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Ioannou LG, Tsoutsoubi L, Mantzios K, Ciuha U, Kenny GP, Nybo L, Flouris AD, Mekjavic IB. Impact of a simulated multiday heatwave on nocturnal physiology, behavior, and sleep: a 10-day confinement study. Appl Physiol Nutr Metab 2024; 49:1394-1408. [PMID: 38917483 DOI: 10.1139/apnm-2024-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
This study investigated the impact of a multiday heatwave on nocturnal physiology, behavior, and sleep under controlled conditions with comprehensive monitoring of environmental factors and participant activities. Seven young healthy males were confined for 10 days in controlled conditions that ranged between hot-to-warm (day: 35.4 °C, night: 26.3 °C) during nights 4-6 and temperate (day: 25.4 °C, night: 22.3 °C) before (nights 1-3) and after (nights 7-10) the heatwave. Measurements included core and skin temperatures, heart rate, sympathovagal balance, vasomotion indicators, urine samples, blanket coverage, subjective sleep assessments, and partial polysomnography. The average nocturnal core temperature was 0.2 °C higher during and after the heatwave compared to the pre-heatwave period, with this difference being more pronounced (+0.3 °C) in the first 2 h of sleep (p < 0.001). For every 0.1 °C rise in overnight core temperature, the total sleep time decreased by 14 min (pseudo-R2 = 0.26, p = 0.01). The elevated core temperatures occurred despite the participants exhibiting evident thermoregulatory behavior, as they covered 30% less body surface during the heatwave compared to pre- and post-heatwave periods (p < 0.001). During the heatwave, mean skin temperature at bedtime was 1.3 °C higher than pre-heatwave and 0.8 °C higher than post-heatwave periods (p < 0.001). No differences in other responses, including heart rate and vasomotion indicators, were observed. The paper details a 20-min sleepwalking episode that was coupled with marked changes in sleepwalker's thermophysiological responses. In conclusion, the simulated heatwave resulted in higher overnight core temperature which was associated with reduced total sleep time. Behavioral thermoregulation during sleep may serve as a defense against these effects, though more research is needed.
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Affiliation(s)
- Leonidas G Ioannou
- Department of Automatics, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Lydia Tsoutsoubi
- Department of Automatics, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Konstantinos Mantzios
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Ursa Ciuha
- Department of Automatics, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Andreas D Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Igor B Mekjavic
- Department of Automatics, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
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Braneon C, Ortiz L, Bader D, Devineni N, Orton P, Rosenzweig B, McPhearson T, Smalls-Mantey L, Gornitz V, Mayo T, Kadam S, Sheerazi H, Glenn E, Yoon L, Derras-Chouk A, Towers J, Leichenko R, Balk D, Marcotullio P, Horton R. NPCC4: New York City climate risk information 2022-observations and projections. Ann N Y Acad Sci 2024; 1539:13-48. [PMID: 38826131 DOI: 10.1111/nyas.15116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
New York City (NYC) faces many challenges in the coming decades due to climate change and its interactions with social vulnerabilities and uneven urban development patterns and processes. This New York City Panel on Climate Change (NPCC) report contributes to the Panel's mandate to advise the city on climate change and provide timely climate risk information that can inform flexible and equitable adaptation pathways that enhance resilience to climate change. This report presents up-to-date scientific information as well as updated sea level rise projections of record. We also present a new methodology related to climate extremes and describe new methods for developing the next generation of climate projections for the New York metropolitan region. Future work by the Panel should compare the temperature and precipitation projections presented in this report with a subset of models to determine the potential impact and relevance of the "hot model" problem. NPCC4 expects to establish new projections-of-record for precipitation and temperature in 2024 based on this comparison and additional analysis. Nevertheless, the temperature and precipitation projections presented in this report may be useful for NYC stakeholders in the interim as they rely on the newest generation of global climate models.
