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Ruiz-Páez R, López-Bueno JA, Padrón-Monedero A, Navas MA, Salvador P, Linares C, Díaz J. Short-term effects of fine particulate matter from biomass combustion and Saharan dust intrusions on emergency hospital admissions due to mental and behavioural disorders, anxiety and depression in Spain. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174316. [PMID: 38945243 DOI: 10.1016/j.scitotenv.2024.174316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/31/2024] [Accepted: 06/24/2024] [Indexed: 07/02/2024]
Abstract
Climate change is affecting both the frequency and scale of wildfires, as well as the increase in the number of days with Saharan dust intrusions. Traditionally, studies have focused on the extent to which the increase in fine particulate matter (PM) has had an impact on cardio-respiratory diseases, but (apart from PM) not on how the meteorological and pollution conditions in these situations affect other diseases, such as those linked to mental health. This study therefore sought to ascertain how daily mean PM10, PM 2.5, NO2, O3 concentrations and daily maximum temperature in heat waves influence daily emergency hospital admissions in Spain caused by mental and behavioural disorders, depression and anxiety on days with PM from biomass combustion and/or Saharan dust intrusions, as compared to days without such conditions, across the period 2009-2018. Our results indicate that on days on which there is biomass combustion, PM concentrations have a statistically significant effect on emergency admissions due to mental disorders, probably related with the toxicity of these particles. Yet on days with intrusions of Saharan dust rather than PM, it is the other variables considered in the analysis that are most closely linked to these types of admissions. The results of this study thus point to the need to implement public health prevention plans which take into account the joint effect of various environmental risk factors that act synergistically in given situations.
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Affiliation(s)
- R Ruiz-Páez
- University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - J A López-Bueno
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), 28029 Madrid, Spain
| | - A Padrón-Monedero
- National School of Health, Carlos III Institute of Health, 28029 Madrid, Spain
| | - M A Navas
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), 28029 Madrid, Spain
| | - P Salvador
- Centre for Energy, Environmental and Technological Research/CIEMAT, Department of the Environment, 28040 Madrid, Spain
| | - C Linares
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), 28029 Madrid, Spain
| | - J Díaz
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), 28029 Madrid, Spain.
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Mullan K, Avery T, Boise P, Leary CS, Rice WL, Semmens EO. Impacts of wildfire-season air quality on park and playground visitation in the Northwest United States. ECOLOGICAL ECONOMICS : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR ECOLOGICAL ECONOMICS 2024; 224:108285. [PMID: 39005240 PMCID: PMC11238847 DOI: 10.1016/j.ecolecon.2024.108285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
A significant cost of wildfires is the exposure of local and regional populations to air pollution from smoke, which can travel hundreds of miles from the source fire and is associated with significant negative health consequences. Wildfires are increasing in frequency and intensity in the United States, driven by historic fire management approaches and global climate change. These influences will take many decades or longer to reverse, so the main opportunities for mitigating health effects involve minimizing human exposure through changes in behavior or infrastructure. One key recommendation for reducing pollution exposures during wildfire smoke events is to limit time and physical activity outdoors, but there is limited evidence on the extent to which people make this change. We estimate how use of parks and playgrounds changes with air quality during wildfire season in the northwest United States. We find small reductions in park and playground visits on moderately polluted days, and large reductions, to 50-60% of baseline visits, when pollution levels are high. Disaggregating results by neighborhood characteristics, we find a significantly greater behavioral response to moderate levels of air pollution in neighborhoods with higher socio-economic status, although responses to high levels of pollution are similar across neighborhood types.
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Affiliation(s)
| | | | | | - Cindy S Leary
- Center for Population Health Research, University of Montana
| | - William L Rice
- Department of Society and Conservation, University of Montana
| | - Erin O Semmens
- School of Public and Community Health Sciences, University of Montana
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Maya S, Mirzazadeh A, Kahn JG. Effect of wildfire on the prevalence of opioid misuse through anxiety among young adults in the United States: a modeling study. BMC Public Health 2024; 24:1915. [PMID: 39014350 PMCID: PMC11253393 DOI: 10.1186/s12889-024-19417-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/09/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Exposure to climate change events like wildfires can lead to health and mental health problems. While conceptual frameworks have been hypothesized describing the potential relationship between disaster exposure and substance use, the association remains under-researched and unquantified. METHODS We constructed a quantitative portrayal of one proposed conceptual framework that focuses on the intermediary role of anxiety. We used the Monte Carlo simulation to estimate the impact of wildfire exposure on opioid misuse outcomes through increased anxiety. We searched for and extracted prior empirical evidence on the associations between wildfire anxiety and anxiety-opioid misuse. Three scenarios were devised: in S1 the impact of wildfire on opioid misuse was limited to increasing anxiety incidence; in S2 we also considered the additive role of altered anxiety phenotype; and in S3 we further considered the role of increased opioid-related consequences of pre-existing anxiety due to wildfire exposure. RESULTS Models show that the prevalence of opioid misuse post-wildfire may rise to 6.0%-7.2% from a baseline of 5.3%. In S1, the opioid misuse prevalence ratio was 1.12 (95% uncertainty interval [UI]: 1.00 - 1.27). The two exploratory scenarios, with less stringent assumptions, yielded prevalence ratios of 1.23 (95% UI: 1.00 - 1.51) and 1.34 (95% UI: 1.11 - 1.63). CONCLUSIONS Our modeling study suggests that exposure to wildfires may elevate opioid misuse through increasing anxiety incidence and severity. This can lead to substantial health burdens, possibly beyond the duration of the wildfire event, which may offset recent gains in opioid misuse prevention.
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Affiliation(s)
- Sigal Maya
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - James G Kahn
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
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Cedeño Laurent JG, Parhizkar H, Calderon L, Lizonova D, Tsiodra I, Mihalopoulos N, Kavouras I, Alam M, Baalousha M, Bazina L, Kelesidis GA, Demokritou P. Physicochemical Characterization of the Particulate Matter in New Jersey/New York City Area, Resulting from the Canadian Quebec Wildfires in June 2023. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024. [PMID: 38984996 DOI: 10.1021/acs.est.4c02016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
The global increase in wildfires, primarily driven by climate change, significantly affects air quality and health. Wildfire-emitted particulate matter (WFPM) is linked to adverse health effects, yet the toxicological mechanisms are not fully understood given its physicochemical complexity and the lack of spatiotemporal exposure data. This study focuses on the physicochemical characterization of WFPM from a Canadian wildfire in June 2023, which affected over 100 million people in the US Northeast, particularly around New Jersey/New York. Aerosol systems were deployed to characterize WFPM during the 3 day event, revealing unprecedented mass concentrations mainly in the WFPM0.1 and WFPM0.1-2.5 size fractions. Peak WFPM2.5 concentrations reached 317 μg/m3, nearly 10 times the National Ambient Air Quality Standard (NAAQS) 24 h average limit. Chemical analysis showed a high organic-to-total carbon ratio (96%), consistent with brown carbon wildfires nanoparticles. Large concentrations of high-molecular-weight PAHs were found predominantly bound to WFPM0.1, with retene, a molecular marker of biomass burning and a known teratogen, being the most abundant (>70%). Computational modeling estimated a total lung deposition of 9.15 mg over 72 h, highlighting the health risks of WFPM, particularly due to its long-distance travel capability and impact on densely populated areas.
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Affiliation(s)
- José Guillermo Cedeño Laurent
- Department of Environmental and Occupational Health and Justice, School of Public Health, Rutgers University, Piscataway, New Jersey 08854, United States
- Nanoscience and Advanced Materials Center, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854, United States
| | - Hooman Parhizkar
- Department of Environmental and Occupational Health and Justice, School of Public Health, Rutgers University, Piscataway, New Jersey 08854, United States
- Nanoscience and Advanced Materials Center, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854, United States
| | - Leonardo Calderon
- Nanoscience and Advanced Materials Center, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854, United States
- School of Environmental and Biological Sciences, Department of Environmental Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey 08901, United States
| | - Denisa Lizonova
- Department of Environmental and Occupational Health and Justice, School of Public Health, Rutgers University, Piscataway, New Jersey 08854, United States
- Nanoscience and Advanced Materials Center, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854, United States
| | - Irini Tsiodra
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Lofos Koufou, Palea Penteli, Athens 15236, Greece
| | - Nikolaos Mihalopoulos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Lofos Koufou, Palea Penteli, Athens 15236, Greece
- Environmental Chemical Processes Laboratory, Department of Chemistry, University of Crete, Heraklion 71003, Greece
| | - Ilias Kavouras
- Department of Environmental, Occupational and Geospatial Health Sciences, School of Public Health, City University of New York, New York, New York 10018, United States
| | - Mahbub Alam
- Center for Environmental Nanoscience and Risk, Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, United States
| | - Mohammed Baalousha
- Center for Environmental Nanoscience and Risk, Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, United States
| | - Lila Bazina
- Department of Environmental and Occupational Health and Justice, School of Public Health, Rutgers University, Piscataway, New Jersey 08854, United States
- Nanoscience and Advanced Materials Center, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854, United States
| | - Georgios A Kelesidis
- Department of Environmental and Occupational Health and Justice, School of Public Health, Rutgers University, Piscataway, New Jersey 08854, United States
- Nanoscience and Advanced Materials Center, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854, United States
| | - Philip Demokritou
- Department of Environmental and Occupational Health and Justice, School of Public Health, Rutgers University, Piscataway, New Jersey 08854, United States
- Nanoscience and Advanced Materials Center, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854, United States
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Du R, Liu K, Zhao D, Fang Q. Climate Disaster and Cognitive Ability: Evidence From Wildfire. Int J Public Health 2024; 69:1607128. [PMID: 39050193 PMCID: PMC11266011 DOI: 10.3389/ijph.2024.1607128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
Objectives We investigate the impact of wildfire disasters on cognitive health (i.e., thinking and language skills) in individuals aged 10 years and older using 2014 and 2018 wildfire and cognitive ability survey data from China. Methods We distinguished wildfires in each county at different wind directions each day by exogenous wind direction changes, and analyzed the effects of wildfires on cognitive abilities through upwind and non-upwind wildfires. Results Our analysis shows that for every 10-unit increase in upwind wildfires compared to non-upwind wildfires, respondents' scores on word and math tests decrease by 0.235 and 0.236 standard deviations, respectively. Furthermore, we find that the impact of wildfire on cognitive ability is more pronounced in younger individuals, and those with lower defensive expenditures experience more severe impacts. Additionally, wildfires negatively affect individuals' cognitive abilities by generating air pollution. Conclusion Wildfires significantly reduce individuals' cognitive abilities. Two recommendations are as follows: 1) governments should follow the principle of green development, introduce relevant regulations, and increase investment in adaptive technologies. 2) Individuals should raise awareness of climate hazards preparedness and strengthen defensive protection.
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Affiliation(s)
- Ran Du
- School of Economics, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Liu
- International Business School, Shaanxi Normal University, Xi’an, Shaanxi, China
| | - Dangru Zhao
- School of Economics, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiyun Fang
- School of Economics, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Mitchell A, Maheen H, Bowen K. Mental health impacts from repeated climate disasters: an australian longitudinal analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101087. [PMID: 38831889 PMCID: PMC11145535 DOI: 10.1016/j.lanwpc.2024.101087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 06/05/2024]
Abstract
Background Extreme weather events are becoming more frequent and intense under changing climatic conditions. Whilst there is substantial evidence that exposure to a single weather related disaster is detrimental for mental health, few studies have explored how exposure to multiple disasters impacts mental health. Methods We utilised 11 waves of data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, yielding a sample of 16,629 observations from 2003 individuals. Fixed effects linear regression analysis was used to estimate the impact of experiencing multiple disasters on mental health. We tested for effect modification on this association by sex, rurality, employment and presence of a long-term health condition. Findings Exposure to multiple disasters was associated with a relative decrease in MHI-5 score compared to baseline by -1.8 points (95% CI -3.4, -0.3), whereas exposure to a single disaster was not associated with a decline in mental health scores. There was evidence of effect modification by employment status. Unemployed individuals had evidence of moderate reduction in MHI-5 scores when exposed to a single disaster (-4.3, 95% CI -7.0, -1.5). Interpretation Findings suggest that repeat exposure to disasters is associated with worsening mental health outcomes. As extreme weather events increase, these findings highlight the need for greater attention on climate change action, and mental health interventions targeting impacted populations. Funding Suicide Prevention Australia.
