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Simpson CH, Brousse O, Heaviside C. Estimated mortality attributable to the urban heat island during the record-breaking 2022 heatwave in London. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2024; 19:094047. [PMID: 39169924 PMCID: PMC11334115 DOI: 10.1088/1748-9326/ad6c65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 08/23/2024]
Abstract
The United Kingdom experienced its most extreme heatwave to date during late July 2022, with maximum air temperatures exceeding 40 °C recorded for the first time in history on July 19th. High ambient temperatures have been statistically shown to lead to increased mortality. Higher nighttime temperatures that occur in more urbanised areas, called the urban heat island (UHI), may contribute to the mortality burden of heat. In this study, we applied health impact assessment methods with advanced urban climate modelling to estimate what contribution the UHI had on the mortality impact of the 10-25 July 2022 heatwave in Greater London. Estimated mortality due to heat and due to the UHI were compared with estimated mortality due to air pollution in the same period, based on monitored concentrations. We estimate that of the 1773 deaths in Greater London in this period 370 (95% confidence interval 328-410) could be attributed to heat. We estimate that 38% of these heat-related deaths could be attributed to the UHI. In the same period is estimate deaths attributable to PM2.5 were 20.6 (10.4-30.8) and to ozone were 52.3 (95% confidence interval 18.6-85.2). Despite not contributing to the record-breaking maximum air temperature observed during this period, the UHI may have contributed to the heatwave's mortality burden through raised nighttime temperature. While air pollutant concentrations were elevated during the period, deaths attributable to air pollution were relatively few compared to deaths attributable to heat.
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Affiliation(s)
- Charles H Simpson
- Institute for Environmental Design and Engineering, University College London, London, United Kingdom
| | - Oscar Brousse
- Institute for Environmental Design and Engineering, University College London, London, United Kingdom
| | - Clare Heaviside
- Institute for Environmental Design and Engineering, University College London, London, United Kingdom
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Quijal-Zamorano M, Martinez-Beneito MA, Ballester J, Marí-Dell’Olmo M. Spatial Bayesian distributed lag non-linear models (SB-DLNM) for small-area exposure-lag-response epidemiological modelling. Int J Epidemiol 2024; 53:dyae061. [PMID: 38641428 PMCID: PMC11031409 DOI: 10.1093/ije/dyae061] [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: 07/21/2023] [Accepted: 04/10/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Distributed lag non-linear models (DLNMs) are the reference framework for modelling lagged non-linear associations. They are usually used in large-scale multi-location studies. Attempts to study these associations in small areas either did not include the lagged non-linear effects, did not allow for geographically-varying risks or downscaled risks from larger spatial units through socioeconomic and physical meta-predictors when the estimation of the risks was not feasible due to low statistical power. METHODS Here we proposed spatial Bayesian DLNMs (SB-DLNMs) as a new framework for the estimation of reliable small-area lagged non-linear associations, and demonstrated the methodology for the case study of the temperature-mortality relationship in the 73 neighbourhoods of the city of Barcelona. We generalized location-independent DLNMs to the Bayesian framework (B-DLNMs), and extended them to SB-DLNMs by incorporating spatial models in a single-stage approach that accounts for the spatial dependence between risks. RESULTS The results of the case study highlighted the benefits of incorporating the spatial component for small-area analysis. Estimates obtained from independent B-DLNMs were unstable and unreliable, particularly in neighbourhoods with very low numbers of deaths. SB-DLNMs addressed these instabilities by incorporating spatial dependencies, resulting in more plausible and coherent estimates and revealing hidden spatial patterns. In addition, the Bayesian framework enriches the range of estimates and tests that can be used in both large- and small-area studies. CONCLUSIONS SB-DLNMs account for spatial structures in the risk associations across small areas. By modelling spatial differences, SB-DLNMs facilitate the direct estimation of non-linear exposure-response lagged associations at the small-area level, even in areas with as few as 19 deaths. The manuscript includes an illustrative code to reproduce the results, and to facilitate the implementation of other case studies by other researchers.
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Affiliation(s)
| | - Miguel A Martinez-Beneito
- Departament d’Estadística i Investigaciò Operativa, Universitat de València, Burjassot, Valencia, Spain
| | | | - Marc Marí-Dell’Olmo
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Makuyana T, Dube K. Mapping disability and climate change knowledge base in Scopus using bibliometric analysis. Afr J Disabil 2024; 13:1339. [PMID: 38628958 PMCID: PMC11019038 DOI: 10.4102/ajod.v13i0.1339] [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: 10/18/2023] [Accepted: 02/21/2024] [Indexed: 04/19/2024] Open
Abstract
Background Climate change and disability are rarely addressed by academic scholars within the spectrum of disabilities and as a single field of study. However, the intersectionality of disability exacerbates the vulnerability of people with disabilities to climate change as climate change frameworks in the Global North and South continue excluding them. Objectives This study aims to map the research-based knowledge housed in Scopus on disability and climate change. At the same time, it provides insights into innovative (novelty) ways of thinking and proposes a futuristic research agenda. Method A bibliometric analysis was conducted on Scopus-indexed articles using VOSviewer to map co-occurrences of keywords and co-authorship, and a manual thematic-scoping review augmented the data analysis. Results The disability and climate change debate as a joint study evolved from concern among health practitioners to human rights and social inclusion. Conclusion In conclusion, there is a skewness towards mental health and medical sociology lens, while other sub-groups of persons with disabilities are yet to be engaged in co-creating disability-inclusive climate change knowledge. Contribution Thematic areas emerged as gaps that future studies embed principles enshrined in the United Nations Convention for the Rights of Persons with Disabilities and the Sustainable Development Goals.
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Affiliation(s)
- Tawanda Makuyana
- Department of Tourism and Integrated Communication, Faculty of Human Sciences, Vaal University of Technology, Vanderbijlpark, South Africa
| | - Kaitano Dube
- Department of Tourism and Integrated Communication, Faculty of Human Sciences, Vaal University of Technology, Vanderbijlpark, South Africa
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Shindell D, Hunter R, Faluvegi G, Parsons L. Premature Deaths Due To Heat Exposure: The Potential Effects of Neighborhood-Level Versus City-Level Acclimatization Within US Cities. GEOHEALTH 2024; 8:e2023GH000970. [PMID: 38169989 PMCID: PMC10759151 DOI: 10.1029/2023gh000970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024]
Abstract
For the population of a given US city, the risk of premature death associated with heat exposure increases as temperatures rise, but risks in hotter cities are generally lower than in cooler cities at equivalent temperatures due to factors such as acclimatization. Those living in especially hot neighborhoods within cities might therefore suffer much more than average if such adaptation is only at the city-wide level, whereas they might not experience greatly increased risk if adjustment is at the neighborhood level. To compare these possibilities, we use high spatial resolution temperature data to evaluated heat-related deaths assuming either adjustment at the city-wide or at the neighborhood scale in 10 large US cities. On average, we find that if inhabitants are adjusted to their local conditions, a neighborhood that was 10°C hotter than a cooler one would experience only about 1.0-1.5 excess heat deaths per year per 100,000 persons. By contrast, if inhabitants are acclimatized to city-wide temperatures, the hotter neighborhood would experience about 15 excess deaths per year per 100,000 persons. Using idealized analyses, we demonstrate that current city-wide epidemiological data do not differentiate between these differing adjustments. Given the very large effects of assumptions about neighborhood-level acclimatization found here, as well as the fact that current literature is conflicting on the spatial scale of acclimatization, more neighborhood-level epidemiological data are urgently needed to determine the health impacts of variations in heat exposure within urban areas, better constrain projected changes, and inform mitigation efforts.
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Affiliation(s)
- D. Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - R. Hunter
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - G. Faluvegi
- NASA Goddard Institute for Space Studies and Center for Climate Systems ResearchColumbia UniversityNew YorkNYUSA
| | - L. Parsons
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
- Global ScienceThe Nature ConservancyDurhamNCUSA
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Cleland SE, Steinhardt W, Neas LM, Jason West J, Rappold AG. Urban heat island impacts on heat-related cardiovascular morbidity: A time series analysis of older adults in US metropolitan areas. ENVIRONMENT INTERNATIONAL 2023; 178:108005. [PMID: 37437316 PMCID: PMC10599453 DOI: 10.1016/j.envint.2023.108005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 07/14/2023]
Abstract
Many United States (US) cities are experiencing urban heat islands (UHIs) and climate change-driven temperature increases. Extreme heat increases cardiovascular disease (CVD) risk, yet little is known about how this association varies with UHI intensity (UHII) within and between cities. We aimed to identify the urban populations most at-risk of and burdened by heat-related CVD morbidity in UHI-affected areas compared to unaffected areas. ZIP code-level daily counts of CVD hospitalizations among Medicare enrollees, aged 65-114, were obtained for 120 US metropolitan statistical areas (MSAs) between 2000 and 2017. Mean ambient temperature exposure was estimated by interpolating daily weather station observations. ZIP codes were classified as low and high UHII using the first and fourth quartiles of an existing surface UHII metric, weighted to each have 25% of all CVD hospitalizations. MSA-specific associations between ambient temperature and CVD hospitalization were estimated using quasi-Poisson regression with distributed lag non-linear models and pooled via multivariate meta-analyses. Across the US, extreme heat (MSA-specific 99th percentile, on average 28.6 °C) increased the risk of CVD hospitalization by 1.5% (95% CI: 0.4%, 2.6%), with considerable variation among MSAs. Extreme heat-related CVD hospitalization risk in high UHII areas (2.4% [95% CI: 0.4%, 4.3%]) exceeded that in low UHII areas (1.0% [95% CI: -0.8%, 2.8%]), with upwards of a 10% difference in some MSAs. During the 18-year study period, there were an estimated 37,028 (95% CI: 35,741, 37,988) heat-attributable CVD admissions. High UHII areas accounted for 35% of the total heat-related CVD burden, while low UHII areas accounted for 4%. High UHII disproportionately impacted already heat-vulnerable populations; females, individuals aged 75-114, and those with chronic conditions living in high UHII areas experienced the largest heat-related CVD impacts. Overall, extreme heat increased cardiovascular morbidity risk and burden in older urban populations, with UHIs exacerbating these impacts among those with existing vulnerabilities.
