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Khoshnaw LJ, Johnson RJ, Young SE. Ten tips on how to care for your CKD patients in episodes of extreme heat. Clin Kidney J 2024; 17:sfae156. [PMID: 38915434 PMCID: PMC11195633 DOI: 10.1093/ckj/sfae156] [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: 03/05/2024] [Indexed: 06/26/2024] Open
Abstract
Climate change is responsible for ≈75% of extreme heat events throughout the world. Heat events are associated with an increased risk for acute kidney injury, which contributes to the development of chronic kidney disease (CKD) and cardiovascular events. Patients with CKD are especially vulnerable to heat stress for a variety of reasons. A disproportionate percentage of patients with CKD live in poverty; experience homelessness, mental illness or disabilities; work outside or are elderly, all demographics that overlap with populations most susceptible to episodes of extreme heat. Therefore, it is reasonable to conclude that exposure to episodes of extreme heat can lead to the progression of CKD and increases morbidity and mortality. Given these concerns, clinicians must be prepared to promptly recognize complications of heat in CKD patients and to help patients appropriately acclimate. We propose the following tips for clinicians to effectively care for their CKD patients during extreme heat days.
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Affiliation(s)
- Laveen J Khoshnaw
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sarah E Young
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Mason HM, King JC, Peden AE, Leicht AS, Franklin RC. The impact of extreme heat on mass-gathering sporting events: Implications for Australia and other countries. J Sci Med Sport 2024:S1440-2440(24)00145-2. [PMID: 38796374 DOI: 10.1016/j.jsams.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/21/2024] [Accepted: 04/29/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVES As temperatures increase across the globe due to climate change, human exposure to extreme heat is a public health challenge. During sporting events, athletes, officials, spectators, and staff are at risk of heat stress and resulting illness. The objective of this review was to explore the impact of heat on the health outcomes of these groups and the wider health system and discuss implications for outdoor mass-gathering sporting events in Australia. DESIGN A systematic review was undertaken to identify literature published from 2010 to 2023. METHODS Seven databases were searched: Web of Science, SportDiscus, Scopus, Medline, CINAHL, Emcare, and PsychInfo, for relevant key search terms such as heatwave, heat stress, extreme heat, stadium, arena, sports facilit*, sport, athletic, and Olympic. An inductive thematic analysis was undertaken. Articles were quality checked using Joanna Briggs Institute critical appraisal tools and data were extracted, tabulated, and synthesized. RESULTS Forty papers were included in the final analysis: 17 quantitative, and 23 descriptive and qualitative (including reviews). Health outcomes explored across the literature included exertional heat illness, exertional heat stroke, hyperthermia, and general heat related illness. Six recommendation themes emerged: planning, mitigation strategies, medical, policy, research, and education. CONCLUSIONS The impact of heat on health outcomes during sporting events is significant, and should be considered by individuals, coaches, officials, and organizers before, during, and after mass-gathering sporting events. These findings can inform evidence-based preparedness strategies to protect the health of those attending and competing in mass-gathering sporting events now and into the future.
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Affiliation(s)
- Hannah M Mason
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia
| | - Jemma C King
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia
| | - Amy E Peden
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Anthony S Leicht
- Sport and Exercise Science, James Cook University, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Australia
| | - Richard C Franklin
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia.
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Bernhardt JM, Amiri A. Application of the socioecological model to mitigate risks of heat illness. Nurs Outlook 2024; 72:102150. [PMID: 38442464 DOI: 10.1016/j.outlook.2024.102150] [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: 11/29/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND The socio-ecological model (SEM) is a widely used framework that can be applied to heat-related illness (HRI) in the context of multiple influencing factors that exist in society. Leaders and policymakers must intervene to mitigate the deleterious effects of climate change on those at risk. PURPOSE The purpose is to introduce the SEM as a framework to address the complex factors contributing to the impact of excess heat. METHODS Conceived through the SEM, the compounding and cumulative impact of excess heat resulting in HRI is operationalized. DISCUSSION The SEM provides a structure for understanding the complex nature of climate change and HRI and proposed interventions. The prevention of HRI is dependent on actions, related to practice, education, research, and advocacy across multiple levels of the SEM. The SEM has the potential to target HRI at all levels of society to reduce the harm of excess heat.
