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Wan K, Hajat S, Doherty RM, Feng Z. Integrating Shared Socioeconomic Pathway-informed adaptation into temperature-related mortality projections under climate change. ENVIRONMENTAL RESEARCH 2024; 251:118731. [PMID: 38492839 DOI: 10.1016/j.envres.2024.118731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/02/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Abstract
The extent to which populations will successfully adapt to continued warming temperatures will be a crucial factor in determining future health burdens. Previous health impact assessments of future temperature-related mortality burdens mostly disregard adaptation or make simplistic assumptions. We apply a novel evidence-based approach to model adaptation that takes into account the fact that adaptation potential is likely to vary at different temperatures. Temporal changes in age-specific mortality risk associated with low and high temperatures were characterised for Scotland between 1974 and 2018 using temperature-specific RR ratios to reflect past changes in adaptive capacity. Three scenarios of future adaption were constructed consistent with the SSPs. These adaptation projections were combined with climate and population projections to estimate the mortality burdens attributable to high (above the 90th percentile of the historical temperature distribution) and low (below the 10th percentile) temperatures up to 2080 under five RCP-SSP scenarios. A decomposition analysis was conducted to attribute the change in the mortality burden into adaptation, climate and population. In 1980-2000, the heat burden (21 deaths/year) was smaller than the colder burden (312 deaths/year). In the 2060-2080 period, the heat burden was projected to be the highest under RCP8.5-SSP5 (1285 deaths/year), and the cold burden was the highest under RCP4.5-SSP4 (320 deaths/year). The net burden was lowest under RCP2.6-SSP1 and highest under RCP8.5-SSP5. Improvements in adaptation was the largest factor reducing the cold burden under RCP2.6-SSP1 whilst temperature increase was the biggest factor contributing to the high heat burdens under RCP8.5-SSP5. Ambient heat will become a more important health determinant than cold in Scotland under all climate change and socio-economic scenarios. Adaptive capacity will not fully counter projected increases in heat deaths, underscoring the need for more ambitious climate mitigation measures for Scotland and elsewhere.
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Affiliation(s)
- Kai Wan
- School of Geosciences, University of Edinburgh, Edinburgh, UK; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth M Doherty
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Zhiqiang Feng
- School of Geosciences, University of Edinburgh, Edinburgh, UK; Scottish Centre for Administrative Data Research, School of Geosciences, University of Edinburgh, Drummond Street, Edinburgh, UK
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Cordiner R, Wan K, Hajat S, Macintyre HL. Accounting for adaptation when projecting climate change impacts on health: A review of temperature-related health impacts. ENVIRONMENT INTERNATIONAL 2024; 188:108761. [PMID: 38788417 DOI: 10.1016/j.envint.2024.108761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
Exposure to high and low ambient temperatures can cause harm to human health. Due to global warming, heat-related health effects are likely to increase substantially in future unless populations adapt to living in a warmer world. Adaptation to temperature may occur through physiological acclimatisation, behavioural mechanisms, and planned adaptation. A fundamental step in informing responses to climate change is understanding how adaptation can be appropriately accounted for when estimating future health burdens. Previous studies modelling adaptation have used a variety of methods, and it is often unclear how underlying assumptions of adaptation are made and if they are based on evidence. Consequently, the most appropriate way to quantitatively model adaptation in projections of health impacts is currently unknown. With increasing interest from decisionmakers around implementation of adaptation strategies, it is important to consider the role of adaptation in anticipating future health burdens of climate change. To address this, a literature review using systematic scoping methods was conducted to document the quantitative methods employed by studies projecting future temperature-related health impacts under climate change that also consider adaptation. Approaches employed in studies were coded into methodological categories. Categories were discussed and refined between reviewers during synthesis. Fifty-nine studies were included and grouped into eight methodological categories. Methods of including adaptation in projections have changed over time with more recent studies using a combination of approaches or modelling adaptation based on specific adaptation strategies or socioeconomic conditions. The most common approaches to model adaptation are heat threshold shifts and reductions in the exposure-response slope. Just under 20% of studies were identified as using an intervention-based empirical basis for statistical assumptions. Including adaptation in projections considerably reduced the projected temperature-mortality burden in the future. Researchers should ensure that all future impact assessments include adaptation uncertainty in projections and assumptions are based on empirical evidence.
