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Hu K, Wang S, Fei F, Song J, Chen F, Zhao Q, Shen Y, Fu J, Zhang Y, Cheng J, Zhong J, Yang X, Wu J. Modifying temperature-related cardiovascular mortality through green-blue space exposure. ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY 2024; 20:100408. [PMID: 38560758 PMCID: PMC10979139 DOI: 10.1016/j.ese.2024.100408] [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: 08/03/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Green-blue spaces (GBS) are pivotal in mitigating thermal discomfort. However, their management lacks guidelines rooted in epidemiological evidence for specific planning and design. Here we show how various GBS types modify the link between non-optimal temperatures and cardiovascular mortality across different thermal extremes. We merged fine-scale population density and GBS data to create novel GBS exposure index. A case time series approach was employed to analyse temperature-cardiovascular mortality association and the effect modifications of type-specific GBSs across 1085 subdistricts in south-eastern China. Our findings indicate that both green and blue spaces may significantly reduce high-temperature-related cardiovascular mortality risks (e.g., for low (5%) vs. high (95%) level of overall green spaces at 99th vs. minimum mortality temperature (MMT), Ratio of relative risk (RRR) = 1.14 (95% CI: 1.07, 1.21); for overall blue spaces, RRR = 1.20 (95% CI: 1.12, 1.29)), while specific blue space types offer protection against cold temperatures (e.g., for the rivers at 1st vs MMT, RRR = 1.17 (95% CI: 1.07, 1.28)). Notably, forests, parks, nature reserves, street greenery, and lakes are linked with lower heat-related cardiovascular mortality, whereas rivers and coasts mitigate cold-related cardiovascular mortality. Blue spaces provide greater benefits than green spaces. The severity of temperature extremes further amplifies GBS's protective effects. This study enhances our understanding of how type-specific GBS influences health risks associated with non-optimal temperatures, offering valuable insights for integrating GBS into climate adaptation strategies for maximal health benefits.
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Affiliation(s)
- Kejia Hu
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, 310058, China
| | - Shiyi Wang
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Jinglu Song
- Department of Urban Planning and Design, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Feng Chen
- Zhejiang Institute of Meteorological Sciences, Hangzhou, 310008, China
| | - Qi Zhao
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Yujie Shen
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Jingqiao Fu
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Jian Cheng
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Xuchao Yang
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Jiayu Wu
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
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Zheng W, Chu J, Bambrick H, Wang N, Mengersen K, Guo X, Hu W. Impacts of heatwaves on type 2 diabetes mortality in China: a comparative analysis between coastal and inland cities. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:939-948. [PMID: 38407634 PMCID: PMC11058751 DOI: 10.1007/s00484-024-02638-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/25/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
The impacts of extreme temperatures on diabetes have been explored in previous studies. However, it is unknown whether the impacts of heatwaves appear variations between inland and coastal regions. This study aims to quantify the associations between heat exposure and type 2 diabetes mellitus (T2DM) deaths in two cities with different climate features in Shandong Province, China. We used a case-crossover design by quasi-Poisson generalized additive regression with a distributed lag model with lag 2 weeks, controlling for relative humidity, the concentration of air pollution particles with a diameter of 2.5 µm or less (PM2.5), and seasonality. The wet- bulb temperature (Tw) was used to measure the heat stress of the heatwaves. A significant association between heatwaves and T2DM deaths was only found in the coastal city (Qingdao) at the lag of 2 weeks at the lowest Tw = 14℃ (relative risk (RR) = 1.49, 95% confidence interval (CI): 1.11-2.02; women: RR = 1.51, 95% CI: 1.02-2.24; elderly: RR = 1.50, 95% CI: 1.08-2.09). The lag-specific effects were significant associated with Tw at lag of 1 week at the lowest Tw = 14℃ (RR = 1.14, 95% CI: 1.03-1.26; women: RR = 1.15, 95% CI: 1.01-1.31; elderly: RR = 1.15, 95% CI: 1.03-1.28). However, no significant association was found in Jian city. The research suggested that Tw was significantly associated with T2DM mortality in the coastal city during heatwaves on T2DM mortality. Future strategies should be implemented with considering socio-environmental contexts in regions.
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Affiliation(s)
- Wenxiu Zheng
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - Jie Chu
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Hilary Bambrick
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ning Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kerrie Mengersen
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Data Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Wenbiao Hu
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, 4059, Australia.