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Affiliation(s)
- Jean M Bernhardt
- School of Nursing, MGH Institute of Health Professions, Charlestown, MA.
| | - Azita Amiri
- College of Nursing, The University of Alabama Huntsville, Huntsville, AL
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Corrente A, Pace MC, Fiore M. Climate change and human health: Last call to arms for us. World J Clin Cases 2024; 12:1870-1874. [PMID: 38660546 PMCID: PMC11036518 DOI: 10.12998/wjcc.v12.i11.1870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/03/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Climate change, now the foremost global health hazard, poses multifaceted challenges to human health. This editorial elucidates the extensive impact of climate change on health, emphasising the increasing burden of diseases and the exacerbation of health disparities. It highlights the critical role of the healthcare sector, particularly anaesthesia, in both contributing to and mitigating climate change. It is a call to action for the medical community to recognise and respond to the health challenges posed by climate change.
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Affiliation(s)
- Antonio Corrente
- Department of Anaesthesiology and Intensive Care Medicine, The Anastasia Guerriero Hospital, Marcianise 81025, Caserta, Italy
| | - Maria Caterina Pace
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Marco Fiore
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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Meltzer GY, Factor-Litvak P, Herbstman JB, Wylie BJ, Hernández D. Indoor Temperature and Energy Insecurity: Implications for Prenatal Health Disparities in Extreme Heat Events. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:35001. [PMID: 38446582 PMCID: PMC10917082 DOI: 10.1289/ehp13706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Extreme heat events are a major public health concern and are only expected to increase in intensity and severity as climate change continues to accelerate. Pregnant people are physiologically more vulnerable to the effects of extreme heat, and exposure can induce harm on both the pregnant person and the fetus. OBJECTIVES This commentary argues that there is a need for greater epidemiological research on indoor heat exposure and energy insecurity as potential drivers of maternal and child environmental health disparities. DISCUSSION While there is substantial evidence linking ambient (outdoor) high temperature to pregnancy-related outcomes, there is a lack of epidemiological evidence to date on pregnant people's exposure to high indoor temperature and adverse maternal and/or child health outcomes. Energy insecurity is disproportionately experienced by people with low incomes and/or people of color, and indoor temperature may play a role in shaping socioeconomic and racial/ethnic disparities in maternal and child health in the United States. Further research is needed to understand the relationship between indoor heat exposure, energy insecurity, and pregnancy outcomes in both parents and children and to inform potential policies and practices to enhance resilience and reduce maternal/child health disparities. https://doi.org/10.1289/EHP13706.
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Affiliation(s)
- Gabriella Y. Meltzer
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Blair J. Wylie
- Collaborative for Women's Environmental Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Diana Hernández
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
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Côté JN, Germain M, Levac E, Lavigne E. Vulnerability assessment of heat waves within a risk framework using artificial intelligence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169355. [PMID: 38123103 DOI: 10.1016/j.scitotenv.2023.169355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
Current efforts to adapt to climate change are not sufficient to reduce projected impacts. Vulnerability assessments are essential to allocate resources where they are needed most. However, current assessments that use principal component analysis suffer from multiple shortcomings and are hard to translate into concrete actions. To address these issues, this article proposes a novel data-driven vulnerability assessment within a risk framework. The framework is based on the definitions from the Sixth Assessment Report of the Intergovernmental Panel on Climate Change, but some definitions, such as sensitivity and adaptive capacity, are clarified. Heat waves that occurred between 2001 and 2018 in Quebec (Canada) are used to validate the framework. The studied impact is the daily mortality rates per cooling degree-days (CDD) region. A vulnerability map is produced to identify the distributions of summer mortality rates in aggregate dissemination areas within each CDD region. Socioeconomic and environmental variables are used to calculate impact and vulnerability. We compared abilities of AutoGluon (an AutoML framework), Gaussian process, and deep Gaussian process to model the impact and vulnerability. We offer advice on how to avoid common pitfalls with artificial intelligence and machine-learning algorithms. Gaussian process is a promising approach for supporting the proposed framework. SHAP values provide an explanation for the model results and are consistent with current knowledge of vulnerability. Recommendations are made to implement the proposed framework quantitatively or qualitatively.
