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Zeng S, Liu H, Li B, Guo X, Chen S, Li X, Liang J, Liang H, Shen T, Long Y, Zhou H, Zhang D. Association of air temperature exposure during pregnancy with risk of preeclampsia in Guangzhou, China. ENVIRONMENT INTERNATIONAL 2024; 186:108646. [PMID: 38615543 DOI: 10.1016/j.envint.2024.108646] [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: 01/25/2024] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
Environmental exposures during pregnancy have been associated with adverse obstetric outcomes. However, limited and inconsistent evidence exists regarding the association between air temperature exposure and the risk of preeclampsia (PE). This study aimed to evaluate the correlation between ambient temperature exposure during pregnancy and PE risk, as well as identify the specific time window of temperature exposure that increases PE risk. A population-based cohort study was conducted from January 2012 to April 2022 in Guangzhou, China. Pregnant women were recruited in early pregnancy and followed until delivery. A total of 3,314 PE patients and 114,201 normal pregnancies were included. Ambient temperature exposures at different gestational weeks were recorded for each participant. Logistic regression models were used to evaluate the correlation between ambient temperature exposure and PE risk. Stratified analyses were conducted based on maternal age and pre-pregnancy BMI. Distributed lag models were employed to identify the time window of temperature exposure related to PE. Exposure to extreme high temperature (aOR = 1.24, 95 % CI 1.12-1.38) and moderate high temperature (aOR = 1.22, 95 % CI 1.10-1.35) during early pregnancy was associated with an increased risk of PE. Furthermore, women with higher pre-pregnancy BMI had a higher risk of developing PE when exposed to high temperature during early pregnancy compared to normal-weight women. The time window of temperature exposure related to PE was identified as pregnancy weeks 1 to 8. This study provides evidence for the association of high temperature exposure during early pregnancy with the risk of PE, as well as identifies the specific time window of temperature exposure related to PE. These findings have implications for developing potential strategies to protect pregnant women, particularly those with higher pre-pregnancy BMI, from the adverse effects of extreme temperatures during early pregnancy.
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Affiliation(s)
- Shanshui Zeng
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China; Department of Laboratory Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, People's Republic of China
| | - Haojing Liu
- Department of Health Management, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China
| | - Bingyu Li
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China
| | - Xuanjie Guo
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China
| | - Shulei Chen
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China
| | - Xuyu Li
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China
| | - Jiarui Liang
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China
| | - Huaaishi Liang
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China
| | - Tingting Shen
- Medicine Laboratory, NanFang Hospital, Southern Medical University, Guangzhou, 510515, People's Republic of China
| | - Yan Long
- Department of Laboratory Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, People's Republic of China.
| | - Hongwei Zhou
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China.
| | - Dongxin Zhang
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China.
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Atkin K, Christopulos G, Turk R, Bernhardt JM, Simmonds K. Educating Pregnant Women About the Dangers of Extreme Heat and Air Pollution. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(24)00007-8. [PMID: 38346676 DOI: 10.1016/j.jogn.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/11/2024] [Accepted: 01/19/2024] [Indexed: 06/22/2024] Open
Abstract
Climate change poses a serious threat to the health and well-being of pregnant women and their developing fetuses. Certain populations are at greater risk of adverse outcomes from air pollution, a contributing factor to climate change. In addition, heightened exposure to extreme heat, a consequence of climate change, exacerbates the existing health care inequities in the United States. Nurses, midwives, and other health care clinicians are uniquely positioned to reduce the harmful effects of climate change by educating pregnant women and their families and advocating for systems and policies that can decelerate climate change. The purpose of this article is to provide resources for clinicians to use in educating pregnant women about the risks of extreme heat and air pollution, their potential effects on pregnancy and neonatal outcomes, and strategies to help mitigate risk. We conclude with implications for practice, opportunities for advocacy, and areas for future research.
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Afzal F, Das A, Chatterjee S. Drawing the Linkage Between Women's Reproductive Health, Climate Change, Natural Disaster, and Climate-driven Migration: Focusing on Low- and Middle-income Countries - A Systematic Overview. Indian J Community Med 2024; 49:28-38. [PMID: 38425973 PMCID: PMC10900460 DOI: 10.4103/ijcm.ijcm_165_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/06/2023] [Indexed: 03/02/2024] Open
Abstract
Background One of the most important aspects of women's well-being and welfare is RSH (reproductive and sexual health). Reproductive health is not an exception to the threat that CCC (climate change and climate crisis) poses to numerous facets of public health. Firstly, the present review seeks to identify the influence of climatic changes, natural disasters, and climate-driven migration on RSH. Secondly, to identify knowledge gaps regarding the same. Material and Methods Two databases (Scopus and PubMed) were scanned using Boolean operation. The literature search aimed to find records pertaining to topics of RSH and climate change. Using the PRISMA-ScR method, records were screened and shortlisted based on established inclusion criteria. This literature search was carried out in November 2022. In the shortlisted records, preference for the comprehensive review articles was given. Results The present review is based on 38 records that collectively revealed that climate crisis and natural disasters have many negative impacts on female reproductive health. These effects are observed in different phases of life, ranging from teenage to menopause. The unique strength of the present review is that it draws a relationship between female reproductive health and the direct as well as indirect effects of the CCC. The available literature about LMICs is predominantly confined to drought, flood, and earthquake. Disasters like tsunamis, cyclones, and avalanches remain unexplored. Conclusion From the available literature, it is quite evident that CCC has an adverse effect on a woman's reproductive life as well as a bearing on future generations' health. Filling these knowledge gaps is pivotal for designing more effective disaster and health policies. Policymakers should take into consideration these detrimental effects while designing health schemes and policies for females.