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Affiliation(s)
- Rhiannon Cordiner
- Centre for Climate and Health Security, UK Health Security Agency, 10 South Colonnade, Canary Wharf, London E14 4PU, England.
| | - Kai Wan
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, England.
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, England.
| | - Helen L Macintyre
- Centre for Climate and Health Security, UK Health Security Agency, 10 South Colonnade, Canary Wharf, London E14 4PU, England; School of Geography Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, England.
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Singh N, Areal AT, Breitner S, Zhang S, Agewall S, Schikowski T, Schneider A. Heat and Cardiovascular Mortality: An Epidemiological Perspective. Circ Res 2024; 134:1098-1112. [PMID: 38662866 PMCID: PMC11042530 DOI: 10.1161/circresaha.123.323615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
As global temperatures rise, extreme heat events are projected to become more frequent and intense. Extreme heat causes a wide range of health effects, including an overall increase in morbidity and mortality. It is important to note that while there is sufficient epidemiological evidence for heat-related increases in all-cause mortality, evidence on the association between heat and cause-specific deaths such as cardiovascular disease (CVD) mortality (and its more specific causes) is limited, with inconsistent findings. Existing systematic reviews and meta-analyses of epidemiological studies on heat and CVD mortality have summarized the available evidence. However, the target audience of such reviews is mainly limited to the specific field of environmental epidemiology. This overarching perspective aims to provide health professionals with a comprehensive overview of recent epidemiological evidence of how extreme heat is associated with CVD mortality. The rationale behind this broad perspective is that a better understanding of the effect of extreme heat on CVD mortality will help CVD health professionals optimize their plans to adapt to the changes brought about by climate change and heat events. To policymakers, this perspective would help formulate targeted mitigation, strengthen early warning systems, and develop better adaptation strategies. Despite the heterogeneity in evidence worldwide, due in part to different climatic conditions and population dynamics, there is a clear link between heat and CVD mortality. The risk has often been found to be higher in vulnerable subgroups, including older people, people with preexisting conditions, and the socioeconomically deprived. This perspective also highlights the lack of evidence from low- and middle-income countries and focuses on cause-specific CVD deaths. In addition, the perspective highlights the temporal changes in heat-related CVD deaths as well as the interactive effect of heat with other environmental factors and the potential biological pathways. Importantly, these various aspects of epidemiological studies have never been fully investigated and, therefore, the true extent of the impact of heat on CVD deaths remains largely unknown. Furthermore, this perspective also highlights the research gaps in epidemiological studies and the potential solutions to generate more robust evidence on the future consequences of heat on CVD deaths.
