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Ko A, Oh S, Byon JY, Weon B, Lee J, Lee W, Oh YK, Kim DK, Kim S, Kim YS, Lim CS, Lee JP. Surviving the cold: Assessing long-term outcomes among Korean CKD patients exposed to low perceived temperature during winter. ENVIRONMENTAL RESEARCH 2024; 261:119636. [PMID: 39029731 DOI: 10.1016/j.envres.2024.119636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/27/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
Perceived temperature (PT), which encompasses meteorological factors such as wind speed, cloud cover, and humidity, reflects the actual effect of temperature on the human body. However, limited data exist on the health implications of prolonged exposure to low temperatures during winter in individuals with chronic kidney disease (CKD). We investigated the association between winter PT and long-term outcomes among CKD patients. A total of 32,870 CKD patients from three tertiary hospitals in Seoul were enrolled in this retrospective study (2001-2018). PT was calculated using Staiger's equation, integrating temperature data from 29 automated weather stations across Seoul, along with dew point temperature, wind velocity, and cloud cover data. Kriging interpolation was utilized to estimate PT values at the patients' locations. Overall mortality and major adverse cardiovascular events (MACEs) were assessed using a time-varying Cox proportional hazards model. Additionally, the Cox regression model evaluated PT corresponding to temperature thresholds for cold surge watches or warnings. Over a median follow-up of 6.14 ± 3.96 years, 6147 deaths (18.7%) were recorded. We found that as the average or minimum PT and Ta decreased by 1 °C, the risk of overall mortality significantly increased. In multivariable analyses, the hazard ratio (HR) for the average PT was 1.049 (95% confidence interval [CI] 1.028-1.071), and that for the minimum PT was 1.038 (CI 1.027-1.052). Furthermore, a cold surge warning at a PT of -25.63 °C indicated an HR of 1.837 (CI 1.764-1.914) and a C-index of 0.792. The increased risk of mortality was more pronounced in patients with low or middle socioeconomic statuses. For MACEs, lower average and minimum PT and Ta were associated with an increased risk, following a similar trend to overall mortality, although not all results reached statistical significance. These findings emphasize the importance of targeted public health policies to mitigate risks among vulnerable CKD patients.
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Affiliation(s)
- Ara Ko
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jae-Young Byon
- National Meteorological Satellite Center, Korea Meteorological Administration, Jincheon, Chungcheongbuk-do, Republic of Korea
| | - Boram Weon
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jeonghwan Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Whanhee Lee
- Data Science, School of Biomedical Convergence Engineering, Pusan National University, Pusan, Republic of Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sejoong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
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Guo YT, Chan KH, Qiu H, Wong ELY, Ho KF. The risk of hospitalization associated with hot nights and excess nighttime heat in a subtropical metropolis: a time-series study in Hong Kong, 2000-2019. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 51:101168. [PMID: 39229334 PMCID: PMC11367509 DOI: 10.1016/j.lanwpc.2024.101168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 09/05/2024]
Abstract
Background Recent studies showed increased mortality risks after hot nights, but their effect on hospitalizations, especially in vulnerable populations, remains under-studied. Methods Daily hospitalization, meteorological (including hourly), and air pollution data were collected for the hot seasons (May-October) of 2000-19 in Hong Kong. We derived three hot-night metrics: HNday28 °C, daily minimum temperature ≥28 °C, the governmental definition of hot nights; HNe, hot night excess calculated by summing heat excess of hourly temperatures above 28 °C at night; and HNday90th, hot nights classified using the 90th percentile HNe (17.7 °C⋅h) as a cutoff. We fitted time-series regression with distributed lag nonlinear models to examine the associations of hot-night metrics with various hospitalizations. Findings During the 3680 study days, 5,002,114 non-cancer non-external (NCNE) hospitalizations were recorded. Half (1874) of the days experienced excess nighttime heat (HNe>0) with a mean (SD) of 8.0 (6.8) °C⋅h; 499 and 187 hot nights were identified by HNday28 °C and HNday90th, respectively. Extreme HNe (99th percentile vs 0 °C⋅h) was significantly associated with increased NCNE hospitalizations over lag 0-4 days by 3.1% [95% confidence interval: 1.5%, 4.8%] overall, with enhanced effects in elderly (5.3% [3.2%, 7.4%]), low-SES individuals (5.3% [2.8%, 8.0%]), and circulatory admissions (3.4% [0.2%, 6.8%]). HNday90th, reflecting extreme HNe, better identified hazardous hot nights than the official HNday28 °C. Interpretation Excessive nighttime heat is significantly associated with increased hospitalizations, particularly affecting the elderly and socioeconomically disadvantaged individuals. Nighttime heat intensity should be incorporated in defining hot nights with public health relevance. Funding British Heart Foundation.
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Affiliation(s)
- Yi Tong Guo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, UK
| | - Hong Qiu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kin Fai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong SAR, China
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Scovronick N, Sera F, Vu B, Vicedo-Cabrera AM, Roye D, Tobias A, Seposo X, Forsberg B, Guo Y, Li S, Honda Y, Abrutzky R, de Sousa Zanotti Stagliorio Coelho M, Nascimento Saldiva PH, Lavigne E, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola JJ, Ryti N, Pascal M, Katsouyanni K, Mayvaneh F, Entezari A, Goodman P, Zeka A, Michelozzi P, de’Donato F, Hashizume M, Alahmad B, Zanobetti A, Schwartz J, Hurtado Diaz M, De La Cruz Valencia C, Rao S, Madureira J, Acquaotta F, Kim H, Lee W, Iniguez C, Ragettli MS, Guo YL, Dang TN, Dung DV, Armstrong B, Gasparrini A. Temperature-mortality associations by age and cause: a multi-country multi-city study. Environ Epidemiol 2024; 8:e336. [PMID: 39323989 PMCID: PMC11424137 DOI: 10.1097/ee9.0000000000000336] [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: 01/10/2024] [Accepted: 08/08/2024] [Indexed: 09/27/2024] Open
Abstract
Background Heterogeneity in temperature-mortality relationships across locations may partly result from differences in the demographic structure of populations and their cause-specific vulnerabilities. Here we conduct the largest epidemiological study to date on the association between ambient temperature and mortality by age and cause using data from 532 cities in 33 countries. Methods We collected daily temperature and mortality data from each country. Mortality data was provided as daily death counts within age groups from all, cardiovascular, respiratory, or noncardiorespiratory causes. We first fit quasi-Poisson regression models to estimate location-specific associations for each age-by-cause group. For each cause, we then pooled location-specific results in a dose-response multivariate meta-regression model that enabled us to estimate overall temperature-mortality curves at any age. The age analysis was limited to adults. Results We observed high temperature effects on mortality from both cardiovascular and respiratory causes compared to noncardiorespiratory causes, with the highest cold-related risks from cardiovascular causes and the highest heat-related risks from respiratory causes. Risks generally increased with age, a pattern most consistent for cold and for nonrespiratory causes. For every cause group, risks at both temperature extremes were strongest at the oldest age (age 85 years). Excess mortality fractions were highest for cold at the oldest ages. Conclusions There is a differential pattern of risk associated with heat and cold by cause and age; cardiorespiratory causes show stronger effects than noncardiorespiratory causes, and older adults have higher risks than younger adults.
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Affiliation(s)
- Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta
| | - Francesco Sera
- Environment and Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Statistics, Computer Science and Applications “G. Parenti,” University of Florence, Florence, Italy
| | - Bryan Vu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Ana M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Dominic Roye
- Climate Research Foundation (FIC), Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Rosana Abrutzky
- Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina
| | | | | | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Jouni J. Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
- School of Population Health and Environmental Sciences, King’s College, London, UK
| | - Fatemeh Mayvaneh
- Climatology Research Group, Institute of Landscape Ecology, University of Münster, Münster, Germany
| | - Alireza Entezari
- Climate, Air Quality Research Unit, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar Khorasan Razavi, Iran
| | | | - Ariana Zeka
- Institute for Global Health, University College London, London, UK
- College of Health, Medicine and Life Sciences, Brunel University London, London, UK
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Barak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Miguel Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - C. De La Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | | | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, South Korea
| | - Carmen Iniguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Statistics and Computational Research. Universitat de València, València, Spain
| | - Martina S. Ragettli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Yue L. Guo
- Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Do V. Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Benedict Armstrong
- Environment and Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Antonio Gasparrini
- Environment and Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Zhao X, Li X, Dong J. Effect of various temperature indicators on patients' hospitalization with cardiovascular diseases in Zhangye city, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02793-4. [PMID: 39347993 DOI: 10.1007/s00484-024-02793-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 09/15/2024] [Accepted: 09/26/2024] [Indexed: 10/01/2024]
Abstract
This study assessed the impact of various temperature indices, including mean temperature (MT), diurnal temperature range (DTR), and temperature changes between neighboring days (TCN) on hospitalization rates for cardiovascular system diseases among residents of Zhangye City, a typical western city in China. The Quasi-Poisson generalized additive regression model (GAM) in conjunction with a distributed lag nonlinear model (DLNM) was applied to estimate the association of temperature indices with CVD hospitalization rates in Zhangye City during the periods of 2015-2021. The exposure-response relationship and relative risk were discussed and stratified analyses by age and gender were conducted. We found that the hospitalization rates of cardiovascular disease (CVD) patients in Zhangye City was significantly related to different temperature indicators (MT, DTR, TCN). Both low and high MT, DTR, and TCN increased the risk of cardiovascular disease (CVD) among residents. Besides, different demographic populations exhibited distinct sensitivities to temperature conditions. Relevant authorities should devise corresponding preventive and control measures to protect vulnerable populations.
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Affiliation(s)
- Xin Zhao
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Xin Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China.
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Pane MM, Davis RE. The association between short-term temperature variability and mortality in Virginia. PLoS One 2024; 19:e0310545. [PMID: 39302917 DOI: 10.1371/journal.pone.0310545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/03/2024] [Indexed: 09/22/2024] Open
Abstract
The objective of this study is to determine the relationship between short-term temperature variability on neighboring days and mortality. The change in maximum temperature in Northern Virginia, Richmond, Roanoke, and Norfolk, Virginia, on neighboring days was calculated from airport observations and associated with total mortality over a multi-county area surrounding each weather station. The association between day-to-day temperature change and mortality, lagged over a 28-day period, was analyzed using distributed lag non-linear models that controlled for air quality, temporal trends, and other factors. Days following large temperature declines were associated with an increased risk of mortality in three of the four locations, and temperature increases were linked to higher mortality risk in two cities. For example, the relative risk of mortality for a 12°C daily temperature decline (1st percentile) was 1.74 [0.92, 3.27] in Roanoke and 1.16 [0.70, 1.92] in Richmond. The net effect of short-term temperature increases was smaller, with the largest relative risk of 1.03 [0.58, 1.83] for a 12°C increase (99th percentile) in maximum temperature in Norfolk. In Richmond and Roanoke, there was an observed lagged effect of increased mortality (maximum relative risks varying from 1.08 to 1.10) that extended from 5 to 25 days associated with large temperature declines of 15°C or more. In contrast, there was a strong and immediate (lag 0-3 day) increase in the risk of mortality (1.10 to 1.15) in northern Virginia and Norfolk when the temperature increase exceeded 10°C (short-term warming). In general, consecutive day warming had a more immediate mortality impact than short-term cooling, when the peak mortality is lagged by one week or more. However, cooling of at least 10°C after a hot (summer) day reduced mortality relative to comparable cooling following a cold (winter) day, which is associated with high mortality. This differential mortality response as a function of temperature suggests that there is some relationship between average temperature, temperature variability, and season. The findings of this study may be useful to public health officials in developing mitigation strategies to reduce the adverse health risks associated with short-term temperature variability.
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Affiliation(s)
- Melanie M Pane
- Department of Environmental Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Robert E Davis
- Department of Environmental Sciences, University of Virginia, Charlottesville, Virginia, United States of America
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Boudreault J, Lavigne É, Campagna C, Chebana F. Estimating the heat-related mortality and morbidity burden in the province of Quebec, Canada. ENVIRONMENTAL RESEARCH 2024; 257:119347. [PMID: 38844034 DOI: 10.1016/j.envres.2024.119347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND As climate change increases the frequency and intensity of extreme heat events, there is an urgent need to quantify the heat-related health burden. However, most past studies have focussed on a single health outcome (mainly mortality) or on specific heatwaves, thus providing limited knowledge of the total pressure heat exerts on health services. OBJECTIVES This study aims to quantify the heat-related mortality and morbidity burden for five different health outcomes including all-cause mortality, hospitalizations, emergency department (ED) visits, ambulance transports and calls to a health hotline, using the province of Quebec (Canada) as a case study. METHODS A two-step statistical analysis was employed to estimate regional heat-health relationships using Distributed Lag Non-Linear Models (DLNM) and pooled estimates using a multivariate meta-regression. Heat burden was quantified by attributable fraction (AF) and attributable number (AN) for two temperature ranges: all heat (above the minimum mortality/morbidity temperature) and extreme heat (above the 95th percentile of temperature). RESULTS Higher temperatures were associated with greater risk ratios for all health outcomes studied, but at different levels. Significant AF ranging from 2 to 3% for the all heat effect and 0.4-1.0% for extreme heat were found for all health outcomes, except for hospitalizations that had an AF of 0.1% for both heat exposures. The estimated burden of all heat (and extreme heat) every summer across the province was 470 (200) deaths, 225 (170) hospitalizations, 36 000 (6 200) ED visits, 7 200 (1 500) ambulance transports and 15 000 (3 300) calls to a health hotline, all figures significant. DISCUSSION This new knowledge on the total heat load will help public health authorities to target appropriate actions to reduce its burden now and in the future. The proposed state-of-the-art framework can easily be applied to other regions also experiencing the adverse effects of extreme heat.