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Affiliation(s)
- Fahad Afzal
- Institute of Health Management Research, IIHMR University, Jaipur, Rajasthan, India
| | - Arindam Das
- Institute of Health Management Research, IIHMR University, Jaipur, Rajasthan, India
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Singh T, Jalaludin B, Hajat S, Morgan GG, Meissner K, Kaldor J, Green D, Jegasothy E. Acute air pollution and temperature exposure as independent and joint triggers of spontaneous preterm birth in New South Wales, Australia: a time-to-event analysis. Front Public Health 2023; 11:1220797. [PMID: 38098836 PMCID: PMC10720724 DOI: 10.3389/fpubh.2023.1220797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/23/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Exposure to high ambient temperatures and air pollution has been shown to increase the risk of spontaneous preterm birth (sPTB). Less clear are the effects of cold and the joint effects of air pollution and temperature. Methods Using a Cox proportional hazard regression model, we assessed the risk of independent and combined short-term exposure to ambient daily mean temperature and PM2.5 associated with sPTB in the last week before delivery on overall sPTB (weeks 23-36) and three subtypes: extremely sPTB, very sPTB, and moderate-to-late sPTB for a birth cohort of 1,318,570 births from Australia (Jan 2001-Dec 2019), while controlling for chronic exposure (i.e., throughout pregnancy except the last week before delivery) to PM2.5 and temperature. The temperature was modeled as a natural cubic spline, PM2.5 as a linear term, and the interaction effect was estimated using a multiplicative term. For short-term exposure to temperature hazard ratios reported are relative to the median temperature (18.1°C). Results Hazard ratios at low temperature [5th percentile(11.5°C)] were 0.95 (95% CI: 0.90, 1.00), 1.08 (95% CI: 0.84, 1.4), 0.87 (95% CI: 0.71, 1.06), and 1.00 (95% CI: 0.94, 1.06) and greater for high temperature [95th percentile (24.5°C)]: 1.22 (95% CI: 1.16, 1.28), 1.27 (95% CI: 1.03, 1.57), and 1.26 (95% CI: 1.05, 1.5) and 1.05 (1.00, 1.11), respectively, for overall, extremely, very, and moderate-to-late sPTBs. While chronic exposure to PM2.5 had adverse effects on sPTB, short-term exposure to PM2.5 appeared to have a negative association with all types of sPTB, with hazard ratios ranging from 0.86 (95th CI: 0.80, 0.94) to 0.98 (95th CI: 0.97, 1.00) per 5 μg/m3 increase in PM2.5. Discussion The risk of sPTB was found to increase following acute exposure to hot and cold ambient temperatures. Earlier sPTB subtypes seemed to be the most vulnerable. This study adds to the evidence that short-term exposure to ambient cold and heat and longer term gestational exposure to ambient PM2.5 are associated with an elevated risk of sPTB.
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Affiliation(s)
- Tanya Singh
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Kensington, NSW, Australia
- Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Geoffrey G. Morgan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Lismore, NSW, Australia
- Healthy Environments and Lives (HEAL) National Research Network, Australian National University, Canberra, ACT, Australia
- Centre for Air Pollution, Energy and Health Research (CAR), Glebe, NSW, Australia
| | - Katrin Meissner
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Donna Green
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - Edward Jegasothy
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Lismore, NSW, Australia
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Lusambili A, Khaemba P, Agoi F, Oguna M, Nakstad B, Scorgie F, Filippi V, Hess J, Roos N, Chersich M, Kovats S, Luchters S. Process and outputs from a community codesign workshop on reducing impact of heat exposure on pregnant and postpartum women and newborns in Kilifi, Kenya. Front Public Health 2023; 11:1146048. [PMID: 37719738 PMCID: PMC10501312 DOI: 10.3389/fpubh.2023.1146048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Background Ambient heat exposure is increasing due to climate change and is known to affect the health of pregnant and postpartum women, and their newborns. Evidence for the effectiveness of interventions to prevent heat health outcomes in east Africa is limited. Codesigning and integrating local-indigenous and conventional knowledge is essential to develop effective adaptation to climate change. Methods Following qualitative research on heat impacts in a community in Kilifi, Kenya, we conducted a two-day codesign workshop to inform a set of interventions to reduce the impact of heat exposure on maternal and neonatal health. Participants were drawn from a diverse group of purposively selected influencers, implementers, policy makers, service providers and community members. The key domains of focus for the discussion were: behavioral practices, health facilities and health system factors, home environment, water scarcity, and education and awareness. Following the discussions and group reflections, data was transcribed, coded and emerging intervention priorities ranked based on the likelihood of success, cost effectiveness, implementation feasibility, and sustainability. Results Twenty one participants participated in the codesign discussions. Accessibility to water supplies, social behavior-change campaigns, and education were ranked as the top three most sustainable and effective interventions with the highest likelihood of success. Prior planning and contextualizing local set-up, cross-cultural and religious practices and budget considerations are important in increasing the chances of a successful outcome in codesign. Conclusion Codesign of interventions on heat exposure with diverse groups of participants is feasible to identify and prioritize adaptation interventions. The codesign workshop was used as an opportunity to build capacity among facilitators and participants as well as to explore interventions to address the impact of heat exposure on pregnant and postpartum women, and newborns. We successfully used the codesign model in co-creating contextualized socio-culturally acceptable interventions to reduce the risk of heat on maternal and neonatal health in the context of climate change. Our interventions can be replicated in other similar areas of Africa and serve as a model for co-designing heat-health adaptation.
