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Osborne NJ, Amoatey P, Selvey L, Phung D. Temporal changes in temperature-related mortality in relation to the establishment of the heat-health alert system in Victoria, Australia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1637-1647. [PMID: 38709342 PMCID: PMC11282152 DOI: 10.1007/s00484-024-02691-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/08/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
Extreme heat alerts are the most common form of weather forecasting services used in Australia, yet very limited studies have documented their effectiveness in improving health outcomes. This study aimed to examine the temporal changes in temperature-related mortality in relation to the activation of the heat-health alert and response system (HARS) in the State of Victoria, Australia. We examined the relationship between temperatures and mortality using quasi-Poisson regression and the distributed lag non-linear model (dlnm) and compared the temperature-mortality association between the two periods: period 1- prior-HARS (1992-2009) and period 2- post-HARS (2010-2019). Since the HARS heavily weights heatwave effects, we also compared the main effects of heatwave events between the two periods. The heatwaves were defined for three levels, including 3 consecutive days at 97th, 98th, and 99th percentiles. We also controlled the potential confounding effect of seasonality by including a natural cubic B-spline of the day of the year with equally spaced knots and 8 degrees of freedom per year. The exposure-response curve reveals the temperature mortality was reduced in period 2 in comparison with period 1. The relative risk ratios (RRR) of Period 2 over Period 1 were all less than one and gradually decreased from 0.86 (95% CI, 0.72-1.03) to 0.64 (95% CI, 0.33-1.22), and the differences in attributable risk percent increased from 13.2 to 25.3%. The reduction in the risk of heatwave-related deaths decreased by 3.4% (RRp1 1.068, 95% CI, 1.024-1.112 versus RRp2 1.034, 95% CI, 0.986-1.082) and 10% (RRp1 1.16, 95% CI, 1.10-1.22 versus RRp2 1.06, 95% CI, 1.002-1.119) for all groups of people. The study indicated a decrease in heat-related mortality following the operation of HARS in Victoria under extreme heat and high-intensity heatwaves conditions. Further studies could investigate the extent of changes in mortality among populations of differing socio-economic groups during the operation of the heat-health alert system.
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Affiliation(s)
- Nicholas J Osborne
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
- Queensland Alliance for Environmental Health Sciences, University of Queensland, 266 Herston Rd, 4006, Herston, QLD, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
- European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Patrick Amoatey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Linda Selvey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Dung Phung
- School of Public Health, University of Queensland, Brisbane, QLD, Australia.
- Queensland Alliance for Environmental Health Sciences, University of Queensland, 266 Herston Rd, 4006, Herston, QLD, Australia.
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Richmond J, Clowes M. Health system adaptations for extreme heat: Protocol for an international scoping review of reviews. PLoS One 2024; 19:e0307417. [PMID: 39024254 PMCID: PMC11257315 DOI: 10.1371/journal.pone.0307417] [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: 11/08/2023] [Accepted: 06/28/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE The objective of this study is to map the international evidence for extreme heat related adaptation strategies by health systems, with a particular focus on how heat-vulnerable populations and local situational awareness are considered in these strategies. INTRODUCTION Since the Paris Climate Accords in 2015, awareness has increased of the health risks posed by extreme heat along with interest in adaptations which aim to reduce heat-health-risks for vulnerable populations. However, the extant literature on these adaptations suggest they are insufficient, and call for research to examine whether, how, and what adaptations for extreme heat are effective as public health interventions. INCLUSION CRITERIA We will include English-language review articles describing and/or evaluating health system adaptations for extreme heat. Health systems will be defined broadly using the WHO Building Blocks model [1] and adaptations will range from the individual level to institutional, regional and national levels, with particular attention to localisation and the protection of vulnerable individuals. METHODS A comprehensive literature search of the published literature will be conducted using MEDLINE, Embase, CINAHL, the Cochrane Library and Web of Science. Searches will be limited to reviews published since 2015 in the English language. Results will be exported to EndNote for screening (with a sample checked by two reviewers to ensure consistency). A complementary search for related reports by major international agencies (e.g. WHO; International Association of Emergency Managers), as well as local searches for current guidance and case studies, will be conducted in parallel. Data from included papers will be presented in tables with a narrative commentary.
