanic white patients, findings among Hispanic and Asian patients were less clear. After stratifying by preexisting comorbidities, cumulative lag exposure to EHEs was associated with increased risk of mortality among patients with ESRD living with congestive heart failure (RR, 1.55; 95% CI, 1.27-1.89), chronic obstructive pulmonary disease (RR, 1.60; 95% CI, 1.24-2.06), or diabetes (RR, 1.83; 95% CI, 1.51-2.21). Conclusions and Relevance In this study, extreme heat events were associated with increased risk of hospital admission or mortality among patients with ESRD, and the association was potentially affected by geographic region and race/ethnicity. Future studies with larger populations and broader geographic coverage are needed to better characterize this variability in risk and inform ESRD management guidelines and differential risk variables, given the projected increases in the frequency, duration, and intensity of EHEs.
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Affiliation(s)
- Richard V. Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Jochen Raimann
- Research Division, Renal Research Institute, New York, New York
| | - Peter Kotanko
- Research Division, Renal Research Institute, New York, New York
- Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Len Usvyat
- Research Division, Renal Research Institute, New York, New York
| | - Frank W. Maddux
- Research Division, Renal Research Institute, New York, New York
| | - Patrick Kinney
- School of Public Health, Boston University, Boston, Massachusetts
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
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