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Niu YL, Lu F, Liu XJ, Wang J, Liu DL, Liu QY, Yang J. Global climate change: Effects of future temperatures on emergency department visits for mental disorders in Beijing, China. ENVIRONMENTAL RESEARCH 2024; 252:119044. [PMID: 38697599 DOI: 10.1016/j.envres.2024.119044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/08/2024] [Accepted: 04/27/2024] [Indexed: 05/05/2024]
Abstract
Rising temperatures can increase the risk of mental disorders. As climate change intensifies, the future disease burden due to mental disorders may be underestimated. Using data on the number of daily emergency department visits for mental disorders at 30 hospitals in Beijing, China during 2016-2018, the relationship between daily mean temperature and such visits was assessed using a quasi-Poisson model integrated with a distributed lag nonlinear model. Emergency department visits for mental disorders attributed to temperature changes were projected using 26 general circulation models under four climate change scenarios. Stratification analyses were then conducted by disease subtype, sex, and age. The results indicate that the temperature-related health burden from mental disorders was projected to increase consistently throughout the 21st century, mainly driven by high temperatures. The future temperature-related health burden was higher for patients with mental disorders due to the use of psychoactive substances and schizophrenia as well as for women and those aged <65 years. These findings enhance our knowledge of how climate change could affect mental well-being and can be used to advance and refine targeted approaches to mitigating and adapting to climate change with a view on addressing mental disorders.
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Affiliation(s)
- Yan-Lin Niu
- Institute for Nutrition and Food Hygiene, Beijing Center for Disease Prevention and Control, 100013 Beijing, China
| | - Feng Lu
- Beijing Municipal Health Big Data and Policy Research Center, 100034 Beijing, China
| | - Xue-Jiao Liu
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
| | - Jun Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - De Li Liu
- NSW Department of Primary Industries, Wagga Wagga Agricultural Institute, NSW 2650, Australia; Climate Change Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Qi-Yong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, 511436 Guangzhou, China.
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Lo YTE, Mitchell DM, Gasparrini A. Compound mortality impacts from extreme temperatures and the COVID-19 pandemic. Nat Commun 2024; 15:4289. [PMID: 38782899 PMCID: PMC11116452 DOI: 10.1038/s41467-024-48207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Extreme weather and coronavirus-type pandemics are both leading global health concerns. Until now, no study has quantified the compound health consequences of the co-occurrence of them. We estimate the mortality attributable to extreme heat and cold events, which dominate the UK health burden from weather hazards, in England and Wales in the period 2020-2022, during which the COVID-19 pandemic peaked in terms of mortality. We show that temperature-related mortality exceeded COVID-19 mortality by 8% in South West England. Combined, extreme temperatures and COVID-19 led to 19 (95% confidence interval: 16-22 in North West England) to 24 (95% confidence interval: 20-29 in Wales) excess deaths per 100,000 population during heatwaves, and 80 (95% confidence interval: 75-86 in Yorkshire and the Humber) to 127 (95% confidence interval: 123-132 in East of England) excess deaths per 100,000 population during cold snaps. These numbers are at least ~2 times higher than the previous decade. Society must increase preparedness for compound health crises such as extreme weather coinciding with pandemics.
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Affiliation(s)
- Y T Eunice Lo
- Cabot Institute for the Environment, University of Bristol, Bristol, UK.
- Elizabeth Blackwell Institute for Health Research, University of Bristol, Bristol, UK.
| | - Dann M Mitchell
- Cabot Institute for the Environment, University of Bristol, Bristol, UK
- School of Geographical Sciences, University of Bristol, Bristol, UK
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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3
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Zhu Q, Zhou M, Zare Sakhvidi MJ, Yang S, Chen S, Feng P, Chen Z, Xu Z, Liu Q, Yang J. Projecting heat-related cardiovascular mortality burden attributable to human-induced climate change in China. EBioMedicine 2024; 103:105119. [PMID: 38631093 PMCID: PMC11035030 DOI: 10.1016/j.ebiom.2024.105119] [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: 12/23/2023] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has been found to be particularly vulnerable to climate change and temperature variability. This study aimed to assess the extent to which human-induced climate change contributes to future heat-related CVD burdens. METHODS Daily data on CVD mortality and temperature were collected in 161 Chinese communities from 2007 to 2013. The association between heat and CVD mortality was established using a two-stage time-series design. Under the natural forcing, human-induced, and combined scenarios, we then separately projected excess cause-/age-/region-/education-specific mortality from future high temperature in 2010-2100, assuming no adaptation and population changes. FINDINGS Under shared socioeconomic pathway with natural forcing scenario (SSP2-4.5-nat), heat-related attributable fraction of CVD deaths decreased slightly from 3.3% [95% empirical confidence interval (eCI): 0.3, 5.8] in the 2010s to 2.8% (95% eCI: 0.1, 5.2) in the 2090s, with relative change of -0.4% (95% eCI: -0.8, 0.0). However, for combined natural and human-induced forcings, this estimate would surge to 8.9% (95% eCI: 1.5, 15.7), 14.4% (95% eCI: 1.5, 25.3), 21.3% (95% eCI: -0.6, 39.4), and 28.7% (95% eCI: -3.3, 48.0) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. When excluding the natural forcing, the number of human-induced heat-related CVD deaths would increase from approximately eight thousand (accounting for 31% of total heat-related CVD deaths) in the 2010s to 33,052 (68%), 63,283 (80%), 101,091 (87%), and 141,948 (90%) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. Individuals with stroke, females, the elderly, people living in rural areas, and those with lower education level would exhibit heightened susceptibility to future high temperature. In addition, Southern and Eastern regions of China were expected to experience a faster increase in heat-related attributable fraction of CVD deaths. INTERPRETATION Human activities would significantly amplify the future burden of heat-related CVD. Our study findings suggested that active adaptation and mitigation measures towards future warming could yield substantial health benefits for the patients with CVD. FUNDING National Natural Science Foundation of China.
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Affiliation(s)
- Qiongyu Zhu
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Siru Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Sujuan Chen
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Puyu Feng
- College of Land Science and Technology, China Agricultural University, Beijing, 100193, China
| | | | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Qiyong Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Jun Yang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China.
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Yin P, He C, Chen R, Huang J, Luo Y, Gao X, Xu Y, Ji JS, Cai W, Wei Y, Li H, Zhou M, Kan H. Projection of Mortality Burden Attributable to Nonoptimum Temperature with High Spatial Resolution in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:6226-6235. [PMID: 38557021 DOI: 10.1021/acs.est.3c09162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The updated climate models provide projections at a fine scale, allowing us to estimate health risks due to future warming after accounting for spatial heterogeneity. Here, we utilized an ensemble of high-resolution (25 km) climate simulations and nationwide mortality data from 306 Chinese cities to estimate death anomalies attributable to future warming. Historical estimation (1986-2014) reveals that about 15.5% [95% empirical confidence interval (eCI):13.1%, 17.6%] of deaths are attributable to nonoptimal temperature, of which heat and cold corresponded to attributable fractions of 4.1% (eCI:2.4%, 5.5%) and 11.4% (eCI:10.7%, 12.1%), respectively. Under three climate scenarios (SSP126, SSP245, and SSP585), the national average temperature was projected to increase by 1.45, 2.57, and 4.98 °C by the 2090s, respectively. The corresponding mortality fractions attributable to heat would be 6.5% (eCI:5.2%, 7.7%), 7.9% (eCI:6.3%, 9.4%), and 11.4% (eCI:9.2%, 13.3%). More than half of the attributable deaths due to future warming would occur in north China and cardiovascular mortality would increase more drastically than respiratory mortality. Our study shows that the increased heat-attributable mortality burden would outweigh the decreased cold-attributable burden even under a moderate climate change scenario across China. The results are helpful for national or local policymakers to better address the challenges of future warming.
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Affiliation(s)
- Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Cheng He
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
- Institute of Epidemiology, Helmholtz Zentrum München─German Research Center for Environmental Health (GmbH), Neuherberg 85764, Germany
| | - Renjie Chen
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
| | - Jianbin Huang
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Yong Luo
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Xuejie Gao
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
- Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100017, China
| | - Ying Xu
- National Climate Center, China Meteorological Administration, Beijing 100044, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Wenjia Cai
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai 200032, China
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5
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Chen K, de Schrijver E, Sivaraj S, Sera F, Scovronick N, Jiang L, Roye D, Lavigne E, Kyselý J, Urban A, Schneider A, Huber V, Madureira J, Mistry MN, Cvijanovic I, Gasparrini A, Vicedo-Cabrera AM. Impact of population aging on future temperature-related mortality at different global warming levels. Nat Commun 2024; 15:1796. [PMID: 38413648 PMCID: PMC10899213 DOI: 10.1038/s41467-024-45901-z] [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: 03/25/2022] [Accepted: 02/07/2024] [Indexed: 02/29/2024] Open
Abstract
Older adults are generally amongst the most vulnerable to heat and cold. While temperature-related health impacts are projected to increase with global warming, the influence of population aging on these trends remains unclear. Here we show that at 1.5 °C, 2 °C, and 3 °C of global warming, heat-related mortality in 800 locations across 50 countries/areas will increase by 0.5%, 1.0%, and 2.5%, respectively; among which 1 in 5 to 1 in 4 heat-related deaths can be attributed to population aging. Despite a projected decrease in cold-related mortality due to progressive warming alone, population aging will mostly counteract this trend, leading to a net increase in cold-related mortality by 0.1%-0.4% at 1.5-3 °C global warming. Our findings indicate that population aging constitutes a crucial driver for future heat- and cold-related deaths, with increasing mortality burden for both heat and cold due to the aging population.
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Affiliation(s)
- Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA.
| | - Evan de Schrijver
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Sidharth Sivaraj
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Noah Scovronick
- Gangarosa Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Leiwen Jiang
- Asian Demographic Research Institute, Shanghai University, Shanghai, China
- Population Council, New York, NY, USA
| | - Dominic Roye
- Climate Research Foundation (FIC), Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Eric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Chair of Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Joana Madureira
- Department of Enviromental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Malcolm N Mistry
- Environment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Ivana Cvijanovic
- ISGlobal - Barcelona Institute for Global Health, Barcelona, Spain
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
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Madaniyazi L, Armstrong B, Tobias A, Mistry MN, Bell ML, Urban A, Kyselý J, Ryti N, Cvijanovic I, Ng CFS, Roye D, Vicedo-Cabrera AM, Tong S, Lavigne E, Íñiguez C, da Silva SDNP, Madureira J, Jaakkola JJK, Sera F, Honda Y, Gasparrini A, Hashizume M. Seasonality of mortality under climate change: a multicountry projection study. Lancet Planet Health 2024; 8:e86-e94. [PMID: 38331534 DOI: 10.1016/s2542-5196(23)00269-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Climate change can directly impact temperature-related excess deaths and might subsequently change the seasonal variation in mortality. In this study, we aimed to provide a systematic and comprehensive assessment of potential future changes in the seasonal variation, or seasonality, of mortality across different climate zones. METHODS In this modelling study, we collected daily time series of mean temperature and mortality (all causes or non-external causes only) via the Multi-Country Multi-City Collaborative (MCC) Research Network. These data were collected during overlapping periods, spanning from Jan 1, 1969 to Dec 31, 2020. We projected daily mortality from Jan 1, 2000 to Dec 31, 2099, under four climate change scenarios corresponding to increasing emissions (Shared Socioeconomic Pathways [SSP] scenarios SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). We compared the seasonality in projected mortality between decades by its shape, timings (the day-of-year) of minimum (trough) and maximum (peak) mortality, and sizes (peak-to-trough ratio and attributable fraction). Attributable fraction was used to measure the burden of seasonality of mortality. The results were summarised by climate zones. FINDINGS The MCC dataset included 126 809 537 deaths from 707 locations within 43 countries or areas. After excluding the only two polar locations (both high-altitude locations in Peru) from climatic zone assessments, we analysed 126 766 164 deaths in 705 locations aggregated in four climate zones (tropical, arid, temperate, and continental). From the 2000s to the 2090s, our projections showed an increase in mortality during the warm seasons and a decrease in mortality during the cold seasons, albeit with mortality remaining high during the cold seasons, under all four SSP scenarios in the arid, temperate, and continental zones. The magnitude of this changing pattern was more pronounced under the high-emission scenarios (SSP3-7.0 and SSP5-8.5), substantially altering the shape of seasonality of mortality and, under the highest emission scenario (SSP5-8.5), shifting the mortality peak from cold seasons to warm seasons in arid, temperate, and continental zones, and increasing the size of seasonality in all zones except the arid zone by the end of the century. In the 2090s compared with the 2000s, the change in peak-to-trough ratio (relative scale) ranged from 0·96 to 1·11, and the change in attributable fraction ranged from 0·002% to 0·06% under the SSP5-8.5 (highest emission) scenario. INTERPRETATION A warming climate can substantially change the seasonality of mortality in the future. Our projections suggest that health-care systems should consider preparing for a potentially increased demand during warm seasons and sustained high demand during cold seasons, particularly in regions characterised by arid, temperate, and continental climates. FUNDING The Environment Research and Technology Development Fund of the Environmental Restoration and Conservation Agency, provided by the Ministry of the Environment of Japan.