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Wu Q, Xing X, Yang M, Bai Z, He Q, Cheng Q, Hu J, Wang H, Fan Y, Su H, Liu Z, Cheng J. Increased Suicide Mortality and Reduced Life Expectancy Associated With Ambient Heat Exposure. Am J Prev Med 2024; 66:780-788. [PMID: 38311191 DOI: 10.1016/j.amepre.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Ambient heat exposure is a risk factor for suicide in many regions of the world. However, little is known about the extent to which life expectancy has been shortened by heat-related suicide deaths. This study aimed to evaluate the short-term effects of heat on suicide mortality and quantify the reduced life expectancy associated with heat in China. METHODS A time-stratified, case-crossover analysis in 2023 was performed during the warm season (May to September) from 2016 to 2020 to assess the short-term association between extreme heat (the 95th percentile of mean temperature) and suicide mortality in Anhui Province, China. A subgroup analysis was performed according to sex, age, marital status, suicide type, and region. The attributable fraction and years of life lost due to heat were calculated, and the heat-related life expectancy loss was estimated. RESULTS This study included 9,642 suicide deaths, with an average age of 62.4 years and 58.8% of suicides in males. Suicide risk was associated with an 80.7% increase (95% confidence interval [CI]: 21.4%-68.9%) after exposure to extreme heat (30.6°C) in comparison to daily minimum temperature (7.9°C). Subgroup analysis revealed that heat-related suicide risk was more prominent in the married population than in the unmarried population. Heat was estimated to be associated with 31.7% (95% CI: 18.0%-43.2%) of the suicides, corresponding to 7.0 years of loss in life expectancy for each decedent. CONCLUSIONS Heat exposure was associated with an increased risk of suicide and reduced life expectancy. However, further prospective studies are required to confirm this relationship.
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Affiliation(s)
- Qiyue Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Xiuya Xing
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China; Public Health Research Institute of Anhui Province, Hefei, China
| | - Min Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Zhongliang Bai
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Qin He
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China; Public Health Research Institute of Anhui Province, Hefei, China
| | - Qianyao Cheng
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China; Public Health Research Institute of Anhui Province, Hefei, China
| | - Jingyao Hu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China; Public Health Research Institute of Anhui Province, Hefei, China
| | - Huadong Wang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China; Public Health Research Institute of Anhui Province, Hefei, China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Zhirong Liu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China; Public Health Research Institute of Anhui Province, Hefei, China.
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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Du H, Yan M, Liu X, Zhong Y, Ban J, Lu K, Li T. Exposure to Concurrent Heatwaves and Ozone Pollution and Associations with Mortality Risk: A Nationwide Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:47012. [PMID: 38662525 PMCID: PMC11045006 DOI: 10.1289/ehp13790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/01/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Concurrent extreme events are projected to occur more frequently under a changing climate. Understanding the mortality risk and burden of the concurrent heatwaves and ozone (O 3 ) pollution may support the formulation of adaptation strategies and early warning systems for concurrent events in the context of climate change. OBJECTIVES We aimed to estimate the mortality risk and excess deaths of concurrent heatwaves and O 3 pollution across 250 counties in China. METHODS We collected daily mortality, meteorological, and air pollution data for the summer (1 June to 30 September) during 2013-2018. We defined heatwaves and high O 3 pollution days, then we divided the identified days into three categories: a) days with only heatwaves (heatwave-only event), b) days with only high O 3 pollution (high O 3 pollution-only event), and c) days with concurrent heatwaves and high O 3 pollution (concurrent event). A generalized linear model with a quasi-Poisson regression was used to estimate the risk of mortality associated with extreme events for each county. Then we conducted a random-effects meta-analysis to pool the county-specific estimates to derive the overall effect estimates. We used mixed-effects meta-regression to identify the drivers of the heterogeneity. Finally, we estimated the excess death attributable to extreme events (heatwave-only, high O 3 pollution-only, and concurrent events) from 2013 to 2020. RESULTS A higher all-cause mortality risk was associated with exposure to the concurrent heatwaves and high O 3 pollution than exposure to a heatwave-only or a high O 3 pollution-only event. The effects of a concurrent event on circulatory and respiratory mortality were higher than all-cause and nonaccidental mortality. Sex and age significantly impacted the association of concurrent events and heatwave-only events with all-cause mortality. We estimated that annual average excess deaths attributed to the concurrent events were 6,249 in China from 2017 to 2020, 5.7 times higher than the annual average excess deaths attributed to the concurrent events from 2013 to 2016. The annual average proportion of excess deaths attributed to the concurrent events in the total excess deaths caused by three types of events (heatwave-only events, high O 3 pollution-only events, and concurrent events) increased significantly in 2017-2020 (31.50%; 95% CI: 26.73%, 35.53%) compared with 2013-2016 (9.65%; 95% CI: 5.67%, 10.81%). Relative excess risk due to interaction revealed positive additive interaction considering the concurrent effect of heatwaves and high O 3 pollution. DISCUSSION Our findings may provide scientific basis for establishing a concurrent event early warning system to reduce the adverse health impact of the concurrent heatwaves and high O 3 pollution. https://doi.org/10.1289/EHP13790.