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Affiliation(s)
- Adelaide Lusambili
- Environmental Health and Governance Center, Leadership and Governance HUB - School of Business, Africa International University, Nairobi, Kenya
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Peter Khaemba
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Felix Agoi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Martha Oguna
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Emergency Medicine, Environmental and Occupational Health Sciences, Global Health, University of Washington, Seattle, WA, United States
| | - Britt Nakstad
- Division of Pediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatric and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Fiona Scorgie
- Wits Reproductive Health Institute (WRHI), University of the Witwatersrand, Johannesburg, South Africa
| | - Veronique Filippi
- MARCH, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jeremy Hess
- Emergency Medicine, Environmental and Occupational Health Sciences, Global Health, University of Washington, Seattle, WA, United States
| | - Nathalie Roos
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden
| | - Mathew Chersich
- Wits Reproductive Health Institute (WRHI), University of the Witwatersrand, Johannesburg, South Africa
| | - Sari Kovats
- MARCH, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Stanley Luchters
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
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Atkin K, Bernhardt JM, Olayinka O, Simmonds K. Screening for Heat Related Illness in Pregnant People: Sample Case Study for Clinician Education. J Midwifery Womens Health 2023; 68:364-370. [PMID: 37025066 DOI: 10.1111/jmwh.13489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 04/08/2023]
Abstract
Climate change has significant implications for pregnant people. The Heat-Related Illness Screening Tool was developed by faculty in the nurse-led Center for Climate Change, Climate Justice, and Health at the MGH Institute of Health Professions. In an effort to integrate content on the health effects of climate change on pregnant people, faculty in the Women's Health/Gender-Related Nurse Practitioner program in the School of Nursing developed a case study that incorporated heat and environmental exposures in pregnancy into an existing module on preterm birth. The case study aims to increase awareness about the intersections between climate change, social determinants of health, structural racism, and potential adverse pregnancy outcomes. Together this case study and screening tool for heat-related illness represent innovations for health professions educators and clinicians to detect intensifying risks to already vulnerable people who are pregnant.
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Affiliation(s)
- Kathryn Atkin
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | - Jean M Bernhardt
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | | | - Katherine Simmonds
- Bouvé College of Health Sciences, Roux Institute at Northeastern University, Portland, Maine
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Ou Y, Papadopoulos EA, Fisher SC, Browne ML, Lin Z, Soim A, Lu Y, Sheridan S, Reefhuis J, Langlois PH, Romitti PA, Bell EM, Feldkamp ML, Malik S, Lin S. Interaction of maternal medication use with ambient heat exposure on congenital heart defects in the National Birth Defects Prevention Study. ENVIRONMENTAL RESEARCH 2022; 215:114217. [PMID: 36041539 PMCID: PMC10947356 DOI: 10.1016/j.envres.2022.114217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Maternal exposure to weather-related extreme heat events (EHEs) has been associated with congenital heart defects (CHDs) in offspring. Certain medications may affect an individual's physiologic responses to EHEs. We evaluated whether thermoregulation-related medications modified associations between maternal EHE exposure and CHDs. METHODS We linked geocoded residence data from the U.S. National Birth Defects Prevention Study, a population-based case-control study, to summertime EHE exposures. An EHE was defined using the 90th percentile of daily maximum temperature (EHE90) for each of six climate regions during postconceptional weeks 3-8. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between EHE90 and the risk of CHDs were estimated by strata of maternal thermoregulation-related medication use and climate region. Interaction effects were evaluated on multiplicative and additive scales. RESULTS Over 45% of participants reported thermoregulation-related medication use during the critical period of cardiogenesis. Overall, these medications did not significantly modify the association between EHEs and CHDs. Still, medications that alter central thermoregulation increased aORs (95% CI) of EHE90 from 0.73 (0.41, 1.30) among non-users to 5.09 (1.20, 21.67) among users in the Southwest region, U.S. This effect modification was statistically significant on the multiplicative (P = 0.03) and additive scales, with an interaction contrast ratio (95% CI) of 1.64 (0.26, 3.02). CONCLUSION No significant interaction was found for the maternal use of thermoregulation-related medications with EHEs on CHDs in general, while medications altering central thermoregulation significantly modified the association between EHEs and CHDs in Southwest U.S. This finding deserves further research.
