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Martin LS, Josset-Lamaugarny A, El Jammal T, Ducreux S, Chevalier FP, Fromy B. Aging is associated with impaired triggering of TRPV3-mediated cutaneous vasodilation: a crucial process for local heat exposure. GeroScience 2024; 46:3567-3580. [PMID: 37855862 PMCID: PMC11226586 DOI: 10.1007/s11357-023-00981-5] [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: 06/12/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
Sensing temperature is vitally important to adapt our body to environmental changes. Local warm detection is required to initiate regulation of cutaneous blood flow, which is part of the peripheral thermoregulatory mechanisms, and thus avoid damage to surrounding tissues. The mechanisms mediating cutaneous vasodilation during local heat stress are impaired with aging. However, the impact of aging on the ability of the skin to detect subtle thermal changes is unknown. Among heat-activated cation channels, transient receptor potential vanilloid 3 (TRPV3) is a thermo-sensor predominantly expressed on keratinocytes and involved in local vascular thermoregulatory mechanisms of the skin in young mice. In the present study, using a murine in vivo model of local heat exposure of the skin, we showed that heat-induced vasodilation was reduced in old mice associated with reduced expression of TRPV3 channels. We also found a decrease in expression and activity of TRPV3 channel, as well as reduced TRPV3-dependent adenosine tri-phosphate release in human primary keratinocytes from old donors. This study shows that aging alters the epidermal TRPV3 channels, which might delay the detection of changes in skin temperature, thereby limiting the mechanisms triggered for local vascular thermoregulation in the old skin.
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Affiliation(s)
- Lisa S Martin
- CNRS UMR 5305, Tissue Biology and Therapeutic Engineering Laboratory (LBTI), 69007, Lyon, France
- Claude Bernard University Lyon 1, 69100, Villeurbanne, France
| | - Audrey Josset-Lamaugarny
- CNRS UMR 5305, Tissue Biology and Therapeutic Engineering Laboratory (LBTI), 69007, Lyon, France
- Claude Bernard University Lyon 1, 69100, Villeurbanne, France
| | - Thomas El Jammal
- CNRS UMR 5305, Tissue Biology and Therapeutic Engineering Laboratory (LBTI), 69007, Lyon, France
- Claude Bernard University Lyon 1, 69100, Villeurbanne, France
- Department of Internal Medicine, University Hospital Lyon Croix-Rousse, Claude Bernard University Lyon 1, Lyon, France
| | - Sylvie Ducreux
- CarMeN Laboratory, INSERM, INRA, INSA Lyon, Claude Bernard University Lyon 1, 69500, Bron, France
| | - Fabien P Chevalier
- CNRS UMR 5305, Tissue Biology and Therapeutic Engineering Laboratory (LBTI), 69007, Lyon, France
- Claude Bernard University Lyon 1, 69100, Villeurbanne, France
| | - Bérengère Fromy
- CNRS UMR 5305, Tissue Biology and Therapeutic Engineering Laboratory (LBTI), 69007, Lyon, France.
- Claude Bernard University Lyon 1, 69100, Villeurbanne, France.
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Shaban M, Amer FGM, Shaban MM. The impact of nursing sustainable prevention program on heat strain among agricultural elderly workers in the context of climate change. Geriatr Nurs 2024; 58:215-224. [PMID: 38838403 DOI: 10.1016/j.gerinurse.2024.05.021] [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: 01/10/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND This study assesses a geriatric nursing-led sustainable heat prevention program for elderly agricultural workers. It targets those aged 60 and above, addressing the heightened risk of heat strain in the era of climate change. METHODS A community-based quasi-experimental design involved 120 elderly agricultural workers, divided into intervention and control groups. The program, spanning three months, included education on hydration, rest, protective clothing, and recognition of heat-related illnesses. RESULTS The intervention led by geriatric nursing professionals showed significant improvements in heat strain metrics. The Heat Strain Score Index (HSSI) and the Observational-Perceptual Heat Strain Risk Assessment (OPHSRA) Index indicated increased safety levels and reduced risk categories among participants. CONCLUSIONS The study demonstrates the effectiveness of a geriatric nursing-led, tailored prevention program in reducing heat strain among elderly agricultural workers. It highlights the crucial role of nursing in adapting healthcare practices to the challenges posed by climate change. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT06192069 retrospectively registered.
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Wang Y, Yang N, Zhang J, Han W, Li X. Construction and validation of a postoperative hypothermia prediction model in elderly patients undergoing colorectal surgery. Heliyon 2024; 10:e32391. [PMID: 38975114 PMCID: PMC11225767 DOI: 10.1016/j.heliyon.2024.e32391] [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: 03/24/2024] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 07/09/2024] Open
Abstract
Background Postoperative hypothermia (POH) is a common issue in colorectal surgery patients, leading to complications. This study aimed to develop and validate a predictive model for identifying POH in colorectal surgery patients. Methods A retrospective analysis of 1,316 patients who underwent colorectal surgery between June 2020 and September 2022 was conducted using institutional medical records. Intraoperative core temperatures and potential influencing factors were collected, and regression analysis was used to identify risk factors for POH and create a model. The model's performance was evaluated using the receiver operating characteristic curve analysis. Results Intraoperative hypothermia occurred in 51.5 % of patients. Significant predictors of POH included gender, alcohol consumption, surgery duration, platelet count, and age. The constructed model included factors like fluid intake, platelets, cigarette use, alcohol consumption, surgery type, muscle relaxants, age, ABSI, and gender. The model showed good predictive performance with an area under the ROC curve of 0.981 and a Hosmer-Lemeshow test p-value of 0.676. The Youden index, sensitivity, specificity, and practical application rate were 0.602, 0.790, 0.812, and 98.81 %, respectively. Conclusion This study developed a predictive model for POH in colorectal surgery patients, considering individual factors and exploring underlying causes. Understanding risk factors and consequences of POH is crucial for nurses and perioperative professionals in clinical practice.
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Affiliation(s)
- Yonghong Wang
- Department of Anesthesiology and Surgery, Capital Medical University Electric Power Teaching Hospital, No. 1 West Lane Tai Ping Bridge, Fengtai District, Beijing, 100073, China
| | - Na Yang
- Department of Outpatient, First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510062, Guangdong Province, China
| | - Jiying Zhang
- Department of Anesthesiology and Surgery, Capital Medical University Electric Power Teaching Hospital, No. 1 West Lane Tai Ping Bridge, Fengtai District, Beijing, 100073, China
| | - Wenyong Han
- Department of Anesthesiology and Surgery, Capital Medical University Electric Power Teaching Hospital, No. 1 West Lane Tai Ping Bridge, Fengtai District, Beijing, 100073, China
| | - Xia Li
- Department of Anesthesiology and Surgery, Capital Medical University Electric Power Teaching Hospital, No. 1 West Lane Tai Ping Bridge, Fengtai District, Beijing, 100073, China
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Xi D, Liu L, Zhang M, Huang C, Burkart KG, Ebi K, Zeng Y, Ji JS. Risk factors associated with heatwave mortality in Chinese adults over 65 years. Nat Med 2024; 30:1489-1498. [PMID: 38528168 DOI: 10.1038/s41591-024-02880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/22/2024] [Indexed: 03/27/2024]
Abstract
Aging populations are susceptible to heat-related mortality because of physiological factors and comorbidities. However, the understanding of individual vulnerabilities in the aging population is incomplete. In the Chinese Longitudinal Healthy Longevity Survey, we assessed daily heatwave exposure individually for 13,527 participants (median age = 89 years) and 3,249 summer mortalities during follow-up from 2008 to 2018. The mortality risk during heatwave days according to relative temperature is approximately doubled (hazard ratio (HR) range = 1.78-1.98). We found that heatwave mortality risks were increased for individuals with functional declines in mobility (HR range = 2.32-3.20), dependency in activities of daily living (HR range = 2.22-3.27), cognitive impairment (HR = 2.22) and social isolation reflected by having nobody to ask for help during difficulties (HR range = 2.14-10.21). Contrary to current understanding, older age was not predictive of heatwave mortality risk after accounting for individual functional declines; no statistical differences were detected according to sex. Beyond age as a risk factor, our findings emphasize that functional aging is an underlying factor in enhancing heatwave resilience. Assessment of functional decline and implementing care strategies are crucial for targeted prevention of mortality during heatwaves.
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Affiliation(s)
- Di Xi
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Linxin Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Min Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Katrin G Burkart
- Institute for Health Metric and Evaluation, University of Washington, Seattle, WA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
- Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, USA
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Requia WJ, Jablinski Castelhano F, Moore J, Maria Damasceno da Silva R, Andreotti Dias M. Thermal stress and hospital admissions for cardiorespiratory disease in Brazil. ENVIRONMENT INTERNATIONAL 2024; 187:108694. [PMID: 38688235 DOI: 10.1016/j.envint.2024.108694] [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: 12/14/2023] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Abstract
The growing body of scientific literature underscores the intricate relationship between meteorological conditions and human health, particularly in the context of extreme temperatures. However, conventional temperature-centric approaches often fall short in capturing the complexity of thermal stress experienced by individuals. Temperature alone, as a metric, fails to encompass the entirety of the thermal stress individuals face, necessitating a more nuanced understanding. In response to this limitation, climatologists have devised thermal indices-composite measures meticulously crafted to reflect the intricate interplay of meteorological factors influencing human perception of temperature. Recognizing the inadequacy of simplistic temperature-focused methodologies, our study aims to address the multifaceted nature of thermal stress. In this study, we explored the association between thermal indices and hospital admissions for circulatory and respiratory diseases in Brazil. We used an extensive dataset spanning 11 years (2008-2018) from the Brazilian Ministry of Health, encompassing a total of 23,791,093 hospitalizations for circulatory and respiratory diseases. We considered four distinct thermal indices-Discomfort Index (DI), Net Effective Temperature (NET), Humidex (H), and Heat Index (HI). We used an extension of the two-stage design with a case time series to assess this relationship. In the first stage, we applied a distributed lag non-linear modeling framework to create a cross-basis function. We next applied quasi-Poisson regression models adjusted by time-varying confounders. In the second stage, we applied meta-analysis with random effects to estimate the national relative risk (RR). Our findings suggest robust variations among the thermal indices under examination. These variations underscore the intricate nature of associations between temperature and health, with each index capturing distinct aspects of thermal conditions. Our results indicate that extreme thermal conditions, both at the low and high ends, are associated with increased risks of hospital admissions. The diverse impact observed among different indices emphasizes the complex interplay between various meteorological factors and their specific physiological consequences. This underscores the necessity for a comprehensive comprehension of temperature metrics to guide precise public health interventions, recognizing the multifaceted nature of temperature-health relationships.