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Affiliation(s)
- John Richmond
- School of Medicine and Population Health, University of Sheffield, Sheffield, South Yorkshire, United Kingdom
| | - Mark Clowes
- School of Medicine and Population Health, University of Sheffield, Sheffield, South Yorkshire, United Kingdom
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Yezli S, Ehaideb S, Yassin Y, Alotaibi B, Bouchama A. Escalating climate-related health risks for Hajj pilgrims to Mecca. J Travel Med 2024; 31:taae042. [PMID: 38457640 PMCID: PMC11149718 DOI: 10.1093/jtm/taae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/02/2024] [Accepted: 03/07/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Global temperatures are on the rise, leading to more frequent and severe heatwaves with associated health risks. Heat-related illnesses (HRIs) are an increasing threat for travellers to hot climate destinations. This study was designed to elucidate the interplay between increasing ambient temperatures, incidence of HRIs and the effectiveness of mitigation strategies during the annual Hajj mass gathering over a 40-year period. METHODS An observational study was conducted utilizing historical records spanning four decades of meteorological data, and the rates of heat stroke (HS) and heat exhaustion (HE) during the Hajj pilgrimage in Mecca, Saudi Arabia. With an annual population exceeding 2 million participants from over 180 countries, the study analysed temporal variations in weather conditions over two distinct Hajj hot cycles and correlated it with the occurrence of HS and HE. The effectiveness of deployed mitigation measures in alleviating health vulnerabilities between the two cycles was also assessed. RESULTS Throughout the study period, average dry and wet bulb temperatures in Mecca escalated by 0.4°C (Mann-Kendall P < 0.0001) and 0.2°C (Mann-Kendall P = 0.25) per decade, respectively. Both temperatures were strongly correlated with the incidence of HS and HE (P < 0.001). Despite the intensifying heat, the mitigation strategies including individual, structural and community measures were associated with a substantial 74.6% reduction in HS cases and a 47.6% decrease in case fatality rate. CONCLUSION The study underscores the escalating climate-related health risks in Mecca over the study period. The mitigation measures' efficacy in such a globally representative setting emphasizes the findings' generalizability and the importance of refining public health interventions in the face of rising temperatures.
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Affiliation(s)
- Saber Yezli
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia
| | - Salleh Ehaideb
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Yara Yassin
- Federation of Saudi Chambers Institute, Federation of Saudi Chambers, Riyadh 12711, Saudi Arabia
| | | | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
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Zhou L, Liu C, He C, Lei J, Zhu Y, Gao Y, Xuan J, Kan H, Chen R. Quantification of the Heat-Related Risk and Burden of Hospitalizations for Cause-Specific Injuries and Contribution of Human-Induced Climate Change: A Time-Stratified Case-Crossover Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57005. [PMID: 38752990 PMCID: PMC11098006 DOI: 10.1289/ehp14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/07/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Although ambient temperature has been linked with injury incidence, there have been few nationwide studies to quantify the temperature-related risk and burden of cause-specific injury hospitalizations. Additionally, the impact of human-induced climate change to injury burden remains unknown. OBJECTIVES Our objectives are to examine the associations between ambient temperature and injury hospitalizations from various causes and to quantify the contribution of human-induced warming to the heat-related burden. METHODS We collected injury hospitalization data from a nationwide hospital-based registry in China during 2000-2019. Using a time-stratified case-crossover design, we investigated the associations between daily mean temperature (°C) and cause-specific injury hospitalizations. We also quantified the burden of heat-related injuries under the scenarios with and without anthropogenic forcing, using the Detection and Attribution Model Intercomparison Project to assess the contribution of human-induced warming. RESULTS Our study included a total of 988,087 patients with hospitalization records for injuries. Overall, compared to the temperature at minimum risk of hospitalization (- 12.1 ° C ), the relative risk of hospitalization at extreme hot temperature (30.8°C, 97.5th percentile) was 1.18 [95% confidence interval (CI): 1.14, 1.22], with an approximately linear association between temperature and hospitalization. Vulnerability to heat-related injuries was more pronounced among males, young (< 18 years of age) or middle-aged (45-64 years of age) individuals, and those living in the North. The heat-related attributable fraction increased from 23.2% in the 2000s to 23.6% in the 2010s, with a corresponding increase in the contribution of human-induced change over time. In the 2010s, the heat-related attributable fractions for specific causes of injury ranged from 12.4% to 54.4%, with human-induced change accounting for 6.7% to 10.6% of the burden. DISCUSSION This nationwide study presents new evidence of significant associations between temperature and cause-specific injury hospitalizations in China and highlights the increasing contribution of human-induced warming to the injury burden. https://doi.org/10.1289/EHP14057.
