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Remigio RV, He H, Raimann JG, Kotanko P, Maddux FW, Sapkota AR, Liang XZ, Puett R, He X, Sapkota A. Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152481. [PMID: 34921874 PMCID: PMC8962569 DOI: 10.1016/j.scitotenv.2021.152481] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Increasing number of studies have linked air pollution exposure with renal function decline and disease. However, there is a lack of data on its impact among end-stage kidney disease (ESKD) patients and its potential modifying effect from extreme heat events (EHE). METHODS Fresenius Kidney Care records from 28 selected northeastern US counties were used to pool daily all-cause mortality (ACM) and all-cause hospital admissions (ACHA) counts. County-level daily ambient PM2.5 and ozone (O3) were estimated using a high-resolution spatiotemporal coupled climate-air quality model and matched to ESKD patients based on ZIP codes of treatment sites. We used time-stratified case-crossover analyses to characterize acute exposures using individual and cumulative lag exposures for up to 3 days (Lag 0-3) by using a distributed lag nonlinear model framework. We used a nested model comparison hypothesis test to evaluate for interaction effects between air pollutants and EHE and stratification analyses to estimate effect measures modified by EHE days. RESULTS From 2001 to 2016, the sample population consisted of 43,338 ESKD patients. We recorded 5217 deaths and 78,433 hospital admissions. A 10-unit increase in PM2.5 concentration was associated with a 5% increase in ACM (rate ratio [RRLag0-3]: 1.05, 95% CI: 1.00-1.10) and same-day O3 (RRLag0: 1.02, 95% CI: 1.01-1.03) after adjusting for extreme heat exposures. Mortality models suggest evidence of interaction and effect measure modification, though not always simultaneously. ACM risk increased up to 8% when daily ozone concentrations exceeded National Ambient Air Quality Standards established by the United States, but the increases in risk were considerably higher during EHE days across lag periods. CONCLUSION Our findings suggest interdependent effects of EHE and air pollution among ESKD patients for all-cause mortality risks. National level assessments are needed to consider the ESKD population as a sensitive population and inform treatment protocols during extreme heat and degraded pollution episodes.
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Affiliation(s)
- Richard V Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Hao He
- Department of Atmospheric and Oceanic Sciences, University of Maryland, College Park, MD, USA
| | | | - Peter Kotanko
- Research Division, Renal Research Institute, New York, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Amy Rebecca Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Xin-Zhong Liang
- Department of Atmospheric and Oceanic Sciences, University of Maryland, College Park, MD, USA; Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
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Effects of Urban Landscape and Sociodemographic Characteristics on Heat-Related Health Using Emergency Medical Service Incidents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031287. [PMID: 35162309 PMCID: PMC8835151 DOI: 10.3390/ijerph19031287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/11/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022]
Abstract
It is well known that extremely hot weather causes heat-related health issues. Health problems, especially in urban areas, are becoming increasingly important due to urban heat island effect. Understanding the impact of neighborhood characteristics is important for research into the relationship between thermal environment and human health. The objectives of this study were to explore the urban landscape and sociodemographic characteristics affecting heat-related health and identify spatial inequalities for vulnerable groups. A total of 27,807 heat-related EMS incidents were used at the census block group level (N = 285). We used land cover database and Landsat satellite images for urban landscape variables and used 2019 U.S. Census data for sociodemographic variables. Negative binomial regression was used to identify the neighborhood variables associated with the heat-related EMS incidents in each block group. Heat-related health has been alleviated in block groups with high green areas. However, the negative effects of thermal environments on human health were higher in areas with a high percentage of impervious surface, over 65 years, non-white people, no high school diploma, or unemployment. The results indicate that heat-related health problems can be addressed through prevention strategies for block group variables. Local intervention efforts to solve health issues should be targeted at more vulnerable areas and groups.