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Affiliation(s)
- Yanqiu Ou
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | | | - Sarah C Fisher
- Birth Defects Registry, New York State Department of Health, Albany, NY, USA
| | - Marilyn L Browne
- Birth Defects Registry, New York State Department of Health, Albany, NY, USA; Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, USA
| | - Ziqiang Lin
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, China
| | - Aida Soim
- Birth Defects Registry, New York State Department of Health, Albany, NY, USA
| | - Yi Lu
- Health Effects Institute, Boston, MA, USA
| | - Scott Sheridan
- Department of Geography, Kent State University, Kent, OH, USA
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Peter H Langlois
- Texas Department of State Health Services, Austin, TX, USA; Department of Epidemiology, Human Genetics, and Environmental Science, UT Health School of Public Health, Austin, TX, USA
| | - Paul A Romitti
- Department of Epidemiology, The University of Iowa, Iowa City, IA, USA
| | - Erin M Bell
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, USA; Department of Environmental Health Sciences, University at Albany, Rensselaer, NY, USA
| | | | - Sadia Malik
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Shao Lin
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, USA; Department of Environmental Health Sciences, University at Albany, Rensselaer, NY, USA.
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Yang HY, Lee JKW, Chio CP. Extreme temperature increases the risk of stillbirth in the third trimester of pregnancy. Sci Rep 2022; 12:18474. [PMID: 36323816 PMCID: PMC9630541 DOI: 10.1038/s41598-022-23155-3] [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: 11/07/2021] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Epidemiological studies have reported the association between extreme temperatures and adverse reproductive effects. However, the susceptible period of exposure during pregnancy remains unclear. This study aimed to assess the impact of extreme temperature on the stillbirth rate. We performed a time-series analysis to explore the associations between temperature and stillbirth with a distributed lag nonlinear model. A total of 22,769 stillbirths in Taiwan between 2009 and 2018 were enrolled. The mean stillbirth rate was 11.3 ± 1.4 per 1000 births. The relative risk of stillbirth due to exposure to extreme heat temperature (> 29 °C) was 1.18 (95% CI 1.11, 1.25). Pregnant women in the third trimester were most susceptible to the effects of extreme cold and heat temperatures. At lag of 0-3 months, the cumulative relative risk (CRR) of stillbirth for exposure to extreme heat temperature (29.8 °C, 97.5th percentile of temperature) relative to the optimal temperature (21 °C) was 2.49 (95% CI: 1.24, 5.03), and the CRR of stillbirth for exposure to extreme low temperature (16.5 °C, 1st percentile) was 1.29 (95% CI: 0.93, 1.80). The stillbirth rate in Taiwan is on the rise. Our findings inform public health interventions to manage the health impacts of climate change.
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Affiliation(s)
- Hsiao-Yu Yang
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,grid.19188.390000 0004 0546 0241Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan ,grid.412094.a0000 0004 0572 7815Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jason Kai Wei Lee
- grid.4280.e0000 0001 2180 6431Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Global Asia Institute, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431N.1 Institute for Health, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Institute for Digital Medicine, National University of Singapore, Singapore, Singapore ,grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Chia-Pin Chio
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,Department of Medical Research, Tung’ Taichung Metro Harbor Hospital, Taichung, Taiwan
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ÖZTÜRK DÖNMEZ R, KURT Ş. İklim Değişikliğinin Anne ve Yenidoğan Sağlığı Üzerine Etkisi. DOKUZ EYLÜL ÜNIVERSITESI HEMŞIRELIK FAKÜLTESI ELEKTRONIK DERGISI 2022. [DOI: 10.46483/deuhfed.1008043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Özellikle son yıllarda üzerinde durulan iklim değişikliği; on yıllardır süren sıcaklık, yağış, rüzgâr gibi hava olaylarındaki değişiklik olarak tanımlanmaktadır. İklim değişikliği ile birlikte, temiz suya erişim, hava kalitesi, hava sıcaklıklarında değişim, güvenli barınma ve gıda güvenliği gibi sağlığın belirleyicileri olumsuz etkilenerek insan sağlığı etkilenmektedir. Bu durumdan etkilenen risk grubunda bulunan bireyler, özellikle gebeler ve yenidoğanlar, savunmasız ve duyarlı alt grupları oluşturmaktadırlar. İklim değişikliği ve sağlığa etkilerini konu alan çalışmaların özellikle son yıllarda yürütülmüş olduğu dikkati çekmektedir. Bu derlemede iklim değişikliğinin anne ve yenidoğan sağlığı üzerine etkilerinin neler olduğuna dikkat çekilmek istenmiştir. İncelenen araştırmalardan yüksek derece sıcaklığa maruz kalma ve hava kirliliği ile gestasyonel diyabet, hipertansiyon, erken doğum, erken membran rüptürü, düşük doğum ağırlığı, ölü doğum, yenidoğan cinsiyeti ve konjenital anomaliler arasında ilişki olduğu saptanmıştır. İklim değişikliğinin sağlık üzerine olumsuz etkilerini azaltmada hemşirelere önemli sorumluluklar düşmektedir. Toplumun ve bireyin dayanıklılık kapasitesini arttırma, başa çıkma stratejilerini ve ileriye dönük davranışlarını geliştirme, sosyal destek ve yeşil çevre için politikalar geliştirmeye yönelik eğitici, savunucu, değişim ajanı, liderlik, bakım verici ve denetleyici gibi var olan rollerini hemşireler etkili bir biçimde kullanmalıdır.