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Affiliation(s)
- Lu Zhou
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cheng He
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Jian Lei
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Sen University, Guangzhou, China
| | - Haidong Kan
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- National Center for Children’s Health, Children’s Hospital of Fudan University, Shanghai, China
| | - Renjie Chen
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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Tetzlaff EJ, Goulet N, Gorman M, Richardson GRA, Enright PM, Meade RD, Kenny GP. Hot Topic: A Systematic Review and Content Analysis of Heat-Related Messages During the 2021 Heat Dome in Canada. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:295-305. [PMID: 38032231 PMCID: PMC10833195 DOI: 10.1097/phh.0000000000001817] [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: 12/01/2023]
Abstract
CONTEXT During the summer of 2021, western Canada experienced a deadly heat event. From the first heat alert to postevent reporting, thousands of media articles were published that reference the heat event. However, a gap remains in understanding how this communication chain-from the release of a public heat alert to information shared through media outlets to the public-currently operates to disseminate heat-related messaging across Canada. OBJECTIVE To understand the role of digital media in delivering heat-health messaging during an extreme heat event in Canada. DESIGN A qualitative content analysis was conducted using Canadian news articles published on the 2021 Heat Dome between June 2021 and February 2022 (n = 2909). The coding frame was designed to align with the basic framework for information gathering used in journalism (who, what, where, when, and how) and included both concept-driven and data-driven codes. RESULTS Overall, 2909 unique media articles discussing the 2021 Heat Dome were identified, with the majority (74%) published by online news agencies (how). The highest article count was on June 29, 2021 (n = 159), representing 5% of the total data set (n = 2909) spanning 260 days (when); 57% of the identified locations were in British Columbia (where). Although we found that the top voices providing media-based heat-health messages are government officials (who), only 23% of articles included heat-health messaging that aligns with the government health alert bulletins released during extreme heat. In addition, heat-health messaging frequently included contradictory content, inconsistent language, or incorrect advice (what). CONCLUSION The findings demonstrate clear opportunities to improve health communication related to extreme heat, perhaps most importantly, including updates to mass media messaging educating the public on heat-protective behaviors.