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Affiliation(s)
- Weeberb J Requia
- Center for Environment and Public Health Studies, School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil.
| | | | - Julia Moore
- Center for Environment and Public Health Studies, School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil
| | - Reizane Maria Damasceno da Silva
- Center for Environment and Public Health Studies, School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil
| | - Mariana Andreotti Dias
- Demography Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Figueiredo T, Midão L, Rocha P, Cruz S, Lameira G, Conceição P, Ramos RJG, Batista L, Corvacho H, Almada M, Martins A, Rocha C, Ribeiro A, Alves F, Costa E. The interplay between climate change and ageing: A systematic review of health indicators. PLoS One 2024; 19:e0297116. [PMID: 38656926 PMCID: PMC11042704 DOI: 10.1371/journal.pone.0297116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/28/2023] [Indexed: 04/26/2024] Open
Abstract
Climate change and rapid population ageing pose challenges for communities and public policies. This systematic review aims to gather data from studies that present health indicators establishing the connection between climate change and the physical and mental health of the older population (≥ 65 years), who experience a heightened vulnerability to the impacts of climate change when compared to other age cohorts. This review was conducted according to the PICO strategy and following Cochrane and PRISMA guidelines. Three databases (PubMed, Scopus and Greenfile) were searched for articles from 2015 to 2022. After applying inclusion and exclusion criteria,nineteen studies were included. The findings indicated that various climate change phenomena are associated with an elevated risk of mortality and morbidity outcomes in older adults. These included cardiovascular, respiratory, renal, and mental diseases, along with physical injuries. Notably, the impact of climate change was influenced by gender, socioeconomic status, education level, and age-vulnerability factors. Climate change directly affected the health of older adults through ambient temperature variability, extreme and abnormal temperatures, strong winds, sea temperature variability, extreme El Niño-southern Oscillation (ENSO) conditions and droughts, and indirectly by air pollution resulting from wildfires. This review presents further evidence confirming that climate change significantly impacts the health and well-being of older adults. It highlights the urgency for implementing effective strategies to facilitate adaptation and mitigation, enhancing the overall quality of life for all individuals.
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Affiliation(s)
- Teodora Figueiredo
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Luís Midão
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Pedro Rocha
- CINTESIS@RISE, “Department of Behavioral Sciences”, ICBAS, University of Porto, Porto, Portugal
| | - Sara Cruz
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Gisela Lameira
- Faculty of Architecture, University of Porto, Porto, Portugal
| | - Paulo Conceição
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Rui J. G. Ramos
- Faculty of Architecture, University of Porto, Porto, Portugal
| | - Luísa Batista
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Helena Corvacho
- CONSTRUCT (LFC), Faculty of Engineering University of Porto, Porto, Portugal
| | - Marta Almada
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Ana Martins
- Faculty of Architecture, University of Porto, Porto, Portugal
| | - Cecília Rocha
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Anabela Ribeiro
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Sciences and Technology of the University of Coimbra, Coimbra, Portugal
| | - Fernando Alves
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Elísio Costa
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
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Janoš T, Ballester J, Čupr P, Achebak H. Countrywide analysis of heat- and cold-related mortality trends in the Czech Republic: growing inequalities under recent climate warming. Int J Epidemiol 2024; 53:dyad141. [PMID: 37857363 PMCID: PMC10859142 DOI: 10.1093/ije/dyad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Only little is known about trends in temperature-mortality associations among the most vulnerable subgroups, especially in the areas of central and eastern Europe, which are considered major climatic hotspots in terms of heatwave exposure. Thus, we aimed to assess trends in temperature-related mortality in the Czech Republic by sex, age and cause of death, and to quantify the temporal evolution of possible inequalities. METHODS We collected daily time series of all-cause (1987-2019) and cause-specific (1994-2019) mortality by sex and age category, and population-weighted daily mean 2-metre temperatures for each region of the Czech Republic. We applied a quasi-Poisson regression model to estimate the trends in region-specific temperature-mortality associations, with distributed lag non-linear models and multivariate random-effects meta-analysis to derive average associations across the country. We then calculated mortality attributable to non-optimal temperatures and implemented the indicator of sex- and age-dependent inequalities. RESULTS We observed a similar risk of mortality due to cold temperatures for men and women. Conversely, for warm temperatures, a higher risk was observed for women. Results by age showed a clear pattern of increasing risk due to non-optimum temperatures with increasing age category. The relative risk (RR) related to cold was considerably attenuated in most of the studied subgroups during the study period, whereas an increase in the RR associated with heat was seen in the overall population, in women, in the age category 90+ years and with respect to respiratory causes. Moreover, underlying sex- and age-dependent inequalities experienced substantial growth. CONCLUSIONS Our findings suggest ongoing adaptation to cold temperatures. Mal/adaptation to hot temperatures occurred unequally among population subgroups and resulted in growing inequalities between the sexes and among age categories.
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Affiliation(s)
- Tomáš Janoš
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | | | - Pavel Čupr
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Hicham Achebak
- ISGlobal, Barcelona, Spain
- Inserm, France Cohortes, Paris, France
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Ho JYE, Lai ET, Chau PH, Chong KC, Woo J. The role of older adult-focused social vulnerability on the relationship between temperature and emergency department attendance in a subtropical Asian city. Arch Gerontol Geriatr 2024; 117:105195. [PMID: 37734171 DOI: 10.1016/j.archger.2023.105195] [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: 08/04/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Older adults exhibit a wide range of capabilities and vulnerabilities that affect their capacity to respond to heat. This study analysed the associations between hot temperatures and Accident & Emergency (A&E) attendance taking into account older adult-focused social vulnerability. METHODS Daily A&E attendance data of Young-old (65-74) and Old-old (75+) was obtained for Hong Kong 2010-2019 hot seasons and stratified into three Social Vulnerability Index (SVI) groups (Low, Moderate, High). Mean temperature (lag 0-2) was analysed on A&E attendance at each SVI using Generalized Additive Models and Distributed Lag Non-linear Models. RESULTS High temperatures were associated with increased same-day (lag 0) relative risk (RR) of A&E attendance for Young-old and Old-old in High SVI districts, with RR being 1.024 (95 % CI: 1.011, 1.037) and 1.036 (95 % CI: 1.018, 1.053), respectively. The Old-old living in Moderate and Low SVI districts also demonstrated increased RR of 1.037 (95 % CI: 1.028, 1.047) and 1.022 (95 % CI: 1.009, 1.036), respectively. Fewer emergency visits were found on the subsequent day (lag 1) of hot temperatures. CONCLUSIONS Older adults, both young-old and old-old, living in districts with higher social vulnerability tended to have increased risk of A&E attendance associated with same-day high temperature. With climate change and rapidly aging population, cities should prepare to meet needs of more vulnerable older adults in extreme heat.
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Affiliation(s)
- Janice Ying-En Ho
- Department of Architecture, The University of Hong Kong, Hong Kong SAR, China; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Eric Tc Lai
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jean Woo
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China; Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
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Cheong SM, Gaynanova I. Sensing the impact of extreme heat on physical activity and sleep. Digit Health 2024; 10:20552076241241509. [PMID: 38528970 PMCID: PMC10962040 DOI: 10.1177/20552076241241509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction This study assesses the person-specific impact of extreme heat on low-income households using wearable sensors. The focus is on the intensive and longitudinal assessment of physical activity and sleep with the rising person-specific ambient temperature. Methods This study recruited 30 participants in a low-income and predominantly Black community in Houston, Texas in August and September of 2022. Each participant wore on his/her wrist an accelerometer that recorded person-specific ambient temperature, sedentary behavior, physical activity intensity (low and moderate to vigorous), and sleep efficiency 24 h over 14 days. Mixed effects models were used to analyze associations among physical activity, sleep, and person-specific ambient temperature. Results The main findings include increased sedentary time, sleep impairment with the rise of person-level ambient temperature, and the mitigating role of AC. Conclusions Extreme heat negatively affects physical activity and sleep. The negative consequences are especially critical for those with limited use of AC in lower-income neighborhoods of color. Staying home with a high indoor temperature during hot days can lead to various adverse health outcomes including accelerated cognitive decline, higher cancer risk, and social isolation.
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Affiliation(s)
- So-Min Cheong
- Department of Public Service & Administration, Texas A&M University, College Station, TX, USA
| | - Irina Gaynanova
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Chang CJ, Yang HY. Chronic Kidney Disease Among Agricultural Workers in Taiwan: A Nationwide Population-Based Study. Kidney Int Rep 2023; 8:2677-2689. [PMID: 38106601 PMCID: PMC10719565 DOI: 10.1016/j.ekir.2023.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Chronic kidney disease (CKD) in agricultural communities is a significant public health issue. We aimed to investigate the epidemiology of CKD among Taiwanese farmers and its association with outdoor heat exposure. Methods A nested case-control study was conducted on participants in the National Adult Health Examination (NAHE) from 2012 to 2018. The farming occupation was identified through National Health Insurance data. The primary outcomes of interest were the development of CKD, defined as a decreased estimated glomerular filtration rate (eGFR) with diagnosis by physicians, and CKD of undetermined etiology (CKDu), defined as CKD excluding common traditional etiologies. We calculated the county-wide average ambient temperature from a climate reanalysis dataset (ERA5-Land). All CKD cases were matched 1:2 to non-CKD participants by age and biological sex. We estimated the odds ratios (ORs) of CKD and CKDu for farmers and changes in mean ambient temperature (°C) before the examination. Results We identified 844,412 farmers and 3,750,273 nonfarmers. Among 24.9% of farmers and 7.4% of nonfarmers with reduced kidney function, only 1 in 7 received a diagnosis of CKD. The farming occupation was independently predictive of CKDu (OR = 1.09, 95% confidence interval [CI] = 1.001-1.18) but not CKD. Increased ambient temperature (°C) was associated with a higher risk of CKD (OR = 1.023, 95% CI = 1.017-1.029), with particularly strong associations observed among middle-aged participants and diabetics. Conclusions Taiwanese farmers might have a higher risk of developing CKDu. Outdoor heat exposure is associated with the development of CKD, and middle-aged participants and those with diabetes are more vulnerable than the general population.
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Affiliation(s)
- Che-Jui Chang
- Institute of Occupational and Environmental Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Hsiao-Yu Yang
- Institute of Occupational and Environmental Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Population Health and Welfare Research Center, National Taiwan University College of Public Health, Taipei, Taiwan
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Moraes SLD, Almendra R, Barrozo LV. Space-time clusters of cardiovascular mortality and the role of heatwaves and cold spells in the city of São Paulo, Brazil. Spat Spatiotemporal Epidemiol 2023; 47:100620. [PMID: 38042539 DOI: 10.1016/j.sste.2023.100620] [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] [Received: 01/20/2023] [Revised: 08/07/2023] [Accepted: 09/17/2023] [Indexed: 12/04/2023]
Abstract
The effects extreme air temperature events are related with an increase in cardiovascular mortality among vulnerable groups worldwide. Therefore, we identify spatiotemporal mortality clusters associated with diseases of the cardiovascular system among people ≥ 65 years in São Paulo, from 2006 to 2015, and investigate whether high-risk mortality clusters occurred during or following extreme air temperature events. To detect the clusters, we used daily mortality data and a retrospective space-time scan analysis with a discrete Poisson model. Extreme air temperature events were defined by daily mean temperatures, below the 10th percentile for cold spells and above the 90th percentile for heatwaves, with two or more consecutive days. We found statistically significant high-risk mortality clusters located in the peripheral areas. The spatiotemporal clusters of risk areas for cardiovascular and ischemic heart disease occurred during or following cold spell events, whereas those for stroke and ischemic stroke events were related to heatwaves.
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Affiliation(s)
- Sara Lopes de Moraes
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo, Brazil; Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.
| | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo, Brazil; Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
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Jašková P, Palarea-Albaladejo J, Gába A, Dumuid D, Pedišić Ž, Pelclová J, Hron K. Compositional functional regression and isotemporal substitution analysis: Methods and application in time-use epidemiology. Stat Methods Med Res 2023; 32:2064-2080. [PMID: 37590096 PMCID: PMC10563378 DOI: 10.1177/09622802231192949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
The distribution of time that people spend in physical activity of various intensities has important health implications. Physical activity (commonly categorised by the intensity into light, moderate and vigorous physical activity), sedentary behaviour and sleep, should not be analysed separately, because they are parts of a time-use composition with a natural constraint of 24 h/day. To find out how are relative reallocations of time between physical activity of various intensities associated with health, herewith we describe compositional scalar-on-function regression and a newly developed compositional functional isotemporal substitution analysis. Physical activity intensity data can be considered as probability density functions, which better reflects the continuous character of their measurement using accelerometers. These probability density functions are characterised by specific properties, such as scale invariance and relative scale, and they are geometrically represented using Bayes spaces with the Hilbert space structure. This makes possible to process them using standard methods of functional data analysis in the L 2 space, via centred logratio (clr) transformation. The scalar-on-function regression with clr transformation of the explanatory probability density functions and compositional functional isotemporal substitution analysis were applied to a dataset from a cross-sectional study on adiposity conducted among school-aged children in the Czech Republic. Theoretical reallocations of time to physical activity of higher intensities were found to be associated with larger and more progressive expected decreases in adiposity. We obtained a detailed insight into the dose-response relationship between physical activity intensity and adiposity, which was enabled by using the compositional functional approach.
