1
|
Dimitrova A, Dimitrova A, Mengel M, Gasparrini A, Lotze-Campen H, Gabrysch S. Temperature-related neonatal deaths attributable to climate change in 29 low- and middle-income countries. Nat Commun 2024; 15:5504. [PMID: 38951496 PMCID: PMC11217431 DOI: 10.1038/s41467-024-49890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/19/2024] [Indexed: 07/03/2024] Open
Abstract
Exposure to high and low ambient temperatures increases the risk of neonatal mortality, but the contribution of climate change to temperature-related neonatal deaths is unknown. We use Demographic and Health Survey (DHS) data (n = 40,073) from 29 low- and middle-income countries to estimate the temperature-related burden of neonatal deaths between 2001 and 2019 that is attributable to climate change. We find that across all countries, 4.3% of neonatal deaths were associated with non-optimal temperatures. Climate change was responsible for 32% (range: 19-79%) of heat-related neonatal deaths, while reducing the respective cold-related burden by 30% (range: 10-63%). Climate change has impacted temperature-related neonatal deaths in all study countries, with most pronounced climate-induced losses from increased heat and gains from decreased cold observed in countries in sub-Saharan Africa. Future increases in global mean temperatures are expected to exacerbate the heat-related burden, which calls for ambitious mitigation and adaptation measures to safeguard the health of newborns.
Collapse
Affiliation(s)
- Asya Dimitrova
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany.
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Anna Dimitrova
- Scripps Institution of Oceanography, University of California, San Diego, CA, 92037, USA
| | - Matthias Mengel
- Research Department 3, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Hermann Lotze-Campen
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
- Department of Agricultural Economics, Faculty of Life Sciences, Humboldt University of Berlin, Berlin, Germany
| | - Sabine Gabrysch
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
2
|
Teyton A, Ndovu A, Baer RJ, Bandoli G, Benmarhnia T. Disparities in the impact of heat wave definitions on emergency department visits during the first year of life among preterm and full-term infants in California. ENVIRONMENTAL RESEARCH 2024; 248:118299. [PMID: 38272297 DOI: 10.1016/j.envres.2024.118299] [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: 11/13/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Heat waves will be aggravated due to climate change, making this a critical public health threat. However, heat wave definitions to activate alert systems can be ambiguous, highlighting the need to assess a range of definitions to identify those that contribute to the most adverse health outcomes. Additionally, children are highly susceptible to the impacts of heat waves, especially infants, despite the lack of focus on this subpopulation. We aimed to assess the relationship between 30 heat wave definitions and the first all-cause emergency department (ED) visits for California infants. We also examined modification of this relationship by preterm birth status and demographic characteristics to identify possible health disparities. METHODS Live-born, singleton deliveries from the Study of Outcomes in Mothers and Infants born in 2014-2018 were included. Thirty heat wave definitions were assessed based on temperature metrics (minimum/maximum temperatures), thresholds (90th; 92.5th; 95th; 97.5th; 99th percentiles), and duration (1-; 2-; 3-days). A time-stratified case-crossover design assessed heat wave impacts on ED visits using infants with a warm season ED visit (May-October) within the first year of life (n = 228,250). Effect modification by preterm birth status, age, sex, race/ethnicity, education, and delivery payment type was also investigated. RESULTS Infants demonstrated increased risk of an ED visit with exposure to all heat definitions. The 3-day minimum temperature 99th percentile definition had the highest adjusted odds ratio (AOR: 1.14; 95% CI: 1.05-1.23) for the total population. Term infants were more affected by some heat waves than preterm infants. Effect modification was additionally identified, such as by maternal education. DISCUSSION This study provides insight on the heat wave definitions that lead to adverse health outcomes and the identification of the most susceptible infants to these impacts, which has implications on heat-related interventions.
Collapse
Affiliation(s)
- Anaïs Teyton
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA; Scripps Institution of Oceanography, University of California, San Diego, 8885, Biological Grade, La Jolla, CA, 92037, USA.
| | - Allan Ndovu
- University of California San Francisco School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Rebecca J Baer
- California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr. 9 Box 2930, San Francisco, CA, 94143, USA; Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Gretchen Bandoli
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, 8885, Biological Grade, La Jolla, CA, 92037, USA
| |
Collapse
|
3
|
Lakhoo DP, Chersich MF, Jack C, Maimela G, Cissé G, Solarin I, Ebi KL, Chande KS, Dumbura C, Makanga PT, van Aardenne L, Joubert BR, McAllister KA, Ilias M, Makhanya S, Luchters S. Protocol of an individual participant data meta-analysis to quantify the impact of high ambient temperatures on maternal and child health in Africa (HE 2AT IPD). BMJ Open 2024; 14:e077768. [PMID: 38262654 PMCID: PMC10824032 DOI: 10.1136/bmjopen-2023-077768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/13/2023] [Indexed: 01/25/2024] Open
Abstract
INTRODUCTION Globally, recognition is growing of the harmful impacts of high ambient temperatures (heat) on health in pregnant women and children. There remain, however, major evidence gaps on the extent to which heat increases the risks for adverse health outcomes, and how this varies between settings. Evidence gaps are especially large in Africa. We will conduct an individual participant data (IPD) meta-analysis to quantify the impacts of heat on maternal and child health in sub-Saharan Africa. A detailed understanding and quantification of linkages between heat, and maternal and child health is essential for developing solutions to this critical research and policy area. METHODS AND ANALYSIS We will use IPD from existing, large, longitudinal trial and cohort studies, on pregnant women and children from sub-Saharan Africa. We will systematically identify eligible studies through a mapping review, searching data repositories, and suggestions from experts. IPD will be acquired from data repositories, or through collaboration with data providers. Existing satellite imagery, climate reanalysis data, and station-based weather observations will be used to quantify weather and environmental exposures. IPD will be recoded and harmonised before being linked with climate, environmental, and socioeconomic data by location and time. Adopting a one-stage and two-stage meta-analysis method, analytical models such as time-to-event analysis, generalised additive models, and machine learning approaches will be employed to quantify associations between exposure to heat and adverse maternal and child health outcomes. ETHICS AND DISSEMINATION The study has been approved by ethics committees. There is minimal risk to study participants. Participant privacy is protected through the anonymisation of data for analysis, secure data transfer and restricted access. Findings will be disseminated through conferences, journal publications, related policy and research fora, and data may be shared in accordance with data sharing policies of the National Institutes of Health. PROSPERO REGISTRATION NUMBER CRD42022346068.