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Affiliation(s)
- Hang Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meilin Yan
- Department of Environmental Science and Engineering, School of Light Industry Science and Engineering, Beijing Technology and Business University, Beijing, China
| | - Xin Liu
- Energy Foundation China, Beijing, China
| | - Yu Zhong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kailai Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Surís X, Rodríguez C, Llargués E, Pueyo-Sánchez MJ, Larrosa M. Trend and Seasonality of Hip Fractures in Catalonia, Spain: Exploring the Influence of Climate. Calcif Tissue Int 2024; 114:326-339. [PMID: 38340169 PMCID: PMC10957628 DOI: 10.1007/s00223-024-01182-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/30/2023] [Indexed: 02/12/2024]
Abstract
To describe the secular trend and seasonality of the incidence of hip fracture (HF) and its relationship with climatic variables during the period 2010-2019 in Catalonia in people aged ≥ 65 years. The results were analyzed by sex, age groups (65-74, 75-84, and ≥ 85), and types of fracture (extracapsular and intracapsular). Data on sex, age, type of fracture, year, and month of hospitalization of patients admitted with a diagnosis of HF between January 1, 2010 and December 31, 2019 were collected. Crude and standardized HF incidence (HFi) rates were obtained. Data on the monthly mean of climatological variables (temperature, insolation, icy days, rain, relative humidity, atmospheric pressure, and wind force) were obtained from the network of meteorological stations in Catalonia. Time series analytical statistics were used to identify trends and seasonality. Linear regression and a seasonal autoregressive integrated moving average (ARIMA) were used to analyze the relationship of each climatic parameter with fracture rates. In addition, generalized additive models were used to ascertain the best predictive model. The total number of HF episodes was 90,149 (74.1% in women and 25.9% in men). The total number of HFs increased by 6.4% between 2010 and 2019. The median age (SD) was 84.5 (7.14) and 54% of patients were ≥ 85 years of age. Extracapsular fractures were the most common (55%). The standardized incidence rates decreased from 728.1/100,000 (95% CI 738.6-769.3) to 624.5/100,000 (95% CI 648.7-677.0), which represents a decrease of 14.2% (p < 0.05). The decline was greater at older ages. There were seasonal variations, with higher incidences in autumn (27.2%) and winter (25.7%) and lower rates in summer (23.5%) and spring (23.6%). Seasonality was more pronounced in elderly people and men. In the bivariate regression analysis, high temperatures and greater insolation were negatively associated with the HF rate, while the number of icy days, rainy days, and high relative humidity were associated with a higher incidence of fractures in all age groups and sexes. In the regression analysis using the seasonal ARIMA model, only insolation had a consistently significant association with overall HFi, after adjusting by trend and other climatic parameters. While the global number of HFs grew in Catalonia due to increases in the elderly population, the standardized HF rate decreased during the years 2010-2019. There was a seasonal trend, with predominance in the cold months and correlations with climatic parameters, especially with insolation.
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Affiliation(s)
- Xavier Surís
- Master Plan of Musculoskeletal Diseases, Department of Health, C/Travessera de les Corts, 131-159, 08028, Barcelona, Catalonia, Spain.
- Rheumatology Department, Hospital General de Granollers, Granollers, Spain.
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain.
| | - Clara Rodríguez
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Esteve Llargués
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
- Internal Medicine Department, Hospital General de Granollers, Granollers, Spain
| | - Maria J Pueyo-Sánchez
- Assistance and Participation Area. La Unió, Association of Health and Social Entities, Barcelona, Spain
| | - Marta Larrosa
- Master Plan of Musculoskeletal Diseases, Department of Health, C/Travessera de les Corts, 131-159, 08028, Barcelona, Catalonia, Spain
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Le VTH, Berman JD, Wattenberg EV, Ngo TV, Tran QA, Alexander BH. Temperature-related emergency injury visits in Hanoi, Vietnam. Inj Prev 2024; 30:33-38. [PMID: 37863513 PMCID: PMC10850667 DOI: 10.1136/ip-2023-044946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/29/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND The short-term association between increasing temperatures and injury has been described in high-income countries, but less is known for low-income and-middle-income countries, including Vietnam. METHODS We used emergency injury visits (EIV) data for 2017-2019 from 733 hospitals and clinics in Hanoi, Vietnam to examine the effects of daily temperature on EIV. Time-series analysis with quasi-Poisson models was used to estimate a linear relative risk increase (RRI) for overall populations and ones stratified by age and sex. Exposure-response curves estimated non-linear associations as an RR between daily temperature and injury. Models were adjusted for the day of week, holidays, daily relative humidity, daily particulate matter, and long-term and seasonal trends. RESULTS AND CONCLUSIONS A total of 39 313 EIV were recorded averaging 36 injuries daily. Injuries more likely occurred in males and those aged 15-44, and aged 44-60. For linear effects, a 5°C increase in same day mean temperature was associated with an overall increased EIV (RRI 4.8; 95% CI 2.3 to 7.3) with males (RRI 5.9; 95% CI 3.0 to 8.9) experiencing a greater effect than females (RRI 3.0; 95% CI -0.5 to 6.5). Non-linear effects showed an increase in EIV at higher temperatures compared with the threshold temperature of 15°C, with the greatest effect at 33°C (RR 1.3; 95% CI 1.2 to 1.6). Further research to investigate temperature-injury among different populations and by the cause of injury is warranted.
