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Hampo CC, Schinasi LH, Hoque S. Surviving indoor heat stress in United States: A comprehensive review exploring the impact of overheating on the thermal comfort, health, and social economic factors of occupants. Heliyon 2024; 10:e25801. [PMID: 38371979 PMCID: PMC10873744 DOI: 10.1016/j.heliyon.2024.e25801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/23/2024] [Accepted: 02/02/2024] [Indexed: 02/20/2024] Open
Abstract
In the face of escalating global climate change and the increasing frequency of extreme heat events, the mitigation of building overheating has become an urgent priority. This comprehensive review converges insights from building science and public health domains to offer a thorough understanding of the multifaceted impacts of indoor overheating on occupants. The paper addresses a significant research gap by offering a holistic exploration of indoor overheating of residential buildings and its consequences, with a specific focus on the United States, an economically diverse nation that has been underrepresented in the literature. The review illuminates the effects of overheating on thermal comfort, health, and socio-economic aspects within the built environment. It emphasizes associated repercussions, including heightened cooling energy consumption, increased peak electricity demand, and elevated vulnerability, leading to exacerbated heat-related mortality and morbidity rates, especially among disadvantaged groups. The study concludes that vulnerabilities to these impacts are intricately tied to regional climatic conditions, highlighting the inadequacy of a one-size-fits-all approach. Tailored interventions for each climate zone are deemed necessary, considering the consistent occurrence of indoor temperatures surpassing outdoor levels, known as superheating, which poses distinct challenges. The research underscores the urgency of addressing indoor overheating as a critical facet of public health, acknowledging direct socioeconomic repercussions. It advocates for further research to inform comprehensive policies that safeguard public health across diverse indoor environments.
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Affiliation(s)
- Chima Cyril Hampo
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, USA
| | - Leah H. Schinasi
- Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Simi Hoque
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, USA
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2
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Gianfredi V, Mazziotta F, Clerici G, Astorri E, Oliani F, Cappellina M, Catalini A, Dell’Osso BM, Pregliasco FE, Castaldi S, Benatti B. Climate Change Perception and Mental Health. Results from a Systematic Review of the Literature. Eur J Investig Health Psychol Educ 2024; 14:215-229. [PMID: 38248134 PMCID: PMC10814599 DOI: 10.3390/ejihpe14010014] [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: 11/07/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Climate change is one of the main global challenges and influences various aspects of human health. Numerous studies have indeed demonstrated an association between extreme climate-related events and physical and mental health outcomes, but little is still known about the association between the perception/awareness of climate change and mental health. In accordance with the PRISMA 2020 guidelines, a search was conducted on PubMed and Scopus. The protocol was registered on PROSPERO. The included studies were original observational studies published in English, reporting the association between the perception/awareness of climate change and mental health. A total of 3018 articles were identified. A total of 10 observational studies were included. The period covered in the included studies ranged between 2012 and 2022. Climate change perception is consistently associated with adverse mental health effects across different types of estimates. In particular, the studies identified an association between a higher level of perception/awareness of climate change and depression, anxiety, eco-anxiety, stress, adjustment disorder, substance use, dysphoria, and even thoughts of suicide. Qualitative data underscore the impact on daily activities, contributing to feelings of loss and suicidal ideation. Moreover, climate change perception correlates with lower well-being and resilience. The association between awareness of climate change and mental health is a complex and still poorly explored phenomenon. The main limitations are the high heterogeneity in terms of exposure assessment and data reporting, which hinders quantitative analysis. These results show that climate change perception impacts mental health. Better understanding the phenomenon represents an opportunity to inform public health interventions that promote mental well-being.
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Affiliation(s)
- Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
| | - Francesco Mazziotta
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
| | - Giovanna Clerici
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
| | - Elisa Astorri
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
| | - Francesco Oliani
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
| | - Martina Cappellina
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, 60100 Ancona, Italy;
| | - Bernardo Maria Dell’Osso
- “Aldo Ravelli” Center for Neurotechnology and Brain Therapeutic, University of Milan, 20157 Milan, Italy; (B.M.D.)
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, 20157 Milan, Italy
| | - Fabrizio Ernesto Pregliasco
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (F.M.); (G.C.); (E.A.); (F.O.); (M.C.); (F.E.P.); (S.C.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Beatrice Benatti
- “Aldo Ravelli” Center for Neurotechnology and Brain Therapeutic, University of Milan, 20157 Milan, Italy; (B.M.D.)
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, 20157 Milan, Italy
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Childs ML, Lyberger K, Harris M, Burke M, Mordecai EA. Climate warming is expanding dengue burden in the Americas and Asia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.08.24301015. [PMID: 38260629 PMCID: PMC10802639 DOI: 10.1101/2024.01.08.24301015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Climate change poses significant threats to public health, with dengue representing a growing concern due to its high existing burden and sensitivity to climatic conditions. Yet, the quantitative impacts of temperature warming on dengue, both in the past and in the future, remain poorly understood. In this study, we quantify how dengue responds to climatic fluctuations, and use this inferred temperature response to estimate the impacts of historical warming and forecast trends under future climate change scenarios. To estimate the causal impact of temperature on the spread of dengue in the Americas and Asia, we assembled a dataset encompassing nearly 1.5 million dengue incidence records from 21 countries. Our analysis revealed a nonlinear relationship between temperature and dengue incidence with the largest marginal effects at lower temperatures (around 15°C), peak incidence at 27.8°C (95% CI: 27.3 - 28.2°C), and subsequent declines at higher temperatures. Our findings indicate that historical climate change has already increased dengue incidence 18% (12 - 25%) in the study region, and projections suggest a potential increase of 40% (17 - 76) to 57% (33 - 107%) by mid-century depending on the climate scenario, with some areas seeing up to 200% increases. Notably, our models suggest that lower emissions scenarios would substantially reduce the warming-driven increase in dengue burden. Together, these insights contribute to the broader understanding of how long-term climate patterns influence dengue, providing a valuable foundation for public health planning and the development of strategies to mitigate future risks due to climate change.
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Affiliation(s)
- Marissa L Childs
- Center for the Environment, Harvard University, Cambridge, MA, USA
| | - Kelsey Lyberger
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Mallory Harris
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Marshall Burke
- Global Environmental Policy, Stanford University, Stanford, CA, USA
- Center on Food Security and the Environment, Stanford University, Stanford, CA, USA
- National Bureau of Economic Research, Cambridge, MA, USA
| | - Erin A Mordecai
- Department of Biology, Stanford University, Stanford, CA, USA
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de Schrijver E, Sivaraj S, Raible CC, Franco OH, Chen K, Vicedo-Cabrera AM. Nationwide projections of heat- and cold-related mortality impacts under various climate change and population development scenarios in Switzerland. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2023; 18:094010. [PMID: 38854588 PMCID: PMC7616072 DOI: 10.1088/1748-9326/ace7e1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Climate change and progressive population development (i.e., ageing and changes in population size) are altering the temporal patterns of temperature-related mortality in Switzerland. However, limited evidence exists on how current trends in heat- and cold-related mortality would evolve in future decades under composite scenarios of global warming and population development. Moreover, the contribution of these drivers to future mortality impacts is not well-understood. Therefore, we aimed to project heat- and cold-related mortality in Switzerland under various combinations of emission and population development scenarios and to disentangle the contribution of each of these two drivers using high-resolution mortality and temperature data. We combined age-specific (<75 and ⩾75 years) temperature-mortality associations in each district in Switzerland (1990-2010), estimated through a two-stage time series analysis, with 2 km downscaled CMIP5 temperature data and population and mortality rate projections under two scenarios: RCP4.5/SSP2 and RCP8.5/SSP5. We derived heat and cold-related mortality for different warming targets (1.5 °C, 2.0 °C and 3.0 °C) using different emission and population development scenarios and compared this to the baseline period (1990-2010). Heat-related mortality is projected to increase from 312 (116; 510) in the 1990-2010 period to 1274 (537; 2284) annual deaths under 2.0 °C of warming (RCP4.5/SSP2) and to 1871 (791; 3284) under 3.0 °C of warming (RCP8.5/SSP5). Cold-related mortality will substantially increase from 4069 (1898; 6016) to 6558 (3223; 9589) annual deaths under 2.0 °C (RCP4.5/SSP2) and to 5997 (2951; 8759) under 3.0 °C (RCP8.5/SSP5). Moreover, while the increase in cold-related mortality is solely driven by population development, for heat, both components (i.e., changes in climate and population) have a similar contribution of around 50% to the projected heat-related mortality trends. In conclusion, our findings suggest that both heat- and cold-related mortality will substantially increase under all scenarios of climate change and population development in Switzerland. Population development will lead to an increase in cold-related mortality despite the decrease in cold temperature under warmer scenarios. Whereas the combination of the progressive warming of the climate and population development will substantially increase and exacerbate the total temperature-related mortality burden in Switzerland.
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Affiliation(s)
- Evan de Schrijver
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Graduate School of Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Sidharth Sivaraj
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
| | - Christoph C Raible
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Climate and Environmental Physics, Physics Institute, University of Bern, Bern, Switzerland
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Julius Center for Health Sciences and Primary Care, University of Utrecht Medical Center, Utrecht, The Netherlands
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States of America
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, United States of America
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
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5
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Wade R. Climate Change and Healthcare: Creating a Sustainable and Climate-Resilient Health Delivery System. J Healthc Manag 2023; 68:227-238. [PMID: 37410987 DOI: 10.1097/jhm-d-23-00096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Climate change poses global challenges as rising temperatures, recurring natural disasters, and the resulting increase in the prevalence of acute and long-term climate-related diseases threaten the health and safety of populations worldwide. The healthcare sector, one of the largest sources of greenhouse gas emissions globally, both exacerbates and suffers from these effects. As leaders in their local communities and the national economy, hospitals and health systems have a responsibility to not only build climate resilience to withstand disaster events but also implement sustainability initiatives that will reduce the healthcare sector's carbon footprint. A wide variety of initiatives that can meet all financial plans and timelines are available. This discussion focuses on three of the most impactful areas for opportunity: building resilience through community, operating room sustainability, and renewable energy sources.
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6
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Samuel G, Richie C. Reimagining research ethics to include environmental sustainability: a principled approach, including a case study of data-driven health research. JOURNAL OF MEDICAL ETHICS 2023; 49:428-433. [PMID: 35922120 DOI: 10.1136/jme-2022-108489] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/23/2022] [Indexed: 05/24/2023]
Abstract
In this paper we argue the need to reimagine research ethics frameworks to include notions of environmental sustainability. While there have long been calls for healthcare ethics frameworks and decision-making to include aspects of sustainability, less attention has focused on how research ethics frameworks could address this. To do this, we first describe the traditional approach to research ethics, which often relies on individualised notions of risk. We argue that we need to broaden this notion of individual risk to consider issues associated with environmental sustainability. This is because research is associated with carbon emissions and other environmental impacts, both of which cause climate change health hazards. We introduce how bioethics frameworks have considered notions of environmental sustainability and draw on these to help develop a framework suitable for researchers. We provide a case study of data-driven health research to apply our framework.