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Affiliation(s)
- Stephanie E Cleland
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Oak Ridge Institute for Science and Education at the Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - William Steinhardt
- Oak Ridge Institute for Science and Education at the Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Lucas M Neas
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - J Jason West
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Ana G Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA.
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Li K, Chen Y. Identifying and characterizing frequency and maximum durations of surface urban heat and cool island across global cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 859:160218. [PMID: 36414050 DOI: 10.1016/j.scitotenv.2022.160218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/27/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Surface urban heat island (SUHI) has been widely reported from a local to global scale. However, variations and controls of temporal indicators for SUHI and SUCI (surface urban cool island) remain unclear. This paper firstly reconstructed the seamless daily LST (land surface temperature) based on ATC-SKT (annual temperature cycle-skin temperature) and comprehensively validated for SUHI applications across 1112 global cities. Based on the seamless daily LST, this paper further characterized the spatiotemporal variations of the frequency (SUHIF and SUCIF) and maximum duration (SUHID and SUCID) and investigated the impacts from related factors, inconsideration of the different characteristics of SUHI and SUCI. There are five major findings. (1) The seamless daily LST reconstructed based on ATC-SKT is validated through pixel-based temperature and city-based SUHII accuracy assessments. (2) The selection of the frequency threshold is based on robustness for LST accuracy, approximation to SUHII global average, and mitigation of frequency saturation. (3) The average daytime SUHIF is 214 days/year, with 44 % of cities exhibiting SUHI occurrences for almost every day in summer. The nighttime SUHIF is 175 days/year, with increasing latitudinal variations from equatorial to polar regions. The daytime SUCIF is 41 days/year, with the greatest average frequency of 172 days/year exhibited in arid regions. (4) The average SUHID is 147 days at daytime and 58 days at nighttime, with relatively opposite geographical distributions between day and night. (5) Greater vegetation difference at daytime and greater albedo difference at nighttime result in more occurrences and longer consecutive durations of SUHI, with opposite effects on the temporal indicators of SUCI. Furthermore, the improvements in daily SUHII and impacts from the maximum duration were discussed. This paper aims to identify and highlight the period with significant SUHI and SUCI effects across global cities for further mitigation.
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Affiliation(s)
- Kangning Li
- State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China; College of Geoscience and Surveying Engineering, China University of Mining and Technology-Beijing, Beijing 100083, China
| | - Yunhao Chen
- State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
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Ho JY, Shi Y, Lau KKL, Ng EYY, Ren C, Goggins WB. Urban heat island effect-related mortality under extreme heat and non-extreme heat scenarios: A 2010-2019 case study in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:159791. [PMID: 36328261 DOI: 10.1016/j.scitotenv.2022.159791] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/02/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The urban heat island (UHI) effect exacerbates the adverse impact of heat on human health. However, while the UHI effect is further intensified during extreme heat events, prior studies have rarely mapped the UHI effect during extreme heat events to assess its direct temperature impact on mortality. This study examined the UHI effect during extreme heat and non-extreme heat scenarios and compared their temperature-mortality associations in Hong Kong from 2010 to 2019. Four urban heat island degree hour (UHIdh) scenarios were mapped onto Hong Kong's tertiary planning units and classified into three levels (Low, Moderate, and High). We assessed the association between temperature and non-external mortality of populations living in each UHIdh level for the extreme heat/non-extreme heat scenarios during the 2010-2019 hot seasons. Our results showed substantial differences between the temperature-mortality associations in the three levels under the UHIdh extreme heat scenario (UHIdh_EH). While there was no evidence of increased mortality in Low UHIdh_EH areas, the mortality risk in Moderate and High UHIdh_EH areas were significantly increased during periods of hot temperature, with the High UHIdh_EH areas displaying almost double the risk (RR: 1.08, 95%CI: 1.03, 1.14 vs. RR: 1.05, 95 % CI: 1.01, 1.09). However, other non-extreme heat UHI scenarios did not demonstrate as prominent of a difference. When stratified by age, the heat effects were found in Moderate and High UHIdh_EH among the elderly aged 75 and above. Our study found a difference in the temperature-mortality associations based on UHI intensity and potential heat vulnerability of populations during extreme heat events. Preventive measures should be taken to mitigate heat especially in urban areas with high UHI intensity during extreme heat events, with particular attention and support for those prone to heat vulnerability, such as the elderly and poorer populations.
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Affiliation(s)
- Janice Y Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Shi
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China; Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, United Kingdom
| | - Kevin K L Lau
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China; Department of Civil, Environmental and Natural Resources Engineering, Luleå University of Technology, Sweden
| | - Edward Y Y Ng
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China; School of Architecture, The Chinese University of Hong Kong, Hong Kong, China
| | - Chao Ren
- Division of Landscape Architecture, Department of Architecture, Faculty of Architecture, The University of Hong Kong, Hong Kong, China.
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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8
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Ambient temperature and stillbirth risks in northern Sweden, 1880-1950. Environ Epidemiol 2021; 5:e176. [PMID: 34909556 PMCID: PMC8663868 DOI: 10.1097/ee9.0000000000000176] [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: 04/22/2021] [Accepted: 09/28/2021] [Indexed: 11/26/2022] Open
Abstract
Background Climate vulnerability of the unborn can contribute to adverse birth outcomes, in particular, but it is still not well understood. We investigated the association between ambient temperature and stillbirth risk among a historical population in northern Sweden (1880-1950). Methods We used digitized parish records and daily temperature data from the study region covering coastal and inland communities some 600 km north of Stockholm, Sweden. The data included 141,880 births, and 3,217 stillbirths, corresponding to a stillbirth rate of 22.7 (1880-1950). The association between lagged temperature (0-7 days before birth) and stillbirths was estimated using a time-stratified case-crossover design. Incidence risk ratios (IRR) with 95% confidence intervals were computed, and stratified by season and sex. Results We observed that the stillbirth risk increased both at low and high temperatures during the extended summer season (April to September), at -10°C, and the IRR was 2.3 (CI 1.28, 4.00) compared to the minimum mortality temperature of +15°C. No clear effect of temperature during the extended winter season (October to March) was found. Climate vulnerability was greater among the male fetus compared to the female counterparts. Conclusion In this subarctic setting before and during industrialization, both heat and cold during the warmer season increased the stillbirth risk. Urbanization and socio-economic development might have contributed to an uneven decline in climate vulnerability of the unborn.
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Taylor J, Symonds P, Heaviside C, Chalabi Z, Davies M, Wilkinson P. Projecting the impacts of housing on temperature-related mortality in London during typical future years. ENERGY AND BUILDINGS 2021; 249:None. [PMID: 34819713 PMCID: PMC8593871 DOI: 10.1016/j.enbuild.2021.111233] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 06/09/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
Climate change means the UK will experience warmer winters and hotter summers in the future. Concurrent energy efficiency improvements to housing may modify indoor exposures to heat or cold, while population aging may increase susceptibility to temperature-related mortality. We estimate heat and cold mortality and energy consumption in London for typical (non-extreme) future climates, given projected changes in population and housing. Building physics models are used to simulate summertime and wintertime indoor temperatures and space heating energy consumption of London dwellings for 'baseline' (2005-2014) and future (2030s, 2050s) periods using data from the English Housing Survey, historical weather data, and projected future weather data with temperatures representative of 'typical' years. Linking to population projections, we calculate future heat and cold attributable mortality and energy consumption with demolition, construction, and alternative scenarios of energy efficiency retrofit. At current retrofit rates, around 168-174 annual cold-related deaths per million population would typically be avoided by the 2050s, or 261-269 deaths per million under ambitious retrofit rates. Annual heat deaths would typically increase by 1 per million per year under the current retrofit rate, and 12-13 per million under ambitious rates without population adaptation to heat. During typical future summers, an estimated 38-73% of heat-related deaths can be avoided using external shutters on windows, with their effectiveness lower during hotter weather. Despite warmer winters, ambitious retrofit rates are necessary to reduce typical annual energy consumption for heating below baseline levels, assuming no improvement in heating system efficiencies. Concerns over future overheating in energy efficient housing are valid but increases in heat attributable mortality during typical and hot (but not extreme) summers are more than offset by significant reductions in cold mortality and easily mitigated using passive measures. More ambitious retrofit rates are critical to reduce energy consumption and offer co-benefits for reducing cold-related mortality.