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Affiliation(s)
- Anna Mitchell
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC, Australia
| | - Humaira Maheen
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC, Australia
| | - Kathryn Bowen
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC, Australia
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Obuobi-Donkor G, Shalaby R, Agyapong B, da Luz Dias R, Agyapong VIO. 2023 Wildfires in Canada: Living in Wildfire Regions in Alberta and Nova Scotia Doubled the Odds for Residents to Experience Likely Generalized Anxiety Disorder Symptoms. J Clin Med 2024; 13:3234. [PMID: 38892945 PMCID: PMC11172488 DOI: 10.3390/jcm13113234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/20/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Wildfires have become increasingly prevalent in various regions, resulting in substantial environmental and psychological consequences that have garnered increasing attention. Objective: This study aims to examine the prevalence of likely Generalized Anxiety Disorder (GAD) and explore the determinants of likely GAD during the wildfires in Alberta and Nova Scotia. Methods: Data were collected online through a cross-sectional survey from 14 May-23 June 2023. Alberta and Nova Scotia participants self-subscribed to the program by texting 'HopeAB' or 'HopeNS' to a short code, respectively. The GAD-7-validated tool was used to collect information on likely GAD. Results: This study included 298 respondents while one hundred and twelve respondents lived in a region of Alberta/Nova Scotia affected by the wildfires (37.7%). The prevalence of likely GAD among the respondents was 41.9%. Respondents who lived in a region of Alberta/Nova Scotia recently impacted by the wildfires were twice as likely to experience GAD symptoms (OR = 2.4; 95% C.I. 1.3-4.3). Conclusions: The study's identification of a statistically significant relationship between residing in a wildfire-impacted region and likely GAD shows the association between environmental and psychological well-being. However, the relatively small sample size and self-reported assessment of GAD symptoms may limit the generalizability of the findings. Further research involving a larger sample size delving into potential predictors could facilitate strategies for mitigating the mental health consequences of natural disasters.
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (B.A.)
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (B.A.)
| | - Raquel da Luz Dias
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (B.A.)
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Casais G, Guimarães NS, Cortes TR, Pescarini J, Rebouças de Magalhães P, Wells V, de Sousa Filho JF, Delgado Neves DJ, Shimonovich M, Olsen JR, de Carvalho Neto EM, Cooper P, Katikireddi SV, Emanuel L, Andrade RFS, Ferreira Dos Santos G, Barreto ML. Wildfire, deforestation and health in tropical rainforest areas: a scoping review protocol. BMJ Open 2024; 14:e082381. [PMID: 38719283 PMCID: PMC11086528 DOI: 10.1136/bmjopen-2023-082381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Wildfires and deforestation potentially have direct effects on multiple health outcomes as well as indirect consequences for climate change. Tropical rainforest areas are characterised by high rainfall, humidity and temperature, and they are predominantly found in low-income and middle-income countries. This study aims to synthesise the methods, data and health outcomes reported in scientific papers on wildfires and deforestation in these locations. METHODS AND ANALYSIS We will carry out a scoping review according to the Joanna Briggs Institute's (JBI) manual for scoping reviews and the framework proposed by Arksey and O'Malley, and Levac et al. The search for articles was performed on 18 August 2023, in 16 electronic databases using Medical Subject Headings terms and adaptations for each database from database inception. The search for local studies will be complemented by the manual search in the list of references of the studies selected to compose this review. We screened studies written in English, French, Portuguese and Spanish. We included quantitative studies assessing any human disease outcome, hospitalisation and vital statistics in regions of tropical rainforest. We exclude qualitative studies and quantitative studies whose outcomes do not cover those of interest. The text screening was done by two independent reviewers. Subsequently, we will tabulate the data by the origin of the data source used, the methods and the main findings on health impacts of the extracted data. The results will provide descriptive statistics, along with visual representations in diagrams and tables, complemented by narrative summaries as detailed in the JBI guidelines. ETHICS AND DISSEMINATION The study does not require an ethical review as it is meta-research and uses published, deidentified secondary data sources. The submission of results for publication in a peer-reviewed journal and presentation at scientific and policymakers' conferences is expected. STUDY REGISTRATION Open Science Framework (https://osf.io/pnqc7/).
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Affiliation(s)
- Gustavo Casais
- Center of Data and Knowledge Integration for Health, Fiocruz/BA, Salvador, Brazil
| | | | | | - Julia Pescarini
- London School of Hygiene & Tropical Medicine, London, UK
- Center of Data and Knowledge Integration for Health (CIDACS), Salvador, Brazil
| | | | | | | | | | | | | | | | - Philip Cooper
- Universidad Internacional del Ecuador, Quito, Ecuador
- St George's, University of London, London, UK
| | | | - Lucas Emanuel
- Center of Data and Knowledge Integration for Health, Fiocruz/BA, Salvador, Brazil
- Federal University of Bahia, Salvador, Brazil
| | - Roberto F S Andrade
- Center of Data and Knowledge Integration for Health, Fiocruz/BA, Salvador, Brazil
- Federal University of Bahia, Salvador, Brazil
| | - Gervasio Ferreira Dos Santos
- Center of Data and Knowledge Integration for Health, Fiocruz/BA, Salvador, Brazil
- Federal University of Bahia, Salvador, Brazil
| | - Mauricio L Barreto
- Center of Data and Knowledge Integration for Health, Fiocruz/BA, Salvador, Brazil
- Federal University of Bahia, Salvador, Brazil
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Johnston FH, Williamson G, Borchers-Arriagada N, Henderson SB, Bowman DMJS. Climate Change, Landscape Fires, and Human Health: A Global Perspective. Annu Rev Public Health 2024; 45:295-314. [PMID: 38166500 DOI: 10.1146/annurev-publhealth-060222-034131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Landscape fires are an integral component of the Earth system and a feature of prehistoric, subsistence, and industrial economies. Specific spatiotemporal patterns of landscape fire occur in different locations around the world, shaped by the interactions between environmental and human drivers of fire activity. Seven distinct types of landscape fire emerge from these interactions: remote area fires, wildfire disasters, savanna fires, Indigenous burning, prescribed burning, agricultural burning, and deforestation fires. All can have substantial impacts on human health and well-being directly and indirectly through (a) exposure to heat flux (e.g., injuries and destructive impacts), (b) emissions (e.g., smoke-related health impacts), and (c) altered ecosystem functioning (e.g., biodiversity, amenity, water quality, and climate impacts). Minimizing the adverse effects of landscape fires on population health requires understanding how human and environmental influences on fire impacts can be modified through interventions targeted at individual, community, and regional levels.
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Affiliation(s)
- Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | - Grant Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | | | - Sarah B Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - David M J S Bowman
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
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Ezeonu NA, Hertelendy AJ, Adu MK, Kung JY, Itanyi IU, Dias RDL, Agyapong B, Hertelendy P, Ohanyido F, Agyapong VIO, Eboreime E. Mobile Apps to Support Mental Health Response in Natural Disasters: Scoping Review. J Med Internet Res 2024; 26:e49929. [PMID: 38520699 PMCID: PMC11063879 DOI: 10.2196/49929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 02/25/2024] [Accepted: 03/23/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Disasters are becoming more frequent due to the impact of extreme weather events attributed to climate change, causing loss of lives, property, and psychological trauma. Mental health response to disasters emphasizes prevention and mitigation, and mobile health (mHealth) apps have been used for mental health promotion and treatment. However, little is known about their use in the mental health components of disaster management. OBJECTIVE This scoping review was conducted to explore the use of mobile phone apps for mental health responses to natural disasters and to identify gaps in the literature. METHODS We identified relevant keywords and subject headings and conducted comprehensive searches in 6 electronic databases. Studies in which participants were exposed to a man-made disaster were included if the sample also included some participants exposed to a natural hazard. Only full-text studies published in English were included. The initial titles and abstracts of the unique papers were screened by 2 independent review authors. Full texts of the selected papers that met the inclusion criteria were reviewed by the 2 independent reviewers. Data were extracted from each selected full-text paper and synthesized using a narrative approach based on the outcome measures, duration, frequency of use of the mobile phone apps, and the outcomes. This scoping review was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). RESULTS Of the 1398 papers retrieved, 5 were included in this review. A total of 3 studies were conducted on participants exposed to psychological stress following a disaster while 2 were for disaster relief workers. The mobile phone apps for the interventions included Training for Life Skills, Sonoma Rises, Headspace, Psychological First Aid, and Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioural Health Disaster Response Apps. The different studies assessed the effectiveness or efficacy of the mobile app, feasibility, acceptability, and characteristics of app use or predictors of use. Different measures were used to assess the effectiveness of the apps' use as either the primary or secondary outcome. CONCLUSIONS A limited number of studies are exploring the use of mobile phone apps for mental health responses to disasters. The 5 studies included in this review showed promising results. Mobile apps have the potential to provide effective mental health support before, during, and after disasters. However, further research is needed to explore the potential of mobile phone apps in mental health responses to all hazards.
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Affiliation(s)
- Nwamaka Alexandra Ezeonu
- Center for Translation and Implementation Research, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Attila J Hertelendy
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, United States
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Medard Kofi Adu
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Janice Y Kung
- Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research, College of Medicine, University of Nigeria, Nsukka, Nigeria
- Department of Community Medicine, University of Nigeria, Enugu, Nigeria
- Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Raquel da Luz Dias
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Petra Hertelendy
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | | | | | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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García YE, Villa-Pérez ME, Li K, Tai XH, Trejo LA, Daza-Torres ML, Montesinos-López JC, Nuño M. Wildfires and social media discourse: exploring mental health and emotional wellbeing through Twitter. Front Public Health 2024; 12:1349609. [PMID: 38680934 PMCID: PMC11046489 DOI: 10.3389/fpubh.2024.1349609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction The rise in global temperatures due to climate change has escalated the frequency and intensity of wildfires worldwide. Beyond their direct impact on physical health, these wildfires can significantly impact mental health. Conventional mental health studies predominantly rely on surveys, often constrained by limited sample sizes, high costs, and time constraints. As a result, there is an increasing interest in accessing social media data to study the effects of wildfires on mental health. Methods In this study, we focused on Twitter users affected by the California Tubbs Fire in 2017 to extract data signals related to emotional well-being and mental health. Our analysis aimed to investigate tweets posted during the Tubbs Fire disaster to gain deeper insights into their impact on individuals. Data were collected from October 8 to October 31, 2017, encompassing the peak activity period. Various analytical methods were employed to explore word usage, sentiment, temporal patterns of word occurrence, and emerging topics associated with the unfolding crisis. Results The findings show increased user engagement on wildfire-related Tweets, particularly during nighttime and early morning, especially at the onset of wildfire incidents. Subsequent exploration of emotional categories using Linguistic Inquiry and Word Count (LIWC) revealed a substantial presence of negative emotions at 43.0%, juxtaposed with simultaneous positivity in 23.1% of tweets. This dual emotional expression suggests a nuanced and complex landscape, unveiling concerns and community support within conversations. Stress concerns were notably expressed in 36.3% of the tweets. The main discussion topics were air quality, emotional exhaustion, and criticism of the president's response to the wildfire emergency. Discussion Social media data, particularly the data collected from Twitter during wildfires, provides an opportunity to evaluate the psychological impact on affected communities immediately. This data can be used by public health authorities to launch targeted media campaigns in areas and hours where users are more active. Such campaigns can raise awareness about mental health during disasters and connect individuals with relevant resources. The effectiveness of these campaigns can be enhanced by tailoring outreach efforts based on prevalent issues highlighted by users. This ensures that individuals receive prompt support and mitigates the psychological impacts of wildfire disasters.