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Affiliation(s)
- Nidhi Singh
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Ashtyn Tracy Areal
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
| | - Siqi Zhang
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Stefan Agewall
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
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de Schrijver E, Sivaraj S, Raible CC, Franco OH, Chen K, Vicedo-Cabrera AM. Nationwide projections of heat- and cold-related mortality impacts under various climate change and population development scenarios in Switzerland. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2023; 18:094010. [PMID: 38854588 PMCID: PMC7616072 DOI: 10.1088/1748-9326/ace7e1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Climate change and progressive population development (i.e., ageing and changes in population size) are altering the temporal patterns of temperature-related mortality in Switzerland. However, limited evidence exists on how current trends in heat- and cold-related mortality would evolve in future decades under composite scenarios of global warming and population development. Moreover, the contribution of these drivers to future mortality impacts is not well-understood. Therefore, we aimed to project heat- and cold-related mortality in Switzerland under various combinations of emission and population development scenarios and to disentangle the contribution of each of these two drivers using high-resolution mortality and temperature data. We combined age-specific (<75 and ⩾75 years) temperature-mortality associations in each district in Switzerland (1990-2010), estimated through a two-stage time series analysis, with 2 km downscaled CMIP5 temperature data and population and mortality rate projections under two scenarios: RCP4.5/SSP2 and RCP8.5/SSP5. We derived heat and cold-related mortality for different warming targets (1.5 °C, 2.0 °C and 3.0 °C) using different emission and population development scenarios and compared this to the baseline period (1990-2010). Heat-related mortality is projected to increase from 312 (116; 510) in the 1990-2010 period to 1274 (537; 2284) annual deaths under 2.0 °C of warming (RCP4.5/SSP2) and to 1871 (791; 3284) under 3.0 °C of warming (RCP8.5/SSP5). Cold-related mortality will substantially increase from 4069 (1898; 6016) to 6558 (3223; 9589) annual deaths under 2.0 °C (RCP4.5/SSP2) and to 5997 (2951; 8759) under 3.0 °C (RCP8.5/SSP5). Moreover, while the increase in cold-related mortality is solely driven by population development, for heat, both components (i.e., changes in climate and population) have a similar contribution of around 50% to the projected heat-related mortality trends. In conclusion, our findings suggest that both heat- and cold-related mortality will substantially increase under all scenarios of climate change and population development in Switzerland. Population development will lead to an increase in cold-related mortality despite the decrease in cold temperature under warmer scenarios. Whereas the combination of the progressive warming of the climate and population development will substantially increase and exacerbate the total temperature-related mortality burden in Switzerland.
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Affiliation(s)
- Evan de Schrijver
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Graduate School of Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Sidharth Sivaraj
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
| | - Christoph C Raible
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
- Climate and Environmental Physics, Physics Institute, University of Bern, Bern, Switzerland
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Julius Center for Health Sciences and Primary Care, University of Utrecht Medical Center, Utrecht, The Netherlands
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States of America
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, United States of America
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, Bern, Switzerland
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Lloyd SJ, Quijal-Zamorano M, Achebak H, Hajat S, Muttarak R, Striessnig E, Ballester J. The Direct and Indirect Influences of Interrelated Regional-Level Sociodemographic Factors on Heat-Attributable Mortality in Europe: Insights for Adaptation Strategies. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87013. [PMID: 37606292 PMCID: PMC10443201 DOI: 10.1289/ehp11766] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/06/2023] [Accepted: 07/19/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Heat is a significant cause of mortality, but impact patterns are heterogenous. Previous studies assessing such heterogeneity focused exclusively on risk rather than heat-attributable mortality burdens and assume predictors are independent. OBJECTIVES We assessed how four interrelated regional-level sociodemographic predictors-education, life expectancy, the ratio of older to younger people (aging index), and relative income-influence heterogeneity in heat-attributable mortality burdens in Europe and then derived insights into adaptation strategies. METHODS We extracted four outcomes from a temperature-mortality study covering 16 European countries: the rate of increase in mortality risk at moderate and extreme temperatures (moderate and extreme slope, respectively), the minimum mortality temperature percentile (MMTP), and the underlying mortality rate. We used structural equation modeling with country-level random effects to quantify the direct and indirect influences of the predictors on the outcomes. RESULTS Higher levels of education were directly associated with lower heat-related mortality at moderate and extreme temperatures via lower slopes and higher MMTPs. A one standard deviation increase in education was associated with a - 0.46 ± 0.14 , - 0.41 ± 0.12 , and 0.41 ± 0.12 standard deviation (± standard error ) change in the moderate slope, extreme slope, and MMTP, respectively. However, education had mixed indirect influences via associations with life expectancy, the aging index, and relative income. Higher life expectancy had mixed relations with heat-related mortality, being associated with higher risk at moderate temperatures (0.33 ± 0.11 for the moderate slope; - 0.19 ± 0.097 for the MMTP) but lower underlying mortality rates (- 0.72 ± 0.097 ). A higher aging index was associated with higher burdens through higher risk at extreme temperatures (0.13 ± 0.072 for the extreme slope) and higher underlying mortality rates (0.93 ± 0.055 ). Relative income had relatively small, mixed influences. DISCUSSION Our novel approach provided insights into actions for reducing the health impacts of heat. First, the results show the interrelations between possible vulnerability-generating mechanisms and suggest future research directions. Second, the findings point to the need for a dual approach to adaptation, with actions that explicitly target heat exposure reduction and actions focused explicitly on the root causes of vulnerability. For the latter, the climate crisis may be leveraged to accelerate ongoing general public health programs. https://doi.org/10.1289/EHP11766.