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Affiliation(s)
- Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Phil Symonds
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Clare Heaviside
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Zaid Chalabi
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Mike Davies
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Wilkinson
- London School of Hygiene and Tropical Medicine, London, UK
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Macintyre HL, Heaviside C, Cai X, Phalkey R. Comparing temperature-related mortality impacts of cool roofs in winter and summer in a highly urbanized European region for present and future climate. ENVIRONMENT INTERNATIONAL 2021; 154:106606. [PMID: 33971480 PMCID: PMC8214226 DOI: 10.1016/j.envint.2021.106606] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Human health can be negatively impacted by hot or cold weather, which often exacerbates respiratory or cardiovascular conditions and increases the risk of mortality. Urban populations are at particular increased risk of effects from heat due to the Urban Heat Island (UHI) effect (higher urban temperatures compared with rural ones). This has led to extensive investigation of the summertime UHI, its impacts on health, and also the consideration of interventions such as reflective 'cool' roofs to help reduce summertime overheating effects. However, interventions aimed at limiting summer heat are rarely evaluated for their effects in wintertime, and thus their overall annual net impact on temperature-related health effects are poorly understood. In this study we use a regional weather model to simulate the winter 2009/10 period for an urbanized region of the UK (Birmingham and the West Midlands), and use a health impact assessment to estimate the impact of reflective 'cool' roofs (an intervention usually aimed at reducing the UHI in summer) on cold-related mortality in winter. Cool roofs have been shown to be effective at reducing maximum temperatures during summertime. In contrast to the summer, we find that cool roofs have a minimal effect on ambient air temperatures in winter. Although the UHI in summertime can increase heat-related mortality, the wintertime UHI can have benefits to health, through avoided cold-related mortality. Our results highlight the potential annual net health benefits of implementing cool roofs to reduce temperature-related mortality in summer, without reducing the protective UHI effect in winter. Further, we suggest that benefits of cool roofs may increase in future, with a doubling of the number of heat-related deaths avoided by the 2080s (RCP8.5) compared to summer 2006, and with insignificant changes in the impact of cool-roofs on cold-related mortality. These results further support reflective 'cool' roof implementation strategies as effective interventions to protect health, both today and in future.
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Affiliation(s)
- Helen L Macintyre
- Climate Change and Health Group, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Clare Heaviside
- Institute for Environmental Design and Engineering, University College London, Central House, 14 Woburn Place, London WC1H 0NN, UK
| | - Xiaoming Cai
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Revati Phalkey
- Climate Change and Health Group, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham City Hospital, Hucknall Road, NG51PB Nottingham, UK; Heidelberg Institute for Global Health, University of Heidelberg, Im Neuenheimer Feld 130.3 69120 Heidelberg, Germany
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11
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Science Policy to Advance a Climate Change and Health Research Agenda in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157868. [PMID: 34360159 PMCID: PMC8345657 DOI: 10.3390/ijerph18157868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 01/27/2023]
Abstract
Climate change is thought to be one of the greatest public health threats of the 21st century and there has been a tremendous growth in the published literature describing the health implications of climate change over the last decade. Yet, there remain several critical knowledge gaps in this field. Closing these gaps is crucial to developing effective interventions to minimize the health risks from climate change. In this commentary, we discuss policy trends that have influenced the advancement of climate change and health research in the United States context. We then enumerate specific knowledge gaps that could be addressed by policies to advance scientific research. Finally, we describe tools and methods that have not yet been fully integrated into the field, but hold promise for advancing the science. Prioritizing this advancement offers the potential to improve public health-related policies on climate change.
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Lee W, Ebi KL, Kim Y, Hashizume M, Honda Y, Hideki H, Choi HM, Choi M, Kim H. Heat-mortality risk and the population concentration of metropolitan areas in Japan: a nationwide time-series study. Int J Epidemiol 2021; 50:602-612. [PMID: 33346831 DOI: 10.1093/ije/dyaa245] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 11/12/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The complex role of urbanisation in heat-mortality risk has not been fully studied. Japan has experienced a rapid population increase and densification in metropolitan areas since the 2000s; we investigated the effects of population concentration in metropolitan areas on heat-mortality risk using nationwide data. METHODS We collected time-series data for mortality and weather variables for all 47 prefectures in Japan (1980-2015). The prefectures were classified into three sub-areas based on population size: lowest (<1 500 000), intermediate (1 500 000 to 3 000 000), and highest (>3 000 000; i.e. metropolitan areas). Regional indicators associated with the population concentration of metropolitan areas were obtained. RESULTS Since the 2000s, the population concentration intensified in the metropolitan areas, with the highest heat-mortality risk in prefectures with the highest population. Higher population density and apartment % as well as lower forest area and medical services were associated with higher heat-mortality risk; these associations have generally become stronger since the 2000s. CONCLUSIONS Population concentration in metropolitan areas intensified interregional disparities in demography, living environments, and medical services in Japan; these disparities were associated with higher heat-mortality risk. Our results can contribute to policies to reduce vulnerability to high temperatures.
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Affiliation(s)
- Whanhee Lee
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Hashimoto Hideki
- Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hayon Michelle Choi
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Moonjung Choi
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
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13
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López-Bueno JA, Navas-Martín MA, Linares C, Mirón IJ, Luna MY, Sánchez-Martínez G, Culqui D, Díaz J. Analysis of the impact of heat waves on daily mortality in urban and rural areas in Madrid. ENVIRONMENTAL RESEARCH 2021; 195:110892. [PMID: 33607097 DOI: 10.1016/j.envres.2021.110892] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/25/2021] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
The objective of this study was to analyze and compare the effect of high temperatures on daily mortality in the urban and rural populations in Madrid. Data were analyzed from municipalities in Madrid with a population of over 10,000 inhabitants during the period from January 1, 2000 to December 31, 2020. Four groups were generated: Urban Metropolitan Center, Rural Northern Mountains, Rural Center, and Southern Rural. The dependent variable used was the rate of daily mortality due to natural causes per million inhabitants (CIE-X: A00-R99) between the months of June and September for the period. The primary independent variable was maximum daily temperature. Social and demographic "context variables" were included: population >64 years of age (%), deprivation index and housing indicators. The analysis was carried out in three phases: 1) determination of the threshold definition temperature of a heat wave (Tumbral) for each study group; 2) determination of relative risks (RR) attributable to heat for each group using Poisson linear regression (GLM), and 3) calculation of odds ratios (OR) using binomial family GLM for the frequency of the appearance of heat waves associated with context variables. The resulting percentiles (for the series of maximum daily temperatures for the summer months) corresponding to Tthreshold were: 74th percentile for Urban Metropolitan Center, 76th percentile for Southern Rural, 83rd for Rural Northern Mountains and 98th percentile for Center Rural (98). Greater vulnerability was found for the first two. In terms of context variables that explained the appearance of heat waves, deprivation index level, population >64 years of age and living in the metropolitan area were found to be risk factors. Rural and urban areas behaved differently, and socioeconomic inequality and the composition of the population over age 64 were found to best explain the vulnerability of the Rural Center and Southern Rural zones.
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Affiliation(s)
- J A López-Bueno
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain.
| | - M A Navas-Martín
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - C Linares
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I J Mirón
- Consejería de Sanidad, Junta de Comunidades de Castilla-La Mancha, Toledo, Spain
| | - M Y Luna
- State Meteorological Agency (AEMET), Madrid, Spain
| | | | - D Culqui
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - J Díaz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
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14
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Evangelopoulos D, Analitis A, Giannakopoulos C, Katsouyanni K. Does climatic zone of birth modify the temperature-mortality association of London inhabitants during the warm season? A time-series analysis for 2004-2013. ENVIRONMENTAL RESEARCH 2021; 193:110357. [PMID: 33131709 DOI: 10.1016/j.envres.2020.110357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/11/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND It is known that on days with high temperatures higher mortality is observed and there is a minimum mortality temperature (MMT) point which is higher in places with warmer climate. This indicates some population adaptation to local climate but information on how quickly this adaptation will occur under climate change is lacking. METHODS To investigate this, we associated daily mortality data with temperature during the warm period in 2004-2013 for London inhabitants born in five climatic zones (UK, Tropical, Sub-tropical, Boreal and Mixed). We fitted Poisson regression with distributed-lag non-linear models for each climatic zone group separately to estimate group-specific exposure-response associations and MMTs. We report relative risks of death comparing the 95th percentile (21 °C) and maximum (25 °C) of the temperature distribution in London with the zone-specific minimum mortality temperature. RESULTS No heat-related mortality was observed for people born in countries with Sub-tropical and Mixed climates. We observed an increase of 26%, 35% and 39% in the risk of death at 25 °C compared to the MMT in people born in the UK (marine climate), Tropical and Boreal climate respectively. The temperatures with the lowest mortality in these groups ranged from 15.9 to 17.7 °C. DISCUSSION Our findings imply that people born in different climatic zones do not adapt fully to their new environment within their lifetime. This implies that populations may not adapt readily to climate change and will suffer increased effects from heat. In the presence of climate change, policy makers should be aware of a delayed process of adaptation.