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Affiliation(s)
- Paulína Jašková
- Faculty of Science, Palacký University Olomouc, Olomoucký, Czech Republic
| | - Javier Palarea-Albaladejo
- Department of Computer Science, Applied Mathematics and Statistics, University of Girona, Catalunya, Spain
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, Olomoucký, Czech Republic
| | - Dorothea Dumuid
- Alliance for Research in Exercice, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville, VC, Australia
| | - Željko Pedišić
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Jana Pelclová
- Faculty of Physical Culture, Palacký University Olomouc, Olomoucký, Czech Republic
| | - Karel Hron
- Faculty of Science, Palacký University Olomouc, Olomoucký, Czech Republic
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Sixtus RP, Gray C, Berry MJ, Dyson RM. Preterm-born individuals: a vulnerable population at risk of cardiovascular morbidity and mortality during thermal extremes? Exp Physiol 2023; 108:1011-1025. [PMID: 37084061 PMCID: PMC10988436 DOI: 10.1113/ep091152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
NEW FINDINGS What is the topic of this review? Thermal extremes disproportionately affect populations with cardiovascular conditions. Preterm birth, across all gestational age ranges below 37 weeks, has been identified as a non-modifiable risk factor for cardiovascular disease. The hypothesis is presented that individuals born preterm are at an increased risk of cardiovascular morbidity and mortality during thermal extremes. What advances does it highlight? Cardiovascular stress tests performed in preterm-born populations, from infancy through adulthood, highlight a progression of cardiovascular dysfunction accelerating through adolescence and adulthood. This dysfunction has many similarities with populations known to be at risk in thermal extremes. ABSTRACT Preterm-born individuals are a uniquely vulnerable population. Preterm exposure to the extrauterine environment and the (mal)adaptations that occur during the transitional period can result in alterations to their macro- and micro-physiological state. The physiological adaptations that increase survival in the short term may place those born preterm on a trajectory of lifelong dysfunction and later-life decompensation. Cardiovascular compensation in children and adolescents, which masks this trajectory of dysfunction, is overcome under stress, such that the functional cardiovascular capacity is reduced and recovery impaired following physiological stress. This has implications for their response to thermal stress. As the Anthropocene introduces greater changes in our environment, thermal extremes will impact vulnerable populations as yet unidentified in the climate change context. Here, we present the hypothesis that individuals born preterm are a vulnerable population at an increased risk of cardiovascular morbidity and mortality during thermal extremes.
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Affiliation(s)
- Ryan Phillip Sixtus
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Clint Gray
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Mary Judith Berry
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Rebecca Maree Dyson
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
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14
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Vishram-Nielsen JK, Mueller B, Ross HJ, Fan CP, Rubin B, Alba AC, Manlhiot C. Association Between the Incidence of Hospitalizations for Acute Cardiovascular Events, Weather, and Air Pollution. JACC. ADVANCES 2023; 2:100334. [PMID: 38938234 PMCID: PMC11198195 DOI: 10.1016/j.jacadv.2023.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 06/29/2024]
Abstract
Background The incidence of hospitalizations for cardiovascular events has been associated with specific weather conditions and air pollution. A comprehensive model including the interactions between various environmental factors remains to be developed. Objectives The purpose of this study was to develop a comprehensive model of the association between weather patterns and the incidence of cardiovascular events and use this model to forecast near-term spatiotemporal risk. Methods We present a spatiotemporal analysis of the association between atmospheric data and the incidence rate of hospital admissions related to heart failure (922,132 episodes), myocardial infarction (521,988 episodes), and ischemic stroke (263,529 episodes) in ∼24 million people in Canada between 2007 and 2017. Our hierarchical Bayesian model captured the spatiotemporal distribution of hospitalizations and identified weather and air pollution-related factors that could partially explain fluctuations in incidence. Results Models that included weather and air pollution variables outperformed models without those covariates for most event types. Our results suggest that environmental factors may interact in complex ways on human physiology. The impact of environmental factors was magnified with increasing age. The weather and air pollution variables included in our models were predictive of the future incidence of heart failure, myocardial infarction, and ischemic strokes. Conclusions The increasing importance of environmental factors on cardiovascular events with increasing age raises the need for the development of educational materials for older patients to recognize environmental conditions where exacerbations are more likely. This model could be the basis of a forecasting system used for local, short-term clinical resource planning based on the anticipated incidence of events.
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Affiliation(s)
- Julie K.K. Vishram-Nielsen
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Brigitte Mueller
- Ted Rogers Computational Program, Ted Rogers Centre for Heart Research, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Heather J. Ross
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Chun-Po Fan
- Ted Rogers Computational Program, Ted Rogers Centre for Heart Research, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Barry Rubin
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Ana Carolina Alba
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Cedric Manlhiot
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Blalock-Taussig-Thomas Pediatric and Congenital Heart Center, John Hopkins University School of Medicine, Baltimore, Maryland, USA
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15
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Kam S, Hwang BJ, Parker ER. The impact of climate change on atopic dermatitis and mental health comorbidities: a review of the literature and examination of intersectionality. Int J Dermatol 2023; 62:449-458. [PMID: 36639925 DOI: 10.1111/ijd.16557] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/19/2022] [Accepted: 11/30/2022] [Indexed: 01/15/2023]
Abstract
Climate change, fueled by increasing concentrations of greenhouse gases, is associated with rising temperatures, extreme weather events, increased aeroallergen production, and air pollution. Our understanding that many inflammatory cutaneous diseases carry important mental health comorbidities is expanding. Simultaneously, the detrimental impacts of climate change on human health are now widely recognized as a global public health crisis. Importantly, these climate-associated phenomena exacerbate the environmental triggers of atopic dermatitis (AD) and are also associated with amplification of comorbid mental health conditions in AD including depression, anxiety, trauma-related disorders, and psychotic spectrum disorders. This review is the first to examine the nexus of climate change, atopic dermatitis, and mental health comorbidities and emphasizes the disproportionate impacts of climate change in vulnerable and marginalized populations.
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Affiliation(s)
- Sharon Kam
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Barrington J Hwang
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eva R Parker
- Department of Dermatology and the Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN, USA
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16
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Deering S. Santé publique clinique, changement climatique et vieillissement. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2023; 69:242-244. [PMID: 37072194 PMCID: PMC10112732 DOI: 10.46747/cfp.6904242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Affiliation(s)
- Susan Deering
- Médecin de famille en pratique ciblée dans le domaine des soins aux personnes âgées en soins de longue durée à Toronto (Ontario), coprésidente du groupe de travail écologique Sunnybrooke au Centre des sciences de la santé Sunnybrooke et professeure adjointe à la Faculté de médecine de l’Université de Toronto
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17
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Sixtus RP, Berry MJ, Gray CL, Dyson RM. A novel whole-body thermal stress test for monitoring cardiovascular responses in Guinea pigs. J Therm Biol 2023; 113:103500. [PMID: 37055107 DOI: 10.1016/j.jtherbio.2023.103500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 01/27/2023] [Accepted: 02/04/2023] [Indexed: 03/12/2023]
Abstract
Cardiovascular disease is a leading cause of morbidity and mortality worldwide. Stress tests are frequently employed to expose early signs of cardiovascular dysfunction or disease and can be employed, for example, in the context of preterm birth. We aimed to establish a safe and effective thermal stress test to examine cardiovascular function. Guinea pigs were anaesthetized using a 0.8% isoflurane, 70% N2O mix. ECG, non-invasive blood pressure, laser Doppler flowmetry, respiratory rate, and an array of skin and rectal thermistors were applied. A physiologically relevant heating and a cooling thermal stress test was developed. Upper and lower thermal limits for core body temperature were set at 41.5 OC and 34 OC, for the safe recovery of animals. This protocol therefore presents a viable thermal stress test for use in guinea pig models of health and disease that facilitates exploration of whole-system cardiovascular function.
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Affiliation(s)
- Ryan P Sixtus
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
| | - Mary J Berry
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Clint L Gray
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Rebecca M Dyson
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
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18
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Huang Y, Song H, Cheng Y, Bi P, Li Y, Yao X. Heatwave and urinary hospital admissions in China: Disease burden and associated economic loss, 2014 to 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159565. [PMID: 36265638 DOI: 10.1016/j.scitotenv.2022.159565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/15/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Many studies have shown that heatwaves are associated with an increased prevalence of urinary diseases. However, few national studies have been undertaken in China, and none have considered the associated economic losses. Such information would be useful for health authorities and medical service providers to improve their policy-making and medical resource allocation decisions. OBJECTIVES To explore the association between heatwaves and hospital admissions for urinary diseases and assess the related medical costs and indirect economic losses in China from 2014 to 2019. METHODS Daily meteorological and hospital admission data from 2014 to 2019 were collected from 23 study sites with different climatic characteristics in China. We assessed the heatwave-hospitalization associations and evaluated the location-specific attributable fractions (AFs) of urinary-related hospital admissions due to heatwaves by using a time-stratified case-crossover method with a distributed lag nonlinear model. We then pooled the AFs in a meta-analysis and estimated the national excess disease burden and associated economic losses. We also performed stratified analyses by sex, age, climate zone, and urinary disease subtype. RESULTS A significant association between heatwaves and urinary-related hospital admissions was found with a relative risk of 1.090 (95 % confidence interval (CI): 1.050, 1.132). The pooled AF was 8.27 % (95%CI: 4.77 %, 11.63 %), indicating that heatwaves during the warm season (May to September) caused 248,364 urinary-related hospital admissions per year, with 2.42 (95%CI: 1.35, 3.45) billion CNY in economic losses, including 2.23 (95%CI: 1.29, 3.14) billion in direct losses and 0.19 (95%CI, 0.06, 0.31) billion in indirect losses, males, people aged 15-64 years, residents of temperate continental climate zones, and patients with urolithiasis were at higher risk. CONCLUSION Tailored community health campaigns should be developed and implemented to reduce the adverse health effects and economic losses of heatwave-related urinary diseases, especially in the context of climate change.
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Affiliation(s)
- Yushu Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hejia Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, South Australia, Australia
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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19
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Donnan KJ, Williams EL, Bargh MJ. The effectiveness of heat preparation and alleviation strategies for cognitive performance: A systematic review. Temperature (Austin) 2023; 10:404-433. [PMID: 38130656 PMCID: PMC10732620 DOI: 10.1080/23328940.2022.2157645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
A range of occupational and performance contexts (e.g. military personnel operations, emergency services, sport) require the critical maintenance of cognitive performance in environmentally challenging environments. Several reviews exist which evaluate the effectiveness of heat preparation strategies to facilitate physical performance. To date, no review has explored the usefulness of heat preparation strategies for cognitive performance. Therefore, this systematic review aimed to evaluate a range of interventions for the maintenance of cognitive performance, during or following active or passive heat exposure. Studies to be included were assessed by two authors reviewing title, abstract, and full-text. Forty articles were identified which met the inclusion criteria. Interventions were categorised into chronic (i.e. acclimation/acclimatisation) and acute strategies (i.e. hydration, cooling, supplementation, psychological). The results indicate that medium-term consecutive heat acclimation may mitigate some cognitive deficits under heat stress, although heat acclimation effectiveness could be influenced by age. Further, pre-cooling appears the most effective cooling method for maintaining cognitive performance under heat stress, although results were somewhat ambiguous. The hydration literature showed that the most effective hydration strategies were those which individualised electrolyte fortified fluid volumes to match for sweat loss. Limited research exploring psychological interventions indicates that motivational self-talk could be facilitative for maintaining cognitive skills following exercise in hot conditions. These findings can be used to help inform strategies for maintaining critical cognitive and decision-making skills in hot environments.