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Affiliation(s)
- Jean-Nicolas Côté
- Department of Applied Geomatics, Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke J1K 2R1, Quebec, Canada.
| | - Mickaël Germain
- Department of Applied Geomatics, Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke J1K 2R1, Quebec, Canada
| | - Elisabeth Levac
- Department of Environment, Agriculture and Geography, Bishop's University, 2600 College St., Sherbrooke J1M 1Z7, Quebec, Canada
| | - Eric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Oberai M, Xu Z, Bach AJE, Phung D, Watzek JT, Rutherford S. Preparing for a hotter climate: A systematic review and meta-analysis of heatwaves and ambulance callouts in Australia. Aust N Z J Public Health 2024; 48:100115. [PMID: 38286717 DOI: 10.1016/j.anzjph.2023.100115] [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: 08/20/2023] [Revised: 11/05/2023] [Accepted: 11/21/2023] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE The objective of this study was to quantify the impact of heatwaves on likelihood of ambulance callouts for Australia. METHODS A systematic review and meta-analysis was conducted to retrieve and synthesise evidence published from 1 January 2011 to 31 May 2023 about the association between heatwaves and the likelihood of ambulance callouts in Australia. Different heatwave definitions were used ranging from excess heat factor to heatwave defined as a continuous period with temperatures above certain defined thresholds (which varied based on study locations). RESULTS We included nine papers which met the inclusion criteria for the review. Eight were eligible for the meta-analyses. The multilevel meta-analyses revealed that the likelihood of ambulance callouts for all causes and for cardiovascular diseases increased by 10% (95% confidence interval: 8%, 13%) and 5% (95% confidence interval: 1%, 3%), respectively, during heatwave days. CONCLUSIONS Exposure to heatwaves is associated with an increased likelihood of ambulance callouts, and there is a dose-response association between heatwave severity and the likelihood of ambulance callouts. IMPLICATIONS FOR PUBLIC HEALTH The number of heatwave days are going to increase, and this will mean an increase in the likelihood of ambulance callouts, thereby, spotlighting the real burden that heatwaves place on our already stressed healthcare system. The findings of this study underscore the critical need for proactive measures, including the establishment of research initiatives and holistic heat health awareness campaigns, spanning from the individual and community levels to the healthcare system, in order to create a more resilient Australia in the face of heatwave-related challenges.
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Affiliation(s)
- Mehak Oberai
- School of Medicine and Dentistry, Griffith University, Australia.