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Affiliation(s)
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Giannakopoulos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens, Greece
| | - Klea Katsouyanni
- Environmental Research Group, Imperial College, London, United Kingdom; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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15
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Temperature-Related Mortality in Helsinki Compared to Its Surrounding Region Over Two Decades, with Special Emphasis on Intensive Heatwaves. ATMOSPHERE 2020. [DOI: 10.3390/atmos12010046] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Urbanization and ongoing climate change increase the exposure of the populations to heat stress, and the urban heat island (UHI) effect may magnify heat-related mortality, especially during heatwaves. We studied temperature-related mortality in the city of Helsinki—with urban and suburban land uses—and in the surrounding Helsinki-Uusimaa hospital district (HUS-H, excluding Helsinki)—with more rural types of land uses—in southern Finland for two decades, 2000–2018. Dependence of the risk of daily all-cause deaths (all-age and 75+ years) on daily mean temperature was modelled using the distributed lag nonlinear model (DLNM). The modelled relationships were applied in assessing deaths attributable to four intensive heatwaves during the study period. The results showed that the heat-related mortality risk was substantially higher in Helsinki than in HUS-H, and the mortality rates attributable to four intensive heatwaves (2003, 2010, 2014 and 2018) were about 2.5 times higher in Helsinki than in HUS-H. Among the elderly, heat-related risks were also higher in Helsinki, while cold-related risks were higher in the surrounding region. The temperature ranges recorded in the fairly coarse resolution gridded datasets were not distinctly different in the two considered regions. It is therefore probable that the modelling underestimated the actual exposure to the heat stress in Helsinki. We also studied the modifying, short-term impact of air quality on the modelled temperature-mortality association in Helsinki; this effect was found to be small. We discuss a need for higher resolution data and modelling the UHI effect, and regional differences in vulnerability to thermal stress.
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16
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Jang J, Lee W, Choi M, Kang C, Kim H. Roles of urban heat anomaly and land-use/land-cover on the heat-related mortality in the national capital region of South Korea: A multi-districts time-series study. ENVIRONMENT INTERNATIONAL 2020; 145:106127. [PMID: 32950794 DOI: 10.1016/j.envint.2020.106127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
The urban heat anomaly has been suggested as a representative risk factor for human health in metropolitan areas, but few studies have measured a quantitative increase in risk due to the urban heat anomaly on heat-related mortality in the summer season or assessed the role of various types of land-use/land-cover (LULC), which may contribute to the urban heat anomaly. In this study, we evaluated the association between the urban heat anomaly and heat-related mortality risk in the summer and the potential roles of multiple types of LULC indicators. We used district-level time-series and cadastral data from 51 urban districts in the national capital region of South Korea. We applied a two-stage analysis. In the first stage, we estimated the district-specific heat-related mortality risk by using a distributed lag non-linear model. In the second stage, we used a meta-analysis to pool the estimates across all districts and calculate the association between the urban heat anomaly/LULC indicators and heat-related mortality risk. We found that the higher urban heat anomaly was related to lower vegetation and higher urban surface indicators, and the urban heat anomaly was positively associated with the heat-related mortality risk. The association between the urban heat anomaly and the heat-related mortality risk was more pronounced in the elderly (age ≥ 65 years) and female population than in the non-elderly and male population. We also found that the LULC indicators affected the heat-related mortality only through the urban heat anomaly. Our findings indicate that urban areas may be more vulnerable to heat-related mortality risk as determined by the urban heat anomaly. These results suggest a need for urban heat mitigation strategies such as increased vegetation or surface albedo to help reduce heat-related mortality risk.
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Affiliation(s)
- Jeongju Jang
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Whanhee Lee
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Munjeong Choi
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Cinoo Kang
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea.
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17
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Jung CC, Hsia YF, Hsu NY, Wang YC, Su HJ. Cumulative effect of indoor temperature on cardiovascular disease-related emergency department visits among older adults in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 731:138958. [PMID: 32408209 DOI: 10.1016/j.scitotenv.2020.138958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
Studies have demonstrated that exposure to extreme outdoor temperatures increases cardiovascular disease mortality and morbidity. However, people spend 80%-90% of their time indoors, and the cumulative effects of exposure to high or low temperature on the risk of cardiovascular diseases had not been considered. This study investigated the cumulative effects of high or low indoor temperature exposure on the risk of cardiovascular diseases. We estimated indoor temperatures by using a prediction model of indoor temperature from a previous study and further calculated the cumulative degree hours at different indoor temperature ranges. Samples of emergency department visits due to cardiovascular diseases were collected from the Longitudinal Health Insurance Database (LHID) from 2000 to 2014 in Taiwan. We used a distributed lag nonlinear model to analyze the data. Our data demonstrated a significant risk of emergency department visits due to cardiovascular diseases at 27, 28, 29, 30, and 31 °C when cooling cumulative degree hours exceeded 62, 43, 16, 1, and 1 during the hot season (May to October), respectively, and at 19, 20, 21, 22, and 23 °C when heating cumulative degree hours exceeded 1, 1, 1, 11, and 33 during the cold season (November to April), respectively. Cumulative degree hours were different according to gender and age groups. Policymakers should further consider the cumulative effects to prevent hot- or cold-related cardiovascular diseases for populations.
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Affiliation(s)
- Chien-Cheng Jung
- Department of Public Health, China Medical University, Taichung City, Taiwan
| | - Ying-Fang Hsia
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Nai-Yun Hsu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, Chung-Yuan Christian University, Taoyuan City, Taiwan
| | - Huey-Jen Su
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
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18
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Hough I, Just AC, Zhou B, Dorman M, Lepeule J, Kloog I. A multi-resolution air temperature model for France from MODIS and Landsat thermal data. ENVIRONMENTAL RESEARCH 2020; 183:109244. [PMID: 32097815 PMCID: PMC7167357 DOI: 10.1016/j.envres.2020.109244] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 01/17/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
Understanding and managing the health effects of ambient temperature (Ta) in a warming, urbanizing world requires spatially- and temporally-resolved Ta at high resolutions. This is challenging in a large area like France which includes highly variable topography, rural areas with few weather stations, and heterogeneous urban areas where Ta can vary at fine spatial scales. We have modeled daily Ta from 2000 to 2016 at a base resolution of 1 km2 across continental France and at a 200 × 200 m2 resolution over large urban areas. For each day we predict three Ta measures: minimum (Tmin), mean (Tmean), and maximum (Tmax). We start by using linear mixed models to calibrate daily Ta observations from weather stations with remotely sensed MODIS land surface temperature (LST) and other spatial predictors (e.g. NDVI, elevation) on a 1 km2 grid. We fill gaps where LST is missing (e.g. due to cloud cover) with additional mixed models that capture the relationship between predicted Ta at each location and observed Ta at nearby weather stations. The resulting 1 km Ta models perform very well, with ten-fold cross-validated R2 of 0.92, 0.97, and 0.95, mean absolute error (MAE) of 1.4 °C, 0.9 °C, and 1.4 °C, and root mean square error (RMSE) of 1.9 °C, 1.3 °C, and 1.8 °C (Tmin, Tmean, and Tmax, respectively) for the initial calibration stage. To increase the spatial resolution over large urban areas, we train random forest and extreme gradient boosting models to predict the residuals (R) of the 1 km Ta predictions on a 200 × 200 m2 grid. In this stage we replace MODIS LST and NDVI with composited top-of-atmosphere brightness temperature and NDVI from the Landsat 5, 7, and 8 satellites. We use a generalized additive model to ensemble the random forest and extreme gradient boosting predictions with weights that vary spatially and by the magnitude of the predicted residual. The 200 m models also perform well, with ten-fold cross-validated R2 of 0.79, 0.79, and 0.85, MAE of 0.4, 0.3, and 0.3, and RMSE of 0.6, 0.4, and 0.5 (Rmin, Rmean, and Rmax, respectively). Our model will reduce bias in epidemiological studies in France by improving Ta exposure assessment in both urban and rural areas, and our methodology demonstrates that MODIS and Landsat thermal data can be used to generate gap-free timeseries of daily minimum, maximum, and mean Ta at a 200 × 200 m2 spatial resolution.
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Affiliation(s)
- Ian Hough
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, Site Sante, Allée des Alpes, 38700, La Tronche, France; Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. 653, Be'er Sheva, Israel.
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029-5674, USA
| | - Bin Zhou
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. 653, Be'er Sheva, Israel
| | - Michael Dorman
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. 653, Be'er Sheva, Israel
| | - Johanna Lepeule
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, Site Sante, Allée des Alpes, 38700, La Tronche, France
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. 653, Be'er Sheva, Israel
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19
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Probability Risk of Heat- and Cold-Related Mortality to Temperature, Gender, and Age Using GAM Regression Analysis. CLIMATE 2020. [DOI: 10.3390/cli8030040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We have examined the heat and cold-related mortality risk subject to cold and heat extremes by using a generalized additive model (GAM) regression technique to quantify the effect of the stimulus of mortality in the presence of covariate data for 2007–2014 in Nicosia, Cyprus. The use of the GAM technique with multiple linear regression allowed for the continuous covariates of temperature and diurnal temperature range (DTR) to be modeled as smooth functions and the lag period was considered to relate mortality to lagged values of temperature. Our findings indicate that the previous three days’ temperatures were strongly predictive of mortality. The mortality risk decreased as the minimum temperature (Tmin) increased from the coldest days to a certain threshold temperature about 20–21°C (different for each age group and gender), above which the mortality risk increased as Tmin increased. The investigated fixed factors analysis showed an insignificant association of gender-mortality, whereas the age-mortality association showed that the population over 80 was more vulnerable to temperature variations. It was recommended that the minimum mortality temperature is calculated using the minimum daily temperatures because it has a stronger correlation to the probability for risk of mortality. It is still undetermined as to what degree a change in existing climatic conditions will increase the environmental stress to humans as the population is acclimatized to different climates with different threshold temperatures and minimum mortality temperatures.