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Affiliation(s)
- Kate J. Donnan
- Department of Sport, Exercise, and Rehabilitation Sciences, University of Hull, Hull, HU6 7RX, UK
| | - Emily L. Williams
- Centre for Human Performance, Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK
| | - Melissa J. Bargh
- School of Sport and Exercise Science, College of Social Science of University of Lincoln, Lincoln, LN6 7TS, UK
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20
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Wolf ST, Vecellio DJ, Kenney WL. Adverse heat-health outcomes and critical environmental limits (Pennsylvania State University Human Environmental Age Thresholds project). Am J Hum Biol 2023; 35:e23801. [PMID: 36125292 PMCID: PMC9840654 DOI: 10.1002/ajhb.23801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/24/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The earth's climate is warming and the frequency, duration, and severity of heat waves are increasing. Meanwhile, the world's population is rapidly aging. Epidemiological data demonstrate exponentially greater increases in morbidity and mortality during heat waves in adults ≥65 years. Laboratory data substantiate the mechanistic underpinnings of age-associated differences in thermoregulatory function. However, the specific combinations of environmental conditions (i.e., ambient temperature and absolute/relative humidity) above which older adults are at increased risk of heat-related morbidity and mortality are less clear. METHODS This review was conducted to (1) examine the recent (past 3 years) literature regarding heat-related morbidity and mortality in the elderly and discuss projections of future heat-related morbidity and mortality based on climate model data, and (2) detail the background and unique methodology of our ongoing laboratory-based projects aimed toward identifying the specific environmental conditions that result in elevated risk of heat illness in older adults, and the implications of using the data toward the development of evidence-based safety interventions in a continually-warming climate (PSU HEAT; Human Environmental Age Thresholds). RESULTS The recent literature demonstrates that extreme heat continues to be increasingly detrimental to the health of the elderly and that this is apparent across the world, although the specific environmental conditions above which older adults are at increased risk of heat-related morbidity and mortality remain unclear. CONCLUSION Characterizing the environmental conditions above which risk of heat-related illnesses increase remains critical to enact policy decisions and mitigation efforts to protect vulnerable people during extreme heat events.
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Affiliation(s)
- S. Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802
| | - Daniel J. Vecellio
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802
| | - W. Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802
- Graduate Program in Physiology, The Pennsylvania State University, University Park, PA, 16802
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21
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He F, Wei J, Dong Y, Liu C, Zhao K, Peng W, Lu Z, Zhang B, Xue F, Guo X, Jia X. Associations of ambient temperature with mortality for ischemic and hemorrhagic stroke and the modification effects of greenness in Shandong Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158046. [PMID: 35987239 DOI: 10.1016/j.scitotenv.2022.158046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence is scant on the relative and attributable contributions of ambient temperature on stroke subtypes mortality. Few studies have examined modification effects of multiple greenness indicators on such contributions, especially in China. We quantified the associations between ambient temperature and overall, ischemic, and hemorrhagic stroke mortality; further examined whether the associations were modified by greenness. METHODS We conducted a multicenter time-series analysis from January 1, 2013 to December 31, 2019. we adopted a distributed lag non-linear model to evaluate county-specific temperature-stroke mortality associations. We then applied a random-effects meta-analysis to pool county-specific effects. Attributable mortality was calculated for cold and heat, defined as temperatures below and above the minimum mortality temperature (MMT). Finally, We conducted a multivariate meta-regression to determine associations between greenness and stroke mortality risks for cold and heat, using normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), and enhanced vegetation index (EVI) as quantitative indicators of greenness exposure. RESULTS In the study period, 138,749 deaths from total stroke were reported: 86,873 ischemic and 51,876 hemorrhagic stroke. We observed significant W-shaped relationships between temperature and stroke mortality, with substantial differences among counties and regions. With MMT as the temperature threshold, 17.16 % (95 % empirical CI, 13.38 %-19.75 %) of overall, 20.05 % (95 % eCI, 16.46 %-22.70 %) of ischemic, and 12.55 % (95 % eCI, 5.59 %-16.24 %) of hemorrhagic stroke mortality were attributable to non-optimum temperature (combining cold and heat), more mortality was caused by cold (14.94 %; 95 % eCI, 11.57 %-17.34 %) than by heat (2.22 %; 95 % eCI, 1.54 %-2.72 %). Higher levels of NDVI, SAVI and EVI were related to mitigated effects of non-optimum temperatures-especially heat. CONCLUSIONS Exposure to non-optimum temperatures aggravated stroke mortality risks; increasing greenness could alleviate that risks. This evidence has important implications for local communities in developing adaptive strategies to minimize the health consequences of adverse temperatures.
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Affiliation(s)
- Fenfen He
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Yilin Dong
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
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22
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Li PL, Yick KL, Yip J, Ng SP. Influence of Upper Footwear Material Properties on Foot Skin Temperature, Humidity and Perceived Comfort of Older Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10861. [PMID: 36078575 PMCID: PMC9518374 DOI: 10.3390/ijerph191710861] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/17/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Studying the in-shoe microclimate of older individuals is important for enhancing their foot comfort and preventing foot diseases. However, there is a lack of scientific work that explores the thermo-physiological wear comfort of older individuals with different footwear. This study aims to examine the effects of upper footwear materials on changes and distributions in the foot skin temperature and relative humidity for older individuals. Forty older individuals are recruited to perform sitting and walking activities under four experimental conditions in a conditioning chamber. The findings indicate that footwear upper constructed of highly permeable mesh fabric with large air holes shows fewer changes in foot skin temperature (ranging from 1.3 to 3.3 °C) and relative humidity (ranging from -13.3 to 5.7%) throughout the entire foot during dynamic walking, as well as higher subjective ratings on perceived thermal comfort when compared to footwear made of synthetic leather and composite layers. The findings serve to enhance current understanding of designing footwear with optimum comfort for older adults.
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Affiliation(s)
- Pui-Ling Li
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong SAR, China
| | - Kit-Lun Yick
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong SAR, China
| | - Joanne Yip
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong SAR, China
| | - Sun-Pui Ng
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
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23
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Predicting Emergency Department Utilization among Older Hong Kong Population in Hot Season: A Machine Learning Approach. INFORMATION 2022. [DOI: 10.3390/info13090410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous evidence suggests that temperature is associated with the number of emergency department (ED) visits. A predictive system for ED visits, which takes local temperature into account, is therefore needed. This study aimed to compare the predictive performance of various machine learning methods with traditional statistical methods based on temperature variables and develop a daily ED attendance rate predictive model for Hong Kong. We analyzed ED utilization among Hong Kong older adults in May to September from 2000 to 2016. A total of 103 potential predictors were derived from 1- to 14-day lag of ED attendance rate and meteorological and air quality indicators and 0-day lag of holiday indicator and month and day of week indicators. LASSO regression was used to identify the most predictive temperature variables. Decision tree regressor, support vector machine (SVM) regressor, and random forest regressor were trained on the selected optimal predictor combination. Deep neural network (DNN) and gated recurrent unit (GRU) models were performed on the extended predictor combination for the previous 14-day horizon. Maximum ambient temperature was identified as a better predictor in its own value than as an indicator defined by the cutoff. GRU achieved the best predictive accuracy. Deep learning methods, especially the GRU model, outperformed conventional machine learning methods and traditional statistical methods.
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24
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Almuzaini Y, Alburayh M, Alahmari A, Alamri F, Sabbagh AY, Alsalamah M, Khan A. Mitigation strategies for heat-related illness during mass gatherings: Hajj experience. Front Public Health 2022; 10:957576. [PMID: 36062122 PMCID: PMC9433897 DOI: 10.3389/fpubh.2022.957576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/29/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction To mitigate morbidity, mortality, and impacts of heat-related illnesses (HRIs) on health, it was vital to implement a comprehensive framework for HRI prevention and control. A recognized tool from the field of trauma prevention known as the Haddon matrix was applied. The matrix states that any event is affected by three factors: host, agent, and environment. In addition, another recognized tool known as the combined model was used in this study. The combined model is a three-dimensional model that includes the idea for the three axes of Haddon's matrix with the methodology of the community risk reduction (CRR) model. Aim of the study To identify the environmental and individual risk factors of HRIs based on the Haddon matrix and the recommended prevention strategies by the CRR tool by using the combined model. Methodology An extensive literature review was conducted to assess all the risk factors associated with HRI, as well as preventive measures. Then the Haddon matrix was used to structure, separating human factors from technical and environmental details and timing. After that, the combined model was used to set all responses and mitigation measures for each element obtained from the Haddon matrix tool. Conclusion Projected increases in heat stress over the globe require the formulation and implementation of evidence-based HRI mitigation and preventive measures. In this study, we implemented the combined model that was utilized as a systematic strategy for the more theoretical framework of Haddon's matrix. Using the Haddon matrix to determine the HRI risk factors and the combined model to mitigate its impact was practical and helpful in planning, preparedness, and mitigating the HRIs during Hajj, provided a broad approach equivalent to the Swiss cheese model, and would facilitate an informed decision.
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Affiliation(s)
- Yasir Almuzaini
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia,*Correspondence: Yasir Almuzaini
| | - Marriyah Alburayh
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Ahmed Alahmari
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Fahad Alamri
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Majid Alsalamah
- Department of Emergency Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Anas Khan
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia,Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Ho JY, Goggins WB, Mo PKH, Chan EYY. The effect of temperature on physical activity: an aggregated timeseries analysis of smartphone users in five major Chinese cities. Int J Behav Nutr Phys Act 2022; 19:68. [PMID: 35701809 PMCID: PMC9195465 DOI: 10.1186/s12966-022-01285-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical activity is an important factor in premature mortality reduction, non-communicable disease prevention, and well-being protection. Climate change will alter temperatures globally, with impacts already found on mortality and morbidity. While uncomfortable temperature is often perceived as a barrier to physical activity, the actual impact of temperature on physical activity has been less well studied, particularly in China. This study examined the associations between temperature and objectively measured physical activity among adult populations in five major Chinese cities. Methods Aggregated anonymized step count data was obtained between December 2017-2018 for five major Chinese cities: Beijing, Shanghai, Chongqing, Shenzhen, and Hong Kong. The associations of temperature with daily aggregated mean step count were assessed using Generalized Additive Models (GAMs), adjusted for meteorological, air pollution, and time-related variables. Results Significant decreases in step counts during periods of high temperatures were found for cold or temperate climate cities (Beijing, Shanghai, and Chongqing), with maximum physical activity occurring between 16 and 19.3 °C. High temperatures were associated with decreases of 800-1500 daily steps compared to optimal temperatures. For cities in subtropical climates (Shenzhen and Hong Kong), non-significant declines were found with high temperatures. Overall, females and the elderly demonstrated lower optimal temperatures for physical activity and larger decreases of step count in warmer temperatures. Conclusions As minor reductions in physical activity could consequentially affect health, an increased awareness of temperature’s impact on physical activity is necessary. City-wide adaptations and physical activity interventions should seek ways to sustain physical activity levels in the face of shifting temperatures from climate change. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01285-1.