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Affiliation(s)
- Simon J Lloyd
- Climate and Health Programme, ISGlobal, Barcelona, Spain
| | - Marcos Quijal-Zamorano
- Climate and Health Programme, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Hicham Achebak
- Climate and Health Programme, ISGlobal, Barcelona, Spain
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Raya Muttarak
- Department of Statistical Sciences "Paolo Fortunati", University of Bologna, Bologna, Italy
| | | | - Joan Ballester
- Climate and Health Programme, ISGlobal, Barcelona, Spain
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Luan G, Liu S, Zhang W, Zhai L, Zhang Y, Sun L, Yao H. Estimating the influence of high temperature on hand, foot, and mouth disease incidence in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:1477-1484. [PMID: 35915310 DOI: 10.1007/s11356-022-22038-4] [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: 03/04/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
The burden of disease caused by ambient high temperature has become a public health concern, but the associations between high temperature and hand, foot, and mouth disease (HFMD) remain indistinct. We used distributed lag non-linear model (DLNM) to estimate the burden of disease attribute to high temperature, adjusting for long-term trend and weather confounders. Total 18,167,455 cases were reported in 31 Chinese provinces, the incidence of HFMD showed a gradually increasing trend from 2008 to 2017 in China. Minimum morbidity temperature (MMT) was mainly concentrated at 17 to 23 °C in ≤ 5 years old group, 18 to 25 °C in 6 ~ 10 years old group and 19 to 27 °C in > 10 years old group. The greatest relative risk (RR) in age group ≤ 5 years old was 2.06 (95% CI: 1.85 ~ 2.30) in Heilongjiang, and the lowest RR was 1.02 (95% CI: 1.00 ~ 1.05) in Guangdong; the greatest RR in age group 6 ~ 10 years old was 2.24 (95% CI: 1.72 ~ 2.91) in Guizhou, and the lowest RR was 1.01 (95% CI: 0.97 ~ 1.12) in Tianjin; the greatest RR in the age group > 10 years old was 2.53 (95% CI: 1.66 ~ 3.87) in Heilongjiang, and the lowest RR was 1.02 (95% CI: 0.71 ~ 1.46) in Henan. We found the positive association between high temperature and HFMD in China.
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Affiliation(s)
- Guijie Luan
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, No.155 Changbai Road, Changping District, Beijing, 102206, China
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Shaonan Liu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Weiyan Zhang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Long Zhai
- Qingdao Center for Disease Control and Prevention, Qingdao, 266033, China
| | - Yingjie Zhang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Liang Sun
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Hongyan Yao
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, No.155 Changbai Road, Changping District, Beijing, 102206, China.