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Affiliation(s)
- Christian Braneon
- CUNY Institute for Demographic Research (CIDR), City University of New York, New York, New York, USA
- Carbon Direct, New York, New York, USA
- Columbia Climate School, Columbia University, New York, New York, USA
| | - Luis Ortiz
- Department of Atmospheric, Oceanic, and Earth Sciences, George Mason University, Fairfax Country, Virginia, USA
| | - Daniel Bader
- Center for Climate Systems Research, Columbia University, New York, New York, USA
- NASA Goddard Institute for Space Studies, New York, New York, USA
| | - Naresh Devineni
- Department of Civil Engineering and CUNY CREST Institute, The City College of New York, New York, New York, USA
| | - Philip Orton
- Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Bernice Rosenzweig
- Department of Environmental Science, Sarah Lawrence College, Bronxville, New York, USA
| | - Timon McPhearson
- Urban Systems Lab, The New School, New York, New York, USA
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | | | - Vivien Gornitz
- NASA Goddard Institute for Space Studies, New York, New York, USA
| | - Talea Mayo
- Department of Mathematics, Emory University, Atlanta, Georgia, USA
| | - Sanketa Kadam
- Columbia Climate School, Columbia University, New York, New York, USA
| | - Hadia Sheerazi
- RMI (founded as the Rocky Mountain Institute), New York, New York, USA
| | - Equisha Glenn
- Metropolitan Transportation Authority, New York, New York, USA
| | - Liv Yoon
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Amel Derras-Chouk
- Department of Earth and Atmospheric Sciences, The City College of New York, New York, New York, USA
| | - Joel Towers
- Parsons School of Design, The New School, New York, New York, USA
| | - Robin Leichenko
- Department of Geography and Rutgers Climate Institute, Rutgers University, New Brunswick, New Jersey, USA
| | - Deborah Balk
- CUNY Institute for Demographic Research (CIDR), City University of New York, New York, New York, USA
- Marxe School of Public and International Affairs, Baruch College, New York, New York, USA
| | - Peter Marcotullio
- Department of Geography and Environmental Science, Hunter College, CUNY, New York, New York, USA
| | - Radley Horton
- Columbia Climate School, Columbia University, New York, New York, USA
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York, USA
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Weitz CA. Coping with extreme heat: current exposure and implications for the future. Evol Med Public Health 2024; 12:eoae015. [PMID: 39359409 PMCID: PMC11445678 DOI: 10.1093/emph/eoae015] [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: 01/20/2024] [Accepted: 07/02/2024] [Indexed: 10/04/2024] Open
Abstract
A preview of how effective behavioral, biological and technological responses might be in the future, when outdoor conditions will be at least 2°C hotter than current levels, is available today from studies of individuals already living in extreme heat. In areas where high temperatures are common-particularly those in the hot and humid tropics-several studies report that indoor temperatures in low-income housing can be significantly hotter than those outdoors. A case study indicates that daily indoor heat indexes in almost all the 123 slum dwellings monitored in Kolkata during the summer were above 41°C (106°F) for at least an hour. Economic constraints make it unlikely that technological fixes, such as air conditioners, will remedy conditions like these-now or in the future. People without access to air conditioning will have to rely on behavioral adjustments and/or biological/physiological acclimatization. One important unknown is whether individuals who have lived their entire lives in hot environments without air conditioning possess natural levels of acclimatization greater than those indicated by controlled laboratory studies. Answering questions about the future will require more studies of heat conditions experienced by individuals, more information on indoor versus outdoor heat conditions, and a greater understanding of the behavioral and biological adjustments made by people living today in extremely hot conditions.
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Affiliation(s)
- Charles A Weitz
- Department of Anthropology, Temple University, Philadelphia, PA 19122, USA
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Tupinier Martin F, Boudreault J, Campagna C, Lavigne É, Gamache P, Tandonnet M, Généreux M, Trottier S, Goupil-Sormany I. The relationship between hot temperatures and hospital admissions for psychosis in adults diagnosed with schizophrenia: A case-crossover study in Quebec, Canada. ENVIRONMENTAL RESEARCH 2024; 246:118225. [PMID: 38253191 DOI: 10.1016/j.envres.2024.118225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Some studies have found hot temperatures to be associated with exacerbations of schizophrenia, namely psychoses. As climate changes faster in Northern countries, our understanding of the association between temperature and hospital admissions (HA) for psychosis needs to be deepened. OBJECTIVES 1) Among adults diagnosed with schizophrenia, measure the relationship between mean temperatures and HAs for psychosis during summer. 2) Determine the influence of individual and ecological characteristics on this relationship. METHODS A cohort of adults diagnosed with schizophrenia (n = 30,649) was assembled using Quebec's Integrated Chronic Disease Surveillance System (QICDSS). The follow-up spanned summers from 2001 to 2019, using hospital data from the QICDSS and meteorological data from the National Aeronautics and Space Administration's (NASA) Daymet database. In four geographic regions of the province of Quebec, a conditional logistic regression was used for the case-crossover analysis of the relationship between mean temperatures (at lags up to 6 days) and HAs for psychosis using a distributed lag non-linear model (DLNM). The analyses were adjusted for relative humidity, stratified according to individual (age, sex, and comorbidities) and ecological (material and social deprivation index and exposure to green space) factors, and then pooled through a meta-regression. RESULTS The statistical analyses revealed a statistically significant increase in HAs three days (lag 3) after elevated mean temperatures corresponding to the 90th percentile relative to a minimum morbidity temperature (MMT) (OR 1.040; 95% CI 1.008-1.074), while the cumulative effect over six days was not statistically significant (OR 1.052; 95% IC 0.993-1.114). Stratified analyses revealed non statistically significant gradients of increasing HAs relative to increasing material deprivation and decreasing green space levels. CONCLUSIONS The statistical analyses conducted in this project showed the pattern of admissions for psychosis after hot days. This finding could be useful to better plan health services in a rapidly changing climate.