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Affiliation(s)
- Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Malcolm N Mistry
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Carmen Íñiguez
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Statistics and Computational Research, Universitat de València, València, Spain
| | | | - Joana Madureira
- Environmental Health Department, National Institute of Health, Porto, Portugal; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Finnish Meteorological Institute, Helsinki, Finland
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Masahiro Hashizume
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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7
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Liang C, Yuan J, Tang X, Kan H, Cai W, Chen J. The influence of humid heat on morbidity of megacity Shanghai in China. ENVIRONMENT INTERNATIONAL 2024; 183:108424. [PMID: 38219539 DOI: 10.1016/j.envint.2024.108424] [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: 08/25/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Increased attention has been paid to humid-heat extremes as they are projected to increase in both frequency and intensity. However, it remains unclear how compound extremes of heat and humidity affects morbidity when the climate is projected to continue warming in the future, in particular for a megacity with a large population. METHODS We chose the Wet-Bulb Globe Temperature (WBGT) index as the metric to characterize the humid-heat exposure. The historical associations between daily outpatient visits and daily mean WBGT was established using a Distributed Lag Non-linear Model (DLNM) during the warm season (June to September) from 2013 to 2015 in Shanghai, a prominent megacity of China. Future morbidity burden related to the combined effect of high temperature and humidity were projected under four greenhouse gases (GHGs) emission scenarios (SSP126, SSP245, SSP370 and SSP585). RESULTS The humid-heat weather was significantly associated with a higher risk of outpatient visits in Shanghai than the high-temperature conditions. Relative to the baseline period (2010-2019), the morbidity burden due to humid-heat weather was projected to increase 4.4 % (95 % confidence interval (CI): 1.1 %-10.1 %) even under the strict emission control scenario (SSP126) by 2100. Under the high-GHGs emission scenario (SSP585), this burden was projected to be 25.4 % (95 % CI: 15.8 %-38.4 %), which is 10.1 % (95 % CI: 6.5 %-15.8 %) more than that due to high-temperature weather. Our results also indicate that humid-hot nights could cause large morbidity risks under high-GHGs emission scenarios particularly in heat-sensible diseases such as the respiratory and cardiovascular disease by the end of this century. CONCLUSIONS Humid heat exposures significantly increased the all-cause morbidity risk in the megacity Shanghai, especially in humid-hot nights. Our findings suggest that the combined effect of elevated temperature and humidity is projected to have more substantial impact on health compared to high temperature alone in a warming climate.
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Affiliation(s)
- Chen Liang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China.
| | - Xu Tang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Haidong Kan
- IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Wenjia Cai
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China
| | - Jianmin Chen
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
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8
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Fonseca-Rodríguez O, Adams RE, Sheridan SC, Schumann B. Projection of extreme heat- and cold-related mortality in Sweden based on the spatial synoptic classification. ENVIRONMENTAL RESEARCH 2023; 239:117359. [PMID: 37863163 DOI: 10.1016/j.envres.2023.117359] [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: 07/21/2023] [Revised: 08/30/2023] [Accepted: 10/07/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Climate change is projected to result in increased heat events and decreased cold events. This will substantially impact human health, particularly when compounded with demographic change. This study employed the Spatial Synoptic Classification (SSC) to categorize daily weather into one of seven types. Here we estimated future mortality due to extremely hot and cold weather types under different climate change scenarios for one southern (Stockholm) and one northern (Jämtland) Swedish region. METHODS Time-series Poisson regression with distributed lags was used to assess the relationship between extremely hot and cold weather events and daily deaths in the population above 65 years, with cumulative effects (6 days in summer, 28 days in winter), 1991 to 2014. A global climate model (MPI-M-MPI-ESM-LR) and two climate change scenarios (RCP 4.5 and 8.5) were used to project the occurrence of hot and cold days from 2031 to 2070. Place-specific projected mortality was calculated to derive attributable numbers and attributable fractions (AF) of heat- and cold-related deaths. RESULTS In Stockholm, for the RCP 4.5 scenario, the mean number of annual deaths attributed to heat increased from 48.7 (CI 32.2-64.2; AF = 0.68%) in 2031-2040 to 90.2 (56.7-120.5; AF = 0.97%) in 2061-2070, respectively. For RCP 8.5, heat-related deaths increased more drastically from 52.1 (33.6-69.7; AF = 0.72%) to 126.4 (68.7-175.8; AF = 1.36%) between the first and the last decade. Cold-related deaths slightly increased over the projected period in both scenarios. In Jämtland, projections showed a small decrease in cold-related deaths but no change in heat-related mortality. CONCLUSIONS In rural northern region of Sweden, a decrease of cold-related deaths represents the dominant trend. In urban southern locations, on the other hand, an increase of heat-related mortality is to be expected. With an increasing elderly population, heat-related mortality will outweigh cold-related mortality at least under the RCP 8.5 scenario, requiring societal adaptation measures.
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Affiliation(s)
- Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87 Umeå, Sweden.
| | - Ryan E Adams
- Department of Geography, Kent State University, Kent, OH 44242, USA
| | - Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH 44242, USA
| | - Barbara Schumann
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87 Umeå, Sweden; Department of Health and Caring Sciences, Linnaeus University, 391 82 Kalmar, Sweden
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9
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Yin P, Gao Y, Chen R, Liu W, He C, Hao J, Zhou M, Kan H. Temperature-related death burden of various neurodegenerative diseases under climate warming: a nationwide modelling study. Nat Commun 2023; 14:8236. [PMID: 38086884 PMCID: PMC10716387 DOI: 10.1038/s41467-023-44066-5] [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: 03/15/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Limited knowledge exists regarding the ramifications of climate warming on death burden from neurodegenerative diseases. Here, we conducted a nationwide, individual-level, case-crossover study between 2013 and 2019 to investigate the effects of non-optimal temperatures on various neurodegenerative diseases and to predict the potential death burden under different climate change scenarios. Our findings reveal that both low and high temperatures are linked to increased risks of neurodegenerative diseases death. We project that heat-related neurodegenerative disease deaths would increase, while cold-related deaths would decrease. This is characterized by a steeper slope in the high-emission scenario, but a less pronounced trend in the scenarios involving mitigation strategies. Furthermore, we predict that the net changes in attributable death would increase after the mid-21st century, especially under the unrestricted-emission scenario. These results highlight the urgent need for effective climate and public health policies to address the growing challenges of neurodegenerative diseases associated with global warming.
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Affiliation(s)
- Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Wei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cheng He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Junwei Hao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
- National Center for Neurological Disorders, Beijing, China.
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
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10
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Liu J, Varghese BM, Hansen A, Dear K, Morgan G, Driscoll T, Zhang Y, Gourley M, Capon A, Bi P. Projection of high temperature-related burden of kidney disease in Australia under different climate change, population and adaptation scenarios: population-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100916. [PMID: 37867620 PMCID: PMC10587708 DOI: 10.1016/j.lanwpc.2023.100916] [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: 05/23/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023]
Abstract
Background The dual impacts of a warming climate and population ageing lead to an increasing kidney disease prevalence, highlighting the importance of quantifying the burden of kidney disease (BoKD) attributable to high temperature, yet studies on this subject are limited. The study aims to quantify the BoKD attributable to high temperatures in Australia across all states and territories, and project future BoKD under climatic, population and adaptation scenarios. Methods Data on disability-adjusted-life-years (DALYs) due to kidney disease, including years of life lost (YLL), and years lived with disability (YLD), were collected during 2003-2018 (baseline) across all states and territories in Australia. The temperature-response association was estimated using a meta-regression model. Future temperature projections were calculated using eight downscaled climate models to estimate changes in attributable BoKD centred around 2030s and 2050s, under two greenhouse gas emissions scenarios (RCP4.5 and RCP8.5), while considering changes in population size and age structure, and human adaptation to climate change. Findings Over the baseline (2003-2018), high-temperature contributed to 2.7% (Standard Deviation: 0.4%) of the observed BoKD in Australia. The future population attributable fraction and the attributable BoKD, projected using RCP4.5 and RCP8.5, showed a gradually increasing trend when assuming no human adaptation. Future projections were most strongly influenced by the population change, with the high temperature-related BoKD increasing by 18.4-67.4% compared to the baseline under constant population and by 100.2-291.2% when accounting for changes in population size and age structure. However, when human adaptation was adopted (from no to partial to full), the high temperature-related BoKD became smaller. Interpretation It is expected that increasing high temperature exposure will substantially contribute to higher BoKD across Australia, underscoring the urgent need for public health interventions to mitigate the negative health impacts of a warming climate on BoKD. Funding Australian Research Council Discovery Program.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia
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Nyadanu SD, Tessema GA, Mullins B, Chai K, Yitshak-Sade M, Pereira G. Critical Windows of Maternal Exposure to Biothermal Stress and Birth Weight for Gestational Age in Western Australia. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127017. [PMID: 38149876 PMCID: PMC10752220 DOI: 10.1289/ehp12660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 10/05/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND There is limited and inconsistent evidence on the risk of ambient temperature on small for gestational age (SGA) and there are no known related studies for large for gestational age (LGA). In addition, previous studies used temperature rather than a biothermal metric. OBJECTIVES Our aim was to examine the associations and critical susceptible windows of maternal exposure to a biothermal metric [Universal Thermal Climate Index (UTCI)] and the hazards of SGA and LGA. METHODS We linked 385,337 singleton term births between 1 January 2000 and 31 December 2015 in Western Australia to daily spatiotemporal UTCI. Distributed lag nonlinear models with Cox regression and multiple models were used to investigate maternal exposure to UTCI from 12 weeks preconception to birth and the adjusted hazard ratios (HRs) of SGA and LGA. RESULTS Relative to the median exposure, weekly and monthly specific exposures showed potential critical windows of susceptibility for SGA and LGA at extreme exposures, especially during late gestational periods. Monthly exposure showed strong positive associations from the 6th to the 10th gestational months with the highest hazard of 13% for SGA (HR = 1.13 ; 95% CI: 1.10, 1.14) and 7% for LGA (HR = 1.07 ; 95% CI: 1.03, 1.11) at the 10th month for the 1st UTCI centile. Entire pregnancy exposures showed the strongest hazards of 11% for SGA (HR = 1.11 ; 95% CI: 1.04, 1.18) and 3% for LGA (HR = 1.03 ; 95% CI: 0.95, 1.11) at the 99th UTCI centile. By trimesters, the highest hazards were found during the second and first trimesters for SGA and LGA, respectively, at the 99th UTCI centile. Based on estimated interaction effects, male births, mothers who were non-Caucasian, smokers, ≥ 35 years of age, and rural residents were most vulnerable. CONCLUSIONS Both weekly and monthly specific extreme biothermal stress exposures showed potential critical susceptible windows of SGA and LGA during late gestational periods with disproportionate sociodemographic vulnerabilities. https://doi.org/10.1289/EHP12660.
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Affiliation(s)
- Sylvester Dodzi Nyadanu
- Curtin School of Population Health, Curtin University, Perth, Bentley, Western Australia, Australia
- Education, Culture, and Health Opportunities (ECHO) Ghana, ECHO Research Group International, Aflao, Ghana
| | - Gizachew A. Tessema
- Curtin School of Population Health, Curtin University, Perth, Bentley, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
- enAble Institute, Curtin University, Perth, Bentley, Western Australia, Australia
| | - Ben Mullins
- Curtin School of Population Health, Curtin University, Perth, Bentley, Western Australia, Australia
| | - Kevin Chai
- Curtin School of Population Health, Curtin University, Perth, Bentley, Western Australia, Australia
| | - Maayan Yitshak-Sade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Bentley, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Bentley, Western Australia, Australia
- World Health Organization Collaborating Centre for Environmental Health Impact Assessment, Faculty of Health Science, Curtin University, Bentley, Western Australia, Australia
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12
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Thawonmas R, Hashizume M, Kim Y. Projections of Temperature-Related Suicide under Climate Change Scenarios in Japan. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:117012. [PMID: 37995154 PMCID: PMC10666824 DOI: 10.1289/ehp11246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND The impact of climate change on mental health largely remains to be evaluated. Although growing evidence has reported a short-term association between suicide and temperature, future projections of temperature-attributable suicide have not been thoroughly examined. OBJECTIVES We aimed to project the excess temperature-related suicide mortality in Japan under three climate change scenarios until the 2090s. METHODS Daily time series of mean temperature and the number of suicide deaths in 1973-2015 were collected for 47 prefectures in Japan. A two-stage time-stratified case-crossover analysis was used to estimate the temperature-suicide association. We obtained the modeled daily temperature series using five general circulation models under three climate change scenarios from the latest Coupled Model Intercomparison Project Phase 6 (CMIP6) Shared Socioeconomic Pathways scenarios (SSPs): SSP1-2.6, SSP2-4.5, and SSP5-8.5. We projected the excess temperature-related suicide mortality until 2099 for each scenario and evaluated the net relative changes compared with the 2010s. RESULTS During 1973-2015, there was a total of 1,049,592 suicides in Japan. Net increases in temperature-related excess suicide mortality were estimated under all scenarios. The net change in 2090-2099 compared with 2010-2019 was 1.3% [95% empirical confidence interval (eCI): 0.6, 2.4] for the intermediate-emission scenario (SSP2-4.5), 0.6% (95% eCI: 0.1, 1.6) for a low-emission scenario (SSP1-2.6), and 2.4% (95% eCI: 0.7, 3.9) for the extreme scenario (SSP5-8.5). The increases were greater the more extreme the scenarios were, with the highest increase under the most extreme scenario (SSP5-8.5). DISCUSSION This study indicates that Japan may experience a net increase in excess temperature-related suicide mortality, especially under the intermediate and extreme scenarios. The findings underscore the importance of mitigation policies. Further investigations of the future impacts of climate change on mental health including suicide are warranted. https://doi.org/10.1289/EHP11246.