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Morgado ME, Jiang C, Zambrana J, Upperman CR, Mitchell C, Boyle M, Sapkota AR, Sapkota A. Climate change, extreme events, and increased risk of salmonellosis: foodborne diseases active surveillance network (FoodNet), 2004-2014. Environ Health 2021; 20:105. [PMID: 34537076 PMCID: PMC8449873 DOI: 10.1186/s12940-021-00787-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/06/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Infections with nontyphoidal Salmonella cause an estimated 19,336 hospitalizations each year in the United States. Sources of infection can vary by state and include animal and plant-based foods, as well as environmental reservoirs. Several studies have recognized the importance of increased ambient temperature and precipitation in the spread and persistence of Salmonella in soil and food. However, the impact of extreme weather events on Salmonella infection rates among the most prevalent serovars, has not been fully evaluated across distinct U.S. regions. METHODS To address this knowledge gap, we obtained Salmonella case data for S. Enteriditis, S. Typhimurium, S. Newport, and S. Javiana (2004-2014; n = 32,951) from the Foodborne Diseases Active Surveillance Network (FoodNet), and weather data from the National Climatic Data Center (1960-2014). Extreme heat and precipitation events for the study period (2004-2014) were identified using location and calendar day specific 95th percentile thresholds derived using a 30-year baseline (1960-1989). Negative binomial generalized estimating equations were used to evaluate the association between exposure to extreme events and salmonellosis rates. RESULTS We observed that extreme heat exposure was associated with increased rates of infection with S. Newport in Maryland (Incidence Rate Ratio (IRR): 1.07, 95% Confidence Interval (CI): 1.01, 1.14), and Tennessee (IRR: 1.06, 95% CI: 1.04, 1.09), both FoodNet sites with high densities of animal feeding operations (e.g., broiler chickens and cattle). Extreme precipitation events were also associated with increased rates of S. Javiana infections, by 22% in Connecticut (IRR: 1.22, 95% CI: 1.10, 1.35) and by 5% in Georgia (IRR: 1.05, 95% CI: 1.01, 1.08), respectively. In addition, there was an 11% (IRR: 1.11, 95% CI: 1.04-1.18) increased rate of S. Newport infections in Maryland associated with extreme precipitation events. CONCLUSIONS Overall, our study suggests a stronger association between extreme precipitation events, compared to extreme heat, and salmonellosis across multiple U.S. regions. In addition, the rates of infection with Salmonella serovars that persist in environmental or plant-based reservoirs, such as S. Javiana and S. Newport, appear to be of particular significance regarding increased heat and rainfall events.
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Affiliation(s)
- Michele E. Morgado
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, MD 20742 USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, MD 20742 USA
| | - Jordan Zambrana
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, MD 20742 USA
| | - Crystal Romeo Upperman
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, MD 20742 USA
- Aclima, Inc., San Francisco, CA USA
| | - Clifford Mitchell
- Maryland Department of Health, Prevention and Health Promotion Administration, Baltimore, MD USA
| | - Michelle Boyle
- Maryland Department of Health, Prevention and Health Promotion Administration, Baltimore, MD USA
| | - Amy R. Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, MD 20742 USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, MD 20742 USA
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McDermott-Levy R, Scolio M, Shakya KM, Moore CH. Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158220. [PMID: 34360518 PMCID: PMC8345936 DOI: 10.3390/ijerph18158220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022]
Abstract
Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl’s framework for an integrative review. Ninety-eight articles were included in the review from three databases—PubMed, Web of Science, and Scopus—with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.
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Affiliation(s)
- Ruth McDermott-Levy
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA
- Correspondence:
| | - Madeline Scolio
- Department of Geography and the Environment, Villanova University, Villanova, PA 19085, USA; (M.S.); (K.M.S.)
| | - Kabindra M. Shakya
- Department of Geography and the Environment, Villanova University, Villanova, PA 19085, USA; (M.S.); (K.M.S.)