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Affiliation(s)
- Vu Thuy Huong Le
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Jesse D Berman
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Elizabeth V Wattenberg
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Toan Van Ngo
- Environmental Health Department, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Quynh Anh Tran
- Environmental Health Department, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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Huang Z, Li Z, Hu J, Zhu S, Gong W, Zhou C, Meng R, Dong X, Yu M, Xu X, Lin L, Xiao J, Zhong J, Jin D, Xu Y, Liu T, Lin Z, He G, Ma W. The association of heatwave with drowning mortality in five provinces of China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 903:166321. [PMID: 37586513 DOI: 10.1016/j.scitotenv.2023.166321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/29/2023] [Accepted: 08/13/2023] [Indexed: 08/18/2023]
Abstract
Drowning is a serious public health problem in the world. Several studies have found that ambient temperature is associated with drowning, but few have investigated the effect of heatwave on drowning. This study aimed to explore the associations between heatwave and drowning mortality, and further estimate the mortality burden of drowning attributed to heatwave in China. Drowning mortality data were collected in 71 prefectures in China during 2013-2018 from provincial vital register system. Meteorological data at the same period were collected from European Centre for Medium-Range Weather Forecasts (ECMWF). A distributed lag non-linear model (DLNM) was first to explore the association between heatwave and drowning mortality in each prefecture. Secondly, the prefecture-specific associations were pooled using meta-analysis. Finally, attributable fractions (AFs) of drowning deaths caused by heatwave were estimated. Compared to normal day, the mortality risk of drowning significantly increased during heatwave (RR = 1.20, 95%CI: 1.18-1.23). Higher risks were observed in males (RR = 1.23, 95%CI: 1.20-1.27) than females (RR = 1.18, 95%CI: 1.13-1.23), in children aged 5-14 years old (RR = 1.24, 95%CI: 1.15-1.33) than other age groups, in urban city (RR = 1.32, 95%CI: 1.28-1.36) than rural area (RR = 1.09, 95%CI: 1.07-1.12) and in Jilin province (RR = 2.85, 95%CI: 1.61-5.06) than other provinces. The AF of drowning deaths due to heatwave was 11.4 % (95%CI: 10.0 %-12.9 %) during heatwave and 1.0 % (95%CI: 0.9 %-1.1 %) during study period, respectively. Moreover, the AFs during study period were higher for male (1.2 %, 95%CI: 1.0 %-1.3 %), children 5-14 years (1.1 %, 95%CI: 0.7 %-1.6 %), urban city (1.6 %, 95%CI: 1.4 %-1.8 %) than their correspondents. These differences were also observed in AFs during heatwave. We found that heatwave may significantly increase the mortality risk of drowning mortality, and its mortality burden attributable to heatwave was noteworthy. Targeted intervention should be carried out to decrease drowning mortality during heatwave.
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Affiliation(s)
- Zhongguo Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Zhixing Li
- Department of Nosocomial Infection Management, Nanfang Hospital, Southern Medical University, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Disease Control and Prevention Institute, Jinan University, Guangzhou 511443, China.
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
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Kim Y, Oka K, Kawazu EC, Ng CFS, Seposo X, Ueda K, Hashizume M, Honda Y. Enhancing health resilience in Japan in a changing climate. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100970. [PMID: 38116496 PMCID: PMC10730320 DOI: 10.1016/j.lanwpc.2023.100970] [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: 07/28/2023] [Revised: 10/17/2023] [Accepted: 11/02/2023] [Indexed: 12/21/2023]
Abstract
Climate change poses significant threats to human health, propelling Japan to take decisive action through the Climate Change Adaptation Act of 2018. This Act has led to the implementation of climate change adaptation policies across various sectors, including healthcare. In this review, we synthesized existing scientific evidence on the impacts of climate change on health in Japan and outlined the adaptation strategies and measures implemented by the central and local governments. The country has prioritized tackling heat-related illness and mortality and undertaken various adaptation measures to mitigate these risks. However, it faces unique challenges due to its super-aged society. Ensuring effective and coordinated strategies to address the growing uncertainties in vulnerability to climate change and the complex intersectoral impacts of disasters remains a critical issue. To combat the additional health risks by climate change, a comprehensive approach embracing adaptation and mitigation policies in the health sector is crucial. Encouraging intersectoral communication and collaboration will be vital for developing coherent and effective strategies to safeguard public health in the face of climate change.