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Affiliation(s)
- Ramita Thawonmas
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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13
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Borg MA, Xiang J, Anikeeva O, Ostendorf B, Varghese B, Dear K, Pisaniello D, Hansen A, Zander K, Sim MR, Bi P. Current and projected heatwave-attributable occupational injuries, illnesses, and associated economic burden in Australia. ENVIRONMENTAL RESEARCH 2023; 236:116852. [PMID: 37558113 DOI: 10.1016/j.envres.2023.116852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/21/2023] [Accepted: 08/06/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION The costs of global warming are substantial. These include expenses from occupational illnesses and injuries (OIIs), which have been associated with increases during heatwaves. This study estimated retrospective and projected future heatwave-attributable OIIs and their costs in Australia. MATERIALS AND METHODS Climate and workers' compensation claims data were extracted from seven Australian capital cities representing OIIs from July 2005 to June 2018. Heatwaves were defined using the Excess Heat Factor. OIIs and associated costs were estimated separately per city and pooled to derive national estimates. Results were projected to 2030 (2016-2045) and 2050 (2036-2065). RESULTS The risk of OIIs and associated costs increased during heatwaves, with the risk increasing during severe and particularly extreme heatwaves. Of all OIIs, 0.13% (95% empirical confidence interval [eCI]: 0.11-0.16%) were heatwave-attributable, equivalent to 120 (95%eCI:70-181) OIIs annually. 0.25% of costs were heatwave-attributable (95%eCI: 0.18-0.34%), equal to $AU4.3 (95%eCI: 1.4-7.4) million annually. Estimates of heatwave-attributable OIIs by 2050, under Representative Concentration Pathway [RCP]4.5 and RCP8.5, were 0.17% (95%eCI: 0.10-0.27%) and 0.23% (95%eCI: 0.13-0.37%), respectively. National costs estimates for 2030 under RCP4.5 and RCP8.5 were 0.13% (95%eCI: 0.27-0.46%) and 0.04% (95%eCI: 0.66-0.60), respectively. These estimates for extreme heatwaves were 0.04% (95%eCI: 0.02-0.06%) and 0.04% (95%eCI: 0.01-0.07), respectively. Cost-AFs in 2050 were, under RCP4.5, 0.127% (95%eCI: 0.27-0.46) for all heatwaves and 0.04% (95%eCI: 0.01-0.09%) for extreme heatwaves. Attributable fractions were approximately similar to baseline when assuming theoretical climate adaptation. DISCUSSION Heatwaves represent notable and preventable portions of preventable OIIs and economic burden. OIIs are likely to increase in the future, and costs during extreme heatwaves in 2030. Workplace and public health policies aimed at heat adaptation can reduce heat-attributable morbidity and costs.
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Affiliation(s)
- Matthew A Borg
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Jianjun Xiang
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia; School of Public Health, Fujian Medical University, 1 Xue Yuan Road, Minhou Campus, Fuzhou, Fujian Province, 350122, China
| | - Olga Anikeeva
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Bertram Ostendorf
- Ecology and Evolutionary Biology, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia
| | - Blesson Varghese
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Keith Dear
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Dino Pisaniello
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Alana Hansen
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Kerstin Zander
- Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, The Alfred Centre, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, 50 Rundle Mall, Adelaide, SA 5000, Australia.
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Zhang G, Han L, Yao J, Yang J, Xu Z, Cai X, Huang J, Pei L. Assessing future heat stress across China: combined effects of heat and relative humidity on mortality. Front Public Health 2023; 11:1282497. [PMID: 37854241 PMCID: PMC10581210 DOI: 10.3389/fpubh.2023.1282497] [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: 08/24/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023] Open
Abstract
This study utilizes China's records of non-accidental mortality along with twenty-five simulations from the NASA Earth Exchange Global Daily Downscaled Projections to evaluate forthcoming heat stress and heat-related mortality across China across four distinct scenarios (SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). The findings demonstrate a projected escalation in the heat stress index (HSI) throughout China from 2031 to 2100. The most substantial increments compared to the baseline (1995-2014) are observed under SSP5-8.5, indicating a rise of 7.96°C by the year 2100, while under SSP1-2.6, the increase is relatively modest at 1.54°C. Disparities in HSI growth are evident among different subregions, with South China encountering the most significant elevation, whereas Northwest China exhibits the lowest increment. Projected future temperatures align closely with HSI patterns, while relative humidity is anticipated to decrease across the majority of areas. The study's projections indicate that China's heat-related mortality is poised to surpass present levels over the forthcoming decades, spanning a range from 215% to 380% from 2031 to 2100. Notably, higher emission scenarios correspond to heightened heat-related mortality. Additionally, the investigation delves into the respective contributions of humidity and temperature to shifts in heat-related mortality. At present, humidity exerts a greater impact on fluctuations in heat-related mortality within China and its subregions. However, with the projected increase in emissions and global warming, temperature is expected to assume a dominant role in shaping these outcomes. In summary, this study underscores the anticipated escalation of heat stress and heat-related mortality across China in the future. It highlights the imperative of emission reduction as a means to mitigate these risks and underscores the variances in susceptibility to heat stress across different regions.
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Affiliation(s)
- Guwei Zhang
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Transforming Climate Resources to Economy, China Meteorological Administration, Chongqing, China
| | - Ling Han
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiajun Yao
- Shengzhou Meteorological Bureau, Shaoxing, China
| | - Jiaxi Yang
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Transforming Climate Resources to Economy, China Meteorological Administration, Chongqing, China
| | - Zhiqi Xu
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Transforming Climate Resources to Economy, China Meteorological Administration, Chongqing, China
| | - Xiuhua Cai
- Chinese Academy of Meteorological Sciences, Beijing, China
| | - Jin Huang
- Chifeng City Center Hospital Ningcheng County, Chifeng, China
| | - Lin Pei
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Urban Meteorology, China Meteorological Administration, Beijing, China
- Key Laboratory of Transforming Climate Resources to Economy, China Meteorological Administration, Chongqing, China
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Hebbern C, Gosselin P, Chen K, Chen H, Cakmak S, MacDonald M, Chagnon J, Dion P, Martel L, Lavigne E. Future temperature-related excess mortality under climate change and population aging scenarios in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:726-736. [PMID: 37308698 PMCID: PMC10484859 DOI: 10.17269/s41997-023-00782-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/27/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Climate change is expected to increase global temperatures. How temperature-related mortality risk will change is not completely understood, and how future demographic changes will affect temperature-related mortality needs to be clarified. We evaluate temperature-related mortality across Canada until 2099, accounting for age groups and scenarios of population growth. METHODS We used daily counts of non-accidental mortality for 2000 to 2015 for all 111 health regions across Canada, incorporating in the study both urban and rural areas. A two-part time series analysis was used to estimate associations between mean daily temperatures and mortality. First, current and future daily mean temperature time series simulations were developed from Coupled Model Inter-Comparison Project 6 (CMIP6) climate model ensembles from past and projected climate change scenarios under Shared Socioeconomic Pathways (SSPs). Next, excess mortality due to heat and cold and the net difference were projected to 2099, also accounting for different regional and population aging scenarios. RESULTS For 2000 to 2015, we identified 3,343,311 non-accidental deaths. On average, a net increase of 17.31% (95% eCI: 13.99, 20.62) in temperature-related excess mortality under a higher greenhouse gas emission scenario is expected for Canada in 2090-2099, which represents a greater burden than a scenario that assumed strong levels of greenhouse gas mitigation policies (net increase of 3.29%; 95% eCI: 1.41, 5.17). The highest net increase was observed among people aged 65 and over, and the largest increases in both net and heat- and cold-related mortality were observed in population scenarios that incorporated the highest rates of aging. CONCLUSION Canada may expect net increases in temperature-related mortality under a higher emissions climate change scenario, compared to one assuming sustainable development. Urgent action is needed to mitigate future climate change impacts.
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Affiliation(s)
| | - Pierre Gosselin
- Institut National de La Recherche Scientifique (Centre Eau-Terre-Environnement), Québec, QC, Canada
- Institut National de Santé Publique du Québec, Québec, QC, Canada
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center On Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Hong Chen
- Population Studies Division, Health Canada, Ottawa, ON, Canada
| | - Sabit Cakmak
- Population Studies Division, Health Canada, Ottawa, ON, Canada
| | - Melissa MacDonald
- Meteorological Service of Canada, Environment and Climate Change Canada, Gatineau, QC, Canada
| | | | - Patrice Dion
- Centre for Demography, Statistics Canada, Ottawa, ON, Canada
| | - Laurent Martel
- Centre for Demography, Statistics Canada, Ottawa, ON, Canada
| | - Eric Lavigne
- Population Studies Division, Health Canada, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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Chitu Z, Bojariu R, Velea L, Van Schaeybroeck B. Large sex differences in vulnerability to circulatory-system disease under current and future climate in Bucharest and its rural surroundings. ENVIRONMENTAL RESEARCH 2023; 234:116531. [PMID: 37394169 DOI: 10.1016/j.envres.2023.116531] [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: 08/01/2022] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
Circulatory-system diseases (CSDs) are responsible for 50-60% of all deaths in Romania. Due to its continental climate, with cold winters and very warm summers, there is a strong temperature dependence of the CSD mortality. Additionally, within its capital Bucharest, the urban heat island (UHI) is expected to enhance (reduce) heat (cold)-related mortality. Using distributed lag non-linear models, we establish the relation between temperature and CSD mortality in Bucharest and its surroundings. A striking finding is the strong temperature-related response to high urban temperatures of women in comparison with men from the total CSDs mortality. In the present climate, estimates of the CSDs attributable fraction (AF) of mortality at high temperatures is about 66% higher in Bucharest than in its rural surroundings for men, while it is about 100% times higher for women. Additionally, the AF in urban areas is also significantly higher for elderly people, and for those with hypertensive and cerebrovascular diseases than in the rural surroundings. On the other hand, in rural areas, men but especially women are currently more vulnerable with respect to low temperatures than in the urban environment. In order to project future thermal-related mortality, we have used five bias-corrected climate projections from regional circulation models under two climate-change scenarios, RCP4.5 and RCP8.5. Analysis of the temperature-mortality associations for future climate reveals the strongest signal under the scenario RCP8.5 for women, elderly people as well as for groups with hypertensive and cerebrovascular diseases. The net AF increase is much larger in urban agglomeration for women (8.2 times higher than in rural surroundings) and elderly people (8.5 times higher than in rural surroundings). However, our estimates of thermal attributable mortality are most likely underestimated due to the poor representation of UHI and future demography.
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Affiliation(s)
- Zenaida Chitu
- National Meteorological Administration, Bucharest, Romania
| | - Roxana Bojariu
- National Meteorological Administration, Bucharest, Romania.
| | - Liliana Velea
- National Meteorological Administration, Bucharest, Romania; University Ca' Foscari, Venice, Italy
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17
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Lüthi S, Fairless C, Fischer EM, Scovronick N, Ben Armstrong, Coelho MDSZS, Guo YL, Guo Y, Honda Y, Huber V, Kyselý J, Lavigne E, Royé D, Ryti N, Silva S, Urban A, Gasparrini A, Bresch DN, Vicedo-Cabrera AM. Rapid increase in the risk of heat-related mortality. Nat Commun 2023; 14:4894. [PMID: 37620329 PMCID: PMC10449849 DOI: 10.1038/s41467-023-40599-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Heat-related mortality has been identified as one of the key climate extremes posing a risk to human health. Current research focuses largely on how heat mortality increases with mean global temperature rise, but it is unclear how much climate change will increase the frequency and severity of extreme summer seasons with high impact on human health. In this probabilistic analysis, we combined empirical heat-mortality relationships for 748 locations from 47 countries with climate model large ensemble data to identify probable past and future highly impactful summer seasons. Across most locations, heat mortality counts of a 1-in-100 year season in the climate of 2000 would be expected once every ten to twenty years in the climate of 2020. These return periods are projected to further shorten under warming levels of 1.5 °C and 2 °C, where heat-mortality extremes of the past climate will eventually become commonplace if no adaptation occurs. Our findings highlight the urgent need for strong mitigation and adaptation to reduce impacts on human lives.
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Affiliation(s)
- Samuel Lüthi
- Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland.
- Federal Office of Meteorology and Climatology MeteoSwiss, Zurich, Switzerland.
| | | | - Erich M Fischer
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Yue Leon Guo
- Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
- Graduate Institute of Environmental and Occupational Health Sciences, NTU College of Public Health, Taipei, Taiwan
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Veronika Huber
- IBE-Chair of Epidemiology, LMU Munich, Munich, Germany
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Dominic Royé
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Susana Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - David N Bresch
- Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland
- Federal Office of Meteorology and Climatology MeteoSwiss, Zurich, Switzerland
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
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18
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de Schrijver E, Sivaraj S, Raible CC, Franco OH, Chen K, Vicedo-Cabrera AM. Nationwide projections of heat- and cold-related mortality impacts under various climate change and population development scenarios in Switzerland. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2023; 18:094010. [PMID: 38854588 PMCID: PMC7616072 DOI: 10.1088/1748-9326/ace7e1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Climate change and progressive population development (i.e., ageing and changes in population size) are altering the temporal patterns of temperature-related mortality in Switzerland. However, limited evidence exists on how current trends in heat- and cold-related mortality would evolve in future decades under composite scenarios of global warming and population development. Moreover, the contribution of these drivers to future mortality impacts is not well-understood. Therefore, we aimed to project heat- and cold-related mortality in Switzerland under various combinations of emission and population development scenarios and to disentangle the contribution of each of these two drivers using high-resolution mortality and temperature data. We combined age-specific (<75 and ⩾75 years) temperature-mortality associations in each district in Switzerland (1990-2010), estimated through a two-stage time series analysis, with 2 km downscaled CMIP5 temperature data and population and mortality rate projections under two scenarios: RCP4.5/SSP2 and RCP8.5/SSP5. We derived heat and cold-related mortality for different warming targets (1.5 °C, 2.0 °C and 3.0 °C) using different emission and population development scenarios and compared this to the baseline period (1990-2010). Heat-related mortality is projected to increase from 312 (116; 510) in the 1990-2010 period to 1274 (537; 2284) annual deaths under 2.0 °C of warming (RCP4.5/SSP2) and to 1871 (791; 3284) under 3.0 °C of warming (RCP8.5/SSP5). Cold-related mortality will substantially increase from 4069 (1898; 6016) to 6558 (3223; 9589) annual deaths under 2.0 °C (RCP4.5/SSP2) and to 5997 (2951; 8759) under 3.0 °C (RCP8.5/SSP5). Moreover, while the increase in cold-related mortality is solely driven by population development, for heat, both components (i.e., changes in climate and population) have a similar contribution of around 50% to the projected heat-related mortality trends. In conclusion, our findings suggest that both heat- and cold-related mortality will substantially increase under all scenarios of climate change and population development in Switzerland. Population development will lead to an increase in cold-related mortality despite the decrease in cold temperature under warmer scenarios. Whereas the combination of the progressive warming of the climate and population development will substantially increase and exacerbate the total temperature-related mortality burden in Switzerland.