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Affiliation(s)
- Janice Y Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. .,Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Hall EJ, Carter AJ, Chico G, Bradbury J, Gentle LK, Barfield D, O’Neill DG. Risk Factors for Severe and Fatal Heat-Related Illness in UK Dogs—A VetCompass Study. Vet Sci 2022; 9:vetsci9050231. [PMID: 35622759 PMCID: PMC9144152 DOI: 10.3390/vetsci9050231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/28/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
Heat-related illness (HRI) is predicted to increase in dogs due to rising global temperatures. This study evaluated retrospective VetCompass veterinary clinical records to explore geographical variability and ambient conditions associated with HRI events in UK dogs, and report the intrinsic (canine) and extrinsic (location, trigger, ambient weather) risk factors for severe disease and fatal outcome in dogs affected by HRI. Dogs living in London had the greatest odds for developing HRI compared with dogs living in the North West (OR 1.9, 95% CI 1.31–2.74). The median ambient temperature on days of HRI events was 16.9 °C. For dogs with HRI, age, bodyweight and trigger were risk factors associated with severe disease. Age, skull shape and clinical grade of HRI presentation were associated with a fatal outcome. Whilst the majority of HRI events overall were triggered by exertion, the risk of severe disease was greater in situations where dogs could not escape the heat source (vehicular confinement), and the risk of death in HRI cases was greater for those dogs with reduced capacity to thermoregulate (older and brachycephalic dogs). These results highlight the need for better owner awareness of the factors that increase the risk of severe and fatal HRI, as a first stage in protecting canine welfare in the face of rising global temperatures.
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Affiliation(s)
- Emily J. Hall
- Department of Clinical Science and Services, The Royal Veterinary College, Herts AL9 7TA, UK;
- Correspondence: or
| | - Anne J. Carter
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Notts NG25 0QF, UK; (A.J.C.); (G.C.); (L.K.G.)
| | - Guaduneth Chico
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Notts NG25 0QF, UK; (A.J.C.); (G.C.); (L.K.G.)
| | - Jude Bradbury
- Royal College of Veterinary Surgeons, London WC2A 1EN, UK;
| | - Louise K. Gentle
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Notts NG25 0QF, UK; (A.J.C.); (G.C.); (L.K.G.)
| | - Dominic Barfield
- Department of Clinical Science and Services, The Royal Veterinary College, Herts AL9 7TA, UK;
| | - Dan G. O’Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Herts AL9 7TA, UK;
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Folkerts MA, Bröde P, Botzen WJW, Martinius ML, Gerrett N, Harmsen CN, Daanen HAM. Sex differences in temperature-related all-cause mortality in the Netherlands. Int Arch Occup Environ Health 2022; 95:249-258. [PMID: 34089351 PMCID: PMC8755659 DOI: 10.1007/s00420-021-01721-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/25/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Over the last few decades, a global increase in both cold and heat extremes has been observed with significant impacts on human mortality. Although it is well-identified that older individuals (> 65 years) are most prone to temperature-related mortality, there is no consensus on the effect of sex. The current study investigated if sex differences in temperature-related mortality exist in the Netherlands. METHODS Twenty-three-year ambient temperature data of the Netherlands were combined with daily mortality data which were subdivided into sex and three age classes (< 65 years, 65-80 years, ≥ 80 years). Distributed lag non-linear models were used to analyze the effect of ambient temperature on mortality and determine sex differences in mortality attributable to the cold and heat, which is defined as mean daily temperatures below and above the Minimum Mortality Temperature, respectively. RESULTS Attributable fractions in the heat were higher in females, especially in the oldest group under extreme heat (≥ 97.5th percentile), whilst no sex differences were found in the cold. Cold- and heat-related mortality was most prominent in the oldest age group (≥ 80 years) and to a smaller extent in the age group between 65-80 years. In the age group < 65 years temperature-related mortality was only significant for males in the heat. CONCLUSION Mortality in the Netherlands represents the typical V- or hockey-stick shaped curve with a higher daily mortality in the cold and heat than at milder temperatures in both males and females, especially in the age group ≥ 80 years. Heat-related mortality was higher in females than in males, especially in the oldest age group (≥ 80 years) under extreme heat, whilst in the cold no sex differences were found. The underlying cause may be of physiological or behavioral nature, but more research is necessary.
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Affiliation(s)
- Mireille A Folkerts
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands
| | - Peter Bröde
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - W J Wouter Botzen
- Institute for Environmental Studies (IVM), Vrije Universiteit Amsterdam, De Boelelaan 1087, 1081 HV, Amsterdam, The Netherlands
| | - Mike L Martinius
- Institute for Environmental Studies (IVM), Vrije Universiteit Amsterdam, De Boelelaan 1087, 1081 HV, Amsterdam, The Netherlands
| | - Nicola Gerrett
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands
| | | | - Hein A M Daanen
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands.
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Ernsberger U, Deller T, Rohrer H. The sympathies of the body: functional organization and neuronal differentiation in the peripheral sympathetic nervous system. Cell Tissue Res 2021; 386:455-475. [PMID: 34757495 PMCID: PMC8595186 DOI: 10.1007/s00441-021-03548-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023]
Abstract
During the last 30 years, our understanding of the development and diversification of postganglionic sympathetic neurons has dramatically increased. In parallel, the list of target structures has been critically extended from the cardiovascular system and selected glandular structures to metabolically relevant tissues such as white and brown adipose tissue, lymphoid tissues, bone, and bone marrow. A critical question now emerges for the integration of the diverse sympathetic neuron classes into neural circuits specific for these different target tissues to achieve the homeostatic regulation of the physiological ends affected.
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Affiliation(s)
- Uwe Ernsberger
- Institute for Clinical Neuroanatomy, Goethe University, Frankfurt/Main, Germany.
| | - Thomas Deller
- Institute for Clinical Neuroanatomy, Goethe University, Frankfurt/Main, Germany
| | - Hermann Rohrer
- Institute for Clinical Neuroanatomy, Goethe University, Frankfurt/Main, Germany.
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Impact of heat waves and cold spells on cause-specific mortality in the city of São Paulo, Brazil. Int J Hyg Environ Health 2021; 239:113861. [PMID: 34688108 DOI: 10.1016/j.ijheh.2021.113861] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 12/27/2022]
Abstract
The impact of heat waves and cold spells on mortality has become a major public health problem worldwide, especially among older adults living in low-to middle-income countries. This study aimed to investigate the effects of heat waves and cold spells under different definitions on cause-specific mortality among people aged ≥65 years in São Paulo from 2006 to 2015. A quasi-Poisson generalized linear model with a distributed lag model was used to investigate the association between cause-specific mortality and extreme air temperature events. To evaluate the effects of the intensity under different durations, we considered twelve heat wave and nine cold spell definitions. Our results showed an increase in cause-specific deaths related to heat waves and cold spells under several definitions. The highest risk of death related to heat waves was identified mostly at higher temperature thresholds with longer events. We verified that men were more vulnerable to die from cerebrovascular diseases and ischemic stroke on cold spells and heat waves days than women, while women presented a higher risk of dying from ischemic heart diseases during cold spells and tended to have a higher risk of chronic obstructive pulmonary disease than men during heat waves. Identification of heat wave- and cold spell-related mortality is important for the development and promotion of public health measures.
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Lu P, Xia G, Zhao Q, Green D, Lim YH, Li S, Guo Y. Attributable risks of hospitalizations for urologic diseases due to heat exposure in Queensland, Australia, 1995-2016. Int J Epidemiol 2021; 51:144-154. [PMID: 34508576 PMCID: PMC8855997 DOI: 10.1093/ije/dyab189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Heat exposure is a risk factor for urologic diseases. However, there are limited existing studies that have examined the relationship between high temperatures and urologic disease. The aim of this study was to examine the associations between heat exposure and hospitalizations for urologic diseases in Queensland, Australia, during the hot seasons of 1995-2016 and to quantify the attributable risks. METHODS We obtained 238 427 hospitalized cases with urologic diseases from Queensland Health between 1 December 1995 and 31 December 2016. Meteorological data were collected from the Scientific Information for Land Owners-a publicly accessible database of Australian climate data that provides daily data sets for a range of climate variables. A time-stratified, case-crossover design fitted with the conditional quasi-Poisson regression model was used to estimate the associations between temperature and hospitalizations for urologic diseases at the postcode level during each hot season (December-March). Attributable rates of hospitalizations for urologic disease due to heat exposure were calculated. Stratified analyses were performed by age, sex, climate zone, socio-economic factors and cause-specific urologic diseases. RESULTS We found that a 1°C increase in temperature was associated with a 3.3% [95% confidence interval (CI): 2.9%, 3.7%] increase in hospitalization for the selected urologic diseases during the hot season. Hospitalizations for renal failure showed the strongest increase 5.88% (95% CI: 5.25%, 6.51%) among the specific causes of hospital admissions considered. Males and the elderly (≥60 years old) showed stronger associations with heat exposure than females and younger groups. The sex- and age-specific associations with heat exposure were similar across specific causes of urologic diseases. Overall, nearly one-fifth of hospitalizations for urologic diseases were attributable to heat exposure in Queensland. CONCLUSIONS Heat exposure is associated with increased hospitalizations for urologic disease in Queensland during the hot season. This finding reinforces the pressing need for dedicated public health-promotion campaigns that target susceptible populations, especially for those more predisposed to renal failure. Given that short-term climate projections identify an increase in the frequency, duration and intensity of heatwaves, this public health advisory will be of increasing urgency in coming years.
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Affiliation(s)
- Peng Lu
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Guoxin Xia
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Donna Green
- Climate Change Research Centre and ARC Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, Australia
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Jingyi M, Shanshan Z, Wu Y. The Influence of Physical Environmental Factors on Older Adults in Residential Care Facilities in Northeast China. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:131-149. [PMID: 34477011 DOI: 10.1177/19375867211036705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the aspects of the objective physical environments of five residential care facilities (RCFs) for older adults and the residents' subjective perceptions of these aspects. BACKGROUND The physical environment in RCFs impacts the health and comfort of the residents. However, the design standards for RCFs lack details which can result in insufficient living conditions. METHODS Through questionnaire surveys, older adults' satisfaction on the degree of the light, acoustic, and thermal environment in the facilities was obtained. Indoor lighting condition was measured by an illuminance meter in lux, sound pressure level (SPL) with sound level meters in dBA, and temperature in °C with a temperature data logger, and an audiometer was used to test the hearing of the older adults. RESULTS A total of 480 questionnaires were obtained. Results show that (a) older adults need an appropriate light environment to avoid the negative impact of limited light, (b) poor acoustic environment could affect their mood and health, and (c) when the room temperature is within the range of 20-26 °C (68-78.8 °F), they feel most comfortable. When the appropriate temperature and humidity, balanced illumination, and SPL meet the needs of older adults, it can provide a more comfortable physical environment for them. CONCLUSION Examining the interaction between the physical environmental factors that affect older adults in RCFs is important for the design of residential housing and provides more theoretical support for research on the influence of the physical environment on the quality of life of older adults.