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Affiliation(s)
- Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kazutaka Oka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Japan
| | | | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan
| | - Xerxes Seposo
- Graduate School of Medicine, Hokkaido University, Japan
| | - Kayo Ueda
- Graduate School of Medicine, Hokkaido University, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Japan
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Japan
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Rahmani M, Silverman AL, Thompson A, Pumariega A. Youth Suicidality in the Context of Disasters. Curr Psychiatry Rep 2023; 25:587-602. [PMID: 37768444 DOI: 10.1007/s11920-023-01454-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the current literature regarding youth suicidality (suicidal ideation, suicidal behavior, and completed suicide) in the context of disasters. RECENT FINDINGS There are fewer studies that examine the effect of disasters on suicidality specifically in children and youth than studies that focus on adults or general population. Numerous studies have reported on the effect of disasters on youth mental health in general without zeroing in on suicide risk. Some variables that have shown to increase suicide risk in children and youth after disasters include female gender, age at the time of disaster exposure, dependence on adults, attachments to places and caregivers, family functioning, and vulnerability to mistreatment. Several studies have demonstrated that youth suicidality fluctuates in response to disasters, at times increasing immediately post-disaster and at other times decreasing immediately post-disaster followed by an increase later. Exposure to natural disasters (e.g., earthquakes, typhoons, hurricanes, wildfires, and extremes of temperature and humidity), man-made disasters (e.g., armed conflict, global warming, and pollution), and unique disasters (e.g., the COVID-19 pandemic) have had significant impact on suicidality in children and adolescents. Although there are several promising interventions to mitigate the post-disaster suicide risk among youth, there is no consensus on a single intervention that is superior to others. More research is needed to study youth suicide risk in the context of disasters and develop culturally appropriate and evidence-based interventions.
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Affiliation(s)
- Mariam Rahmani
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.
| | - Andrew L Silverman
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andrew Thompson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andres Pumariega
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
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He C, Yin P, Chen R, Gao Y, Liu W, Schneider A, Bell ML, Kan H, Zhou M. Cause-specific accidental deaths and burdens related to ambient heat in a warming climate: A nationwide study of China. ENVIRONMENT INTERNATIONAL 2023; 180:108231. [PMID: 37778287 DOI: 10.1016/j.envint.2023.108231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/14/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on non-accidental morbidity or mortality, with far less research on heat-related accidental events. METHODS We collected individual accidental death records among all residents in Chinese mainland from June to August during 2013-2019. Accidental deaths were further divided into several subtypes by different causes. We used an individual-level, time-stratified, case-crossover study design to estimate the association between daily mean temperature and accidental deaths, and estimate its variation in seven geo-climatic zones, age (5-64, 65-74, ≥75), and sex (male, female). We then estimated the temperature-related excess accidental deaths under global warming scenarios of 1.5, 2, and 3℃. FINDINGS A total of 711,929 accidental death records were included in our study. We found that higher temperatures were associated with increased risks of deaths from the total accidental events and four main subtypes, including traffic, falls, drowning, and unintentional injuries. We also found that younger individuals (ages 5-64) and males faced a higher risk of heat-related mortality due to total accidents, traffic incidents, and drowning. For future climate scenarios, even under the 1.5℃ climate change scenario, 6,939 (95% eCI (empirical Confidence Interval): 6,818-7,067) excess accidental deaths per year are attributed to higher summertime daily temperature over mainland China, and the number of accidental deaths would increase by 16.71% and 33.59% under the 2℃ and 3℃ climate change scenarios, respectively. For residents living in southern coastal and northwest inland regions, the projected increase in accidental death is higher. CONCLUSIONS This nationwide study confirms that higher summer temperatures are linked to an increased risk of accidental deaths. Younger age groups and males face a higher risk. This indicates that current estimates of the health effects of climate change might be underestimated, particularly for younger populations.