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Affiliation(s)
- Gabrielle Samuel
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Cristina Richie
- Philosophy and Ethics of Technology Department, Delft University of Technology, Delft, Netherlands
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7
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Errett NA, Dolan K, Hartwell C, Vickery J, Hess JJ. Climate Change Adaptation Activities and Needs in US State and Territorial Health Agencies. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:E115-E123. [PMID: 36729985 DOI: 10.1097/phh.0000000000001674] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To characterize US State and Territorial Health Agencies' (S/THA) climate change adaptation activities and priorities to facilitate appropriate investments, skills development, and support that will strengthen health sector capacity in response to a changing climate. DESIGN In 2021, we conducted an online survey of S/THA staff requesting information on current activities related to climate change and health, the state of climate and health programming, and anticipated needs and priorities for assistance. We analyzed survey results using descriptive statistics. SETTING US State and Territorial Health Agencies. PARTICIPANTS We received responses from 41 of 59 S/THAs (69.5%). MAIN OUTCOME MEASURES Implementation of S/THA climate and health programs (CHPs); engagement in climate and health activities; maintenance of hazard early warning systems and action plans; employment of climate and health communications strategies; capability to assess risks and adaptation needs related to various climate-sensitive conditions; priorities and plans for climate change adaptation in relation to climate-sensitive health risks; climate change adaptation-related partnerships and collaborations; requests of the Association of State and Territorial Health Officials (ASTHO) for advancing climate change adaptation activities; and the impacts of the COVID-19 pandemic on climate change work. RESULTS Nineteen S/THAs reported having CHPs, the majority of which are federally funded. On average, S/THAs without CHPs reported engagement in fewer climate and health activities and more early warning activities. The S/THAs reported the highest levels of concerns regarding non-vector-borne infectious disease (66%), vector-borne infectious diseases (61%), and extreme heat (61%) hazards. CONCLUSIONS As S/THAs with CHPs report substantially greater climate and health capacity than those without, additional federal and state investments (eg, Building Resilience Against Climate Effects [BRACE]) are urgently needed to catalyze climate and health capacity.
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Affiliation(s)
- Nicole A Errett
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington (Drs Errett, Vickery, and Hess and Ms Hartwell); Center for Health and the Global Environment, School of Public Health, University of Washington, Seattle, Washington (Drs Errett and Hess); Association of State and Territorial Health Officials, Washington, District of Columbia (Ms Dolan); Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, Washington (Dr Hess); and Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, Washington (Dr Hess)
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8
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Yan M, Xie Y, Zhu H, Ban J, Gong J, Li T. The exceptional heatwaves of 2017 and all-cause mortality: An assessment of nationwide health and economic impacts in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152371. [PMID: 34919930 DOI: 10.1016/j.scitotenv.2021.152371] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Heatwaves with unprecedented conditions have devastating health impacts. The summer of 2017 saw unusual heat in China and other regions on earth. Although epidemiologic evidence is clear for elevated mortality risks of heatwaves, the economic impacts due to heatwave-associated mortality remain poorly characterized. Hence, this study systematically assessed the mortality and economic impacts of the 2017 exceptional heatwaves in China. We first used the generalized linear mixed-effect model with Poisson distribution to examine the mortality risks of the 2017 heatwaves in 91 Chinese counties. Further, we calculated the excess deaths attributable to heatwaves in 2852 counties. Finally, we evaluated the city- and province-level death-related economic burden of the 2017 heatwaves based on the value of statistical life (VSL). We found that the 2017 exceptional heatwaves had a statistically significant association (relative risk was 1.23, 95% confidence interval 1.14-1.32) with all-cause mortality across 91 Chinese counties. Nationwide, a total of 16,299 all-cause deaths that occurred in 2017 were attributable to the exceptional heatwaves, resulting in an overall death-related economic loss of 61,304 million RMB as valued by VSL. Given that extraordinary heatwaves are projected to be more frequent under global climate change, our findings could enhance the current understanding of heatwaves' health and economic impacts and add valuable insights in projection studies of estimating the future health burden of heatwaves.
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Affiliation(s)
- Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China; Future Cities Lab, Beihang University, China
| | - Huanhuan Zhu
- China CDC Key Laboratory of Environment and Population Health, 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, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology and State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Chen S, Zhao J, Lee SB, Kim SW. Estimation of Relative Risk of Mortality and Economic Burden Attributable to High Temperature in Wuhan, China. Front Public Health 2022; 10:839204. [PMID: 35252103 PMCID: PMC8888530 DOI: 10.3389/fpubh.2022.839204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/24/2022] [Indexed: 02/01/2023] Open
Abstract
In the context of climate change, most of the global regions are facing the threat of high temperature. Influenced by tropical cyclones in the western North Pacific Ocean, high temperatures are more likely to occur in central China, and the economic losses caused by heat are in urgent need of quantification to form the basis for health decisions. In order to study the economic burden of high temperature on the health of Wuhan residents between 2013 and 2019, we employed meta-analysis and the value of statistical life (VSL) approach to calculate the relative risk of high temperature health endpoints, the number of premature deaths, and the corresponding economic losses in Wuhan City, China. The results suggested that the pooled estimates of relative risk of death from high temperature health endpoints was 1.26 [95% confidence interval (CI): 1.15, 1.39]. The average number of premature deaths caused by high temperature was estimated to be 77,369 (95% CI: 48,906–105,198) during 2013–2019, and the induced economic losses were 156.1 billion RMB (95% CI: 92.28–211.40 billion RMB), accounting for 1.81% (95% CI: 1.14–2.45%) of Wuhan's annual GDP in the seven-year period. It can be seen that high temperature drives an increase in the premature deaths, and the influence of high temperature on human health results in an economic burden on the health system and population in Wuhan City. It is necessary for the decision-makers to take measures to reduce the risk of premature death and the proportion of economic loss of residents under the impacts of climate change.
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Affiliation(s)
- Si Chen
- School of Resources and Environmental Science, Hubei University, Wuhan, China
| | - Junrui Zhao
- School of Resources and Environmental Science, Hubei University, Wuhan, China
| | - Soo-Beom Lee
- Department of Transportation Engineering, University of Seoul, Seoul, South Korea
| | - Seong Wook Kim
- Department of Applied Mathematics, Hanyang University, Ansan, South Korea
- *Correspondence: Seong Wook Kim
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10
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Adélaïde L, Chanel O, Pascal M. Health effects from heat waves in France: an economic evaluation. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:119-131. [PMID: 34304326 PMCID: PMC8310615 DOI: 10.1007/s10198-021-01357-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/13/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND Scarcity of data on the health impacts and associated economic costs of heat waves may limit the will to invest in adaptation measures. We assessed the economic impact associated with mortality, morbidity, and loss of well-being during heat waves in France between 2015 and 2019. METHODS Health indicators monitored by the French national heat wave plan were used to estimate excess visits to emergency rooms and outpatient clinics and hospitalizations for heat-related causes. Total excess mortality and years of life loss were considered, as well as the size of the population that experienced restricted activity. A cost-of-illness and willingness-to-pay approach was used to account for associated costs. RESULTS Between 2015 and 2019, the economic impact of selected health effects of heat waves amounts to €25.5 billion, mainly in mortality (€23.2 billion), minor restricted activity days (€2.3 billion), and morbidity (€0.031 billion). CONCLUSION The results highlight a significant economic burden on the French health system and the population. A better understanding of the economic impacts of climate change on health is required to alert decision-makers to the urgency of mitigation and to support concrete adaptation actions.
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Affiliation(s)
- Lucie Adélaïde
- Santé publique France (SpF), 12, rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Olivier Chanel
- Aix-Marseille Univ, CNRS, AMSE, 5 boulevard Maurice Bourdet CS50498, 13205, Marseille Cedex 01, France.
| | - Mathilde Pascal
- Santé publique France (SpF), 12, rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
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11
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Pata UK. Do renewable energy and health expenditures improve load capacity factor in the USA and Japan? A new approach to environmental issues. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:1427-1439. [PMID: 34019219 DOI: 10.1007/s10198-021-01321-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
This study performs the augmented autoregressive distributed lag (ARDL) approach to investigate the impact of renewable energy and health expenditures on the load capacity factor in Japan and the United States of America (USA) over the period 1982-2016. The load capacity factor is obtained by dividing the biocapacity into the ecological footprint and provides a general picture of environmental quality. Thus, the study departs from the current literature by approaching environmental problems from a broader perspective. The results of this study confirm the existence of cointegration in the USA and Japan. The long-run estimates demonstrate that renewable energy and health expenditures improve environmental quality in the USA, while renewable energy has a positive but insignificant impact on load capacity factor in Japan. It has also been determined economic growth causes significant environmental degradation, which cannot be compensated by renewables and health expenditures in both countries. According to these findings, Japanese and American governments should promote green growth, support the increase in health expenditures, and diversify renewable energy sources to reduce environmental pressure.
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Affiliation(s)
- Ugur Korkut Pata
- Faculty of Economics and Administrative Sciences, Department of Economics, Osmaniye Korkut Ata University, 80000, Osmaniye, Turkey.
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12
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Crandall T, Jones E, Greenhalgh M, Frei RJ, Griffin N, Severe E, Maxwell J, Patch L, St. Clair SI, Bratsman S, Merritt M, Norris AJ, Carling GT, Hansen N, St. Clair SB, Abbott BW. Megafire affects stream sediment flux and dissolved organic matter reactivity, but land use dominates nutrient dynamics in semiarid watersheds. PLoS One 2021; 16:e0257733. [PMID: 34555099 PMCID: PMC8460006 DOI: 10.1371/journal.pone.0257733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/08/2021] [Indexed: 01/05/2023] Open
Abstract
Climate change is causing larger wildfires and more extreme precipitation events in many regions. As these ecological disturbances increasingly coincide, they alter lateral fluxes of sediment, organic matter, and nutrients. Here, we report the stream chemistry response of watersheds in a semiarid region of Utah (USA) that were affected by a megafire followed by an extreme precipitation event in October 2018. We analyzed daily to hourly water samples at 10 stream locations from before the storm event until three weeks after its conclusion for suspended sediment, solute and nutrient concentrations, water isotopes, and dissolved organic matter concentration, optical properties, and reactivity. The megafire caused a ~2,000-fold increase in sediment flux and a ~6,000-fold increase in particulate carbon and nitrogen flux over the course of the storm. Unexpectedly, dissolved organic carbon (DOC) concentration was 2.1-fold higher in burned watersheds, despite the decreased organic matter from the fire. DOC from burned watersheds was 1.3-fold more biodegradable and 2.0-fold more photodegradable than in unburned watersheds based on 28-day dark and light incubations. Regardless of burn status, nutrient concentrations were higher in watersheds with greater urban and agricultural land use. Likewise, human land use had a greater effect than megafire on apparent hydrological residence time, with rapid stormwater signals in urban and agricultural areas but a gradual stormwater pulse in areas without direct human influence. These findings highlight how megafires and intense rainfall increase short-term particulate flux and alter organic matter concentration and characteristics. However, in contrast with previous research, which has largely focused on burned-unburned comparisons in pristine watersheds, we found that direct human influence exerted a primary control on nutrient status. Reducing anthropogenic nutrient sources could therefore increase socioecological resilience of surface water networks to changing wildfire regimes.