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Affiliation(s)
- Frédéric Tupinier Martin
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City (Quebec), Canada; Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Jérémie Boudreault
- Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Water Earth and Environment Research Center, National institute of scientific research (INRS), Quebec City (Quebec), Canada.
| | - Céline Campagna
- Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Water Earth and Environment Research Center, National institute of scientific research (INRS), Quebec City (Quebec), Canada.
| | - Éric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa (Ontario), Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa (Ontario), Canada.
| | - Philippe Gamache
- Bureau d'information et d'études en santé des populations (BIESP), Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Matthieu Tandonnet
- Bureau d'information et d'études en santé des populations (BIESP), Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Mélissa Généreux
- Department of Community health sciences, Faculty of medicine and health sciences, Sherbrooke University, Sherbrooke (Quebec), Canada; Estrie's Public Health Department, Sherbrooke (Quebec), Canada.
| | - Simon Trottier
- Service des bibliothèques et archives, Université de Sherbrooke, Sherbrooke (Quebec), Canada.
| | - Isabelle Goupil-Sormany
- Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Laval University, Quebec City (Quebec), Canada.
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Uejio CK, Joiner AP, Gonsoroski E, Tamerius JD, Jung J, Moran TP, Yancey AH. The association of indoor heat exposure with diabetes and respiratory 9-1-1 calls through emergency medical dispatch and services documentation. ENVIRONMENTAL RESEARCH 2022; 212:113271. [PMID: 35427590 DOI: 10.1016/j.envres.2022.113271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND People with pre-existing medical conditions, who spend a large proportion of their time indoors, are at risk of emergent morbidities from elevated indoor heat exposures. In this study, indoor heat of structures wherein exposed people received Grady Emergency Services based care in Atlanta, GA, U.S., was measured from May to September 2016. METHOD ology: In this case-control study, analyses were conducted to investigate the effect of indoor heat on the odds of 9-1-1 calls for diabetic (n = 90 cases) and separately, for respiratory (n = 126 cases), conditions versus heat-insensitive emergencies (n = 698 controls). Generalized Additive Models considered both linear and non-linear indoor heat and health outcome associations using thin-plate regression splines. RESULTS Hotter and more humid indoor conditions were non-linearly associated with an increasing likelihood of receiving emergency care for complications of diabetes and severe respiratory distress. Higher heat indices were associated with increased odds of a diabetes (odds ratio for change from 30 to 31 °C: 1.12, 95% CI: 1.08-1.16) or respiratory 9-1-1 medical call versus control (odds ratio for change from 34 to 35 °C: 1.18, 95% CI: 1.09-1.28) call. Both diabetic and respiratory distress patients were more likely to be African-American and/or have comorbidities. CONCLUSIONS In this study, the statistical association of indoor heat exposure with emergency morbidities (diabetic, respiratory) was demonstrated. The study also showcased the value and utility of data gathered by emergency medical dispatch and services from inaccessible private indoor sources (i.e., domiciles) for environmental health.
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Affiliation(s)
- Christopher K Uejio
- Florida State University, Department of Geography, Bellamy Building, Room 323, 113 Collegiate Loop, PO Box 3062190, Tallahassee, FL, 32306, USA.
| | - Anjni Patel Joiner
- Duke University, Department of Surgery, Division of Emergency Medicine. 2301 Erwin Road, Duke Hospital North, Box 3096, Durham, NC, 27710, USA.
| | - Elaina Gonsoroski
- Florida State University, Department of Geography, Bellamy Building, Room 323, 113 Collegiate Loop, PO Box 3062190, Tallahassee, FL, 32306, USA.
| | - James D Tamerius
- Center of Sustainable Energy, 3980 Sherman St #170, San Diego, CA, 92110, USA.
| | - Jihoon Jung
- University of North Carolina at Chapel Hill, Department of City and Regional Planning, New East Building, CB3140, Chapel Hill, NC, 27599, USA.
| | - Tim P Moran
- Emory University, Department of Emergency Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.
| | - Arthur H Yancey
- Emory University, Department of Emergency Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.
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Teyton A, Tremblay M, Tardif I, Lemieux MA, Nour K, Benmarhnia T. A Longitudinal Study on the Impact of Indoor Temperature on Heat-Related Symptoms in Older Adults Living in Non-Air-Conditioned Households. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:77003. [PMID: 35857398 PMCID: PMC9282277 DOI: 10.1289/ehp10291] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 05/08/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Both chronic and acute heat result in a substantial health burden globally, causing particular concern for at-risk populations, such as older adults. Outdoor temperatures are often assessed as the exposure and are used for heat warning systems despite individuals spending most of their time indoors. Many studies use ecological designs, with death or hospitalizations rates. Individual-level outcomes that are directly related to heat-symptoms should also be considered to refine prevention efforts. OBJECTIVES In this longitudinal study, we assessed the association between indoor temperature and proximal symptoms in individuals ≥60 years of age living in non-air-conditioned households in Montérégie, Quebec, during the 2017-2018 summer months. METHODS We gathered continuously measured indoor temperature and humidity from HOBO sensors and repeated health-related questionnaires about health-related symptoms administered across three periods of increasing outdoor temperatures, where the reference measurement (T1) occurred during a cool period with a target temperature of 18-22°C and two measurements (T2 and T3) occurred during warmer periods with target temperatures of 28-30°C and 30-33°C, respectively. We used generalized estimating equations with Poisson regression models and estimated risk ratios (RRs) between temperature, humidity, and each heat-related symptom. RESULTS Participants (n=277) had an average age (mean±standard deviation) of 72.8±7.02y. Higher indoor temperatures were associated with increased risk of dry mouth (T3 RR=2.5; 95% CI: 1.8, 3.5), fatigue (RR=2.3; 95% CI: 1.8, 3.0), thirst (RR=3.4; 95% CI: 2.5, 4.5), less frequent urination (RR=3.7; 95% CI: 1.8, 7.3), and trouble sleeping (RR=2.2; 95% CI: 1.6, 3.2) compared with T1. We identified a nonlinear relationship with indoor temperatures across most symptoms of interest. DISCUSSION This study identified that increasing indoor temperatures were associated with various health symptoms. By considering the prevalence of these early stage outcomes and indoor temperature exposures, adaptation strategies may be improved to minimize the burden of heat among vulnerable communities. https://doi.org/10.1289/EHP10291.