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Affiliation(s)
- Cheng He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Wei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | | | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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Yang Y, Lian J, Jia X, Wang T, Fan J, Yang C, Wang Y, Bao J. Spatial distribution and driving factors of the associations between temperature and influenza-like illness in the United States: a time-stratified case-crossover study. BMC Public Health 2023; 23:1403. [PMID: 37474889 PMCID: PMC10360314 DOI: 10.1186/s12889-023-16240-3] [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: 02/04/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Several previous studies investigated the associations between temperature and influenza in a single city or region without a national picture. The attributable risk of influenza due to temperature and the corresponding driving factors were unclear. This study aimed to evaluate the spatial distribution characteristics of attributable risk of Influenza-like illness (ILI) caused by adverse temperatures and explore the related driving factors in the United States. METHODS ILI, meteorological factors, and PM2.5 of 48 states in the United States were collected during 2011-2019. The time-stratified case-crossover design with a distributed lag non-linear model was carried out to evaluate the association between temperature and ILI at the state level. The multivariate meta-analysis was performed to obtain the combined effects at the national level. The attributable fraction (AF) was calculated to assess the ILI burden ascribed to adverse temperatures. The ordinary least square model (OLS), spatial lag model (SLM), and spatial error model (SEM) were utilized to identify driving factors. RESULTS A total of 7,716,115 ILI cases were included in this study. Overall, the temperature was negatively associated with ILI risk, and lower temperature gave rise to a higher risk of ILI. AF ascribed to adverse temperatures differed across states, from 49.44% (95% eCI: 36.47% ~ 58.68%) in Montana to 6.51% (95% eCI: -6.49% ~ 16.46%) in Wisconsin. At the national level, 29.08% (95% eCI: 27.60% ~ 30.24%) of ILI was attributable to cold. Per 10,000 dollars increase in per-capita income was associated with the increment in AF (OLS: β = -6.110, P = 0.021; SLM: β = -5.496, P = 0.022; SEM: β = -6.150, P = 0.022). CONCLUSION The cold could enhance the risk of ILI and result in a considerable proportion of ILI disease burden. The ILI burden attributed to cold varied across states and was higher in those states with lower economic status. Targeted prevention programs should be considered to lower the burden of influenza.
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Affiliation(s)
- Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Jiao Lian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiaocan Jia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Tianrun Wang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Jingwen Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Chaojun Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Yuping Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Junzhe Bao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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Zheng H, Cheng J, Ho HC, Zhu B, Ding Z, Du W, Wang X, Yu Y, Fei J, Xu Z, Zhou J, Yang J. Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study. FRONTIERS OF ENVIRONMENTAL SCIENCE & ENGINEERING 2023; 17:105. [PMID: 37033401 PMCID: PMC10067518 DOI: 10.1007/s11783-023-1705-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/19/2023]
Abstract
UNLABELLED Although studies have suggested that non-optimal temperatures may increase the risk of injury, epidemiological studies focusing on the association between temperature and non-fatal injury among children and adolescents are limited. Therefore, we investigated the short-term effect of ambient temperature on non-fatal falls and road traffic injuries (RTIs) among students across Jiangsu Province, China. Meteorological data and records of non-fatal outdoor injuries due to falls and RTIs among students aged 6-17 were collected during 2018-2020. We performed a time-stratified case-crossover analysis with a distributed lag nonlinear model to examine the effect of ambient temperature on the risk of injury. Individual meteorological exposure was estimated based on the address of the selected school. We also performed stratified analyses by sex, age, and area. A total of 57322 and 5455 cases of falls and RTIs were collected, respectively. We observed inverted U-shaped curves for temperature-injury associations, with maximum risk temperatures at 18 °C (48th of daily mean temperature distribution) for falls and 22 °C (67th of daily mean temperature distribution) for RTIs. The corresponding odds ratios (95% confidence intervals) were 2.193 (2.011, 2.391) and 3.038 (1.988, 4.644) for falls and RTIs, respectively. Notably, there was a significant age-dependent trend in which the temperature effect on falls was greater in older students (P-trend < 0.05). This study suggests a significant association between ambient temperature and students' outdoor falls and RTIs. Our findings may help advance tailored strategies to reduce the incidence of outdoor falls and RTIs in children and adolescents. ELECTRONIC SUPPLEMENTARY MATERIAL Supplementary material is available in the online version of this article at 10.1007/s11783-023-1705-1 and is accessible for authorized users.