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Affiliation(s)
| | - Şeyma KURT
- EGE ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ ENSTİTÜSÜ
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Girardi G, Bremer AA. Effects of Climate and Environmental Changes on Women's Reproductive Health. J Womens Health (Larchmt) 2022; 31:755-757. [PMID: 35708571 DOI: 10.1089/jwh.2021.0631] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Guillermina Girardi
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew A Bremer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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11
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Syed S, O’Sullivan TL, Phillips KP. Extreme Heat and Pregnancy Outcomes: A Scoping Review of the Epidemiological Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042412. [PMID: 35206601 PMCID: PMC8874707 DOI: 10.3390/ijerph19042412] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 12/04/2022]
Abstract
Background: Extreme heat caused by climate change is a major public health concern, disproportionately affecting poor and racialized communities. Gestational heat exposure is a well-established teratogen in animal studies, with a growing body of literature suggesting human pregnancies are similarly at risk. Characterization of extreme heat as a pregnancy risk is problematic due to nonstandard definitions of heat waves, and variable study designs. To better focus future research in this area, we conducted a scoping review to assess the effects of extreme heat on pregnancy outcomes. Methods: A scoping review of epidemiological studies investigating gestational heat-exposure and published 2010 and 2020, was conducted with an emphasis on study design, gestational windows of sensitivity, adverse pregnancy outcomes and characterization of environmental temperatures. Results: A sample of 84 studies was identified, predominantly set in high-income countries. Preterm birth, birthweight, congenital anomalies and stillbirth were the most common pregnancy outcome variables. Studies reported race/ethnicity and/or socioeconomic variables, however these were not always emphasized in the analysis. Conclusion: Use of precise temperature data by most studies avoided pitfalls of imprecise, regional definitions of heat waves, however inconsistent study design, and exposure windows are a significant challenge to systematic evaluation of this literature. Despite the high risk of extreme heat events and limited mitigation strategies in the global south, there is a significant gap in the epidemiological literature from these regions. Greater consistency in study design and exposure windows would enhance the rigor of this field.
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12
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Lane MKM, Garedew M, Deary EC, Coleman CN, Ahrens-Víquez MM, Erythropel HC, Zimmerman JB, Anastas PT. What to Expect When Expecting in Lab: A Review of Unique Risks and Resources for Pregnant Researchers in the Chemical Laboratory. Chem Res Toxicol 2022; 35:163-198. [PMID: 35130693 PMCID: PMC8864617 DOI: 10.1021/acs.chemrestox.1c00380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
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Pregnancy presents a unique risk
to chemical researchers due to
their occupational exposures to chemical, equipment, and physical
hazards in chemical research laboratories across science, engineering,
and technology disciplines. Understanding “risk” as
a function of hazard, exposure, and vulnerability, this review aims
to critically examine the state of the science for the risks and associated
recommendations (or lack thereof) for pregnant researchers in chemical
laboratories (labs). Commonly encountered hazards for pregnant lab
workers include chemical hazards (organic solvents, heavy metals,
engineered nanomaterials, and endocrine disruptors), radiation hazards
(ionizing radiation producing equipment and materials and nonionizing
radiation producing equipment), and other hazards related to the lab
environment (excessive noise, excessive heat, psychosocial stress,
strenuous physical work, and/or abnormal working hours). Lab relevant
doses and routes of exposure in the chemical lab environment along
with literature and governmental recommendations or resources for
exposure mitigation are critically assessed. The specific windows
of vulnerability based on stage of pregnancy are described for each
hazard, if available. Finally, policy gaps for further scientific
research are detailed to enhance future guidance to protect pregnant
lab workers.