Collapse
Affiliation(s)
- Darshnika Pemi Lakhoo
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Chris Jack
- Climate System Analysis Group, University of Cape Town, Rondebosch, South Africa
| | - Gloria Maimela
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Guéladio Cissé
- University Peleforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Ijeoma Solarin
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Kshama S Chande
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Cherlynn Dumbura
- Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
| | - Prestige Tatenda Makanga
- Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
- Place Alert Labs, Department of Surveying and Geomatics, Faculty of the Built Environment, Midlands State University, Gweru, Zimbabwe
| | - Lisa van Aardenne
- Climate System Analysis Group, University of Cape Town, Rondebosch, South Africa
| | - Bonnie R Joubert
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, North Carolina, USA
| | - Kimberly A McAllister
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, North Carolina, USA
| | - Maliha Ilias
- National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | | | - Stanley Luchters
- Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
- Liverpool School of Tropical Medicine, Liverpool, UK
- Department of Public Health and Primary Care, Ghent Unviersity, Ghent, Belgium
| |
Collapse
|
4
|
Bekkar B, DeNicola N, Girma B, Potarazu S, Sheffield P. Pregnancy and newborn health - heat impacts and emerging solutions. Semin Perinatol 2023; 47:151837. [PMID: 37838485 DOI: 10.1016/j.semperi.2023.151837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Evidence is accumulating, both in the US and abroad, of the apparent serious health impacts of various environmental exposures tied to climate change. High ambient temperature, or heat, is a worsening global health risk. Heat risk is affected by many factors such as the magnitude, duration, and timing of exposure - such as specific, critical windows during pregnancy. This article focuses on the association of heat with both adverse pregnancy and newborn health outcomes. Regarding pregnancy, studies link heat and preterm birth, low birth weight and stillbirth. Multiple potential mechanisms support the biological plausibility of these associations. Emerging evidence suggests that heat, via epigenetics, may affect maternal health far beyond pregnancy. For newborn health impacts, heat is associated with increased hospitalization, neurologic and gastrointestinal dysfunction, and infant death. Research gaps include the need to study neonates separately from children and determining the mechanisms linking heat to adverse outcomes. We also highlight disparate adverse reproductive health outcomes for communities of color and low income tied to disproportionate exposures to environmental stressors like heat. Finally, we summarize educational and clinical tool resources for clinicians, information for patients, and opportunities for near-term action using the precautionary principle framework.
Collapse
Affiliation(s)
| | - Nathaniel DeNicola
- Department of Obstetrics and Gynecology, Johns Hopkins Health System, Washington, DC, USA
| | - Blean Girma
- University of Maryland-College Park, Maryland Institute for Applied Environmental Health, Center for Community Engagement, Environmental Justice, and Health, USA
| | - Savita Potarazu
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Perry Sheffield
- Departments of Environmental Medicine and Public Health and of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
5
|
Rekha S, Nalini SJ, Bhuvana S, Kanmani S, Vidhya V. A Comprehensive Review on Hot Ambient Temperature and its Impacts on Adverse Pregnancy Outcomes. JOURNAL OF MOTHER AND CHILD 2023; 27:10-20. [PMID: 37368943 PMCID: PMC10298495 DOI: 10.34763/jmotherandchild.20232701.d-22-00051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 12/18/2022] [Indexed: 06/29/2023]
Abstract
INTRODUCTION High workplace/ambient temperatures have been associated with Adverse Pregnancy Outcomes (APO). Millions of women working in developing nations suffer due to the rising temperatures caused by climate change. There are few pieces of research linking occupational heat stress to APO, and fresh evidence is required. METHODOLOGY We used databases including PubMed, Google Scholar, and Science Direct to search for research on high ambient/workplace temperatures and their effects. Original articles, newsletters, and book chapters were examined. The literature we analysed was categorised as follows: Heat, strain, and physical activity harming both mother and fetus. After categorising the literature, it was examined to identify the major results. RESULTS We found a definite association between heat stress and APOs such as miscarriages, premature birth, stillbirth, low birthweight, and congenital abnormalities in 23 research articles. Our work provides important information for future research into the biological mechanisms that create APOs and various prevention measures. CONCLUSION Our data suggest that temperature has long-term and short-term effects on maternal and fetal health. Though small in number, this study stressed the need for bigger cohort studies in tropical developing countries to create evidence for coordinated policies to safeguard pregnant women.