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Affiliation(s)
- Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032 China
- Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, 230032 China
| | - Hung Chak Ho
- Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, 999077 China
| | - Baoli Zhu
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Zhen Ding
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Wencong Du
- Department of Noncommunicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Xin Wang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Yang Yu
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Juan Fei
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Zhiwei Xu
- School of Public Health, University of Queensland, Queensland, 4006 Australia
| | - Jinyi Zhou
- Department of Noncommunicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Jie Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
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Pascal M, Wagner V, Corso M. Changes in the temperature-mortality relationship in France: Limited evidence of adaptation to a new climate. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:725-734. [PMID: 36930363 DOI: 10.1007/s00484-023-02451-1] [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: 06/21/2022] [Revised: 01/18/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
CONTEXT Documenting trends in the health impacts of ambient temperature is key to supporting adaptation strategies to climate change. This paper explores changes in the temperature-related mortality in 18 French urban centers between 1970 and 2015. METHOD A multicentric time-series design with time-varying distributed lag nonlinear models was adopted to model the shape of the relationship and assess temporal changes in risks and impacts. RESULTS The general shape of the temperature-mortality relationship did not change over time, except for an increasing risk at very low percentiles and a decreasing risk at very high percentiles. The relative risk at the 99.9th percentile compared to the 50th percentile of the 1970-2015 temperature distribution decreased from 2.33 [95% confidence interval (CI): 1.95:2.79] in 1975 to 1.33 [95% CI: 1.14:1.55] in 2015. Between 1970 and 2015, 302,456 [95% CI: 292,723:311,392] deaths were attributable to non-optimal temperatures, corresponding to 5.5% [95% CI: 5.3:5.6] of total mortality. This burden decreased progressively, representing 7.2% [95% CI: 6.7:7.7] of total mortality in the 1970s to 3.4% [95% CI: 3.2:3.6] in the 2000s. However, the contribution of hot temperatures to this burden (higher than the 90th percentile) increased. DISCUSSION Despite the decreasing relative risk, the fraction of mortality attributable to extreme heat increased between 1970 and 2015, thus highlighting the need for proactive adaptation.
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Affiliation(s)
- Mathilde Pascal
- Department of Environmental and Occupational Health, Santé Publique France, 12 Rue du Val d'Osne, 94415, St Maurice, France.
| | - Vérène Wagner
- Department of Environmental and Occupational Health, Santé Publique France, 12 Rue du Val d'Osne, 94415, St Maurice, France
| | - Magali Corso
- Department of Environmental and Occupational Health, Santé Publique France, 12 Rue du Val d'Osne, 94415, St Maurice, France
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Wu Q, Yang M, Wu K, Su H, Huang C, Xu Z, Ho HC, Zheng H, Zhang W, Tao J, Dang TAT, Hossain MZ, Khan MA, Bogale D, Cheng J. Abnormal ambient temperature change increases the risk of out-of-hospital cardiac arrest: A systematic review and meta-analysis of exposure types, risk, and vulnerable populations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 861:160554. [PMID: 36574560 DOI: 10.1016/j.scitotenv.2022.160554] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/08/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There is growing evidence in support of a short-term association between ambient temperature and cardiac arrest attacks that is a serious manifestation of cardiovascular disease and has a high incidence and low survival rate. However, it remains unrecognized about the hazardous temperature exposure types, exposure risk magnitude, and vulnerable populations. OBJECTIVES We comprehensively summarize prior epidemiological studies looking at the short-term associations of out-of-hospital cardiac arrest (OHCA) with various temperature exposures among different populations. METHODS We searched PubMed and Web of Science databases from inception to October 2021 for eligible English language. Temperature exposure was categorized into three types: heat (included high temperature, extreme heat, and heatwave), cold (included low temperature and extreme cold), and temperature variation (included diurnal temperature range and temperature change between two adjacent days). Meta-analysis weighted by inverse variance was used to pool effect estimates. RESULTS This study included 15 studies from 8 countries, totaling around 1 million OHCA events. Extreme heat and extreme cold were significantly associated with an increased risk of OHCA, and the pooled relative risks (RRs) were 1.071 [95 % confidence interval (CI): 1.019-1.126] and 1.662 (95%CI: 1.138-2.427), respectively. The risk of OHCA was also elevated by heatwaves (RR = 1.248, 95%CI: 1.091-1.427) and more intensive heatwaves had a greater effect. Notably, the elderly and males seemed to be more vulnerable to the effects of heat and cold. However, we did not observe a significant association between temperature variation and the risk of OHCA (1.005, 95%CI: 0.999-1.012). CONCLUSION Short-term exposure to heat and cold may be novel risk factors for OHCA. Considering available studies in limited regions, the temperature effect on OHCA should be urgently confirmed in different regions.
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Affiliation(s)
- Qiyue Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Min Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Keyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, QLD, Australia
| | - Hung Chak Ho
- Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Thi Anh Thu Dang
- Institute for Community Health Research, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Alfazal Khan
- Matlab Health Research Centre, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Daniel Bogale
- College of Health Sciences, Arsi University, Asela, Ethiopia
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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Corvetto JF, Helou AY, Dambach P, Müller T, Sauerborn R. A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1190. [PMID: 36673946 PMCID: PMC9858749 DOI: 10.3390/ijerph20021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.