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Affiliation(s)
- Trevor Crandall
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
- Cimarron Valley Research Station, Oklahoma State University, Perkins, Oklahoma, United States of America
| | - Erin Jones
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Mitchell Greenhalgh
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Rebecca J. Frei
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
- Department of Renewable Resources, University of Alberta, Edmonton, Alberta, Canada
| | - Natasha Griffin
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Emilee Severe
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Jordan Maxwell
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Leika Patch
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - S. Isaac St. Clair
- Department of Statistics, Brigham Young University, Provo, Utah, United States of America
| | - Sam Bratsman
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Marina Merritt
- Department of Chemical Engineering, Brigham Young University, Provo, Utah, United States of America
| | - Adam J. Norris
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Gregory T. Carling
- Department of Geological Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Neil Hansen
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Samuel B. St. Clair
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
| | - Benjamin W. Abbott
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah, United States of America
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Nabeel I, Caraballo-Arias Y, Perkison WB, McCarthy RB, Saberi P, Berenji M, Goldman RH, Laestadius JG, Sokas RK, Das R, Senay E, Wilkenfeld M, Cook-Shimanek M. Proposed Mitigation and Adaptation Strategies Related to Climate Change: Guidance for OEM Professionals. J Occup Environ Med 2021; 63:e650-e656. [PMID: 34491973 DOI: 10.1097/jom.0000000000002321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Climate change is an urgent challenge amplified by socioeconomic factors that demands thoughtful public health responses from OEM professionals. This guidance statement from the American College of Occupational and Environmental Medicine focuses on the different strategies that these health professionals can implement to protect workers from health impacts associated with climate change hazards, foster workplace resilience in the face of rapidly changing environments, and take the necessary steps to mitigate the effects of global climate change.
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Affiliation(s)
- Ismail Nabeel
- American College of Occupational and Environmental Medicine, Elk Grove, Illinois
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14
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Science Policy to Advance a Climate Change and Health Research Agenda in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157868. [PMID: 34360159 PMCID: PMC8345657 DOI: 10.3390/ijerph18157868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 01/27/2023]
Abstract
Climate change is thought to be one of the greatest public health threats of the 21st century and there has been a tremendous growth in the published literature describing the health implications of climate change over the last decade. Yet, there remain several critical knowledge gaps in this field. Closing these gaps is crucial to developing effective interventions to minimize the health risks from climate change. In this commentary, we discuss policy trends that have influenced the advancement of climate change and health research in the United States context. We then enumerate specific knowledge gaps that could be addressed by policies to advance scientific research. Finally, we describe tools and methods that have not yet been fully integrated into the field, but hold promise for advancing the science. Prioritizing this advancement offers the potential to improve public health-related policies on climate change.
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15
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Increasing impacts of temperature on hospital admissions, length of stay, and related healthcare costs in the context of climate change in Adelaide, South Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145656. [PMID: 33592481 DOI: 10.1016/j.scitotenv.2021.145656] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND A growing number of studies have investigated the effect of increasing temperatures on morbidity and health service use. However, there is a lack of studies investigating the temperature-attributable cost burden. OBJECTIVES This study examines the relationship of daily mean temperature with hospital admissions, length of hospital stay (LoS), and costs; and estimates the baseline temperature-attributable hospital admissions, and costs and in relation to warmer climate scenarios in Adelaide, South Australia. METHOD A daily time series analysis using distributed lag non-linear models (DLNM) was used to explore exposure-response relationships and to estimate the aggregated burden of hospital admissions for conditions associated with temperatures (i.e. renal diseases, mental health, diabetes, ischaemic heart diseases and heat-related illnesses) as well as the associated LoS and costs, for the baseline period (2010-2015) and different future climate scenarios in Adelaide, South Australia. RESULTS During the six-year baseline period, the overall temperature-attributable hospital admissions, LoS, and associated costs were estimated to be 3915 cases (95% empirical confidence interval (eCI): 235, 7295), 99,766 days (95% eCI: 14,484, 168,457), and AU$159 million (95% eCI: 18.8, 269.0), respectively. A climate scenario consistent with RCP8.5 emissions, and including projected demographic change, is estimated to lead to increases in heat-attributable hospital admissions, LoS, and costs of 2.2% (95% eCI: 0.5, 3.9), 8.4% (95% eCI: 1.1, 14.3), and 7.7% (95% eCI: 0.3, 13.3), respectively by mid-century. CONCLUSIONS There is already a substantial temperature-attributable impact on hospital admissions, LoS, and costs which are estimated to increase due to climate change and an increasing aged population. Unless effective climate and public health interventions are put into action, the costs of treating temperature-related admissions will be high.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia; College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Keith Dear
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Alana Hansen
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Monika Nitschke
- South Australian Department of Health and Wellbeing, Adelaide, South Australia, Australia.
| | - John Nairn
- Australian Bureau of Meteorology, South Australia, Australia.
| | - Ben Scalley
- Metropolitan Communicable Disease Control, Department of Health WA, Perth, Western Australia, Australia.
| | - Alex Xiao
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Michael Tong
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
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16
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Wang Y, Liu Y, Ye D, Li N, Bi P, Tong S, Wang Y, Cheng Y, Li Y, Yao X. Temperatures and health costs of emergency department visits: A multisite time series study in China. ENVIRONMENTAL RESEARCH 2021; 197:111023. [PMID: 33745933 DOI: 10.1016/j.envres.2021.111023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/26/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Evidence is limited regarding the association between temperatures and health costs. OBJECTIVES We tried to investigate the association between temperatures and emergency department visits (EDVs) costs in China. METHODS Daily data on EDVs costs, weather, air pollution were collected from 17 sites in China during 2014-2018. A quasi-Poisson generalized additive regression with distributed lag nonlinear model was applied to assess the temperature-EDVs cost association. Random-effect meta-analysis was used to pool the estimates from each site. Attributable fractions and national attributable EDVs costs due to heat and cold were calculated. RESULTS Relative risk (RR) due to extreme heat over 0-7 lag days was 1.14 [95% confidence intervals (CI): 1.08-1.19] and 1.11 (95% CI: 1.07-1.16) for EDVs examination (including treatment) and medicine cost, respectively. People aged 18-44 and those with genitourinary diseases were at higher risk from heat. 0.72% of examination cost and 0.57% of medicine cost were attributed to extreme heat, costing 274 million Chinese Yuan annually. Moderate heat had lower RR but higher attributable fraction of EDVs costs. Exposure to extreme cold over 0-21 lag days increased the risk of medicine cost for people aged 18-44 [RR: 1.30 (95% CI: 1.10-1.55)] and those with respiratory diseases [RR: 1.56 (95% CI: 1.14-2.14)], but had non-statistically significant attributable fraction of the total EDVs cost. CONCLUSIONS Exposure to heat and cold resulted in remarkable health costs. More resources and preparedness are needed to tackle such a challenge as our climate is rapidly changing.
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Affiliation(s)
- Yu Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dianxiu Ye
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Na Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Yan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yibin Cheng
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yonghong Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoyuan Yao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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17
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Sorensen C, House JA, O'Dell K, Brey SJ, Ford B, Pierce JR, Fischer EV, Lemery J, Crooks JL. Associations Between Wildfire-Related PM 2.5 and Intensive Care Unit Admissions in the United States, 2006-2015. GEOHEALTH 2021; 5:e2021GH000385. [PMID: 33977181 PMCID: PMC8095362 DOI: 10.1029/2021gh000385] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 05/29/2023]
Abstract
Wildfire smoke is a growing public health concern in the United States. Numerous studies have documented associations between ambient smoke exposure and severe patient outcomes for single-fire seasons or limited geographic regions. However, there are few national-scale health studies of wildfire smoke in the United States, few studies investigating Intensive Care Unit (ICU) admissions as an outcome, and few specifically framed around hospital operations. This study retrospectively examined the associations between ambient wildfire-related PM2.5 at a hospital ZIP code with total hospital ICU admissions using a national-scale hospitalization data set. Wildfire smoke was characterized using a combination of kriged PM2.5 monitor observations and satellite-derived plume polygons from National Oceanic and Atmospheric Administration's Hazard Mapping System. ICU admissions data were acquired from Premier, Inc. and encompass 15%-20% of all U.S. ICU admissions during the study period. Associations were estimated using a distributed-lag conditional Poisson model under a time-stratified case-crossover design. We found that a 10 μg/m3 increase in daily wildfire PM2.5 was associated with a 2.7% (95% CI: 1.3, 4.1; p = 0.00018) increase in ICU admissions 5 days later. Under stratification, positive associations were found among patients aged 0-20 and 60+, patients living in the Midwest Census Region, patients admitted in the years 2013-2015, and non-Black patients, though other results were mixed. Following a simulated severe 7-day 120 μg/m3 smoke event, our results predict ICU bed utilization peaking at 131% (95% CI: 43, 239; p < 10-5) over baseline. Our work suggests that hospitals may need to preposition vital critical care resources when severe smoke events are forecast.