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Affiliation(s)
- Mary Kate M Lane
- Department of Chemical and Environmental Engineering, Yale University, New Haven, Connecticut 06511, United States.,Center for Green Chemistry and Green Engineering, Yale University, New Haven, Connecticut 06511, United States
| | - Mahlet Garedew
- Center for Green Chemistry and Green Engineering, Yale University, New Haven, Connecticut 06511, United States.,School of the Environment, Yale University, New Haven, Connecticut 06511, United States
| | - Emma C Deary
- Department of Anthropology, Wellesley College, Wellesley, Massachusetts 02481, United States
| | - Cherish N Coleman
- Department of Biology, University of Detroit Mercy, Detroit, Michigan 48221, United States
| | - Melissa M Ahrens-Víquez
- Department of Chemical and Environmental Engineering, Yale University, New Haven, Connecticut 06511, United States
| | - Hanno C Erythropel
- Department of Chemical and Environmental Engineering, Yale University, New Haven, Connecticut 06511, United States.,Center for Green Chemistry and Green Engineering, Yale University, New Haven, Connecticut 06511, United States
| | - Julie B Zimmerman
- Department of Chemical and Environmental Engineering, Yale University, New Haven, Connecticut 06511, United States.,Center for Green Chemistry and Green Engineering, Yale University, New Haven, Connecticut 06511, United States.,School of the Environment, Yale University, New Haven, Connecticut 06511, United States
| | - Paul T Anastas
- Center for Green Chemistry and Green Engineering, Yale University, New Haven, Connecticut 06511, United States.,School of the Environment, Yale University, New Haven, Connecticut 06511, United States.,School of Public Health, Yale University, New Haven, Connecticut 06510, United States
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13
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Tapia VL, Vasquez-Apestegui BV, Alcantara-Zapata D, Vu B, Steenland K, Gonzales GF. Association between maximum temperature and PM 2.5 with pregnancy outcomes in Lima, Peru. Environ Epidemiol 2021; 5:e179. [PMID: 34909559 PMCID: PMC8663809 DOI: 10.1097/ee9.0000000000000179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND We have previously documented an inverse relationship between PM2.5 in Lima, Peru, and reproductive outcomes. Here, we investigate the effect of temperature on birth weight, birth weight-Z-score adjusted for gestational age, low birth weight, and preterm birth. We also explore interactions between PM2.5 and temperature. METHODS We studied 123,034 singleton births in three public hospitals of Lima with temperature and PM2.5 during gestation between 2012 and 2016. We used linear, logistic, and Cox regression to estimate associations between temperature during gestation and birth outcomes and explored possible modification of the temperature effect by PM2.5. RESULTS Exposure to maximum temperature in the last trimester was inversely associated with both birth weight [β: -23.7; 95% confidence interval [CI]: -28.0, -19.5] and z-score weight-for-gestational-age (β: -0.024; 95% CI: -0.029, -0.020) with an interquartile range of 5.32 °C. There was also an increased risk of preterm birth with higher temperature (interquartile range) in the first trimester (hazard ratio: 1.04; 95% CI: 1.001, 1.070). The effect of temperature on birthweight was primarily seen at higher PM2.5 levels. There were no statistically significant associations between temperature exposure with low birth weight. CONCLUSIONS Exposition to maximum temperature was associated with lower birth weight and z-score weight-for-gestational-age and higher risk of preterm birth, in accordance with much of the literature. The effects on birth weight were seen only in the third trimester.
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Affiliation(s)
- Vilma L Tapia
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Bertha Vanessa Vasquez-Apestegui
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Diana Alcantara-Zapata
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Bryan Vu
- Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kyle Steenland
- Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Gustavo F Gonzales
- Laboratorio de Endocrinología y Reproducción, LID, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
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14
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Basagaña X, Michael Y, Lensky IM, Rubin L, Grotto I, Vadislavsky E, Levi Y, Amitai E, Agay-Shay K. Low and High Ambient Temperatures during Pregnancy and Birth Weight among 624,940 Singleton Term Births in Israel (2010-2014): An Investigation of Potential Windows of Susceptibility. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:107001. [PMID: 34643443 PMCID: PMC8513522 DOI: 10.1289/ehp8117] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Exposure to heat during pregnancy has been associated with reduced fetal growth. Less is known about associations with cold and the potential for critical time windows of exposure. OBJECTIVES We aimed to evaluate, in a national retrospective cohort, critical windows of susceptibility during pregnancy to extreme temperatures (low and high) and fetal growth, among 624,940 singleton term births in Israel during the period 2010-2014. METHODS Temperature exposures were estimated using a spatially refined gridded climate data set with a 1-h and 1-km2 resolution. Percentiles of temperature were categorized by climatic zone for the entire pregnancy and by trimesters and weeks. Generalized additive models with the distributed lag nonlinear model framework were used to estimate unadjusted and adjusted associations between percentiles and categories of temperature and fetal growth markers: term [births after 36 weeks of gestational age (GA)] mean birth weight and term low birth weight (tLBW, term infants with birth weight below 2,500g). RESULTS After adjustment, extreme temperatures (percentiles) during the entire pregnancy were associated with a lower mean birth weight {≤10th vs. 41st-50th percentile: -56g [95% confidence interval (CI): -63g, -50g)]; >90th vs. 41st-50th percentile: -65g; 95% CI: -72g, -58g}. Similar inverse U-shaped patterns were observed for all trimesters, with stronger associations for heat than for cold and for exposures during the third trimester. For heat, results suggest critical windows between 3-9 and 19-34 GA-weeks, with the strongest association estimated at 3 GA-weeks (temperature >90th vs. 41st-50th percentiles: -3.8g; 95% CI: -7.1g, -0.4g). For cold, there was a consistent trend of null associations early in pregnancy and stronger inverse associations over time, with the strongest association at 36 GA-week (≤10th vs. 41st-50th percentiles: -2.9g; 95% CI: -6.5g, 0.7g). For tLBW, U-shape patterns were estimated for the entire pregnancy and third trimester exposures, as well as nonsignificant associations with heat for 29-36 GA-weeks. Generally, the patterns of associations with temperatures during the entire pregnancy were consistent when stratified by urbanicity and geocoding hierarchy, when estimated for daily minimum and maximum temperatures, when exposures were classified based on temperature distributions in 49 natural regions, and when estimated for all live births. DISCUSSION Findings from our study of term live births in Israel (2010-2014) suggest that exposure to extreme temperatures, especially heat, during specific time windows may result in reduced fetal growth. https://doi.org/10.1289/EHP8117.