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Affiliation(s)
- Mu Jingyi
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, School of Architecture, 48722Harbin Institute of Technology, China
- School of Architecture, The University of Sheffield, United Kingdom
| | - Zhang Shanshan
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, School of Architecture, 48722Harbin Institute of Technology, China
| | - Yue Wu
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, School of Architecture, 48722Harbin Institute of Technology, China
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Chan LP, Tseng YP, Liu C, Liang CH. Fermented pomegranate extracts protect against oxidative stress and aging of skin. J Cosmet Dermatol 2021; 21:2236-2245. [PMID: 34416060 DOI: 10.1111/jocd.14379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Punica granatum (pomegranate) potentially ameliorates skin inflammation and pain, including herpetic stromal keratitis. Fermentation is a biotechnological technique that may naturally induce health benefits by producing antioxidants. However, the anti-aging effect of fermented pomegranate extracts (FPE) on the skin is still unclear. AIM This investigation evaluates the effects of fermented pomegranate as a functional supplement (FPE drink, FPE-D) and a cosmetic ingredient (FPE serum, FPE-S) in vitro and in vivo. PATIENTS/METHODS The effects of FPE products for anti-oxidation, anti-tyrosinase, anti-inflammation, and anti-aging were examined. Forty subjects were randomly allocated to FPE-D or placebo drink groups (50 ml of a FPE-D /placebo drink daily for 8 weeks for each subject), and another 40 subjects were recruited to FPE-S or placebo serum groups (about 3 ml of a FPE-S /placebo serum daily and nightly/daily for 4 weeks for each subject) in a double-blind study. RESULTS The effects of FPE products on the DPPH, ABTS+ , and NO· free radical scavenging activities, their inhibiting of tyrosinase activity and their enhancement of the skin health of healthy subjects, were investigated. FPE-D improved the moisture, brightness, elasticity, and collagen density of the skin of most subjects at 8 weeks relative to the baseline without treatment (p < 0.05). After 4 weeks of FPE-S serum consumption, the moisture, brightness, elasticity, spots, UV spots, and collagen density of skin were slightly better than those at week 0 (p < 0.05). CONCLUSIONS The daily consumption of fermented pomegranate extracts can protect the skin against oxidative stress and slow skin aging.
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Affiliation(s)
- Leong-Perng Chan
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Ping Tseng
- Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Cheng Liu
- Department of Health and Beauty, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,Department of Dental Technology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Chia-Hua Liang
- Department of Cosmetic Science and Institute of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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Presbitero A, Melnikov VR, Krzhizhanovskaya VV, Sloot PMA. A unifying model to estimate the effect of heat stress in the human innate immunity during physical activities. Sci Rep 2021; 11:16688. [PMID: 34404876 PMCID: PMC8371171 DOI: 10.1038/s41598-021-96191-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/30/2021] [Indexed: 02/07/2023] Open
Abstract
Public health is threatened by climate change and extreme temperature events worldwide. Differences in health predispositions, access to cooling infrastructure and occupation raises an issue of heat-related health inequality in those vulnerable and disadvantaged demographic groups. To address these issues, a comprehensive understanding of the effect of elevated body temperatures on human biological systems and overall health is urgently needed. In this paper we look at the inner workings of the human innate immunity under exposure to heat stress induced through exposure to environment and physical exertion. We couple two experimentally validated computational models: the innate immune system and thermal regulation of the human body. We first study the dynamics of critical indicators of innate immunity as a function of human core temperature. Next, we identify environmental and physical activity regimes that lead to core temperature levels that can potentially compromise the performance of the human innate immunity. Finally, to take into account the response of innate immunity to various intensities of physical activities, we utilise the dynamic core temperatures generated by a thermal regulation model. We compare the dynamics of all key players of the innate immunity for a variety of stresses like running a marathon, doing construction work, and leisure walking at speed of 4 km/h, all in the setting of a hot and humid tropical climate such as present in Singapore. We find that exposure to moderate heat stress leading to core temperatures within the mild febrile range (37, 38][Formula: see text], nudges the innate immune system into activation and improves the efficiency of its response. Overheating corresponding to core temperatures beyond 38[Formula: see text], however, has detrimental effects on the performance of the innate immune system, as it further induces inflammation, which causes a series of reactions that may lead to the non-resolution of the ongoing inflammation. Among the three physical activities considered in our simulated scenarios (marathon, construction work, and walking), marathon induces the highest level of inflammation that challenges the innate immune response with its resolution. Our study advances the current state of research towards understanding the implications of heat exposure for such an essential physiological system as the innate immunity. Although we find that among considered physical activities, a marathon of 2 h and 46 min induces the highest level of inflammation, it must be noted that construction work done on a daily basis under the hot and humid tropical climate, can produce a continuous level of inflammation triggering moieties stretched at a longer timeline beating the negative effects of running a marathon. Our study demonstrates that the performance of the innate immune system can be severely compromised by the exposure to heat stress and physical exertion. This poses significant risks to health especially to those with limited access to cooling infrastructures. This is due in part to having low income, or having to work on outdoor settings, which is the case for construction workers. These risks to public health should be addressed through individual and population-level measures via behavioural adaptation and provision of the cooling infrastructure in outdoor environments.
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Affiliation(s)
- Alva Presbitero
- grid.464507.40000 0001 2219 7447Asian Institute of Management, Makati, Philippines ,grid.35915.3b0000 0001 0413 4629National Center of Cognitive Research, ITMO University, St. Petersburg, Russian Federation
| | - Valentin R. Melnikov
- grid.7177.60000000084992262Institute for Advanced Study, University of Amsterdam, Amsterdam, The Netherlands ,grid.59025.3b0000 0001 2224 0361Complexity Institute, Nanyang Technological University, Singapore, Singapore ,Future Cities Laboratory, Singapore-ETH Centre, Singapore, Singapore
| | - Valeria V. Krzhizhanovskaya
- grid.35915.3b0000 0001 0413 4629National Center of Cognitive Research, ITMO University, St. Petersburg, Russian Federation ,grid.7177.60000000084992262Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter M. A. Sloot
- grid.35915.3b0000 0001 0413 4629National Center of Cognitive Research, ITMO University, St. Petersburg, Russian Federation ,grid.7177.60000000084992262Institute for Advanced Study, University of Amsterdam, Amsterdam, The Netherlands ,grid.484678.1Complexity Science Hub Vienna, Vienna, Austria
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Morrissey MC, Wu Y, Zuk EF, Livingston J, Casa DJ, Pescatello LS. The impact of body fat on thermoregulation during exercise in the heat: A systematic review and meta-analysis. J Sci Med Sport 2021; 24:843-850. [DOI: 10.1016/j.jsams.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 12/16/2022]
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Mitigating the Effects of Climate Change on Health and Health Care: The Role of the Emergency Nurse. J Emerg Nurs 2021; 47:621-626. [PMID: 34275528 DOI: 10.1016/j.jen.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 12/29/2022]
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Petkova EP, Dimitrova LK, Sera F, Gasparrini A. Mortality attributable to heat and cold among the elderly in Sofia, Bulgaria. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:865-872. [PMID: 33416949 DOI: 10.1007/s00484-020-02064-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 05/21/2023]
Abstract
Although a number of epidemiological studies have examined the effects of non-optimal temperatures on mortality in Europe, evidence about the mortality risks associated with exposures to hot and cold temperatures in Bulgaria is scarce. This study provides evidence about mortality attributable to non-optimal temperatures in adults aged 65 and over in Sofia, Bulgaria, between 2000 and 2017. We quantified the relationship between the daily mean temperature and mortality in the total elderly adult population aged 65 and over, among males and females aged 65 and over, as well as individuals aged 65-84 and 85 years or older. We used a distributed lag non-linear model with a 25-day lag to fully capture the effects of both cold and hot temperatures and calculated the fractions of mortality attributable to mild and extreme hot and cold temperatures. Cold temperatures had a greater impact on mortality than hot temperatures during the studied period. Most of the temperature-attributable mortality was due to moderate cold, followed by moderate heat, extreme cold, and extreme heat. The total mortality attributable to non-optimal temperatures was greater among females compared to males and among individuals aged 85 and over compared to those aged 65 to 84. The findings of this study can serve as a foundation for future research and policy development aimed at characterizing and reducing the risks from temperature exposures among vulnerable populations in the country, climate adaptation planning and improved public health preparedness, and response to non-optimal temperatures.
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Affiliation(s)
- Elisaveta P Petkova
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA.
| | - Lyudmila K Dimitrova
- Department of Computer and Information Technology, Prof. Asen Zlatarov University, Burgas, Bulgaria
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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Ganse B, Degens H. Current Insights in the Age-related Decline in Sports Performance of the Older Athlete. Int J Sports Med 2021; 42:879-888. [PMID: 34000751 DOI: 10.1055/a-1480-7730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The higher performance level of master athletes compared to non-athletes is often associated with better health throughout life. However, even the physical performance of master athletes declines with age, and this decline accelerates from about the age of 70 years onwards. A progressive loss of muscle mass, declines in force- and power-generating capacity, decreased flexibility, and the concomitant decline in specific tension characterize the muscular changes underlying performance declines. In the cardiovascular system, declines in stroke volume and cardiac output, and cardiac and vascular stiffness contribute to decreasing performance. Recent studies have shown that long-term endurance exercise in master athletes does not only have positive effects, but is associated with an increased incidence of atrial fibrillation, atherosclerotic plaques, and aortic dilation, and even more so in men than in women. Recently, larger longitudinal datasets were analysed and showed that the age-related decline in performance was similar in longitudinal and cross-sectional data. In conclusion, regular physical activity enhances the exercise capacity, and hence quality of life in old age, but it is not without risks.
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Affiliation(s)
- Bergita Ganse
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland.,Innovative Implant Development, Clinics and Institutes of Surgery, Universität des Saarlandes, Homburg, Germany
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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Knechtle B, Valero D, Villiger E, Alvero-Cruz JR, Nikolaidis PT, Cuk I, Rosemann T, Scheer V. Trends in Weather Conditions and Performance by Age Groups Over the History of the Berlin Marathon. Front Physiol 2021; 12:654544. [PMID: 34054573 PMCID: PMC8155689 DOI: 10.3389/fphys.2021.654544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
The effect of different environmental conditions such as temperature, wind, barometric pressure, and precipitation has been well investigated in elite marathoners, but not by age categories (i.e., age group marathoners). The aim of the study was to investigate the potential influence of environmental conditions such as temperature, precipitation, and atmospheric pressure on marathon performance in age group marathoners competing in the ‘Berlin Marathon’ from 1974 to 2019. A total of 869,474 valid finisher records were available for analysis, of which 711,136 correspond to males and 158,338 to females. The influence of temperature, atmospheric pressure, and precipitation on marathon race times was investigated in age group marathoners grouped in 5-year-intervals. Within the 46 years of Berlin marathons under investigation, there was some level of precipitation for 18 years, and 28 years without any rain. Sunshine was predominant in 25 of the events, whilst in the other 21 years, cloud cover was predominant. Marathon race times were significantly and positively correlated with age (i.e., older runners were slower than younger runners) where the correlation was higher for males than for females. Marathon race times were significantly and positively correlated with both the hours of sunshine and the daily maximum temperature. The fastest marathon runners (meaning the minimum times) achieved the fastest race times on race days with higher maximum temperatures (i.e., 15–30°C). Daily maximum temperatures showed an influence on age group marathoners from age group 35–40 years and older. Higher precipitation levels impaired performance across most age groups. In summary, higher daily maximum temperatures (i.e., >15°C) and higher precipitation levels impaired performance of master marathoners (i.e., 35–40 years and older) competing in the ‘Berlin Marathon’ in the last 45 years. Master marathoners should start in marathon races with temperatures < 15°C and no precipitation in order to achieve a fast marathon race time.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland.,Institute of Primary Care, University Hospital Zurich, Zurich, Switzerland
| | - David Valero
- Ultra Sports Science Foundation, Pierre-Bénite, France
| | - Elias Villiger
- Institute of Primary Care, University Hospital Zurich, Zurich, Switzerland
| | - José R Alvero-Cruz
- Departamento de Fisiología Humana, Histología, Anatomia Patológica y Educación Física y Deportiva, University of Málaga, Málaga, Spain
| | - Pantelis T Nikolaidis
- School of Health and Caring Sciences, University of West Attica, Athens, Greece.,Laboratory of Exercise Testing, Hellenic Air Force Academy, Acharnes, Greece
| | - Ivan Cuk
- Faculty of Physical Education and Sports Management, Singidunum University, Belgrade, Serbia
| | - Thomas Rosemann
- Institute of Primary Care, University Hospital Zurich, Zurich, Switzerland
| | - Volker Scheer
- Ultra Sports Science Foundation, Pierre-Bénite, France
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Ryu JH, Min MK. Diagnosis and treatment of patients with heat-related illnesses. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.4.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Heat stress disorders or heat-related illnesses are a kind of physiological damage that occurs when the body cannot dissipate enough heat due to its thermoregulatory dysfunction. This paper aims to summarize the latest information on the diagnosis and treatment of heat-related illnesses. Heat stress disorders come in a variety of forms including heat edema, heat rash, heat cramps, heat syncope, heat tetany, severe heat exhaustion, and life-threatening heatstroke. Major risk factors may include excessive exercise, continuous exposure to high temperatures or humid environments, lack of acclimation, excessive clothing or protective equipment, obesity, and dehydration. Additional risk factors may include the patientʼs existing medical condition, environmental and personal factors, and the use of various drugs. Mild heat-related illnesses can be treated only by supportive care such as moving patients to a cool place and laying them in a supine position while elevating their legs and loosening their clothes. However, in the case of heatstroke, quickly lowering the body temperature is an essential in reducing the mortality rate. The most effective cooling method is to immerse the entire body in ice cold water.