Collapse
Affiliation(s)
- Shanmugam Rekha
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Sirala Jagadeesh Nalini
- Faculty of Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Srinivasan Bhuvana
- Department of Obstetrics and Gynecology, Sri Ramachandra Medical Centre, Chennai, Tamil Nadu, India
| | - S. Kanmani
- Centre for Environmental Studies, College of Engineering Guindy, Anna University, Chennai, Tamil Nadu, India
| | - Venugopal Vidhya
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| |
Collapse
|
6
|
Baharav Y, Nichols L, Wahal A, Gow O, Shickman K, Edwards M, Huffling K. The Impact of Extreme Heat Exposure on Pregnant People and Neonates: A State of the Science Review. J Midwifery Womens Health 2023; 68:324-332. [PMID: 37218676 DOI: 10.1111/jmwh.13502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 05/24/2023]
Abstract
The relationship between heat exposure and perinatal morbidity and mortality is of increasing concern as global temperatures rise and extreme heat events become more frequent and intense. Heat exposure can lead to a multitude of harmful outcomes for pregnant individuals and neonates, including hospitalization and death. This state of the science review explored the evidence on the associations between heat exposure and negative health outcomes during pregnancy and the neonatal period. Findings suggest that improving health care provider and patient awareness of heat-related risks and implementing specific interventions could mitigate adverse outcomes. Furthermore, public health and other policy interventions are needed to increase thermal comfort and reduce societal exposure to extreme heat and related risks. Early warning systems, medical alerts, provider and patient education, and increased access to health care and thermal comfort may improve pregnancy and early life health outcomes.
Collapse
Affiliation(s)
- Yuval Baharav
- Adrienne Arsht-Rockefeller Foundation Resilience Center, Atlantic Council, Washington, District of Columbia
| | - Lilly Nichols
- Adrienne Arsht-Rockefeller Foundation Resilience Center, Atlantic Council, Washington, District of Columbia
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Anya Wahal
- Adrienne Arsht-Rockefeller Foundation Resilience Center, Atlantic Council, Washington, District of Columbia
| | - Owen Gow
- Adrienne Arsht-Rockefeller Foundation Resilience Center, Atlantic Council, Washington, District of Columbia
| | - Kurt Shickman
- Adrienne Arsht-Rockefeller Foundation Resilience Center, Atlantic Council, Washington, District of Columbia
| | - Maya Edwards
- Adrienne Arsht-Rockefeller Foundation Resilience Center, Atlantic Council, Washington, District of Columbia
| | - Katie Huffling
- Alliance of Nurses for Healthy Environments, Mount Rainier, Maryland
| |
Collapse
|
7
|
Chersich MF, Scorgie F, Filippi V, Luchters S. Increasing global temperatures threaten gains in maternal and newborn health in Africa: A review of impacts and an adaptation framework. Int J Gynaecol Obstet 2023; 160:421-429. [PMID: 35906840 PMCID: PMC10087975 DOI: 10.1002/ijgo.14381] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/26/2022] [Indexed: 01/20/2023]
Abstract
Anatomical, physiologic, and socio-cultural changes during pregnancy and childbirth increase vulnerability of women and newborns to high ambient temperatures. Extreme heat can overwhelm thermoregulatory mechanisms in pregnant women, especially during labor, cause dehydration and endocrine dysfunction, and compromise placental function. Clinical sequelae include hypertensive disorders, gestational diabetes, preterm birth, and stillbirth. High ambient temperatures increase rates of infections, and affect health worker performance and healthcare seeking. Rising temperatures with climate change and limited resources heighten concerns. We propose an adaptation framework containing four prongs. First, behavioral changes such as reducing workloads during pregnancy and using low-cost water sprays. Second, health system interventions encompassing Early Warning Systems centered around existing community-based outreach; heat-health indicator tracking; water supplementation and monitoring for heat-related conditions during labor. Building modifications, passive and active cooling systems, and nature-based solutions can reduce temperatures in facilities. Lastly, structural interventions and climate financing are critical. The overall package of interventions, ideally selected following cost-effectiveness and thermal modeling trade-offs, needs to be co-designed and co-delivered with affected communities, and take advantage of existing maternal and child health platforms. Robust-applied research will set the stage for programs across Africa that target pregnant women. Adequate research and climate financing are now urgent.
Collapse
Affiliation(s)
- Matthew F Chersich
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Fiona Scorgie
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Veronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Stanley Luchters
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe
| | | |
Collapse
|
8
|
Rajput P, Singh S, Singh TB, Mall RK. The nexus between climate change and public health: a global overview with perspectives for Indian cities. ARABIAN JOURNAL OF GEOSCIENCES 2023; 16:15. [PMCID: PMC9765391 DOI: 10.1007/s12517-022-11099-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/08/2022] [Indexed: 06/28/2023]
Abstract
Climate change is widely recognized as a major threat to public health. The Intergovernmental Panel on Climate Change’s Sixth Assessment Report (IPCC AR6), assessing different Shared Socioeconomic Pathway scenarios (SSP1-1.9, SSP1-2.6, SSP2-4.5, SSP3-7.0 and SSP5-8.5), projects that relative to 1850–1900, the global temperature is rising and would exceed 2 °C during the twenty-first century under the high (SSP3-7.0) and very high (SSP5-8.5) greenhouse gas (GHG) emission scenarios considered. Populations within tropical and subtropical regions are more likely to experience increased vulnerability towards heat stress. In this study, a summary of some of the important aspects of climate change and human health has been presented. The effects of climate change on India’s energy demand, employment, labor market and benefits have also been highlighted. Finally, we have discussed the national policies implemented or action underway to mitigate climate change and improve public health and have also provided some recommendations to carry forward. The current study overviewing the nexus between climate change and public health has a major aim to provide a perspective towards strengthening the health system in Indian cities.