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Affiliation(s)
- Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences (Ms Tetzlaff, Mr Goulet, and Drs Meade and Kenny) and Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences (Mr Goulet), University of Ottawa, Ottawa, Ontario, Canada; Climate Change and Innovation Bureau, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada (Mss Tetzlaff and Gorman and Messrs Goulet, Richardson, and Enright); Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Ontario, Canada (Mr Enright); Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Meade); and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Kenny)
| | - Nicholas Goulet
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences (Ms Tetzlaff, Mr Goulet, and Drs Meade and Kenny) and Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences (Mr Goulet), University of Ottawa, Ottawa, Ontario, Canada; Climate Change and Innovation Bureau, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada (Mss Tetzlaff and Gorman and Messrs Goulet, Richardson, and Enright); Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Ontario, Canada (Mr Enright); Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Meade); and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Kenny)
| | - Melissa Gorman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences (Ms Tetzlaff, Mr Goulet, and Drs Meade and Kenny) and Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences (Mr Goulet), University of Ottawa, Ottawa, Ontario, Canada; Climate Change and Innovation Bureau, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada (Mss Tetzlaff and Gorman and Messrs Goulet, Richardson, and Enright); Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Ontario, Canada (Mr Enright); Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Meade); and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Kenny)
| | - Gregory R. A. Richardson
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences (Ms Tetzlaff, Mr Goulet, and Drs Meade and Kenny) and Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences (Mr Goulet), University of Ottawa, Ottawa, Ontario, Canada; Climate Change and Innovation Bureau, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada (Mss Tetzlaff and Gorman and Messrs Goulet, Richardson, and Enright); Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Ontario, Canada (Mr Enright); Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Meade); and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Kenny)
| | - Paddy M. Enright
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences (Ms Tetzlaff, Mr Goulet, and Drs Meade and Kenny) and Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences (Mr Goulet), University of Ottawa, Ottawa, Ontario, Canada; Climate Change and Innovation Bureau, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada (Mss Tetzlaff and Gorman and Messrs Goulet, Richardson, and Enright); Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Ontario, Canada (Mr Enright); Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Meade); and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Kenny)
| | - Robert D. Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences (Ms Tetzlaff, Mr Goulet, and Drs Meade and Kenny) and Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences (Mr Goulet), University of Ottawa, Ottawa, Ontario, Canada; Climate Change and Innovation Bureau, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada (Mss Tetzlaff and Gorman and Messrs Goulet, Richardson, and Enright); Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Ontario, Canada (Mr Enright); Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Meade); and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Kenny)
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences (Ms Tetzlaff, Mr Goulet, and Drs Meade and Kenny) and Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences (Mr Goulet), University of Ottawa, Ottawa, Ontario, Canada; Climate Change and Innovation Bureau, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada (Mss Tetzlaff and Gorman and Messrs Goulet, Richardson, and Enright); Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Ontario, Canada (Mr Enright); Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Meade); and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Kenny)
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Laurent AA, Vo L, Wong EY. Lessons Learned From Applying a Monitoring and Evaluation Framework to Economic, Social, and Other Health Impacts of the COVID-19 Pandemic. Public Health Rep 2024; 139:18-25. [PMID: 38031714 PMCID: PMC10905755 DOI: 10.1177/00333549231208489] [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] [Indexed: 12/01/2023] Open
Abstract
Individual and community-level COVID-19 mitigation policies can have effects beyond direct COVID-19 health outcomes, including social, behavioral, and economic outcomes. These social, behavioral, and economic outcomes can extend beyond the pandemic period and have disparate effects on populations. Public Health-Seattle & King County (PHSKC) built on the Centers for Disease Control and Prevention's community mitigation strategy framework to create a local project tracking near-real-time data to understand factors affected by mitigation approaches, inform decision-making, and monitor and evaluate community-level disparities during the pandemic. This case study describes the framework and lessons learned from PHSKC's collation, use, and dissemination of local data from 20 data sources to guide community and public health decision-making. Social, behavioral, economic, and health indicators were regularly updated and disseminated through interactive dashboards and products that examined data in the context of applicable policies. Data disaggregated by demographic characteristics and geography highlighted inequities, but not all datasets contained the same details; local surveys or qualitative data were used to fill gaps. Project outcomes included informing city and county emergency response planning related to implementation of financial and food assistance programs. Key lessons learned included the need to (1) build on existing processes and use automated processes and (2) partner with other sectors to use nontraditional public health data for active dissemination and data disaggregation and for real-time data contextualized by policy changes. This project provided programs and communities with timely, reliable data to understand where to invest recovery funding. A similar framework could position other health departments to examine social and economic effects during future public health emergencies.