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Affiliation(s)
- Anaïs Teyton
- Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, California, USA
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California, USA
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Mathieu Tremblay
- Public Health Department, Centre intégré de santé et de services sociaux de la Montérégie-Centre, Longueuil, Québec, Canada
| | - Isabelle Tardif
- Public Health Department, Centre intégré de santé et de services sociaux de la Montérégie-Centre, Longueuil, Québec, Canada
| | - Marc-André Lemieux
- Public Health Department, Centre intégré de santé et de services sociaux de la Montérégie-Centre, Longueuil, Québec, Canada
| | - Kareen Nour
- Public Health Department, Centre intégré de santé et de services sociaux de la Montérégie-Centre, Longueuil, Québec, Canada
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, California, USA
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California, USA
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Schmidt MD, Notley SR, Meade RD, Akerman AP, Rutherford MM, Kenny GP. Revisiting regional variation in the age-related reduction in sweat rate during passive heat stress. Physiol Rep 2022; 10:e15250. [PMID: 35411704 PMCID: PMC9001962 DOI: 10.14814/phy2.15250] [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: 03/11/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023] Open
Abstract
Aging is associated with attenuated sweat gland function, which has been suggested to occur in a peripheral-to-central manner. However, evidence supporting this hypothesis remains equivocal. We revisited this hypothesis by evaluating the sweat rate across the limbs and trunk in young and older men during whole-body, passive heating. A water-perfused suit was used to raise and clamp esophageal temperature at 0.6°C (low-heat strain) and 1.2°C (moderate-heat strain) above baseline in 14 young (24 (SD 5) years) and 15 older (69 (4) years) men. Sweat rate was measured at multiple sites on the trunk (chest, abdomen) and limbs (biceps, forearm, quadriceps, calf) using ventilated capsules (3.8 cm2 ). Sweat rates, expressed as the average of 5 min of stable sweating at low- and moderate-heat strain, were compared between groups (young, older) and regions (trunk, limbs) within each level of heat strain using a linear mixed-effects model with nested intercepts (sites nested within region nested within participant). At low-heat strain, the age-related reduction in sweat rate (older-young values) was greater at the trunk (0.65 mg/cm2 /min [95% CI 0.44, 0.86]) compared to the limbs (0.42 mg/cm2 /min [0.22, 0.62]; interaction: p = 0.010). At moderate-heat strain, sweat rate was lower in older compared to young (main effect: p = 0.025), albeit that reduction did not differ between regions (interaction: p = 0.888). We conclude that, contrary to previous suggestions, the age-related decline in sweat rate was greater at the trunk compared to the limbs at low-heat strain, with no evidence of regional variation in that age-related decline at moderate-heat strain.
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Affiliation(s)
- Madison D. Schmidt
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of OttawaOttawaOntarioCanada
| | - Sean R. Notley
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of OttawaOttawaOntarioCanada
| | - Robert D. Meade
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of OttawaOttawaOntarioCanada
- Harvard T.H. Chan School of Public HealthHarvard UniversityBostonMassachusettsUSA
| | - Ashley P. Akerman
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of OttawaOttawaOntarioCanada
| | - Maura M. Rutherford
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of OttawaOttawaOntarioCanada
| | - Glen P. Kenny
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
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8
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Hamilton SA, Jarhyan P, Fecht D, Venkateshmurthy NS, Pearce N, Venkat Narayan KM, Ali MK, Mohan V, Tandon N, Prabhakaran D, Mohan S. Environmental risk factors for reduced kidney function due to undetermined cause in India: an environmental epidemiologic analysis. Environ Epidemiol 2021; 5:e170. [PMID: 34934891 PMCID: PMC8683143 DOI: 10.1097/ee9.0000000000000170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/10/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND An epidemic of chronic kidney disease is occurring in rural communities in low-income and middle-income countries that do not share common kidney disease risk factors such as diabetes and hypertension. This chronic kidney disease of unknown etiology occurs primarily in agricultural communities in Central America and South Asia. Consequently, environmental risk factors including heat stress, heavy metals exposure, and low altitude have been hypothesized as risk factors. We conducted an environmental epidemiological analysis investigating these exposures in India which reports the disease. METHODS We used a random sample population in rural and urban sites in Northern and Southern India in 2010, 2011, and 2014 (n = 11,119). We investigated associations of the heat index, altitude, and vicinity to cropland with estimated glomerular filtration rate (eGFR) using satellite-derived data assigned to residential coordinates. We modeled these exposures with eGFR using logistic regression to estimate the risk of low eGFR, and linear mixed models (LMMs) to analyze site-specific eGFR-environment associations. RESULTS Being over 55 years of age, male, and living in proximity to cropland was associated with increased risk of low eGFR [odds ratio (OR) (95% confidence interval (CI) = 2.24 (1.43, 3.56), 2.32 (1.39, 3.88), and 1.47 (1.16, 2.36)], respectively. In LMMs, vicinity to cropland was associated with low eGFR [-0.80 (-0.44, -0.14)]. No associations were observed with temperature or altitude. CONCLUSIONS Older age, being male, and living in proximity to cropland were negatively associated with eGFR. These analyses are important in identifying subcommunities at higher risk and can help direct future environmental investigations.