Collapse
Affiliation(s)
- Prashant Rajput
- DST-Mahamana Centre of Excellence in Climate Change Research, IESD, Banaras Hindu University, Varanasi, 221 005 India
| | - Saumya Singh
- DST-Mahamana Centre of Excellence in Climate Change Research, IESD, Banaras Hindu University, Varanasi, 221 005 India
| | - Tej Bali Singh
- Centre of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005 India
| | - Rajesh Kumar Mall
- DST-Mahamana Centre of Excellence in Climate Change Research, IESD, Banaras Hindu University, Varanasi, 221 005 India
| |
Collapse
|
9
|
The Effect of High and Low Ambient Temperature on Infant Health: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159109. [PMID: 35897477 PMCID: PMC9331681 DOI: 10.3390/ijerph19159109] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 02/01/2023]
Abstract
Children, and particularly infants, have physiological, anatomic, and social factors that increase vulnerability to temperature extremes. We performed a systematic review to explore the association between acute adverse infant outcomes (children 0–1 years) and exposure to high and low ambient temperatures. MEDLINE (Pubmed), Embase, CINAHL Plus, and Global Health were searched alongside the reference lists of key papers. We included published journal papers in English that assessed adverse infant outcomes related to short-term weather-related temperature exposure. Twenty-six studies met our inclusion criteria. Outcomes assessed included: infant mortality (n = 9), sudden infant death syndrome (n = 5), hospital visits or admissions (n = 5), infectious disease outcomes (n = 5), and neonatal conditions such as jaundice (n = 2). Higher temperatures were associated with increased risk of acute infant mortality, hospital admissions, and hand, foot, and mouth disease. Several studies identified low temperature impacts on infant mortality and episodes of respiratory disease. Findings on temperature risks for sudden infant death syndrome were inconsistent. Only five studies were conducted in low- or middle-income countries, and evidence on subpopulations and temperature-sensitive infectious diseases was limited. Public health measures are required to reduce the impacts of heat and cold on infant health.
Collapse
|
10
|
Theron E, Bills CB, Calvello Hynes EJ, Stassen W, Rublee C. Climate change and emergency care in Africa: A scoping review. Afr J Emerg Med 2022; 12:121-128. [PMID: 35371912 PMCID: PMC8958270 DOI: 10.1016/j.afjem.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 01/18/2022] [Accepted: 02/13/2022] [Indexed: 11/01/2022] Open
Abstract
Introduction Climate change is a global public health emergency with implications for access to care and emergency care service disruptions. The African continent is particularly vulnerable to climate-related extreme weather events due to an already overburdened health system, lack of early warning signs, poverty, inadequate infrastructure, and variable adaptive capacity. Emergency care services are not only utilized during these events but also threatened by these hazards. Considering that the effects of climate change are expected to increase in intensity and prevalence, it is increasingly important for emergency care to prepare to respond to the changes in presentation and demand. The aim of this study was to perform a scoping review of the available literature on the relationship between climate change and emergency care on the African continent. Methods A scoping review was completed using five databases: Pubmed, Web of Science, GreenFILE, Africa Wide Information, and Google Scholar. A 'grey' literature search was done to identify key reports and references from included articles. Two independent reviewers screened articles and a third reviewer decided conflicts. A total of 1,382 individual articles were initially screened with 17 meeting full text review. A total of six articles were included in the final analysis. Data from four countries were represented including Uganda, Ghana, Tanzania, and Nigeria. Results Analysis of the six articles yielded three key themes that were identified: climate-related health impacts that contribute to surges in demand and resource utilization, opportunities for health sector engagement, and solutions to improve emergency preparedness. Authors used the outcomes of the review to propose 10 recommendations for decision-makers and leaders. DXDiscussion Incorporating these key recommendations at the local and national level could help improve preparedness and adaptation measures in highly vulnerable, populated areas on the African continent.
Collapse
|
11
|
Nakstad B, Filippi V, Lusambili A, Roos N, Scorgie F, Chersich MF, Luchters S, Kovats S. How Climate Change May Threaten Progress in Neonatal Health in the African Region. Neonatology 2022; 119:644-651. [PMID: 35850106 DOI: 10.1159/000525573] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022]
Abstract
Climate change is likely to have wide-ranging impacts on maternal and neonatal health in Africa. Populations in low-resource settings already experience adverse impacts from weather extremes, a high burden of disease from environmental exposures, and limited access to high-quality clinical care. Climate change is already increasing local temperatures. Neonates are at high risk of heat stress and dehydration due to their unique metabolism, physiology, growth, and developmental characteristics. Infants in low-income settings may have little protection against extreme heat due to housing design and limited access to affordable space cooling. Climate change may increase risks to neonatal health from weather disasters, decreasing food security, and facilitating infectious disease transmission. Effective interventions to reduce risks from the heat include health education on heat risks for mothers, caregivers, and clinicians; nature-based solutions to reduce urban heat islands; space cooling in health facilities; and equitable improvements in housing quality and food systems. Reductions in greenhouse gas emissions are essential to reduce the long-term impacts of climate change that will further undermine global health strategies to reduce neonatal mortality.
Collapse
Affiliation(s)
- Britt Nakstad
- Department of Pediatric and Adolescent Health, University of Botswana, Gaborone, Botswana.,Division of Pediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Adelaide Lusambili
- Institute for Human Development, The Aga Khan University, Nairobi, Kenya
| | - Nathalie Roos
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Fiona Scorgie
- University of Witswatersand, Johannesburg, South Africa
| | | | - Stanley Luchters
- Institute for Human Development, The Aga Khan University, Nairobi, Kenya
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
12
|
Renteria R, Grineski S, Collins T, Flores A, Trego S. Social disparities in neighborhood heat in the Northeast United States. ENVIRONMENTAL RESEARCH 2022; 203:111805. [PMID: 34339695 DOI: 10.1016/j.envres.2021.111805] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/22/2021] [Accepted: 07/28/2021] [Indexed: 05/28/2023]
Abstract
Upward trends in ground-level warming are expected to intensify, affecting the health of human populations. Specific to the United States, the Northeast (NE) region is one of the most vulnerable to these warming trends. Previous research has found social disparities in the distribution of heat, while recent studies have examined associations between metropolitan racial/ethnic segregation and heat exposures. We advance upon previous research by including a novel measure of neighborhood-level racial/ethnic diversity in our examination of social inequalities in heat for NE neighborhoods (census tracts). We paired data derived from the United States Geological Survey on mean land surface temperature (LST) for the summer months of 2013-2017 with sociodemographic data from the American Community Survey (5-year estimates, 2013-2017). We use multivariable generalized estimating equations (GEEs) that adjust for geographic clustering. Findings reveal heat exposure disparities across NE neighborhoods. Neighborhoods with higher proportions of racial/ethnic minorities, people of lower socioeconomic status, households without access to an automobile, and greater diversity experience higher temperatures. Diversity was more strongly related to increased heat in neighborhoods with lower Latinx and lower Black composition suggesting that neighborhood homogeneity confers a differentially greater cooling effect based on higher White composition. The social groups that carry the unequal thermal burdens are also those who are most vulnerable. Interventions to reduce heat risks in the NE should therefore prioritize reducing the burden on historically disadvantaged communities.