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Affiliation(s)
- Evan de Schrijver
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Graduate School of Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Sidharth Sivaraj
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
| | - Christoph C Raible
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Climate and Environmental Physics, Physics Institute, University of Bern, Bern, Switzerland
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Julius Center for Health Sciences and Primary Care, University of Utrecht Medical Center, Utrecht, The Netherlands
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States of America
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, United States of America
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
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19
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Vicedo-Cabrera AM, de Schrijver E, Schumacher DL, Ragettli MS, Fischer EM, Seneviratne SI. The footprint of human-induced climate change on heat-related deaths in the summer of 2022 in Switzerland. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2023; 18:074037. [PMID: 38476980 PMCID: PMC7615730 DOI: 10.1088/1748-9326/ace0d0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Human-induced climate change is leading to an increase in the intensity and frequency of extreme weather events, which are severely affecting the health of the population. The exceptional heat during the summer of 2022 in Europe is an example, with record-breaking temperatures only below the infamous 2003 summer. High ambient temperatures are associated with many health outcomes, including premature mortality. However, there is limited quantitative evidence on the contribution of anthropogenic activities to the substantial heat-related mortality observed in recent times. Here we combined methods in climate epidemiology and attribution to quantify the heat-related mortality burden attributed to human-induced climate change in Switzerland during the summer of 2022. We first estimated heat-mortality association in each canton and age/sex population between 1990 and 2017 in a two-stage time-series analysis. We then calculated the mortality attributed to heat in the summer of 2022 using observed mortality, and compared it with the hypothetical heat-related burden that would have occurred in absence of human-induced climate change. This counterfactual scenario was derived by regressing the Swiss average temperature against global mean temperature in both observations and CMIP6 models. We estimate 623 deaths [95% empirical confidence interval (95% eCI): 151-1068] due to heat between June and August 2022, corresponding to 3.5% of all-cause mortality. More importantly, we find that 60% of this burden (370 deaths [95% eCI: 133-644]) could have been avoided in absence of human-induced climate change. Older women were affected the most, as well as populations in western and southern Switzerland and more urbanized areas. Our findings demonstrate that human-induced climate change was a relevant driver of the exceptional excess health burden observed in the 2022 summer in Switzerland.
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Affiliation(s)
- Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Evan de Schrijver
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | | | - Martina S Ragettli
- Swiss Tropical and Public Health Institute (SwissTPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Erich M Fischer
- Institute for Atmospheric and Climate Science, ETH Zürich, Zürich, Switzerland
| | - Sonia I Seneviratne
- Institute for Atmospheric and Climate Science, ETH Zürich, Zürich, Switzerland
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20
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Fatima SH, Rothmore P, Giles LC, Bi P. Intra-urban risk assessment of occupational injuries and illnesses associated with current and projected climate: Evidence from three largest Australian cities. ENVIRONMENTAL RESEARCH 2023; 228:115855. [PMID: 37028539 DOI: 10.1016/j.envres.2023.115855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Increased risk of occupational injuries and illnesses (OI) is associated with ambient temperature. However, most studies have reported the average impacts within cities, states, or provinces at broader scales. METHODS We assessed the intra-urban risk of OI associated with ambient temperature in three Australian cities at statistical area level 3 (SA3). We collected daily workers' compensation claims data and gridded meteorological data from July 1, 2005, to June 30, 2018. Heat index was used as the primary temperature metric. We performed a two-stage time series analysis: we generated location-specific estimates using Distributed Lag Non-Linear Models (DLNM) and estimated the cumulative effects with multivariate meta-analysis. The risk was estimated at moderate heat (90th percentile) and extreme heat (99th percentile). Subgroup analyses were conducted to identify vulnerable groups of workers. Further, the OI risk in the future was estimated for two projected periods: 2016-2045 and 2036-2065. RESULTS The cumulative risk of OI was 3.4% in Greater Brisbane, 9.5% in Greater Melbourne, and 8.9% in Greater Sydney at extreme heat. The western inland regions in Greater Brisbane (17.4%) and Greater Sydney (32.3%) had higher risk of OI for younger workers, workers in outdoor and indoor industries, and workers reporting injury claims. The urbanized SA3 regions posed a higher risk (19.3%) for workers in Greater Melbourne. The regions were generally at high risk for young workers and illness-related claims. The projected risk of OI increased with time in climate change scenarios. CONCLUSIONS This study provides a comprehensive spatial profile of OI risk associated with hot weather conditions across three cities in Australia. Risk assessment at the intra-urban level revealed strong spatial patterns in OI risk distribution due to heat exposure. These findings provide much-needed scientific evidence for work, health, and safety regulators, industries, unions, and workers to design and implement location-specific preventative measures.
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Affiliation(s)
- Syeda Hira Fatima
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Paul Rothmore
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lynne C Giles
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
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21
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Liu J, Hansen A, Varghese BM, Dear K, Tong M, Prescott V, Dolar V, Gourley M, Driscoll T, Zhang Y, Morgan G, Capon A, Bi P. Estimating the burden of disease attributable to high ambient temperature across climate zones: methodological framework with a case study. Int J Epidemiol 2023; 52:783-795. [PMID: 36511334 PMCID: PMC10244055 DOI: 10.1093/ije/dyac229] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 11/30/2022] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND With high temperature becoming an increasing health risk due to a changing climate, it is important to quantify the scale of the problem. However, estimating the burden of disease (BoD) attributable to high temperature can be challenging due to differences in risk patterns across geographical regions and data accessibility issues. METHODS We present a methodological framework that uses Köppen-Geiger climate zones to refine exposure levels and quantifies the difference between the burden observed due to high temperatures and what would have been observed if the population had been exposed to the theoretical minimum risk exposure distribution (TMRED). Our proposed method aligned with the Australian Burden of Disease Study and included two parts: (i) estimation of the population attributable fractions (PAF); and then (ii) estimation of the BoD attributable to high temperature. We use suicide and self-inflicted injuries in Australia as an example, with most frequent temperatures (MFTs) as the minimum risk exposure threshold (TMRED). RESULTS Our proposed framework to estimate the attributable BoD accounts for the importance of geographical variations of risk estimates between climate zones, and can be modified and adapted to other diseases and contexts that may be affected by high temperatures. CONCLUSIONS As the heat-related BoD may continue to increase in the future, this method is useful in estimating burdens across climate zones. This work may have important implications for preventive health measures, by enhancing the reproducibility and transparency of BoD research.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Alana Hansen
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Blesson M Varghese
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Keith Dear
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Michael Tong
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Vanessa Prescott
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Vergil Dolar
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Ying Zhang
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
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22
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Li C, Liu Z, Li W, Lin Y, Hou L, Niu S, Xing Y, Huang J, Chen Y, Zhang S, Gao X, Xu Y, Wang C, Zhao Q, Liu Q, Ma W, Cai W, Gong P, Luo Y. Projecting future risk of dengue related to hydrometeorological conditions in mainland China under climate change scenarios: a modelling study. Lancet Planet Health 2023; 7:e397-e406. [PMID: 37164516 DOI: 10.1016/s2542-5196(23)00051-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 02/01/2023] [Accepted: 02/28/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND We have limited knowledge on the impact of hydrometeorological conditions on dengue incidence in China and its associated disease burden in a future with a changed climate. This study projects the excess risk of dengue caused by climate change-induced hydrometeorological conditions across mainland China. METHODS In this modelling study, the historical association between the Palmer drought severity index (PDSI) and dengue was estimated with a spatiotemporal Bayesian hierarchical model from 70 cities. The association combined with the dengue-transmission biological model was used to project the annual excess risk of dengue related to PDSI by 2100 across mainland China, under three representative concentration pathways ([RCP] 2·6, RCP 4·5, and RCP 8·5). FINDINGS 93 101 dengue cases were reported between 2013 and 2019 in mainland China. Dry and wet conditions within 3 months lag were associated with increased risk of dengue. Locations with potential dengue risk in China will expand in the future. The hydrometeorological changes are projected to substantially affect the risk of dengue in regions with mid-to-low latitudes, especially the coastal areas under high emission scenarios. By 2100, the annual average increased excess risk is expected to range from 12·56% (95% empirical CI 9·54-22·24) in northwest China to 173·62% (153·15-254·82) in south China under the highest emission scenario. INTERPRETATION Hydrometeorological conditions are predicted to increase the risk of dengue in the future in the south, east, and central areas of mainland China in disproportionate patterns. Our findings have implications for the preparation of public health interventions to minimise the health hazards of non-optimal hydrometeorological conditions in a context of climate change. FUNDING National Natural Science Foundation of China.
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Affiliation(s)
- Chuanxi Li
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China
| | - Zhao Liu
- School of Linkong Economics and Management, Beijing Institute of Economics and Management, Beijing, China
| | - Wen Li
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China
| | - Yuxi Lin
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China
| | - Liangyu Hou
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China
| | - Shuyue Niu
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China
| | - Yue Xing
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China
| | - Jianbin Huang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China; Beijing Yanshan Earth Critical Zone National Research Station, Chinese Academy of Sciences, Beijing, China
| | - Yidan Chen
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, China
| | - Shangchen Zhang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Xuejie Gao
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China; Climate Change Research Centre, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Ying Xu
- National Climate Centre, China Meteorological Administration, Beijing, China
| | - Can Wang
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, China
| | - Qi Zhao
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China; Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
| | - Qiyong Liu
- Department of Epidemiology, Shandong University, Jinan, China; Department of Vector Control, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China; State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
| | - Wei Ma
- Department of Epidemiology, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, and Shandong University Climate Change and Health Centre, Shandong University, Jinan, China.
| | - Wenjia Cai
- Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing, China
| | - Peng Gong
- Institute for Climate and Carbon Neutrality, Department of Earth Sciences and Geography, University of Hong Kong, Hong Kong, China
| | - Yong Luo
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
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23
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Zhou Y, Gao Y, Yin P, He C, Liu W, Kan H, Zhou M, Chen R. Assessing the Burden of Suicide Death Associated With Nonoptimum Temperature in a Changing Climate. JAMA Psychiatry 2023; 80:488-497. [PMID: 36988931 PMCID: PMC10061320 DOI: 10.1001/jamapsychiatry.2023.0301] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/11/2023] [Indexed: 03/30/2023]
Abstract
Importance Few studies have projected future suicide burden associated with daily temperatures in a warming climate. Objectives To assess the burden of suicide death associated with daily nonoptimal temperature and to project the change of suicide burden associated with nonoptimal temperature in different regions and seasons under various climate change scenarios. Design, Setting, and Participants Between January 1, 2013, and December 31, 2019, we conducted a time-stratified, case-control study among more than 430 000 individual suicide decedents from all counties in mainland China. Exposures Daily meteorological data were obtained from the European Centre for Medium-Range Weather Forecasts Reanalysis Fifth Generation (ERA5) reanalysis product. Historical and future temperature series were projected under 3 scenarios of greenhouse-gas emissions from 1980 to 2099, with 10 general circulation models. Main Outcomes and Measures The relative risk (RR) and burden of suicide death associated with nonoptimal temperature (ie, temperatures greater than or less than minimum-mortality temperature); the change of suicide burden associated with future climate warming in different regions and seasons under various climate change scenarios. Results Of 432 008 individuals (mean [SD] age; 57.6 [19.0] years; 253 093 male [58.6%]) who died by suicide, 85.8% (370 577) had a middle school education or less. The temperature-suicide associations were approximately linear, with increasing death risks at higher temperatures. The excess risk was more prominent among older adults (ie, ≥75 years; RR, 1.71; 95% CI, 1.46-1.99) and those with low education level (ie, middle school education or less; RR, 1.46; 95% CI, 1.36-1.57). There were 15.2% suicide deaths (95% estimated CI [eCI], 14.6%-15.6%) associated with nonoptimal temperature nationally. Consistent and drastic increases in excess suicide deaths over this century were predicted under the high-emission scenario, whereas a leveling-off trend after the mid-21st century was predicted under the medium- and low-emission scenarios. Nationally, compared with the historical period (1980-2009), excess suicide deaths were predicted to increase by 8.3% to 11.4% in the 2050s and 8.5% to 21.7% in the 2090s under the 3 scenarios. The projected percentage increments of excess suicide deaths were predicted to be greater in the South (55.0%; 95% eCI, 30.5%-85.6%) and in winter (54.5%; 95% eCI, 30.4%-77.0%) in the 2090s under the high-emission scenario. Conclusions and Relevance Findings of this nationwide case-control study suggest that higher temperature may be associated with the risk and burden of suicide death in China. These findings highlight the importance of implementing effective climate policies to reduce greenhouse gas emissions and tailoring public health policies to adapt to global warming.