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Affiliation(s)
- Cecilia Sorensen
- University of Colorado School of MedicineDepartment of Emergency MedicineAuroraCOUSA
- Center for Health, Work & EnvironmentColorado School of Public HealthAuroraCOUSA
| | | | - Katelyn O'Dell
- Department of Atmospheric ScienceColorado State UniversityFt. CollinsCOUSA
| | - Steven J. Brey
- Department of Atmospheric ScienceColorado State UniversityFt. CollinsCOUSA
| | - Bonne Ford
- Department of Atmospheric ScienceColorado State UniversityFt. CollinsCOUSA
| | - Jeffrey R. Pierce
- Department of Atmospheric ScienceColorado State UniversityFt. CollinsCOUSA
| | - Emily V. Fischer
- Department of Atmospheric ScienceColorado State UniversityFt. CollinsCOUSA
| | - Jay Lemery
- University of Colorado School of MedicineDepartment of Emergency MedicineAuroraCOUSA
| | - James L. Crooks
- Division of Biostatistics and Bioinformatics and Department of Immunology and Genomic MedicineNational Jewish HealthDenverCOUSA
- Department of EpidemiologyColorado School of Public HealthAuroraCOUSA
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18
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Bikomeye JC, Rublee CS, Beyer KMM. Positive Externalities of Climate Change Mitigation and Adaptation for Human Health: A Review and Conceptual Framework for Public Health Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2481. [PMID: 33802347 PMCID: PMC7967605 DOI: 10.3390/ijerph18052481] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 12/17/2022]
Abstract
Anthropogenic climate change is adversely impacting people and contributing to suffering and increased costs from climate-related diseases and injuries. In responding to this urgent and growing public health crisis, mitigation strategies are in place to reduce future greenhouse gas emissions (GHGE) while adaptation strategies exist to reduce and/or alleviate the adverse effects of climate change by increasing systems' resilience to future impacts. While these strategies have numerous positive benefits on climate change itself, they also often have other positive externalities or health co-benefits. This knowledge can be harnessed to promote and improve global public health, particularly for the most vulnerable populations. Previous conceptual models in mitigation and adaptation studies such as the shared socioeconomic pathways (SSPs) considered health in the thinking, but health outcomes were not their primary intention. Additionally, existing guidance documents such as the World Health Organization (WHO) Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities is designed primarily for public health professionals or healthcare managers in hospital settings with a primary focus on resilience. However, a detailed cross sectoral and multidisciplinary conceptual framework, which links mitigation and adaptation strategies with health outcomes as a primary end point, has not yet been developed to guide research in this area. In this paper, we briefly summarize the burden of climate change on global public health, describe important mitigation and adaptation strategies, and present key health benefits by giving context specific examples from high, middle, and low-income settings. We then provide a conceptual framework to inform future global public health research and preparedness across sectors and disciplines and outline key stakeholders recommendations in promoting climate resilient systems and advancing health equity.
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Affiliation(s)
- Jean C. Bikomeye
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Caitlin S. Rublee
- Department of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Kirsten M. M. Beyer
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
- Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
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19
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Limaye VS. Making the climate crisis personal through a focus on human health. CLIMATIC CHANGE 2021; 166:43. [PMID: 34155416 PMCID: PMC8210734 DOI: 10.1007/s10584-021-03107-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 04/20/2021] [Indexed: 05/19/2023]
Abstract
Climate change-driven health impacts are serious, widespread, and costly. Importantly, such damages are largely absent from policy debates around the costs of delay and inaction on this crisis. While climate change is a global problem, its impacts are localized and personal, and there is growing demand for specific information on how climate change affects human health in different places. Existing research indicates that climate-fueled health problems are growing, and that investments in reducing carbon pollution and improving community resilience could help to avoid tens to hundreds of billions of dollars in climate-sensitive health impacts across the USA each year, including those stemming from extreme heat, air pollution, hurricanes, and wildfires. Science that explores the underappreciated local health impacts and health-related costs of climate change can enhance advocacy by demonstrating the need to both address the root causes of climate change and enhance climate resilience in vulnerable communities. The climate crisis has historically been predominantly conceived as a global environmental challenge; examination of climate impacts on public health enables researchers to localize this urgent problem for members of the public and policymakers. In turn, approaches to climate science that focus on health can make dangerous climate impacts and the need for cost-effective solutions more salient and tangible.
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20
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Limaye VS, Max W, Constible J, Knowlton K. Estimating The Costs Of Inaction And The Economic Benefits Of Addressing The Health Harms Of Climate Change. Health Aff (Millwood) 2020; 39:2098-2104. [PMID: 33284700 DOI: 10.1377/hlthaff.2020.01109] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
National and international assessments have drawn attention to the substantial economic risks of climate change. The costs of climate-sensitive health outcomes responsive to meteorological or seasonal patterns are among the least studied of those risks. In this article we describe how cost valuation analyses that relate climate-sensitive health outcomes to damages in economic terms can illuminate the costs of inaction on the climate crisis and the economic savings of addressing this problem. We identify major challenges to expanding the application of climate-health valuation research and suggest solutions to overcome these obstacles to better characterize the burden of climate-sensitive health outcomes and health disparities. The projected health and economic harms of climate-sensitive risks could be enormous if climate change continues to accelerate and communities are not prepared to reduce or prevent their impact. Expanded valuation of climate-sensitive health outcomes can inform policies that slow climate change and promote stronger investments in health-protective climate change adaptation efforts.
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Affiliation(s)
- Vijay S Limaye
- Vijay S. Limaye is a a climate and health scientist at the Natural Resources Defense Council, in New York, New York
| | - Wendy Max
- Wendy Max is a professor of health economics in the Department of Social and Behavioral Sciences and director of the Institute for Health and Aging at the University of California San Francisco, in San Francisco, California
| | - Juanita Constible
- Juanita Constible is a senior advocate at the Natural Resources Defense Council
| | - Kim Knowlton
- Kim Knowlton is a senior scientist at the Natural Resources Defense Council and an assistant professor of environmental health sciences at the Mailman School of Public Health, Columbia University, in New York, New York
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21
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Gündüz M. Healthcare expenditure and carbon footprint in the USA: evidence from hidden cointegration approach. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:801-811. [PMID: 32172391 DOI: 10.1007/s10198-020-01174-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
The priority aim of this study is to investigate the effect of carbon footprint, which is an indicator of environmental degradation, on health expenditures for the USA. In the study, cointegration analysis was performed for the period 1970-2016 by using health expenditures, carbon footprint, gross domestic product per capita and life expectancy at birth variables. According to the results of standard cointegration analysis, only cointegration relationship between health expenditures and income was found. In the models with carbon footprint, no cointegration relationship was discovered between the original values of the variables. This result was approached with suspicion, and it was thought that there might be a hidden cointegration between healthcare expenditures and carbon footprint. For this purpose, the hidden cointegration analysis and crouching error correction model proposed by Granger and Yoon [18] were employed among the positive and negative components of the variables of healthcare expenditures and carbon footprint. The results of the hidden cointegration analysis revealed that there was a hidden cointegration relationship between the positive components of healthcare expenditures and the positive components of carbon footprint. Analysis results show that a 1% increase in carbon footprint will cause a 2.04% increase in healthcare expenditures in the long term in the USA. When the positive components of the variables were considered, it was concluded that there was a one-way long-term asymmetric causality relationship between carbon footprint and healthcare expenditures. As a result of the study, it was proposed that the carbon footprint should be diminished to prevent the increasing burden of the healthcare expenditures on the budget.
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Affiliation(s)
- Murat Gündüz
- Faculty of Economics and Administrative Sciences, Department of Econometrics, Usak University, Usak, Turkey.
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22
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Millyard A, Layden JD, Pyne DB, Edwards AM, Bloxham SR. Impairments to Thermoregulation in the Elderly During Heat Exposure Events. Gerontol Geriatr Med 2020; 6:2333721420932432. [PMID: 32596421 PMCID: PMC7297481 DOI: 10.1177/2333721420932432] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/06/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022] Open
Abstract
Heat waves represent a public health risk to elderly people, and typically result in an increased rate of hospital admissions and deaths. Studies of thermoregulation in this cohort have generally focused on single elements such as sweating capacity. Sweating capacity and skin blood flow reduce with age, reducing ability to dissipate heat. Perception of effort during heat exposure is emerging as an area that needs further investigation as the elderly appear to lack the ability to adequately perceive increased physiological strain during heat exposure. The role of the gut and endotoxemia in heat stress has received attention in young adults, while the elderly population has been neglected. This shortcoming offers another potential avenue for identifying effective integrated health interventions to reduce heat illnesses. Increasing numbers of elderly individuals in populations worldwide are likely to increase the incidence of heat wave-induced deaths if adequate interventions are not developed, evaluated, and implemented. In this narrative-style review we identify and discuss health-related interventions for reducing the impact of heat illnesses in the elderly.
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Affiliation(s)
| | | | - David B Pyne
- University of Canberra, Australian Capital Territory, Australia
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23
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Ragavan MI, Marcil LE, Garg A. Climate Change as a Social Determinant of Health. Pediatrics 2020; 145:peds.2019-3169. [PMID: 32265296 PMCID: PMC7193972 DOI: 10.1542/peds.2019-3169] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2019] [Indexed: 01/23/2023] Open
Affiliation(s)
- Maya I. Ragavan
- Division of General Academic Pediatrics, University of Pittsburgh and Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Lucy E. Marcil
- Division of General Academic Pediatrics, School of Medicine, Boston University and Boston Medical Center, Boston, Massachusetts
| | - Arvin Garg
- Division of General Academic Pediatrics, School of Medicine, Boston University and Boston Medical Center, Boston, Massachusetts
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24
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First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis. Resuscitation 2020; 148:173-190. [PMID: 31981710 DOI: 10.1016/j.resuscitation.2020.01.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 01/02/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Heat stroke is an emergent condition characterized by hyperthermia (>40 °C/>104 °F) and nervous system dysregulation. There are two primary etiologies: exertional which occurs during physical activity and non-exertional which occurs during extreme heat events without physical exertion. Left untreated, both may lead to significant morbidity, are considered a special circumstance for cardiac arrest, and cause of mortality. METHODS We searched Medline, Embase, CINAHL and SPORTDiscus. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods and risk of bias assessments to determine the certainty and quality of evidence. We included randomized controlled trials, non-randomized trials, cohort studies and case series of five or more patients that evaluated adults and children with non-exertional or exertional heat stroke or exertional hyperthermia, and any cooling technique applicable to first aid and prehospital settings. Outcomes included: cooling rate, mortality, neurological dysfunction, adverse effects and hospital length of stay. RESULTS We included 63 studies, of which 37 were controlled studies, two were cohort studies and 24 were case series of heat stroke patients. Water immersion of adults with exertional hyperthermia [cold water (14-17 °C/57.2-62.6 °F), colder water (8-12 °C/48.2-53.6 °F) and ice water (1-5 °C/33.8-41 °F)] resulted in faster cooling rates when compared to passive cooling. No single water temperature range was found to be associated with a quicker core temperature reduction than another (cold, colder or ice). CONCLUSION Water immersion techniques (using 1-17 °C water) more effectively lowered core body temperatures when compared with passive cooling, in hyperthermic adults. The available evidence suggests water immersion can rapidly reduce core body temperature in settings where it is feasible.