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Affiliation(s)
- Yury E. García
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | | | - Kuang Li
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Xiao Hui Tai
- Department of Statistics, University of California, Davis, Davis, CA, United States
| | - Luis A. Trejo
- School of Engineering and Sciences, Tecnologico de Monterrey, Atizapán de Zaragoza, Mexico
| | - Maria L. Daza-Torres
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | | | - Miriam Nuño
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
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van der Kruk SR, Gunn KM. 'It sort of broke me': A thematic analysis of the psychological experiences and coping strategies employed by Australian fire-affected farmers. Aust J Rural Health 2024; 32:299-310. [PMID: 38407355 DOI: 10.1111/ajr.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/10/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
INTRODUCTION People exposed to bushfires are known to be at heightened risk of experiencing mental health challenges. When farms are impacted, farmers often risk losing not only their homes but also their businesses, containing their livestock, infrastructure and identities. OBJECTIVE To understand the psychological experiences of farmers who have been exposed to fires on their farms and identify the coping strategies they already employ to recover and prepare psychologically for future bushfires. DESIGN In-depth, semi-structured interviews were conducted face-to-face or via Zoom. Thematic analysis was used to analyse the data, using a descriptive, essentialist approach. Sixteen farmers and/or their spouses (50% female; median age of 50.8 years), who owned and/or played an active role in the operation of a farming or pastoral enterprise and had been affected by a farm fire within the last 20 years, participated. Participants resided in inner regional, outer regional and remote South Australia and New South Wales. FINDINGS Seven overarching themes and 22 subthemes resulted: (1) intense emotions in the aftermath, (2) long-term psychological challenges, (3) deliberate focus on organising, prioritising and completing recovery-focused tasks, (4) importance of seeking and/or accessing support to rebuild, (5) adopting a positive attitude and outlook, (6) (dis)engaging from/with community and social connection and (7) various strategies employed to self-regulate emotions. DISCUSSION/CONCLUSION This study demonstrates the unique set of psychological challenges Australian farmers experience in the wake of a farm fire and the coping strategies they report using to help them manage. Findings will inform the development of contextually and culturally appropriate bushfire recovery and preparedness initiatives that are tailored to meet the unique needs of farmers and build upon their existing strengths.
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Affiliation(s)
- Shannen R van der Kruk
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kate M Gunn
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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13
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Madani Hosseini M, Zargoush M, Ghazalbash S. Climate crisis risks to elderly health: strategies for effective promotion and response. Health Promot Int 2024; 39:daae031. [PMID: 38568732 PMCID: PMC10989664 DOI: 10.1093/heapro/daae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis.
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Affiliation(s)
- Mahsa Madani Hosseini
- Ted Rogers School of Management, Toronto Metropolitan University, Toronto, ON, M5B 2K3, Canada
| | - Manaf Zargoush
- Health Policy & Management, DeGroote School of Business, McMaster University, Hamilton, ON, L8S 4M4, Canada
| | - Somayeh Ghazalbash
- Management Analytics, Smith School of Business, Queen’s University, Kingston, ON, K7L 3N6, Canada
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14
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Beggs PJ, Trueck S, Linnenluecke MK, Bambrick H, Capon AG, Hanigan IC, Arriagada NB, Cross TJ, Friel S, Green D, Heenan M, Jay O, Kennard H, Malik A, McMichael C, Stevenson M, Vardoulakis S, Dang TN, Garvey G, Lovett R, Matthews V, Phung D, Woodward AJ, Romanello MB, Zhang Y. The 2023 report of the MJA-Lancet Countdown on health and climate change: sustainability needed in Australia's health care sector. Med J Aust 2024; 220:282-303. [PMID: 38522009 DOI: 10.5694/mja2.52245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/06/2023] [Indexed: 03/25/2024]
Abstract
The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020, 2021 and 2022. It examines five broad domains: health hazards, exposures and impacts; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In this, the sixth report of the MJA-Lancet Countdown, we track progress on an extensive suite of indicators across these five domains, accessing and presenting the latest data and further refining and developing our analyses. Our results highlight the health and economic costs of inaction on health and climate change. A series of major flood events across the four eastern states of Australia in 2022 was the main contributor to insured losses from climate-related catastrophes of $7.168 billion - the highest amount on record. The floods also directly caused 23 deaths and resulted in the displacement of tens of thousands of people. High red meat and processed meat consumption and insufficient consumption of fruit and vegetables accounted for about half of the 87 166 diet-related deaths in Australia in 2021. Correction of this imbalance would both save lives and reduce the heavy carbon footprint associated with meat production. We find signs of progress on health and climate change. Importantly, the Australian Government released Australia's first National Health and Climate Strategy, and the Government of Western Australia is preparing a Health Sector Adaptation Plan. We also find increasing action on, and engagement with, health and climate change at a community level, with the number of electric vehicle sales almost doubling in 2022 compared with 2021, and with a 65% increase in coverage of health and climate change in the media in 2022 compared with 2021. Overall, the urgency of substantial enhancements in Australia's mitigation and adaptation responses to the enormous health and climate change challenge cannot be overstated. Australia's energy system, and its health care sector, currently emit an unreasonable and unjust proportion of greenhouse gases into the atmosphere. As the Lancet Countdown enters its second and most critical phase in the leadup to 2030, the depth and breadth of our assessment of health and climate change will be augmented to increasingly examine Australia in its regional context, and to better measure and track key issues in Australia such as mental health and Aboriginal and Torres Strait Islander health and wellbeing.
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Affiliation(s)
| | | | | | - Hilary Bambrick
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Anthony G Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | | | | | | | | | - Donna Green
- Climate Change Research Centre and ARC Centre of Excellence for Climate Extremes, UNSW, Sydney, NSW
| | - Maddie Heenan
- Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW
- The George Institute for Global Health, Sydney, NSW
| | - Ollie Jay
- Thermal Ergonomics Laboratory, University of Sydney, Sydney, NSW
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | | | | | - Mark Stevenson
- Transport, Health and Urban Design (THUD) Research Lab, University of Melbourne, Melbourne, VIC
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Tran N Dang
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
- Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra, ACT
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, Sydney, NSW
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15
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Adu MK, Shalaby R, Agyapong B, Dias RDL, Agyapong VIO. Exploring the prevalence and predictors of low resilience and likely PTSD in residents of two provinces in Canada during the 2023 wildfires. Front Public Health 2024; 12:1343399. [PMID: 38590805 PMCID: PMC10999595 DOI: 10.3389/fpubh.2024.1343399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Background The recent wildfires in Canada serve as a stark example of the substantial and enduring harm they cause to the health of individuals and communities. Assessing the prevalence and correlates of Post-traumatic stress disorder (PTSD) and low resilience is valuable for policymakers in public health. Objectives The study aimed to assess the prevalence and predictors of low resilience and likely PTSD among subscribers of Text4Hope, an e-mental health program that delivered daily supportive messages to residents of Nova Scotia (NS) and Alberta(AB) during the recent wildfires. Method Data collection was through a self-administered online survey completed by residents of the affected regions of NS and AB from May 14 to June 23, 2023. Data were analyzed using Statistical Package for the Social Sciences. Results Out of 298 respondents, the prevalence of low resilience and likely PTSD in our sample were 52.0 and 39.3%, respectively. Unemployed respondents were about 3 times more likely to experience both low resilience and PTSD symptoms compared to those employed. Respondents with a history of mental health diagnosis were about 4 times more likely to experience likely PTSD compared to those with no history of mental health diagnosis. Conclusion This study established that unemployment and a history of mental health diagnosis predicted likely PTSD, while unemployment was associated with low resilience during the wildfire. These findings offer insights for clinical interventions and the creation of psychosocial support programs for vulnerable populations.
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Affiliation(s)
- Medard K. Adu
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Vincent I. O. Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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Barkoski J, Van Fleet E, Liu A, Ramsey S, Kwok RK, Miller AK. Data Linkages for Wildfire Exposures and Human Health Studies: A Scoping Review. GEOHEALTH 2024; 8:e2023GH000991. [PMID: 38487553 PMCID: PMC10937504 DOI: 10.1029/2023gh000991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 03/17/2024]
Abstract
Wildfires are increasing in frequency and intensity, with significant consequences that impact human health. A scoping review was conducted to: (a) understand wildfire-related health effects, (b) identify and describe environmental exposure and health outcome data sources used to research the impacts of wildfire exposures on health, and (c) identify gaps and opportunities to leverage exposure and health data to advance research. A literature search was conducted in PubMed and a sample of 83 articles met inclusion criteria. A majority of studies focused on respiratory and cardiovascular outcomes. Hospital administrative data was the most common health data source, followed by government data sources and health surveys. Wildfire smoke, specifically fine particulate matter (PM2.5), was the most common exposure measure and was predominantly estimated from monitoring networks and satellite data. Health data were not available in real-time, and they lacked spatial and temporal coverage to study health outcomes with longer latency periods. Exposure data were often available in real-time and provided better temporal and spatial coverage but did not capture the complex mixture of hazardous wildfire smoke pollutants nor exposures associated with non-air pathways such as soil, household dust, food, and water. This scoping review of the specific health and exposure data sources used to underpin these studies provides a framework for the research community to understand: (a) the use and value of various environmental and health data sources, and (b) the opportunities for improving data collection, integration, and accessibility to help inform our understanding of wildfires and other environmental exposures.
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Affiliation(s)
- J. Barkoski
- Social & Scientific Systems, Inc.a DLH Holdings CompanyDurhamNCUSA
| | - E. Van Fleet
- Social & Scientific Systems, Inc.a DLH Holdings CompanyDurhamNCUSA
| | - A. Liu
- Department of Health and Human ServicesNational Institute of Environmental Health SciencesNational Institutes of HealthDurhamNCUSA
- Kelly Government SolutionsRockvilleMDUSA
| | - S. Ramsey
- Social & Scientific Systems, Inc.a DLH Holdings CompanyDurhamNCUSA
| | - R. K. Kwok
- Department of Health and Human ServicesNational Institute on AgingNational Institutes of HealthBaltimoreMDUSA
| | - A. K. Miller
- Department of Health and Human ServicesNational Institute of Environmental Health SciencesNational Institutes of HealthDurhamNCUSA
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Lichter KE, Baniel CC, Do I, Medhat Y, Avula V, Nogueira LM, Bates JE, Paulsson A, Malik N, Hiatt RA, Yom SS, Mohamad O. Effects of Wildfire Events on California Radiation Oncology Clinics and Patients. Adv Radiat Oncol 2024; 9:101395. [PMID: 38304108 PMCID: PMC10831805 DOI: 10.1016/j.adro.2023.101395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 02/03/2024] Open
Abstract
Purpose The effect of climate-driven events, such as wildfires, on health care delivery and cancer care is a growing concern. Patients with cancer undergoing radiation therapy are particularly vulnerable to treatment interruptions, which have a direct effect on survival. We report the results of a study characterizing the effect of wildfires on radiation oncology clinics and their patients. Methods and Materials A survey of California radiation oncologists was used to evaluate emergency preparedness and the effect of wildfires on the delivery of radiation therapy services between 2017 and 2022. Descriptive statistics and Pearson's χ2 tests were performed to investigate potential relationships between provider characteristics, practice settings, and perceptions of the effect of wildfire events. California Department of Forestry and Fire Protection data were employed to map the geographic distribution of wildfires to clinic locations. Results Response rate was 12.3% (51/415 radiation oncologists), representing 25% of clinics (43/176) in 41% (24/58) of California counties. Sixty-one percent (31/51) of respondents reported being affected by a wildfire, 2 of which are rural clinics (100%, 2/2) and 29 are (59%, 29/49) metropolitan practices. Of these, 18% (9/51) reported a clinic closure, and 29% (15/51) reported staffing shortages. Respondents reported effects on patients, including having to evacuate (55%, 28/51), cancel/reschedule treatments (53%, 27/51), and experiencing physical, mental, or financial hardship due to wildfires (45%, 23/51). Respondents described effects on clinical operations, including being forced to transfer patients (24%, 12/51), transportation interruptions (37%, 19/51), regional/community evacuations (35%, 18/51), and physical/mental health effects (27%, 14/51) on clinic personnel. Less than half of the respondents (47%, 24/51) reported their workplace had a wildfire emergency preparedness plan. Additionally, geographic analysis revealed that 100% (176/176) of clinics were located within 25 miles of a wildfire. Conclusions This study highlights the effects of wildfires on radiation oncology clinics and patients and underscores the need for emergency preparedness planning to minimize the consequences of such disasters.