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20
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Linares C, Díaz J, Negev M, Martínez GS, Debono R, Paz S. Impacts of climate change on the public health of the Mediterranean Basin population - Current situation, projections, preparedness and adaptation. ENVIRONMENTAL RESEARCH 2020; 182:109107. [PMID: 32069750 DOI: 10.1016/j.envres.2019.109107] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/24/2019] [Accepted: 12/31/2019] [Indexed: 05/04/2023]
Abstract
The Mediterranean Basin is undergoing a warming trend with longer and warmer summers, an increase in the frequency and the severity of heat waves, changes in precipitation patterns and a reduction in rainfall amounts. In this unique populated region, which is characterized by significant gaps in the socio-economic levels particularly between the North (Europe) and South (Africa), parallel with population growth and migration, increased water demand and forest fires risk - the vulnerability of the Mediterranean population to human health risks increases significantly. Indeed, climatic changes impact the health of the Mediterranean population directly through extreme heat, drought or storms, or indirectly by changes in water availability, food provision and quality, air pollution and other stressors. The main health effects are related to extreme weather events (including extreme temperatures and floods), changes in the distribution of climate-sensitive diseases and changes in environmental and social conditions. The poorer countries, particularly in North Africa and the Levant, are at highest risk. Climate change affects the vulnerable sectors of the region, including an increasingly older population, with a larger percentage of those with chronic diseases, as well as poor people, which are therefore more susceptible to the effects of extreme temperatures. For those populations, a better surveillance and control systems are especially needed. In view of the climatic projections and the vulnerability of Mediterranean countries, climate change mitigation and adaptation become ever more imperative. It is important that prevention Health Action Plans will be implemented, particularly in those countries that currently have no prevention plans. Most adaptation measures are "win-win situation" from a health perspective, including reducing air pollution or providing shading solutions. Additionally, Mediterranean countries need to enhance cross-border collaboration, as adaptation to many of the health risks requires collaboration across borders and also across the different parts of the basin.
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Affiliation(s)
- Cristina Linares
- National School of Public Health. Carlos III Institute of Health, Madrid, Spain
| | - Julio Díaz
- National School of Public Health. Carlos III Institute of Health, Madrid, Spain
| | - Maya Negev
- School of Public Health, University of Haifa, Israel
| | | | | | - Shlomit Paz
- Department of Geography and Environmental Studies, University of Haifa, Israel.
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21
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Zafeiratou S, Analitis A, Founda D, Giannakopoulos C, Varotsos KV, Sismanidis P, Keramitsoglou I, Katsouyanni K. Spatial Variability in the Effect of High Ambient Temperature on Mortality: An Analysis at Municipality Level within the Greater Athens Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193689. [PMID: 31575034 PMCID: PMC6801795 DOI: 10.3390/ijerph16193689] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/02/2019] [Accepted: 09/27/2019] [Indexed: 01/03/2023]
Abstract
Spatial variability in temperature exists within metropolitan areas but very few studies have investigated intra-urban differentiation in the temperature-mortality effects. We investigated whether local characteristics of 42 Municipalities within the Greater Athens Area lead to modified temperature effects on mortality and if effect modifiers can be identified. Generalized Estimating Equations models were used to assess the effect of high ambient temperature on the total and cause-specific daily number of deaths and meta-regression to investigate effect modification. We found significant effects of daily temperature increases on all-cause, cardiovascular, and respiratory mortality (e.g., for all ages 4.16% (95% CI: 3.73,4.60%) per 1 °C increase in daily temperature (lags 0–3). Heterogeneity in the effect estimates between Municipalities was observed in several outcomes and environmental and socio-economic effect modifying variables were identified, such as % area coverage of buildings, length of roads/km2, population density, % unemployed, % born outside the EU countries and mean daily temperature. To further examine the role of temperature, we alternatively used modelled temperature per Municipality and calculated the effects. We found that heterogeneity was reduced but not eliminated. It appears that there are socioeconomic status and environmental determinants of the magnitude of heat-related effects on mortality, which are detected with some consistency and should be further investigated.
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Affiliation(s)
- Sofia Zafeiratou
- Department of Hygiene and Epidemiology, University of Athens Medical School, Athens GR11527, Greece.
| | - Antonis Analitis
- Department of Hygiene and Epidemiology, University of Athens Medical School, Athens GR11527, Greece.
| | - Dimitra Founda
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens GR15236, Greece.
| | - Christos Giannakopoulos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens GR15236, Greece.
| | - Konstantinos V Varotsos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens GR15236, Greece.
| | - Panagiotis Sismanidis
- Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing, National Observatory of Athens, Athens GR15236, Greece.
| | - Iphigenia Keramitsoglou
- Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing, National Observatory of Athens, Athens GR15236, Greece.
| | - Klea Katsouyanni
- Department of Hygiene and Epidemiology, University of Athens Medical School, Athens GR11527, Greece.
- School of Population Health & Environmental Sciences, King's College London, London SE1 9NH, UK.
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22
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Díaz J, López-Bueno JA, Sáez M, Mirón IJ, Luna MY, Sánchez-Martínez G, Carmona R, Barceló MA, Linares C. Will there be cold-related mortality in Spain over the 2021-2050 and 2051-2100 time horizons despite the increase in temperatures as a consequence of climate change? ENVIRONMENTAL RESEARCH 2019; 176:108557. [PMID: 31265969 DOI: 10.1016/j.envres.2019.108557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/20/2019] [Accepted: 06/24/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Global warming is resulting in an increase in temperatures which is set to become more marked by the end of the century and depends on the accelerating pace of greenhouse gas emissions into the atmosphere. Yet even in this scenario, so-called "cold waves" will continue to be generated and have an impact on health. OBJECTIVES This study sought to analyse the impact of cold waves on daily mortality at a provincial level in Spain over the 2021-2050 and 2051-2100 time horizons under RCP4.5 and RCP 8.5 emission scenarios, on the basis of two hypotheses: (1) that the cold-wave definition temperature (T threshold) would not vary over time; and, (2) that there would be a variation in T threshold. MATERIAL AND METHODS The results of a retrospective study undertaken for Spain as a whole across the period 2000-2009 enabled us to ascertain the cold-wave definition temperature at a provincial level and its impact on health, measured by reference to population attributable risk (PAR). The minimum daily temperatures projected for each provincial capital considering the above time horizons and emission scenarios were provided by the State Meteorological Agency. On the basis of the T threshold definition values and minimum daily temperatures projected for each province, we calculated the expected impact of low temperatures on mortality under the above two hypotheses. Keeping the PAR values constant, it was assumed that the mortality rate would vary in accordance with the available data. RESULTS If T threshold remained constant over the above time horizons under both emission scenarios, there would be no cold-related mortality. If T threshold were assumed to vary over time, however, then cold-related mortality would not disappear: it would instead remain practically constant over time and give rise to an estimated overall figure of around 250 deaths per year, equivalent to close on a quarter of Spain's current annual cold-related mortality and entailing a cost of approximately €1000 million per year. CONCLUSION Given that cold waves are not going to disappear and that their impact on mortality is far from negligible and is likely to remain so, public health prevention measures must be implemented to minimise these effects as far as possible.
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Affiliation(s)
- J Díaz
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain.
| | - J A López-Bueno
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - M Sáez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Calle de la Universitat de Girona 10, Campus de Montilivi, 17003, Girona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Avda. Monforte de Lemos, 5, Pabellón 11, Planta Baja, 28029, Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health Authority (Consejería de Sanidad, Torrijos (Toledo), Spain
| | - M Y Luna
- State Meteorological Agency (Agencia Estatal de Meteorología/AEMET), Madrid, Spain
| | | | - R Carmona
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - M A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Calle de la Universitat de Girona 10, Campus de Montilivi, 17003, Girona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Avda. Monforte de Lemos, 5, Pabellón 11, Planta Baja, 28029, Madrid, Spain
| | - C Linares
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
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23
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Remigio RV, Jiang C, Raimann J, Kotanko P, Usvyat L, Maddux FW, Kinney P, Sapkota A. Association of Extreme Heat Events With Hospital Admission or Mortality Among Patients With End-Stage Renal Disease. JAMA Netw Open 2019; 2:e198904. [PMID: 31397862 PMCID: PMC6692691 DOI: 10.1001/jamanetworkopen.2019.8904] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 12/11/2022] Open
Abstract
Importance Extreme heat events (EHEs) are increasing in frequency, duration, and intensity, and this trend is projected to continue as part of ongoing climate change. There is a paucity of data regarding how EHEs may affect highly vulnerable populations, such as patients with end-stage renal disease (ESRD). Such data are needed to inform ESRD patient management guidelines in a changing climate. Objectives To investigate the association between EHEs and the risk of hospital admission or mortality among patients with ESRD and further characterize how this risk may vary among races/ethnicities or patients with preexisting comorbidities. Design, Setting, and Participants This study used hospital admission and mortality records of patients with ESRD who underwent hemodialysis treatment at Fresenius Kidney Care clinics in Boston, Massachusetts; Philadelphia, Pennsylvania; or New York, New York, from January 1, 2001, to December 31, 2012. Data were analyzed using a time-stratified case-crossover design with conditional Poisson regression to investigate associations between EHEs and risk of hospital admission or mortality among patients with ESRD. Data were analyzed from July 1, 2017, to March 31, 2019. Exposures Calendar day- and location-specific 95th-percentile maximum temperature thresholds were calculated using daily meteorological data from 1960 to 1989. These thresholds were used to identify EHEs in each of the 3 cities during the study. Main Outcomes and Measures Daily all-cause hospital admission and all-cause mortality among patients with ESRD. Results The study included 7445 patients with ESRD (mean [SD] age, 61.1 [14.1] years; 4283 [57.5%] men), among whom 2953 deaths (39.7%) and 44 941 hospital admissions (mean [SD], 6.0 [7.5] per patient) were recorded. Extreme heat events were associated with increased risk of same-day hospital admission (rate ratio [RR], 1.27; 95% CI, 1.13-1.43) and same-day mortality (RR, 1.31; 95% CI, 1.01-1.70) among patients with ESRD. There was some heterogeneity in risk, with patients in Boston showing statistically significant increased risk for hospital admission (RR, 1.15; 95% CI, 1.00-1.31) and mortality (RR, 1.45; 95% CI, 1.04-2.02) associated with cumulative exposure to EHEs, while such risk was absent among patients with ESRD in Philadelphia. While increases in risks were similar among non-Hispanic black and non-Hispanic white patients, findings among Hispanic and Asian patients were less clear. After stratifying by preexisting comorbidities, cumulative lag exposure to EHEs was associated with increased risk of mortality among patients with ESRD living with congestive heart failure (RR, 1.55; 95% CI, 1.27-1.89), chronic obstructive pulmonary disease (RR, 1.60; 95% CI, 1.24-2.06), or diabetes (RR, 1.83; 95% CI, 1.51-2.21). Conclusions and Relevance In this study, extreme heat events were associated with increased risk of hospital admission or mortality among patients with ESRD, and the association was potentially affected by geographic region and race/ethnicity. Future studies with larger populations and broader geographic coverage are needed to better characterize this variability in risk and inform ESRD management guidelines and differential risk variables, given the projected increases in the frequency, duration, and intensity of EHEs.