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Affiliation(s)
- Yuchang Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ya Gao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cheng He
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Wei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
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24
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Masselot P, Mistry M, Vanoli J, Schneider R, Iungman T, Garcia-Leon D, Ciscar JC, Feyen L, Orru H, Urban A, Breitner S, Huber V, Schneider A, Samoli E, Stafoggia M, de'Donato F, Rao S, Armstrong B, Nieuwenhuijsen M, Vicedo-Cabrera AM, Gasparrini A. Excess mortality attributed to heat and cold: a health impact assessment study in 854 cities in Europe. Lancet Planet Health 2023; 7:e271-e281. [PMID: 36934727 DOI: 10.1016/s2542-5196(23)00023-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Heat and cold are established environmental risk factors for human health. However, mapping the related health burden is a difficult task due to the complexity of the associations and the differences in vulnerability and demographic distributions. In this study, we did a comprehensive mortality impact assessment due to heat and cold in European urban areas, considering geographical differences and age-specific risks. METHODS We included urban areas across Europe between Jan 1, 2000, and Dec 12, 2019, using the Urban Audit dataset of Eurostat and adults aged 20 years and older living in these areas. Data were extracted from Eurostat, the Multi-country Multi-city Collaborative Research Network, Moderate Resolution Imaging Spectroradiometer, and Copernicus. We applied a three-stage method to estimate risks of temperature continuously across the age and space dimensions, identifying patterns of vulnerability on the basis of city-specific characteristics and demographic structures. These risks were used to derive minimum mortality temperatures and related percentiles and raw and standardised excess mortality rates for heat and cold aggregated at various geographical levels. FINDINGS Across the 854 urban areas in Europe, we estimated an annual excess of 203 620 (empirical 95% CI 180 882-224 613) deaths attributed to cold and 20 173 (17 261-22 934) attributed to heat. These corresponded to age-standardised rates of 129 (empirical 95% CI 114-142) and 13 (11-14) deaths per 100 000 person-years. Results differed across Europe and age groups, with the highest effects in eastern European cities for both cold and heat. INTERPRETATION Maps of mortality risks and excess deaths indicate geographical differences, such as a north-south gradient and increased vulnerability in eastern Europe, as well as local variations due to urban characteristics. The modelling framework and results are crucial for the design of national and local health and climate policies and for projecting the effects of cold and heat under future climatic and socioeconomic scenarios. FUNDING Medical Research Council of UK, the Natural Environment Research Council UK, the EU's Horizon 2020, and the EU's Joint Research Center.
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Affiliation(s)
- Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
| | - Malcolm Mistry
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Jacopo Vanoli
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Rochelle Schneider
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; ϕ-Lab, European Space Agency, Frascati, Italy
| | - Tamara Iungman
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | - Luc Feyen
- Joint Research Centre, European Commission, Ispra, Italy
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Aleš Urban
- Institute of Atmospheric Physics, Academy of Sciences of the Czech Republic, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; IBE-Chair of Epidemiology, LMU Munich, Munich, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; IBE-Chair of Epidemiology, LMU Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
| | - Francesca de'Donato
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
| | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
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Shrikhande SS, Pedder H, Röösli M, Dalvie MA, Lakshmanasamy R, Gasparrini A, Utzinger J, Cissé G. Non-optimal apparent temperature and cardiovascular mortality: the association in Puducherry, India between 2011 and 2020. BMC Public Health 2023; 23:291. [PMID: 36755271 PMCID: PMC9909923 DOI: 10.1186/s12889-023-15128-6] [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: 05/26/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs), the leading cause of death worldwide, are sensitive to temperature. In light of the reported climate change trends, it is important to understand the burden of CVDs attributable to temperature, both hot and cold. The association between CVDs and temperature is region-specific, with relatively few studies focusing on low-and middle-income countries. This study investigates this association in Puducherry, a district in southern India lying on the Bay of Bengal, for the first time. METHODS Using in-hospital CVD mortality data and climate data from the Indian Meteorological Department, we analyzed the association between apparent temperature (Tapp) and in-hospital CVD mortalities in Puducherry between 2011 and 2020. We used a case-crossover model with a binomial likelihood distribution combined with a distributed lag non-linear model to capture the delayed and non-linear trends over a 21-day lag period to identify the optimal temperature range for Puducherry. The results are expressed as the fraction of CVD mortalities attributable to heat and cold, defined relative to the optimal temperature. We also performed stratified analyses to explore the associations between Tapp and age-and-sex, grouped and considered together, and different types of CVDs. Sensitivity analyses were performed, including using a quasi-Poisson time-series approach. RESULTS We found that the optimal temperature range for Puducherry is between 30°C and 36°C with respect to CVDs. Both cold and hot non-optimal Tapp were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Cumulatively, up to 17% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to heat (9.1%) than cold (8.3%). We also found that males were more vulnerable to colder temperature; females above 60 years were more vulnerable to heat while females below 60 years were affected by both heat and cold. Mortality with cerebrovascular accidents was associated more with heat compared to cold, while ischemic heart diseases did not seem to be affected by temperature. CONCLUSION Both heat and cold contribute to the burden of CVDs attributable to non-optimal temperatures in the tropical Puducherry. Our study also identified the age-and-sex and CVD type differences in temperature attributable CVD mortalities. Further studies from India could identify regional associations, inform our understanding of the health implications of climate change in India and enhance the development of regional and contextual climate-health action-plans.
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Affiliation(s)
- Shreya S Shrikhande
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Hugo Pedder
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- School of Public Health and Family Medicine, Centre for Environmental and Occupational Health Research, University of Cape Town, Cape Town, South Africa
| | - Ravivarman Lakshmanasamy
- State Surveillance Officer, Department of Health and Family Welfare Services, Govt. of Puducherry, Puducherry, India
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre On Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Bühler JL, Shrikhande S, Kapwata T, Cissé G, Liang Y, Pedder H, Kwiatkowski M, Kunene Z, Mathee A, Peer N, Wright CY. The Association between Apparent Temperature and Hospital Admissions for Cardiovascular Disease in Limpopo Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010116. [PMID: 36612437 PMCID: PMC9820030 DOI: 10.3390/ijerph20010116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 05/27/2023]
Abstract
Cardiovascular diseases (CVDs) have a high disease burden both globally and in South Africa. They have also been found to be temperature-sensitive globally. The association between temperature and CVD morbidity has previously been demonstrated, but little is known about it in South Africa. It is important to understand how changes in temperature in South Africa will affect CVD morbidity, especially in rural regions, to inform public health interventions and adaptation strategies. This study aimed to determine the short-term effect of apparent temperature (Tapp) on CVD hospital admissions in Mopani District, Limpopo province, South Africa. A total of 3124 CVD hospital admissions records were obtained from two hospitals from 1 June 2009 to 31 December 2016. Daily Tapp was calculated using nearby weather station measurements. The association was modelled using a distributed lag non-linear model with a negative binomial regression over a 21-day lag period. The fraction of morbidity attributable to non-optimal Tapp, i.e., cold (6-25 °C) and warm (27-32 °C) Tapp was reported. We found an increase in the proportion of admissions due to CVDs for warm and cold Tapp cumulatively over 21 days. Increasing CVD admissions due to warm Tapp appeared immediately and lasted for two to four days, whereas the lag-structure for the cold effect was inconsistent. A proportion of 8.5% (95% Confidence Interval (CI): 3.1%, 13.7%) and 1.1% (95% CI: -1.4%, 3.5%) of the total CVD admissions was attributable to cold and warm temperatures, respectively. Warm and cold Tapp may increase CVD admissions, suggesting that the healthcare system and community need to be prepared in the context of global temperature changes.
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Affiliation(s)
- Jacqueline Lisa Bühler
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Shreya Shrikhande
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
| | - Guéladio Cissé
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Hugo Pedder
- Population Health Sciences, University of Bristol, Bristol BS8 2PS, UK
| | - Marek Kwiatkowski
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Zamantimande Kunene
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Durban 4091, South Africa
- Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Caradee Y. Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa
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Rai M, Breitner S, Zhang S, Rappold AG, Schneider A. Achievements and gaps in projection studies on the temperature-attributable health burden: Where should we be headed? FRONTIERS IN EPIDEMIOLOGY 2022; 2:1-9. [PMID: 37942471 PMCID: PMC10631562 DOI: 10.3389/fepid.2022.1063871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Future projection of the temperature-related health burden, including mortality and hospital admissions, is a growing field of research. These studies aim to provide crucial information for decision-makers considering existing health policies as well as integrating targeted adaptation strategies to evade the health burden. However, this field of research is still overshadowed by large uncertainties. These uncertainties exist to an extent in the future climate and population models used by such studies but largely in the disparities in underlying assumptions. Existing studies differ in the factors incorporated for projection and strategies for considering the future adaptation of the population to temperature. These differences exist to a great degree because of a lack of robust evidence as well as gaps in the field of climate epidemiology that still require extensive input from the research community. This narrative review summarizes the current status of projection studies of temperature-attributable health burden, the guiding assumptions behind them, the common grounds, as well as the differences. Overall, the review aims to highlight existing evidence and knowledge gaps as a basis for designing future studies on temperature-attributable health burden estimation. Finding a robust methodology for projecting the future health burden could be a milestone for climate epidemiologists as this would largely benefit the world when applying this technique to project the climate-attributable cause-specific health burden and adapt our existing health policies accordingly.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Center Munich, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, LMU Munich, Munich, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Center Munich, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, LMU Munich, Munich, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Center Munich, Neuherberg, Germany
| | - Ana G. Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, Durham, NC, United States
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The burden of heatwave-related preterm births and associated human capital losses in China. Nat Commun 2022; 13:7565. [PMID: 36513644 PMCID: PMC9747907 DOI: 10.1038/s41467-022-35008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022] Open
Abstract
Frequent heatwaves under global warming can increase the risk of preterm birth (PTB), which in turn will affect physical health and human potential over the life course. However, what remains unknown is the extent to which anthropogenic climate change has contributed to such burdens. We combine health impact and economic assessment methods to comprehensively evaluate the entire heatwave-related PTB burden in dimensions of health, human capital and economic costs. Here, we show that during 2010-2020, an average of 13,262 (95%CI 6,962-18,802) PTBs occurred annually due to heatwave exposure in China. In simulated scenarios, 25.8% (95%CI 17.1%-34.5%) of heatwave-related PTBs per year on average can be attributed to anthropogenic climate change, which further result in substantial human capital losses, estimated at over $1 billion costs. Our findings will provide additional impetus for introducing more stringent climate mitigation policies and also call for more sufficient adaptations to reduce heatwave detriments to newborn.
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Dawson LP, Andrew E, Nehme Z, Bloom J, Cox S, Anderson D, Stephenson M, Lefkovits J, Taylor AJ, Kaye D, Guo Y, Smith K, Stub D. Temperature-related chest pain presentations and future projections with climate change. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 848:157716. [PMID: 35914598 DOI: 10.1016/j.scitotenv.2022.157716] [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: 05/30/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Climate change has led to increased interest in studying adverse health effects relating to ambient temperatures. It is unclear whether incident chest pain is associated with non-optimal temperatures and how chest pain presentation rates might be affected by climate change. METHODS The study included ambulance data of chest pain presentations in Melbourne, Australia from 1/1/2015 to 30/6/2019 with linkage to hospital and emergency discharge diagnosis data. A time series quasi-Poisson regression with a distributed lag nonlinear model was fitted to assess the temperature-chest pain presentation associations overall and according to age, sex, socioeconomic status, and event location subgroups, with adjustment for season, day of the week and long-term trend. Future excess chest pain presentations associated with cold and heat were projected under six general circulation models under medium and high emission scenarios. RESULTS In 206,789 chest pain presentations, mean (SD) age was 61.2 (18.9) years and 50.3 % were female. Significant heat- and cold-related increased risk of chest pain presentations were observed for mean air temperatures above and below 20.8 °C, respectively. Excess chest pain presentations related to heat were observed in all subgroups, but appeared to be attenuated for older patients (≥70 years), patients of higher socioeconomic status (SES), and patients developing chest pain at home. We projected increases in heat-related chest pain presentations with climate change under both medium- and high-emission scenarios, which are offset by decreases in chest pain presentations related to cold temperatures. CONCLUSIONS Heat- and cold- exposure appear to increase the risk of chest pain presentations, especially among younger patients and patients of lower SES. This will have important implications with climate change modelling of chest pain, in particular highlighting the importance of risk mitigation strategies to minimise adverse health impacts on hotter days.
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Affiliation(s)
- Luke P Dawson
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Emily Andrew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia
| | - Ziad Nehme
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia; Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
| | - Jason Bloom
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; The Baker Institute, Melbourne, Victoria, Australia
| | - Shelley Cox
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia
| | - David Anderson
- Ambulance Victoria, Melbourne, Victoria, Australia; Department of Intensive Care Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Michael Stephenson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia; Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
| | - Jeffrey Lefkovits
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Andrew J Taylor
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Victoria, Australia
| | - David Kaye
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; The Baker Institute, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia; Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
| | - Dion Stub
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; The Baker Institute, Melbourne, Victoria, Australia.