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Alkassas W, Rajab AM, Alrashood ST, Khan MA, Dibas M, Zaman M. Heat-related illnesses in a mass gathering event and the necessity for newer diagnostic criteria: a field study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:16682-16689. [PMID: 33389467 PMCID: PMC7778691 DOI: 10.1007/s11356-020-12154-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Heat-related illnesses (HRIs), mainly heat exhaustion (HE) and heat stroke (HS), are characterized by an elevation of core body temperature. In this study, we aimed to explore the HRIs' types and patient characteristics among a sample taken from various representative in-field points in the Hajj season. A cross-sectional study was conducted in 2018 at 80 data collection points distributed in the field. Data related to demographics, features and risk factors were collected and analyzed from all encountered cases with suspected HRIs. Moreover, we developed a diagnostic tree for HRIs by using the XGBoost model. Out of the 1200 persons encountered during the study period, 231 fulfilled the criteria of HRIs spectrum and were included in this study. Around 6% had HS and 20% had HE. All HS cases (100%) were from outside of Saudi Arabia as compared with 72.5% diagnosed with HE (27.5% were from Saudi Arabia). In addition, 16% were considered as heat-induced muscle spasms, and 7% had limb heat edema. Additionally, most of HRIs cases were reported between 11 am and 1 pm. The HRIs diagnostic tree model gave a diagnostic accuracy of 93.6%. This study highlights the magnitude of HRIs among pilgrims in Hajj and provides a diagnostic tree that can aid in the risk stratification and diagnosis of these patients. We advise the implementation of more educational campaigns to pilgrims regarding preventable measures especially for the vulnerable groups (e.g. from outside Saudi Arabia, those with comorbidities and light-skinned people).
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Affiliation(s)
- Wesam Alkassas
- Department of Research, Saudi Medical Academy for Volunteering, Riyadh, Saudi Arabia
- College of Medicine, Sulaiman Al Rajhi University, Qassim, Saudi Arabia
| | | | - Sara T Alrashood
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Ayub Khan
- Departments of Mathematics and Computer Science, Leicester University, Leicester, UK
| | - Mahmoud Dibas
- College of Medicine, Sulaiman Al Rajhi University, Qassim, Saudi Arabia
| | - Mohsin Zaman
- Department of Critical Care and Acute Medicine, Northampton General Hospital, Northampton, 01060, UK.
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Proposing the VetCompass clinical grading tool for heat-related illness in dogs. Sci Rep 2021; 11:6828. [PMID: 33767275 PMCID: PMC7994647 DOI: 10.1038/s41598-021-86235-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/11/2021] [Indexed: 01/31/2023] Open
Abstract
Heat-related illness is a potentially fatal condition in dogs. Rapid and accurate recognition of the severity can improve clinical management in affected dogs and lead to better outcomes. This study explored retrospective VetCompass veterinary clinical records to investigate the clinical signs recorded for dogs presenting with heat-related illness to primary-care veterinary practice from 2016 to 2018. The relative risk of death associated with these clinical signs was reported and used to develop a novel clinical grading tool. From the clinical records of 856 heat-related illness events, the most frequently recorded clinical signs were respiratory changes (68.73%) and lethargy (47.79%). The clinical signs with the highest relative risk of death were neurological dysfunction, gastrointestinal haemorrhage and bleeding disorders. The novel VetCompass Clinical Grading Tool for Heat-Related Illness in dogs defines three grades: mild (altered respiration, lethargy), moderate (gastrointestinal signs, a single seizure, episodic collapse) and severe (neurological dysfunction, gastrointestinal haemorrhage, bleeding disorders). This novel grading tool offers a simple, evidence-based device to improve recognition of heat-related illness in dogs and promote improved decision-making for earlier interventions such as cooling and hospitalisation. This could improve outcomes and protect the welfare of dogs in the face of rising global temperatures.
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Waldock KAM, Hayes M, Watt PW, Maxwell NS. The elderly's physiological and perceptual responses to cooling during simulated activities of daily living in UK summer climatic conditions. Public Health 2021; 193:1-9. [PMID: 33662760 DOI: 10.1016/j.puhe.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/16/2020] [Accepted: 01/14/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The elderly are the most at-risk population for heat-related illness and mortality during the periods of hot weather. However, evidence-based elderly-specific cooling strategies to prevent heat-illness are limited. The aim of this investigation was to quantify the elderly's physiological and perceptual responses to cooling through cold water ingestion (COLD) or an L-menthol mouth rinse (MENT) during simulated activities of daily living in UK summer climatic conditions. STUDY DESIGN Randomised, controlled repeated measures research design. METHODS A total of ten participants (men n = 7, women n = 3: age; 69 ± 3 yrs, height; 168 ± 10 cm, body mass; 68.88 ± 13.72 kg) completed one preliminary and three experimental trials; control (CON), COLD and MENT. Experimental trials consisted of 40 min rest followed by 30 min of cycling exercise at 6 metabolic equivalents and a 6-min walk test (6MWT), within a 35 °C, 50% relative humidity environment. Experimental interventions (every 10 min); cold water (4 °C) ingestion (total of 1.5L) or menthol (5 ml mouth swill for 5 s, menthol concentration of 0.01%). RESULTS Peak rectal temperature (Tre) was significantly (P < 0.05) lower in COLD compared with CON (-0.34 ± 0.16 °C) and MENT (-0.36 ± 0.20 °C). End exercise heart rate (HR) decreased in COLD compared with CON (-7 ± 9 b min-1) and MENT (-6 ± 7 b min-1). There was no difference in end exercise thermal sensation (TS) (CON; 6.1 ± 0.4, COLD; 6.0 ± 0.4, MENT; 6.4 ± 0.6) or thermal comfort (TC) (CON; 4 ± 1, COLD; 4 ± 1, MENT; 4 ± 1) between trials. The participants walked significantly further during the COLD 6MWT compared with CON (40 m ± 40 m) and MENT (40 m ± 30 m). There was reduced physiological strain in the COLD 6MWT compared with CON (Tre; -0.21 ± 0.24 °C, HR; -7 ± 8 b min-1) and MENT (Tre; -0.23 ± 0.24 °C, HR; -4 ± 7 b min-1). CONCLUSION The elderly have reduced physiological strain (Tre and HR) during activities of daily living and a 6MWT in hot UK climatic conditions, when they drink cold water. Furthermore, the elderly's perception (TS and TC) of the hot environment did not differ from CON at the end of exercise with COLD or MENT interventions. Menthol provided neither perceptual benefit to exercise in the heat nor functional gain. The TS data indicate that elderly may be at increased risk of heat illness, due to not feeling hot and uncomfortable enough to implement physiological strain reducing strategies such as cold-water ingestion.
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Affiliation(s)
- K A M Waldock
- Army Health and Performance Research, Andover, United Kingdom; Environmental Extremes Laboratory, University of Brighton, Eastbourne, United Kingdom.
| | - M Hayes
- Environmental Extremes Laboratory, University of Brighton, Eastbourne, United Kingdom
| | - P W Watt
- Environmental Extremes Laboratory, University of Brighton, Eastbourne, United Kingdom
| | - N S Maxwell
- Environmental Extremes Laboratory, University of Brighton, Eastbourne, United Kingdom
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43
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See L, Rasiah RL, Laing R, Thompson SC. Considerations in Planning Physical Activity for Older Adults in Hot Climates: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031331. [PMID: 33540584 PMCID: PMC7908220 DOI: 10.3390/ijerph18031331] [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: 01/18/2021] [Accepted: 01/26/2021] [Indexed: 12/25/2022]
Abstract
Regular physical activity has multiple health benefits for both the prevention and management of disease, including for older adults. However, additional precautions are needed with ageing given physiological changes and the increasing prevalence of comorbidities. Hot ambient temperatures increase the risks of exercise at any age, but are particularly important given thermoregulatory changes in older people. This narrative review informs planning of physical activity programs for older people living in rural areas with very hot climates for a period of the year. A multi-database search of peer-reviewed literature was undertaken with attention to its relevance to Australia, starting with definitions and standard advice in relation to physical activity programming and the incremental limitations imposed by age, rurality, and extreme heat. The enablers of and barriers to increasing physical activities in older adults and how they can be modified for those living in extreme hot climates is described. We describe multiple considerations in program design to improve safety, adherence and sustaining physical activity, including supervision, simple instructions, provision of reminders, social support, encouraging self-efficacy. Group-based activities may be preferred by some and can accommodate special populations, cultural considerations. Risk management is an important consideration and recommendations are provided to assist program planning.
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Affiliation(s)
- Lydia See
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
- Oral Health Centre of Western Australia, School of Dentistry, University of Western Australia, Nedlands 6009, Australia
- Correspondence: ; Tel.: +61-8-6457-4400
| | - Rohan L. Rasiah
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
| | - Rachael Laing
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
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Grosiak M, Koteja P, Bauchinger U, Sadowska ET. Age-Related Changes in the Thermoregulatory Properties in Bank Voles From a Selection Experiment. Front Physiol 2020; 11:576304. [PMID: 33329026 PMCID: PMC7711078 DOI: 10.3389/fphys.2020.576304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/09/2020] [Indexed: 01/21/2023] Open
Abstract
As with many physiological performance traits, the capacity of endotherms to thermoregulate declines with age. Aging compromises both the capacity to conserve or dissipate heat and the thermogenesis, which is fueled by aerobic metabolism. The rate of metabolism, however, not only determines thermogenic capacity but can also affect the process of aging. Therefore, we hypothesized that selection for an increased aerobic exercise metabolism, which has presumably been a crucial factor in the evolution of endothermic physiology in the mammalian and avian lineages, affects not only the thermoregulatory traits but also the age-related changes of these traits. Here, we test this hypothesis on bank voles (Myodes glareolus) from an experimental evolution model system: four lines selected for high swim-induced aerobic metabolism (A lines), which have also increased the basal, average daily, and maximum cold-induced metabolic rates, and four unselected control (C) lines. We measured the resting metabolic rate (RMR), evaporative water loss (EWL), and body temperature in 72 young adult (4 months) and 65 old (22 months) voles at seven ambient temperatures (13-32°C). The RMR was 6% higher in the A than in the C lines, but, regardless of the selection group or temperature, it did not change with age. However, EWL was 12% higher in the old voles. An increased EWL/RMR ratio implies either a compromised efficiency of oxygen extraction in the lungs or increased skin permeability. This effect was more profound in the A lines, which may indicate their increased vulnerability to aging. Body temperature did not differ between the selection and age groups below 32°C, but at 32°C it was markedly higher in the old A-line voles than in those from other groups. As expected, the thermogenic capacity, measured as the maximum cold-induced oxygen consumption, was decreased by about 13% in the old voles from both selection groups, but the performance of old A-line voles was the same as that of the young C-line ones. Thus, the selection for high aerobic exercise metabolism attenuated the adverse effects of aging on cold tolerance, but this advantage has been traded off by a compromised coping with hot conditions by aged voles.