Collapse
Affiliation(s)
- Roger Renteria
- Department of Sociology, University of Utah, USA; Center for Natural and Technological Hazards, University of Utah, USA
| | - Sara Grineski
- Department of Sociology, University of Utah, USA; Center for Natural and Technological Hazards, University of Utah, USA.
| | - Timothy Collins
- Department of Geography, University of Utah, USA; Center for Natural and Technological Hazards, University of Utah, USA
| | - Aaron Flores
- Department of Geography, University of Utah, USA; Center for Natural and Technological Hazards, University of Utah, USA
| | - Shaylynn Trego
- Department of Geography, University of Utah, USA; Center for Natural and Technological Hazards, University of Utah, USA
| |
Collapse
|
13
|
Farré R, Rodríguez-Lázaro MA, Dinh-Xuan AT, Pons-Odena M, Navajas D, Gozal D. A Low-Cost, Easy-to-Assemble Device to Prevent Infant Hyperthermia under Conditions of High Thermal Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413382. [PMID: 34948991 PMCID: PMC8703827 DOI: 10.3390/ijerph182413382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 12/14/2022]
Abstract
High ambient temperature and humidity greatly increase the risk of hyperthermia and mortality, particularly in infants, who are especially prone to dehydration. World areas at high risk of heat stress include many of the low- and middle-income countries (LMICs) where most of their inhabitants have no access to air conditioning. This study aimed to design, evaluate, and test a novel low-cost and easy-to-assemble device aimed at preventing the risk of infant hyperthermia in LMICs. The device is based on optimizing negative heat transfer from a small amount of ice and transferring it directly to the infant by airflow of refrigerated air. As a proof of concept, a device was assembled mainly using recycled materials, and its performance was assessed under laboratory-controlled conditions in a climatic chamber mimicking realistic stress conditions of high temperature and humidity. The device, which can be assembled by any layperson using easily available materials, provided sufficient refrigerating capacity for several hours from just 1–2 kg of ice obtained from a domestic freezer. Thus, application of this novel device may serve to attenuate the adverse effects of heat stress in infants, particularly in the context of the evolving climatic change trends.
Collapse
Affiliation(s)
- Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain; (M.A.R.-L.); (D.N.)
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain
- Institut Investigacions Biomèdiques August Pi Sunyer, 08036 Barcelona, Spain
- Correspondence:
| | - Miguel A. Rodríguez-Lázaro
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain; (M.A.R.-L.); (D.N.)
| | - Anh Tuan Dinh-Xuan
- Service de Physiologie-Explorations Fonctionnelles, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France;
| | - Martí Pons-Odena
- Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Pediatric Intensive Care and Intermediate Care Department, Sant Joan de Déu University Hospital, Universitat de Barcelona, 08950 Esplugues de Llobregat, Spain;
| | - Daniel Navajas
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain; (M.A.R.-L.); (D.N.)
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain
- The Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), 08028 Barcelona, Spain
| | - David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, MO 65201, USA;
| |
Collapse
|
14
|
Social Inequities in Urban Heat and Greenspace: Analyzing Climate Justice in Delhi, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094800. [PMID: 33946259 PMCID: PMC8124940 DOI: 10.3390/ijerph18094800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Climate change and rapid urbanization currently pose major challenges for equitable development in megacities of the Global South, such as Delhi, India. This study considers how urban social inequities are distributed in terms of burdens and benefits by quantifying exposure through an urban heat risk index (UHRI), and proximity to greenspace through the normalized difference vegetation index (NDVI), at the ward level in Delhi. Landsat derived remote sensing imagery for May and September 2011 is used in a sensitivity analysis of varying seasonal exposure. Multivariable models based on generalized estimating equations (GEEs) reveal significant statistical associations (p < 0.05) between UHRI/NDVI and several indicators of social vulnerability. For example, the proportions of children (β = 0.922, p = 0.024) and agricultural workers (β = 0.394, p = 0.016) are positively associated with the May UHRI, while the proportions of households with assets (β = -1.978, p = 0.017) and households with electricity (β = -0.605, p = 0.010) are negatively associated with the May UHRI. In contrast, the proportions of children (β = 0.001, p = 0.633) and agricultural workers (β = 0.002, p = 0.356) are not significantly associated with the May NDVI, while the proportions of households with assets (β = 0.013, p = 0.010) and those with electricity (β = 0.008, p = 0.006) are positively associated with the May NDVI. Our findings emphasize the need for future research and policies to consider how socially vulnerable groups are inequitably exposed to the impact of climate change-related urban heat without the mitigating effects of greenspace.