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Chen H, Zhao L, Cheng L, Zhang Y, Wang H, Gu K, Bao J, Yang J, Liu Z, Huang J, Chen Y, Gao X, Xu Y, Wang C, Cai W, Gong P, Luo Y, Liang W, Huang C. Projections of heatwave-attributable mortality under climate change and future population scenarios in China. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 28:100582. [PMID: 36105236 PMCID: PMC9465423 DOI: 10.1016/j.lanwpc.2022.100582] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND In China, most previous projections of heat-related mortality have been based on modeling studies using global climate models (GCMs), which can help to elucidate the risks of extreme heat events in a changing climate. However, spatiotemporal changes in the health effects of climate change considering specific regional characteristics remain poorly understood. We aimed to use credible climate and population projections to estimate future heatwave-attributable deaths under different emission scenarios and to explore the drivers underlying these patterns of changes. METHODS We derived climate data from a regional climate model driven by three CMIP5 GCM models and calculated future heatwaves in China under Representative Concentration Pathway (RCP) 2.6, RCP4.5, and RCP8.5. The future gridded population data were based on Shared Socioeconomic Pathway 2 assumption with different fertility rates. By applying climate zone-specific exposure-response functions to mortality during heatwave events, we projected the scale of heatwave-attributable deaths under each RCP scenario. We further analyzed the factors driving changes in heatwave-related deaths and main sources of uncertainty using a decomposition method. We compared differences in death burden under the 1.5°C target, which is closely related to achieving carbon neutrality by mid-century. FINDINGS The number of heatwave-related deaths will increase continuously to the mid-century even under RCP2.6 and RCP4.5 scenarios, and will continue increasing throughout the century under RCP8.5. There will be 20,303 deaths caused by heatwaves in 2090 under RCP2.6, 35,025 under RCP4.5, and 72,260 under RCP8.5, with half of all heatwave-related deaths in any scenario concentrated in east and central China. Climate effects are the main driver for the increase in attributable deaths in the near future till 2060, explaining 78% of the total change. Subsequent population decline cannot offset the losses caused by higher incidence of heatwaves and an aging population under RCP8.5. Although health loss under the 1.5°C warming scenario is 1.6-fold higher than the baseline period 1986-2005, limiting the temperature rise to 1.5°C can reduce the annual mortality burden in China by 3,534 deaths in 2090 compared with RCP2.6 scenarios. INTERPRETATION With accelerating climate change and population aging, the effects of future heatwaves on human health in China are likely to increase continuously even under a low emission scenario. Significant health benefits are expected if the optimistic 1.5°C goal is achieved, suggesting that carbon neutrality by mid-century is a critical target for China's sustainable development. Policymakers need to tighten climate mitigation policies tailored to local conditions while enhancing climate resilience technically and infrastructurally, especially for vulnerable elderly people. FUNDING National Key R&D Program of China (2018YFA0606200), Wellcome Trust (209734/Z/17/Z), Natural Science Foundation of China (41790471), and Guangdong Major Project of Basic and Applied Basic Research (2020B0301030004).
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Affiliation(s)
- Huiqi Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Shanghai Typhoon Institute, China Meteorological Administration & Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Liang Zhao
- The State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics (LASG), Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Liangliang Cheng
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yali Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huibin Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Kuiying Gu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Junzhe Bao
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Zhao Liu
- School of Linkong Economics and Management, Beijing Institute of Economics and Management, Beijing, China
| | - Jianbin Huang
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Yidan Chen
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, China
| | - Xuejie Gao
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China
- Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Ying Xu
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Can Wang
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, China
| | - Wenjia Cai
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, China
| | - Peng Gong
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
- Department of Earth Sciences and Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yong Luo
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute of Healthy China, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute of Healthy China, Tsinghua University, Beijing, China
- Corresponding author at: Vanke School of Public Health, Tsinghua University, Beijing 100084, China.
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Rai M, Breitner S, Wolf K, Peters A, Schneider A, Chen K. Future temperature-related mortality considering physiological and socioeconomic adaptation: a modelling framework. Lancet Planet Health 2022; 6:e784-e792. [PMID: 36208641 DOI: 10.1016/s2542-5196(22)00195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND As the climate changes, it is crucial to focus not only on mitigation measures but also on building climate change resilience by developing efficient adaptation strategies. Although population adaptation is a major determinant of future climate-related health burden, it is not well accounted for in studies that project the health impact of climate change. We propose a methodological framework for temperature-related mortality that incorporates two simultaneous adaptation-sensitivity pathways: the physiological pathway, considering both heat adaptation and cold sensitivity, and the socioeconomic pathway, which is influenced by changes in future adaptive capacities. To demonstrate its utility we apply the framework to a case study mortality time-series dataset from Bavaria, Germany. METHODS In this modelling framework, we used extrapolated location-specific and age-specific baseline exposure-response functions and propose different future scenarios of cold sensitivity and heat adaptation on the basis of varying slopes of these exposure-response functions. We also incorporated future socioeconomic adaptation in the exposure-response functions using projections of gross domestic product under the respective shared socioeconomic pathways. Future adaptable fractions, representing the deaths avoided under each of the future scenarios, are projected under combinations of two climate change scenarios (shared socioeconomic pathway [SSP]1-2.6 and SSP3-7.0) and the respective plausible population projection scenarios (SSP1 and SSP3), also incorporating the future changes in demographic age structure and mortality. The case study for this framework was done for five districts in Bavaria, for both total non-accidental mortality and cardiovascular disease mortality. The baseline data was obtained for the period 1990-2006, and the future period was defined as 2083-99. FINDINGS In our Bavaria case study, average temperature was projected to increase by 2099 by an average of 1·1°C under SSP1-2.6 and by 4·1°C under SSP3-7.0. We observed the adaptable fraction to be largely influenced by socioeconomic adaptation for both total mortality and cardiovascular disease mortality, and for both climate change scenarios. For example, for total mortality, the highest adaptable fraction of 18·56% (95% empirical CI 10·77-23·67) was observed under the SSP1-2.6 future scenario, in the presence of socioeconomic adaptation and under the highest heat adaptation (10%) provided the cold sensitivity remains 0%. The cold adaptable fraction is lower than the heat adaptable fraction under all scenarios. In the absence of socioeconomic adaptation, population ageing will lead to higher temperature-related mortality. INTERPRETATION Our developed framework helps to systematically understand the effectiveness of adaptation mechanisms. In the future, socioeconomic adaptation is estimated to play a major role in determining temperature-related excess mortality. Furthermore, cold sensitivity might outweigh heat adaptation in the majority of locations worldwide. Similarly, population ageing is projected to continue to determine future temperature-related mortality. FUNDING EU Horizon 2020 (EXHAUSTION).
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Kai Chen
- Department of Environmental Health Sciences and Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Tong M, Wondmagegn B, Xiang J, Hansen A, Dear K, Pisaniello D, Varghese B, Xiao J, Jian L, Scalley B, Nitschke M, Nairn J, Bambrick H, Karnon J, Bi P. Hospitalization Costs of Respiratory Diseases Attributable to Temperature in Australia and Projections for Future Costs in the 2030s and 2050s under Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159706. [PMID: 35955062 PMCID: PMC9368165 DOI: 10.3390/ijerph19159706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 05/06/2023]
Abstract
This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010-2016 were analyzed using distributed non-linear lag models. Future hospitalization costs were estimated based on three predicted climate change scenarios-RCP2.6, RCP4.5 and RCP8.5. The estimated respiratory disease hospitalization costs attributable to ambient temperatures increased from 493.2 million Australian dollars (AUD) in the 2010s to more than AUD 700 million in 2050s in Sydney and from AUD 98.0 million to about AUD 150 million in Perth. The current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1-20.1%) and (5.1-6.6%), respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Limitations of this study should be noted, such as lacking information on individual-level exposures, local air pollution levels, and other behavioral risks, which is common in such ecological studies. Nonetheless, this study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change may result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location.
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Affiliation(s)
- Michael Tong
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Berhanu Wondmagegn
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Alana Hansen
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Blesson Varghese
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianguo Xiao
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Le Jian
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Benjamin Scalley
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Monika Nitschke
- Department of Health, Government of South Australia, Adelaide, SA 5000, Australia
| | - John Nairn
- Australian Bureau of Meteorology, Adelaide, SA 5000, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QL 4000, Australia
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5001, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
- Correspondence: ; Tel.: +61-8-8313-3583
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Michetti M, Gualtieri M, Anav A, Adani M, Benassi B, Dalmastri C, D'Elia I, Piersanti A, Sannino G, Zanini G, Uccelli R. Climate change and air pollution: Translating their interplay into present and future mortality risk for Rome and Milan municipalities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 830:154680. [PMID: 35314224 DOI: 10.1016/j.scitotenv.2022.154680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Heat and cold temperatures associated with exposure to poor air quality lead to increased mortality. Using a generalized linear model with Poisson regression for overdispersion, this study quantifies the natural-caused mortality burden attributable to heat/cold temperatures and PM10 and O3 air pollutants in Rome and Milan, the two most populated Italian cities. We calculate local-specific mortality relative risks (RRs) for the period 2004-2015 considering the overall population and the most vulnerable age category (≥85 years). Combining a regional climate model with a chemistry-transport model under future climate and air pollution scenarios (RCP2.6 and RCP8.5), we then project mortality to 2050. Results show that for historical mortality the burden is much larger for cold than for warm temperatures. RR peaks during wintertime in Milan and summertime in Rome, highlighting the relevance of accounting for the effects of air pollution besides that of climate, in particular PM10 for Milan and O3 for Rome. Overall, Milan reports higher RRs while, in both cities, the elderly appear more susceptible to heat/cold and air pollution events than the average population. Two counterbalancing effects shape mortality in the future: an increase associated with higher and more frequent warmer daily temperatures - especially in the case of climate inaction - and a decrease due to declining cold-mortality burden. The outcomes highlight the urgent need to adopt more stringent and integrated climate and air quality policies to reduce the temperature and air pollution combined effects on health.
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Affiliation(s)
- M Michetti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy.
| | - M Gualtieri
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - A Anav
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - M Adani
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - B Benassi
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - C Dalmastri
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - I D'Elia
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma, Lungotevere Thaon de Revel, 76, 00196 Rome, Italy
| | - A Piersanti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - G Sannino
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - G Zanini
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - R Uccelli
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
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Winklmayr C, Muthers S, Niemann H, Mücke HG, an der Heiden M. Heat-Related Mortality in Germany From 1992 to 2021. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:451-457. [PMID: 35583101 PMCID: PMC9639227 DOI: 10.3238/arztebl.m2022.0202] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/21/2021] [Accepted: 04/13/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND 2018-2020 were unusually warm years in Germany, and the summer of 2018 was the second warmest summer since record-keeping began in 1881. Higher temperatures regularly lead to increased mortality, particularly among the elderly. METHODS We used weekly data on all-cause mortality and mean temperature from the period 1992-2021 and estimated the number of heat-related deaths in all of Germany, and in the northern, central, and southern regions of Germany, employing a generalized additive model (GAM). To characterize long-term trends, we compared the effect of heat on mortality over the decades. RESULTS Our estimate reveals that the unusually high summer temperatures in Germany between 2018 and 2020 led to a statistically significant number of deaths in all three years. There were approximately 8700 heat-related deaths in 2018, 6900 in 2019, and 3700 in 2020. There was no statistically significant heat-related increase in deaths in 2021. A comparison of the past three decades reveals a slight overall decline in the effect of high temperatures on mortality. CONCLUSION Although evidence suggests that there has been some adaptation to heat over the years, the data from 2018-2020 in particular show that heat events remain a significant threat to human health in Germany.
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Affiliation(s)
- Claudia Winklmayr
- Department of Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany,*Abteilung für Infektionsepidemiologie Robert Koch-Institut Nordufer 20, 13353 Berlin, Germany
| | - Stefan Muthers
- Research Centre Human Biometeorology, Deutscher Wetterdienst (DWD), Freiburg, Germany
| | - Hildegard Niemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), Berlin, Germany
| | - Hans-Guido Mücke
- Department of Environmental Hygiene, German Environment Agency (UBA), Berlin, Germany
| | - Matthias an der Heiden
- Department of Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
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35
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Climate Change, Drought and Rural Suicide in New South Wales, Australia: Future Impact Scenario Projections to 2099. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137855. [PMID: 35805514 PMCID: PMC9266200 DOI: 10.3390/ijerph19137855] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 02/01/2023]
Abstract
Mental health problems are associated with droughts, and suicide is one of the most tragic outcomes. We estimated the numbers of suicides attributable to drought under possible climate change scenarios for the future years until 2099, based on the historical baseline period 1970–2007. Drought and rural suicide data from the Australian state of New South Wales (NSW) were analyzed for the baseline data period. Three global climate models and two representative concentration pathways were used to assess the range of potential future outcomes. Drought-related suicides increased among rural men aged 10–29 and 30–49 yrs in all modelled climate change scenarios. Rural males aged over 50 yrs and young rural females (10–29) showed no increased suicide risk, whereas decreased suicide rates were predicted for rural women of 30–49 and 50-plus years of age, suggesting resilience (according to the baseline historical relationship in those population sub-groups). No association between suicide and drought was identified in urban populations in the baseline data. Australian droughts are expected to increase in duration and intensity as climate change progresses. Hence, estimates of impacts, such as increased rural suicide rates, can inform mitigation and adaptation strategies that will help prepare communities for the effects of climate change.
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Michetti M, Adani M, Anav A, Benassi B, Dalmastri C, D'Elia I, Gualtieri M, Piersanti A, Sannino G, Uccelli R, Zanini G. From single to multivariable exposure models to translate climatic and air pollution effects into mortality risk. A customized application to the city of Rome, Italy. MethodsX 2022; 9:101717. [PMID: 35620759 PMCID: PMC9127213 DOI: 10.1016/j.mex.2022.101717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
This study presents an approach developed to derive a Delayed-Multivariate Exposure-Response Model (D-MERF) useful to assess the short-term influence of temperature on mortality, accounting also for the effect of air pollution (O3 and PM10). By using Distributed, lag non-linear models (DLNM) we explain how city-specific exposure-response functions are derived for the municipality of Rome, which is taken as an example. The steps illustrated can be replicated to other cities while the statistical model presented here can be further extended to other exposure variables. We derive the mortality relative-risk (RR) curve averaged over the period 2004–2015, which accounts for city-specific climate and pollution conditions. Key aspects of customization are as follows: This study reports the steps followed to derive a combined, multivariate exposure-response model aimed at translating climatic and air pollution effects into mortality risk. Integration of climate and air pollution parameters to derive RR values. A specific interest is devoted to the investigation of delayed effects on mortality in the presence of different exposure factors.