| | - Caroline H. Moore
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA 30341, USA;
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Li L, Jiang C, Murtugudde R, Liang XZ, Sapkota A. Global Population Exposed to Extreme Events in the 150 Most Populated Cities of the World: Implications for Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031293. [PMID: 33535524 PMCID: PMC7908124 DOI: 10.3390/ijerph18031293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 02/08/2023]
Abstract
Climate change driven increases in the frequency of extreme heat events (EHE) and extreme precipitation events (EPE) are contributing to both infectious and non-infectious disease burden, particularly in urban city centers. While the share of urban populations continues to grow, a comprehensive assessment of populations impacted by these threats is lacking. Using data from weather stations, climate models, and urban population growth during 1980–2017, here, we show that the concurrent rise in the frequency of EHE, EPE, and urban populations has resulted in over 500% increases in individuals exposed to EHE and EPE in the 150 most populated cities of the world. Since most of the population increases over the next several decades are projected to take place in city centers within low- and middle-income countries, skillful early warnings and community specific response strategies are urgently needed to minimize public health impacts and associated costs to the global economy.
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Affiliation(s)
- Linze Li
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD 20742, USA; (L.L.); (C.J.)
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan 430079, China
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD 20742, USA; (L.L.); (C.J.)
| | - Raghu Murtugudde
- Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20742, USA; (R.M.); (X.-Z.L.)
| | - Xin-Zhong Liang
- Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20742, USA; (R.M.); (X.-Z.L.)
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD 20742, USA; (L.L.); (C.J.)
- Correspondence: ; Tel.: +301-405-8716
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Remigio RV, Jiang C, Raimann J, Kotanko P, Usvyat L, Maddux FW, Kinney P, Sapkota A. Association of Extreme Heat Events With Hospital Admission or Mortality Among Patients With End-Stage Renal Disease. JAMA Netw Open 2019; 2:e198904. [PMID: 31397862 PMCID: PMC6692691 DOI: 10.1001/jamanetworkopen.2019.8904] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 12/11/2022] Open
Abstract
Importance Extreme heat events (EHEs) are increasing in frequency, duration, and intensity, and this trend is projected to continue as part of ongoing climate change. There is a paucity of data regarding how EHEs may affect highly vulnerable populations, such as patients with end-stage renal disease (ESRD). Such data are needed to inform ESRD patient management guidelines in a changing climate. Objectives To investigate the association between EHEs and the risk of hospital admission or mortality among patients with ESRD and further characterize how this risk may vary among races/ethnicities or patients with preexisting comorbidities. Design, Setting, and Participants This study used hospital admission and mortality records of patients with ESRD who underwent hemodialysis treatment at Fresenius Kidney Care clinics in Boston, Massachusetts; Philadelphia, Pennsylvania; or New York, New York, from January 1, 2001, to December 31, 2012. Data were analyzed using a time-stratified case-crossover design with conditional Poisson regression to investigate associations between EHEs and risk of hospital admission or mortality among patients with ESRD. Data were analyzed from July 1, 2017, to March 31, 2019. Exposures Calendar day- and location-specific 95th-percentile maximum temperature thresholds were calculated using daily meteorological data from 1960 to 1989. These thresholds were used to identify EHEs in each of the 3 cities during the study. Main Outcomes and Measures Daily all-cause hospital admission and all-cause mortality among patients with ESRD. Results The study included 7445 patients with ESRD (mean [SD] age, 61.1 [14.1] years; 4283 [57.5%] men), among whom 2953 deaths (39.7%) and 44 941 hospital admissions (mean [SD], 6.0 [7.5] per patient) were recorded. Extreme heat events were associated with increased risk of same-day hospital admission (rate ratio [RR], 1.27; 95% CI, 1.13-1.43) and same-day mortality (RR, 1.31; 95% CI, 1.01-1.70) among patients with ESRD. There was some heterogeneity in risk, with patients in Boston showing statistically significant increased risk for hospital admission (RR, 1.15; 95% CI, 1.00-1.31) and mortality (RR, 1.45; 95% CI, 1.04-2.02) associated with cumulative exposure to EHEs, while such risk was absent among patients with ESRD in Philadelphia. While increases in risks were similar among non-Hispanic black and non-Hispanic white patients, findings among Hispanic and Asian patients were less clear. After stratifying by preexisting comorbidities, cumulative lag exposure to EHEs was associated with increased risk of mortality among patients with ESRD living with congestive heart failure (RR, 1.55; 95% CI, 1.27-1.89), chronic obstructive pulmonary disease (RR, 1.60; 95% CI, 1.24-2.06), or diabetes (RR, 1.83; 95% CI, 1.51-2.21). Conclusions and Relevance In this study, extreme heat events were associated with increased risk of hospital admission or mortality among patients with ESRD, and the association was potentially affected by geographic region and race/ethnicity. Future studies with larger populations and broader geographic coverage are needed to better characterize this variability in risk and inform ESRD management guidelines and differential risk variables, given the projected increases in the frequency, duration, and intensity of EHEs.