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Affiliation(s)
- Jérémie Boudreault
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3.
| | - Éric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON, Canada, K1A 0K9; School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, Canada, G1K 5Z3
| | - Céline Campagna
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9; Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Av. Wolfe, Québec, QC, Canada, G1V 5B3; Department of social and preventive medicine, Laval University, 1050 Av. de la Médecine, Québec, QC, Canada, G1V 0A6
| | - Fateh Chebana
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de la Couronne, Québec, QC, Canada, G1K 9A9
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Sohail H, Zhang S, Kraus U, Mikkonen S, Breitner S, Wolf K, Nikolaou N, Peters A, Lanki T, Schneider A. Association between air temperature and self-perceived health status in Southern Germany: Results from KORA FIT study. Int J Hyg Environ Health 2024; 262:114431. [PMID: 39096579 DOI: 10.1016/j.ijheh.2024.114431] [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: 01/31/2024] [Revised: 06/26/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Short-term exposure to low and high air temperatures can cause serious harmful effects on human health. Existing literature has mostly focused on associations of ambient air temperature with mortality and the need for health care in population-level studies. Studies that have considered self-perceived health status as an outcome when examining the effects of air temperature on health are scarce. In this study, we explored the short-term association of daily mean air temperature with various measures of self-perceived health status. METHODS This cross-sectional analysis is based on the Cooperative Health Research in the Region of Augsburg (KORA) FIT study conducted in 2018/2019 and included participants from the Augsburg region of Southern Germany. Health-related quality of life (HRQOL) was evaluated by using the 5-level EuroQol Five Dimension (EQ-5D-5L) questionnaire, including the EuroQol visual analog scale (EQ-VAS). Self-rated health (SRH) and comparative self-rated health (CSRH) were each assessed using a single question. Daily mean air temperature data was estimated using a spatiotemporal model and assigned to participants' home addresses at a resolution of 1 × 1 km. Regression models with a Distributed Lag Non-linear Modeling (DLNM) approach were used to investigate the associations between daily mean air temperature and self-perceived health measures. RESULTS We found no association of heat or cold with the HRQOL, SRH or CSRH. Nevertheless, there was a significant protective association of low air temperature with the EQ-5D-5L dimension "usual activities." CONCLUSION There was no evidence of daily mean air temperature adversely affecting participants' self-perceived health status.
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Affiliation(s)
- Hasan Sohail
- Department of Environmental and Biological Sciences, University of Eastern Finland, 70211, Kuopio, Finland; Department of Health Security, Finnish Institute for Health and Welfare (THL), 70701, Kuopio, Finland.
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Ute Kraus
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Santtu Mikkonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, 70211, Kuopio, Finland; Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany; LMU Munich, IBE-Chair of Epidemiology, 85764, Neuherberg, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Nikolaos Nikolaou
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Timo Lanki
- Department of Environmental and Biological Sciences, University of Eastern Finland, 70211, Kuopio, Finland; Department of Health Security, Finnish Institute for Health and Welfare (THL), 70701, Kuopio, Finland; School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
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Leach OK, Cottle RM, Fisher KG, Wolf ST, Kenney WL. Sex differences in heat stress vulnerability among middle-aged and older adults (PSU HEAT Project). Am J Physiol Regul Integr Comp Physiol 2024; 327:R320-R327. [PMID: 39005081 PMCID: PMC11444510 DOI: 10.1152/ajpregu.00114.2024] [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: 04/30/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024]
Abstract
Individuals over the age of 65 yr are the most vulnerable population during severe environmental heat events, experiencing worse health outcomes than any other age cohort. The risk is greater in older women than in age-matched men; however, whether that reflects a greater susceptibility to heat in women, or simply population sex proportionality, is unclear. Seventy-two participants (29 M/43 F) aged 40-92 yr were exposed to progressive heat stress at a metabolic rate designed to reflect activities of daily living. Experiments were conducted in both hot-dry (HD; up to 53°C; ≤25% rh) and warm-humid (WH; ∼35°C; ≥50% rh) environments. After critical limits were determined for each condition, forward stepwise multiple linear regression analyses were conducted with net metabolic rate (Mnet) and age entered into the model first, followed by sex, body mass (mb), maximal oxygen consumption (V̇o2max), body surface area, and LDL cholesterol. After accounting for Mnet and age, sex further improved the regression model in the HD environment ([Formula: see text] = 0.34, P < 0.001) and the WH environment ([Formula: see text] = 0.36, P < 0.005). Sex explained ∼15% of the variance in critical environmental limits in HD conditions and 12% in WH conditions. Heat compensability curves were shifted leftward for older women, indicating age- and sex-dependent heat vulnerability compared with middle-aged women and older men in WH (P = 0.007, P = 0.03) and HD (P = 0.001, P = 0.01) environments. This reflects the heterogeneity of thermal-balance thresholds associated with aging relative to those seen in young adults and suggests that older females are more vulnerable than their age-matched male counterparts.NEW & NOTEWORTHY In contrast to young adults, there are sex differences in critical environmental limits in middle-aged and older adults. Older women exhibit lower critical environmental limits in both humid and dry extreme environments demonstrated by a leftward shift in heat compensability curves. These data confirm a true sex difference in heat vulnerability of older adults and support the epidemiological mortality data from environmental heat waves.
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Affiliation(s)
- Olivia K Leach
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Rachel M Cottle
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Kat G Fisher
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - S Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - W Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, United States
- Graduate Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania, United States
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9
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Urbanowicz T, Skotak K, Bratkowski J, Olasińska-Wiśniewska A, Filipiak KJ, Michalak M, Grodecki K, Szczepański K, Tykarski A, Krasińska B, Krasiński Z, Krasińska-Płachta A, Jemielity M. Long-Term Survival after Coronary Artery Surgical Revascularization-Does Ambient Temperature Matter? MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1220. [PMID: 39202501 PMCID: PMC11356662 DOI: 10.3390/medicina60081220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/11/2024] [Accepted: 07/25/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: The progression of global warming results in an increased exposure to extreme heat, leading to exaggeration of preexisting diseases and premature deaths. The aim of the study was to present possible risk factors for all-cause long-term mortality in patients who underwent surgical revascularization, including an assessment of the influence of ambient temperature exposure. Materials and Methods: Retrospective analysis included 153 (123 (80%) males and 30 (20%) females) patients who underwent off-pump revascularization and were followed for a median time of 2533 (1035-3250) days. The demographical, clinical data and ambient temperature exposure were taken into analysis for prediction of all-cause mortality. Individual exposure was calculated based on the place of habitation. Results: In the multivariate logistic regression model with backward stepwise elimination method, risk factors such as dyslipidaemia (p = 0.001), kidney disease (p = 0.005), age (p = 0.006), and body mass index (p = 0.007) were found to be significant for late mortality prediction. In addition to traditional factors, environmental characteristics, including tropical nights (p = 0.043), were revealed to be significant. Conclusions: High night-time ambient temperatures known as tropical nights may be regarded as additional long-term mortality risk factor after surgical revascularization.
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Affiliation(s)
- Tomasz Urbanowicz
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Krzysztof Skotak
- Institute of Environmental Protection–National Research Institute, 02-170 Warsaw, Poland
| | - Jakub Bratkowski
- Institute of Environmental Protection–National Research Institute, 02-170 Warsaw, Poland
| | - Anna Olasińska-Wiśniewska
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Krzysztof J. Filipiak
- Institute of Clinical Science, Maria Sklodowska-Curie Medical Academy, 00-136 Warsaw, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Kajetan Grodecki
- 1st Cardiology Department, Warsaw University of Medical Sciences, 02-091 Warsaw, Poland
| | - Krystian Szczepański
- Institute of Environmental Protection–National Research Institute, 02-170 Warsaw, Poland
| | - Andrzej Tykarski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Beata Krasińska
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Zbigniew Krasiński
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | | | - Marek Jemielity
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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10
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Stumpe B, Stuhrmann N, Jostmeier A, Marschner B. Urban cemeteries: The forgotten but powerful cooling islands. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 934:173167. [PMID: 38761931 DOI: 10.1016/j.scitotenv.2024.173167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/23/2024] [Accepted: 05/10/2024] [Indexed: 05/20/2024]
Abstract
Urban parks play a key role in UHI mitigation. However, the role of other prominent types of urban green infrastructure has not been comprehensively studied. Thus, the main objective of this study was to evaluate the role of cemeteries and allotments as cooling islands compared to the well-studied park areas. We assessed the LST of cemeteries, allotments and parks based on Landsat 8 TM images across the five largest German cities during summertime. Random forest regressions explain the LST spatial variability of the different urban green spaces (UGS) with spectral indices (NDVI, NDMI, NDBaI) as well as with tree characteristics (tree type, tree age, trunk circumferences, trunk height or canopy density). As a result, allotments were identified as the hottest UGS with the city means varying between 23.1 and 26.9 °C, since they contain a relatively high proportion of sealed surfaces. The LST spatial variability of allotment gardens was best explained by the NDVI indicating that fields with a higher percentage of flowering shrubs and trees reveal lower LST values than those covered by annual crops. Interestingly, cemeteries were characterized as the coolest UGS, with city means between 20.4 and 24.7 °C. Despite their high proportion of sealed surfaces, they are dominated by old trees resulting in intensive transpiration processes. Parks show heterogeneous LST patterns which could not be systematically explained by spectral indices due to the variability of park functionality and shape. Compared to parks, the tree-covered areas of cemeteries have a higher cooling potential since cemeteries as cultural heritage sites are well-protected allowing old tree growth with intensive transpiration. These findings underline the relevance of cemeteries as cooling islands and deepen the understanding of the role of tree characteristics in the cooling process.
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Affiliation(s)
- Britta Stumpe
- Department of General Geography/Human-Environment Research, Institute of Geography, University of Wuppertal, 42119 Wuppertal, Germany.
| | - Niklas Stuhrmann
- Department of General Geography/Human-Environment Research, Institute of Geography, University of Wuppertal, 42119 Wuppertal, Germany
| | - Anna Jostmeier
- Department of General Geography/Human-Environment Research, Institute of Geography, University of Wuppertal, 42119 Wuppertal, Germany
| | - Bernd Marschner
- Department of Soil Science and Soil Ecology, Geographical Institute, Ruhr-University Bochum, Universitaetsstr. 150, 44801 Bochum, Germany
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11
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Yang X, Xu X, Wang Y, Yang J, Wu X. Heat exposure impacts on urban health: A meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 947:174650. [PMID: 38986701 DOI: 10.1016/j.scitotenv.2024.174650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/27/2024] [Accepted: 07/07/2024] [Indexed: 07/12/2024]
Abstract
The escalating health risks posed by warm weather in urban areas have become a pressing global public health issue. This study undertakes a meta-analysis to evaluate the impact of warm weather on health in urban settings. We comprehensively searched PubMed, Embase, Scopus, and Web of Science for literature published before September 6, 2023, evaluating evidence quality using the Navigation Guide Criteria. We included original studies utilizing high temperatures or heatwaves as exposure metrics and employing observational designs. A meta-analysis was carried out to assess the relative risk (RR) of the association between high temperatures (or heatwaves) and disease outcomes. Out of 12,893 studies identified, 188 met the inclusion criteria for meta-analysis. Results demonstrate a statistically significant association between a 1 °C temperature increase and a 2.1 % elevation in disease-related mortality (RR 1.021 [95 % CI 1.018-1.023]), alongside a 1.1 % increase in morbidity (RR 1.011 [95 % CI 1.007-1.016]). Heatwaves also showed associations with increased total mortality (RR 1.224 [95 % CI 1.186-1.264]) and morbidity (RR 1.038 [95 % CI 1.010-1.066]). Subgroup analyses for diseases, sex, age, climatic zones, countries, and time periods consistently indicated heightened disease-related mortality and morbidity linked to high temperatures. Notably, China's urban population faced an elevated mortality risk (RR 1.027 [95 % CI 1.018-1.036]) compared to other countries (RR 1.021 [95 % CI 1.019-1.024]). Mortality associated with high temperatures after 2007 (RR 1.022 [95 % CI 1.015-1.029]) was higher than before 2007 (RR 1.017 [95 % CI 1.013-1.021]), reflecting increased health risks as the global warming accelerates. Our findings underscore the positive association between rising temperatures and/or heatwaves and adverse health outcomes in urban populations. The widespread exposure to high temperatures amplifies health risks across various diseases, demographics, climates, and countries, with potential exacerbation under ongoing global warming. Further research is imperative to delineate factors influencing altered heat exposure impacts.
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Affiliation(s)
- Xudong Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China
| | - Xingyuan Xu
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Yize Wang
- Department of Radiology, Hefei Binhu Hospital, Anhui province, Hefei 230092, China
| | - Jun Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China.
| | - Xingwang Wu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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12
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Li F, Liu X, Niu Y, Gao J, Li M, Zhao Y, Ji C, Pan G, Zhao M, Wu B, Tang X, Wu G, Tian J, Chen J, Yan S, Tan J, Li Y, Zhao W, Li L, Qiu Y, Yao W, Zhu L. The impact of apparent temperature on the emergency visits for traumatic fractures in Hangzhou, China. BMC Public Health 2024; 24:1681. [PMID: 38914979 PMCID: PMC11197263 DOI: 10.1186/s12889-024-19119-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Traumatic fractures occur frequently worldwide. However, research remains limited on the association between short-term exposure to temperature and traumatic fractures. This study aims to explore the impact of apparent temperature (AT) on emergency visits (EVs) due to traumatic fractures. METHODS Based on EVs data for traumatic fractures and the contemporary meteorological data, a generalized Poisson regression model along with a distributed lag nonlinear model (DLNM) were undertaken to determine the impact of AT on traumatic fracture EVs. Subgroup analysis by gender and age and sensitivity analysis were also performed. RESULTS A total of 25,094 EVs for traumatic fractures were included in the study. We observed a wide "J"-shaped relationship between AT and risk of traumatic fractures, with AT above 9.5 °C positively associated with EVs due to traumatic fractures. The heat effects became significant at cumulative lag 0-11 days, and the relative risk (RR) for moderate heat (95th percentile, 35.7 °C) and extreme heat (99.5th percentile, 38.8 °C) effect was 1.311 (95% CI: 1.132-1.518) and 1.418 (95% CI: 1.191-1.688) at cumulative lag 0-14 days, respectively. The cold effects were consistently non-significant on single or cumulative lag days across 0-14 days. The heat effects were higher among male and those aged 18-65 years old. The sensitivity analysis results remained robust. CONCLUSION Higher AT is associated with cumulative and delayed higher traumatic fracture EVs. The male and those aged 18-65 years are more susceptible to higher AT.