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Affiliation(s)
- Sophie A. Hamilton
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Global NCDs, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
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Royé D, Sera F, Tobías A, Lowe R, Gasparrini A, Pascal M, de'Donato F, Nunes B, Teixeira JP. Effects of Hot Nights on Mortality in Southern Europe. Epidemiology 2021; 32:487-498. [PMID: 33935136 DOI: 10.1097/ede.0000000000001359] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is strong evidence concerning the impact of heat stress on mortality, particularly from high temperatures. However, few studies to our knowledge emphasize the importance of hot nights, which may prevent necessary nocturnal rest. OBJECTIVES In this study, we use hot-night duration and excess to predict daily cause-specific mortality in summer, using multiple cities across Southern Europe. METHODS We fitted time series regression models to summer cause-specific mortality, including natural, respiratory, and cardiovascular causes, in 11 cities across four countries. We included a distributed lag nonlinear model with lags up to 7 days for hot night duration and excess adjusted by daily mean temperature. We summarized city-specific associations as overall-cumulative exposure-response curves at the country level using meta-analysis. RESULTS We found positive but generally nonlinear associations between relative risk (RR) of cause-specific mortality and duration and excess of hot nights. RR of duration associated with nonaccidental mortality in Portugal was 1.29 (95% confidence interval [CI] = 1.07, 1.54); other associations were imprecise, but we also found positive city-specific estimates for Rome and Madrid. Risk of hot-night excess ranged from 1.12 (95% CI = 1.05, 1.20) for France to 1.37 (95% CI = 1.26, 1.48) for Portugal. Risk estimates for excess were consistently higher than for duration. CONCLUSIONS This study provides new evidence that, over a wider range of locations, hot night indices are strongly associated with cause-specific deaths. Modeling the impact of thermal characteristics during summer nights on mortality could improve decisionmaking for preventive public health strategies.
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Affiliation(s)
- Dominic Royé
- From the Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Aurelio Tobías
- 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
| | - Rachel Lowe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, 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
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | | | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - Joao Paulo Teixeira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
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10
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Bock J, Srivastava P, Jessel S, Klopp JM, Parks RM. Compounding Risks Caused by Heat Exposure and COVID-19 in New York City: A Review of Policies, Tools, and Pilot Survey Results. JOURNAL OF EXTREME EVENTS 2021; 8:2150015. [PMID: 35474914 PMCID: PMC9036680 DOI: 10.1142/s2345737621500159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic changed many social, economic, environmental, and healthcare determinants of health in New York City (NYC) and worldwide. COVID-19 potentially heightened the risk of heat-related health impacts in NYC, particularly on the most vulnerable communities, who often lack equitable access to adequate cooling mechanisms such as air conditioning (AC) and good quality green space. Here, we review some of the policies and tools which have been developed to reduce vulnerability to heat in NYC. We then present results from an online pilot survey of members of the environmental justice organization WE ACT for Environmental Justice (WE ACT) between July 11 and August 8, 2020, which asked questions to evaluate how those in Northern Manhattan coped with elevated summer heat in the midst of the COVID-19 pandemic. We also make some policy recommendations based on our initial findings. Results of our pilot survey suggest that people stayed indoors more due to COVID-19 and relied more on AC units to stay cool. Survey responses also indicated that some avoided visiting green spaces due to concerns around overcrowding and did not regularly frequent them due to the distance from their homes. The responses also demonstrate a potential racial disparity in AC access; AC ownership and access was highest amongst white and lowest amongst Latino/a/x and Black respondents. The impacts of COVID-19 have highlighted the need to accelerate efforts to improve preparedness for extreme heat like the City of New York's AC and cooling center programs, heat ventilation and air conditioning (HVAC) retrofitting, equitable green space expansion, and stronger environmental justice community networks and feedback mechanisms to hear from affected residents. Conducting a survey of this kind annually may provide an additional effective component of evaluating cooling initiatives in NYC.