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Affiliation(s)
- Marta Grosiak
- Institute of Environmental Sciences, Faculty of Biology, Jagiellonian University, Kraków, Poland
| | - Paweł Koteja
- Institute of Environmental Sciences, Faculty of Biology, Jagiellonian University, Kraków, Poland
| | - Ulf Bauchinger
- Institute of Environmental Sciences, Faculty of Biology, Jagiellonian University, Kraków, Poland
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Edyta T. Sadowska
- Institute of Environmental Sciences, Faculty of Biology, Jagiellonian University, Kraków, Poland
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Rogerson S, Brearley M, Meir R, Brooks L. Influence of age, geographical region, and work unit on heat strain symptoms: a cross-sectional survey of electrical utility workers. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2020; 17:515-522. [PMID: 33196398 DOI: 10.1080/15459624.2020.1834112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study assessed self-reported heat strain symptoms in workers of a state wide electrical utility distributor to determine risk differences between age groups, geographical work regions and work units. Out of a total 3,250 workers, 918 (∼28%) outdoor staff completed an online survey, which assessed the frequency of self-reported heat strain symptoms in the work and post-work settings, factors contributing to symptoms and symptom management. Heat strain symptoms were grouped into chronic low-grade cases and isolated high-grade cases based on the severity and frequency of symptoms. The risk (likelihood) of an employee being classified as either a chronic low-grade or isolated high-grade case was calculated and compared to the mean risk of all categories to determine risk difference, expressed as -1.00 to 1.00. For chronic low-grade cases, the 41-50 years age group had significantly increased risk (+0.08, p < 0.05) while the over 60 years age group had significantly decreased risk (-0.14, p < 0.05). Two of the three regions (p < 0.01) and three of the nine work units also demonstrated risk differences (p < 0.01) for chronic low-grade cases. Work units were the sole grouping to demonstrate risk difference for isolated high-risk cases. Work units with greater exposure to heat and higher requirement for protective clothing, such as Underground (+0.19, p < 0.05), Overhead - Predominantly Live Line (+0.18, p < 0.01), and Overhead - Distribution and Transmission (+0.11, p < 0.05) were at greater risk of reporting heat stress symptoms. This study demonstrates that the pattern of self-reported chronic low-grade heat strain cases differs to isolated high-grade cases within the electrical utility industry. Age, geographical location, and work unit independently alter the risk of chronic low-grade heat strain, while the risk of isolated high-grade heat strain was only related to work unit. These outcomes support implementation of a flexible and targeted approach to heat stress management in large and diverse organizations in which employees are routinely exposed to heat.
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Affiliation(s)
- Shane Rogerson
- Department of Health, Safety and Environment, Energy Queensland, Brisbane, Queensland, Australia
| | - Matt Brearley
- Thermal Hyperformance, Hervey Bay, Queensland, Australia
- National Critical Care and Trauma Response Centre, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Rudi Meir
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Lyndon Brooks
- School of Environment, Science and Engineering, Marine Ecology Research Centre (MERC), Southern Cross University, Lismore, New South Wales, Australia
- StatPlan Consulting Pty Ltd, Woodburn, New South Wales, Australia
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Evaluating Mortality Response Associated with Two Different Nordic Heat Warning Systems in Riga, Latvia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217719. [PMID: 33105717 PMCID: PMC7672594 DOI: 10.3390/ijerph17217719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/31/2022]
Abstract
Background and objectives: Progressing climate change is accompanied by a worldwide increase in the intensity, frequency, and duration of heat wave events. Research has shown that heat waves are an emerging public health problem, as they have a significant impact on mortality. As studies exploring this relationship are scarce for Latvia, this study aims to investigate the short-term associations between heat waves and all-cause mortality as well as cause-specific mortality, during the summer months (May-September) in Riga. Materials and Methods: An ecological time series study using daily reported mortality and temperature data from Riga between 2009 and 2015 was employed. Heat waves were defined based on the categories of the Latvian and Swedish heat warning system. Using a Quasi-Poisson regression, the relationships between heat waves and all-cause as well as cause-specific mortality were investigated. Results: Heat waves in Riga were associated with a 10% to 20% increase in the risk of all-cause mortality, depending on the applied heat wave definition, compared to days with normal temperature. In addition, heat-related mortality was found to increase significantly in the ≥65 age group between 12% and 22% during heat waves. In terms of cause-specific mortality, a significant increase of approximately 15% to 26% was observed for cardiovascular mortality. No significant associations were found between heat waves and respiratory or external causes of mortality. Conclusion: These results indicate that there are short-term associations between heat waves and all-cause as well as cardiovascular mortality in Riga and that heat waves therefore represent a public health problem in this Baltic city.
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Lenzer B, Rupprecht M, Hoffmann C, Hoffmann P, Liebers U. Health effects of heating, ventilation and air conditioning on hospital patients: a scoping review. BMC Public Health 2020; 20:1287. [PMID: 32843012 PMCID: PMC7448359 DOI: 10.1186/s12889-020-09358-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background In the face of climate change, the protection of vulnerable patients from extreme climatic conditions is of growing interest to the healthcare sector and governments. Inpatients are especially susceptible to heat due to acute illness and/or chronic diseases. Their condition can be aggravated by adverse environmental factors. Installing air conditioning can be seen as an element of public health adaptation because it was shown to improve mortality rates of hospital patients experiencing hot temperatures. Still, the mediating factors and resulting health effects are largely unknown. Method The PRISMA-ScR guideline was followed for this scoping review. Available evidence on the health effects of Heating, Ventilation, Air Conditioning (HVAC) and fans was searched in Medline, Embase and the Cochrane Library. The focus of the search strategy was on inpatients of the hospital. Grey literature was screened on 14 relevant websites. English and German publications were eligible without restrictions on publication date. Results were charted according to the categories population, intervention, control and outcome together with a qualitative description. Results The review process yielded eleven publications of which seven were issued after 2003. Seven were clinical trials, three cross-sectional studies and one was a case report. The publications described the installation of HVAC on general wards and in intensive care units. Main topics were heat stress protection and support of thermoregulation, but also the rewarming of hypothermic patients. HVAC use resulted in a recovery effect shown by improved vital signs, reduced cardiac stress, accelerated recuperation and greater physical activity. This protective effect was demonstrated by a shorter hospital stay for patients with respiratory disease and a reduction of mortality for heat illness patients. Conclusion This scoping review summarises the fragmented evidence on health effects of HVAC and fan utilisation for inpatients. Installing HVAC has the potential to improve patients’ outcomes and to make hospital treatment more efficient during heat waves. The application of HVAC could be a promising adaptation measure to mitigate the adverse effects of climate change on health and healthcare systems.
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Affiliation(s)
- Benedikt Lenzer
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. .,Institute of Laboratory Medicine, Clinical Chemistry, and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Manuel Rupprecht
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christina Hoffmann
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute of Laboratory Medicine, Clinical Chemistry, and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Peter Hoffmann
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute of Laboratory Medicine, Clinical Chemistry, and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Uta Liebers
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Hall EJ, Carter AJ, O’Neill DG. Dogs Don't Die Just in Hot Cars-Exertional Heat-Related Illness (Heatstroke) Is a Greater Threat to UK Dogs. Animals (Basel) 2020; 10:E1324. [PMID: 32751913 PMCID: PMC7459873 DOI: 10.3390/ani10081324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/21/2022] Open
Abstract
Heat-related illness will affect increasing numbers of dogs as global temperatures rise unless effective mitigation strategies are implemented. This study aimed to identify the key triggers of heat-related illness in dogs and investigate canine risk factors for the most common triggers in UK dogs. Using the VetCompassTM programme, de-identified electronic patient records of 905,543 dogs under primary veterinary care in 2016 were reviewed to identify 1259 heat-related illness events from 1222 dogs. Exertional heat-related illness was the predominant trigger (74.2% of events), followed by environmental (12.9%) and vehicular confinement (5.2%). Canine and human risk factors appear similar; young male dogs had greater odds of exertional heat-related illness, older dogs and dogs with respiratory compromise had the greatest odds of environmental heat-related illness. Brachycephalic dogs had greater odds of all three types of heat-related illness compared with mesocephalic dogs. The odds of death following vehicular heat-related illness (OR 1.47, p = 0.492) was similar to that of exertional heat-related illness. In the UK, exertional heat-related illness affects more dogs, and kills more dogs, than confinement in a hot vehicle. Campaigns to raise public awareness about heat-related illness in dogs need to highlight that dogs don't die just in hot cars.
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Affiliation(s)
- Emily J. Hall
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Brackenhurst, Southwell, Notts NG25 0QF, UK;
| | - Anne J. Carter
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Brackenhurst, Southwell, Notts NG25 0QF, UK;
| | - Dan G. O’Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK;
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Notley SR, Meade RD, Kenny GP. Effect of aerobic fitness on the relation between age and whole‐body heat exchange during exercise‐heat stress: a retrospective analysis. Exp Physiol 2020; 105:1550-1560. [DOI: 10.1113/ep088783] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/30/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Sean R. Notley
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of Ottawa Ottawa Canada
| | - Robert D. Meade
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of Ottawa Ottawa Canada
| | - Glen P. Kenny
- Human and Environmental Physiology Research UnitSchool of Human KineticsUniversity of Ottawa Ottawa Canada
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Incidence and risk factors for heat-related illness (heatstroke) in UK dogs under primary veterinary care in 2016. Sci Rep 2020; 10:9128. [PMID: 32555323 PMCID: PMC7303136 DOI: 10.1038/s41598-020-66015-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 05/13/2020] [Indexed: 12/26/2022] Open
Abstract
As climate change causes global temperatures to rise, heat-related illness, a potentially fatal condition in dogs, will become an ever-greater threat. This study aimed to report the incidence, fatality and canine risk factors of heat-related illness in UK dogs under primary veterinary care in 2016. The VetCompassTM programme collects de-identified electronic patient records from UK veterinary practices for research. From the clinical records of 905,543 dogs under veterinary care in 2016, 395 confirmed heat-related illness events were identified. The estimated 2016 incidence of heat-related illness was 0.04% (95% CI 0.04-0.05%), with an event fatality rate of 14.18% (95% CI 11.08 – 17.96%). Multivariable analysis identified significant risk factors including breed (e.g. Chow Chow, Bulldog and French Bulldog), higher bodyweight relative to the breed/sex mean and being over two years of age. Dogs with a brachycephalic skull shape and dogs weighing over 50 kg were also at greater risk. As we move into an ever-warmer world, veterinary professionals may need to include resistance to heat-related illness amongst their rationales when advising owners on breed selection. Breeding for good respiratory function and maintaining a healthy bodyweight should be considered key welfare priorities for all dogs to limit the risk of heat-related illness.
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