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Affiliation(s)
- Richard V. Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
| | - Jochen Raimann
- Research Division, Renal Research Institute, New York, New York
| | - Peter Kotanko
- Research Division, Renal Research Institute, New York, New York
- Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Len Usvyat
- Research Division, Renal Research Institute, New York, New York
| | - Frank W. Maddux
- Research Division, Renal Research Institute, New York, New York
| | - Patrick Kinney
- School of Public Health, Boston University, Boston, Massachusetts
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park
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Moulton AD, Schramm PJ. Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23:618-626. [PMID: 28169865 PMCID: PMC5603401 DOI: 10.1097/phh.0000000000000550] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity. OBJECTIVE Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted. METHODS Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations. FINDINGS Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity. CONCLUSIONS A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic plan to create and sustain that capacity.
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Affiliation(s)
- Anthony Drummond Moulton
- Climate and Health Program, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia (Mr Schramm). Dr Moulton was with the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, during research for this study
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Motesharrei S, Rivas J, Kalnay E, Asrar GR, Busalacchi AJ, Cahalan RF, Cane MA, Colwell RR, Feng K, Franklin RS, Hubacek K, Miralles-Wilhelm F, Miyoshi T, Ruth M, Sagdeev R, Shirmohammadi A, Shukla J, Srebric J, Yakovenko VM, Zeng N. Modeling Sustainability: Population, Inequality, Consumption, and Bidirectional Coupling of the Earth and Human Systems. Natl Sci Rev 2016; 3:470-494. [PMID: 32747868 PMCID: PMC7398446 DOI: 10.1093/nsr/nww081] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Over the last two centuries, the impact of the Human System has grown dramatically, becoming strongly dominant within the Earth System in many different ways. Consumption, inequality, and population have increased extremely fast, especially since about 1950, threatening to overwhelm the many critical functions and ecosystems of the Earth System. Changes in the Earth System, in turn, have important feedback effects on the Human System, with costly and potentially serious consequences. However, current models do not incorporate these critical feedbacks. We argue that in order to understand the dynamics of either system, Earth System Models must be coupled with Human System Models through bidirectional couplings representing the positive, negative, and delayed feedbacks that exist in the real systems. In particular, key Human System variables, such as demographics, inequality, economic growth, and migration, are not coupled with the Earth System but are instead driven by exogenous estimates, such as UN population projections. This makes current models likely to miss important feedbacks in the real Earth-Human system, especially those that may result in unexpected or counterintuitive outcomes, and thus requiring different policy interventions from current models. The importance and imminence of sustainability challenges, the dominant role of the Human System in the Earth System, and the essential roles the Earth System plays for the Human System, all call for collaboration of natural scientists, social scientists, and engineers in multidisciplinary research and modeling to develop coupled Earth-Human system models for devising effective science-based policies and measures to benefit current and future generations.