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Affiliation(s)
- Feng Li
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Xuejiao Liu
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Capital Medical Univisity, Beijing, 100035, China
| | - Yanlin Niu
- Beijing Center for Disease Prevention and Control, Institute for Nutrition and Food Hygiene, Beijing, 100035, China
| | - Jinghong Gao
- Institute for Hospital Management of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450000, China
| | - Maoqiang Li
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Yipin Zhao
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Cheng Ji
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Guobiao Pan
- Department of Orthopedics, Third People's Hospital of Hangzhou, Hangzhou, 310009, China
| | - Mingxing Zhao
- Department of orthopedics, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, 311199, China
| | - Boliang Wu
- Department of orthopedics, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, 311199, China
| | - Xiaoxiang Tang
- Department of Orthopedics, The Second People's Hospital of Jiande, Hangzhou, 311600, China
| | - Gang Wu
- Department of Orthopedics, The Second People's Hospital of Fuyang District, Hangzhou, Hangzhou, 311400, China
| | - Jun Tian
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Jianwei Chen
- Department of Orthopedics, The Second People's Hospital of Fuyang District, Hangzhou, Hangzhou, 311400, China
| | - Shiyu Yan
- Department of Orthopedics, The Second People's Hospital of Jiande, Hangzhou, 311600, China
| | - Jianlu Tan
- Department of orthopedics, Affiliated Hospital of Jining Medical University, Jining, 272007, China
| | - Yunqing Li
- Nanjing University of Chinese Medicine, Nangjing, 210023, China
| | - Wentao Zhao
- Department of orthopedics, Beijing Shunyi Hospital, Beijing, 101300, China
| | - Lingyun Li
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Yinmiao Qiu
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Wangxiang Yao
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Liulong Zhu
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.
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13
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Kenny GP, Tetzlaff EJ, Journeay WS, Henderson SB, O’Connor FK. Indoor overheating: A review of vulnerabilities, causes, and strategies to prevent adverse human health outcomes during extreme heat events. Temperature (Austin) 2024; 11:203-246. [PMID: 39193048 PMCID: PMC11346563 DOI: 10.1080/23328940.2024.2361223] [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: 01/16/2024] [Revised: 05/07/2024] [Accepted: 05/20/2024] [Indexed: 08/29/2024] Open
Abstract
The likelihood of exposure to overheated indoor environments is increasing as climate change is exacerbating the frequency and severity of hot weather and extreme heat events (EHE). Consequently, vulnerable populations will face serious health risks from indoor overheating. While the relationship between EHE and human health has been assessed in relation to outdoor temperature, indoor temperature patterns can vary markedly from those measured outside. This is because the built environment and building characteristics can act as an important modifier of indoor temperatures. In this narrative review, we examine the physiological and behavioral determinants that influence a person's susceptibility to indoor overheating. Further, we explore how the built environment, neighborhood-level factors, and building characteristics can impact exposure to excess heat and we overview how strategies to mitigate building overheating can help reduce heat-related mortality in heat-vulnerable occupants. Finally, we discuss the effectiveness of commonly recommended personal cooling strategies that aim to mitigate dangerous increases in physiological strain during exposure to high indoor temperatures during hot weather or an EHE. As global temperatures continue to rise, the need for a research agenda specifically directed at reducing the likelihood and impact of indoor overheating on human health is paramount. This includes conducting EHE simulation studies to support the development of consensus-based heat mitigation solutions and public health messaging that provides equitable protection to heat-vulnerable people exposed to high indoor temperatures.
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Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - W. Shane Journeay
- Departments of Medicine and Community Health and Epidemiology, Dalhousie Medicine New Brunswick and Dalhousie University, Saint John, NB, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
- Department of Rehabilitative Care, Providence Healthcare-Unity Health Toronto, Toronto, ON, Canada
| | - Sarah B. Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
- National Collaborating Centre for Environmental Health, Vancouver, BC, Canada
| | - Fergus K. O’Connor
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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14
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Alahmad B, Yuan Q, Achilleos S, Salameh P, Papatheodorou SI, Koutrakis P. Evaluating the temperature-mortality relationship over 16 years in Cyprus. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2024; 74:439-448. [PMID: 38718302 DOI: 10.1080/10962247.2024.2345637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/08/2024] [Indexed: 06/01/2024]
Abstract
In many regions of the world, the relationship between ambient temperature and mortality is well-documented, but little is known about Cyprus, a Mediterranean island country where climate change is progressing faster than the global average. We Examined the association between daily ambient temperature and all-cause mortality risk in Cyprus. We conducted a time-series analysis with quasipoisson distribution and distributed lag non-linear models to investigate the association between temperature and all-cause mortality from 1 January 2004 to 31 December 2019 in five districts in Cyprus. We then performed a meta-analysis to estimate the overall temperature-mortality dose-response relationship in Cyprus. Excess mortality was computed to determine the public health burden caused by extreme temperatures. We did not find evidence of heterogeneity between the five districts (p = 0.47). The pooled results show that for cold effects, comparing the 1st, 2.5th, and 5th percentiles to the optimal temperature (temperature associated with least mortality, 25 ℃), the overall relative risks of mortality were 1.55 (95% CI: 1.32, 1.82), 1.41 (95% CI: 1.21, 1.64), and 1.32 (95% CI: 1.15, 1.52), respectively. For heat effects, the overall relative risks of mortality at the 95th, 97.5th and 99th percentiles were 1.10 (95% CI: 1.04, 1.16), 1.17 (95% CI: 1.07, 1.29), and 1.29 (95% CI: 1.11, 1.5), respectively. The excess mortality attributable to cold days accounted for 8.0 deaths (95% empirical CI: 4.5-10.8) for every 100 deaths, while the excess mortality attributable to heat days accounted for 1.3 deaths (95% empirical CI: 0.7-1.7) for every 100 deaths. The results prompt additional research into environmental risk prevention in this under-studied hot and dry region that could experience disproportionate climate change related exposures.Implications: The quantification of excess mortality attributable to temperature extremes shows an urgent need for targeted public health interventions and climate adaptation strategies in Cyprus and similar regions facing rapid climate change. Future steps should look into subpopulation sensitivity, coping strategies, and adaptive interventions to reduce potential future risks.
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Affiliation(s)
- Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Qinni Yuan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Souzana Achilleos
- School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Pascale Salameh
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Stefania I Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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15
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Runkle JD, Sugg MM, Berry A, Reed C, Cowan K, Wertis L, Ryan S. Association of Psychiatric Emergency Visits and Warm Ambient Temperature during Pregnancy: A Time-Stratified Case-Crossover Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:67001. [PMID: 38829735 PMCID: PMC11166382 DOI: 10.1289/ehp13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Acute exposure to high ambient temperature and heat waves during the warm season has been linked with psychiatric disorders. Emerging research has shown that pregnant people, due to physiological and psychological changes, may be more sensitive to extreme heat, and acute exposure has been linked to increased risk of pregnancy complications; however, few studies have examined psychiatric complications. OBJECTIVE Our objective was to examine the association between acute exposure to warm ambient temperatures and emergency department (ED) visits for mental disorders during pregnancy. METHODS A time-stratified case-crossover design with conditional logistic regression was performed on ∼ 206,000 psychiatric ED visits for pregnant patients in North Carolina, from May to September 2016 to 2019. Daily average ambient temperature was the main exposure and was linked to daily visits by maternal zip code of residence for prenatal mood and anxiety disorders (PMAD), severe mental illness (SMI), mental disorder of pregnancy (MDP), suicidal thoughts (SUIC), and any psychiatric disorder (Any). Effect modification by trimester, residential segregation, economic segregation, urbanicity, and availability of greenspace was also investigated. RESULTS Each 5 ° C increase in same-day exposure to warm ambient temperature on case days was associated with an increase in incidence rate ratio (IRR) for any psychiatric disorder [IRR = 1.07; 95% confidence interval (CI): 1.01, 1.14] including anxiety (IRR = 1.14; 95% CI: 1.00, 1.30), bipolar disorder (IRR = 1.28; 95% CI: 0.98, 1.67), and suicidal thoughts (IRR = 1.28; 95% CI: 1.00, 1.65) compared to control days. In general, the associations were strongest for warm season temperatures on the same day of exposure or for temperatures averaged over the 3 or 6 d preceding the ED visit. The greatest risk of an incident ED admission for PMAD (RR = 1.20; 95% CI: 1.04, 1.39), particularly for anxiety (RR = 1.30; 95% CI: 1.07, 1.59), and any psychiatric disorder (RR = 1.17; 95% CI: 1.07, 1.28) occurred following cumulative exposure to hot temperatures the week before admission. Higher psychiatric burden from temperature was observed in urban areas and on extreme heat days. CONCLUSIONS For this pregnant population in the southeastern United States, short-term exposure to high ambient temperatures during the warm season was associated with a greater risk of ED visits for an array of psychiatric disorders. Findings show that climate-related increases in ambient temperature may contribute to psychiatric morbidity in pregnant people. https://doi.org/10.1289/EHP13293.
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Affiliation(s)
- Jennifer D. Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Margaret M. Sugg
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Anne Berry
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Charlie Reed
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Kristen Cowan
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Sophie Ryan
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
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16
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Kunda JJ, Gosling SN, Foody GM. The effects of extreme heat on human health in tropical Africa. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1015-1033. [PMID: 38526600 PMCID: PMC11108931 DOI: 10.1007/s00484-024-02650-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024]
Abstract
This review examines high-quality research evidence that synthesises the effects of extreme heat on human health in tropical Africa. Web of Science (WoS) was used to identify research articles on the effects extreme heat, humidity, Wet-bulb Globe Temperature (WBGT), apparent temperature, wind, Heat Index, Humidex, Universal Thermal Climate Index (UTCI), heatwave, high temperature and hot climate on human health, human comfort, heat stress, heat rashes, and heat-related morbidity and mortality. A total of 5, 735 articles were initially identified, which were reduced to 100 based on a set of inclusion and exclusion criteria. The review discovered that temperatures up to 60°C have been recorded in the region and that extreme heat has many adverse effects on human health, such as worsening mental health in low-income adults, increasing the likelihood of miscarriage, and adverse effects on well-being and safety, psychological behaviour, efficiency, and social comfort of outdoor workers who spend long hours performing manual labour. Extreme heat raises the risk of death from heat-related disease, necessitating preventative measures such as adaptation methods to mitigate the adverse effects on vulnerable populations during hot weather. This study highlights the social inequalities in heat exposure and adverse health outcomes.
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Affiliation(s)
- Joshua Jonah Kunda
- School of Geography, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
| | - Simon N Gosling
- School of Geography, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Giles M Foody
- School of Geography, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
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17
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Yang X, Wang J, Zhang G, Yu Z. Spatiotemporal distribution and lag effect of extreme temperature exposure on mortality of residents in Jiangsu, China. Heliyon 2024; 10:e30538. [PMID: 38765142 PMCID: PMC11098786 DOI: 10.1016/j.heliyon.2024.e30538] [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: 08/19/2023] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024] Open
Abstract
Background With the ever-increasing occurrence of extreme weather events as a result of global climate change, the impact of extreme temperatures on human health has become a critical area of concern. Specifically, it is imperative to investigate the impact of extreme weather conditions on the health of residents. Methods In this study, we analyze the daily death data from 13 prefecture-level cities in Jiangsu Province from January 2014 to September 2022, using the distributed lag nonlinear model (DLNM) to comprehensively account for factors such as relative humidity, atmospheric pressure, air pollutants, and other factors to evaluate the lag and cumulative effects of extreme low temperature and high temperature on the death of residents across different age groups. Additionally, we utilize the Geographical Detector to analyze the effects of various meteorological and environmental factors on the distribution of resident death in Jiangsu Province. This provides valuable insights that can guide health authorities in decision-making and in the protection of residents. Results The experimental results indicate that both extreme low and high temperatures increase the mortality of residents. We observe that the impact of extreme low temperatures has a delayed effect, peaking after 3-5 days and lasting up to 11-21 days. In contrast, the impact of extreme high temperature is greatest on the first day, and lasts only 2-4 days. Conclusion Both extreme high and low temperatures increase the mortality of residents, with the former being more transient and stronger and the latter being more persistent and slower. Furthermore, residents over 75 years of age are more vulnerable to the effects of extreme temperatures. Finally, we note that the spatial distribution of resident deaths is most closely associated consistent with the spatial distribution of daily mean temperature, and there is significant spatial heterogeneity in deaths among residents in Jiangsu Province.
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Affiliation(s)
- Xu Yang
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, Jiangsu, 210023, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, Jiangsu, 210023, China
| | - Junshu Wang
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, Jiangsu, 210023, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, Jiangsu, 210023, China
| | - Guoming Zhang
- Health Information Center of Jiangsu Province, Nanjing, Jiangsu, 210008, China
| | - Zhaoyuan Yu
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, Jiangsu, 210023, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, Jiangsu, 210023, China
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18
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Mirsanei Z, Asemani Y, Derakhshanjazari M, Gharibi V, Norouzi P, Mahdavi S, Cousins R. The influence of occupational heat stress on serum inflammatory cytokines among traditional bakery workers in Iran. PLoS One 2024; 19:e0302847. [PMID: 38709796 PMCID: PMC11073666 DOI: 10.1371/journal.pone.0302847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024] Open
Abstract
Heat exposure exceeding the ISO7243:1989 standard limit can contribute to health problems among employees in a variety of workplaces. Ignoring heat standard requirements in hot working conditions such as bakeries results in physiologic and health problems, as well as an elevated risk of later illnesses. In this analytical case-control study, the serum levels of four inflammatory factors (interleukin-1 beta, interleukin-6, tumor necrosis factor-α, and C-reactive protein) were assessed using an enzyme-linked immunosorbent assay. 105 male artisan bakers (in four job classifications in bakeries and staff) were compared based on demographic characteristics and inflammatory factors. The findings of the study showed correlations between serum interleukin-1β, interleukin-6, and C-reactive protein levels and thermal exposure in the occupational environment and employment type. Moreover, some differences in serum level of interleukin-1β and job type were observed. Heat overexposure affected the increase of interleukin-1β and C-reactive protein secretion. As a result of years of working in high-temperature conditions, inflammation can lead to subsequent diseases in workers. To protect their health from this occupational hazard, additional safeguards are needed. Our recommendations could also be applied to overly hot work environments that may cause heat stress in workers.