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Rai M, Breitner S, Zhang S, Rappold AG, Schneider A. Achievements and gaps in projection studies on the temperature-attributable health burden: Where should we be headed? FRONTIERS IN EPIDEMIOLOGY 2022; 2:1-9. [PMID: 37942471 PMCID: PMC10631562 DOI: 10.3389/fepid.2022.1063871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Future projection of the temperature-related health burden, including mortality and hospital admissions, is a growing field of research. These studies aim to provide crucial information for decision-makers considering existing health policies as well as integrating targeted adaptation strategies to evade the health burden. However, this field of research is still overshadowed by large uncertainties. These uncertainties exist to an extent in the future climate and population models used by such studies but largely in the disparities in underlying assumptions. Existing studies differ in the factors incorporated for projection and strategies for considering the future adaptation of the population to temperature. These differences exist to a great degree because of a lack of robust evidence as well as gaps in the field of climate epidemiology that still require extensive input from the research community. This narrative review summarizes the current status of projection studies of temperature-attributable health burden, the guiding assumptions behind them, the common grounds, as well as the differences. Overall, the review aims to highlight existing evidence and knowledge gaps as a basis for designing future studies on temperature-attributable health burden estimation. Finding a robust methodology for projecting the future health burden could be a milestone for climate epidemiologists as this would largely benefit the world when applying this technique to project the climate-attributable cause-specific health burden and adapt our existing health policies accordingly.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Center Munich, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, LMU Munich, Munich, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Center Munich, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, LMU Munich, Munich, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Center Munich, Neuherberg, Germany
| | - Ana G. Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, Durham, NC, United States
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He F, Wei J, Dong Y, Liu C, Zhao K, Peng W, Lu Z, Zhang B, Xue F, Guo X, Jia X. Associations of ambient temperature with mortality for ischemic and hemorrhagic stroke and the modification effects of greenness in Shandong Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158046. [PMID: 35987239 DOI: 10.1016/j.scitotenv.2022.158046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence is scant on the relative and attributable contributions of ambient temperature on stroke subtypes mortality. Few studies have examined modification effects of multiple greenness indicators on such contributions, especially in China. We quantified the associations between ambient temperature and overall, ischemic, and hemorrhagic stroke mortality; further examined whether the associations were modified by greenness. METHODS We conducted a multicenter time-series analysis from January 1, 2013 to December 31, 2019. we adopted a distributed lag non-linear model to evaluate county-specific temperature-stroke mortality associations. We then applied a random-effects meta-analysis to pool county-specific effects. Attributable mortality was calculated for cold and heat, defined as temperatures below and above the minimum mortality temperature (MMT). Finally, We conducted a multivariate meta-regression to determine associations between greenness and stroke mortality risks for cold and heat, using normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), and enhanced vegetation index (EVI) as quantitative indicators of greenness exposure. RESULTS In the study period, 138,749 deaths from total stroke were reported: 86,873 ischemic and 51,876 hemorrhagic stroke. We observed significant W-shaped relationships between temperature and stroke mortality, with substantial differences among counties and regions. With MMT as the temperature threshold, 17.16 % (95 % empirical CI, 13.38 %-19.75 %) of overall, 20.05 % (95 % eCI, 16.46 %-22.70 %) of ischemic, and 12.55 % (95 % eCI, 5.59 %-16.24 %) of hemorrhagic stroke mortality were attributable to non-optimum temperature (combining cold and heat), more mortality was caused by cold (14.94 %; 95 % eCI, 11.57 %-17.34 %) than by heat (2.22 %; 95 % eCI, 1.54 %-2.72 %). Higher levels of NDVI, SAVI and EVI were related to mitigated effects of non-optimum temperatures-especially heat. CONCLUSIONS Exposure to non-optimum temperatures aggravated stroke mortality risks; increasing greenness could alleviate that risks. This evidence has important implications for local communities in developing adaptive strategies to minimize the health consequences of adverse temperatures.
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Affiliation(s)
- Fenfen He
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Yilin Dong
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
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Wang P, Tong HW, Lee TC, Goggins WB. Projecting future temperature-related mortality using annual time series data: An example from Hong Kong. ENVIRONMENTAL RESEARCH 2022; 212:113351. [PMID: 35490827 DOI: 10.1016/j.envres.2022.113351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous studies projecting future temperature-related mortality under climate change have mostly used short-term temperature-mortality associations based on daily time series data. The present study aimed to project mortality under different Representative Concentration Pathways (RCPs) in 21st century in Hong Kong by using analysis of annual data during 1976-2018. METHODS We employed a degree-days approach, calculating the sum of daily degrees above or below certain temperature threshold within a relevant historical year. The yearly age-standardized mortality rates (ASMRs) were regressed on annual hot and cold degree-days in quasi-Poisson generalized additive models to assess the exposure-response function that was subsequently used to calculate future changes in ASMR. The projection was performed without and with certain human adaptation assumed. RESULTS ASMRs were projected to have net increases under RCPs 4.5, 6.0, and 8.5, with increased mortality attributable to excess hot days exceeding decreases attributable to excess cold days. The average net changes under RCP8.5 was estimated to be 0.12%, 12.44%, 38.99%, and 89.25% during 2030s, 2050s, 2070s, and 2090s, respectively. Higher projected ASMRs were estimated for those aged over 75 years and for cardiovascular deaths. When human adaptation was considered, slope reduction alone under RCP4.5 and 6.0 and all adaptation assumptions under RCP8.5 might still not offset its corresponding adverse impact. CONCLUSIONS The projected decreases in cold-related mortality do not compensate for projected increases in heat-related mortality in Hong Kong. Better public adaptations strategies are warranted for coping with the adverse health impacts of climate change on a local scale.