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Affiliation(s)
| | - Linda Vo
- Office of the Associate Director for Policy and Strategy, Program Performance and Evaluation Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eva Y. Wong
- Public Health–Seattle & King County, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Kinney PL, Ge B, Sampath V, Nadeau K. Health-based strategies for overcoming barriers to climate change adaptation and mitigation. J Allergy Clin Immunol 2023; 152:1053-1059. [PMID: 37742936 DOI: 10.1016/j.jaci.2023.09.012] [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: 07/31/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/26/2023]
Abstract
Climate change poses an unequivocal threat to the respiratory health of current and future generations. Human activities-largely through the release of greenhouse gases-are driving rising global temperatures. Without a concerted effort to mitigate greenhouse gas emissions or adapt to the effects of a changing climate, each increment of warming increases the risk of climate hazards (eg, heat waves, floods, and droughts) that that can adversely affect allergy and immunologic diseases. For instance, wildfires, which release large quantities of particulate matter with a diameter of less than 2.5 μm (an air pollutant), occur with greater intensity, frequency, and duration in a hotter climate. This increases the risk of associated respiratory outcomes such as allergy and asthma. Fortunately, many mitigation and adaptation strategies can be applied to limit the impacts of global warming. Adaptation strategies, ranging from promotions of behavioral changes to infrastructural improvements, have been effectively deployed to increase resilience and alleviate adverse health effects. Mitigation strategies aimed at reducing greenhouse gas emissions can not only address the problem at the source but also provide numerous direct health cobenefits. Although it is possible to limit the impacts of climate change, urgent and sustained action must be taken now. The health and scientific community can play a key role in promoting and implementing climate action to ensure a more sustainable and healthy future.
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Affiliation(s)
- Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, Mass.
| | - Beverly Ge
- Department of Environmental Health, Boston University School of Public Health, Boston, Mass
| | - Vanitha Sampath
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston
| | - Kari Nadeau
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston
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Nassikas NJ, Gold DR. Climate change is a health crisis with opportunities for health care action: A focus on health care providers, patients with asthma and allergic immune diseases, and their families and neighbors. J Allergy Clin Immunol 2023; 152:1047-1052. [PMID: 37742937 PMCID: PMC10841871 DOI: 10.1016/j.jaci.2023.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023]
Abstract
Climate change has increased the frequency of extreme weather events and compounded natural disasters. Heat, wildfires, flooding, and pollen are already threatening public health and disproportionately affecting individuals in susceptible situations and vulnerable locations. In this theme issue of the Journal of Allergy and Clinical Immunology, we address what is known and not known about the biologic as well as clinical upstream and downstream effects of climate change on asthma and allergy development and exacerbation. We present potential actions that individuals can take at the family, neighborhood, community, health care system, and national and international levels to build climate resilience and protect their own health and the health and welfare of others. We emphasize the importance of actions and policies that are context specific and just. We emphasize the need for the health care system, which contributes between 3% and 5% of global greenhouse gas emissions, to reduce its carbon footprint and build resiliency. Health care providers play a pivotal role in helping policymakers understand the effects of climate on the health of our patients. There is still a window to avoid the most serious effects of climate change on human health and our planet.
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Affiliation(s)
- Nicholas J Nassikas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Mass.
| | - Diane R Gold
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
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NORI‐SARMA AMRUTA, WELLENIUS GREGORYA. Human Health and Well-being in a Warming World. Milbank Q 2023; 101:99-118. [PMID: 37096613 PMCID: PMC10126986 DOI: 10.1111/1468-0009.12608] [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: 06/22/2022] [Revised: 11/01/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points After decades of scientific progress and growth in academic literature, there is a recognition that climate change poses a substantial threat to the health and well-being of individuals and communities both in the United States and globally. Solutions to mitigate and adapt to climate change can have important health cobenefits. A vital component of these policy solutions is that they must also take into consideration historic issues of environmental justice and racism, and implementation of these policies must have a strong equity lens.