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Affiliation(s)
- Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Yaron Michael
- Department of Geography and Environment, Bar-Ilan University, Ramat-Gan, Israel
| | - Itamar M. Lensky
- Department of Geography and Environment, Bar-Ilan University, Ramat-Gan, Israel
| | - Lisa Rubin
- School of Public Health, University of Haifa, Haifa, Israel
| | - Itamar Grotto
- Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | - Yoav Levi
- Israel Meteorological Service (IMS), Bet Dagan, Israel
| | - Eyal Amitai
- Israel Meteorological Service (IMS), Bet Dagan, Israel
| | - Keren Agay-Shay
- Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
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15
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Qu Y, Zhang W, Ryan I, Deng X, Dong G, Liu X, Lin S. Ambient extreme heat exposure in summer and transitional months and emergency department visits and hospital admissions due to pregnancy complications. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 777:146134. [PMID: 33689898 DOI: 10.1016/j.scitotenv.2021.146134] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Although extreme heat exposure (EHE) was reported to be associated with increased risks of multiple diseases, little is known about the effects of EHE on pregnancy complications. We examined the EHE-pregnancy complications associations by lag days, subtypes, sociodemographic characteristics, and areas in New York State (NYS). We conducted a case-crossover analysis to assess the EHE-pregnancy complications associations in summer (June-August) and transitional months (May and September). All emergency department (ED) visits and hospital admissions due to pregnancy complications (ICD 9 codes: 630-649) from 2005 to 2013 in NYS were included. Daily mean temperature > 90th percentile of the monthly mean temperature in each county was defined as an EHE. We used conditional logistic regression while controlling for other weather factors, air pollutants and holidays to assess the EHE-pregnancy complications associations. EHE was significantly associated with increased ED visits for pregnancy complications in summer (ORs ranged: 1.01-1.04 from lag days 0-5). There was also a significant and stronger association in transitional months (ORs ranged: 1.02-1.06, Lag 0). Furthermore, we found EHE affected multiple subtypes of pregnancy complications, including threatened/spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension (ORs range: 1.13-1.90) during transitional months. A significant concentration response effect between the number of consecutive days of EHE and ED visits in summer (P for trend <0.001), ED visits in September (P for trend =0.03), and hospital admission in May (P for trend<0.001) due to pregnancy complications was observed, respectively. African Americans and residents in lower socioeconomic position (SEP) counties were more susceptible to the effects of EHE. In conclusion, we found an immediate and prolonged effect of EHE on pregnancy complications in summer and a stronger, immediate effect in transitional months. These effects were stronger in African Americans and counties with lower SEP. Earlier warnings regarding extreme heat are recommended to decrease pregnancy complications.
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Affiliation(s)
- Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China; Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Ian Ryan
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Xinlei Deng
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China.
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA.
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16
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Goshua A, Gomez J, Erny B, Burke M, Luby S, Sokolow S, LaBeaud AD, Auerbach P, Gisondi MA, Nadeau K. Addressing Climate Change and Its Effects on Human Health: A Call to Action for Medical Schools. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:324-328. [PMID: 33239537 DOI: 10.1097/acm.0000000000003861] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Human health is increasingly threatened by rapid and widespread changes in the environment and climate, including rising temperatures, air and water pollution, disease vector migration, floods, and droughts. In the United States, many medical schools, the American Medical Association, and the National Academy of Sciences have published calls for physicians and physicians-in-training to develop a basic knowledge of the science of climate change and an awareness of the associated health risks. The authors-all medical students and educators-argue for the expeditious redesign of medical school curricula to teach students to recognize, diagnose, and treat the many health conditions exacerbated by climate change as well as understand public health issues. In this Invited Commentary, the authors briefly review the health impacts of climate change, examine current climate change course offerings and proposals, and describe the rationale for promptly and comprehensively including climate science education in medical school curricula. Efforts in training physicians now will benefit those physicians' communities whose health will be impacted by a period of remarkable climate change. The bottom line is that the health effects of climate reality cannot be ignored, and people everywhere must adapt as quickly as possible.