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Affiliation(s)
- Julia Feriato Corvetto
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ammir Yacoub Helou
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Thomas Müller
- Private Clinic Meiringen, 3860 Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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Demoury C, De Troeyer K, Berete F, Aerts R, Van Schaeybroeck B, Van der Heyden J, De Clercq EM. Association between temperature and natural mortality in Belgium: Effect modification by individual characteristics and residential environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158336. [PMID: 36037893 DOI: 10.1016/j.scitotenv.2022.158336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is strong evidence of mortality being associated to extreme temperatures but the extent to which individual or residential factors modulate this temperature vulnerability is less clear. METHODS We conducted a multi-city study with a time-stratified case-crossover design and used conditional logistic regression to examine the association between extreme temperatures and overall natural and cause-specific mortality. City-specific estimates were pooled using a random-effect meta-analysis to describe the global association. Cold and heat effects were assessed by comparing the mortality risks corresponding to the 2.5th and 97.5th percentiles of the daily temperature, respectively, with the minimum mortality temperature. For cold, we cumulated the risk over lags of 0 to 28 days before death and 0 to 7 days for heat. We carried out stratified analyses and assessed effect modification by individual characteristics, preexisting chronic health conditions and residential environment (population density, built-up area and air pollutants: PM2.5, NO2, O3 and black carbon) to identify more vulnerable population subgroups. RESULTS Based on 307,859 deaths from natural causes, we found significant cold effect (OR = 1.42, 95%CI: 1.30-1.57) and heat effect (OR = 1.17, 95%CI: 1.12-1.21) for overall natural mortality and for respiratory causes in particular. There were significant effects modifications for some health conditions: people with asthma were at higher risk for cold, and people with psychoses for heat. In addition, people with long or frequent hospital admissions in the year preceding death were at lower risk. Despite large uncertainties, there was suggestion of effect modification by air pollutants: the effect of heat was higher on more polluted days of O3 and black carbon, and a higher cold effect was observed on more polluted days of PM2.5 and NO2 while for O3, the effect was lower. CONCLUSIONS These findings allow for targeted planning of public-health measures aiming to prevent the effects of extreme temperatures.
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Affiliation(s)
- Claire Demoury
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium.
| | | | - Finaba Berete
- Lifestyle and Chronic Diseases, Sciensano, Brussels, Belgium
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, KU Leuven, Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - Bert Van Schaeybroeck
- Department of Meteorological Research and Development, Royal Meteorological Institute of Belgium, Brussels, Belgium
| | | | - Eva M De Clercq
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
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17
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Phung VLH, Oka K, Hijioka Y, Ueda K, Sahani M, Wan Mahiyuddin WR. Environmental variable importance for under-five mortality in Malaysia: A random forest approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 845:157312. [PMID: 35839873 DOI: 10.1016/j.scitotenv.2022.157312] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/29/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Environmental factors have been associated with adverse health effects in epidemiological studies. The main exposure variable is usually determined via prior knowledge or statistical methods. It may be challenging when evidence is scarce to support prior knowledge, or to address collinearity issues using statistical methods. This study aimed to investigate the importance level of environmental variables for the under-five mortality in Malaysia via random forest approach. METHOD We applied a conditional permutation importance via a random forest (CPI-RF) approach to evaluate the relative importance of the weather- and air pollution-related environmental factors on daily under-five mortality in Malaysia. This study spanned from January 1, 2014 to December 31, 2016. In data preparation, deviation mortality counts were derived through a generalized additive model, adjusting for long-term trend and seasonality. Analyses were conducted considering mortality causes (all-cause, natural-cause, or external-cause) and data structures (continuous, categorical, or all types [i.e., include all variables of continuous type and all variables of categorical type]). The main analysis comprised of two stages. In Stage 1, Boruta selection was applied for preliminary screening to remove highly unimportant variables. In Stage 2, the retained variables from Boruta were used in the CPI-RF analysis. The final importance value was obtained as an average value from a 10-fold cross-validation. RESULT Some heat-related variables (maximum temperature, heat wave), temperature variability, and haze-related variables (PM10, PM10-derived haze index, PM10- and fire-derived haze index, fire hotspot) were among the prominent variables associated with under-five mortality in Malaysia. The important variables were consistent for all- and natural-cause mortality and sensitivity analyses. However, different most important variables were observed between natural- and external-cause under-five mortality. CONCLUSION Heat-related variables, temperature variability, and haze-related variables were consistently prominent for all- and natural-cause under-five mortalities, but not for external-cause.
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Affiliation(s)
- Vera Ling Hui Phung
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan.
| | - Kazutaka Oka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yasuaki Hijioka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Kyoto, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Kyoto, Japan
| | - Mazrura Sahani
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Environmental Health Research Center, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health, Shah Alam, Selangor, Malaysia
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