Collapse
|
15
|
Bikomeye JC, Rublee CS, Beyer KMM. Positive Externalities of Climate Change Mitigation and Adaptation for Human Health: A Review and Conceptual Framework for Public Health Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2481. [PMID: 33802347 PMCID: PMC7967605 DOI: 10.3390/ijerph18052481] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 12/17/2022]
Abstract
Anthropogenic climate change is adversely impacting people and contributing to suffering and increased costs from climate-related diseases and injuries. In responding to this urgent and growing public health crisis, mitigation strategies are in place to reduce future greenhouse gas emissions (GHGE) while adaptation strategies exist to reduce and/or alleviate the adverse effects of climate change by increasing systems' resilience to future impacts. While these strategies have numerous positive benefits on climate change itself, they also often have other positive externalities or health co-benefits. This knowledge can be harnessed to promote and improve global public health, particularly for the most vulnerable populations. Previous conceptual models in mitigation and adaptation studies such as the shared socioeconomic pathways (SSPs) considered health in the thinking, but health outcomes were not their primary intention. Additionally, existing guidance documents such as the World Health Organization (WHO) Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities is designed primarily for public health professionals or healthcare managers in hospital settings with a primary focus on resilience. However, a detailed cross sectoral and multidisciplinary conceptual framework, which links mitigation and adaptation strategies with health outcomes as a primary end point, has not yet been developed to guide research in this area. In this paper, we briefly summarize the burden of climate change on global public health, describe important mitigation and adaptation strategies, and present key health benefits by giving context specific examples from high, middle, and low-income settings. We then provide a conceptual framework to inform future global public health research and preparedness across sectors and disciplines and outline key stakeholders recommendations in promoting climate resilient systems and advancing health equity.
Collapse
Affiliation(s)
- Jean C. Bikomeye
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Caitlin S. Rublee
- Department of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Kirsten M. M. Beyer
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
- Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| |
Collapse
|
16
|
Evaluation of the Impact of the Envelope System on Thermal Energy Demand in Hospital Buildings. BUILDINGS 2020. [DOI: 10.3390/buildings10120250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Construction materials and systems for the thermal building envelope have played a key role in the improvement of energy efficiency in buildings. Urban heat islands together with the upcoming rising global temperature demand construction solutions that are adapted to the specific microclimate conditions. These circumstances are even more dramatic in the case of healthcare buildings where the need to preserve constant indoor temperatures is a priority for the proper recovery of patients. A new neonatal hospital, located in Madrid (Spain), has been monitored, and building energy simulations were performed to evaluate the effect of the building envelope on the energy demand. Based on the simulation results, the design of the building envelope was found to be insufficiently optimised to properly protect the building from the external heat flow. This is supported by the monitored results of the indoor temperatures, which went over the standard limit for about 50% of the hours, achieving up to 27 °C in June and July, and 28 °C in August. The results showed, on one hand, that solar radiation gains transmitted through the façade have an important impact on the indoor temperature in the analysed rooms. Heat gains through the opaque envelope showed an average of 8.37 kWh/day, followed by heat gains through the glazing with an average value of 5.29 kWh/day; while heat gains from lighting and occupancy were 5.21 kWh/day and 4.47 kWh/day, respectively. Moreover, it was shown that a design of the envelope characterised by large glass surfaces and without solar protection systems, resulted in excessive internal thermal loads that the conditioning system was not able to overcome.
Collapse
|
17
|
Salve HR, Parthasarathy R, Krishnan A, Pattanaik DR. Impact of ambient air temperature on human health in India. REVIEWS ON ENVIRONMENTAL HEALTH 2018; 33:433-439. [PMID: 30256763 DOI: 10.1515/reveh-2018-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
A systematic search was carried out in the databases of Pubmed, Indmed and Mausam for articles on the effect of ambient temperature on health. Relevant data were extracted using a standard data abstraction form by two authors independently. The overall effects of ambient air temperature are reported as odds ratio (OR) and 95% confidence intervals (CIs) on mortality. Of 812 records identified, only seven were included in the final review as per pre-defined criteria. An increase in the all-cause mortality rate of 41% are reported during a heat wave in India. Risk ratios for all-cause mortality was in the range of 1.7-2.1. The dose-response relationship of ambient temperature and all-cause mortality and cardiovascular diseases are been reported. Current evidence on the effect of ambient temperature and health is sufficient to initiate an integrated response from policy makers, climate scientists and public health practitioners in India. Continued advocacy and generation of more robust evidence is needed.
Collapse
Affiliation(s)
- Harshal R Salve
- All India Institute of Medical Sciences, Centre for Community Medicine, Old OT Block, AIIMS, Ansari Nagar, New Delhi, India
| | - Raghavan Parthasarathy
- All India Institute of Medical Sciences, Centre for Community Medicine, New Delhi, India
| | - Anand Krishnan
- All India Institute of Medical Sciences, Centre for Community Medicine, New Delhi, India
| | - D R Pattanaik
- Extended Range Forecast Group (Numerical Weather Prediction) Division, Head, Publication and Human Resource Development, India Meteorological Department, New Delhi, India
| |
Collapse
|
18
|
Sorensen C, Saunik S, Sehgal M, Tewary A, Govindan M, Lemery J, Balbus J. Climate Change and Women's Health: Impacts and Opportunities in India. GEOHEALTH 2018; 2:283-297. [PMID: 32159002 PMCID: PMC7007102 DOI: 10.1029/2018gh000163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 05/28/2023]
Abstract
Climate change impacts on health, including increased exposures to heat, poor air quality, extreme weather events, and altered vector-borne disease transmission, reduced water quality, and decreased food security, affect men and women differently due to biologic, socioeconomic, and cultural factors. In India, where rapid environmental changes are taking place, climate change threatens to widen existing gender-based health disparities. Integration of a gendered perspective into existing climate, development, and disaster-risk reduction policy frameworks can decrease negative health outcomes. Modifying climate risks requires multisector coordination, improvement in data acquisition, monitoring of gender specific targets, and equitable stakeholder engagement. Empowering women as agents of social change can improve mitigation and adaptation policy interventions.