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Affiliation(s)
- Zahra Mirsanei
- Department of Immunology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yahya Asemani
- Department of Immunology, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Milad Derakhshanjazari
- Department of Occupational Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Vahid Gharibi
- Department of Occupational Health and Safety Engineering, School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Pirasteh Norouzi
- Department of Physiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sepideh Mahdavi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Rosanna Cousins
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom
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19
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Ming Y, Liu Y, Liu X, Tian Z. Demographic disparity in diurnal surface urban Heat Island exposure across local climate zones: A case study of Chongqing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171203. [PMID: 38428601 DOI: 10.1016/j.scitotenv.2024.171203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
Surface urban heat island (SUHI) exposure significantly harms human health during rapid urbanization. Identifying the areas and demographic groups under high SUHI exposure is critical for mitigating heat-related hazards. However, despite broad concern in US-European countries, rare studies discuss the diurnal SUHI exposure of demographic subgroups across Local Climate Zones (LCZs) in Chinese cities. Therefore, taking Chongqing as the case study, we measured the diurnal SUHI exposure of demographic subgroups (e.g., gender, age, and income) across different LCZs (compact, open, and sparsely-built zones) by coupling the ECOSTRESS data and mobile phone signaling data. The results indicated that Chongqing's compact high/middle-rise zones suffered a higher SUHI exposure due to high land surface temperature (LST) and a larger size of population than open zones. Despite a relatively low population density, extremely high LST in compact low-rise zones (e.g., industrial parks) contributes to considerable accumulated SUHI exposure. The SUHI exposure risk exhibited the differences between daytime and nighttime, resulting from SUHI variation and population flow. The demographic analysis showed that Chongqing's demographic subgroups are exposed disproportionately to SUHI. Elderly groups suffered relatively high exposure in compact high-rise zones. Low-incomers witnessed a high exposure in open zones. These findings call for alleviating SUHI exposure risk by targeting vulnerable groups and high-intensity exposure areas.
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Affiliation(s)
- Yujia Ming
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, PR China.
| | - Yong Liu
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, PR China.
| | - Xue Liu
- School of Geographic Sciences, East China Normal University, Shanghai 200241, PR China.
| | - Zongshun Tian
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, PR China.
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20
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Teyton A, Ndovu A, Baer RJ, Bandoli G, Benmarhnia T. Disparities in the impact of heat wave definitions on emergency department visits during the first year of life among preterm and full-term infants in California. ENVIRONMENTAL RESEARCH 2024; 248:118299. [PMID: 38272297 DOI: 10.1016/j.envres.2024.118299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Heat waves will be aggravated due to climate change, making this a critical public health threat. However, heat wave definitions to activate alert systems can be ambiguous, highlighting the need to assess a range of definitions to identify those that contribute to the most adverse health outcomes. Additionally, children are highly susceptible to the impacts of heat waves, especially infants, despite the lack of focus on this subpopulation. We aimed to assess the relationship between 30 heat wave definitions and the first all-cause emergency department (ED) visits for California infants. We also examined modification of this relationship by preterm birth status and demographic characteristics to identify possible health disparities. METHODS Live-born, singleton deliveries from the Study of Outcomes in Mothers and Infants born in 2014-2018 were included. Thirty heat wave definitions were assessed based on temperature metrics (minimum/maximum temperatures), thresholds (90th; 92.5th; 95th; 97.5th; 99th percentiles), and duration (1-; 2-; 3-days). A time-stratified case-crossover design assessed heat wave impacts on ED visits using infants with a warm season ED visit (May-October) within the first year of life (n = 228,250). Effect modification by preterm birth status, age, sex, race/ethnicity, education, and delivery payment type was also investigated. RESULTS Infants demonstrated increased risk of an ED visit with exposure to all heat definitions. The 3-day minimum temperature 99th percentile definition had the highest adjusted odds ratio (AOR: 1.14; 95% CI: 1.05-1.23) for the total population. Term infants were more affected by some heat waves than preterm infants. Effect modification was additionally identified, such as by maternal education. DISCUSSION This study provides insight on the heat wave definitions that lead to adverse health outcomes and the identification of the most susceptible infants to these impacts, which has implications on heat-related interventions.
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Affiliation(s)
- Anaïs Teyton
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA; Scripps Institution of Oceanography, University of California, San Diego, 8885, Biological Grade, La Jolla, CA, 92037, USA.
| | - Allan Ndovu
- University of California San Francisco School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Rebecca J Baer
- California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr. 9 Box 2930, San Francisco, CA, 94143, USA; Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Gretchen Bandoli
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, 8885, Biological Grade, La Jolla, CA, 92037, USA
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21
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Liu J, Zhang M, Huang J, Guo C, Yang J, Yue C, Zi W, Yang Q. Short-Term Effect of Ambient Temperature in Acute Ischemic Stroke with Endovascular Treatment Due to Large Vessel Occlusion. Clin Interv Aging 2024; 19:627-638. [PMID: 38646590 PMCID: PMC11032672 DOI: 10.2147/cia.s453268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/04/2024] [Indexed: 04/23/2024] Open
Abstract
Purpose Acute ischemic stroke (AIS) stands as the primary cause of mortality and extended disability globally. While prior studies have examined the connection between stroke and local weather, they have produced conflicting results. Our goal was to examine the correlation between temperature and functional prognosis in patients with large vessel occlusion (LVO) undergoing endovascular therapy (EVT). Patients and methods This study included a total of 1809 patients. Temperatures from stroke onset to groin puncture were categorized into Cold (10th percentile of temperature), Cool (10th-50th percentile of temperature), Warm (50th-90th percentile of temperature), and Hot (90th percentile of temperature) groups. The primary efficacy result was the modified Rankin Scale (mRS) score at 90 days. Safety outcomes included mortality, symptomatic intracranial hemorrhage (sICH) and complications after cerebral infarction. Results The primary efficacy results demonstrated a statistical enhancement in functional outcomes at 90 days for patients in the Warm group compared to the Cold group (adjusted common odds ratio [OR]: 1.386; 95% confidence interval [CI]: 1.024-1.878, P=0.035). Secondary efficacy results showed that temperature was associated with a higher rate of 90-day functional independence (adjusted OR: 1.016; 95% CI: 1.004-1.029; P=0.009), which was higher in the Warm group compared with patients in the Cold group (adjusted OR: 1.646; 95% CI: 1.107-2.448, P=0.014). There were no significant differences between groups in terms of sICH, 90-day mortality, and post-infarction complications. Conclusion Compared with Cold temperature, Warm temperature is associated with better functional outcomes and reduced mortality risk without increasing the risk of sICH.
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Affiliation(s)
- Juan Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Min Zhang
- Department of Neurology, Jiangmen Central Hospital, Jiangmen, People’s Republic of China
| | - Jiandi Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Changwei Guo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Jie Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Qingwu Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
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22
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Jiang S, Han C, Ma Y, Ji J, Chen G, Guo Y. Temporal dynamic effects of meteorological factors and air quality on the physical health of the older adults in Shenzhen, China. Front Public Health 2024; 12:1289253. [PMID: 38510362 PMCID: PMC10951054 DOI: 10.3389/fpubh.2024.1289253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/02/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Meteorological and environmental factors can affect people's lives and health, which is crucial among the older adults. However, it is currently unclear how they specifically affect the physical condition of older adults people. Methods We collected and analyzed the basic physical examination indicators of 41 older adults people for two consecutive years (2021 and 2022), and correlated them with meteorological and environmental factors. Partial correlation was also conducted to exclude unrelated factors as well. Results We found that among the physical examination indicators of the older adults for two consecutive years, five indicators (HB, WBC, HbAlc, CB, LDL-C) showed significant differences across the population, and they had significantly different dynamic correlation patterns with six meteorological (air pressure, temperature, humidity, precipitation, wind speed, and sunshine duration) and seven air quality factors (NO2, SO2, PM10, O3-1h, O3-8h, CO, PM2.5). Discussion Our study has discovered for the first time the dynamic correlation between indicators in normal basic physical examinations and meteorological factors and air quality indicators, which will provide guidance for the future development of policies that care for the healthy life of the older adults.
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Affiliation(s)
- Shuai Jiang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Chuanliang Han
- Department of Electrical Engineering, The City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yue Ma
- Department of Healthcare-Associated Infection Management, National Clinical Research Center for Infectious Diseases, Third People’s Hospital of Shenzhen and The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Guomin Chen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Yinsheng Guo
- Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
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Geronikolou S, Zimeras S, Tsitomeneas S, Chrousos GP. Heatwave 1987: the Piraeus versus Athens case. F1000Res 2024; 12:115. [PMID: 38434656 PMCID: PMC10907872 DOI: 10.12688/f1000research.124999.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Background Heatwaves represent the main indices of climate change, while mortality is one of the established markers of their human effects. For unknown reasons populations adapt to temperature variations/challenges differently. Thus, to allow better precision and prediction, heatwave evaluations should be enriched by historical context and local data. Methods The mortality data for 1987 were collected from the Piraeus municipality registry, whereas data for Athens were obtained from literature retrieved from PUBMED. Ambient characteristics were extracted from the Geronikolou's 1991 BSc thesis and the reports of national organizations. From the death events, the odds ratio and relative risk in Piraeus compared to the Athens were calculated. Finally, a simple neural network proposed the dominant ambient parameter of the heatwave effects in the city residents of each location. Results The 1987 heatwave was more lethal (seven-fold) in Athens than in Piraeus and dependent on atmospheric nitric oxide (NO) concentration (with probability 0.999). In the case of Piraeus in 1987, ozone characterized the phenomenon (with probability 0.993). Conclusions The odds of dying due to a heatwave are highly dependent on lifestyle, population sensitivity to preventive measures and public health policy, while the phenomenon was mainly moderated by ozone in Piraeus in 1987, and NO in Athens irrespective of year.
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Affiliation(s)
- Stella Geronikolou
- Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation Academy of Athens, Athens, 11527, Greece
- University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
- UNESCO Chair of Adolescent Health, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Stelios Zimeras
- Mathematics & Statistics, University of Aegean, Samos, Greece
| | | | - George P Chrousos
- Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation Academy of Athens, Athens, 11527, Greece
- University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
- UNESCO Chair of Adolescent Health, National and Kapodistrian University of Athens, Athens, 11527, Greece
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24
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Lee J, Oh S, Byon JY, Lee W, Weon B, Ko A, Jin W, Kim DK, Kim S, Oh YK, Kim YS, Lim CS, Lee JP. Long-term exposure to high perceived temperature and risk of mortality among patients with chronic kidney disease. Heliyon 2024; 10:e25222. [PMID: 38322898 PMCID: PMC10844275 DOI: 10.1016/j.heliyon.2024.e25222] [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: 08/06/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Health risks due to climate change are emerging, particularly from high-temperature exposure. The perceived temperature is an equivalent temperature based on the complete heat budget model of the human body. Therefore, we aimed to analyze the effect of perceived temperature on overall mortality among patients with chronic kidney disease. In total, 32,870 patients with chronic kidney disease in Seoul participated in this retrospective study (2001-2018) at three medical centers. The perceived temperature during the summer season was calculated using meteorological factors, including the air temperature near the automated weather station, dew point temperature, wind velocity, and total cloud amount. We assessed the association between perceived temperature using Kriging spatial interpolation and mortality in patients with CKD in the time-varying Cox proportional hazards model that was adjusted for sex, age, body mass index, hypertension, diabetes mellitus, estimated glomerular filtration rate, smoking, alcohol consumption, and educational level. During the 6.14 ± 3.96 years of follow-up, 3863 deaths were recorded. In multivariable analysis, the average level of perceived temperature and maximum level of perceived temperature demonstrated an increased risk of overall mortality among patients with chronic kidney disease. The concordance index for mortality of perceived temperature was higher than temperature, discomfort index, and heat index. When stratified by age, diabetes mellitus, and estimated glomerular filtration rate, patients with chronic kidney disease with young age (age <65 years) showed higher hazard ratio for mortality (interaction P = 0.049). Moreover, the risk of death in the winter and spring seasons was more significant compared to that of the summer and autumn seasons. Therefore, long-term exposure to high perceived temperature during summer increases the risk of mortality among patients with chronic kidney disease.
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Affiliation(s)
- Jeonghwan Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jae-Young Byon
- National Meteorological Satellite Center, Korea Meteorological Administration, Jincheon, Chungcheongbuk-do, Republic of Korea
| | - Whanhee Lee
- Data Science, School of Biomedical Convergence Engineering, Pusan National University, Pusan, Republic of Korea
| | - Boram Weon
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ara Ko
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Wencheng Jin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sejoong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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Boudreault J, Campagna C, Chebana F. Revisiting the importance of temperature, weather and air pollution variables in heat-mortality relationships with machine learning. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:14059-14070. [PMID: 38270762 DOI: 10.1007/s11356-024-31969-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024]
Abstract
Extreme heat events have significant health impacts that need to be adequately quantified in the context of climate change. Traditionally, heat-health association methods have relied on statistical models using a single air temperature index, without considering other heat-related variables that may influence the relationship and their potentially complex interactions. This study aims to introduce and compare different machine learning (ML) models, which naturally consider interactions between predictors and non-linearities, to re-examine the importance of temperature, weather and air pollution predictors in modeling the heat-mortality relationship. ML approaches based on tree ensembles and neural networks, as well as non-linear statistical models, were used to model the heat-mortality relationship in the two most populated metropolitan areas of the province of Quebec, Canada. The models were calibrated using a comprehensive database of heat-related predictors including various lagged temperature indices, temperature variations, meteorological and air pollution variables. Performance was evaluated based on out-of-sample summer mortality predictions. For the two studied regions, models relying only on lagged temperature indices performed better, or equally well, than models considering more heat-related predictors such as temperature variations, weather and air pollution variables. The temperature index with the best performance differed by region, but both mean temperature and humidex were among the best indices. In terms of modeling approaches, non-linear statistical models were as competent as more advanced ML models for predicting out-of-sample summer mortality. This research validated the current use of non-linear statistical models with the appropriate lagged temperature index to model the heat-mortality relationship. Although ML models have not improved the performance of all-cause mortality modeling, these approaches should continue to be explored, particularly for other health effects that may be more directly linked to heat exposure and, in the future, when more data become available.
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Affiliation(s)
- Jérémie Boudreault
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de La Couronne, Quebec, QC, G1K 9A9, Canada.
- Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Avenue Wolfe, Quebec, QC, G1V 5B3, Canada.
| | - Céline Campagna
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de La Couronne, Quebec, QC, G1K 9A9, Canada
- Direction de la santé environnementale, au travail et de la toxicologie, Institut national de santé publique du Québec (INSPQ), 945 Avenue Wolfe, Quebec, QC, G1V 5B3, Canada
| | - Fateh Chebana
- Centre Eau Terre Environnement, Institut national de la recherche scientifique (INRS), 490 de La Couronne, Quebec, QC, G1K 9A9, Canada
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Kapwata T, Abdelatif N, Scovronick N, Gebreslasie MT, Acquaotta F, Wright CY. Identifying heat thresholds for South Africa towards the development of a heat-health warning system. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:381-392. [PMID: 38157021 PMCID: PMC10794383 DOI: 10.1007/s00484-023-02596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
Exposure to heatwaves may result in adverse human health impacts. Heat alerts in South Africa are currently based on defined temperature-fixed threshold values for large towns and cities. However, heat-health warning systems (HHWS) should incorporate metrics that have been shown to be effective predictors of negative heat-related health outcomes. This study contributes to the development of a HHWS for South Africa that can potentially minimize heat-related mortality. Distributed lag nonlinear models (DLNM) were used to assess the association between maximum and minimum temperature and diurnal temperature range (DTR) and population-adjusted mortality during summer months, and the effects were presented as incidence rate ratios (IRR). District-level thresholds for the best predictor from these three metrics were estimated with threshold regression. The mortality dataset contained records of daily registered deaths (n = 8,476,532) from 1997 to 2013 and data for the temperature indices were for the same period. Maximum temperature appeared to be the most statistically significant predictor of all-cause mortality with strong associations observed in 40 out of 52 districts. Maximum temperature was associated with increased risk of mortality in all but three of the districts. Our results also found that heat-related mortality was influenced by regional climate because the spatial distribution of the thresholds varied according to the climate zones across the country. On average, districts located in the hot, arid interior provinces of the Northern Cape and North West experienced some of the highest thresholds compared to districts located in temperate interior or coastal provinces. As the effects of climate change become more significant, population exposure to heat is increasing. Therefore, evidence-based HHWS are required to reduce heat-related mortality and morbidity. The exceedance of the maximum temperature thresholds provided in this study could be used to issue heat alerts as part of effective heat health action plans.
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Affiliation(s)
- Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2028, South Africa.
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa.
| | - Nada Abdelatif
- Biostatistics Research Unit, South African Medical Research Council, Durban, 4001, South Africa
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Michael T Gebreslasie
- School of Agriculture, Earth, and Environmental Sciences, University of KwaZulu-Natal, Durban, 3629, South Africa
| | | | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0084, South Africa
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Scovronick N, Pillarisetti A. Invited Perspective: Beating the Heat. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:21302. [PMID: 38329751 PMCID: PMC10852038 DOI: 10.1289/ehp14343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Affiliation(s)
- Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Ajay Pillarisetti
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, California, USA
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Sayyed TK, Ovienmhada U, Kashani M, Vohra K, Kerr GH, O’Donnell C, Harris MH, Gladson L, Titus AR, Adamo SB, Fong KC, Gargulinski EM, Soja AJ, Anenberg S, Kuwayama Y. Satellite data for environmental justice: a scoping review of the literature in the United States. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2024; 19:10.1088/1748-9326/ad1fa4. [PMID: 39377051 PMCID: PMC11457489 DOI: 10.1088/1748-9326/ad1fa4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/09/2024]
Abstract
In support of the environmental justice (EJ) movement, researchers, activists, and policymakers often use environmental data to document evidence of the unequal distribution of environmental burdens and benefits along lines of race, class, and other socioeconomic characteristics. Numerous limitations, such as spatial or temporal discontinuities, exist with commonly used data measurement techniques, which include ground monitoring and federal screening tools. Satellite data is well poised to address these gaps in EJ measurement and monitoring; however, little is known about how satellite data has advanced findings in EJ or can help to promote EJ through interventions. Thus, this scoping review aims to (1) explore trends in study design, topics, geographic scope, and satellite datasets used to research EJ, (2) synthesize findings from studies that use satellite data to characterize disparities and inequities across socio-demographic groups for various environmental categories, and (3) capture how satellite data are relevant to policy and real-world impact. Following PRISMA extension guidelines for scoping reviews, we retrieved 81 articles that applied satellite data for EJ research in the United States from 2000 to 2022. The majority of the studies leveraged the technical advantages of satellite data to identify socio-demographic disparities in exposure to environmental risk factors, such as air pollution, and access to environmental benefits, such as green space, at wider coverage and with greater precision than previously possible. These disparities in exposure and access are associated with health outcomes such as increased cardiovascular and respiratory diseases, mental illness, and mortality. Research using satellite data to illuminate EJ concerns can contribute to efforts to mitigate environmental inequalities and reduce health disparities. Satellite data for EJ research can therefore support targeted interventions or influence planning and policy changes, but significant work remains to facilitate the application of satellite data for policy and community impact.
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Affiliation(s)
- Tanya Kreutzer Sayyed
- School of Public Policy, University of Maryland, Baltimore County, Baltimore, MD, United States of America
- Author Kreutzer Sayyed, author Ovienmhada and author Kashani contributed equally to this work
| | - Ufuoma Ovienmhada
- Department of Aeronautics and Astronautics, Massachusetts institute of Technology, Cambridge, MA, United States of America
- Author Kreutzer Sayyed, author Ovienmhada and author Kashani contributed equally to this work
| | - Mitra Kashani
- Environmental Public Health Tracking Program, Division of Environmental Health Science and Practice, National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States of America
- Author Kreutzer Sayyed, author Ovienmhada and author Kashani contributed equally to this work
| | - Karn Vohra
- Department of Geography, University College London, London, United Kingdom
| | - Gaige Hunter Kerr
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
| | - Catherine O’Donnell
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
| | - Maria H Harris
- Environmental Defense Fund, New York, NY, United States of America
| | - Laura Gladson
- Marron Institute of Urban Management, New York University, New York, NY, United States of America
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Andrea R Titus
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Susana B Adamo
- Center for International Earth Science Information Network, The Climate School, Columbia University, New York, NY, United States of America
| | - Kelvin C Fong
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
| | | | - Amber J Soja
- National Institute of Aerospace, Hampton, VA, United States of America
- NASA Langley Research Center, Hampton, VA, United States of America
| | - Susan Anenberg
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
| | - Yusuke Kuwayama
- School of Public Policy, University of Maryland, Baltimore County, Baltimore, MD, United States of America
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29
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Caldeira D, Dores H, Franco F, Bravo Baptista S, Cabral S, Cachulo MDC, Peixeiro A, Rodrigues R, Santos M, Timóteo AT, Campos L, Vasconcelos J, Nogueira PJ, Gonçalves L. Global warming and heat wave risks for cardiovascular diseases: A position paper from the Portuguese Society of Cardiology. Rev Port Cardiol 2023; 42:1017-1024. [PMID: 36758747 DOI: 10.1016/j.repc.2023.02.002] [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: 01/21/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Global warming is a result of the increased emission of greenhouse gases. The consequences of this climate change threaten society, biodiversity, food and resource availability. The consequences include an increased risk of cardiovascular (CV) disease and cardiovascular mortality. In this position paper, we summarize the data from the main studies that assess the risks of a temperature increase or heat waves in CV events (CV mortality, myocardial infarction, heart failure, stroke, and CV hospitalizations), as well as the data concerning air pollution as an enhancer of temperature-related CV risks. The data currently support global warming/heat waves (extreme temperatures) as cardiovascular threats. Achieving neutrality in emissions to prevent global warming is essential and it is likely to have an effect in the global health, including the cardiovascular health. Simultaneously, urgent steps are required to adapt the society and individuals to this new climatic context that is potentially harmful for cardiovascular health. Multidisciplinary teams should plan and intervene healthcare related to temperature changes and heat waves and advocate for a change in environmental health policy.
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Affiliation(s)
- Daniel Caldeira
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria - CHULN, Portugal; Cardiovascular Pharmacology and Therapeutics Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CEMBE, CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Portugal.
| | - Hélder Dores
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Hospital da Luz, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal
| | - Fátima Franco
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Unidade Tratamento IC Avançada (UTICA), Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Sérgio Bravo Baptista
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Hospital Prof. Doutor Fernando da Fonseca, EPE, Cardiology Department, Amadora, Portugal; Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Sofia Cabral
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Maria do Carmo Cachulo
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Centro Hospitalar e Universitário de Coimbra, ICBR - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - António Peixeiro
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Serviço de Cardiologia, Centro Hospitalar e Universitário da Cova da Beira (CHUCB), Covilhã, Portugal
| | - Rui Rodrigues
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Mário Santos
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Ana Teresa Timóteo
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; NOVA Medical School, Lisbon, Portugal; Serviço de Cardiologia, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
| | - Luís Campos
- Department of Internal Medicine, Hospital CUF Tejo, Portuguese Council for Health and Environment, Lisbon, Portugal
| | - João Vasconcelos
- Universidade de Lisboa, Instituto de Geografia e Ordenamento do Território (Centro de Estudos Geográficos), Portugal; Instituto Politécnico de Leiria, Portugal
| | - Paulo Jorge Nogueira
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Comprehensive Health Research Center (CHRC), Lisbon, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; CIDNUR - Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, Lisboa, Portugal
| | - Lino Gonçalves
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Centro Hospitalar e Universitário de Coimbra, ICBR - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Jingesi M, Lan S, Hu J, Dai M, Huang S, Chen S, Liu N, Lv Z, Ji J, Li X, Wang P, Cheng J, Peng J, Yin P. Association between thermal stress and cardiovascular mortality in the subtropics. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2093-2106. [PMID: 37878088 DOI: 10.1007/s00484-023-02565-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
Hazardous thermal conditions resulting from climate change may play a role in cardiovascular disease development. We chose the Universal Thermal Climate Index (UTCI) as the exposure metric to evaluate the relationship between thermal conditions and cardiovascular mortality in Shenzhen, China. We applied quasi-Poisson regression non-linear distributed lag models to evaluate the exposure-response associations. The findings suggest that cardiovascular mortality risks were significantly increased under heat and cold stress, and the adverse effects of cold stress were stronger than heat stress. Referencing the 50th percentile of UTCI (25.4°C), the cumulative risk of cardiovascular mortality was 75% (RRlag0-21 =1.75, 95%CI: 1.32, 2.32) higher in the 1st percentile (3.5°C), and 40% (RRlag0-21=1.40, 95%CI: 1.09, 1.80) higher in the 99th percentile (34.1°C). We observed that individuals older than 65 years were more vulnerable to both cold and heat stress, and females were identified as more susceptible to heat stress than males. Moreover, increased mortality risks of hypertensive disease and cerebrovascular disease were observed under cold stress, while heat stress was related to higher risks of mortality for hypertensive disease and ischemic heart disease. We also observed a stronger relationship between cold stress and ischemic heart disease mortality during the cold season, as well as a significant impact of heat stress on cerebrovascular disease mortality in the warm season when compared to the analysis of the entire year. These results confirm the significant relationship between thermal stress and cardiovascular mortality, with age and sex as potential effect modifiers of this association. Providing affordable air conditioning equipment, increasing the amount of vegetation, and establishing comprehensive early warning systems that take human thermoregulation into account could all help to safeguard the well-being of the public, particularly vulnerable populations, in the event of future extreme weather.
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Affiliation(s)
- Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Shuhua Lan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Ning Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Xiaoheng Li
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Rd, Shenzhen, 518020, Guangdong, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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Kivimäki M, Batty GD, Pentti J, Suomi J, Nyberg ST, Merikanto J, Nordling K, Ervasti J, Suominen SB, Partanen AI, Stenholm S, Käyhkö J, Vahtera J. Climate Change, Summer Temperature, and Heat-Related Mortality in Finland: Multicohort Study with Projections for a Sustainable vs. Fossil-Fueled Future to 2050. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127020. [PMID: 38150315 PMCID: PMC10752417 DOI: 10.1289/ehp12080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Climate change scenarios illustrate various pathways in terms of global warming ranging from "sustainable development" (Shared Socioeconomic Pathway SSP1-1.9), the best-case scenario, to 'fossil-fueled development' (SSP5-8.5), the worst-case scenario. OBJECTIVES We examined the extent to which increase in daily average urban summer temperature is associated with future cause-specific mortality and projected heat-related mortality burden for the current warming trend and these two scenarios. METHODS We did an observational cohort study of 363,754 participants living in six cities in Finland. Using residential addresses, participants were linked to daily temperature records and electronic death records from national registries during summers (1 May to 30 September) 2000 to 2018. For each day of observation, heat index (average daily air temperature weighted by humidity) for the preceding 7 d was calculated for participants' residential area using a geographic grid at a spatial resolution of 1 km × 1 km . We examined associations of the summer heat index with risk of death by cause for all participants adjusting for a wide range of individual-level covariates and in subsidiary analyses using case-crossover design, computed the related period population attributable fraction (PAF), and projected change in PAF from summers 2000-2018 compared with those in 2030-2050. RESULTS During a cohort total exposure period of 582,111,979 summer days (3,880,746 person-summers), we recorded 4,094 deaths, including 949 from cardiovascular disease. The multivariable-adjusted rate ratio (RR) for high (≥ 21 ° C ) vs. reference (14 - 15 ° C ) heat index was 1.70 (95% CI: 1.28, 2.27) for cardiovascular mortality, but it did not reach statistical significance for noncardiovascular deaths, RR = 1.14 (95% CI: 0.96, 1.36), a finding replicated in case-crossover analysis. According to projections for 2030-2050, PAF of summertime cardiovascular mortality attributable to high heat will be 4.4% (1.8%-7.3%) under the sustainable development scenario, but 7.6% (3.2%-12.3%) under the fossil-fueled development scenario. In the six cities, the estimated annual number of summertime heat-related cardiovascular deaths under the two scenarios will be 174 and 298 for a total population of 1,759,468 people. DISCUSSION The increase in average urban summer temperature will raise heat-related cardiovascular mortality burden. The estimated magnitude of this burden is > 1.5 times greater if future climate change is driven by fossil fuels rather than sustainable development. https://doi.org/10.1289/EHP12080.