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Affiliation(s)
- Jennifer Bock
- The Earth Institute, Columbia University New York, NY, USA
| | | | - Sonal Jessel
- WE ACT for Environmental Justice, New York, NY, USA
| | | | - Robbie M. Parks
- The Earth Institute, Columbia University New York, NY, USA
- Mailman School of Public Health Columbia University, New York, NY, USA
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11
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Waugh DW, He Z, Zaitchik B, Peng RD, Diette GB, Hansel NN, Matsui EC, Breysse PN, Breysse DH, Koehler K, Williams D, McCormack MC. Indoor heat exposure in Baltimore: does outdoor temperature matter? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:479-488. [PMID: 33089367 DOI: 10.1007/s00484-020-02036-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 10/06/2020] [Accepted: 10/14/2020] [Indexed: 06/11/2023]
Abstract
Heat exposure of a population is often estimated by applying temperatures from outdoor monitoring stations. However, this can lead to exposure misclassification if residents do not live close to the monitoring station and temperature varies over small spatial scales due to land use/built environment variability, or if residents generally spend more time indoors than outdoors. Here, we compare summertime temperatures measured inside 145 homes in low-income households in Baltimore city with temperatures from the National Weather Service weather station in Baltimore. There is a large variation in indoor temperatures, with daily-mean indoor temperatures varying from 10 °C lower to 10 °C higher than outdoor temperatures. Furthermore, there is only a weak association between the indoor and outdoor temperatures across all houses, indicating that the outdoor temperature is not a good predictor of the indoor temperature for the residences sampled. It is shown that much of the variation is due to differences in the availability of air conditioning (AC). Houses with central AC are generally cooler than outdoors (median difference of - 3.4 °C) while those with no AC are generally warmer (median difference of 1.4 °C). For the collection of houses with central or room AC, there is essentially no relationship between indoor and outdoor temperatures, but for the subset of houses with no AC, there is a weak relationship (correlation coefficient of 0.36). The results presented here suggest future epidemiological studies of indoor exposure to heat would benefit from information on the availability of AC within the population.
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Affiliation(s)
- D W Waugh
- Department of Earth and Planetary Sciences, Johns Hopkins University School of Arts and Sciences, Baltimore, MD, USA.
| | - Z He
- Department of Earth and Planetary Sciences, Johns Hopkins University School of Arts and Sciences, Baltimore, MD, USA
| | - B Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University School of Arts and Sciences, Baltimore, MD, USA
| | - R D Peng
- Department of Biostatistics, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - G B Diette
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - N N Hansel
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E C Matsui
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - P N Breysse
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - D H Breysse
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - K Koehler
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - D Williams
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - M C McCormack
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
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12
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Gronlund CJ, Berrocal VJ. Modeling and comparing central and room air conditioning ownership and cold-season in-home thermal comfort using the American Housing Survey. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:814-823. [PMID: 32203058 PMCID: PMC7483423 DOI: 10.1038/s41370-020-0220-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/10/2020] [Accepted: 02/07/2020] [Indexed: 05/30/2023]
Abstract
Household-level information on central air conditioning (cenAC) and room air conditioning (rmAC) air conditioning and cold-weather thermal comfort are often missing from publicly available housing databases hindering research and action on climate adaptation and air pollution exposure reduction. We modeled these using information from the American Housing Survey for 2003-2013 and 140 US core-based statistical areas employing variables that would be present in publicly available parcel records. We present random-intercept logistic regression models with either cenAC, rmAC or "home was uncomfortably cold for 24 h or more" (tooCold) as outcome variables and housing value, rented vs. owned, age, and multi- vs. single-family, each interacted with cooling- or heating-degree days as predictors. The out-of-sample predicted probabilities for years 2015-2017 were compared with corresponding American Housing Survey values (0 or 1). Using a 0.5 probability threshold, the model had 63% specificity (true negative rate), and 91% sensitivity (true positive rate) for cenAC, while specificity and sensitivity for rmAC were 94% and 34%, respectively. Area-specific sensitivities and specificities varied widely. For tooCold, the overall sensitivity was effectively 0%. Future epidemiologic studies, heat vulnerability maps, and intervention screenings may reliably use these or similar AC models with parcel-level data to improve understanding of health risk and the spatial patterning of homes without AC.
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Affiliation(s)
- Carina J Gronlund
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, USA.
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13
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Abstract
R is an open-source programming language which gained a central place in the geosciences over the last two decades as the primary tool for research. Now, biometeorological research is driven by the diverse datasets related to the atmosphere and other biological agents (e.g., plants, animals and human beings) and the wide variety of software to handle and analyse them. The demand of the scientific community for the automation of analysis processes, data cleaning, results sharing, reproducibility and the capacity to handle big data brings a scripting language such as R in the foreground of the academic universe. This paper presents the advantages and the benefits of the R language for biometeorological and other atmospheric sciences’ research, providing an overview of its typical workflow. Moreover, we briefly present a group of useful and popular packages for biometeorological research and a road map for further scientific collaboration on the R basis. This paper could be a short introductory guide to the world of the R language for biometeorologists.