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Affiliation(s)
- Richard V. Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Jochen Raimann
- Research Division, Renal Research Institute, New York, New York
| | - Peter Kotanko
- Research Division, Renal Research Institute, New York, New York
- Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Len Usvyat
- Research Division, Renal Research Institute, New York, New York
| | - Frank W. Maddux
- Research Division, Renal Research Institute, New York, New York
| | - Patrick Kinney
- School of Public Health, Boston University, Boston, Massachusetts
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
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Milner J, Harpham C, Taylor J, Davies M, Le Quéré C, Haines A, Wilkinson P. The Challenge of Urban Heat Exposure under Climate Change: An Analysis of Cities in the Sustainable Healthy Urban Environments (SHUE) Database. CLIMATE 2019; 5:93. [PMID: 31285999 PMCID: PMC6614032 DOI: 10.3390/cli5040093] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The so far largely unabated emissions of greenhouse gases (GHGs) are expected to increase global temperatures substantially over this century. We quantify the patterns of increases for 246 globally-representative cities in the Sustainable Healthy Urban Environments (SHUE) database. We used an ensemble of 18 global climate models (GCMs) run under a low (RCP2.6) and high (RCP8.5) emissions scenario to estimate the increase in monthly mean temperatures by 2050 and 2100 based on 30-year averages. Model simulations were from the Coupled Model Inter-comparison Project Phase 5 (CMIP5). Annual mean temperature increases were 0.93 degrees Celsius by 2050 and 1.10 degrees Celsius by 2100 under RCP2.6, and 1.27 and 4.15 degrees Celsius under RCP8.5, but with substantial city-to-city variation. By 2100, under RCP2.6 no city exceeds an increase in Tmean > 2 degrees Celsius (relative to a 2017 baseline), while all do under RCP8.5, some with increases in Tmean close to, or even greater than, 7 degrees Celsius. The increases were greatest in cities of mid to high latitude, in humid temperate and dry climate regions, and with large seasonal variation in temperature. Cities are likely to experience large increases in hottest month mean temperatures under high GHG emissions trajectories, which will often present substantial challenges to adaptation and health protection.
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Affiliation(s)
- James Milner
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
- Correspondence: ; Tel.: +44-020-7927-2510
| | - Colin Harpham
- Climatic Research Unit, School of Environmental Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
| | - Jonathon Taylor
- UCL Institute for Environmental Design & Engineering, University College London, Central House, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Mike Davies
- UCL Institute for Environmental Design & Engineering, University College London, Central House, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Corinne Le Quéré
- Tyndall Centre for Climate Change Research, School of Environmental Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
| | - Andy Haines
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Paul Wilkinson
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
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Macintyre HL, Heaviside C. Potential benefits of cool roofs in reducing heat-related mortality during heatwaves in a European city. ENVIRONMENT INTERNATIONAL 2019; 127:430-441. [PMID: 30959308 DOI: 10.1016/j.envint.2019.02.065] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/25/2019] [Accepted: 02/25/2019] [Indexed: 06/09/2023]
Abstract
Hot weather can exacerbate health conditions such as cardiovascular and respiratory diseases, and lead to heat stroke and death. In built up areas, temperatures are commonly observed to be higher than those in surrounding rural areas, due to the Urban Heat Island (UHI) effect. Climate change and increasing urbanisation mean that future populations are likely to be at increased risk of overheating in cities, although building and city scale interventions have the potential to reduce this risk. We use a regional weather model to assess the potential effect of one type of urban intervention - reflective 'cool' roofs - to reduce local ambient temperatures, and the subsequent impact on heat-related mortality in the West Midlands, UK, with analysis undertaken for the summer of 2006, as well as two shorter heatwave periods in 2006 and 2003. We show that over a summer season, the population-weighted UHI intensity (the difference between simulated urban and rural temperature) was 1.1 °C on average, but 1.8 °C when including only night times, and reached a maximum of 9 °C in the West Midlands. Our results suggest that the UHI contributes up to 40% of heat related mortality over the summer period and that cool roofs implemented across the whole city could potentially offset 18% of seasonal heat-related mortality associated with the UHI (corresponding to 7% of total heat-related mortality). For heatwave periods, our modelling suggests that cool roofs could reduce city centre daytime 2 m air temperature by 0.5 °C on average, and up to a maximum of ~3 °C. Cool roofs reduced average UHI intensity by ~23%, and reduced heat related mortality associated with the UHI by ~25% during a heatwave. Cool roofs were most effective at reducing peak temperatures during the daytime, and therefore have the potential to limit dangerous extreme temperatures during heatwaves. Temperature reductions were dependent on the category of buildings where cool roofs were applied; targeting only commercial and industrial type buildings contributed more than half of the reduction for heatwave periods. Our modelling suggested that modifying half of all industrial/commercial urban buildings could have the same impact as modifying all high-intensity residential buildings in the West Midlands.
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Affiliation(s)
- H L Macintyre
- Chemicals and Environmental Effects Department, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - C Heaviside
- Chemicals and Environmental Effects Department, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; Environmental Change Institute, University of Oxford, OX1 3QY, UK
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26
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López-Bueno JA, Díaz J, Linares C. Differences in the impact of heat waves according to urban and peri-urban factors in Madrid. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:371-380. [PMID: 30694395 DOI: 10.1007/s00484-019-01670-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/02/2019] [Accepted: 01/02/2019] [Indexed: 06/09/2023]
Abstract
Aside from climatic factors, the impact of heat waves on mortality depends on the demographic and socio-economic structure of the population as well as variables relating to local housing. Hence, this study's main aim was to ascertain whether there might be a differential impact of heat waves on daily mortality by area of residence. The study is a time-series analysis (2000-2009) of daily mortality and minimum and maximum daily temperatures (°C) in five geographical areas of the Madrid region. The impact of such waves on heat-related mortality due to natural causes (ICD-10: A00- R99), circulatory causes (ICD-10: I00-I99) and respiratory causes (ICD-10: J00-J99) was obtained by calculating the relative risk (RR) and attributable risk (AR), using GLM models with the Poisson link and controlling for trend, seasonalities and the autoregressive nature of the series. Furthermore, we also evaluated other external variables, such as the percentage of the population aged over 65 years and the percentage of old housing. No heat-related mortality threshold temperature with statistical significance was detected in the northern and eastern areas. While the threshold temperatures in the central and southern areas were very similar and close to the 90th percentile, the threshold in the western area corresponded to the 97th percentile. Attributable mortality proved to be highest in the central area with 85 heat wave-related deaths per annum. External factors found to influence the impact of heat on mortality in Madrid were the size of the population aged over 65 years and the age of residential housing. Demographic structure and the percentage of old housing play a key role in modulating the impact of heat waves. This study concludes that the areas in which heat acts earliest are those having a higher degree of population ageing.
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Affiliation(s)
- J A López-Bueno
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - J Díaz
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain.