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Affiliation(s)
- M. Michetti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
- Corresponding author.
| | - M. Adani
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - A. Anav
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - B. Benassi
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - C. Dalmastri
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - I. D'Elia
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma, Lungotevere Thaon de Revel, 76, Rome 00196, Italy
| | - M. Gualtieri
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - A. Piersanti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - G. Sannino
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - R. Uccelli
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - G. Zanini
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
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Mortality Burden of Heatwaves in Sydney, Australia Is Exacerbated by the Urban Heat Island and Climate Change: Can Tree Cover Help Mitigate the Health Impacts? ATMOSPHERE 2022. [DOI: 10.3390/atmos13050714] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Heatwaves are associated with increased mortality and are exacerbated by the urban heat island (UHI) effect. Thus, to inform climate change mitigation and adaptation, we quantified the mortality burden of historical heatwave days in Sydney, Australia, assessed the contribution of the UHI effect and used climate change projection data to estimate future health impacts. We also assessed the potential for tree cover to mitigate against the UHI effect. Mortality (2006–2018) records were linked with census population data, weather observations (1997–2016) and climate change projections to 2100. Heatwave-attributable excess deaths were calculated based on risk estimates from a published heatwave study of Sydney. High resolution satellite observations of UHI air temperature excesses and green cover were used to determine associated effects on heat-related mortality. These data show that >90% of heatwave days would not breach heatwave thresholds in Sydney if there were no UHI effect and that numbers of heatwave days could increase fourfold under the most extreme climate change scenario. We found that tree canopy reduces urban heat, and that widespread tree planting could offset the increases in heat-attributable deaths as climate warming progresses.
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Projecting the Impacts of a Changing Climate: Tropical Cyclones and Flooding. Curr Environ Health Rep 2022; 9:244-262. [PMID: 35403997 DOI: 10.1007/s40572-022-00340-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW There is clear evidence that the earth's climate is changing, largely from anthropogenic causes. Flooding and tropical cyclones have clear impacts on human health in the United States at present, and projections of their health impacts in the future will help inform climate policy, yet to date there have been few quantitative climate health impact projections. RECENT FINDINGS Despite a wealth of studies characterizing health impacts of floods and tropical cyclones, many are better suited for qualitative, rather than quantitative, projections of climate change health impacts. However, a growing number have features that will facilitate their use in quantitative projections, features we highlight here. Further, while it can be difficult to project how exposures to flood and tropical cyclone hazards will change in the future, climate science continues to advance in its capabilities to capture changes in these exposures, including capturing regional variation. Developments in climate epidemiology and climate science are opening new possibilities in projecting the health impacts of floods and tropical cyclones under a changing climate.
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Understanding current and projected emergency department presentations and associated healthcare costs in a changing thermal climate in Adelaide, South Australia. Occup Environ Med 2022; 79:421-426. [DOI: 10.1136/oemed-2021-107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/18/2022] [Indexed: 11/03/2022]
Abstract
BackgroundExposure to extreme temperatures is associated with increased emergency department (ED) presentations. The resulting burden on health service costs and the potential impact of climate change is largely unknown. This study examines the temperature-EDs/cost relationships in Adelaide, South Australia and how this may be impacted by increasing temperatures.MethodsA time series analysis using a distributed lag nonlinear model was used to explore the exposure–response relationships. The net-attributable, cold-attributable and heat-attributable ED presentations for temperature-related diseases and costs were calculated for the baseline (2014–2017) and future periods (2034–2037 and 2054–2057) under three climate representative concentration pathways (RCPs).ResultsThe baseline heat-attributable ED presentations were estimated to be 3600 (95% empirical CI (eCI) 700 to 6500) with associated cost of $A4.7 million (95% eCI 1.8 to 7.5). Heat-attributable ED presentations and costs were projected to increase during 2030s and 2050s with no change in the cold-attributable burden. Under RCP8.5 and population growth, the increase in heat-attributable burden would be 1.9% (95% eCI 0.8% to 3.0%) for ED presentations and 2.5% (95% eCI 1.3% to 3.7%) for ED costs during 2030s. Under the same conditions, the heat effect is expected to increase by 3.7% (95% eCI 1.7% to 5.6%) for ED presentations and 5.0% (95% eCI 2.6% to 7.1%) for ED costs during 2050s.ConclusionsProjected climate change is likely to increase heat-attributable emergency presentations and the associated costs in Adelaide. Planning health service resources to meet these changes will be necessary as part of broader risk mitigation strategies and public health adaptation actions.
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Mistry MN, Schneider R, Masselot P, Royé D, Armstrong B, Kyselý J, Orru H, Sera F, Tong S, Lavigne É, Urban A, Madureira J, García-León D, Ibarreta D, Ciscar JC, Feyen L, de Schrijver E, de Sousa Zanotti Stagliorio Coelho M, Pascal M, Tobias A, Guo Y, Vicedo-Cabrera AM, Gasparrini A. Comparison of weather station and climate reanalysis data for modelling temperature-related mortality. Sci Rep 2022; 12:5178. [PMID: 35338191 PMCID: PMC8956721 DOI: 10.1038/s41598-022-09049-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/15/2022] [Indexed: 11/15/2022] Open
Abstract
Epidemiological analyses of health risks associated with non-optimal temperature are traditionally based on ground observations from weather stations that offer limited spatial and temporal coverage. Climate reanalysis represents an alternative option that provide complete spatio-temporal exposure coverage, and yet are to be systematically explored for their suitability in assessing temperature-related health risks at a global scale. Here we provide the first comprehensive analysis over multiple regions to assess the suitability of the most recent generation of reanalysis datasets for health impact assessments and evaluate their comparative performance against traditional station-based data. Our findings show that reanalysis temperature from the last ERA5 products generally compare well to station observations, with similar non-optimal temperature-related risk estimates. However, the analysis offers some indication of lower performance in tropical regions, with a likely underestimation of heat-related excess mortality. Reanalysis data represent a valid alternative source of exposure variables in epidemiological analyses of temperature-related risk.
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Affiliation(s)
- Malcolm N Mistry
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK. .,Department of Economics, Ca' Foscari University of Venice, Venice, Italy.
| | - Rochelle Schneider
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.,The Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.,Forecast Department, European Centre for Medium-Range Weather Forecast (ECMWF), Reading, UK.,Ф-Lab, European Space Agency (ESA-ESRIN), Frascati, Italy
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Dominic Royé
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.,The Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jan Kyselý
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic.,Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.,Department of Statistics, Computer Science and Applications 'G. Parenti', University of Florence, Florence, Italy
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Éric Lavigne
- Air Health Science Division, Health Canada, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Aleš Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic.,Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal.,EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - David García-León
- The Joint Research Center (JRC), European Commission, Seville, Spain
| | - Dolores Ibarreta
- The Joint Research Center (JRC), European Commission, Seville, Spain
| | | | - Luc Feyen
- The Joint Research Center (JRC), European Commission, Ispra, Italy
| | - Evan de Schrijver
- Graduate School of Health Science, University of Bern, Bern, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | | | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK. .,The Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK. .,Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK.
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de Schrijver E, Bundo M, Ragettli MS, Sera F, Gasparrini A, Franco OH, Vicedo-Cabrera AM. Nationwide Analysis of the Heat- and Cold-Related Mortality Trends in Switzerland between 1969 and 2017: The Role of Population Aging. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:37001. [PMID: 35262415 PMCID: PMC8906252 DOI: 10.1289/ehp9835] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Because older adults are particularly vulnerable to nonoptimal temperatures, it is expected that the progressive population aging will amplify the health burden attributable to heat and cold due to climate change in future decades. However, limited evidence exists on the contribution of population aging on historical temperature-mortality trends. OBJECTIVES We aimed to a) assess trends in heat- and cold-related mortality in Switzerland between 1969 and 2017 and b) to quantify the contribution of population aging to the observed patterns. METHODS We collected daily time series of all-cause mortality by age group (<65, 65-79, and 80 y and older) and mean temperature for each Swiss municipality (1969-2017). We performed a two-stage time-series analysis with distributed lag nonlinear models and multivariate longitudinal meta-regression to obtain temperature-mortality associations by canton, decade, and age group. We then calculated the corresponding excess mortality attributable to nonoptimal temperatures and compared it to the estimates obtained in a hypothetical scenario of no population aging. RESULTS Between 1969 and 2017, heat- and cold-related mortality represented 0.28% [95% confidence interval (CI): 0.18, 0.37] and 8.91% (95% CI: 7.46, 10.21) of total mortality, which corresponded to 2.4 and 77 deaths per 100,000 people annually, respectively. Although mortality rates for heat slightly increased over time, annual number of deaths substantially raised up from 74 (12;125) to 181 (39;307) between 1969-78 and 2009-17, mostly driven by the ≥80-y-old age group. Cold-related mortality rates decreased across all ages, but annual cold-related deaths still increased among the ≥80, due to the increase in the population at risk. We estimated that heat- and cold-related deaths would have been 52.7% and 44.6% lower, respectively, in the most recent decade in the absence of population aging. DISCUSSION Our findings suggest that a substantial proportion of historical temperature-related impacts can be attributed to population aging. We found that population aging has attenuated the decrease in cold-related mortality and amplified heat-related mortality. https://doi.org/10.1289/EHP9835.
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Affiliation(s)
- Evan de Schrijver
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Graduate school of Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Marvin Bundo
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Graduate school of Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Martina S. Ragettli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Francesco Sera
- Department of Statistics, Informatics, Applications, University of Florence, Florence, Italy
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Ana M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
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42
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Lo YTE, Mitchell DM, Thompson R, O’Connell E, Gasparrini A. Estimating heat-related mortality in near real time for national heatwave plans. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2022; 17:024017-24017. [PMID: 35341022 PMCID: PMC7612535 DOI: 10.1088/1748-9326/ac4cf4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Heatwaves are a serious threat to human life. Public health agencies that are responsible for delivering heat-health action plans need to assess and reduce the mortality impacts of heat. Statistical models developed in epidemiology have previously been used to attribute past observed deaths to high temperatures and project future heat-related deaths. Here, we investigate the novel use of summer temperature-mortality associations established by these models for monitoring heat-related deaths in regions in England in near real time. For four summers in the period 2011-2020, we find that coupling these associations with observed daily mean temperatures results in England-wide heatwave mortality estimates that are consistent with the excess deaths estimated by UK Health Security Agency. However, our results for 2013, 2018 and 2020 highlight that the lagged effects of heat and characteristics of individual summers contribute to disagreement between the two methods. We suggest that our method can be used for heatwave mortality monitoring in England because it has the advantages of including lagged effects and controlling for other risk factors. It could also be employed by health agencies elsewhere for reliably estimating the health burden of heat in near real time and near-term forecasts.
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Affiliation(s)
- Y T Eunice Lo
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Cabot Institute for the Environment, University of Bristol, Bristol, United Kingdom
- Author to whom any correspondence should be addressed.
| | - Dann M Mitchell
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Cabot Institute for the Environment, University of Bristol, Bristol, United Kingdom
| | - Ross Thompson
- Extreme Events and Health Protection Team, UK Health Security Agency, London, United Kingdom
| | - Emer O’Connell
- Extreme Events and Health Protection Team, UK Health Security Agency, London, United Kingdom
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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43
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Gong J, Part C, Hajat S. Current and future burdens of heat-related dementia hospital admissions in England. ENVIRONMENT INTERNATIONAL 2022; 159:107027. [PMID: 34890899 PMCID: PMC8739554 DOI: 10.1016/j.envint.2021.107027] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/15/2021] [Accepted: 12/03/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The impacts of a changing climate on current and future dementia burdens have not been widely explored. METHODS Time-series negative binomial regression analysis was used to assess acute associations between daily ambient temperature and counts of emergency admissions for dementia in each Government region of England, adjusting for season and day-of-week. Using the latest climate and dementia projections data, we then estimate future heat-related dementia burdens under a high emission scenario (Representative Concentration Pathway (RCP8.5), where global greenhouse gas (GHG) emissions continue to rise, and a low emissions scenario (RCP2.6), where GHG emissions are sizeably reduced under a strong global mitigation policy. RESULTS A raised risk associated with high temperatures was observed in all regions. Nationally, a 4.5% (95% Confidence interval (CI) 2.9%-6.1%) increase in risk of dementia admission was observed for every 1 °C increase in temperature above 17 °C associated with current climate. Under a high emissions scenario, heat-related admissions are projected to increase by almost 300% by 2040 compared to baseline levels. CONCLUSIONS People living with dementia should be considered a high-risk group during hot weather. Our results support arguments for more stringent climate change mitigation policies.