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Affiliation(s)
- Katie E. Lichter
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
- The Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Claire C. Baniel
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Isabelle Do
- University of California, Berkeley, Berkeley, California
| | - Yasmeen Medhat
- University of California, Berkeley, Berkeley, California
| | - Vennela Avula
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - James E. Bates
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | | | - Nauman Malik
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Robert A. Hiatt
- The Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Sue S. Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Osama Mohamad
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Wettstein ZS, Vaidyanathan A. Psychotropic Medication Prescriptions and Large California Wildfires. JAMA Netw Open 2024; 7:e2356466. [PMID: 38407907 PMCID: PMC10897744 DOI: 10.1001/jamanetworkopen.2023.56466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/26/2023] [Indexed: 02/27/2024] Open
Abstract
Importance Wildfires, intensified by climate change, have known effects on physical health but their effects on mental health are less well characterized. It has been hypothesized that the residential proximity to a large wildfire can exacerbate underlying mental health conditions as evidenced by increased prescriptions of psychotropic medications. Objective To evaluate the association between the occurrence of large wildfires and the prescription rates of psychotropic medications immediately following the start of the fire. Design, Setting, and Participants This cohortstudy used an interrupted time-series analysis to compare psychotropic medication prescriptions in the 6 weeks before and after each of 25 wildfires. The setting was California counties within metropolitan statistical areas (MSAs) experiencing large wildfires from 2011 through 2018. Participants included individuals residing in California MSAs with prescriptions of psychotropic medications recorded in the Merative MarketScan Research Database (MarketScan) during the study period. Statistical analysis was performed for these 25 large wildfires occurring between September 2011 and November 2018. Exposure Residential proximity to large wildfires that burned more than 25 000 acres occurring in a California county within an MSA. Main Outcomes and Measures Prescriptions of psychotropic medications, including antidepressants, antipsychotics, anxiolytics, hypnotics, and mood-stabilizers, with statins as a negative control outcome. Results For the study period, prescription data and patient-level attributes were extracted for 7 115 690 unique individuals (annual mean [range]: 889 461 [455 705-1 426 928] individuals) enrolled in MarketScan and residing in fire-affected MSAs. This study found a statistically significant increase in prescriptions of antidepressants (rate ratio [RR], 1.04 [95% CI, 1.01-1.07]), anxiolytics (RR, 1.05 [95% CI, 1.02-1.09]), and mood-stabilizing medications (RR, 1.06 [95% CI, 1.01-1.13]) in the fire period compared with the prefire baseline. However, the prescriptions of antipsychotics, hypnotics, and the negative control outcome, statins, showed no significant association. Conclusions and Relevance In this cohort study of large California wildfires, the occurrence of wildfire was associated with increased mental health burden as reflected in increased prescription rates of certain psychotropic medications. The findings underscore the need for further scientific examination into the mental health effects of wildfires and the allocation of mental health resources in disaster responses. California experienced a substantial burden of wildfires from 2011 to 2018, and as wildfires become more intense and frequent in the context of anthropogenic climate change, it is increasingly important to understand and address their mental health effects.
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Affiliation(s)
- Zachary S Wettstein
- Climate and Health Program, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- University of Washington School of Medicine, Department of Emergency Medicine, Seattle
| | - Ambarish Vaidyanathan
- Climate and Health Program, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Hurst KP, Ramsden R, Roach C, Colbran R. Exploring the impact of recovery funding on the well-being and health workforce capability of rural practices during natural disasters and emergencies. Aust J Rural Health 2024; 32:90-102. [PMID: 37997633 DOI: 10.1111/ajr.13062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION This study examines the impact of funding provided to support the well-being of rural health practitioners and their practice staff following the 2019-2022 bushfires. OBJECTIVE To assess the benefits and implications of grant funding for rural practices to aid recovery following bushfires in NSW, Australia. DESIGN An explanatory sequential mixed method design consisted of a survey and a thematic analysis of semi-structured Interviews. FINDINGS Five key themes emerged from analysis: (1) the disasters altered the role of the practice and therapeutic relationships; (2) the funding had a positive impact on access to professional development; (3) the training had a positive impact on staff well-being and resilience; (4) the professional development had a positive impact on rural practitioner's sense of capability; and (5) important elements of future grant opportunities. DISCUSSION The findings indicate the importance of recovering funding to facilitate access to professional development for rural health practioners during natural disasters which improved their mental health and wellbeing, capability and support to clients. CONCLUSION Recovery funding facilitated improvement in workforce capability, professional resilience, mental health and well-being in the face of natural disasters and emergencies. There was a link between training and maintaining the capability of rural health care practitioners and their practice staff. Capability was an important factor in the well-being and resilience of the health workforce and their ability to support clients.
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Affiliation(s)
- Kate P Hurst
- Wagga Wagga Clinical School, The University of Notre Dame Australia, South Bowenfels, New South Wales, Australia
| | - Robyn Ramsden
- NSW Rural Doctors Network, St Leonards, New South Wales, Australia
| | - Christine Roach
- NSW Rural Doctors Network, St Leonards, New South Wales, Australia
| | - Richard Colbran
- NSW Rural Doctors Network, St Leonards, New South Wales, Australia
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Obuobi-Donkor G, Shalaby R, Agyapong B, Dias RDL, Agyapong VIO. Mitigating Psychological Problems Associated with the 2023 Wildfires in Alberta and Nova Scotia: Six-Week Outcomes from the Text4Hope Program. J Clin Med 2024; 13:865. [PMID: 38337558 PMCID: PMC10856019 DOI: 10.3390/jcm13030865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/21/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Background: In 2023, wildfires led to widespread destruction of property and displacement of residents in Alberta and Nova Scotia, Canada. Previous research suggests that wildfires increase the psychological burden of impacted communities, necessitating population-level interventions. Cognitive Behavioural Therapy (CBT)-based text message interventions, Text4HopeAB and Text4HopeNS, were launched in Alberta and Nova Scotia, respectively, during the 2023 wildfire season to support the mental health of impacted individuals. Objectives: The study examines the effectiveness of Text4HopeNS and Text4HopeAB in alleviating psychological symptoms and improving wellbeing among subscribers. Methods: The study involved longitudinal and naturalistic controlled trial designs. The longitudinal study comprised subscribers who completed program surveys at baseline and six weeks post-enrolment, while the naturalistic controlled study compared psychological symptoms in subscribers who had received daily supportive text messages for six weeks (intervention group) and new subscribers who had enrolled in the program during the same period but had not yet received any text messages (control group). The severity of low resilience, poor mental wellbeing, likely Major Depressive Disorder (MDD), likely Generalized Anxiety Disorder (GAD), likely Post-Traumatic Stress Disorder (PTSD), and suicidal ideation were measured on the Brief Resilience Scale (BRS), the World Health Organization-5 Wellbeing Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) scale, PTSD Checklist-Civilian Version (PCL-C), and the ninth question on the PHQ-9, respectively. The paired and independent sample t-tests were employed in data analysis. Results: The results from the longitudinal study indicated a significant reduction in the mean scores on the PHQ-9 (-12.3%), GAD-7 (-14.8%), and the PCL-C (-5.8%), and an increase in the mean score on the WHO-5, but not on the BRS, from baseline to six weeks. In the naturalistic controlled study, the intervention group had a significantly lower mean score on the PHQ-9 (-30.1%), GAD-7 (-29.4%), PCL-C (-17.5%), and the ninth question on the PHQ-9 (-60.0%) which measures the intensity of suicidal ideation, and an increase in the mean score on the WHO-5 (+24.7%), but not on the BRS, from baseline to six weeks compared to the control group. Conclusions: The results of this study suggests that the Text4Hope program is an effective intervention for mitigating psychological symptoms in subscribers during wildfires. This CBT-based text messaging program can be adapted to provide effective support for individuals' mental health, especially in the context of traumatic events and adverse experiences such as those induced by climate change. Policymakers and mental health professionals should consider these findings when shaping strategies for future disaster response efforts, emphasizing the value of scalable and culturally sensitive mental health interventions.
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (B.A.)
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (B.A.)
| | - Raquel da Luz Dias
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (B.A.)
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21
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Abstract
We review current knowledge on the trends and drivers of global wildfire activity, advances in the measurement of wildfire smoke exposure, and evidence on the health effects of this exposure. We describe methodological issues in estimating the causal effects of wildfire smoke exposures on health and quantify their importance, emphasizing the role of nonlinear and lagged effects. We conduct a systematic review and meta-analysis of the health effects of wildfire smoke exposure, finding positive impacts on all-cause mortality and respiratory hospitalizations but less consistent evidence on cardiovascular morbidity. We conclude by highlighting priority areas for future research, including leveraging recently developed spatially and temporally resolved wildfire-specific ambient air pollution data to improve estimates of the health effects of wildfire smoke exposure.