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14
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Milà C, Curto A, Dimitrova A, Sreekanth V, Kinra S, Marshall JD, Tonne C. Identifying predictors of personal exposure to air temperature in peri-urban India. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 707:136114. [PMID: 31863998 DOI: 10.1016/j.scitotenv.2019.136114] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/12/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
Characterizing personal exposure to air temperature is critical to understanding exposure measurement error in epidemiologic studies using fixed-site exposure data and to identify strategies to protect public health. To date, no study evaluating personal air temperature in the general population has been conducted in a low-and-middle income country. We used data from the CHAI study consisting of 50 adults monitored in up to six non-consecutive 24 h sessions in peri-urban south India. We quantified the agreement and association between fixed-site ambient and personal air temperature, and identified predictors of personal air temperature based on housing assessment, self-reported, GPS, remote sensing, and wearable camera data. Mean (SD) daytime (6 am-10 pm) average personal air temperature was 31.2 (2.6) °C and mean nighttime (10 pm-6 am) average temperature was 28.8 (2.8) °C. Agreement between average personal air and fixed-site ambient temperatures was limited, especially at night when personal air temperatures were underestimated by fixed-site temperatures (MBE = -5.6 °C). The proportion of average personal nighttime temperature variability explained by ambient fixed-site temperatures was moderate (R2mar = 0.39); daytime associations were stronger for women (R2mar = 0.51) than for men (R2mar = 0.3). Other predictors of average nighttime personal air temperature included residential altitude, ceiling height, and household income. Predictors of average daytime personal air temperature included roof materials, GPS-tracked altitude, time working in agriculture (for women), and time travelling (for men). No biomass cooking, urban heat island, or greenspace effects were identified. R2mar between ambient fixed-site and personal air temperature indicate that ambient fixed-site temperature is only a moderately useful proxy of personal air temperature in the context of peri-urban India. Our findings suggest that people living in houses at lower altitude, with lower ceiling height and asbestos roofing sheets might be more vulnerable to heat. We also identified households with higher income, women working in agriculture and men with long commutes as disproportionately exposed to high temperatures.
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Affiliation(s)
- Carles Milà
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Ariadna Curto
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Asya Dimitrova
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - V Sreekanth
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA; Center for Study of Science, Technology & Policy, Bengaluru 560 094, India
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Cathryn Tonne
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain.
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15
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Remigio RV, Jiang C, Raimann J, Kotanko P, Usvyat L, Maddux FW, Kinney P, Sapkota A. Association of Extreme Heat Events With Hospital Admission or Mortality Among Patients With End-Stage Renal Disease. JAMA Netw Open 2019; 2:e198904. [PMID: 31397862 PMCID: PMC6692691 DOI: 10.1001/jamanetworkopen.2019.8904] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 12/11/2022] Open
Abstract
Importance Extreme heat events (EHEs) are increasing in frequency, duration, and intensity, and this trend is projected to continue as part of ongoing climate change. There is a paucity of data regarding how EHEs may affect highly vulnerable populations, such as patients with end-stage renal disease (ESRD). Such data are needed to inform ESRD patient management guidelines in a changing climate. Objectives To investigate the association between EHEs and the risk of hospital admission or mortality among patients with ESRD and further characterize how this risk may vary among races/ethnicities or patients with preexisting comorbidities. Design, Setting, and Participants This study used hospital admission and mortality records of patients with ESRD who underwent hemodialysis treatment at Fresenius Kidney Care clinics in Boston, Massachusetts; Philadelphia, Pennsylvania; or New York, New York, from January 1, 2001, to December 31, 2012. Data were analyzed using a time-stratified case-crossover design with conditional Poisson regression to investigate associations between EHEs and risk of hospital admission or mortality among patients with ESRD. Data were analyzed from July 1, 2017, to March 31, 2019. Exposures Calendar day- and location-specific 95th-percentile maximum temperature thresholds were calculated using daily meteorological data from 1960 to 1989. These thresholds were used to identify EHEs in each of the 3 cities during the study. Main Outcomes and Measures Daily all-cause hospital admission and all-cause mortality among patients with ESRD. Results The study included 7445 patients with ESRD (mean [SD] age, 61.1 [14.1] years; 4283 [57.5%] men), among whom 2953 deaths (39.7%) and 44 941 hospital admissions (mean [SD], 6.0 [7.5] per patient) were recorded. Extreme heat events were associated with increased risk of same-day hospital admission (rate ratio [RR], 1.27; 95% CI, 1.13-1.43) and same-day mortality (RR, 1.31; 95% CI, 1.01-1.70) among patients with ESRD. There was some heterogeneity in risk, with patients in Boston showing statistically significant increased risk for hospital admission (RR, 1.15; 95% CI, 1.00-1.31) and mortality (RR, 1.45; 95% CI, 1.04-2.02) associated with cumulative exposure to EHEs, while such risk was absent among patients with ESRD in Philadelphia. While increases in risks were similar among non-Hispanic black and non-Hispanic white patients, findings among Hispanic and Asian patients were less clear. After stratifying by preexisting comorbidities, cumulative lag exposure to EHEs was associated with increased risk of mortality among patients with ESRD living with congestive heart failure (RR, 1.55; 95% CI, 1.27-1.89), chronic obstructive pulmonary disease (RR, 1.60; 95% CI, 1.24-2.06), or diabetes (RR, 1.83; 95% CI, 1.51-2.21). Conclusions and Relevance In this study, extreme heat events were associated with increased risk of hospital admission or mortality among patients with ESRD, and the association was potentially affected by geographic region and race/ethnicity. Future studies with larger populations and broader geographic coverage are needed to better characterize this variability in risk and inform ESRD management guidelines and differential risk variables, given the projected increases in the frequency, duration, and intensity of EHEs.