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Affiliation(s)
- Pin Wang
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | | | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Chen CC, Wang YR, Wang YC, Lin SL, Chen CT, Lu MM, Guo YLL. Projection of future temperature extremes, related mortality, and adaptation due to climate and population changes in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 760:143373. [PMID: 33172628 DOI: 10.1016/j.scitotenv.2020.143373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Extreme temperature events have been observed to appear more frequently and with greater intensity in Taiwan in recent decades due to climate change, following the global trend. Projections of temperature extremes across different climate zones and their impacts on related mortality and adaptation have not been well studied. METHODS We projected site-specific future temperature extremes by statistical downscaling of 8 global climate models followed by Bayesian model averaging from 2021 to 2060 across Taiwan under the representative concentration pathway (RCP) scenarios RCP2.6, RCP4.5, and RCP8.5. We then calculated the attributable mortality (AM) in 6 municipalities and in the eastern area by multiplying the city/county- and degree-specific relative risk of mortality according to the future population projections. We estimated the degree of adaptation to heat by slope reduction of the projected AM to be comparable with that in 2018. RESULTS The annual number of hot days with mean temperatures over 30 °C was predicted to have a substantial 2- to 5-fold increase throughout the residential areas of Taiwan by the end of 2060 under RCP8.5, whereas the decrease in cold days was less substantial. The decrease in cold-related mortality below 15 °C was projected to outweigh heat-related mortality for the next two decades, and then heat-related mortality was predicted to drastically increase and cross over cold-related mortality, surpassing it from 2045 to 2055. Adjusting for future population size, the percentage increase in heat-related deaths per 100,000 people could increase by more than 10-fold under the worst scenario (RCP8.5), especially for those over 65 years old. The heat-related impacts will be most severe in southern Taiwan, which has a tropical climate. There is a very high demand for heat-adaptation prior to 2050 under all RCP scenarios. CONCLUSIONS Spatiotemporal variations in AM in cities in different climate zones are projected in Taiwan and are expected to have a net negative effect in the near future before shifting to a net positive effect from 2045 to 2055. However, there is an overall positive and increasing trend of net effect for elderly individuals under all the emission scenarios. Active adaptation plans need to be well developed to face future challenges due to climate change, especially for the elderly population in central and southern Taiwan.
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Affiliation(s)
- Chu-Chih Chen
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan.
| | - Yin-Ru Wang
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Yu-Chun Wang
- Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, Taiwan.
| | - Shiou-Li Lin
- Institute of Marine Environmental Science and Technology, National Taiwan Normal University, Taiwan
| | - Cheng-Ta Chen
- Institute of Marine Environmental Science and Technology, National Taiwan Normal University, Taiwan
| | - Mong-Ming Lu
- Department of Atmospheric Sciences, National Taiwan University, Taiwan
| | - Yue-Liang L Guo
- Institute of Environmental and Occupational Health Sciences, School of Public Health, National Taiwan University, Taiwan.