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Affiliation(s)
- Carlos F Gould
- Doerr School of Sustainability, Stanford University, Stanford, California, USA; ,
| | - Sam Heft-Neal
- Center on Food Security and the Environment, Stanford University, Stanford, California, USA;
| | - Mary Johnson
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; ,
| | - Juan Aguilera
- Center for Community Health Impact, The University of Texas Health Science Center at Houston School of Public Health, El Paso, Texas, USA;
| | - Marshall Burke
- Doerr School of Sustainability, Stanford University, Stanford, California, USA; ,
- Center on Food Security and the Environment, Stanford University, Stanford, California, USA;
- National Bureau of Economic Research, Boston, Massachusetts, USA
| | - Kari Nadeau
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; ,
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22
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Landrigan PJ, Britt M, Fisher S, Holmes A, Kumar M, Mu J, Rizzo I, Sather A, Yousuf A, Kumar P. Assessing the Human Health Benefits of Climate Mitigation, Pollution Prevention, and Biodiversity Preservation. Ann Glob Health 2024; 90:1. [PMID: 38186855 PMCID: PMC10768568 DOI: 10.5334/aogh.4161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Background Since the Industrial Revolution, humanity has amassed great wealth and achieved unprecedented material prosperity. These advances have come, however, at great cost to the planet. They are guided by an economic model that focuses almost exclusively on short-term gain, while ignoring natural capital and human capital. They have relied on the combustion of vast quantities of fossil fuels, massive consumption of the earth's resources, and production and environmental release of enormous quantities of chemicals, pesticides, fertilizers, and plastics. They have caused climate change, pollution, and biodiversity loss, the "Triple Planetary Crisis". They are responsible for more than 9 million premature deaths per year and for widespread disease - impacts that fall disproportionately upon the poor and the vulnerable. Goals To map the human health impacts of climate change, pollution, and biodiversity loss. To outline a framework for assessing the health benefits of interventions against these threats. Findings Actions taken by national governments and international agencies to mitigate climate change, pollution, and biodiversity loss can improve health, prevent disease, save lives, and enhance human well-being. Yet assessment of health benefits is largely absent from evaluations of environmental remediation programs. This represents a lost opportunity to quantify the full benefits of environmental remediation and to educate policy makers and the public. Recommendations We recommend that national governments and international agencies implementing interventions against climate change, pollution, and biodiversity loss develop metrics and strategies for quantifying the health benefits of these interventions. We recommend that they deploy these tools in parallel with assessments of ecologic and economic benefits. Health metrics developed by the Global Burden of Disease (GBD) study may provide a useful starting point.Incorporation of health metrics into assessments of environmental restoration will require building transdisciplinary collaborations. Environmental scientists and engineers will need to work with health scientists to establish evaluation systems that link environmental and economic data with health data. Such systems will assist international agencies as well as national and local governments in prioritizing environmental interventions.
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Affiliation(s)
- Philip J. Landrigan
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
- Centre Scientifique de Monaco, MC
| | - Michael Britt
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
| | - Samantha Fisher
- City University of New York, Graduate School of Public Health and Health Policy, New York City, NY, US
| | | | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Kenya
- Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, US
| | - Jenna Mu
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
| | - Isabella Rizzo
- The George Washington University, Elliot School of International Affairs, Washington D.C., US
| | - Anna Sather
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
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23
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Lebenbaum M, Hassan SA. Screening and Treatment of Posttraumatic Stress Disorder in Wildfire Evacuees: A Cost-Utility Analysis. MDM Policy Pract 2024; 9:23814683241260423. [PMID: 38904072 PMCID: PMC11189003 DOI: 10.1177/23814683241260423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/24/2024] [Indexed: 06/22/2024] Open
Abstract
Background. Global climate change is resulting in dramatic increases in wildfires. Individuals exposed to wildfires experience a high burden of posttraumatic stress disorder (PTSD), and the cost-effectiveness of the treatment options to address PTSD from wildfires has not been studied. The objective of this study was to conduct a cost-utility analysis comparing screening followed by treatment with paroxetine or trauma-focused cognitive behavioral therapy (TF-CBT) versus no screening in Canadian adult wildfire evacuees. Methods. Using a Markov model, quality-adjusted life-years (QALYs) and costs were evaluated over a 5-y time horizon using health care and societal perspectives. All costs and utilities in the model were discounted at 1.5%. Probabilistic and deterministic sensitivity analyses examined the uncertainty in the incremental net monetary benefit (INMB) under a willingness-to-pay threshold of $50,000. Results. From a societal perspective, no screening (NMB = $177,641) was dominated by screening followed by treatment with paroxetine (NMB = $180,733) and TF-CBT (NMB = $181,787), with TF-CBT having the highest likelihood of being cost-effective at a willingness-to-pay threshold of $50,000 per QALY (probability = 0.649). The initial prevalence of PTSD, probability of acceptance of treatment, and costs of productivity had the largest impact on the INMB of both paroxetine or TF-CBT versus no screening. Neither intervention was cost-effective at a willingness-to-pay threshold of $50,000 per QALY from a health care perspective. Interpretation. Screening followed by treatment with paroxetine or TF-CBT compared with no screening was found to be cost-saving while providing additional QALYs in wildfire evacuees. Governments should consider funding screening programs for PTSD followed by treatment with TF-CBT for wildfire evacuees. Highlights Two prior studies examined the cost-effectiveness of screening followed by treatment for PTSD among individuals exposed to other disaster-type events (i.e., terrorist attack and Hurricane Sandy) and found screening followed by treatment (i.e., cognitive behavioral therapy [CBT]) to be highly cost-effective.Among wildfire evacuees, screening followed by treatment with paroxetine or trauma-focused (TF)-CBT provides additional quality-adjusted life-years (QALYs) and is cost-saving from a societal perspective. TF-CBT was the treatment option found most likely to be cost-effective.Neither treatment option was cost-effective at a willingness-to-pay threshold of $50,000 per QALY from a health care perspective.Screening programs for PTSD should be considered for wildfire evacuees, and individuals diagnosed with PTSD could be prescribed either TF-CBT or paroxetine depending on their preference and resources availability.
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Affiliation(s)
- Michael Lebenbaum
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada
- Canadian Centre for Health Economics, Toronto, ON, Canada
- Center for Demography of Health and Aging, University of Wisconsin–Madison, Madison, WI, USA
| | - S. Ahmed Hassan
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada
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24
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Isaac F, Toukhsati SR, Klein B, Di Benedetto M, Kennedy GA. Differences in Anxiety, Insomnia, and Trauma Symptoms in Wildfire Survivors from Australia, Canada, and the United States of America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:38. [PMID: 38248503 PMCID: PMC10815777 DOI: 10.3390/ijerph21010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/17/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024]
Abstract
Many survivors of wildfires report elevated levels of psychological distress following the trauma of wildfires. However, there is only limited research on the effects of wildfires on mental health. This study examined differences in anxiety, depression, insomnia, sleep quality, nightmares, and post-traumatic stress disorder (PTSD) symptoms following wildfires in Australia, Canada, and the United States of America (USA). One hundred and twenty-six participants from Australia, Canada, and the USA completed an online survey. The sample included 102 (81%) women, 23 (18.3%) men, and one non-binary (0.8%) individual. Participants were aged between 20 and 92 years (M age = 52 years, SD = 14.4). They completed a demographic questionnaire, the Disturbing Dream and Nightmare Severity Index (DDNSI), Generalized Anxiety Disorder Questionnaire (GAD-7), the Insomnia Severity Index (ISI), Patient Health Questionnaire (PHQ-9), the Pittsburgh Sleep Quality Index (PSQI), and PTSD Checklist (PCL-5). Results showed that participants from the USA scored significantly higher on the GAD-7 (p = 0.009), ISI (p = 0.003), and PCL-5 (p = 0.021) than participants from Australia and Canada. The current findings suggest a need for more international collaboration to reduce the severity of mental health conditions in Australia, Canada, and the USA.
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Affiliation(s)
- Fadia Isaac
- Institute of Health and Wellbeing, Federation University, Mt Helen, VIC 3350, Australia (G.A.K.)
| | - Samia R. Toukhsati
- Institute of Health and Wellbeing, Federation University, Mt Helen, VIC 3350, Australia (G.A.K.)
| | - Britt Klein
- Health Innovation and Transformation Centre, Federation University, Mt Helen, VIC 3350, Australia;
- Biopsychosocial & eHealth Research & Innovation (BeRI) Hub, Federation University, Mt Helen, VIC 3350, Australia
| | | | - Gerard A. Kennedy
- Institute of Health and Wellbeing, Federation University, Mt Helen, VIC 3350, Australia (G.A.K.)
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3083, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, VIC 3084, Australia
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25
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Taparra K, Apana NK. Rising From Ruin-Revitalizing Native Hawaiian Health. JAMA 2023; 330:2051-2052. [PMID: 37930729 DOI: 10.1001/jama.2023.21427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
This Viewpoint offers insight into the health effects of the recent fires in Hawaiʻi and what culturally conscious approaches are needed to ensure the health of Native Hawaiians going forward.
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Affiliation(s)
- Kekoa Taparra
- Department of Radiation Oncology, Stanford University, Palo Alto, California
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26
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Zheng J. Exposure to wildfires and health outcomes of vulnerable people: Evidence from US data. ECONOMICS AND HUMAN BIOLOGY 2023; 51:101311. [PMID: 37816268 DOI: 10.1016/j.ehb.2023.101311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/21/2023] [Accepted: 10/02/2023] [Indexed: 10/12/2023]
Abstract
This paper investigates the causal effect of wildfire exposure on birth outcomes and older people's health outcomes in United States (US). The study focuses on three sub-questions for each health outcome: (1) the causal effect of each of the five largest wildfires on individual health, (2) the causal impact of multiple large wildfires on individual health outcomes, and (3) the causal influence of wildfires larger than different sizes within different distances of counties on health outcomes at the county level. The analysis exploits data from National Vital Statistics System, Behavioural Risk Factor Surveillance System and FIRESTAT. In terms of birth outcomes, the findings show that the largest wildfire slightly increased the risk of other circulatory or respiratory anomalies. Multiple large wildfires moderately raised the risk of prematurity and led to a small decline in the probability of getting omphalocele and cleft lip. The county-level analysis suggests an increased risk of macrosomia following maternal exposure to wildfires. As for the elderly aged 65 + , the results indicate that exposure to multiple massive wildfires led to frequent occurrence of asthma symptoms, while the largest wildfire led to sleeping difficulty caused by asthma symptoms. The number of days older people experienced psychological problems was increased following exposure to multiple large wildfires.
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Affiliation(s)
- Jiyuan Zheng
- Department of Economics, University of Southampton, Southampton SO17 1BJ, United Kingdom.
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27
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Chen AI, Ebisu K, Benmarhnia T, Basu R. Emergency department visits associated with wildfire smoke events in California, 2016-2019. ENVIRONMENTAL RESEARCH 2023; 238:117154. [PMID: 37716386 DOI: 10.1016/j.envres.2023.117154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/09/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023]
Abstract
Wildfire smoke has been associated with adverse respiratory outcomes, but the impacts of wildfire on other health outcomes and sensitive subpopulations are not fully understood. We examined associations between smoke events and emergency department visits (EDVs) for respiratory, cardiovascular, diabetes, and mental health outcomes in California during the wildfire season June-December 2016-2019. Daily, zip code tabulation area-level wildfire-specific fine particulate matter (PM2.5) concentrations were aggregated to air basins. A "smoke event" was defined as an air basin-day with a wildfire-specific PM2.5 concentration at or above the 98th percentile across all air basin-days (threshold = 13.5 μg/m3). We conducted a two-stage time-series analysis using quasi-Poisson regression considering lag effects and random effects meta-analysis. We also conducted analyses stratified by race/ethnicity, age, and sex to assess potential effect modification. Smoke events were associated with an increased risk of EDVs for all respiratory diseases at lag 1 [14.4%, 95% confidence interval (CI): (6.8, 22.5)], asthma at lag 0 [57.1% (44.5, 70.8)], and chronic lower respiratory disease at lag 0 [12.7% (6.2, 19.6)]. We also found positive associations with EDVs for all cardiovascular diseases at lag 10. Mixed results were observed for mental health outcomes. Stratified results revealed potential disparities by race/ethnicity. Short-term exposure to smoke events was associated with increased respiratory and schizophrenia EDVs. Cardiovascular impacts may be delayed compared to respiratory outcomes.
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Affiliation(s)
- Annie I Chen
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Keita Ebisu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
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28
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Karl S, Meyer-Lindenberg A. [Climate change, biodiversity loss and pollution: consequences for psychiatry]. DER NERVENARZT 2023; 94:1019-1025. [PMID: 37410101 DOI: 10.1007/s00115-023-01523-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
The climate crisis, loss of biodiversity and increasing global pollution are a threat to mental health. Comprehensive transformations are needed to overcome these crises, which will also affect the mental healthcare system. If done correctly these change processes can seize the chance to improve mental health while at the same time addressing the crises. This includes avoiding the need for psychiatric treatment by strengthening the focus on mental health promotion and prevention, and also considering environmental aspects when targetting therapy procedures. In addition, by focusing on nutrition, mobility and the effects of nature, patients can be empowered to increase their mental resilience whilst reducing the negative effects on the environment. At the same time, the mental healthcare system must adapt to changing environmental conditions: increasing heat waves make protective measures necessary, especially for people with mental illnesses and increasing extreme weather events can lead to shifts in the spectrum of illnesses. Appropriate funding mechanisms will have to be established to support mental healthcare throughout this transformation.