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Affiliation(s)
- Mika Kivimäki
- University College London (UCL) Brain Sciences, UCL, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - G. David Batty
- University College London (UCL) Brain Sciences, UCL, London, UK
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
| | - Juuso Suomi
- Department of Geography and Geology, UTU, Turku, Finland
| | - Solja T. Nyberg
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Kalle Nordling
- Finnish Meteorological Institute, Helsinki, Finland
- Centre for International Climate and Environmental Research, Oslo, Norway
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Sakari B. Suominen
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Turku University Hospital, Turku, Finland
- School of Health Science, University of Skövde, Skövde, Sweden
| | | | - Sari Stenholm
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
| | - Jukka Käyhkö
- Department of Geography and Geology, UTU, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
- Turku University Hospital, Turku, Finland
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32
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Huang WTK, Masselot P, Bou-Zeid E, Fatichi S, Paschalis A, Sun T, Gasparrini A, Manoli G. Economic valuation of temperature-related mortality attributed to urban heat islands in European cities. Nat Commun 2023; 14:7438. [PMID: 37978178 PMCID: PMC10656443 DOI: 10.1038/s41467-023-43135-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
As the climate warms, increasing heat-related health risks are expected, and can be exacerbated by the urban heat island (UHI) effect. UHIs can also offer protection against cold weather, but a clear quantification of their impacts on human health across diverse cities and seasons is still being explored. Here we provide a 500 m resolution assessment of mortality risks associated with UHIs for 85 European cities in 2015-2017. Acute impacts are found during heat extremes, with a 45% median increase in mortality risk associated with UHI, compared to a 7% decrease during cold extremes. However, protracted cold seasons result in greater integrated protective effects. On average, UHI-induced heat-/cold-related mortality is associated with economic impacts of €192/€ - 314 per adult urban inhabitant per year in Europe, comparable to air pollution and transit costs. These findings urge strategies aimed at designing healthier cities to consider the seasonality of UHI impacts, and to account for social costs, their controlling factors, and intra-urban variability.
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Affiliation(s)
- Wan Ting Katty Huang
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK
- Met Office, Exeter, UK
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Elie Bou-Zeid
- Department of Civil and Environmental Engineering, Princeton University, Princeton, USA
| | - Simone Fatichi
- Department of Civil & Environmental Engineering, National University of Singapore, Singapore, Singapore
| | - Athanasios Paschalis
- Department of Civil & Environmental Engineering, Imperial College London, London, UK
| | - Ting Sun
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Gabriele Manoli
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK.
- Laboratory of Urban and Environmental Systems, School of Architecture, Civil and Environmental Engineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
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Stafoggia M, Michelozzi P, Schneider A, Armstrong B, Scortichini M, Rai M, Achilleos S, Alahmad B, Analitis A, Åström C, Bell ML, Calleja N, Krage Carlsen H, Carrasco G, Paul Cauchi J, Dszs Coelho M, Correa PM, Diaz MH, Entezari A, Forsberg B, Garland RM, Leon Guo Y, Guo Y, Hashizume M, Holobaca IH, Íñiguez C, Jaakkola JJK, Kan H, Katsouyanni K, Kim H, Kyselý J, Lavigne E, Lee W, Li S, Maasikmets M, Madureira J, Mayvaneh F, Fook Sheng Ng C, Nunes B, Orru H, V Ortega N, Osorio S, Palomares ADL, Pan SC, Pascal M, Ragettli MS, Rao S, Raz R, Roye D, Ryti N, Hn Saldiva P, Samoli E, Schwartz J, Scovronick N, Sera F, Tobias A, Tong S, Dlc Valencia C, Maria Vicedo-Cabrera A, Urban A, Gasparrini A, Breitner S, De' Donato FK. Joint effect of heat and air pollution on mortality in 620 cities of 36 countries. ENVIRONMENT INTERNATIONAL 2023; 181:108258. [PMID: 37837748 PMCID: PMC10702017 DOI: 10.1016/j.envint.2023.108258] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. OBJECTIVES To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. METHODS We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. RESULTS We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. CONCLUSIONS Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy.
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven CT, USA
| | | | - Hanne Krage Carlsen
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gabriel Carrasco
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Micheline Dszs Coelho
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia M Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Magali H Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Yue Leon Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven CT, USA
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Nicolás V Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | | | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Paulo Hn Saldiva
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - César Dlc Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Francesca K De' Donato
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
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Landguth EL, Knudson J, Graham J, Orr A, Coyle EA, Smith P, Semmens EO, Noonan C. Seasonal extreme temperatures and short-term fine particulate matter increases child respiratory hospitalizations in a sparsely populated region of the intermountain western United States. RESEARCH SQUARE 2023:rs.3.rs-3438033. [PMID: 37886498 PMCID: PMC10602161 DOI: 10.21203/rs.3.rs-3438033/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Background Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Few studies have evaluated these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health. Methods We explored short-term exposure to air pollution on childhood respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated hospitalizations. The main outcome measure included all respiratory-related hospital admissions for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for all individuals aged 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis and distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 15 prior-days modified by temperature or season. Results Short-term exposure increases of 1 μg/m3 in PM2.5 were associated with elevated odds of all three respiratory hospital admission categories. PM2.5 was associated with the largest increased odds of hospitalizations for asthma at lag 7-13 days [1.87(1.17-2.97)], for LRTI at lag 6-12 days [2.18(1.20-3.97)], and for URTI at a cumulative lag of 13 days [1.29(1.07-1.57)]. The impact of PM2.5 varied by temperature and season for each respiratory outcome scenario. For asthma, PM2.5 was associated most strongly during colder temperatures [3.11(1.40-6.89)] and the winter season [3.26(1.07-9.95)]. Also in colder temperatures, PM2.5 was associated with increased odds of LRTI hospitalization [2.61(1.15-5.94)], but no seasonal effect was observed. Finally, 13 days of cumulative PM2.5 prior to admissions date was associated with the greatest increased odds of URTI hospitalization during summer days [3.35(1.85-6.04)] and hotter temperatures [1.71(1.31-2.22)]. Conclusions Children's respiratory-related hospital admissions were associated with short-term exposure to PM2.5. PM2.5 associations with asthma and LRTI hospitalizations were strongest during cold periods, whereas associations with URTI were largest during hot periods. Classification environmental public health, fine particulate matter air pollution, respiratory infections.
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Wang Z, Lu B, Wang B, Qiu YL, Shi H, Zhang B, Li J, Li H, Zhao W. Incentive based emergency demand response effectively reduces peak load during heatwave without harm to vulnerable groups. Nat Commun 2023; 14:6202. [PMID: 37794008 PMCID: PMC10550920 DOI: 10.1038/s41467-023-41970-8] [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: 11/07/2020] [Accepted: 09/25/2023] [Indexed: 10/06/2023] Open
Abstract
The incentive-based emergency demand response measure serves as an important regulatory tool during energy system operations. However, whether people will sacrifice comfort to respond to it during heatwave and what the effect on heat vulnerable populations will be are still unclear. A large-scale emergency demand response pilot involving 205,129 households was conducted in southwestern China during continuous extreme high temperatures in summer. We found that the incentive-based emergency demand response causes a statistically significant decline in electricity use with no additional financial burden on vulnerable groups. The electricity conservation potential of urban households was higher than that of rural households. Households with children did not respond to the emergency demand response, while the response of households with elderly individuals proved to be more positive. The repeated and frequent implementation of this policy did not result in an attenuation of the regulatory effect. This research can serve as a reference for countries with similar regulated power markets.
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Affiliation(s)
- Zhaohua Wang
- School of Management and Economics, Beijing Institute of Technology, Beijing, 100081, China
- Research Center for Sustainable Development and Intelligent Decision Making, Beijing, 100081, China
- Ministry of Industry and Information Technology Key Lab of Digital Economy and Policy Intelligence, Beijing Institute of Technology, Beijing, 100081, China
| | - Bin Lu
- School of Management and Economics, Beijing Institute of Technology, Beijing, 100081, China.
- Research Center for Sustainable Development and Intelligent Decision Making, Beijing, 100081, China.
- Ministry of Industry and Information Technology Key Lab of Digital Economy and Policy Intelligence, Beijing Institute of Technology, Beijing, 100081, China.
| | - Bo Wang
- School of Management and Economics, Beijing Institute of Technology, Beijing, 100081, China.
- Research Center for Sustainable Development and Intelligent Decision Making, Beijing, 100081, China.
- Ministry of Industry and Information Technology Key Lab of Digital Economy and Policy Intelligence, Beijing Institute of Technology, Beijing, 100081, China.
| | - Yueming Lucy Qiu
- School of Public Policy, University of Maryland College Park, College Park, MD, 20742, USA.
| | - Han Shi
- School of Management and Economics, Beijing Institute of Technology, Beijing, 100081, China
- Research Center for Sustainable Development and Intelligent Decision Making, Beijing, 100081, China
- Ministry of Industry and Information Technology Key Lab of Digital Economy and Policy Intelligence, Beijing Institute of Technology, Beijing, 100081, China
| | - Bin Zhang
- School of Management and Economics, Beijing Institute of Technology, Beijing, 100081, China.
- Research Center for Sustainable Development and Intelligent Decision Making, Beijing, 100081, China.
- Ministry of Industry and Information Technology Key Lab of Digital Economy and Policy Intelligence, Beijing Institute of Technology, Beijing, 100081, China.
| | - Jingyun Li
- School of Management and Economics, Beijing Institute of Technology, Beijing, 100081, China
- Research Center for Sustainable Development and Intelligent Decision Making, Beijing, 100081, China
- Ministry of Industry and Information Technology Key Lab of Digital Economy and Policy Intelligence, Beijing Institute of Technology, Beijing, 100081, China
| | - Hao Li
- School of Management and Economics, Beijing Institute of Technology, Beijing, 100081, China
- Research Center for Sustainable Development and Intelligent Decision Making, Beijing, 100081, China
- Ministry of Industry and Information Technology Key Lab of Digital Economy and Policy Intelligence, Beijing Institute of Technology, Beijing, 100081, China
| | - Wenhui Zhao
- Business School, Sichuan University, Chengdu, 610065, China
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Fu G, Cheng H, Lu Q, Liu H, Zhang X, Zhang X. The synergistic effect of high temperature and ozone on the number of deaths from circulatory system diseases in Shijiazhuang, China. Front Public Health 2023; 11:1266643. [PMID: 37854243 PMCID: PMC10581204 DOI: 10.3389/fpubh.2023.1266643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Urban ozone pollution in China is becoming increasingly serious. Climate warming, high temperatures, and ozone pollution all have significant impacts on human health. However, the synergistic effects of high temperatures and ozone pollution in summer on human health are rarely studied. China is at a critical stage of environmental pollution control. Assessing the health impact of high temperatures and ozone exposure on the number of deaths from circulatory diseases is of great significance for formulating ozone-related prevention and control policies. Methods This study uses daily data on deaths from circulatory system diseases in Shijiazhuang from June to August during the summer of 2013-2016, as well as concurrent meteorological data and concentration of O3 and PM2.5 pollution data. The generalized additive model (GAM) with Poisson distribution, smooth curve threshold effect, and saturation effect method is used to control for confounding effects. Results The study evaluates the impact of short-term exposure to temperature and ozone on deaths from circulatory system diseases and the synergistic effect after controlling for confounding factors. The results show that the impact of temperature and ozone on deaths from circulatory system diseases in Shijiazhuang is nonlinear, with a temperature threshold of 27.5°C and an ozone concentration threshold of 100 μg/m3. With an increase of temperature by 1°C, the risk of deaths for total population, men and women are 6.8%, 4.6% and 9.3%, respectively. The increase in temperature and ozone concentration has a greater impact on women; in men, the increase has a lag effect of 2 to 3 days, but the lag did not affect women. Discussion In conclusion, high temperatures and high ozone concentration have synergistic enhancement effects on circulatory system diseases. Prevention and scientific management strategies of circulatory system diseases in high temperatures and high ozone environments should be strengthened.
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Affiliation(s)
- Guiqin Fu
- China Meteorological Administration Xiong’an Atmospheric Boundary Layer Laboratory, Xiong’anChina
- Key Laboratory of Meteorology and Ecological Environment of Hebei Province, Shijiazhuang, China
- Hebei Meteorological Service Center, Shijiazhuang, China
| | - Haimin Cheng
- Key Laboratory of Meteorology and Ecological Environment of Hebei Province, Shijiazhuang, China
- Hebei Meteorological Service Center, Shijiazhuang, China
| | - Qian Lu
- China Meteorological Administration Xiong’an Atmospheric Boundary Layer Laboratory, Xiong’anChina
- Key Laboratory of Meteorology and Ecological Environment of Hebei Province, Shijiazhuang, China
- Chengde Meteorological Service of Hebei Province, Chengde, China
| | - Huayue Liu
- China Meteorological Administration Xiong’an Atmospheric Boundary Layer Laboratory, Xiong’anChina
- Hebei Meteorological Service Center, Shijiazhuang, China
| | - Xiaohui Zhang
- Chengde Meteorological Service of Hebei Province, Chengde, China
| | - Xingshan Zhang
- Handan Meteorological Service of Hebei Province, Handan, China
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Li X, Luo M, Zhao Y, Zhang H, Ge E, Huang Z, Wu S, Wang P, Wang X, Tang Y. A daily high-resolution (1 km) human thermal index collection over the North China Plain from 2003 to 2020. Sci Data 2023; 10:634. [PMID: 37723201 PMCID: PMC10507099 DOI: 10.1038/s41597-023-02535-y] [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: 02/23/2023] [Accepted: 09/01/2023] [Indexed: 09/20/2023] Open
Abstract
Human-perceived temperature (HPT) describes the joint effects of multiple climatic factors such as temperature and humidity. Extreme HPT events may reduce labor capacity and cause thermal discomfort and even mortality. These events are becoming more frequent and more intense under global warming, posing severe threats to human and natural systems worldwide, particularly in populated areas with intensive human activities, e.g., the North China Plain (NCP). Therefore, a fine-scale HPT dataset in both spatial and temporal dimensions is urgently needed. Here we construct a daily high-resolution (~1 km) human thermal index collection over NCP from 2003 to 2020 (HiTIC-NCP). This dataset contains 12 HPT indices and has high accuracy with averaged determination coefficient, mean absolute error, and root mean squared error of 0.987, 0.970 °C, and 1.292 °C, respectively. Moreover, it exhibits high spatiotemporal consistency with ground-level observations. The dataset provides a reference for human thermal environment and could facilitate studies such as natural hazards, regional climate change, and urban planning.