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Australia; Cities Research Institute, Griffith University, Australia
| | - Aaron J E Bach
- School of Medicine and Dentistry, Griffith University, Australia; Cities Research Institute, Griffith University, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Australia
| | - Jessica T Watzek
- School of Medicine and Dentistry, Griffith University, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Australia; Cities Research Institute, Griffith University, Australia
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Ashe N, Wozniak S, Conner M, Ahmed R, Demetres MR, Makarem N, Tehranifar P, Nandakumar R, Ghosh A. Association of extreme heat events with sleep and cardiovascular health: A scoping review. RESEARCH SQUARE 2023:rs.3.rs-3678410. [PMID: 38196642 PMCID: PMC10775383 DOI: 10.21203/rs.3.rs-3678410/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Extreme heat events (EHEs), driven by anthropogenic climate change, exacerbate the risk of cardiovascular disease (CVD), although the underlying mechanisms are unclear. Disturbances in sleep health, caused by excessive heat, may be one way EHEs increase the risk of incident or recurrent CVD. Our objective was to systematically review the empirical peer-reviewed literature on the relationship between EHEs, sleep health, and cardiovascular measures and outcomes, and narratively describe methodologies, evidence, and gaps in this area. METHODS A comprehensive literature search was performed in the following databases from inception - June 2023: Ovid MEDLINE, Ovid EMBASE, CINAHL, Web of Science and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. RESULTS Of the 2035 records screened, three studies met the inclusion criteria. Cardiovascular (CV) measures described included blood pressure (BP), heart rate (HR), and HR variability (no CVD outcomes were described) and objective and subjective measurements of sleep health outcomes included sleep duration, calmness, ease of falling asleep, ease of awakening, freshness after awakening, and sleep satisfaction. Two studies were controlled trials, and one was a cohort study. During EHEs, individuals slept for shorter periods of time and less efficiently, with greater degrees of HR variability in two of the three studies lasting at most 1-2 days; BP (both systolic and diastolic) significantly decreased during EHEs in two of the studies. No formal assessment of a mediating relationship between EHE exposure, sleep outcomes, and the CV measures was undertaken. CONCLUSIONS There is a paucity of data that examines the link between CVD, sleep, and extreme heat as a possible mechanism of elevated CVD risk during EHEs, despite a strong physiological rationale. Further research is needed to empirically test this relationship rigorously as EHEs become more frequent and their deleterious impacts of health increase.
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Affiliation(s)
- Nathan Ashe
- Weill Cornell Medical College: Weill Cornell Medicine
| | - Sarah Wozniak
- Weill Cornell Medical College: Weill Cornell Medicine
| | - Malcom Conner
- Weill Cornell Medical College: Weill Cornell Medicine
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Achebak H, Garcia-Aymerich J, Rey G, Chen Z, Méndez-Turrubiates RF, Ballester J. Ambient temperature and seasonal variation in inpatient mortality from respiratory diseases: a retrospective observational study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 35:100757. [PMID: 38115961 PMCID: PMC10730325 DOI: 10.1016/j.lanepe.2023.100757] [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: 06/29/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 12/21/2023]
Abstract
Background The seasonal fluctuation in mortality and hospital admissions from respiratory diseases, with a winter peak and a summer trough, is widely recognized in extratropical countries. However, little is known about the seasonality of inpatient mortality and the role of ambient temperature remains uncertain. We aimed to analyse the association between ambient temperature and in-hospital mortality from respiratory diseases in the provinces of Madrid and Barcelona, Spain. Methods We used data on daily hospitalisations, weather (ie, temperature and relative humidity) and air pollutants (ie, PM2.5, PM10, NO2 and O3) for the Spanish provinces of Madrid and Barcelona during 2006-2019. We applied a daily time-series quasi-Poisson regression in combination with distributed lag non-linear models (DLNM) to assess, on the one hand, the seasonal variation in fatal hospitalisations and the contribution of ambient temperature, and on the other hand, the day-to-day association between temperature and fatal hospital admissions. The analyses were stratified by sex, age and primary diagnostic of hospitalisation. Findings The study analysed 1 710 012 emergency hospital admissions for respiratory diseases (mean [SD] age, 60.4 [31.0] years; 44.2% women), from which 103 845 resulted in in-hospital death (81.4 [12.3] years; 45.1%). We found a strong seasonal fluctuation in in-hospital mortality from respiratory diseases. While hospital admissions were higher during the cold season, the maximum incidence of inpatient mortality was during the summer and was strongly related to high temperatures. When analysing the day-to-day association between temperature and in-hospital mortality, we only found an effect for high temperatures. The relative risk (RR) of fatal hospitalisation at the 99th percentile of the distribution of daily temperatures vs the minimum mortality temperature (MMT) was 1.395 (95% eCI: 1.211-1.606) in Madrid and 1.612 (1.379-1.885) in Barcelona. In terms of attributable burden, summer temperatures (June-September) were responsible for 16.2% (8.8-23.3) and 22.3% (15.4-29.2) of overall fatal hospitalisations from respiratory diseases in Madrid and Barcelona, respectively. Women were more vulnerable to heat than men, whereas the results by diagnostic of admission showed heat effects for acute bronchitis and bronchiolitis, pneumonia and respiratory failure. Interpretation Unless effective adaptation measures are taken in hospital facilities, climate warming could exacerbate the burden of inpatient mortality from respiratory diseases during the warm season. Funding European Research Council Consolidator Grant EARLY-ADAPT, European Research Council Proof-of-Concept Grants HHS-EWS and FORECAST-AIR.