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Limaye VS, Max W, Constible J, Knowlton K. Estimating the Health-Related Costs of 10 Climate-Sensitive U.S. Events During 2012. GEOHEALTH 2019; 3:245-265. [PMID: 32159045 PMCID: PMC7007172 DOI: 10.1029/2019gh000202] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/30/2019] [Accepted: 07/25/2019] [Indexed: 05/14/2023]
Abstract
Climate change threatens human health, but there remains a lack of evidence on the economic toll of climate-sensitive public health impacts. We characterize human mortality and morbidity costs associated with 10 climate-sensitive case study events spanning 11 US states in 2012: wildfires in Colorado and Washington, ozone air pollution in Nevada, extreme heat in Wisconsin, infectious disease outbreaks of tick-borne Lyme disease in Michigan and mosquito-borne West Nile virus in Texas, extreme weather in Ohio, impacts of Hurricane Sandy in New Jersey and New York, allergenic oak pollen in North Carolina, and harmful algal blooms on the Florida coast. Applying a consistent economic valuation approach to published studies and state estimates, we estimate total health-related costs from 917 deaths, 20,568 hospitalizations, and 17,857 emergency department visits of $10.0 billion in 2018 dollars, with a sensitivity range of $2.7-24.6 billion. Our estimates indicate that the financial burden of deaths, hospitalizations, emergency department visits, and associated medical care is a key dimension of the overall economic impact of climate-sensitive events. We found that mortality costs (i.e., the value of a statistical life) of $8.4 billion exceeded morbidity costs and lost wages ($1.6 billion combined). By better characterizing health damages in economic terms, this work helps to shed light on the burden climate-sensitive events already place on U.S. public health each year. In doing so, we provide a conceptual framework for broader estimation of climate-sensitive health-related costs. The high health-related costs associated with climate-sensitive events highlight the importance of actions to mitigate climate change and adapt to its unavoidable impacts.
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Affiliation(s)
| | - Wendy Max
- Institute for Health & AgingUniversity of CaliforniaSan FranciscoCAUSA
| | | | - Kim Knowlton
- Natural Resources Defense CouncilNew YorkNYUSA
- Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
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Liu Y, Saha S, Hoppe BO, Convertino M. Degrees and dollars - Health costs associated with suboptimal ambient temperature exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 678:702-711. [PMID: 31078861 PMCID: PMC10184024 DOI: 10.1016/j.scitotenv.2019.04.398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/26/2019] [Accepted: 04/26/2019] [Indexed: 05/14/2023]
Abstract
Suboptimal ambient temperature exposure significantly affects public health. Previous studies have primarily focused on risk assessment, with few examining the health outcomes from an economic perspective. To inform environmental health policies, we estimated the economic costs of health outcomes associated with suboptimal temperature in the Minneapolis/St. Paul Twin Cities Metropolitan Area. We used a distributed lag nonlinear model to estimate attributable fractions/cases for mortality, emergency department visits, and emergency hospitalizations at various suboptimal temperature levels. The analyses were stratified by age group (i.e., youth (0-19 years), adult (20-64 years), and senior (65+ years)). We considered both direct medical costs and loss of productivity during economic cost assessment. Results show that youth have a large number of temperature-related emergency department visits, while seniors have large numbers of temperature-related mortality and emergency hospitalizations. Exposures to extremely low and high temperatures lead to $2.70 billion [95% empirical confidence interval (eCI): $1.91 billion, $3.48 billion] (costs are all based on 2016 USD value) economic costs annually. Moderately and extremely low and high temperature leads to $9.40 billion [eCI: $6.05 billion, $12.57 billion] economic costs. The majority of the economic costs are consistently attributed to cold (>75%), rather than heat exposures and to mortality (>95%), rather than morbidity. Our findings support prioritizing temperature-related health interventions designed to minimize the economic costs by targeting seniors and to reduce attributable cases by targeting youth.
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Affiliation(s)
- Yang Liu
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota Twin-Cities, 420 Delaware St SE, Minneapolis, MN 55414, USA.
| | - Shubhayu Saha
- National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
| | - Brendalynn O Hoppe
- Environmental Health Division, Minnesota Department of Health, 625 Robert St N, St. Paul, MN 55164, USA.
| | - Matteo Convertino
- Nexus Group, Graduate School of Information Science and Technology & GI-CoRE for Big-Data and Cybersecurity, Hokkaido University, Sapporo 060-0814, Japan.
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Air Quality Standards and Extreme Ozone Events in the São Paulo Megacity. SUSTAINABILITY 2019. [DOI: 10.3390/su11133725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ozone events in South America might be triggered by increasing air temperatures and dry conditions, leading to vulnerable population exposure. The current air quality standards and attention levels in São Paulo state, Brazil, are 40% higher and 25% higher, respectively, than the limits recommended by the World Health Organization (WHO). We simulated an extreme ozone event in the São Paulo megacity using the Weather Research and Forecast/Chemistry model during an extreme event characterized by positive anomalies of air temperature and solar radiation. Results were evaluated using the different air quality limits from São Paulo state and the WHO, also with socioeconomic vulnerability data from the Brazilian census and cost analysis for the public health system from the extreme episode. More than 3 million people in vulnerability conditions, such as low income and families with an above-average percentage of children, live in areas where ozone concentrations exceeded the attention levels of the WHO during the episode, which is ignored by the lenient SP state environmental laws. WHO air quality guidelines must be adopted urgently in developing nations in order to provide a more accurate basis for cost analysis and population exposure, particularly the for vulnerable population groups.
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Salas RN, Slutzman JE, Sorensen C, Lemery J, Hess JJ. Climate Change and Health: An Urgent Call to Academic Emergency Medicine. Acad Emerg Med 2019; 26:837-840. [PMID: 30408266 DOI: 10.1111/acem.13657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Renee N. Salas
- Massachusetts General Hospital and Harvard Medical School Boston MA
| | | | - Cecilia Sorensen
- Department of Emergency Medicine University of Colorado School of Medicine Anschutz Medical Campus Aurora CO
| | - Jay Lemery
- Department of Emergency Medicine University of Colorado School of Medicine Anschutz Medical Campus Aurora CO
| | - Jeremy J. Hess
- Harborview Medical Center and University of Washington School of Medicine Seattle WA
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Lemery J, Sorensen C, Balbus J, Newman L, Davis C, Reno E, Salas R, Hynes EC. Science Policy Training for a New Physician Leader: Description and Framework of a Novel Climate and Health Science Policy Fellowship. AEM EDUCATION AND TRAINING 2019; 3:233-242. [PMID: 31360816 PMCID: PMC6637012 DOI: 10.1002/aet2.10323] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/26/2018] [Accepted: 01/02/2019] [Indexed: 06/10/2023]
Abstract
The accelerating health impacts of climate change are undermining global health, and the roles of the health sector in addressing the many challenges of climate change are being articulated by governments, multilateral institutions, and professional societies. Given the paucity of physician engagement on this issue to date, there now exists a clear need for health professionals to meet this new challenge with the development and cultivation of new knowledge and skill sets in public health, environmental science, policy, and communication. We describe a novel GME fellowship in climate and health science policy, designed to train a new generation of clinicians to provide the necessary perspective and skills for effective leadership in this field. This fellowship identifies available university resources and leverages external collaborations (government, medical consortiums, affiliate institutions in public health, and environmental science), which we describe as being replicatable to similar training programs of any number of medical specialties and likewise bring meaningful opportunities to their respective training programs and academic departments. The creation of this novel fellowship in climate and health policy provides a roadmap and potential path for similar programs to join us in addressing the defining health issue of this generation and many to follow.
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Affiliation(s)
- Jay Lemery
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - Cecilia Sorensen
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - John Balbus
- National Institute of Environmental Health SciencesBethesdaMD
| | - Lee Newman
- Departments of Environmental and Occupational Health and EpidemiologyColorado School of Public HealthAuroraCO
| | - Christopher Davis
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - Elaine Reno
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - Renee Salas
- Department of Emergency Medicine at Harvard Medical SchoolBostonMA
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McDonald RI, Kroeger T, Zhang P, Hamel P. The Value of US Urban Tree Cover for Reducing Heat-Related Health Impacts and Electricity Consumption. Ecosystems 2019. [DOI: 10.1007/s10021-019-00395-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Perera F, Ashrafi A, Kinney P, Mills D. Towards a fuller assessment of benefits to children's health of reducing air pollution and mitigating climate change due to fossil fuel combustion. ENVIRONMENTAL RESEARCH 2019; 172:55-72. [PMID: 30771627 DOI: 10.1016/j.envres.2018.12.016] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/20/2018] [Accepted: 12/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Fossil fuel combustion by-products, including particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAH), nitrogen dioxide (NO2) and carbon dioxide (CO2), are a significant threat to children's health and equality. Various policies to reduce emissions have been implemented to reduce air pollution and mitigate climate change, with sizeable estimated health and economic benefits. However, only a few adverse outcomes in children have been considered, resulting in an undercounting of the benefits to this vulnerable population. OBJECTIVES Our goal was to expand the suite of child health outcomes addressed by programs to assess health and economic benefits, such as the Environmental Protection Agency (EPA) Benefits Mapping and Analysis Program (BenMAP), by identifying concentration-response (C-R) functions for six outcomes related to PM2.5, NO2, PAH, and/or PM10: preterm birth (PTB), low birthweight (LBW), autism, attention deficit hyperactivity disorder, IQ reduction, and the development of childhood asthma. METHODS We conducted a systematic review of the literature published between January 1, 2000 and April 30, 2018 to identify relevant peer-reviewed case-control and cohort studies and meta-analyses. In some cases meta-analyses were available that provided reliable C-R functions and we assessed their consistency with subsequent studies. Otherwise, we reviewed all eligible studies published between our search dates. RESULTS For each pollutant and health outcome, we present the characteristics of each selected study. We distinguish between C-R functions for endpoints having a causal or likely relationship (PTB, LBW, autism, asthma development) with the pollutants for incorporation into primary analyses and endpoints having a suggestive causal relationship with the pollutants (IQ reduction, ADHD) for secondary analyses. CONCLUSION We have identified C-R functions for a number of adverse health outcomes in children associated with air pollutants largely from fossil fuel combustion. Their incorporation into expanded assessments of health benefits of clean air and climate mitigation policies will provide an important incentive for preventive action.
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Affiliation(s)
- F Perera
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
| | - A Ashrafi
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
| | - P Kinney
- Boston University School of Public Health, Boston, MA, USA.
| | - D Mills
- Abt Associates, Boulder, CO, USA.