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Affiliation(s)
- Xiang Li
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China
| | - Ming Luo
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China.
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China.
| | - Yongquan Zhao
- Key Laboratory of Watershed Geographic Sciences, Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences, Nanjing, 210008, China.
| | - Hui Zhang
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China
| | - Erjia Ge
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada
| | - Ziwei Huang
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China
| | - Sijia Wu
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China
| | - Peng Wang
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China
| | - Xiaoyu Wang
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China
| | - Yu Tang
- School of Geography and Planning, and Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-sen University, Guangzhou, 510006, China
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Zhai G, Gao Z, Zhou W. Effects of apparent temperature on cardiovascular disease admissions in rural areas of Linxia Hui Autonomous Prefecture. Sci Rep 2023; 13:14971. [PMID: 37696907 PMCID: PMC10495458 DOI: 10.1038/s41598-023-42232-9] [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: 05/27/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023] Open
Abstract
Cardiovascular disease (CVD) is a major threat to public health worldwide. The relationship between CVD and temperature has been widely reported in developed countries and regions. However, there are few studies of severe CVD in poor rural areas of developing countries. Therefore, this study aimed to explore the relationship between CVD and apparent temperature (AT) in a rural area of Linxia Hui Autonomous Prefecture, China. Daily CVD admission data and meteorological data were collected from Linxia between 2014 and 2015. The media of AT was used as the reference temperature to estimate the cumulative relative risk (RR) of CVD admission. The distributed lag non-linear models were used to examine the association between AT and cumulative RR of CVD admission at lag 0-21 days. In Linxia, high AT (20 °C) had a persistent adverse effect on cumulative RR of CVD admissions, and the RR increased with increasing lag days. Cold (- 10 °C) had a protective effect on the first and later lag days (lag 0-14 and lag 0-21). Adults (aged < 65 years) and females were more susceptible to the effects of heat than males and the elderly (aged ≥ 65 years). In Linxia, China, extremely high AT is an important risk factor for CVD hospitalizations in suburban and rural populations.
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Affiliation(s)
- Guangyu Zhai
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China
| | - Ziyao Gao
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China.
| | - Wenjuan Zhou
- Gansu Provincial Hospital, Lanzhou, 730000, Gansu, People's Republic of China
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Park H, Lee SM, Kim WJ, Chae Y. Analysis of compound health impacts of heatwave and COVID-19 in Korea from May to September in 2020. Sci Rep 2023; 13:14880. [PMID: 37689740 PMCID: PMC10492780 DOI: 10.1038/s41598-023-41880-1] [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: 01/30/2023] [Accepted: 09/01/2023] [Indexed: 09/11/2023] Open
Abstract
The number of non-accidental deaths and heat-related illnesses due to the co-occurrence of heatwaves and COVID-19 has been identified to estimate compound health impacts between two risks. We have analyzed data from historical years (2013-2019) to calculate the baseline values of the number of non-accidental deaths and heat-related illness patients from May to September using a quasi-Poisson generalized linear model and compared them to data from 2020 in Korea. We also assessed the relative risk and absolute cumulative number of non-accidental deaths and heat-related illnesses in the summer of 2020 in Seoul, Daegu, and Gyeongnam region of Korea. In the Summer of 2020, Korea experienced 0.8% of non-accidental excess deaths, with the highest in August, and 46% of reduction was observed in heat-related throughout the study period, except in Daegu, where excess of heat-related illness occurred in August. The relative risk (RR) of non-accidental deaths at 33.1 °C, was 1.00 (CI 0.99-1.01) and 1.04 (CI 1.02-1.07) in 2013-2019 and 2020, respectively. The RR of heat-related illness at 33.1 °C, was 1.44 (CI 1.42-1.45) and 1.59 (CI 1.54-1.64) in 2013-2019 and 2020, respectively. The absolute cumulative trends of non-accidental deaths and heat-related illnesses were similar in the three regions, indicating increased non-accidental deaths and decreased heat-related illnesses at similar temperatures in 2020. During the COVID-19 pandemic, the fear of infection by the virus and the limited access to healthcare services led to changes in health-seeking behaviors. These results indicate social distancing could have had adverse impacts on other health conditions. A comprehensive health risk assessment is important when facing simultaneous risks, such as heatwaves and pandemics, in the implementation of effective countermeasures.
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Affiliation(s)
- Haemin Park
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Sang-Min Lee
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Woo Joong Kim
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Yeora Chae
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea.
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Zheng S, Zhang X, Zhu W, Nie Y, Ke X, Liu S, Wang X, You J, Kang F, Bai Y, Wang M. A study of temperature variability on admissions and deaths for cardiovascular diseases in Northwestern China. BMC Public Health 2023; 23:1751. [PMID: 37684635 PMCID: PMC10486070 DOI: 10.1186/s12889-023-16650-3] [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: 05/10/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE To explore the effect of temperature variability (TV) on admissions and deaths for cardiovascular diseases (CVDs). METHOD The admissions data of CVDs were collected in 4 general hospitals in Jinchang City, Gansu Province from 2013 to 2016. The monitoring data of death for CVDs from 2013 to 2017 were collected through the Jinchang City Center for Disease Control and Prevention. Distributed lag nonlinear model (DLNM) was combined to analyze the effects of TV (daily temperature variability (DTV) and hourly temperature variability (HTV)) on the admissions and deaths for CVDs after adjusting confounding effects. Stratified analysis was conducted by age and gender. Then the attribution risk of TV was evaluated. RESULTS There was a broadly linear correlation between TV and the admissions and deaths for CVDs, but only the association between TV and outpatient and emergency room (O&ER) visits for CVDs have statistically significant. DTV and HTV have similar lag effect. Every 1 ℃ increase in DTV and HTV was associated with a 3.61% (95% CI: 1.19% ~ 6.08%), 3.03% (95% CI: 0.27% ~ 5.86%) increase in O&ER visits for CVDs, respectively. There were 22.75% and 14.15% O&ER visits for CVDs can attribute to DTV and HTV exposure during 2013-2016. Males and the elderly may be more sensitive to the changes of TV. Greater effect of TV was observed in non-heating season than in heating season. CONCLUSION TV was an independent risk factor for the increase of O&ER visits for CVDs, suggesting effective guidance such as strengthening the timely prevention for vulnerable groups before or after exposure, which has important implications for risk management of CVDs.
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Affiliation(s)
- Shan Zheng
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China.
| | - Xiaofei Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Wenzhi Zhu
- Center for Immunological and Metabolic Diseases (CIMD), MED-X Institute, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yonghong Nie
- Jinchang Center for Disease Control and Prevention, Jinchang, 737100, China
| | - Ximeng Ke
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Shaodong Liu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xue Wang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Jinlong You
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Feng Kang
- Workers' Hospital of Jinchuan Group Co., Ltd, Jinchang, 737103, China
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Minzhen Wang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China.
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Hou Y, Cao B, Zhu Y, Zhang H, Yang L, Duanmu L, Lian Z, Zhang Y, Zhai Y, Wang Z, Zhou X, Xie J. Temporal and spatial heterogeneity of indoor and outdoor temperatures and their relationship with thermal sensation from a global perspective. ENVIRONMENT INTERNATIONAL 2023; 179:108174. [PMID: 37660634 DOI: 10.1016/j.envint.2023.108174] [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: 05/05/2023] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/05/2023]
Abstract
People spend most of their time indoors. However, indoor temperature and individual thermal exposure are generally not considered in epidemiological studies of temperature and health. Based on the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) RP-884 Database, the ASHRAE Global Thermal Comfort Database II and the Chinese Thermal Comfort Database, this study first explored the relationship between outdoor temperature, indoor temperature and thermal sensation from a global perspective. Moreover, the potential influence of spatiotemporal heterogeneity on health studies was explored. A breakpoint was found at approximately 11.5 °C in the segmented regression of indoor and outdoor temperature, and the slope of the curve was greater when outdoor temperature was above the breakpoint (n = 67,896). Based on multi-group propensity score matching (PSM) and generalizedadditivemodels (GAM), spatiotemporal heterogeneity was found in the relationship between indoor and outdoor temperatures after adjusting for building type and year. Furthermore, the relationship between indoor temperature and thermal sensation was influenced by the outdoor temperature. This study highlights the importance of considering indoor temperature or individual thermal exposure in temperature-related health studies.
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Affiliation(s)
- Yuchen Hou
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China; Key Laboratory of Eco Planning & Green Building, Ministry of Education (Tsinghua University), Beijing, China
| | - Bin Cao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China; Key Laboratory of Eco Planning & Green Building, Ministry of Education (Tsinghua University), Beijing, China.
| | - Yingxin Zhu
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control (Tsinghua University), Beijing, China
| | - Hui Zhang
- Center for the Built Environment, University of California, Berkeley, USA
| | - Liu Yang
- College of Architecture, Xi'an University of Architecture and Technology, Xi'an, China
| | - Lin Duanmu
- School of Civil Engineering, Dalian University of Technology, Dalian, China
| | - Zhiwei Lian
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Yufeng Zhang
- School of Architecture, South China University of Technology, Guangzhou, China
| | - Yongchao Zhai
- College of Architecture, Xi'an University of Architecture and Technology, Xi'an, China
| | - Zhaojun Wang
- School of Architecture, Harbin Institute of Technology, Harbin, China
| | - Xiang Zhou
- School of Mechanical Engineering, Tongji University, Shanghai, China
| | - Jingchao Xie
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
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Parks RM, Kontis V, Anderson GB, Baldwin JW, Danaei G, Toumi R, Dominici F, Ezzati M, Kioumourtzoglou MA. Short-term excess mortality following tropical cyclones in the United States. SCIENCE ADVANCES 2023; 9:eadg6633. [PMID: 37585525 PMCID: PMC10431701 DOI: 10.1126/sciadv.adg6633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/14/2023] [Indexed: 08/18/2023]
Abstract
Knowledge of excess deaths after tropical cyclones is critical to understanding their impacts, directly relevant to policies on preparedness and mitigation. We applied an ensemble of 16 Bayesian models to 40.7 million U.S. deaths and a comprehensive record of 179 tropical cyclones over 32 years (1988-2019) to estimate short-term all-cause excess deaths. The deadliest tropical cyclone was Hurricane Katrina in 2005, with 1491 [95% credible interval (CrI): 563, 3206] excess deaths (>99% posterior probability of excess deaths), including 719 [95% CrI: 685, 752] in Orleans Parish, LA (>99% probability). Where posterior probabilities of excess deaths were >95%, there were 3112 [95% CrI: 2451, 3699] total post-hurricane force excess deaths and 15,590 [95% CrI: 12,084, 18,835] post-gale to violent storm force deaths; 83.1% of post-hurricane force and 70.0% of post-gale to violent storm force excess deaths occurred more recently (2004-2019); and 6.2% were in least socially vulnerable counties.
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Affiliation(s)
- Robbie M. Parks
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Vasilis Kontis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - G. Brooke Anderson
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Jane W. Baldwin
- Department of Earth System Science, University of California, Irvine, Irvine, CA, USA
- Lamont-Doherty Earth Observatory, Palisades, NY, USA
| | - Goodarz Danaei
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ralf Toumi
- Space and Atmospheric Physics Imperial College London, London, UK
| | - Francesca Dominici
- Department of Biostatistics, T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Majid Ezzati
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
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Parsons LA, Lo F, Ward A, Shindell D, Raman SR. Higher Temperatures in Socially Vulnerable US Communities Increasingly Limit Safe Use of Electric Fans for Cooling. GEOHEALTH 2023; 7:e2023GH000809. [PMID: 37577109 PMCID: PMC10413955 DOI: 10.1029/2023gh000809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/09/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023]
Abstract
As the globe warms, people will increasingly need affordable, safe methods to stay cool and minimize the worst health impacts of heat exposure. One of the cheapest cooling methods is electric fans. Recent research has recommended ambient air temperature thresholds for safe fan use in adults. Here we use hourly weather reanalysis data (1950-2021) to examine the temporal and spatial evolution of ambient climate conditions in the continental United States (CONUS) considered safe for fan use, focusing on high social vulnerability index (SVI) regions. We find that although most hours in the day are safe for fan use, there are regions that experience hundreds to thousands of hours per year that are too hot for safe fan use. Over the last several decades, the number of hours considered unsafe for fan use has increased across most of the CONUS (on average by ∼70%), with hotspots across the US West and South, suggesting that many individuals will increasingly need alternative cooling strategies. People living in high-SVI locations are 1.5-2 times more likely to experience hotter climate conditions than the overall US population. High-SVI locations also experience higher rates of warming that are approaching and exceeding important safety thresholds that relate to climate adaptation. These results highlight the need to direct additional resources to these communities for heat adaptive strategies.