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Kim S, Kim SY, Oh J, Chae Y, Park J, Kim D, Kim YM. Effects of the 2018 heat wave on health in the elderly: implications for adaptation strategies to climate change. Environ Anal Health Toxicol 2020; 35:e2020024-0. [PMID: 33434424 PMCID: PMC7829408 DOI: 10.5620/eaht.2020024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/10/2020] [Indexed: 12/02/2022] Open
Abstract
There has been growing concern over the effects of heat waves on health. However, the effects of heat waves on the health of individuals in vulnerable groups have rarely been examined. We aimed to investigate the acute health effects of heat waves in elderly individuals living in rural areas and to survey their adaptation capacity. Repeated measurements of body temperature (BT), blood pressure, sleep disturbance, and indoor temperature were conducted up to six times for each of 104 elderly individuals living in rural areas of South Korea during the 2018 heat wave. Changes in BT, systolic blood pressure (SBP), and diastolic blood pressure (DBP) according to variations in indoor and outdoor temperature were analyzed using linear mixed effect models controlling for age, sex, smoking, and drug use. We also surveyed heat wave adaptation capacity, heat wave shelters, and self-reported health problems. The average indoor temperature measured during the study period was 30.5°C (range: 22.9-38.3°C) and that of ambient temperature was 30.6°C (range: 24.6-36.3°C). BT significantly increased with indoor and outdoor temperatures. The effect on BT was greater in elderly women and the elderly with hypertension. DBP generally decreased with increasing indoor temperature, though the correlation was only statistically significant among the elderly with hypertension. Only 22 (21.2%) individuals used air conditioners during the heat wave. Most did not use an air conditioner mainly to avoid high electricity costs. Of the participants, 58.7% reported experiencing sleep disturbance, which was the most frequent self-reported health problem. Elderly individuals living in rural areas are directly exposed to high temperatures during heat waves, and their vital signs are sensitive to increases in indoor temperature due to poor adaptation capacity. Well-designed strategies for alleviating health-related stress during heat waves are necessary.
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Affiliation(s)
- Soyeon Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Sang-Yub Kim
- Korea Climate & Environment Network, Gwacheon, Korea
| | - Jongmin Oh
- Korea Climate & Environment Network, Gwacheon, Korea
| | - Yeora Chae
- Korea Environment Institute, Sejong, Korea
| | | | - Daesoo Kim
- Korea Environment Institute, Sejong, Korea
| | - Young-Min Kim
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul Korea; Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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12
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Fundamental Concepts of Human Thermoregulation and Adaptation to Heat: A Review in the Context of Global Warming. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217795. [PMID: 33114437 PMCID: PMC7662600 DOI: 10.3390/ijerph17217795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 12/18/2022]
Abstract
The international community has recognized global warming as an impending catastrophe that poses significant threat to life on earth. In response, the signatories of the Paris Agreement (2015) have committed to limit the increase in global mean temperature to <1.5 °C from pre-industry period, which is defined as 1850–1890. Considering that the protection of human life is a central focus in the Paris Agreement, the naturally endowed properties of the human body to protect itself from environmental extremes should form the core of an integrated and multifaceted solution against global warming. Scholars believe that heat and thermoregulation played important roles in the evolution of life and continue to be a central mechanism that allows humans to explore, labor and live in extreme conditions. However, the international effort against global warming has focused primarily on protecting the environment and on the reduction of greenhouse gases by changing human behavior, industrial practices and government policies, with limited consideration given to the nature and design of the human thermoregulatory system. Global warming is projected to challenge the limits of human thermoregulation, which can be enhanced by complementing innate human thermo-plasticity with the appropriate behavioral changes and technological innovations. Therefore, the primary aim of this review is to discuss the fundamental concepts and physiology of human thermoregulation as the underlying bases for human adaptation to global warming. Potential strategies to extend human tolerance against environmental heat through behavioral adaptations and technological innovations will also be discussed. An important behavioral adaptation postulated by this review is that sleep/wake cycles would gravitate towards a sub-nocturnal pattern, especially for outdoor activities, to avoid the heat in the day. Technologically, the current concept of air conditioning the space in the room would likely steer towards the concept of targeted body surface cooling. The current review was conducted using materials that were derived from PubMed search engine and the personal library of the author. The PubMed search was conducted using combinations of keywords that are related to the theme and topics in the respective sections of the review. The final set of articles selected were considered “state of the art,” based on their contributions to the strength of scientific evidence and novelty in the domain knowledge on human thermoregulation and global warming.