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain.
| | - C Linares
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
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Jänicke B, Holtmann A, Kim KR, Kang M, Fehrenbach U, Scherer D. Quantification and evaluation of intra-urban heat-stress variability in Seoul, Korea. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1-12. [PMID: 30460432 DOI: 10.1007/s00484-018-1631-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 10/03/2018] [Accepted: 10/07/2018] [Indexed: 06/09/2023]
Abstract
This study quantifies heat-stress hazard (air temperature), vulnerability (heat vulnerability index and age score), and risk (heat-related mortality) on the district scale in Seoul, Korea, for a comprehensive heat-stress impact assessment. Moreover, the heat-stress impact assessment is evaluated by checking the spatial consistency between heat-stress hazard, vulnerability, and risk, which was rarely done before. We applied numerical and geo-empirical models to simulate the spatial pattern of heat-stress hazard. For heat-stress vulnerability, we used demographic and socioeconomic factors. Heat-related mortality was estimated based on an event-based heat-stress risk analysis. Results are that heat-stress hazard, vulnerability, and risk are spatially variable in Seoul. The highest heat-stress hazard was detected in the districts Mapo, Yeongdeungpo, and Yangcheon, the highest vulnerability in Jongno and the highest risk in Jongno and Yangcheon. The different components (heat-stress hazard, vulnerability, and risk) and variables (heat vulnerability index and percentage of seniors) showed different spatial patterns. Knowledge about the causes of higher heat-stress risk, either the hazard or vulnerability, is helpful to design tailored adaptation measures that focus on the reduction of thermal loads or on the preparation of the vulnerable population. The evaluation showed that heat-stress vulnerability and hazard explain the spatial pattern of risk only partly. This highlights the need to evaluate heat-stress impact assessment systems to produce reliable urban heat-stress maps.
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Affiliation(s)
- Britta Jänicke
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea.
| | - Achim Holtmann
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
| | - Kyu Rang Kim
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea
| | - Misun Kang
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea
| | - Ute Fehrenbach
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
| | - Dieter Scherer
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
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Armstrong B, Bonnington O, Chalabi Z, Davies M, Doyle Y, Goodwin J, Green J, Hajat S, Hamilton I, Hutchinson E, Mavrogianni A, Milner J, Milojevic A, Picetti R, Rehill N, Sarran C, Shrubsole C, Symonds P, Taylor J, Wilkinson P. The impact of home energy efficiency interventions and winter fuel payments on winter- and cold-related mortality and morbidity in England: a natural equipment mixed-methods study. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
England, and the UK more generally, has a large burden of winter- and cold-related mortality/morbidity in comparison with nearby countries in continental Europe. Improving the energy efficiency of the housing stock may help to reduce this, as well as being important for climate change and energy security objectives.
Objectives
To evaluate the impact of home energy efficiency (HEE) interventions on winter- and cold-related mortality/morbidity, including assessing the impact of winter fuel payments (WFPs) and fuel costs.
Design
A mixed-methods study – an epidemiological time-series analysis, an analysis of data on HEE interventions, the development and application of modelling methods including a multicriteria decision analysis and an in-depth interview study of householders.
Setting
England, UK.
Participants
The population of England. In-depth interviews were conducted with 12 households (2–4 participants each) and 41 individuals in three geographical regions.
Interventions
HEE interventions.
Main outcome measures
Mortality, morbidity and intervention-related changes to the home indoor environment.
Data sources
The Homes Energy Efficiency Database, mortality and hospital admissions data and weather (temperature) data.
Results
There has been a progressive decline in cold-related deaths since the mid-1970s. Since the introduction of WFPs, the gradient of association between winter cold and mortality [2.00%, 95% confidence interval (CI) 1.74% to 2.28%] per degree Celsius fall in temperature is somewhat weaker (i.e. that the population is less vulnerable to cold) than in earlier years (2.37%, 95% CI 0.22% to 2.53%). There is also evidence that years with above-average fuel costs were associated with higher vulnerability to outdoor cold. HEE measures installed in England in 2002–10 have had a relatively modest impact in improving the indoor environment. The gains in winter temperatures (around +0.09 °C on a day with maximum outdoor temperature of 5 °C) are associated with an estimated annual reduction of ≈280 cold-related deaths in England (an eventual maximum annual impact of 4000 life-years gained), but these impacts may be appreciably smaller than those of changes in indoor air quality. Modelling studies indicate the potential importance of the medium- and longer-term impacts that HEE measures have on health, which are not observable in short-term studies. They also suggest that HEE improvements of similar annualised cost to current WFPs would achieve greater improvements in health while reducing (rather than increasing) carbon dioxide emissions. In-depth interviews suggest four distinct householder framings of HEE measures (as home improvement, home maintenance, subsidised public goods and contributions to sustainability), which do not dovetail with current ‘consumerist’ national policy and may have implications for the uptake of HEE measures.
Limitations
The quantification of intervention impacts in this national study is reliant on various indirect/model-based assessments.
Conclusions
Larger-scale changes are required to the housing stock in England if the full potential benefits for improving health and for reaching increasingly important climate change mitigation targets are to be realised.
Future work
Studies based on data linkage at individual dwelling level to examine health impacts. There is a need for empirical assessment of HEE interventions on indoor air quality.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 11. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ben Armstrong
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Oliver Bonnington
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Zaid Chalabi
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | | | - James Goodwin
- Design School, Loughborough University, Loughborough, UK
- Energy Institute, University College London, London, UK
| | - Judith Green
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Shakoor Hajat
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Emma Hutchinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Mavrogianni
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - James Milner
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ai Milojevic
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Roberto Picetti
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Nirandeep Rehill
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Clive Shrubsole
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Phil Symonds
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Jonathon Taylor
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Wilkinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Abstract
PURPOSE OF REVIEW The Urban Heat Island (UHI) is a well-studied phenomenon, whereby urban areas are generally warmer than surrounding suburban and rural areas. The most direct effect on health from the UHI is due to heat risk, which is exacerbated in urban areas, particularly during heat waves. However, there may be health benefits from warming during colder months. This review highlights recent attempts to quantitatively estimate the health impacts of the UHI and estimations of the health benefits of UHI mitigation measures. RECENT FINDINGS Climate change, increasing urbanisation and an ageing population in much of the world, is likely to increase the risks to health from the UHI, particularly from heat exposure. Studies have shown increased health risks in urban populations compared with rural or suburban populations in hot weather and a disproportionate impact on more vulnerable social groups. Estimations of the impacts of various mitigation techniques suggest that a range of measures could reduce health impacts from heat and bring other benefits to health and wellbeing. The impact of the UHI on heat-related health is significant, although often overlooked, particularly when considering future impacts associated with climate change. Multiple factors should be considered when designing mitigation measures in urban environments in order to maximise health benefits and avoid unintended negative effects.
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Schinasi LH, Benmarhnia T, De Roos AJ. Modification of the association between high ambient temperature and health by urban microclimate indicators: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2018; 161:168-180. [PMID: 29149680 DOI: 10.1016/j.envres.2017.11.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 05/12/2023]
Abstract
BACKGROUND Landscape characteristics, including vegetation and impervious surfaces, influence urban microclimates and may lead to within-city differences in the adverse health effects of high ambient temperatures. OBJECTIVE Our objective was to quantitatively summarize the epidemiologic literature that assessed microclimate indicators as effect measure modifiers (EMM) of the association between ambient temperature and mortality or morbidity. METHODS We systematically identified papers and abstracted relative risk estimates for hot and cool microclimate indicator strata. We calculated the ratio of the relative risks (RRR) and 95% confidence intervals (95% CI) to assess differences in health effects across strata, and pooled the RRR estimates using random effects meta-analyses. RESULTS Eleven papers were retained. In the pooled analyses, people living in hotter areas within cities (based on land surface temperature or modeled estimates of air temperature) had 6% higher risk of mortality/morbidity compared to those in cooler areas (95% CI: 1.03-1.09). Those living in less vegetated areas had 5% higher risk compared to those living in more vegetated areas (95% CI: 1.00-1.11). DISCUSSION There is epidemiologic evidence that those living in hotter, and less vegetated areas of cities have higher risk of morbidity or mortality from higher ambient temperature. Further research with improved assessment of landscape characteristics and investigation of the joint effects of physiologic adaptation and landscape will advance the current understanding. CONCLUSION This review provides quantitative evidence that intra-urban differences in landscape characteristics and micro-urban heat islands contribute to within-city variability in the health effects of high ambient temperatures.
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Affiliation(s)
- Leah H Schinasi
- Drexel University, Dornsife School of Public Health, Department of Environmental and Occupational Health, UC San Diego, United States.
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, UC San Diego, United States
| | - Anneclaire J De Roos
- Drexel University, Dornsife School of Public Health, Department of Environmental and Occupational Health, UC San Diego, United States
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31
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Anderson GB, Oleson KW, Jones B, Peng RD. Projected trends in high-mortality heatwaves under different scenarios of climate, population, and adaptation in 82 US communities. CLIMATIC CHANGE 2018; 146:455-470. [PMID: 29628541 PMCID: PMC5881935 DOI: 10.1007/s10584-016-1779-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 08/17/2016] [Indexed: 05/23/2023]
Abstract
Some rare heatwaves have extreme daily mortality impacts; moderate heatwaves have lower daily impacts but occur much more frequently at present and so account for large aggregated impacts. We applied health-based models to project trends in high-mortality heatwaves, including proportion of all heatwaves expected to be high-mortality, using the definition that a high-mortality heatwave increases mortality risk by ≥20 %. We projected these trends in 82 US communities in 2061-2080 under two scenarios of climate change (RCP4.5, RCP8.5), two scenarios of population change (SSP3, SSP5), and three scenarios of community adaptation to heat (none, lagged, on-pace) for large- and medium-ensemble versions of the National Center for Atmospheric Research's Community Earth System Model. More high-mortality heatwaves were expected compared to present under all scenarios except on-pace adaptation, and population exposure was expected to increase under all scenarios. At least seven more high-mortality heatwaves were expected in a twenty-year period in the 82 study communities under RCP8.5 than RCP4.5 when assuming no adaptation. However, high-mortality heatwaves were expected to remain <1 % of all heatwaves and heatwave exposure under all scenarios. Projections were most strongly influenced by the adaptation scenario- going from a scenario of on-pace to lagged adaptation or from lagged to no adaptation more than doubled the projected number of and exposure to high-mortality heatwaves. Based on our results, fewer high-mortality heatwaves are expected when following RCP4.5 versus RCP8.5 and under higher levels of adaptation, but high-mortality heatwaves are expected to remain a very small proportion of total heatwave exposure.