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Affiliation(s)
- L. A. Parsons
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
- Global ScienceThe Nature ConservancyDurhamNCUSA
| | - F. Lo
- Environmental Defense FundNew York CityNYUSA
| | - A. Ward
- Nicholas Institute for Energy, Environment, and SustainabilityDuke UniversityDurhamNCUSA
| | - D. Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - S. R. Raman
- Population Health SciencesDuke UniversityDurhamNCUSA
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Xu R, Huang S, Shi C, Wang R, Liu T, Li Y, Zheng Y, Lv Z, Wei J, Sun H, Liu Y. Extreme Temperature Events, Fine Particulate Matter, and Myocardial Infarction Mortality. Circulation 2023; 148:312-323. [PMID: 37486993 DOI: 10.1161/circulationaha.122.063504] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/08/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Extreme temperature events (ETEs), including heat wave and cold spell, have been linked to myocardial infarction (MI) morbidity; however, their effects on MI mortality are less clear. Although ambient fine particulate matter (PM2.5) is suggested to act synergistically with extreme temperatures on cardiovascular mortality, it remains unknown if and how ETEs and PM2.5 interact to trigger MI deaths. METHODS A time-stratified case-crossover study of 202 678 MI deaths in Jiangsu province, China, from 2015 to 2020, was conducted to investigate the association of exposure to ETEs and PM2.5 with MI mortality and evaluate their interactive effects. On the basis of ambient apparent temperature, multiple temperature thresholds and durations were used to build 12 ETE definitions. Daily ETEs and PM2.5 exposures were assessed by extracting values from validated grid datasets at each subject's geocoded residential address. Conditional logistic regression models were applied to perform exposure-response analyses and estimate relative excess odds due to interaction, proportion attributable to interaction, and synergy index. RESULTS Under different ETE definitions, the odds ratio of MI mortality associated with heat wave and cold spell ranged from 1.18 (95% CI, 1.14-1.21) to 1.74 (1.66-1.83), and 1.04 (1.02-1.06) to 1.12 (1.07-1.18), respectively. Lag 01-day exposure to PM2.5 was significantly associated with an increased odds of MI mortality, which attenuated at higher exposures. We observed a significant synergistic interaction of heat wave and PM2.5 on MI mortality (relative excess odds due to interaction >0, proportion attributable to interaction >0, and synergy index >1), which was higher, in general, for heat wave with greater intensities and longer durations. We estimated that up to 2.8% of the MI deaths were attributable to exposure to ETEs and PM2.5 at levels exceeding the interim target 3 value (37.5 μg/m3) of World Health Organization air quality guidelines. Women and older adults were more vulnerable to ETEs and PM2.5. The interactive effects of ETEs or PM2.5 on MI mortality did not vary across sex, age, or socioeconomic status. CONCLUSIONS This study provides consistent evidence that exposure to both ETEs and PM2.5 is significantly associated with an increased odds of MI mortality, especially for women and older adults, and that heat wave interacts synergistically with PM2.5 to trigger MI deaths but cold spell does not. Our findings suggest that mitigating both ETE and PM2.5 exposures may bring health cobenefits in preventing premature deaths from MI.
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Affiliation(s)
- Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China (S.H.)
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China (C.S.)
| | - Rui Wang
- Luohu District Chronic Disease Hospital, Shenzhen, Guangdong, China (R.W.)
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Ziquan Lv
- Central Laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China (Z.L.)
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park (J.W.)
| | - Hong Sun
- Institute of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China (H.S.)
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
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Vésier C, Urban A. Gender inequalities in heat-related mortality in the Czech Republic. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02507-2. [PMID: 37428233 PMCID: PMC10386945 DOI: 10.1007/s00484-023-02507-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/22/2023] [Accepted: 05/10/2023] [Indexed: 07/11/2023]
Abstract
It is acknowledged that climate change exacerbates social inequalities, and women have been reported as more vulnerable to heat than men in many studies in Europe, including the Czech Republic. This study aimed at investigating the associations between daily temperature and mortality in the Czech Republic in the light of a sex and gender perspective, taking into account other factors such as age and marital status. Daily mean temperature and individual mortality data recorded during the five warmest months of the year (from May to September) over the period 1995-2019 were used to fit a quasi-Poisson regression model, which included a distributed lag non-linear model (DLNM) to account for the delayed and non-linear effects of temperature on mortality. The heat-related mortality risks obtained in each population group were expressed in terms of risk at the 99th percentile of summer temperature relative to the minimum mortality temperature. Women were found generally more at risk to die because of heat than men, and the difference was larger among people over 85 years old. Risks among married people were lower than risks among single, divorced, and widowed people, while risks in divorced women were significantly higher than in divorced men. This is a novel finding which highlights the potential role of gender inequalities in heat-related mortality. Our study underlines the relevance of including a sex and gender dimension in the analysis of the impacts of heat on the population and advocates the development of gender-based adaptation policies to extreme heat.
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Affiliation(s)
- Chloé Vésier
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamycka 129, 165 00, Prague, Czech Republic.
| | - Aleš Urban
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamycka 129, 165 00, Prague, Czech Republic
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Boční II 1401, 141 00, Prague, Czech Republic
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Kai X, Hong Z, Hong Y, Wang X, Li C. Short-term impact of diurnal temperature range on cardiovascular diseases mortality in residents in northeast China. Sci Rep 2023; 13:11037. [PMID: 37419976 PMCID: PMC10328923 DOI: 10.1038/s41598-023-38129-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 07/03/2023] [Indexed: 07/09/2023] Open
Abstract
It has been reported that cardiovascular disease (CVD) has become one of the major threats to global public health and is associated with climate change. Several previous studies have shown the influence of ambient temperature on CVD, but lack some evidence for the short-term effect of diurnal temperature range (DTR) on CVD mortality in northeast China. This is the first study to assess the correlation between DTR and CVD mortality in Hulunbuir located in northeast China. Daily CVD mortality data and meteorological data were collected from 2014 to 2020. A quasi-Poisson generalized linear regression with a distributed lag non-linear model (DLNM) was applied to exploring the short-term impact of DTR on CVD mortality. Stratified analyses by gender, age, and season were conducted and the short-term impacts of extremely high DTR on CVD mortality were investigated. In this study, a total of 21,067 CVD mortality cases were recorded in Hulunbuir, China from 2014 to 2020. Compared to the reference value (11.20 [Formula: see text]C, 50[Formula: see text] percentile), a "U-shaped" non-linear relationship between DTR and CVD mortality was observed, and extremely high DTR increased the risk of CVD mortality. The short-term effect of extremely high DTR occurred immediately and lasted up to 6 days. In addition, the male and the age [Formula: see text] 65 groups were more likely to be affected by extremely high DTR compared with the female and the age < 65 groups, respectively. The results also showed that extremely high DTR in cold season had a more adverse effect on CVD mortality than warm season. This study suggests that extremely high DTR for cold season should be paid enough attention to for residents in northeast China. The male and the age [Formula: see text] 65 groups were more vulnerable to the impacts of DTR. The study results may provide some suggestions for decision-making by local public health authorities to avoid the adverse impacts of high DTR, and improve the health of residents, especially vulnerable groups in cold season.
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Affiliation(s)
- Xuan Kai
- Department of Mathematics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China
| | - Zhimin Hong
- Department of Mathematics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China.
| | - Yang Hong
- Department of Mechanics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China
| | - Xiaolei Wang
- Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Chunyang Li
- Department of Neurology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
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Seltenrich N. No Reprieve: Extreme Heat at Night Contributes to Heat Wave Mortality. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:74003. [PMID: 37477717 PMCID: PMC10361253 DOI: 10.1289/ehp13206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/22/2023] [Indexed: 07/22/2023]
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Wang S, Zhang Y, Li X, Zhao J, Zhang N, Guo Y, Chen J, Liu Y, Cui Z, Lyu Y, Gao J, Li C, Zhang W, Ma J. Effect of short-term exposure to ambient air pollutants on non-accidental mortality in emergency department visits: a time-series study. Front Public Health 2023; 11:1208514. [PMID: 37457252 PMCID: PMC10348907 DOI: 10.3389/fpubh.2023.1208514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023] Open
Abstract
Objectives Exposure to air pollution has been linked to an increased risk of premature mortality. However, the acute effects of air pollution on the risk of non-accidental mortality have not been extensively researched in developing countries, and the findings thus far have been inconsistent. Therefore, this study aimed to examine the association between short-term exposure to six pollutants (PM2.5, PM10, SO2, NO2, O3, and CO) and non-accidental mortality in Beijing, China. Methods Daily data on non-accidental deaths were gathered from 1 January 2017 to 31 December 2018. Air pollution data for the same period were collected from 35 fixed-site air quality monitoring stations in Beijing. Generalized additive models (GAM) based on Poisson regression were used to investigate the association between non-accidental mortality in emergency department visits and the daily average levels of air pollutants. Results There were 8,676 non-accidental deaths recorded during 2017-2018. After sensitivity analysis, short-term exposure to air pollutants, particularly gaseous pollutants, was linked to non-accidental mortality. Specifically, for every 10 μg/m3 increase (5 μg/m3 in SO2, 0.5 mg/m3 in CO) of SO2 (lag 04), NO2 (lag 04), O3 (lag 05), and CO (lag 04), the relative risk (RR) values were 1.054 (95% CI: 1.009, 1.100), 1.038 (95% CI: 1.013, 1.063), 1.032 (95% CI: 1.011, 1.054), and 1.034 (95% CI: 1.004, 1.066), respectively. In terms of causes of death, short-term exposure to NO2, SO2, and O3 increased the risk of circulatory mortality. Further stratified analysis revealed that the stronger associations were presented in females for O3 while in males for CO. People aged 65 and over were strongly associated with ambient air pollution. Conclusions Our study showed that ambient air pollutants were associated with non-accidental mortality. Our findings suggested that efforts to control gaseous pollution should be stepped up, and vulnerable groups should be the focus of health protection education.
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Affiliation(s)
- Siting Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Xia Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Clinical Pharmacology Department, Zhejiang Hisun Pharmaceutical Co., Ltd., Taizhou, Zhejiang, China
| | - Jinhua Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Naijian Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jiageng Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuanjun Lyu
- Department of Endocrinology, Tianjin Hospital, Tianjin, China
| | - Jing Gao
- Thoracic Clinical College, Tianjin Medical University, Tianjin, China
- Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, China
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Jun Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Wu Y, Yuan J, Yuan Y, Kong C, Jing W, Liu J, Ye H, Liu M. Effects of ambient temperature and relative humidity on preterm birth during early pregnancy and before parturition in China from 2010 to 2018: a population-based large-sample cohort study. Front Public Health 2023; 11:1101283. [PMID: 37408740 PMCID: PMC10319007 DOI: 10.3389/fpubh.2023.1101283] [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: 11/17/2022] [Accepted: 05/26/2023] [Indexed: 07/07/2023] Open
Abstract
Background The progression of global warming and increase in instances of extreme weather have received considerable attention. We conducted a cohort study on women of childbearing age in Yunnan Province, examined the association between ambient temperature and humidity on preterm birth and evaluated the effects of extreme weather during early pregnancy and before parturition on preterm birth. Methods We conducted a population-based cohort study on women of childbearing age 18-49 years who participated in National Free Preconception Health Examination Project (NFPHEP) in Yunnan Province from January 1, 2010, to December 31, 2018. Meteorological data, namely daily average temperature (°C) and daily average relative humidity (%), were obtained from China National Meteorological Information Center. Four exposure windows were explored: 1 week of pregnancy, 4 weeks of pregnancy, 4 weeks before delivery, and 1 week before delivery. We used a Cox proportional hazards model and adjusted the potential risk factors for preterm birth to obtain the effects of exposure to temperature and humidity on preterm birth among the stages of pregnancy. Results At 1 week of pregnancy and at 4 weeks of pregnancy, the association between temperature and preterm birth was U-shaped. The correlation between relative humidity and the risk of preterm birth was n-type at 1 week of pregnancy. The correlation between preterm birth and temperature and relative humidity at 4 weeks before delivery and at 1 week before delivery is J-shaped. Low temperature and low humidity were protective factors against preterm birth, whereas high temperature and high humidity were risk factors for preterm birth.The effects of high temperature and extremely high temperature were the strongest at 4 weeks before delivery, with HRs of 1.417 (95% CI: 1.362-1.474) and 1.627 (95% CI: 1.537-1.722), respectively. The effects of extremely low humidity and low humidity were strongest at 1 week before delivery, with HRs of 0.681 (95% CI: 0.609-0.761) and 0.696 (95% CI: 0.627-0.771), respectively. Conclusion Temperature and relative humidity affect preterm birth differently for each pregnancy stage. The effects of meteorological factors on pregnancy outcomes such as premature birth should not be ignored.
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Affiliation(s)
- Yu Wu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
| | - Jie Yuan
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
| | - Yanling Yuan
- Yunnan Population and Family Planning Research Institute, Yunnan, China
| | - Cai Kong
- Yunnan Population and Family Planning Research Institute, Yunnan, China
| | - Wenzhan Jing
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
| | - Hanfeng Ye
- Yunnan Population and Family Planning Research Institute, Yunnan, China
| | - Min Liu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
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Coma E, Pino D, Mora N, Fina F, Perramon A, Prats C, Medina M, Planella A, Mompart A, Mendioroz J, Cabezas C. Mortality in Catalonia during the summer of 2022 and its relation with high temperatures and COVID-19 cases. Front Public Health 2023; 11:1157363. [PMID: 37275503 PMCID: PMC10235629 DOI: 10.3389/fpubh.2023.1157363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023] Open
Abstract
Purpose To analyse the association between the mortality during the summer 2022 and either high temperatures or the COVID-19 wave with data from the Catalan Health Care System (7.8 million people). Methods We performed a retrospective study using publicly available data of meteorological variables, influenza-like illness (ILI) cases (including COVID-19) and deaths. The study comprises the summer months of the years 2021 and 2022. To compare the curves of mortality, ILI and temperature we calculated the z-score of each series. We assessed the observed lag between curves using the cross-correlation function. Finally, we calculated the correlation between the z-scores using the Pearson correlation coefficient (R2). Results During the study period, 33,967 deaths were reported in Catalonia (16,416 in the summer of 2021 and 17,551 in the summer of 2022). In 2022, the observed lag and the correlation between the z-scores of temperature and all-cause deaths was 3 days and R2 = 0.86, while between ILI and all-cause deaths was 22 days and R2 = 0.21. This high correlation between temperature and deaths increased up to 0.91 when we excluded those deaths reported as COVID-19 deaths, while the correlation between ILI and non-COVID-19 deaths decreased to -0.19. No correlation was observed between non-COVID deaths and temperature or ILI cases in 2021. Conclusion Our study suggests that the main cause of the increase in deaths during summer 2022 in Catalonia was the high temperatures and its duration. The contribution of the COVID-19 seems to be limited.
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Affiliation(s)
- Ermengol Coma
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - David Pino
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Aida Perramon
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Clara Prats
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Manuel Medina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Antoni Planella
- Department of Health, Generalitat de Catalunya, Direcció General de Planificació i Recerca en Salut, Barcelona, Spain
| | - Anna Mompart
- Department of Health, Generalitat de Catalunya, Direcció General de Planificació i Recerca en Salut, Barcelona, Spain
| | - Jacobo Mendioroz
- Department of Health, Public Health Secretariat, Generalitat de Catalunya, Barcelona, Spain
| | - Carmen Cabezas
- Department of Health, Public Health Secretariat, Generalitat de Catalunya, Barcelona, Spain
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