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Chen K, Vicedo-Cabrera AM, Dubrow R. Projections of Ambient Temperature- and Air Pollution-Related Mortality Burden Under Combined Climate Change and Population Aging Scenarios: a Review. Curr Environ Health Rep 2020; 7:243-255. [PMID: 32542573 DOI: 10.1007/s40572-020-00281-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Climate change will affect mortality associated with both ambient temperature and air pollution. Because older adults have elevated vulnerability to both non-optimal ambient temperature (heat and cold) and air pollution, population aging can amplify future population vulnerability to these stressors through increasing the number of vulnerable older adults. We aimed to review recent evidence on projections of temperature- or air pollution-related mortality burden (i.e., number of deaths) under combined climate change and population aging scenarios, with a focus on evaluating the role of population aging in assessing these health impacts of climate change. We included studies published between 2014 and 2019 with age-specific population projections. RECENT FINDINGS We reviewed 16 temperature projection studies and 15 air pollution projection studies. Nine of the temperature studies and four of the air pollution studies took population aging into account by performing age-stratified analyses that utilized age-specific relationships between temperature or air pollution exposures and mortality (i.e., age-specific exposure-response functions (ERFs)). Population aging amplifies the projected mortality burden of temperature and air pollution under a warming climate. Compared with a constant population scenario, population aging scenarios lead to less reduction or even increases in cold-related mortality burden, resulting in substantial net increases in future overall (heat and cold) temperature-related mortality burden. There is strong evidence suggesting that to accurately assess the future temperature- and air pollution-related mortality burden of climate change, investigators need to account for the amplifying effect of population aging. Thus, all future studies should incorporate age-specific population size projections and age-specific ERFs into their analyses. These studies would benefit from refinement of age-specific ERF estimates.
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Affiliation(s)
- Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA. .,Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, 43 Mittelstrasse, 3012, Bern, Switzerland.,Oeschger Center for Climate Change Research, University of Bern, 4 Hochschulstrasse, 3012, Bern, Switzerland
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.,Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
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Varquez ACG, Darmanto NS, Honda Y, Ihara T, Kanda M. Future increase in elderly heat-related mortality of a rapidly growing Asian megacity. Sci Rep 2020; 10:9304. [PMID: 32518364 PMCID: PMC7283254 DOI: 10.1038/s41598-020-66288-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/15/2020] [Indexed: 11/17/2022] Open
Abstract
Urban dwellers are at risk of heat-related mortality in the onset of climate change. In this study, future changes in heat-related mortality of elderly citizens were estimated while considering the combined effects of spatially-varying megacity’s population growth, urbanization, and climate change. The target area is the Jakarta metropolitan area of Indonesia, a rapidly developing tropical country. 1.2 × 1.2 km2 daily maximum temperatures were acquired from weather model outputs for the August months from 2006 to 2015 (present 2010s) and 2046 to 2055 (future 2050s considering pseudo-global warming of RCP2.6 and RCP8.5). The weather model considers population-induced spatial changes in urban morphology and anthropogenic heating distribution. Present and future heat-related mortality was mapped out based on the simulated daily maximum temperatures. The August total number of heat-related elderly deaths in Jakarta will drastically increase by 12~15 times in the 2050s compared to 2010s because of population aging and rising daytime temperatures under “compact city” and “business-as-usual” scenarios. Meanwhile, mitigating climate change (RCP 2.6) could reduce the August elderly mortality count by up to 17.34%. The downwind areas of the densest city core and the coastal areas of Jakarta should be avoided by elderly citizens during the daytime.
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Affiliation(s)
| | - Nisrina S Darmanto
- Department of Transdisciplinary Science and Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tomohiko Ihara
- Department of Environment Systems, University of Tokyo, Tokyo, Japan
| | - Manabu Kanda
- Department of Transdisciplinary Science and Engineering, Tokyo Institute of Technology, Tokyo, Japan
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