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Wondmagegn BY, Xiang J, Williams S, Pisaniello D, Bi P. What do we know about the healthcare costs of extreme heat exposure? A comprehensive literature review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 657:608-618. [PMID: 30677927 DOI: 10.1016/j.scitotenv.2018.11.479] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/23/2018] [Accepted: 11/30/2018] [Indexed: 05/04/2023]
Abstract
Exposure to extreme heat can lead to a range of heat-related illnesses, exacerbate pre-existing health conditions and cause increased demand on the healthcare system. A projected increase in temperature may lead to greater healthcare expenditure, however, at present the costs of heat-related healthcare utilization is under-researched. This study aims to review the literature on heat-related costs for the healthcare system with a focus on ED visits, hospitalization, and ambulance call-outs. PubMed, Scopus, and Embase were used to search relevant literature from database inception to December 2017 and limited to human studies and English language. After screening, a total of ten papers were identified for final inclusion. In general, the healthcare costs of heat extremes have been poorly investigated in developed countries and not reported in developing countries where the largest heat-vulnerable populations reside. Studies showed that exposure to extreme heat was causing a substantial economic burden on healthcare systems. Females, the elderly, low-income families, and ethnic minorities had the highest healthcare costs on a range of health services utilization. Although a few studies have estimated heat healthcare costs, none of them quantified the temperature-healthcare cost relationship. There is a need to systematically examine heat-attributable costs for the healthcare system in the context of climate change to better inform heat-related policy making, target interventions and resource allocation.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia; College of Health and Medical Sciences, Haramaya University, Ethiopia, P.O. Box 138, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
| | - Susan Williams
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, 57 North Terrace, Adelaide, South Australia 5000, Australia.
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Liu Y, Hoppe BO, Convertino M. Threshold Evaluation of Emergency Risk Communication for Health Risks Related to Hazardous Ambient Temperature. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:2208-2221. [PMID: 29637591 DOI: 10.1111/risa.12998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/25/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
Emergency risk communication (ERC) programs that activate when the ambient temperature is expected to cross certain extreme thresholds are widely used to manage relevant public health risks. In practice, however, the effectiveness of these thresholds has rarely been examined. The goal of this study is to test if the activation criteria based on extreme temperature thresholds, both cold and heat, capture elevated health risks for all-cause and cause-specific mortality and morbidity in the Minneapolis-St. Paul Metropolitan Area. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson generalized linear model is used to derive the exposure-response functions between daily maximum heat index and mortality (1998-2014) and morbidity (emergency department visits; 2007-2014). Specific causes considered include cardiovascular, respiratory, renal diseases, and diabetes. Six extreme temperature thresholds, corresponding to 1st-3rd and 97th-99th percentiles of local exposure history, are examined. All six extreme temperature thresholds capture significantly increased relative risks for all-cause mortality and morbidity. However, the cause-specific analyses reveal heterogeneity. Extreme cold thresholds capture increased mortality and morbidity risks for cardiovascular and respiratory diseases and extreme heat thresholds for renal disease. Percentile-based extreme temperature thresholds are appropriate for initiating ERC targeting the general population. Tailoring ERC by specific causes may protect some but not all individuals with health conditions exacerbated by hazardous ambient temperature exposure.
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Affiliation(s)
- Yang Liu
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Brenda O Hoppe
- Department of Health, Environmental Health Division, Minnesota, St. Paul, MN, USA
| | - Matteo Convertino
- Complexity Group, Division of Frontier Science & Media and Network Technologies, Laboratory of Information Communication Networks, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
- Global Station for Big Data and Cybersecurity, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
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Patella V, Florio G, Magliacane D, Giuliano A, Crivellaro MA, Di Bartolomeo D, Genovese A, Palmieri M, Postiglione A, Ridolo E, Scaletti C, Ventura MT, Zollo A. Urban air pollution and climate change: "The Decalogue: Allergy Safe Tree" for allergic and respiratory diseases care. Clin Mol Allergy 2018; 16:20. [PMID: 30214380 PMCID: PMC6134633 DOI: 10.1186/s12948-018-0098-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/27/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND According to the World Health Organization, air pollution is closely associated with climate change and, in particular, with global warming. In addition to melting of ice and snow, rising sea level, and flooding of coastal areas, global warming is leading to a tropicalization of temperate marine ecosystems. Moreover, the effects of air pollution on airway and lung diseases are well documented as reported by the World Allergy Organization. METHODS Scientific literature was searched for studies investigating the effect of the interaction between air pollution and climate change on allergic and respiratory diseases. RESULTS Since 1990s, a multitude of articles and reviews have been published on this topic, with many studies confirming that the warming of our planet is caused by the "greenhouse effect" as a result of increased emission of "greenhouse" gases. Air pollution is also closely linked to global warming: the emission of hydrocarbon combustion products leads to increased concentrations of biological allergens such as pollens, generating a mixture of these particles called particulate matter (PM). The concept is that global warming is linked to the emission of hydrocarbon combustion products, since both carbon dioxide and heat increase pollen emission into the atmosphere, and all these particles make up PM10. However, the understanding of the mechanisms by which PM affects human health is still limited. Therefore, several studies are trying to determine the causes of global warming. There is also evidence that increased concentrations of air pollutants and pollens can activate inflammatory mediators in the airways. Our Task Force has prepared a Decalogue of rules addressing public administrators, which aims to limit the amount of allergenic pollen in the air without sacrificing public green areas. CONCLUSIONS Several studies underscore the significant risks of global warming on human health due to increasing levels of air pollution. The impact of climate change on respiratory diseases appears well documented. The last decades have seen a rise in the concentrations of pollens and pollutants in the air. This rise parallels the increase in the number of people presenting with allergic symptoms (e.g., allergic rhinitis, conjunctivitis, and asthma), who often require emergency medical care. Our hope is that scientists from different disciplines will work together with institutions, pharmaceutical companies and lay organizations to limit the adverse health effects of air pollution and global warming.
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Affiliation(s)
- Vincenzo Patella
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
| | - Giovanni Florio
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
| | - Diomira Magliacane
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
| | - Ada Giuliano
- Laboratory of Environmental Analysis, Department of Public Health, ASL Salerno, Salerno, Italy
| | - Maria Angiola Crivellaro
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Daniela Di Bartolomeo
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Association of International Culture, Athena of Paestum, Capaccio-Paestum, Salerno, Italy
| | - Arturo Genovese
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
| | - Mario Palmieri
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Former Primary of Unit of Pediatry, Hospital of Eboli, Salerno, Italy
| | - Amedeo Postiglione
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- International Court of the Environment Foundation (ICEF), Rome, Italy
| | - Erminia Ridolo
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Cristina Scaletti
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Unit of Internal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Teresa Ventura
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Anna Zollo
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Studies and Researches, Movimento Ecologista Europeo FareAmbiente, Rome, Italy
| | - Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC)
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Laboratory of Environmental Analysis, Department of Public Health, ASL Salerno, Salerno, Italy
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
- Association of International Culture, Athena of Paestum, Capaccio-Paestum, Salerno, Italy
- Former Primary of Unit of Pediatry, Hospital of Eboli, Salerno, Italy
- International Court of the Environment Foundation (ICEF), Rome, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Unit of Internal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
- Department of Studies and Researches, Movimento Ecologista Europeo FareAmbiente, Rome, Italy
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Kenny GP, Flouris AD, Yagouti A, Notley SR. Towards establishing evidence-based guidelines on maximum indoor temperatures during hot weather in temperate continental climates. Temperature (Austin) 2018; 6:11-36. [PMID: 30906809 PMCID: PMC6422495 DOI: 10.1080/23328940.2018.1456257] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/15/2018] [Indexed: 11/09/2022] Open
Abstract
Rising environmental temperatures represent a major threat to human health. The activation of heat advisories using evidence-based thresholds for high-risk outdoor ambient temperatures have been shown to be an effective strategy to save lives during hot weather. However, although the relationship between weather and human health has been widely defined by outdoor temperature, corresponding increases in indoor temperature during heat events can also be harmful to health especially in vulnerable populations. In this review, we discuss our current understanding of the relationship between outdoor temperature and human health and examine how human health can also be adversely influenced by high indoor temperatures during heat events. Our assessment of the existing literature revealed a high degree of variability in what can be considered an acceptable indoor temperature because there are differences in how different groups of people may respond physiologically and behaviorally to the same living environment. Finally, we demonstrate that both non-physiological (e.g., geographical location, urban density, building design) and physiological (e.g., sex, age, fitness, state of health) factors must be considered when defining an indoor temperature threshold for preserving human health in a warming global climate.
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Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | | | - Sean R. Notley
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Voelkel J, Hellman D, Sakuma R, Shandas V. Assessing Vulnerability to Urban Heat: A Study of Disproportionate Heat Exposure and Access to Refuge by Socio-Demographic Status in Portland, Oregon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040640. [PMID: 29601546 PMCID: PMC5923682 DOI: 10.3390/ijerph15040640] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 12/02/2022]
Abstract
Extreme urban heat is a powerful environmental stressor which poses a significant threat to human health and well-being. Exacerbated by the urban heat island phenomenon, heat events are expected to become more intense and frequent as climate change progresses, though we have limited understanding of the impact of such events on vulnerable populations at a neighborhood or census block group level. Focusing on the City of Portland, Oregon, this study aimed to determine which socio-demographic populations experience disproportionate exposure to extreme heat, as well as the level of access to refuge in the form of public cooling centers or residential central air conditioning. During a 2014 heat wave, temperature data were recorded using a vehicle-traverse collection method, then extrapolated to determine average temperature at the census block group level. Socio-demographic factors including income, race, education, age, and English speaking ability were tested using statistical assessments to identify significant relationships with heat exposure and access to refuge from extreme heat. Results indicate that groups with limited adaptive capacity, including those in poverty and non-white populations, are at higher risk for heat exposure, suggesting an emerging concern of environmental justice as it relates to climate change. The paper concludes by emphasizing the importance of cultural sensitivity and inclusion, in combination with effectively distributing cooling centers in areas where the greatest burden befalls vulnerable populations.
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Affiliation(s)
- Jackson Voelkel
- School of Urban Studies and Planning, Portland State University, Portland, OR 97201, USA.
| | - Dana Hellman
- School of Urban Studies and Planning, Portland State University, Portland, OR 97201, USA.
| | - Ryu Sakuma
- Peace Winds Japan, Tokyo 151-0063, Japan.
| | - Vivek Shandas
- School of Urban Studies and Planning, Portland State University, Portland, OR 97201, USA.