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Affiliation(s)
- Richard V. Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Jochen Raimann
- Research Division, Renal Research Institute, New York, New York
| | - Peter Kotanko
- Research Division, Renal Research Institute, New York, New York
- Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Len Usvyat
- Research Division, Renal Research Institute, New York, New York
| | - Frank W. Maddux
- Research Division, Renal Research Institute, New York, New York
| | - Patrick Kinney
- School of Public Health, Boston University, Boston, Massachusetts
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
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16
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Williams AA, Spengler JD, Catalano P, Allen JG, Cedeno-Laurent JG. Building Vulnerability in a Changing Climate: Indoor Temperature Exposures and Health Outcomes in Older Adults Living in Public Housing during an Extreme Heat Event in Cambridge, MA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2373. [PMID: 31277359 PMCID: PMC6651653 DOI: 10.3390/ijerph16132373] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/18/2019] [Accepted: 06/29/2019] [Indexed: 12/12/2022]
Abstract
In the Northeastern U.S., future heatwaves will increase in frequency, duration, and intensity due to climate change. A great deal of the research about the health impacts from extreme heat has used ambient meteorological measurements, which can result in exposure misclassification because buildings alter indoor temperatures and ambient temperatures are not uniform across cities. To characterize indoor temperature exposures during an extreme heat event in buildings with and without central air conditioning (AC), personal monitoring was conducted with 51 (central AC, n = 24; non-central AC, n = 27) low-income senior residents of public housing in Cambridge, Massachusetts in 2015, to comprehensively assess indoor temperatures, sleep, and physiological outcomes of galvanic skin response (GSR) and heart rate (HR), along with daily surveys of adaptive behaviors and health symptoms. As expected, non-central AC units (Tmean = 25.6 °C) were significantly warmer than those with central AC (Tmean = 23.2 °C, p < 0.001). With higher indoor temperatures, sleep was more disrupted and GSR and HR both increased (p < 0.001). However, there were no changes in hydration behaviors between residents of different buildings over time and few moderate/several health symptoms were reported. This suggests both a lack of behavioral adaptation and thermal decompensation beginning, highlighting the need to improve building cooling strategies and heat education to low-income senior residents, especially in historically cooler climates.
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Affiliation(s)
- Augusta A Williams
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - John D Spengler
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Paul Catalano
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Joseph G Allen
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Jose G Cedeno-Laurent
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA.
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17
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Royé D. The effects of hot nights on mortality in Barcelona, Spain. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:2127-2140. [PMID: 28852883 DOI: 10.1007/s00484-017-1416-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/14/2017] [Accepted: 07/20/2017] [Indexed: 05/23/2023]
Abstract
Heat-related effects on mortality have been widely analyzed using maximum and minimum temperatures as exposure variables. Nevertheless, the main focus is usually on the former with the minimum temperature being limited in use as far as human health effects are concerned. Therefore, new thermal indices were used in this research to describe the duration of night hours with air temperatures higher than the 95% percentile of the minimum temperature (hot night hours) and intensity as the summation of these air temperatures in degrees (hot night degrees). An exposure-response relationship between mortality due to natural, respiratory, and cardiovascular causes and summer night temperatures was assessed using data from the Barcelona region between 2003 and 2013. The non-linear relationship between the exposure and response variables was modeled using a distributed lag non-linear model. The estimated associations for both exposure variables and mortality shows a relationship with high and medium values that persist significantly up to a lag of 1-2 days. In mortality due to natural causes, an increase of 1.1% per 10% (CI95% 0.6-1.5) for hot night hours and 5.8% per each 10° (CI95% 3.5-8.2%) for hot night degrees is observed. The effects of hot night hours reach their maximum with 100% and lead to an increase by 9.2% (CI95% 5.3-13.1%). The hourly description of night heat effects reduced to a single indicator in duration and intensity is a new approach and shows a different perspective and significant heat-related effects on human health.
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Affiliation(s)
- D Royé
- GeoBioMet, Department of Geography, Urbanism and Spatial Planning, University of Cantabria, Avda. los Castros, 39005, Santander, Spain.
- Department of Geography, University of Santiago de Compostela, La Coruña, Spain.
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