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Affiliation(s)
- Sebastian Karl
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland.
| | - Andreas Meyer-Lindenberg
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland
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29
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Priller J, Schäfer S, Safaiyan S. [Nature and immune mechanisms of mental illnesses]. DER NERVENARZT 2023; 94:1010-1018. [PMID: 37815590 DOI: 10.1007/s00115-023-01554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 10/11/2023]
Abstract
The impacts of nature and climate change on mental health are substantial but the underlying mechanisms are still poorly understood. The immune system in particular could play an important role. Therefore, the German Center for Mental Health (DZPG) in Munich will use state of the art model systems to elucidate the role of the immune system in the pathogenesis of mental disorders under altered environmental conditions and to develop preventive treatment strategies.
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Affiliation(s)
- Josef Priller
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.
- Deutsches Zentrum für Psychische Gesundheit (DZPG), Standort München, München, Deutschland.
- CCBS und UK DRI, University of Edinburgh, Edinburgh, Großbritannien.
- Neuropsychiatrie und Labor für Molekulare Psychiatrie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
| | - Simon Schäfer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland
- Deutsches Zentrum für Psychische Gesundheit (DZPG), Standort München, München, Deutschland
| | - Shima Safaiyan
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland
- Deutsches Zentrum für Psychische Gesundheit (DZPG), Standort München, München, Deutschland
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30
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Harper SL, Cunsolo A, Aylward B, Clayton S, Minor K, Cooper M, Vriezen R. Estimating climate change and mental health impacts in Canada: A cross-sectional survey protocol. PLoS One 2023; 18:e0291303. [PMID: 37819884 PMCID: PMC10566728 DOI: 10.1371/journal.pone.0291303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/22/2023] [Indexed: 10/13/2023] Open
Abstract
Climate change has severe and sweeping impacts on mental health. Although research is burgeoning on mental health impacts following climate and weather extremes, less is known about how common these impacts are outside of extreme events. Existing research exploring the prevalence of psychosocial responses to climate change primarily examines university students and uses non-random sampling methods. Herein, our protocol outlines an approach to data collection, processing, and analysis to estimate the population prevalence, magnitude, and distribution of mental health responses to climate change in Canada. A cross-sectional survey of youth and adults aged 13 years and older in Canada will be administered over the course of one year. The questionnaire will take approximately 10 minutes to complete orally and will be administered in English, French, and Inuktitut. The survey will consist of six sections: (1) self-reported past experiences of climate change; (2) self-reported climate-related emotions; (3) self-reported past and current impacts, anticipatory impacts, and vicarious experiences; (4) self-reported subclinical outcomes; (5) self-reported behavioural responses; and (6) demographics. A multi-stage, multi-stratified random probability sampling method will be used to obtain a sample representative of the Canadian population. We will use two different modes of recruitment: an addressed letter sent by postal mail or a telephone call (landlines and cellular). Population-weighted descriptive statistics, principal component analysis, and weighted multivariable regression will be used to analyse the data. The results of this survey will provide the first national prevalence estimates of subclinical mental health responses to climate change outcomes of people living in Canada.
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Affiliation(s)
| | - Ashlee Cunsolo
- School of Arctic & Subarctic Studies, Labrador Campus of Memorial University, Happy Valley-Goose Bay, Canada
| | - Breanne Aylward
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Susan Clayton
- College of Wooster, Wooster, Ohio, United States of America
| | - Kelton Minor
- Data Science Institute, Columbia University, New York, New York, United States of America
| | - Madison Cooper
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Rachael Vriezen
- School of Public Health, University of Alberta, Edmonton, Canada
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31
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ALACA Ç. Solastalgia and Forest Fires. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1172916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
One of the important problems created by climate change is forest fires. Forest fires occur due to both natural and anthropogenic causes. Forest fires, which occur with the effects of climate change such as an increase in temperature, drought, heat waves, and climatic conditions, are increasing gradually. Acute and chronic effects caused by forest fires cause significant life changes. As a result of the fire, not only forests are damaged, but also flora, wildlife, water resources, soil, climate, areas used by people for recreational purposes, and settlements near and around forested areas. As a result, changes such as increases in temperature, pollution, epidemics, drought, food shortage, and forest fires, affect mental and physical health. While exposure to forest fires creates a direct traumatic effect; indirectly, it affects mental health for a number of social, political and economic reasons such as poverty, unemployment and housing. Forest fires also create an environmental change. This environmental change creates a sense of loss, the sense of belonging is lost, it cannot connect with the new environment, it becomes difficult to adapt and causes distress.Uncertainty about the future, helplessness, stress, anxiety, post-traumatic stress disorder and depression are common psychological problems due to climate change. It defines some new mental health concepts as the consequences of climate change affect mental health. "Solastalgia" is one pf these new concepts. Solastalgia is defined as a term that expresses the pain and distress caused by the loss of the thing/things that people find solace and environmental change. Solastalgia is a necessary concept for mental health professionals to understand the links between ecosystem health and human health, especially the cumulative effects of climatic and environmental change on mental, emotional and spiritual health.
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Affiliation(s)
- Çiğdem ALACA
- MUĞLA SITKI KOÇMAN ÜNİVERSİTESİ, FETHİYE SAĞLIK HİZMETLERİ MESLEK YÜKSEKOKULU
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32
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Buckner A, Khau A, Martin A. Responding to multiple events in 2020: A qualitative study exploring areas of growth and development among California college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37722866 DOI: 10.1080/07448481.2023.2253917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/25/2023] [Indexed: 09/20/2023]
Abstract
In 2020, the US was consumed by the COVID-19 pandemic and racial justice protests. California was further compounded by a devastating fall wildfire season. Negative effects related to these events have been documented in research. Objective: This study sought to expand the literature by exploring areas of personal growth and development among college students with a lens on the impact of these three events. Methods: A diverse group of undergraduate and graduate students enrolled in a large public university system in California were recruited to participate in one of six focus groups held during the winter of 2020/2021 with 35 students. Findings: Thematic analysis was used to develop three themes: 1) experiencing fluctuation and repetition, 2) understanding myself and the world, and 3) finding hope and wanting action. Conclusions: Findings suggest opportunities for academic institutions to enhance critical thinking about contemporary issues and support students in developing skills to navigate change and transition successfully.
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Affiliation(s)
- Anji Buckner
- Public Health and Recreation Department, San José State University, San José, California, USA
| | - Allyson Khau
- Public Health and Recreation Department, San José State University, San José, California, USA
- SJV PRIME Program, University of California San Francisco, San Francisco, California, USA
| | - Alana Martin
- Public Health and Recreation Department, San José State University, San José, California, USA
- Emergency Management, University of California Davis, Davis, California, USA
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33
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Zhang D, Xi Y, Boffa DJ, Liu Y, Nogueira LM. Association of Wildfire Exposure While Recovering From Lung Cancer Surgery With Overall Survival. JAMA Oncol 2023; 9:1214-1220. [PMID: 37498574 PMCID: PMC10375383 DOI: 10.1001/jamaoncol.2023.2144] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/26/2023] [Indexed: 07/28/2023]
Abstract
Importance With a changing climate, wildfire activity in the US has increased dramatically, presenting multifaceted and compounding health hazards. Individuals discharged from the hospital following surgical resection of non-small cell lung cancer (NSCLC) are potentially at higher risk from wildfires' health hazards. Objective To assess the association between wildfire exposure and postoperative long-term overall survival among patients with lung cancer in the US. Design, Setting, and Participants In this cohort study, individuals who underwent curative-intent NSCLC resection between January 1, 2004, and December 31, 2019, were selected from the National Cancer Database. Daily wildfire information was aggregated at the zip code level from the National Aeronautics and Space Administration Fire Information for Resource Management System. The data analysis was performed between July 19, 2022, and April 14, 2023. Exposure An active wildfire detected at the zip code of residence between 0 and 3, 4 and 6, or 7 and 12 months after NSCLC surgery. Main Outcome Overall survival was defined as the interval between age at hospital discharge and age at death, last contact, or study end, whichever came first. Cox proportional hazards were used for estimating hazard ratios (HRs) adjusted for sex, region, metropolitan category, health insurance type, comorbidities, tumor size, lymph node involvement, era, and facility type. Results A total of 466 912 individuals included in the study (249 303 female and [53.4] and 217 609 male [46.6%]; mean [SD] age at diagnosis, 67.3 [9.9] years), with 48 582 (10.4%) first exposed to a wildfire between 0 and 3 months, 48 328 (10.6%) between 4 and 6 months, and 71 735 (15.3%) between 7 and 12 months following NSCLC surgery. Individuals exposed to a wildfire within 3 months (adjusted HR [AHR], 1.43; 95% CI, 1.41-1.45), between 4 and 6 months (AHR, 1.39; 95% CI, 1.37-1.41), and between 7 and 12 months (AHR, 1.17; 95% CI, 1.15-1.19) after discharge from the hospital following stage I to III NSCLC resection had worse overall survival than unexposed individuals. Conclusions In this cohort study, wildfire exposure was associated with worse overall survival following NSCLC surgical resection, suggesting that patients with lung cancer are at greater risk from the health hazards of wildfires and need to be prioritized in climate adaptation efforts.
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Affiliation(s)
- Danlu Zhang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Yuzhi Xi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Leticia M. Nogueira
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, Georgia
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Gao CX, Menssink J, Campbell TCH, Smith CL, Ikin JF, Lane T, Abramson MJ, Carroll M. Somatic symptoms, psychological distress and trauma after disasters: lessons from the 2014 Hazelwood mine fire and 2019-20 Black Summer bushfires. BMC Public Health 2023; 23:1573. [PMID: 37596570 PMCID: PMC10436633 DOI: 10.1186/s12889-023-16501-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 08/10/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Wildfires cause significant physical and mental ill-health. How physical and mental symptoms interact following wildfire smoke exposure is unclear, particularly in the context of repeated exposures. In this cross-sectional study we investigated how posttraumatic stress and general psychological distress associated with somatic symptoms in a community exposed to multiple smoke events. METHODS A random weighted sample of 709 adults exposed to smoke during the 2014 Hazelwood coal mine fire in south-eastern Australia completed a survey in 2020. The survey coincided with the Black Summer wildfires that caused a similar period of smoke haze in the region. Participants self-reported somatic symptoms (PHQ-15) and mine fire-related posttraumatic stress (IES-R) experienced over the previous week, general psychological distress (K10) experienced over the previous four weeks, lifetime health diagnoses and demographic information. Associations between posttraumatic stress, general psychological distress, and each PHQ-15 somatic symptom were analysed using ordinal logistic regression models. RESULTS Overall, 36.2% of participants reported moderate- or high-level somatic symptomology. The most frequent somatic symptoms were fatigue, limb pain, trouble sleeping, back pain, headaches, and shortness of breath. After controlling for confounding factors, general psychological distress and posttraumatic stress were independently associated with all somatic symptoms (except menstrual problems in females for posttraumatic stress). CONCLUSIONS Results highlight the high prevalence of somatic symptoms and their association with general psychological distress and posttraumatic stress within a community in the midst of a second large-scale smoke event. It is essential that healthcare providers and public health authorities consider the interconnections of these conditions when supporting communities affected by climate-related disasters.