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Almuzaini Y, Alburayh M, Alahmari A, Alamri F, Sabbagh AY, Alsalamah M, Khan A. Mitigation strategies for heat-related illness during mass gatherings: Hajj experience. Front Public Health 2022; 10:957576. [PMID: 36062122 PMCID: PMC9433897 DOI: 10.3389/fpubh.2022.957576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/29/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction To mitigate morbidity, mortality, and impacts of heat-related illnesses (HRIs) on health, it was vital to implement a comprehensive framework for HRI prevention and control. A recognized tool from the field of trauma prevention known as the Haddon matrix was applied. The matrix states that any event is affected by three factors: host, agent, and environment. In addition, another recognized tool known as the combined model was used in this study. The combined model is a three-dimensional model that includes the idea for the three axes of Haddon's matrix with the methodology of the community risk reduction (CRR) model. Aim of the study To identify the environmental and individual risk factors of HRIs based on the Haddon matrix and the recommended prevention strategies by the CRR tool by using the combined model. Methodology An extensive literature review was conducted to assess all the risk factors associated with HRI, as well as preventive measures. Then the Haddon matrix was used to structure, separating human factors from technical and environmental details and timing. After that, the combined model was used to set all responses and mitigation measures for each element obtained from the Haddon matrix tool. Conclusion Projected increases in heat stress over the globe require the formulation and implementation of evidence-based HRI mitigation and preventive measures. In this study, we implemented the combined model that was utilized as a systematic strategy for the more theoretical framework of Haddon's matrix. Using the Haddon matrix to determine the HRI risk factors and the combined model to mitigate its impact was practical and helpful in planning, preparedness, and mitigating the HRIs during Hajj, provided a broad approach equivalent to the Swiss cheese model, and would facilitate an informed decision.
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Affiliation(s)
- Yasir Almuzaini
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Marriyah Alburayh
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Ahmed Alahmari
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Fahad Alamri
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Majid Alsalamah
- Department of Emergency Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Anas Khan
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Razzak JA, Agrawal P, Chand Z, Quraishy S, Ghaffar A, Hyder AA. Impact of community education on heat-related health outcomes and heat literacy among low-income communities in Karachi, Pakistan: a randomised controlled trial. BMJ Glob Health 2022; 7:bmjgh-2021-006845. [PMID: 35101860 PMCID: PMC8804631 DOI: 10.1136/bmjgh-2021-006845] [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: 07/08/2021] [Accepted: 01/03/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Extreme heat exposure is a growing public health concern. In this trial, we tested the impact of a community health worker (CHW) led heat education programme on all-cause mortality, unplanned hospital visits and changes in knowledge and practices in Karachi, Pakistan. METHODS The Heat Emergency Awareness and Treatment trial was a community-based, open-label, two-group, unblinded cluster-randomised controlled trial that implemented a CHW-led educational intervention between March and May 2018 in Karachi, Pakistan. We randomly assigned (1:1) 16 clusters, each with ~185 households or 1000 population, to the intervention or usual care (control group). We collected data on all-cause mortality, unplanned hospital visits, evidence of heat illness through surveillance and a knowledge and practice survey during the summer months of 2017 (preintervention) and 2018 (postintervention). FINDINGS We recruited 18 554 participants from 2991 households (9877 individuals (1593 households) in the control group and 8668 individuals (1398 households) in the intervention group). After controlling for temporal trends, there was a 38% (adjusted OR 0.62, 95% CI 0.49 to 0.77) reduction in hospital visits for any cause in the intervention group compared with the control group. In addition, there was an improvement in many areas of knowledge and practices, but there was no significant difference in all-cause mortality. INTERPRETATION A CHW-led community intervention was associated with decreased unscheduled hospital visits, improved heat literacy and practices but did not impact all-cause mortality. CHWs could play an essential role in preparing communities for extreme heat events. TRIAL REGISTRATION NUMBER NCT03513315.
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Affiliation(s)
- Junaid Abdul Razzak
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Priyanka Agrawal
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Zaheer Chand
- MLE Department, Aman Foundation, Karachi, Pakistan
| | - Saadia Quraishy
- MLE Department, Aman Foundation/West London Heath Trust, London, UK
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, World Health Organization, Geneve, Switzerland
| | - Adnan A Hyder
- MLE Department, George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA
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