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Perera F. Pollution from Fossil-Fuel Combustion is the Leading Environmental Threat to Global Pediatric Health and Equity: Solutions Exist. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:E16. [PMID: 29295510 PMCID: PMC5800116 DOI: 10.3390/ijerph15010016] [Citation(s) in RCA: 199] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/15/2017] [Accepted: 12/20/2017] [Indexed: 02/07/2023]
Abstract
Fossil-fuel combustion by-products are the world's most significant threat to children's health and future and are major contributors to global inequality and environmental injustice. The emissions include a myriad of toxic air pollutants and carbon dioxide (CO₂), which is the most important human-produced climate-altering greenhouse gas. Synergies between air pollution and climate change can magnify the harm to children. Impacts include impairment of cognitive and behavioral development, respiratory illness, and other chronic diseases-all of which may be "seeded" in utero and affect health and functioning immediately and over the life course. By impairing children's health, ability to learn, and potential to contribute to society, pollution and climate change cause children to become less resilient and the communities they live in to become less equitable. The developing fetus and young child are disproportionately affected by these exposures because of their immature defense mechanisms and rapid development, especially those in low- and middle-income countries where poverty and lack of resources compound the effects. No country is spared, however: even high-income countries, especially low-income communities and communities of color within them, are experiencing impacts of fossil fuel-related pollution, climate change and resultant widening inequality and environmental injustice. Global pediatric health is at a tipping point, with catastrophic consequences in the absence of bold action. Fortunately, technologies and interventions are at hand to reduce and prevent pollution and climate change, with large economic benefits documented or predicted. All cultures and communities share a concern for the health and well-being of present and future children: this shared value provides a politically powerful lever for action. The purpose of this commentary is to briefly review the data on the health impacts of fossil-fuel pollution, highlighting the neurodevelopmental impacts, and to briefly describe available means to achieve a low-carbon economy, and some examples of interventions that have benefited health and the economy.
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Affiliation(s)
- Frederica Perera
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
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McGinn R, Poirier MP, Louie JC, Sigal RJ, Boulay P, Flouris AD, Kenny GP. Increasing age is a major risk factor for susceptibility to heat stress during physical activity. Appl Physiol Nutr Metab 2017; 42:1232-1235. [DOI: 10.1139/apnm-2017-0322] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We evaluated the extent to which age, cardiorespiratory fitness, and body fat can independently determine whole-body heat loss (WBHL) in 87 otherwise healthy adults. We show that increasing age is a major predictor for decreasing WBHL in otherwise healthy adults (aged 20–70 years), accounting for 40% of the variation in the largest study to date. While greater body fat also had a minor detrimental impact on WBHL, there was no significant role for cardiorespiratory fitness.
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Affiliation(s)
- Ryan McGinn
- Human and Environmental Physiological Research Unit, Faculty of Health Sciences, University of Ottawa; Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Martin P. Poirier
- Human and Environmental Physiological Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Jeffrey C. Louie
- Human and Environmental Physiological Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Ronald J. Sigal
- Departments of Medicine, Cardiac Sciences, and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Human and Environmental Physiological Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Pierre Boulay
- Faculty of Human Kinetics, University of Sherbrooke, Sherbrooke, QC J1K 0A5, Canada
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala 382 21, Greece
| | - Glen P. Kenny
- Human and Environmental Physiological Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1N 6N5, Canada
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Kaulfus AS, Nair U, Jaffe D, Christopher SA, Goodrick S. Biomass Burning Smoke Climatology of the United States: Implications for Particulate Matter Air Quality. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:11731-11741. [PMID: 28960063 DOI: 10.1021/acs.est.7b03292] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We utilize the NOAA Hazard Mapping System smoke product for the period of 2005 to 2016 to develop climatology of smoke occurrence over the Continental United States (CONUS) region and to study the impact of wildland fires on particulate matter air quality at the surface. Our results indicate that smoke is most frequently found over the Great Plains and western states during the summer months. Other hotspots of smoke occurrence are found over state and national parks in the southeast during winter and spring, in the Gulf of Mexico southwards of the Texas and Louisiana coastline during spring season and along the Mississippi River Delta during the fall season. A substantial portion (20%) of the 24 h federal standard for particulate pollution exceedance events in the CONUS region occur when smoke is present. If the U.S. Environmental Protection Agency regulations continue to reduce anthropogenic emissions, wildland fire emissions will become the major contributor to particulate pollution and exceedance events. In this context, we show that HMS smoke product is a valuable tool for analysis of exceptional events caused by wildland fires and our results indicate that these tools can be valuable for policy and decision makers.
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Affiliation(s)
- Aaron S Kaulfus
- Department of Atmospheric Science, University of Alabama in Huntsville , Huntsville, Alabama 35806, United States
| | - Udaysankar Nair
- Department of Atmospheric Science, University of Alabama in Huntsville , Huntsville, Alabama 35806, United States
| | - Daniel Jaffe
- School of Science, Technology, Engineering and Math, University of Washington-Bothell , Bothell, Washington 98011-8246, United States
| | - Sundar A Christopher
- Department of Atmospheric Science, University of Alabama in Huntsville , Huntsville, Alabama 35806, United States
| | - Scott Goodrick
- Forest Service, Southern Research Station, Center for Forest Disturbance Science, Athens, Georgia 30602, United States
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Jagai JS, Grossman E, Navon L, Sambanis A, Dorevitch S. Hospitalizations for heat-stress illness varies between rural and urban areas: an analysis of Illinois data, 1987-2014. Environ Health 2017; 16:38. [PMID: 28388909 PMCID: PMC5384150 DOI: 10.1186/s12940-017-0245-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 03/30/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND The disease burden due to heat-stress illness (HSI), which can result in significant morbidity and mortality, is expected to increase as the climate continues to warm. In the United States (U.S.) much of what is known about HSI epidemiology is from analyses of urban heat waves. There is limited research addressing whether HSI hospitalization risk varies between urban and rural areas, nor is much known about additional diagnoses of patients hospitalized for HSI. METHODS Hospitalizations in Illinois for HSI (ICD-9-CM codes 992.x or E900) in the months of May through September from 1987 to 2014 (n = 8667) were examined. Age-adjusted mean monthly hospitalization rates were calculated for each county using U.S. Census population data. Counties were categorized into five urban-rural strata using Rural Urban Continuum Codes (RUCC) (RUCC1, most urbanized to RUCC5, thinly populated). Average maximum monthly temperature (°C) was calculated for each county using daily data. Multi-level linear regression models were used, with county as the fixed effect and temperature as random effect, to model monthly hospitalization rates, adjusting for the percent of county population below the poverty line, percent of population that is Non-Hispanic Black, and percent of the population that is Hispanic. All analyses were stratified by county RUCC. Additional diagnoses of patients hospitalized for HSI and charges for hospitalization were summarized. RESULTS Highest rates of HSI hospitalizations were seen in the most rural, thinly populated stratum (mean annual summer hospitalization rate of 1.16 hospitalizations per 100,000 population in the thinly populated strata vs. 0.45 per 100,000 in the metropolitan urban strata). A one-degree Celsius increase in maximum monthly average temperature was associated with a 0.34 increase in HSI hospitalization rate per 100,000 population in the thinly populated counties compared with 0.02 per 100,000 in highly urbanized counties. The most common additional diagnoses of patients hospitalized with HSI were dehydration, electrolyte abnormalities, and acute renal disorders. Total and mean hospital charges for HSI cases were $167.7 million and $20,500 (in 2014 US dollars). CONCLUSION Elevated temperatures appear to have different impacts on HSI hospitalization rates as function of urbanization. The most rural and the most urbanized counties of Illinois had the largest increases in monthly hospitalization rates for HSI per unit increase in the average monthly maximum temperature. This suggests that vulnerability of communities to heat is complex and strategies to reduce HSI may need to be tailored to the degree of urbanization of a county.
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Affiliation(s)
- Jyotsna S. Jagai
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Elena Grossman
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Livia Navon
- Centers for Disease Control and Prevention, Illinois Department of Public Health, Chicago, USA
| | - Apostolis Sambanis
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Samuel Dorevitch
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
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41
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Anderko L. Climate Change and Public Health: Nurses Can Make a Difference. Public Health Nurs 2017; 34:99-100. [DOI: 10.1111/phn.12316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Anderko
- School of Nursing & Health Studies; Georgetown University; Washington District of Columbia
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42
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Perera FP. Multiple Threats to Child Health from Fossil Fuel Combustion: Impacts of Air Pollution and Climate Change. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:141-148. [PMID: 27323709 PMCID: PMC5289912 DOI: 10.1289/ehp299] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/01/2016] [Accepted: 05/31/2016] [Indexed: 05/04/2023]
Abstract
BACKGROUND Approaches to estimating and addressing the risk to children from fossil fuel combustion have been fragmented, tending to focus either on the toxic air emissions or on climate change. Yet developing children, and especially poor children, now bear a disproportionate burden of disease from both environmental pollution and climate change due to fossil fuel combustion. OBJECTIVE This commentary summarizes the robust scientific evidence regarding the multiple current and projected health impacts of fossil fuel combustion on the young to make the case for a holistic, child-centered energy and climate policy that addresses the full array of physical and psychosocial stressors resulting from fossil fuel pollution. DISCUSSION The data summarized here show that by sharply reducing our dependence on fossil fuels we would achieve highly significant health and economic benefits for our children and their future. These benefits would occur immediately and also play out over the life course and potentially across generations. CONCLUSION Going beyond the powerful scientific and economic arguments for urgent action to reduce the burning of fossil fuels is the strong moral imperative to protect our most vulnerable populations. Citation: Perera FP. 2017. Multiple threats to child health from fossil fuel combustion: impacts of air pollution and climate change. Environ Health Perspect 125:141-148; http://dx.doi.org/10.1289/EHP299.
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Affiliation(s)
- Frederica P. Perera
- Columbia Center for Children’s Environmental Health, Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
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43
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Kenny GP, Poirier MP, Metsios GS, Boulay P, Dervis S, Friesen BJ, Malcolm J, Sigal RJ, Seely AJE, Flouris AD. Hyperthermia and cardiovascular strain during an extreme heat exposure in young versus older adults. Temperature (Austin) 2017; 4:79-88. [PMID: 28349096 PMCID: PMC5356213 DOI: 10.1080/23328940.2016.1230171] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/21/2016] [Accepted: 08/25/2016] [Indexed: 11/21/2022] Open
Abstract
We examined whether older individuals experience greater levels of hyperthermia and cardiovascular strain during an extreme heat exposure compared to young adults. During a 3-hour extreme heat exposure (44°C, 30% relative humidity), we compared body heat storage, core temperature (rectal, visceral) and cardiovascular (heart rate, cardiac output, mean arterial pressure, limb blood flow) responses of young adults (n = 30, 19-28 years) against those of older adults (n = 30, 55-73 years). Direct calorimetry measured whole-body evaporative and dry heat exchange. Body heat storage was calculated as the temporal summation of heat production (indirect calorimetry) and whole-body heat loss (direct calorimetry) over the exposure period. While both groups gained a similar amount of heat in the first hour, the older adults showed an attenuated increase in evaporative heat loss (p < 0.033) in the first 30-min. Thereafter, the older adults were unable to compensate for a greater rate of heat gain (11 ± 1 ; p < 0.05) with a corresponding increase in evaporative heat loss. Older adults stored more heat (358 ± 173 kJ) relative to their younger (202 ± 92 kJ; p < 0.001) counterparts at the end of the exposure leading to greater elevations in rectal (p = 0.043) and visceral (p = 0.05) temperatures, albeit not clinically significant (rise < 0.5°C). Older adults experienced a reduction in calf blood flow (p < 0.01) with heat stress, yet no differences in cardiac output, blood pressure or heart rate. We conclude, in healthy habitually active individuals, despite no clinically observable cardiovascular or temperature changes, older adults experience greater heat gain and decreased limb perfusion in response to 3-hour heat exposure.