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Affiliation(s)
| | - Jorge Rivas
- Institute for Global Environment and Society
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Upperman CR, Parker JD, Akinbami LJ, Jiang C, He X, Murtugudde R, Curriero FC, Ziska L, Sapkota A. Exposure to Extreme Heat Events Is Associated with Increased Hay Fever Prevalence among Nationally Representative Sample of US Adults: 1997-2013. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 5:435-441.e2. [PMID: 27840238 DOI: 10.1016/j.jaip.2016.09.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/09/2016] [Accepted: 09/08/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Warmer temperature can alter seasonality of pollen as well as pollen concentration, and may impact allergic diseases such as hay fever. Recent studies suggest that extreme heat events will likely increase in frequency, intensity, and duration in coming decades in response to changing climate. OBJECTIVE The overall objective of this study was to investigate if extreme heat events are associated with hay fever. METHODS We linked National Health Interview Survey (NHIS) data from 1997 to 2013 (n = 505,386 respondents) with extreme heat event data, defined as days when daily maximum temperature (TMAX) exceeded the 95th percentile values of TMAX for a 30-year reference period (1960-1989). We used logistic regression to investigate the associations between exposure to annual and seasonal extreme heat events and adult hay fever prevalence among the NHIS respondents. RESULTS During 1997-2013, hay fever prevalence among adults 18 years and older was 8.43%. Age, race/ethnicity, poverty status, education, and sex were significantly associated with hay fever status. We observed that adults in the highest quartile of exposure to extreme heat events had a 7% increased odds of hay fever compared with those in the lowest quartile of exposure (odds ratios: 1.07, 95% confidence interval: 1.02-1.11). This relationship was more pronounced for extreme heat events that occurred during spring season, with evidence of an exposure-response relationship (Ptrend < .01). CONCLUSIONS Our data suggest that exposure to extreme heat events is associated with increased prevalence of hay fever among US adults.
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Affiliation(s)
- Crystal Romeo Upperman
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md; Marine Estuarine Environmental Science Program, College of Computer Mathematics and Natural Sciences, University of Maryland, College Park, Md
| | - Jennifer D Parker
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md
| | - Lara J Akinbami
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md
| | - Xin He
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Md
| | - Raghuram Murtugudde
- Department of Atmospheric and Oceanic Science, University of Maryland, College Park, Md
| | - Frank C Curriero
- Department of Epidemiology and Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md
| | - Lewis Ziska
- Crop Systems and Global Change Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Md
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md.
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LaKind JS, Overpeck J, Breysse PN, Backer L, Richardson SD, Sobus J, Sapkota A, Upperman CR, Jiang C, Beard CB, Brunkard JM, Bell JE, Harris R, Chretien JP, Peltier RE, Chew GL, Blount BC. Exposure science in an age of rapidly changing climate: challenges and opportunities. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:529-538. [PMID: 27485992 PMCID: PMC5071542 DOI: 10.1038/jes.2016.35] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/13/2016] [Indexed: 05/18/2023]
Abstract
Climate change is anticipated to alter the production, use, release, and fate of environmental chemicals, likely leading to increased uncertainty in exposure and human health risk predictions. Exposure science provides a key connection between changes in climate and associated health outcomes. The theme of the 2015 Annual Meeting of the International Society of Exposure Science-Exposures in an Evolving Environment-brought this issue to the fore. By directing attention to questions that may affect society in profound ways, exposure scientists have an opportunity to conduct "consequential science"-doing science that matters, using our tools for the greater good and to answer key policy questions, and identifying causes leading to implementation of solutions. Understanding the implications of changing exposures on public health may be one of the most consequential areas of study in which exposure scientists could currently be engaged. In this paper, we use a series of case studies to identify exposure data gaps and research paths that will enable us to capture the information necessary for understanding climate change-related human exposures and consequent health impacts. We hope that paper will focus attention on under-developed areas of exposure science that will likely have broad implications for public health.