Collapse
Affiliation(s)
- Cecilia Sorensen
- National Institute of Environmental Health SciencesBethesdaMDUSA
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCOUSA
| | - Sujata Saunik
- Department of Global Health and Population, TH Chan School of Public HealthHarvard UniversityCambridgeMAUSA
| | - Meena Sehgal
- The Energy and Resources InstituteNew DelhiIndia
| | | | | | - Jay Lemery
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCOUSA
| | - John Balbus
- National Institute of Environmental Health SciencesBethesdaMDUSA
| |
Collapse
|
19
|
Limaye VS, Knowlton K, Sarkar S, Ganguly PS, Pingle S, Dutta P, M SL, Tiwari A, Solanki B, Shah C, Raval G, Kakkad K, Beig G, Parkhi N, Jaiswal A, Mavalankar D. Development of Ahmedabad's Air Information and Response (AIR) Plan to Protect Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1460. [PMID: 29996566 PMCID: PMC6068810 DOI: 10.3390/ijerph15071460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 06/29/2018] [Accepted: 07/05/2018] [Indexed: 12/26/2022]
Abstract
Indian cities struggle with some of the highest ambient air pollution levels in the world. While national efforts are building momentum towards concerted action to reduce air pollution, individual cities are taking action on this challenge to protect communities from the many health problems caused by this harmful environmental exposure. In 2017, the city of Ahmedabad launched a regional air pollution monitoring and risk communication project, the Air Information and Response (AIR) Plan. The centerpiece of the plan is an air quality index developed by the Indian Institute of Tropical Meteorology’s System for Air Quality and Weather Forecasting and Research program that summarizes information from 10 new continuous air pollution monitoring stations in the region, each reporting data that can help people avoid harmful exposures and inform policy strategies to achieve cleaner air. This paper focuses on the motivation, development, and implementation of Ahmedabad’s AIR Plan. The project is discussed in terms of its collaborative roots, public health purpose in addressing the grave threat of air pollution (particularly to vulnerable groups), technical aspects in deploying air monitoring technology, and broader goals for the dissemination of an air quality index linked to specific health messages and suggested actions to reduce harmful exposures. The city of Ahmedabad is among the first cities in India where city leaders, state government, and civil society are proactively working together to address the country’s air pollution challenge with a focus on public health. The lessons learned from the development of the AIR Plan serve as a template for other cities aiming to address the heavy burden of air pollution on public health. Effective working relationships are vital since they form the foundation for long-term success and useful knowledge sharing beyond a single city.
Collapse
Affiliation(s)
- Vijay S Limaye
- Natural Resources Defense Council (NRDC), New York, NY 10011, USA.
| | - Kim Knowlton
- Natural Resources Defense Council (NRDC), New York, NY 10011, USA.
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Sayantan Sarkar
- Natural Resources Defense Council (NRDC), New York, NY 10011, USA.
| | | | - Shyam Pingle
- Indian Institute of Public Health, Gandhinagar (IIPH-G), Gandhinagar 382042, India.
| | - Priya Dutta
- Indian Institute of Public Health, Gandhinagar (IIPH-G), Gandhinagar 382042, India.
| | - Sathish L M
- Indian Institute of Public Health, Gandhinagar (IIPH-G), Gandhinagar 382042, India.
| | - Abhiyant Tiwari
- Indian Institute of Public Health, Gandhinagar (IIPH-G), Gandhinagar 382042, India.
- Harvard T.H. Chan School of Public Health, Cambridge, MA 02115, USA.
| | - Bhavin Solanki
- Health Department, Ahmedabad Municipal Corporation (AMC), Ahmedabad 380001, India.
| | - Chirag Shah
- Health Department, Ahmedabad Municipal Corporation (AMC), Ahmedabad 380001, India.
- Apollo Hospital, Ahmedabad 382428, India.
| | - Gopal Raval
- Ashrai Associates and Sparsh Chest Diseases Center, Ahmedabad 380009, India.
| | - Khyati Kakkad
- L.G. Hospital, AMC MET Medical College, Ahmedabad 380008, India.
| | - Gufran Beig
- Indian Institute of Tropical Meteorology (IITM), Pune 411008, India.
| | - Neha Parkhi
- Indian Institute of Tropical Meteorology (IITM), Pune 411008, India.
| | - Anjali Jaiswal
- Natural Resources Defense Council (NRDC), New York, NY 10011, USA.
| | - Dileep Mavalankar
- Indian Institute of Public Health, Gandhinagar (IIPH-G), Gandhinagar 382042, India.
| |
Collapse
|
20
|
Abstract
In a Perspective, Hannah Nissan and Declan Conway discuss the implications of uncertainty about projected impacts of climate change on health.
Collapse
|
21
|
Abstract
In a Policy Forum, Cecilia Sorensen and colleagues discuss the implications of climate change for women's health.
Collapse
Affiliation(s)
- Cecilia Sorensen
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado, United States of America
| | | | - Jay Lemery
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado, United States of America
| | - John Balbus
- National Institute of Environmental Health Sciences, Bethesda, Maryland, United States of America
| |
Collapse
|
22
|
Abstract
In a Perspective, Lawrence Stanberry and colleagues discuss impacts of climate change on children.