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Affiliation(s)
- Hicham Achebak
- Inserm, France Cohortes, Paris, France
- ISGlobal, Barcelona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Forzano F, Babb de Villiers C, Farley M, Fowler H, Taylor RW. A genomic perspective on climate change. EBioMedicine 2023; 98:104871. [PMID: 37944272 PMCID: PMC10641736 DOI: 10.1016/j.ebiom.2023.104871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- Francesca Forzano
- Clinical Genetics Department, Guy's and St Thomas NHS Foundation Trust, London SE1 9RT, UK.
| | | | - Martin Farley
- Sustainable UCL, University College London (UCL), London SE1 9RT, UK; Green Lab Associates, UK
| | - Hayley Fowler
- Centre for Climate and Environmental Resilience, Newcastle University, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
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Wedmore F, Nolan T, Watts N. Sustainable practice: what can I do? BMJ 2023; 383:2461. [PMID: 37931936 DOI: 10.1136/bmj.p2461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Affiliation(s)
| | | | - Nick Watts
- Centre for Sustainable Medicine, National University of Singapore, Singapore
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Sapari H, Selamat MI, Isa MR, Ismail R, Wan Mahiyuddin WR. The Impact of Heat Waves on Health Care Services in Low- or Middle-Income Countries: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e44702. [PMID: 37843898 PMCID: PMC10616749 DOI: 10.2196/44702] [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: 12/04/2022] [Revised: 06/02/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce. OBJECTIVE This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs. METHODS We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity. RESULTS This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs. CONCLUSIONS The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities. TRIAL REGISTRATION PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44702.
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Affiliation(s)
- Hadita Sapari
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Ikhsan Selamat
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Rodi Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
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Barnett-Itzhaki Z, Sar-Shalom A, Cohn L, Chen L, Steinitz O. The effect of heatwaves on the number of visits to national parks and reserves. PLoS One 2023; 18:e0289201. [PMID: 37556414 PMCID: PMC10411752 DOI: 10.1371/journal.pone.0289201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Climate change is leading to an increase in the frequency and intensity of heatwaves in many regions of the world. Climate change is also related to air pollution. Both heatwaves and air pollution have adverse health effects, and can also affect social behaviors, including tourism and touristic activities. The aim of this study was to examine the association between heatwaves, air pollution and visits to national parks and reserves in Israel. METHODS Data on 68,518 visits in 51 national parks and reserves in Israel in the years 2016-2019 was crossed with temperature and air pollution data (represented by particulate matter PM10) and analyzed using statistical tests. RESULTS Number of visits, as a function of temperature followed a unimodal distribution, in which more visits were reported on mild temperature days (in comparison to hot or cold days). In addition, the number of visits in sites with beaches was linearly correlated with temperature. Negative associations were found between number of visits and heatwaves, and between number of visits and exceedances in PM10 levels. CONCLUSIONS Heatwaves were shown to have a negative effect on the number of visits in national parks and reserves in Israel. The negative association between exceedances in air pollution and number of visits may be mediated by the positive correlation between air pollution exceedance events and heatwaves.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel
- Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel
| | | | - Liav Cohn
- Ruppin Academic Center, Emek Hefer, Israel
| | - Lior Chen
- Israel Nature and Parks Authority, Jerusalem, Israel
| | - Ofer Steinitz
- Israel Nature and Parks Authority, Jerusalem, Israel
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