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Affiliation(s)
- Caroline X Gao
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Jana Menssink
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Timothy C H Campbell
- Monash Rural Health, Monash University, Northways Road, Churchill, VIC, 3842, Australia
| | - Catherine L Smith
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jillian F Ikin
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Tyler Lane
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Matthew Carroll
- Monash Rural Health, Monash University, Northways Road, Churchill, VIC, 3842, Australia.
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Saberi P, Ming K, Arnold EA, Leddy AM, Weiser SD. Extreme weather events and HIV: development of a conceptual framework through qualitative interviews with people with HIV impacted by the California wildfires and their clinicians. BMC Public Health 2023; 23:950. [PMID: 37231393 DOI: 10.1186/s12889-023-15957-5] [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: 07/22/2022] [Accepted: 05/22/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND People with HIV (PWH) are disproportionately vulnerable to the impacts of wildfires, given the need for frequent access to healthcare systems, higher burden of comorbidities, higher food insecurity, mental and behavioral health challenges, and challenges of living with HIV in a rural area. In this study, we aim to better understand the pathways through which wildfires impact health outcomes among PWH. METHODS From October 2021 through February 2022, we conducted individual semi-structured qualitative interviews with PWH impacted by the Northern California wildfires and clinicians of PWH who were impacted by wildfires. The study aims were to explore the influence of wildfires on the health of PWH and to discuss measures at the individual, clinic, and system levels that helped to mitigate these impacts. RESULTS We interviewed 15 PWH and 7 clinicians. While some PWH felt that surviving the HIV epidemic added to their resilience against wildfires, many felt that the wildfires compounded the HIV-related traumas that they have experienced. Participants outlined five main routes by which wildfires negatively impacted their health: (1) access to healthcare (medications, clinics, clinic staff), (2) mental health (trauma; anxiety, depression, or stress; sleep disturbances; coping strategies), (3) physical health (cardiopulmonary, other co-morbidities), (4) social/economic impacts (housing, finances, community), and (5) nutrition and exercise. The recommendations for future wildfire preparedness were at the (1) individual-level (what to have during evacuation), (2) pharmacy-level (procedural, staffing), and (3) clinic- or county-level (funds and vouchers; case management; mental health services; emergency response planning; other services such as telehealth, home visits, home laboratory testing). CONCLUSIONS Based on our data and prior research, we devised a conceptual framework that acknowledges the impact of wildfires at the community-, household-, and individual-level with implications for physical and mental health outcomes among PWH. These findings and framework can help in developing future interventions, programs, and policies to mitigate the cumulative impacts of extreme weather events on the health of PWH, particularly among individuals living in rural areas. Further studies are needed to examine health system strengthening strategies, innovative methods to improve access to healthcare, and community resilience through disaster preparedness. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Parya Saberi
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Kristin Ming
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Emily A Arnold
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Anna M Leddy
- Division of pulmonary and critical care medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Beames JR, Huckvale K, Fujimoto H, Maston K, Batterham PJ, Calear AL, Mackinnon A, Werner-Seidler A, Christensen H. The impact of COVID-19 and bushfires on the mental health of Australian adolescents: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2023; 17:34. [PMID: 36895004 PMCID: PMC9998012 DOI: 10.1186/s13034-023-00583-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND When COVID-19 spread to Australia in January 2020, many communities were already in a state of emergency from the Black Summer bushfires. Studies of adolescent mental health have typically focused on the effects of COVID-19 in isolation. Few studies have examined the impact of COVID-19 and other co-occurring disasters, such as the Black Summer bushfires in Australia, on adolescent mental health. METHODS We conducted a cross-sectional survey to examine the impact of COVID-19 and the Black Summer bushfires on the mental health of Australian adolescents. Participants (N = 5866; mean age 13.61 years) answered self-report questionnaires about COVID-19 diagnosis/quarantine (being diagnosed with and/or quarantined because of COVID-19) and personal exposure to bushfire harm (being physically injured, evacuated from home and/or having possessions destroyed). Validated standardised scales were used to assess depression, psychological distress, anxiety, insomnia, and suicidal ideation. Trauma related to COVID-19 and the bushfires was also assessed. The survey was completed in two large school-based cohorts between October 2020 and November 2021. RESULTS Exposure to COVID-19 diagnosis/quarantine was associated with increased probability of elevated trauma. Exposure to personal harm by the bushfires was associated with increased probability of elevated insomnia, suicidal ideation, and trauma. There were no interactive effects between disasters on adolescent mental health. Effects between personal risk factors and disasters were generally additive or sub-additive. CONCLUSIONS Adolescent mental health responses to community-level disasters are multi-faceted. Complex psychosocial factors associated with mental ill health may be relevant irrespective of disaster. Future research is needed to investigate synergistic effects of disasters on young mental health.
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Affiliation(s)
- Joanne R Beames
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
| | - Kit Huckvale
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, VIC, Australia
| | - Hiroko Fujimoto
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Kate Maston
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Andrew Mackinnon
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Helen Christensen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Heinz A, Meyer-Lindenberg A. [Climate change and mental health. Position paper of a task force of the DGPPN]. DER NERVENARZT 2023; 94:225-233. [PMID: 36820855 PMCID: PMC9992044 DOI: 10.1007/s00115-023-01457-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/24/2023]
Abstract
Climate change and the resulting higher frequency of extreme weather events have a direct negative impact on mental health. Natural disasters are particularly associated with an increase in the prevalence of depression, anxiety and posttraumatic stress disorder. Indirect consequences of climate change, such as food shortages, economic crises, violent conflicts and forced migration, additionally represent severe psychological risk and stress factors. Climate anxiety and solastalgia, the distress induced by environmental change, are new psychological syndromes in the face of the existential threat posed by the climate crisis. Accordingly, a sustainable psychiatry must prepare for increasing and changing demands. The principles of psychiatric treatment need to focus more on prevention to reduce the overall burden on the healthcare system. Waste of resources and CO2 emissions in psychiatric treatment processes as well as infrastructure must be perceived and prevented. Psychiatric education, training and continuing education concepts should be expanded to include the topic of climate change in order to comprehensively inform and sensitize professionals, those affected and the public and to encourage climate-friendly and health-promoting behavior. More in-depth research is needed on the impact of climate change on mental health. The DGPPN becomes a sponsor and aims for climate neutrality by 2030 by committing to climate-friendly and energy-saving measures in the area of finance, in relation to the DGPPN congress as well as the DGPPN office.
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Affiliation(s)
- Andreas Heinz
- Klinik für Psychiatrie und Psychotherapie CCM, Charité - Universitätsmedizin Berlin, 10117, Charitéplatz 1, Berlin, Deutschland.
| | - Andreas Meyer-Lindenberg
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, 68159, J5, Mannheim, Deutschland. .,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e.V., Berlin, Deutschland.
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Abstract
PURPOSE OF REVIEW Stress plays a central role in the onset and course of depression. However, only a subset of people who encounter stressful life events go on to experience a depressive episode. The current review highlights recent advances in understanding when, why, and for whom the stress-depression link occurs, and we identify avenues for future research. RECENT FINDINGS In the last 18 months, researchers have taken a more nuanced perspective on the biopsychosocial mechanisms critical to the stress-depression link. For example, examination of specific facets of emotion regulation, including emotion regulation flexibility and interpersonal emotion regulation, has been critical to understanding its role in depression. Similarly, refined investigations of social support allowed researchers to identify distinct - and occasionally opposite - outcomes depending on the context or manner in which the support was provided. Researchers also documented that the stress-depression link was enhanced by dysregulation of several stress-sensitive biological systems, such as the immune system, microbiome, endocrine system, and neuroanatomical substrates. SUMMARY Recent studies highlight the importance of adopting a nuanced understanding of mechanisms and moderators that explain the stress-depression link. We also encourage continued engagement in collaborative, open science that uses multiple methods to study the full breadth of human diversity.
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Eisenman DP, Galway LP. The mental health and well-being effects of wildfire smoke: a scoping review. BMC Public Health 2022; 22:2274. [PMID: 36471306 PMCID: PMC9724257 DOI: 10.1186/s12889-022-14662-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Smoke from wildfires is a growing public health risk due to the enormous amount of smoke-related pollution that is produced and can travel thousands of kilometers from its source. While many studies have documented the physical health harms of wildfire smoke, less is known about the effects on mental health and well-being. Understanding the effects of wildfire smoke on mental health and well-being is crucial as the world enters a time in which wildfire smoke events become more frequent and severe. We conducted a scoping review of the existing information on wildfire smoke's impact on mental health and well-being and developed a model for understanding the pathways in which wildfire smoke may contribute to mental health distress. METHODS We conducted searches using PubMed, Medline, Embase, Google, Scopus, and ProQuest for 1990-2022. These searches yielded 200 articles. Sixteen publications met inclusion criteria following screening and eligibility assessment. Three more publications from the bibliographies of these articles were included for a total of 19 publications. RESULTS Our review suggests that exposure to wildfire smoke may have mental health impacts, particularly in episodes of chronic and persistent smoke events, but the evidence is inconsistent and limited. Qualitative studies disclose a wider range of impacts across multiple mental health and well-being domains. The potential pathways connecting wildfire smoke with mental health and well-being operate at multiple interacting levels including individual, social and community networks, living and working conditions, and ecological levels. CONCLUSIONS Priorities for future research include: 1) applying more rigorous methods; 2) differentiating between mental illness and emotional well-being; 3) studying chronic, persistent or repeated smoke events; 4) identifying the contextual factors that set the stage for mental health and well-being effects, and 5) identifying the causal processes that link wildfire smoke to mental health and well-being effects. The pathways model can serve as a basis for further research and knowledge synthesis on this topic. Also, it helps public health, community mental health, and emergency management practitioners mitigate the mental health and well-being harms of wildfire smoke.
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Affiliation(s)
- David P. Eisenman
- grid.19006.3e0000 0000 9632 6718David Geffen School of Medicine at UCLA, UCLA Fielding School of Public Health, Center for Healthy Climate Solutions and Center for Public Health and Disasters, 1100 Glendon Avenue, Suite 850-878, Los Angeles, CA 90024 USA
| | - Lindsay P. Galway
- grid.258900.60000 0001 0687 7127Lakehead University Department of Health Sciences, 955 Oliver Road, Thunder Bay, ON P7B 5E1 Canada
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Tseregounis IE, Delcher C, Stewart SL, Gasper JJ, Shev AB, Crawford A, Wintemute G, Henry SG. The impact of California wildfires on patient access to prescription opioids. J Am Pharm Assoc (2003) 2022; 62:1769-1777. [PMID: 35660074 PMCID: PMC9637732 DOI: 10.1016/j.japh.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patients on long-term opioid therapy are particularly vulnerable to disruptions in medication access, especially during traumatic and chaotic events such as wildfires and other natural disasters. OBJECTIVES To determine whether past highly destructive California wildfires were associated with disrupted access to prescription opioids for patients receiving long-term, and therefore physically dependent on, opioid medications. METHODS Using California prescription drug monitoring program data, this retrospective study selected patients with long-term prescription opioid use episodes residing in ZIP code tabulation areas impacted by either the Camp Fire or Tubbs Fire. Autoregressive integrated moving average time series models were fit to pre-fire data to forecast post-fire expected values and then compared with observed post-fire data, specifically for weekly proportions of long-term episodes with early fills, late fills, changes in patients' prescriber and pharmacy, and fills within a different ZIP code tabulation area than the patient's residence. RESULTS After the Camp Fire, there were significant spikes in the proportions of early fills (peak at 56% of total, week 1 after fire), late fills (peak at 29%, week 6), and immediate significant increases in prescriber (peak at 37%, week 3) and pharmacy changes (peak at 71%, week 1) in high-impact ZIP code tabulation areas. Low-impact ZIP code tabulation areas experienced no similar disruptions. Disruptions due to the Tubbs Fire were far less severe. CONCLUSION Access to prescription opioids was greatly disrupted for patients living in areas most impacted by the Camp Fire. Future research should explore effectiveness of current state and federal controlled substance prescribing policies to determine what improvements are needed to minimize disruptions in medication access due to wildfires and other natural disasters.