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Affiliation(s)
- G. Brooke Anderson
- Department of Environmental & Radiological Health Sciences, Colorado State University, Lake Street, Fort Collins, CO 80521, USA
| | | | - Bryan Jones
- CUNY Institute for Demographic Research, New York, NY, USA
| | - Roger D. Peng
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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32
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Dang TN, Van DQ, Kusaka H, Seposo XT, Honda Y. Green Space and Deaths Attributable to the Urban Heat Island Effect in Ho Chi Minh City. Am J Public Health 2017; 108:S137-S143. [PMID: 29072938 DOI: 10.2105/ajph.2017.304123] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To quantify heat-related deaths in Ho Chi Minh City, Vietnam, caused by the urban heat island (UHI) and explore factors that may alleviate the impact of UHIs. METHODS We estimated district-specific meteorological conditions from 2010 to 2013 using the dynamic downscaling model and calculated the attributable fraction and number of mortalities resulting from the total, extreme, and mild heat in each district. The difference in attributable fraction of total heat between the central and outer districts was classified as the attributable fraction resulting from the UHI. The association among attributable fraction, attributable number with a green space, population density, and budget revenue of each district was then explored. RESULTS The temperature-mortality relationship between the central and outer areas was almost identical. The attributable fraction resulting from the UHI was 0.42%, which was contributed by the difference in temperature distribution between the 2 areas. Every 1-square-kilometer increase in green space per 1000 people can prevent 7.4 deaths caused by heat. CONCLUSIONS Green space can alleviate the impacts of UHIs, although future studies conducting a heath economic evaluation of tree planting are warranted.
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Affiliation(s)
- Tran Ngoc Dang
- Tran Ngoc Dang is with the Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam, and the Institute of Research and Development, Duy Tan University, Da Nang City, Vietnam. Doan Quang Van and Hiroyuki Kusaka are with the Center for Computational Sciences, University of Tsukuba, Tsukuba, Japan. Xerxes T. Seposo is with the Department of Environmental Engineering, Kyoto University, Kyoto, Japan. Yasushi Honda is with the Faculty of Health and Sport Sciences, University of Tsukuba
| | - Doan Quang Van
- Tran Ngoc Dang is with the Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam, and the Institute of Research and Development, Duy Tan University, Da Nang City, Vietnam. Doan Quang Van and Hiroyuki Kusaka are with the Center for Computational Sciences, University of Tsukuba, Tsukuba, Japan. Xerxes T. Seposo is with the Department of Environmental Engineering, Kyoto University, Kyoto, Japan. Yasushi Honda is with the Faculty of Health and Sport Sciences, University of Tsukuba
| | - Hiroyuki Kusaka
- Tran Ngoc Dang is with the Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam, and the Institute of Research and Development, Duy Tan University, Da Nang City, Vietnam. Doan Quang Van and Hiroyuki Kusaka are with the Center for Computational Sciences, University of Tsukuba, Tsukuba, Japan. Xerxes T. Seposo is with the Department of Environmental Engineering, Kyoto University, Kyoto, Japan. Yasushi Honda is with the Faculty of Health and Sport Sciences, University of Tsukuba
| | - Xerxes T Seposo
- Tran Ngoc Dang is with the Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam, and the Institute of Research and Development, Duy Tan University, Da Nang City, Vietnam. Doan Quang Van and Hiroyuki Kusaka are with the Center for Computational Sciences, University of Tsukuba, Tsukuba, Japan. Xerxes T. Seposo is with the Department of Environmental Engineering, Kyoto University, Kyoto, Japan. Yasushi Honda is with the Faculty of Health and Sport Sciences, University of Tsukuba
| | - Yasushi Honda
- Tran Ngoc Dang is with the Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam, and the Institute of Research and Development, Duy Tan University, Da Nang City, Vietnam. Doan Quang Van and Hiroyuki Kusaka are with the Center for Computational Sciences, University of Tsukuba, Tsukuba, Japan. Xerxes T. Seposo is with the Department of Environmental Engineering, Kyoto University, Kyoto, Japan. Yasushi Honda is with the Faculty of Health and Sport Sciences, University of Tsukuba
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Milojevic A, Niedzwiedz CL, Pearce J, Milner J, MacKenzie IA, Doherty RM, Wilkinson P. Socioeconomic and urban-rural differentials in exposure to air pollution and mortality burden in England. Environ Health 2017; 16:104. [PMID: 28985761 PMCID: PMC6389046 DOI: 10.1186/s12940-017-0314-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/02/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Socioeconomically disadvantaged populations often have higher exposures to particulate air pollution, which can be expected to contribute to differentials in life expectancy. We examined socioeconomic differentials in exposure and air pollution-related mortality relating to larger scale (5 km resolution) variations in background concentrations of selected pollutants across England. METHODS Ozone and particulate matter (sub-divided into PM10, PM2.5, PM2.5-10, primary, nitrate and sulphate PM2.5) were simulated at 5 km horizontal resolution using an atmospheric chemistry transport model (EMEP4UK). Annual mean concentrations of these pollutants were assigned to all 1,202,578 residential postcodes in England, which were classified by urban-rural status and socioeconomic deprivation based on the income and employment domains of the 2010 English Index of Multiple Deprivation for the Lower-level Super Output Area of residence. We used life table methods to estimate PM2.5-attributable life years (LYs) lost in both relative and absolute terms. RESULTS Concentrations of the most particulate fractions, but not of nitrate PM2.5 or ozone, were modestly higher in areas of greater socioeconomic deprivation. Relationships between pollution level and socioeconomic deprivation were non-linear and varied by urban-rural status. The pattern of PM2.5 concentrations made only a small contribution to the steep socioeconomic gradient in LYs lost due to PM2.5 per 103 population, which primarily was driven by the steep socioeconomic gradient in underlying mortality rates. In rural areas, the absolute burden of air pollution-related LYs lost was lowest in the most deprived deciles. CONCLUSIONS Air pollution shows modest socioeconomic patterning at 5 km resolution in England, but absolute attributable mortality burdens are strongly related to area-level deprivation because of underlying mortality rates. Measures that cause a general reduction in background concentrations of air pollution may modestly help narrow socioeconomic differences in health.
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Affiliation(s)
- Ai Milojevic
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Claire L. Niedzwiedz
- Centre for Research on Environment Society and Health, School of GeoSciences, University of Edinburgh, Drummond Street, Edinburgh, EH8 9XP UK
| | - Jamie Pearce
- Centre for Research on Environment Society and Health, School of GeoSciences, University of Edinburgh, Drummond Street, Edinburgh, EH8 9XP UK
| | - James Milner
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Ian A. MacKenzie
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh, EH9 3FE UK
| | - Ruth M. Doherty
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh, EH9 3FE UK
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
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Benmarhnia T, Kihal-Talantikite W, Ragettli MS, Deguen S. Small-area spatiotemporal analysis of heatwave impacts on elderly mortality in Paris: A cluster analysis approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 592:288-294. [PMID: 28319715 DOI: 10.1016/j.scitotenv.2017.03.102] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/21/2017] [Accepted: 03/10/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Heat-waves have a substantial public health burden. Understanding spatial heterogeneity at a fine spatial scale in relation to heat and related mortality is central to target interventions towards vulnerable communities. OBJECTIVES To determine the spatial variability of heat-wave-related mortality risk among elderly in Paris, France at the census block level. We also aimed to assess area-level social and environmental determinants of high mortality risk within Paris. METHODS We used daily mortality data from 2004 to 2009 among people aged >65 at the French census block level within Paris. We used two heat wave days' definitions that were compared to non-heat wave days. A Bernoulli cluster analysis method was applied to identify high risk clusters of mortality during heat waves. We performed random effects meta-regression analyses to investigate factors associated with the magnitude of the mortality risk. RESULTS The spatial approach revealed a spatial aggregation of death cases during heat wave days. We found that small scale chronic PM10 exposure was associated with a 0.02 (95% CI: 0.001; 0.045) increase of the risk of dying during a heat wave episode. We also found a positive association with the percentage of foreigners and the percentage of labor force, while the proportion of elderly people living in the neighborhood was negatively associated. We also found that green space density had a protective effect and inversely that the density of constructed feature increased the risk of dying during a heat wave episode. CONCLUSION We showed that a spatial variation in terms of heat-related vulnerability exists within Paris and that it can be explained by some contextual factors. This study can be useful for designing interventions targeting more vulnerable areas and reduce the burden of heat waves.
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Affiliation(s)
- Tarik Benmarhnia
- Department of Family Medicine and Public Health, Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
| | | | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland
| | - Séverine Deguen
- EHESP School of Public Health-Rennes, Sorbonne-Paris Cité, France
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