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Affiliation(s)
- Judy S LaKind
- LaKind Associates, LLC, 106 Oakdale Avenue, Catonsville, 21228 MD USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, 21201 MD USA
- Department of Pediatrics, Hershey Medical Center, Penn State U College of Medicine, Hershey, 17033 PA USA
| | - Jonathan Overpeck
- Institute of the Environment, University of Arizona, ENR2 Building, Room N523, 1064 East Lowell Street, PO Box 210137, Tucson, 85721-013 7 AZ USA
| | - Patrick N Breysse
- National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, 4770 Buford Highway, NE, MS-F60,, Atlanta, 30341 GA USA
| | - Lorrie Backer
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS-F60, Atlanta, 30341 GA USA
| | - Susan D Richardson
- Department of Chemistry and Biochemistry, University of South Carolina, 631 Sumter Street, JM Palms Center for GSR, Columbia, 29208 SC USA
| | - Jon Sobus
- National Exposure Research Laboratory, US Environmental Protection Agency, Mail Code: E205-04, Research Triangle Park, 27711 NC USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, 20742 MD USA
| | - Crystal R Upperman
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, 20742 MD USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, 20742 MD USA
| | - C Ben Beard
- Division of Vector-Borne Diseases, Bacterial Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Mail Stop P-02, 3156 Rampart Road, Fort Collins, 80521 CO USA
| | - J M Brunkard
- Waterborne Diseases Prevention Branch, Centers for Disease Control and Prevention, Mail Stop C-09, 1600 Clifton Road NE, Atlanta, 30333 GA USA
| | - Jesse E Bell
- Cooperative Institute for Climate and Satellites—NC, North Carolina State University, 151 Patton Avenue, Asheville, 28801 NC USA
| | - Ryan Harris
- USAF, 14th Weather Squadron (DoD Applied Climate Services), Asheville, NC USA
| | - Jean-Paul Chretien
- Armed Forces Health Surveillance Branch, Defense Health Agency, Silver Spring, MD USA
| | - Richard E Peltier
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, 149 Goessmann Laboratory, 686 North Pleasant Street, Amherst, 01003 MA USA
| | - Ginger L Chew
- Division of Environmental Hazards and Health Effects, Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS-F60, Atlanta, 30341 GA USA
| | - Benjamin C Blount
- Tobacco and Volatiles Branch of the Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS F47, Atlanta, 30341 GA USA
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11
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Soneja S, Jiang C, Fisher J, Upperman CR, Mitchell C, Sapkota A. Exposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A. Environ Health 2016; 15:57. [PMID: 27117324 PMCID: PMC4847234 DOI: 10.1186/s12940-016-0142-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/22/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Several studies have investigated the association between asthma exacerbations and exposures to ambient temperature and precipitation. However, limited data exists regarding how extreme events, projected to grow in frequency, intensity, and duration in the future in response to our changing climate, will impact the risk of hospitalization for asthma. The objective of our study was to quantify the association between frequency of extreme heat and precipitation events and increased risk of hospitalization for asthma in Maryland between 2000 and 2012. METHODS We used a time-stratified case-crossover design to examine the association between exposure to extreme heat and precipitation events and risk of hospitalization for asthma (ICD-9 code 493, n = 115,923). RESULTS Occurrence of extreme heat events in Maryland increased the risk of same day hospitalization for asthma (lag 0) by 3 % (Odds Ratio (OR): 1.03, 95 % Confidence Interval (CI): 1.00, 1.07), with a considerably higher risk observed for extreme heat events that occur during summer months (OR: 1.23, 95 % CI: 1.15, 1.33). Likewise, summertime extreme precipitation events increased the risk of hospitalization for asthma by 11 % in Maryland (OR: 1.11, 95 % CI: 1.06, 1.17). Across age groups, increase in risk for asthma hospitalization from exposure to extreme heat event during the summer months was most pronounced among youth and adults, while those related to extreme precipitation event was highest among ≤4 year olds. CONCLUSION Exposure to extreme heat and extreme precipitation events, particularly during summertime, is associated with increased risk of hospitalization for asthma in Maryland. Our results suggest that projected increases in frequency of extreme heat and precipitation event will have significant impact on public health.
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Affiliation(s)
- Sutyajeet Soneja
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Jared Fisher
- Department of Epidemiology, University of Maryland School of Public Health, College Park, 20742, MD, USA
| | - Crystal Romeo Upperman
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Clifford Mitchell
- Maryland Department of Health and Mental Hygiene, Prevention and Health Promotion Administration, Baltimore, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA.
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