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Blacklow SO. Haze. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:579. [PMID: 35352324 DOI: 10.1007/s40596-022-01623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Serena O Blacklow
- University of California, San Francisco School of Medicine, San Francisco, CA, USA.
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Mao W, Adu M, Eboreime E, Shalaby R, Nkire N, Agyapong B, Pazderka H, Obuobi-Donkor G, Owusu E, Oluwasina F, Zhang Y, Agyapong VIO. Post-Traumatic Stress Disorder, Major Depressive Disorder, and Wildfires: A Fifth-Year Postdisaster Evaluation among Residents of Fort McMurray. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9759. [PMID: 35955114 PMCID: PMC9368448 DOI: 10.3390/ijerph19159759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Background: Over 90,000 residents had to be evacuated from Fort McMurray (FMM), Alberta, Canada due to the wildfire that engulfed the city in May 2016. Overall, about 2400 homes or 10% of the housing stock in Fort McMurray were destroyed. The fire consumed about 200,000 hectors of forest, reaching into Saskatchewan. During major disasters, communities’ infrastructure is disrupted, and psychological, economic, and environmental effects are felt for years afterwards. Objective: Five years after the wildfire disaster, this study assessed the prevalence rate of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in Fort McMurray residents and determined the demographic, clinical, and other risk factors of probable MDD and PTSD. Methodology: A quantitative cross-sectional survey was conducted to collect data through an online questionnaire administered via REDCap between 24 April and 2 June 2021. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of MDD symptoms in respondents. The PTSD Checklist for DSM-5 (PCL-C) was used to assess likely PTSD in respondents. Descriptive, univariate, and multivariate regression analyses were employed. Results: 186 out of 249 individuals who accessed the survey link completed it (74.7% response rate). The median age of the subscribers was 42. The sample included a majority of 159 (85.5%) females; 98 (52.7%) > 40 years of age; 175 (94.1%) employed; and 132 (71%) in a relationship. The overall prevalence of MDD symptoms in our study sample was 45.0% (76). Four variables independently predicted MDD symptoms in the multivariate logistic regression model, including: unemployed (OR = 12.39; 95% CI: 1.21−126.37), have received a mental diagnosis of MDD (OR = 4.50; 95% CI: 1.57−12.92), taking sedative-hypnotics (OR = 5.27; 95% CI: 1.01−27.39), and willingness to receive mental health counseling (OR = 4.90; 95% CI: 1.95−12.31). The prevalence of likely PTSD among our respondents was 39.6% (65). Three independent variables: received a mental health depression diagnosis from a health professional (OR = 4.49; 95% CI: 1.40−14.44), would like to receive mental health counseling (OR = 4.36, 95% CI: 1.54−12.34), and have only limited or no support from family (OR = 11.01, 95% CI: 1.92−63.20) contributed significantly to the model for predicting likely PTSD among respondents while controlling the other factors in the regression model. Conclusions: According to this study, unemployment, taking sleeping pills, having a prior depression diagnosis, and the willingness to receive mental health counseling significantly increase the odds of having MDD and PTSD following wildfires. Family support may protect against the development of these conditions.
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Affiliation(s)
- Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Medard Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Nnamdi Nkire
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Global Psychological E-Health Foundation, Edmonton, AB T6G 2B7, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | | | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Yanbo Zhang
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada
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Haymond R, Jesrani L. Wildfires: Implications for nurses. Nursing 2022; 52:17-21. [PMID: 35866853 DOI: 10.1097/01.nurse.0000839804.04081.c0] [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: 06/15/2023]
Abstract
Wildfire smoke can travel hundreds of miles from its source, resulting in poor air quality. Exposure to poor air quality has been associated with health risks. Nurses should be knowledgeable about such risks to provide appropriate care and education in affected communities.
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Affiliation(s)
- Reena Haymond
- Reena Haymond is an assistant professor at California State University, Sacramento. Lena Jesrani is a family nurse practitioner at Dignity Health Foundation-Lassen Medical in Redding, Ca
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Reid CE. Invited Perspective: What Do We Know about Fetal-Maternal Health and Health Care Needs after Wildfires? Not Nearly Enough. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:81304. [PMID: 35980336 PMCID: PMC9387503 DOI: 10.1289/ehp11699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Colleen E Reid
- Geography Department, University of Colorado, Boulder, Colorado, USA
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Prevalence and Predictors of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray Five Years after the Devastating Wildfires. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Natural disasters adversely impact individuals living in places where they occur, resulting in emotional distress. The wildfire that occurred in Fort McMurray (FMM), Alberta in 2016 is no different. Objective: This study aims to identify the prevalence and predictors of Generalized Anxiety Disorder (GAD) symptoms in residents of FMM five years after the devastating wildfires. Methods: Data for the study were collected through a cross-sectional survey conducted online from the 24th of April to the 2nd of June 2021. A validated instrument, the GAD-7 scale, was used to collect information on anxiety. Results: This study involved 186 residents of FMM, of which the majority were females (85.5%), employed (94.1%), working at school boards (50.0%), and were either married, cohabiting, or partnered (71.0%). The prevalence of likely GAD among the study sample was 42.5%. Unemployed respondents were seventeen times more likely to develop GAD symptoms (OR = 16.62; 95% C.I. 1.23–223.67) while respondents who would like to receive mental health counseling were five times more likely to experience GAD symptoms (OR = 5.35; 95% C.I. 2.03–14.15). Respondents who suffered a loss of property because of the wildfire were two times more likely to develop GAD symptoms (OR = 2.36; 95% C.I. 1.01–22.62). Conclusion: Policymakers may mitigate GAD symptoms, particularly after natural disasters, by making long-term mental health counseling available and a key component of post-disaster management, and by investing in the social capital of the people to build resilience and support to deal with the post-disaster mental health effects.
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Paus T, Brook J, Doiron D. Mapping Inequalities in the Physical, Built and Social Environment in Population-Based Studies of Brain Health. FRONTIERS IN NEUROIMAGING 2022; 1:884191. [PMID: 37555183 PMCID: PMC10406296 DOI: 10.3389/fnimg.2022.884191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/28/2022] [Indexed: 08/10/2023]
Abstract
This mini-tutorial describes how combining aggregate-level data about the physical, built and social environment can facilitate our understanding of factors shaping the human brain and, in turn, brain health. It provides entry-level information about methods and approaches one can use to uncover how inequalities in the local environment lead to health inequalities in general, and those in brain health in particular. This background knowledge should be helpful to those who are interested in using neuroimaging to investigate how environmental factors shape inter-individual variations in the human brain.
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Affiliation(s)
- Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jeff Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Dany Doiron
- Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
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Agyapong B, Shalaby R, Eboreime E, Obuobi-Donkor G, Owusu E, Adu MK, Mao W, Oluwasina F, Agyapong VIO. Cumulative trauma from multiple natural disasters increases mental health burden on residents of Fort McMurray. Eur J Psychotraumatol 2022; 13:2059999. [PMID: 35599978 PMCID: PMC9116266 DOI: 10.1080/20008198.2022.2059999] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumatic events in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Traumatic events often lead to increased mental health burdens in affected communities. OBJECTIVE To assess if the number of traumatic events experienced by residents of Fort McMurray correlates with the prevalence and severity of mental health issues experienced. METHODOLOGY A cross-sectional study using an online survey questionnaire was used to gather demographic, trauma (wildfire, flooding, and COVID-19), and clinical information from the resident of Fort McMurray between April 24 to June 2 2021. Likely Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD) and low resilience were measured using standardised rating scales. Data were analyzed with SPSS version 26 using Chi-Square tests and multivariate regression analysis. RESULTS Respondents who experienced COVID-19 and either flood or wildfire traumas (N = 101) were eleven times more likely to have GAD symptoms (OR: 11.39; 95% CI: 1.43-91.04), four times more likely to have likely MDD, (OR: 3.85; 95% CI: .995-14.90), ten times more likely to have likely PTSD (OR: 10.47; 95% CI: 1.28-85.67), and low resilience (OR: 10.56; 95% CI: 1.21-92.17). Respondents who experienced COVID-19, flooding, and wildfire traumas (N = 47) were eighteen times more likely to express GAD symptoms (OR: 18.30; 95% CI: 2.20-152.45) and more than eleven times likely to have likely PTSD (OR: 11.41; 95% CI: 1.34-97.37) in comparison to the respondents who experienced COVID-19 only trauma (N = 19). CONCLUSION Measures to reduce climate change and associated natural disasters could reduce the impact of cumulative trauma and associated mental health burden in vulnerable populations. It is essential that more mental health resources are mobilised to support communities impacted by multiple natural disasters. HIGHLIGHTS The number of traumatic disasters experienced in residents of Fort McMurray five years after the 2016 wildfires, a year after the 2020 flooding, and during the COVID-19 pandemic correlates with the prevalence and severity of the mental health conditions reported in this study.
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Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | | | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Medard K Adu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Canada
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Owusu E, Shalaby R, Eboreime E, Nkire N, Lawal MA, Agyapong B, Pazderka H, Obuobi-Donkor G, Adu MK, Mao W, Oluwasina F, Agyapong VIO. Prevalence and Determinants of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray 12 Months Following the 2020 Flooding. Front Psychiatry 2022; 13:844907. [PMID: 35815045 PMCID: PMC9263447 DOI: 10.3389/fpsyt.2022.844907] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/06/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The flood in Fort McMurray (FMM) which occurred between April 26 and May 2, 2020, is known to have displaced an estimated population of 1,500 people, and destroyed or damaged about 1,230 buildings. In all, it is estimated to have caused about $228 million in losses. OBJECTIVE This study aims to identify the prevalence and determinants of likely Generalized Anxiety disorder (GAD) in among respondents 12-months after the 2020 flooding. METHODS Data for the study were collected through a cross-sectional survey sent through REDCap and hosted online from the 24th of April to the 2nd of June 2021. The self-administered questionnaire was emailed to respondents using community, government, school, and occupational platforms. Demographic, flooding-related variables, and clinical data were collected. A validated instrument, the GAD-7 was used to collect information on likely GAD. Consent was implied by completing the survey forms, and the University of Alberta Health Research Ethics Committee approved the study. RESULTS Of the 249 residents surveyed, 74.7% (186) respondents completed the online survey, 81.6% (80) were above 40 years, 71% (132) were in a relationship, 85.5% (159) were females, and 94.1% (175) were employed. The prevalence of likely GAD was 42.5% in our study. Predictors of likely GAD among respondents included positive employment status (OR = 30.70; 95% C.I. 2.183-423.093), prior diagnosis of depression (OR = 3.30; 95% C.I. 1.157-9.43), and the perceived need to have mental health counseling (OR = 6.28; 95% C.I. 2.553-15.45). CONCLUSION This study showed that there was an increased magnitude of moderate to high anxiety symptoms among respondents following the natural disaster particularly the flood in 2020. The predictors of likely GAD include positive employment status, history of depression diagnosis, and the need to have mental health counseling. Policymakers may mitigate the rise of anxiety after flooding in vulnerable areas by addressing these and other factors.
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Affiliation(s)
- Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Nnamdi Nkire
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Mobolaji A Lawal
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Medard K Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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