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Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
- CONTACT Glen P. Kenny, PhD 125 University Private, Room 367, Montpetit Hall, Ottawa, Ontario K1N 6N5, Canada
| | - Martin P. Poirier
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - George S. Metsios
- Institute of Sport, Faculty of Education Health and Wellbeing, University of Wolverhampton, Walsall, UK
| | - Pierre Boulay
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, Canada
| | - Sheila Dervis
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Brian J. Friesen
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Janine Malcolm
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Ronald J. Sigal
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
- Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Canada
| | - Andrew J. E. Seely
- Divisions of Thoracic Surgery and Critical Care Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Andreas D. Flouris
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
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Ahmed QA, Memish ZA. The public health planners' perfect storm: Hurricane Matthew and Zika virus. Travel Med Infect Dis 2016; 15:63-66. [PMID: 28017726 DOI: 10.1016/j.tmaid.2016.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 11/26/2022]
Abstract
Hurricane Matthew threatened to be one of the most powerful Hurricanes to hit the United States in a century. Fortunately, it avoided making landfall on Florida, the eye of the Hurricane remaining centered 40 miles off the Florida coast. Even so it has resulted in over $7 Billion USD in damage according to initial estimates with much of the damage ongoing in severe flooding. Response to and recovery from Hurricane Matthew challenged Florida's public health services and resources just as emergency Zika-specific congressional funding to combat Zika outbreaks in Florida had become available. Hurricanes can disrupt the urban environment in a way that increases the likelihood of vector-borne illnesses and their aftermath can severely strain the very infectious disease and infection control academe needed to combat vector-borne outbreaks. This commentary attempts to examine the challenges posed by Hurricane Matthew in Florida's efforts to contain Zika.
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Affiliation(s)
- Qanta A Ahmed
- Division of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Winthrop University Hospital, USA; State University of New York (SUNY) at Stony Brook, New York, USA.
| | - Ziad A Memish
- Ministry of Health & College of Medicine Alfaisal University, Riyadh, Saudi Arabia.
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45
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Rudolph L, Gould S. Climate Change and Health Inequities: A Framework for Action. Ann Glob Health 2016; 81:432-44. [PMID: 26615079 DOI: 10.1016/j.aogh.2015.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Linda Rudolph
- Center for Climate Change and Health, Public Health Institute, Oakland, CA.
| | - Solange Gould
- School of Public Health, University of California, Berkeley, CA
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46
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Schmitt LHM, Graham HM, White PCL. Economic Evaluations of the Health Impacts of Weather-Related Extreme Events: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1105. [PMID: 27834843 PMCID: PMC5129315 DOI: 10.3390/ijerph13111105] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/17/2016] [Accepted: 10/19/2016] [Indexed: 12/02/2022]
Abstract
The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies) or Asia (seven studies), whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies), closely followed by flooding (six studies). No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events.
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Affiliation(s)
- Laetitia H M Schmitt
- Centre for Health Economics, University of York, YO10 5DD York, UK.
- Academic Unit of Health Economics, University of Leeds, LS2 9LJ Leeds, UK.
| | - Hilary M Graham
- Health Sciences Department, University of York, YO10 5DD York, UK.
| | - Piran C L White
- Environment Department, University of York, Wentworth Way, YO10 5NG York, UK.
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47
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Fechter-Leggett ED, Vaidyanathan A, Choudhary E. Heat Stress Illness Emergency Department Visits in National Environmental Public Health Tracking States, 2005-2010. J Community Health 2016. [PMID: 26205070 DOI: 10.1007/s10900-015-0064-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Variability of heat stress illness (HSI) by urbanicity and climate region has rarely been considered in previous HSI studies. We investigated temporal and geographic trends in HSI emergency department (ED) visits in CDC Environmental Public Health Tracking Network (Tracking) states for 2005-2010. We obtained county-level HSI ED visit data for 14 Tracking states. We used the National Center for Health Statistics Urban-Rural Classification Scheme to categorize counties by urbanicity as (1) large central metropolitan (LCM), (2) large fringe metropolitan, (3) small-medium metropolitan, or (4) nonmetropolitan (NM). We also assigned counties to one of six US climate regions. Negative binomial regression was used to examine trends in HSI ED visits over time across all counties and by urbanicity for each climate region, adjusting for pertinent variables. During 2005-2010, there were 98,462 HSI ED visits in the 14 states. ED visits for HSI decreased 3.0% (p < 0.01) per year. Age-adjusted incidence rates of HSI ED visits increased from most urban to most rural. Overall, ED visits were significantly higher for NM areas (IRR = 1.41, p < 0.01) than for LCM areas. The same pattern was observed in all six climate regions; compared with LCM, NM areas had from 14 to 90% more ED visits for HSI. These findings of significantly increased HSI ED visit rates in more rural settings suggest a need to consider HSI ED visit variability by county urbanicity and climate region when designing and implementing local HSI preventive measures and interventions.
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Affiliation(s)
- Ethan D Fechter-Leggett
- Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop F-60, Chamblee, GA, 30341, USA.
- Field Studies Branch, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd, Mailstop H2800, Morgantown, WV, 26505, USA.
- Epidemic Intelligence Service Program, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Ambarish Vaidyanathan
- Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop F-60, Chamblee, GA, 30341, USA
| | - Ekta Choudhary
- Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001-2010. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13090894. [PMID: 27618079 PMCID: PMC5036727 DOI: 10.3390/ijerph13090894] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 12/05/2022]
Abstract
Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI) in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS). Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat.
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49
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Wang Y, Bobb JF, Papi B, Wang Y, Kosheleva A, Di Q, Schwartz JD, Dominici F. Heat stroke admissions during heat waves in 1,916 US counties for the period from 1999 to 2010 and their effect modifiers. Environ Health 2016; 15:83. [PMID: 27503399 PMCID: PMC4977899 DOI: 10.1186/s12940-016-0167-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/27/2016] [Indexed: 05/16/2023]
Abstract
BACKGROUND Heat stroke is a serious heat-related illness, especially among older adults. However, little is known regarding the spatiotemporal variation of heat stroke admissions during heat waves and what factors modify the adverse effects. METHODS We conducted a large-scale national study among 23.5 million Medicare fee-for-service beneficiaries per year residing in 1,916 US counties during 1999-2010. Heat wave days, defined as a period of at least two consecutive days with temperatures exceeding the 97th percentile of that county's temperatures, were matched to non-heat wave days by county and week. We fitted random-effects Poisson regression models to estimate the relative risk (RR) of heat stroke admissions on a heat wave day as compared to a matched non-heat wave day. A variety of effect modifiers were tested including individual-level covariates, community-level covariates, meteorological conditions, and the intensity and duration of the heat wave event. RESULTS The RR declined substantially from 71.0 (21.3-236.2) in 1999 to 3.5 (1.9-6.5) in 2010, and was highest in the northeast and lowest in the west north central regions of the US. We found a lower RR among counties with higher central air conditioning (AC) prevalence. More severe and longer-lasting heat waves had higher RRs. CONCLUSIONS Heat stroke hospitalizations associated with heat waves declined dramatically over time, indicating increased resilience to extreme heat among older adults. Considerable risks, however, still remain through 2010, which could be addressed through public health interventions at a regional scale to further increase central AC and monitoring heat waves.
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Affiliation(s)
- Yan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215 USA
| | - Jennifer F. Bobb
- Biostatistics Unit, Group Health Research Institute, 1730 Minor Ave #1600, Seattle, WA 98101 USA
| | - Bianca Papi
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Yun Wang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Anna Kosheleva
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215 USA
| | - Qian Di
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215 USA
| | - Joel D. Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215 USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
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Ganesan S, Reynolds C, Hollinger K, Pearce SC, Gabler NK, Baumgard LH, Rhoads RP, Selsby JT. Twelve hours of heat stress induces inflammatory signaling in porcine skeletal muscle. Am J Physiol Regul Integr Comp Physiol 2016; 310:R1288-96. [PMID: 27009052 DOI: 10.1152/ajpregu.00494.2015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/21/2016] [Indexed: 01/08/2023]
Abstract
Heat stress causes morbidity and mortality in humans and animals and threatens food security by limiting livestock productivity. Inflammatory signaling may contribute to heat stress-mediated skeletal muscle dysfunction. Previously, we discovered increased circulating endotoxin and intramuscular oxidative stress and TNF-α protein abundance, but not inflammatory signaling following 24 and 72 h of heat stress. Thus the purpose of this investigation was to clarify the role of inflammatory signaling in heat-stressed skeletal muscle. Crossbred gilts (n = 8/group) were assigned to either thermal neutral (24°C), heat stress (37°C), or pair-fed thermal neutral (24°C) conditions for 12 h. Following treatment, animals were euthanized, and the semitendinosus red (STR) and white (STW) were recovered. Heat stress did not alter inflammatory signaling in STW. In STR, relative heat shock protein abundance was similar between groups, as was nuclear content of heat shock factor 1. In whole homogenate, relative abundance of the NF-κB activator inhibitory κB kinase-α was increased by heat stress, although abundance of NF-κB was similar between groups. Relative abundance of phosphorylated NF-κB was increased by heat stress in nuclear fractions. Activator protein-1 (AP-1) signaling was similar between groups. While there were few differences in transcript expression between thermal neutral and heat stress, 80 and 56% of measured transcripts driven by NF-κB or AP-1, respectively, were increased by heat stress compared with pair-fed thermal neutral. Heat stress also caused a reduction in IL-6 transcript and relative protein abundance. These data demonstrate that short-term heat stress causes inflammatory signaling through NF-κB in oxidative, but not glycolytic, skeletal muscle.
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Affiliation(s)
- Shanthi Ganesan
- Department of Animal Science, Iowa State University, Ames, Iowa; and
| | - Carmen Reynolds
- Department of Animal Science, Iowa State University, Ames, Iowa; and
| | - Katrin Hollinger
- Department of Animal Science, Iowa State University, Ames, Iowa; and
| | - Sarah C Pearce
- Department of Animal Science, Iowa State University, Ames, Iowa; and
| | - Nicholas K Gabler
- Department of Animal Science, Iowa State University, Ames, Iowa; and
| | - Lance H Baumgard
- Department of Animal Science, Iowa State University, Ames, Iowa; and
| | - Robert P Rhoads
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Joshua T Selsby
- Department of Animal Science, Iowa State University, Ames, Iowa; and
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