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Affiliation(s)
- Anna Goshua
- A. Goshua is a second-year medical student, Stanford University School of Medicine, Stanford, California
| | - Jason Gomez
- J. Gomez is a second-year medical student, Stanford University School of Medicine, Stanford, California
| | - Barbara Erny
- B. Erny is medical liaison for international programs, American Society of Cataract and Refractive Surgery Foundation, Fairfax, Virginia, and a member, Environmental Health Committee, Physicians for Social Responsibility, Washington, DC
| | - Marshall Burke
- M. Burke is associate professor, Department of Earth System Science and Center on Food Security and the Environment, Stanford University, Stanford, California
| | - Stephen Luby
- S. Luby is professor of medicine and associate dean of global health research, Stanford University, Stanford, California
| | - Susanne Sokolow
- S. Sokolow is senior research scientist, Stanford Woods Institute for the Environment, Stanford University, Stanford, California
| | - A Desiree LaBeaud
- A.D. LaBeaud is professor of pediatrics, Stanford University School of Medicine, and a senior fellow, Stanford Woods Institute for the Environment, Stanford, California
| | - Paul Auerbach
- P. Auerbach is the Redlich Family Professor Emeritus, Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Michael A Gisondi
- M.A. Gisondi is associate professor and vice chair of education, Department of Emergency Medicine, Stanford University, Stanford, California
| | - Kari Nadeau
- K. Nadeau is the Naddisy Family Foundation Professor of Allergy and director, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
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17
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Nyadanu SD, Tessema GA, Mullins B, Kumi-Boateng B, Bell ML, Pereira G. Ambient Air Pollution, Extreme Temperatures and Birth Outcomes: A Protocol for an Umbrella Review, Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:8658. [PMID: 33561059 PMCID: PMC7700558 DOI: 10.3390/ijerph17228658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/10/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023]
Abstract
Prenatal exposure to ambient air pollution and extreme temperatures are among the major risk factors of adverse birth outcomes and with potential long-term effects during the life course. Although low- and middle-income countries (LMICs) are most vulnerable, there is limited synthesis of evidence in such settings. This document describes a protocol for both an umbrella review (Systematic Review 1) and a focused systematic review and meta-analysis of studies from LMICs (Systematic Review 2). We will search from start date of each database to present, six major academic databases (PubMed, CINAHL, Scopus, MEDLINE/Ovid, EMBASE/Ovid and Web of Science Core Collection), systematic reviews repositories and references of eligible studies. Additional searches in grey literature will also be conducted. Eligibility criteria include studies of pregnant women exposed to ambient air pollutants and/or extreme temperatures during pregnancy with and without adverse birth outcomes. The umbrella review (Systematic Review 1) will include only previous systematic reviews while Systematic Review 2 will include quantitative observational studies in LMICs. Searches will be restricted to English language using comprehensive search terms to consecutively screen the titles, abstracts and full-texts to select eligible studies. Two independent authors will conduct the study screening and selection, risk of bias assessment and data extraction using JBI SUMARI web-based software. Narrative and semi-quantitative syntheses will be employed for the Systematic Review 1. For Systematic Review 2, we will perform meta-analysis with two alternative meta-analytical methods (quality effect and inverse variance heterogeneity) as well as the classic random effect model. If meta-analysis is infeasible, narrative synthesis will be presented. Confidence in cumulative evidence and the strength of the evidence will be assessed. This protocol is registered with PROSPERO (CRD42020200387).
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Affiliation(s)
- Sylvester Dodzi Nyadanu
- Education, Culture and Health Opportunities (ECHO) Ghana, ECHO Research Group International, P. O. Box 424, Aflao, Ghana
- School of Public Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; (G.A.T.); (B.M.); (G.P.)
| | - Gizachew Assefa Tessema
- School of Public Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; (G.A.T.); (B.M.); (G.P.)
- School of Public Health, University of Adelaide, Adelaide, South Australia 5000, Australia
| | - Ben Mullins
- School of Public Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; (G.A.T.); (B.M.); (G.P.)
| | - Bernard Kumi-Boateng
- Department of Geomatic Engineering, University of Mines and Technology, P.O. Box 237, Tarkwa, Ghana;
| | - Michelle Lee Bell
- School of the Environment, Yale University, New Haven, CT 06511, USA;
| | - Gavin Pereira
- School of Public Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; (G.A.T.); (B.M.); (G.P.)
- Telethon Kids Institute, Northern Entrance, Perth Children’s Hospital, Nedlands, Western Australia 6009, Australia
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473 Oslo, Norway
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18
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Association between ambient temperature and hypertensive disorders in pregnancy in China. Nat Commun 2020; 11:2925. [PMID: 32522990 PMCID: PMC7286884 DOI: 10.1038/s41467-020-16775-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
Hypertensive disorders in pregnancy (HDPs) are leading perinatal diseases. Using a national cohort of 2,043,182 pregnant women in China, we evaluated the association between ambient temperatures and HDP subgroups, including preeclampsia or eclampsia, gestational hypertension, and superimposed preeclampsia. Under extreme temperatures, very cold exposure during preconception (12 weeks) increases odds of preeclampsia or eclampsia and gestational hypertension. Compared to preconception, in the first half of pregnancy, the impact of temperature on preeclampsia or eclampsia and gestational hypertension is opposite. Cold exposure decreases the odds, whereas hot exposure increases the odds. Under average temperatures, a temperature increase during preconception decreases the risk of preeclampsia or eclampsia and gestational hypertension. However, in the first half of pregnancy, temperature is positively associated with a higher risk. No significant association is observed between temperature and superimposed preeclampsia. Here we report a close relationship exists between ambient temperature and preeclampsia or eclampsia and gestational hypertension. Hypertensive disorders in pregnancy are prevalent perinatal diseases. Here the authors report an association between ambient temperature before or after conception and risk of preeclampsia or eclampsia and gestational hypertension.
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