Collapse
Affiliation(s)
- Lawrence R. Stanberry
- Department of Pediatrics, Columbia University Irving Medical Center, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Madeleine C. Thomson
- International Research Institute for Climate and Society, the Earth Institute, Columbia University, New York, New York, United States of America
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Wilmot James
- Department of Pediatrics, Columbia University Irving Medical Center, Columbia University, New York, New York, United States of America
- School of International and Public Affairs, Columbia University, New York, New York, United States of America
| |
Collapse
|
23
|
Heat Exposure and Maternal Health in the Face of Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080853. [PMID: 28758917 PMCID: PMC5580557 DOI: 10.3390/ijerph14080853] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 07/18/2017] [Accepted: 07/23/2017] [Indexed: 12/17/2022]
Abstract
Climate change will increasingly affect the health of vulnerable populations, including maternal and fetal health. This systematic review aims to identify recent literature that investigates increasing heat and extreme temperatures on pregnancy outcomes globally. We identify common research findings in order to create a comprehensive understanding of how immediate effects will be sustained in the next generation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide, we systematically reviewed articles from PubMed and Cochrane Reviews. We included articles that identify climate change-related exposures and adverse health effects for pregnant women. There is evidence that temperature extremes adversely impact birth outcomes, including, but not limited to: changes in length of gestation, birth weight, stillbirth, and neonatal stress in unusually hot temperature exposures. The studies included in this review indicate that not only is there a need for further research on the ways that climate change, and heat in particular, may affect maternal health and neonatal outcomes, but that uniform standards for assessing the effects of heat on maternal fetal health also need to be established.
Collapse
|
24
|
Heat Wave Vulnerability Mapping for India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040357. [PMID: 28358338 PMCID: PMC5409558 DOI: 10.3390/ijerph14040357] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/13/2017] [Accepted: 03/28/2017] [Indexed: 11/19/2022]
Abstract
Assessing geographic variability in heat wave vulnerability forms the basis for planning appropriate targeted adaptation strategies. Given several recent deadly heatwaves in India, heat is increasingly being recognized as a public health problem. However, to date there has not been a country-wide assessment of heat vulnerability in India. We evaluated demographic, socioeconomic, and environmental vulnerability factors and combined district level data from several sources including the most recent census, health reports, and satellite remote sensing data. We then applied principal component analysis (PCA) on 17 normalized variables for each of the 640 districts to create a composite Heat Vulnerability Index (HVI) for India. Of the total 640 districts, our analysis identified 10 and 97 districts in the very high and high risk categories (> 2SD and 2-1SD HVI) respectively. Mapping showed that the districts with higher heat vulnerability are located in the central parts of the country. On examination, these are less urbanized and have low rates of literacy, access to water and sanitation, and presence of household amenities. Therefore, we concluded that creating and mapping a heat vulnerability index is a useful first step in protecting the public from the health burden of heat. Future work should incorporate heat exposure and health outcome data to validate the index, as well as examine sub-district levels of vulnerability.
Collapse
|
25
|
Dutta P, Rajiva A, Andhare D, Azhar GS, Tiwari A, Sheffield P. Perceived heat stress and health effects on construction workers. Indian J Occup Environ Med 2015; 19:151-8. [PMID: 26957814 PMCID: PMC4765254 DOI: 10.4103/0019-5278.174002] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Increasing heat waves-particularly in urban areas where construction is most prevalent, highlight a need for heat exposure assessment of construction workers. This study aims to characterize the effects of heat on construction workers from a site in Gandhinagar. MATERIALS AND METHODS This study involved a mixed methods approach consisting of a cross sectional survey with anthropometric measurements (n = 219) and four focus groups with construction workers, as well as environmental measurements of heat stress exposure at a construction site. Survey data was collected in two seasons i.e., summer and winter months, and heat illness and symptoms were compared between the two time periods. Thematic coding of focus group data was used to identify vulnerability factors and coping mechanisms of the workers. Heat stress, recorded using a wet bulb globe temperature monitor, was compared to international safety standards. RESULTS The survey findings suggest that heat-related symptoms increased in summer; 59% of all reports in summer were positive for symptoms (from Mild to Severe) as compared to 41% in winter. Focus groups revealed four dominant themes: (1) Non-occupational stressors compound work stressors; (2) workers were particularly attuned to the impact of heat on their health; (3) workers were aware of heat-related preventive measures; and (4) few resources were currently available to protect workers from heat stress. Working conditions often exceed international heat stress safety thresholds. Female workers and new employees might be at increased risk of illness or injury. CONCLUSION This study suggests significant health impacts on construction workers from heat stress exposure in the workplace, showed that heat stress levels were higher than those prescribed by international standards and highlights the need for revision of work practices, increased protective measures, and possible development of indigenous work safety standards for heat exposure.
Collapse
Affiliation(s)
- Priya Dutta
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Ajit Rajiva
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Dileep Andhare
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Gulrez Shah Azhar
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Abhiyant Tiwari
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Perry Sheffield
- Department of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | | |
Collapse
|
26
|
Development and implementation of South Asia's first heat-health action plan in Ahmedabad (Gujarat, India). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:3473-92. [PMID: 24670386 PMCID: PMC4024996 DOI: 10.3390/ijerph110403473] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 02/26/2014] [Accepted: 03/04/2014] [Indexed: 11/16/2022]
Abstract
Recurrent heat waves, already a concern in rapidly growing and urbanizing South Asia, will very likely worsen in a warming world. Coordinated adaptation efforts can reduce heat's adverse health impacts, however. To address this concern in Ahmedabad (Gujarat, India), a coalition has been formed to develop an evidence-based heat preparedness plan and early warning system. This paper describes the group and initial steps in the plan's development and implementation. Evidence accumulation included extensive literature review, analysis of local temperature and mortality data, surveys with heat-vulnerable populations, focus groups with health care professionals, and expert consultation. The findings and recommendations were encapsulated in policy briefs for key government agencies, health care professionals, outdoor workers, and slum communities, and synthesized in the heat preparedness plan. A 7-day probabilistic weather forecast was also developed and is used to trigger the plan in advance of dangerous heat waves. The pilot plan was implemented in 2013, and public outreach was done through training workshops, hoardings/billboards, pamphlets, and print advertisements. Evaluation activities and continuous improvement efforts are ongoing, along with plans to explore the program's scalability to other Indian cities, as Ahmedabad is the first South Asian city to address heat-health threats comprehensively.
Collapse
|