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Affiliation(s)
- Jessica Gong
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Cherie Part
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
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44
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The impact of heat on kidney stone presentations in South Carolina under two climate change scenarios. Sci Rep 2022; 12:369. [PMID: 35013464 PMCID: PMC8748744 DOI: 10.1038/s41598-021-04251-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/13/2021] [Indexed: 11/09/2022] Open
Abstract
The risk of kidney stone presentations increases after hot days, likely due to greater insensible water losses resulting in more concentrated urine and altered urinary flow. It is thus expected that higher temperatures from climate change will increase the global prevalence of kidney stones if no adaptation measures are put in place. This study aims to quantify the impact of heat on kidney stone presentations through 2089, using South Carolina as a model state. We used a time series analysis of historical kidney stone presentations (1997–2014) and distributed lag non-linear models to estimate the temperature dependence of kidney stone presentations, and then quantified the projected impact of climate change on future heat-related kidney stone presentations using daily projections of wet-bulb temperatures to 2089, assuming no adaptation or demographic changes. Two climate change models were considered—one assuming aggressive reduction in greenhouse gas emissions (RCP 4.5) and one representing uninibited greenhouse gas emissions (RCP 8.5). The estimated total statewide kidney stone presentations attributable to heat are projected to increase by 2.2% in RCP 4.5 and 3.9% in RCP 8.5 by 2085–89 (vs. 2010–2014), with an associated total excess cost of ~ $57 million and ~ $99 million, respectively.
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45
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Scripcă AS, Acquaotta F, Croitoru AE, Fratianni S. The impact of extreme temperatures on human mortality in the most populated cities of Romania. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:189-199. [PMID: 34739588 DOI: 10.1007/s00484-021-02206-w] [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: 04/21/2020] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
The impact of extreme weather conditions on humans is one of the most important topics in biometeorology studies. The main objective of this study is to analyze the relationship between temperature-related weather conditions and natural mortality in the five most populated cities of Romania, namely, Bucharest, Cluj-Napoca, Constanța, Iași, and Timișoara. The results of this study aim to bridge a gap in national research. In the present paper, we used daily natural mortality data and daily minimum and maximum air temperatures. The distributed lag nonlinear model (DLNM) allowed us to identify weather conditions associated with natural mortality. The most important results are as follows: (i) a higher daily mortality is related to a high frequency of heat stress conditions; (ii) a higher maximum temperature increases the relative risk (RR) of natural mortality; (iii) the maximum number of fatalities is recorded on the first day of high-temperature events; and (iv) individuals much more easily adapt to cold stress conditions. The main conclusion in this study is that the inhabitants of the most populated cities in Romania are more sensitive to high-temperature stress than to low-temperature stress.
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Affiliation(s)
- Andreea-Sabina Scripcă
- Doctoral School of Geography, Babeș-Bolyai University, 5-7, Clinicilor Street, 400006, Cluj-Napoca, Romania
| | - Fiorella Acquaotta
- Department of Earth Sciences, University of Turin, Via Valperga Caluso 35, 10125, Turin, Italy
- Centro Interdipartimentale Sui Rischi Naturali in Ambiente Montano E Collinare, NatRisk University of Turin, Turin, Italy
| | - Adina-Eliza Croitoru
- Department of Physical and Technical Geography, Babeș-Bolyai University, 5-7, Clinicilor Street, 400006, Cluj-Napoca, Romania.
- Research Centre for Sustainable Development, Babeș-Bolyai University, 5-7, Clinicilor Street, 400006, Cluj-Napoca, Romania.
| | - Simona Fratianni
- Department of Earth Sciences, University of Turin, Via Valperga Caluso 35, 10125, Turin, Italy
- Centro Interdipartimentale Sui Rischi Naturali in Ambiente Montano E Collinare, NatRisk University of Turin, Turin, Italy
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46
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Integrating Climate Change in the Curriculum: Using Instructional Design Methods to Create an Educational Innovation for Nurse Practitioners in a Doctor of Nursing Practice Program. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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47
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Onozuka D, Tanoue Y, Nomura S, Kawashima T, Yoneoka D, Eguchi A, Ng CFS, Matsuura K, Shi S, Makiyama K, Uryu S, Kawamura Y, Takayanagi S, Gilmour S, Hayashi TI, Miyata H, Sera F, Sunagawa T, Takahashi T, Tsuchihashi Y, Kobayashi Y, Arima Y, Kanou K, Suzuki M, Hashizume M. Reduced mortality during the COVID-19 outbreak in Japan, 2020: a two-stage interrupted time-series design. Int J Epidemiol 2021; 51:75-84. [PMID: 34718594 PMCID: PMC8856001 DOI: 10.1093/ije/dyab216] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) continues to be a major global health burden. This study aims to estimate the all-cause excess mortality occurring in the COVID-19 outbreak in Japan, 2020, by sex and age group. Methods Daily time series of mortality for the period January 2015–December 2020 in all 47 prefectures of Japan were obtained from the Ministry of Health, Labour and Welfare, Japan. A two-stage interrupted time-series design was used to calculate excess mortality. In the first stage, we estimated excess mortality by prefecture using quasi-Poisson regression models in combination with distributed lag non-linear models, adjusting for seasonal and long-term variations, weather conditions and influenza activity. In the second stage, we used a random-effects multivariate meta-analysis to synthesize prefecture-specific estimates at the nationwide level. Results In 2020, we estimated an all-cause excess mortality of −20 982 deaths [95% empirical confidence intervals (eCI): −38 367 to −5472] in Japan, which corresponded to a percentage excess of −1.7% (95% eCI: −3.1 to −0.5) relative to the expected value. Reduced deaths were observed for both sexes and in all age groups except those aged <60 and 70–79 years. Conclusions All-cause mortality during the COVID-19 outbreak in Japan in 2020 was decreased compared with a historical baseline. Further evaluation of cause-specific excess mortality is warranted.
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Affiliation(s)
- Daisuke Onozuka
- Department of Medical Informatics and Clinical Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuta Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan.,Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takayuki Kawashima
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Daisuke Yoneoka
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Akifumi Eguchi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Kentaro Matsuura
- Department of Management Science, Graduate School of Engineering, Tokyo University of Science, Tokyo, Japan.,HOXO-M Inc., Tokyo, Japan
| | - Shoi Shi
- Department of Systems Pharmacology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Laboratory for Synthetic Biology, RIKEN Center for Biosystems Dynamics Research, Osaka, Japan
| | | | - Shinya Uryu
- Center for Environmental Biology and Ecosystem Studies, National Institute for Environmental Studies (NIES), Tokyo, Japan
| | - Yumi Kawamura
- RIKEN Center for Sustainable Resource Science, Saitama, Japan
| | | | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Takehiko I Hayashi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaraki, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications 'G. Parenti', University of Florence, Florence, Italy
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Takuri Takahashi
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuuki Tsuchihashi
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Yusuke Kobayashi
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuzo Arima
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuhiko Kanou
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoi Suzuki
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Martínez-Solanas È, Quijal-Zamorano M, Achebak H, Petrova D, Robine JM, Herrmann FR, Rodó X, Ballester J. Projections of temperature-attributable mortality in Europe: a time series analysis of 147 contiguous regions in 16 countries. Lancet Planet Health 2021; 5:e446-e454. [PMID: 34245715 DOI: 10.1016/s2542-5196(21)00150-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/14/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Europe has emerged as a major climate change hotspot, both in terms of an increase in seasonal averages and climate extremes. Projections of temperature-attributable mortality, however, have not been comprehensively reported for an extensive part of the continent. Therefore, we aim to estimate the future effect of climate change on temperature-attributable mortality across Europe. METHODS We did a time series analysis study. We derived temperature-mortality associations by collecting daily temperature and all-cause mortality records of both urban and rural areas for the observational period between 1998 and 2012 from 147 regions in 16 European countries. We estimated the location-specific temperature-mortality relationships by using standard time series quasi-Poisson regression in conjunction with a distributed lag non-linear model. These associations were used to transform the daily temperature simulations from the climate models in the historical period (1971-2005) and scenario period (2006-2099) into projections of temperature-attributable mortality. We combined the resulting risk functions with daily time series of future temperatures simulated by four climate models (ie, GFDL-ESM2M, HadGEM2-ES, IPSL-CM5A-LR, and MIROC5) under three greenhouse gas emission scenarios (ie, Representative Concentration Pathway [RCP]2.6, RCP6.0, and RCP8.5), providing projections of future mortality attributable fraction due to moderate and extreme cold and heat temperatures. FINDINGS Overall, 7·17% (95% CI 5·81-8·50) of deaths registered in the observational period were attributed to non-optimal temperatures, cold being more harmful than heat by a factor of ten (6·51% [95% CI 5·14-7·80] vs 0·65% [0·40-0·89]), and with large regional differences across countries-eg, ranging from 4·85% (95% CI 3·75-6·00) in Germany to 9·87% (8·53-11·19) in Italy. The projection of temperature anomalies by RCP scenario depicts a progressive increase in temperatures, more exacerbated in the high-emission scenario RCP8.5 (4·54°C by 2070-2099) than in RCP6.0 (2·89°C) and RCP2.6 (1·67°C). This increase in temperatures was transformed into attributable fraction. Projections consistently indicated that the increase in heat attributable fraction will start to exceed the reduction of cold attributable fraction in the second half of the 21st century, especially in the Mediterranean and in the higher emission scenarios. The comparison between scenarios highlighted the important role of mitigation, given that the total attributable fraction will only remain stable in RCP2.6, whereas the total attributable fraction will rapidly start to increase in RCP6.0 by the end of the century and in RCP8.5 already by the middle of the century. INTERPRETATION The increase in heat attributable fraction will start to exceed the reduction of cold attributable fraction in the second half of the 21st century. This finding highlights the importance of implementing mitigation policies. These measures would be especially beneficial in the Mediterranean, where the high vulnerability to heat will lead to an imbalance between the decreasing cold and increasing heat-attributable mortality. FUNDING None.
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Affiliation(s)
| | | | - Hicham Achebak
- ISGlobal, Barcelona, Spain; Centre for Demographic Studies, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
| | | | - Jean-Marie Robine
- Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France; École Pratique des Hautes Études, Paris, France
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland
| | - Xavier Rodó
- ISGlobal, Barcelona, Spain; ICREA, Barcelona, Spain
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49
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Increasing impacts of temperature on hospital admissions, length of stay, and related healthcare costs in the context of climate change in Adelaide, South Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145656. [PMID: 33592481 DOI: 10.1016/j.scitotenv.2021.145656] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND A growing number of studies have investigated the effect of increasing temperatures on morbidity and health service use. However, there is a lack of studies investigating the temperature-attributable cost burden. OBJECTIVES This study examines the relationship of daily mean temperature with hospital admissions, length of hospital stay (LoS), and costs; and estimates the baseline temperature-attributable hospital admissions, and costs and in relation to warmer climate scenarios in Adelaide, South Australia. METHOD A daily time series analysis using distributed lag non-linear models (DLNM) was used to explore exposure-response relationships and to estimate the aggregated burden of hospital admissions for conditions associated with temperatures (i.e. renal diseases, mental health, diabetes, ischaemic heart diseases and heat-related illnesses) as well as the associated LoS and costs, for the baseline period (2010-2015) and different future climate scenarios in Adelaide, South Australia. RESULTS During the six-year baseline period, the overall temperature-attributable hospital admissions, LoS, and associated costs were estimated to be 3915 cases (95% empirical confidence interval (eCI): 235, 7295), 99,766 days (95% eCI: 14,484, 168,457), and AU$159 million (95% eCI: 18.8, 269.0), respectively. A climate scenario consistent with RCP8.5 emissions, and including projected demographic change, is estimated to lead to increases in heat-attributable hospital admissions, LoS, and costs of 2.2% (95% eCI: 0.5, 3.9), 8.4% (95% eCI: 1.1, 14.3), and 7.7% (95% eCI: 0.3, 13.3), respectively by mid-century. CONCLUSIONS There is already a substantial temperature-attributable impact on hospital admissions, LoS, and costs which are estimated to increase due to climate change and an increasing aged population. Unless effective climate and public health interventions are put into action, the costs of treating temperature-related admissions will be high.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia; College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Keith Dear
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Alana Hansen
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Monika Nitschke
- South Australian Department of Health and Wellbeing, Adelaide, South Australia, Australia.
| | - John Nairn
- Australian Bureau of Meteorology, South Australia, Australia.
| | - Ben Scalley
- Metropolitan Communicable Disease Control, Department of Health WA, Perth, Western Australia, Australia.
| | - Alex Xiao
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Michael Tong
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
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50
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Impact of ambient temperature on ovarian reserve. Fertil Steril 2021; 116:1052-1060. [PMID: 34116830 DOI: 10.1016/j.fertnstert.2021.05.091] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the association between ambient temperature and antral follicle count (AFC), a standard measure of ovarian reserve. DESIGN Prospective cohort study. SETTING Fertility center at an academic hospital in the northeastern United States. PATIENT(S) 631 women attending the Massachusetts General Hospital Fertility Center (2005-2015) who participated in the Environment and Reproductive Health Study. INTERVENTION(S) Daily temperature at the women's residential address was estimated for the 90 days before their antral follicle scan using a spatially refined gridded climate data set. We evaluated the associations between temperature and AFC using Poisson regression with robust standard errors, adjusting for relative humidity, fine particulate matter exposure, age, education, smoking status, year and month of AFC, and diagnosis of diminished ovarian reserve and ovulation disorders. MAIN OUTCOME MEASURE(S) Antral follicle count as measured with transvaginal ultrasonography. RESULT(S) A 1°C increase in average maximum temperature during the 90 days before ovarian reserve testing was associated with a -1.6% (95% confidence interval [CI], -2.8, -0.4) lower AFC. Associations remained negative, but were attenuated, for average maximum temperature exposure in the 30 days (-0.9%, 95% CI, -1.8, 0.1) and 14 days (-0.8%, 95% CI, -1.6, 0.0) before AFC. The negative association between average maximum temperature and AFC was stronger in November through June than during the summer months, suggesting that timing of heat exposure and acclimatization to heat may be important factors to consider in future research. CONCLUSION(S) Exposure to higher temperatures was associated with lower ovarian reserve. These results raise concern that rising ambient temperatures worldwide may result in accelerated reproductive aging among women.
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