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Robinson Y, Khorram-Manesh A, Arvidsson N, Sinai C, Taube F. Does climate change transform military medicine and defense medical support? Front Public Health 2023; 11:1099031. [PMID: 37213601 PMCID: PMC10194660 DOI: 10.3389/fpubh.2023.1099031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
Background Climate change has effects on multiple aspects of human life, such as access to food and water, expansion of endemic diseases as well as an increase of natural disasters and related diseases. The objective of this review is to summarize the current knowledge on climate change effects on military occupational health, military healthcare in a deployed setting, and defense medical logistics. Methods Online databases and registers were searched on August 22nd, 2022 and 348 papers retrieved, published between 2000 and 2022, from which we selected 8 publications that described climate effects on military health. Papers were clustered according to a modified theoretical framework for climate change effects on health, and relevant items from each paper were summarized. Results During the last decades a growing body of climate change related publications was identified, which report that climate change has a significant impact on human physiology, mental health, water- and vector borne infectious diseases, as well as air pollution. However, regarding the specific climate effects on military health the level of evidence is low. The effects on defense medical logistics include vulnerabilities in the cold supply chain, in medical devices functioning, in need for air conditioning, and in fresh water supply. Conclusions Climate change may transform both the theoretical framework and practical implementations in military medicine and military healthcare systems. There are significant knowledge gaps on climate change effects on the health of military personnel in operations of both combat and non-combat nature, alerting the need for prevention and mitigation of climate-related health issues. Further research within the fields of disaster and military medicine is needed to explore this novel field. As climate effects on humans and the medical supply chain may degrade military capability, significant investments in military medical research and development are needed.
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Affiliation(s)
- Yohan Robinson
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
- *Correspondence: Yohan Robinson
| | | | - Niclas Arvidsson
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
| | - Cave Sinai
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
| | - Fabian Taube
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
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Hodgson JR, Chapman L, Pope FD. Amateur runners more influenced than elite runners by temperature and air pollution during the UK's Great North Run half marathon. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 842:156825. [PMID: 35752238 DOI: 10.1016/j.scitotenv.2022.156825] [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: 04/10/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
The short- and long-term impacts of air pollution on human health are well documented and include cardiovascular, neurological, immune system and developmental damage. Additionally, the irritant qualities of air pollutants can cause respiratory and cardiovascular distress. This can be heightened during exercise and especially so for those with respiratory conditions such as asthma. Meteorological conditions have also been shown to adversely impact athletic performance; but research has mostly examined the impact of pollution and meteorology on marathon times or running under laboratory settings. This study focuses on the half marathon distance (13.1 miles/21.1 km) and utilises the Great North Run held in Newcastle-upon-Tyne, England, between 2006 and 2019. Local meteorological (temperature, relative humidity, heat index and wind speed) and air quality (ozone, nitrogen dioxide and PM2.5) data is used in conjunction with finishing times of the quickest and slowest amateur participants, along with the elite field, to determine the extent to which each group is influenced in real-world conditions. Results show that increased temperatures, heat index and ozone concentrations are significantly detrimental to amateur half marathon performances. The elite field meanwhile is influenced by higher ozone concentrations. It is thought that the increased exposure time to the environmental conditions contributes to this greater decrease in performance for the slowest participants. For elite athletes that are performing closer to their maximal capacity (VO2 max), the higher ozone concentrations likely results in respiratory irritation and decreased performance. Nitrogen dioxide and PM2.5 pollution showed no significant relationship with finishing times. These results provide additional insight into the environmental effects on exercise, which is particularly important under the increasing effects climate change and regional air pollution. This study can be used to inform event organisation and start times for both mass participation and major elite events with the aim to reduce heat- and pollution-related incidents.
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Affiliation(s)
- James R Hodgson
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Lee Chapman
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Francis D Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom.
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Tanaka H, Kinoshi T, Tanaka S, Sagisaka R, Takahashi H, Sone E, Hara T, Takeda Y, Takyu H. Prehospital interventions and neurological outcomes in marathon-related sudden cardiac arrest using a rapid mobile automated external defibrillator system in Japan: a prospective observational study. Br J Sports Med 2022; 56:bjsports-2021-104964. [PMID: 35589377 DOI: 10.1136/bjsports-2021-104964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe neurological outcomes after sudden cardiac arrests (SCAs) in road and long-distance races using a rapid mobile automated external defibrillator system (RMAEDS) intervention. METHODS A total of 42 SCAs from 3 214 701 runners in 334 road and long-distance races from 1 February 2007 to 29 February 2020 were examined. Demographics, SCA interventions, EMS-related data and SCA-related outcomes were measured. Primary endpoints were favourable neurological outcomes (Cerebral Performance Categories 1-2) at 1-month and 1-year post-SCA. Secondary endpoints were factors related to the field return of spontaneous circulation (ROSC) and resuscitation characteristics, including the initial ECG waveform classification and resuscitation sequence times according to the initial ECG rhythm. RESULTS The SCA incidence rate was 1.31 per 100 000 runners (age: median (IQR), 51 (36.5, 58.3) years). Field ROSC and full neurological recovery at 1-month post-SCA was achieved 90.4% and 92.9% of cases, respectively. In 22 cases in which bystander cardiopulmonary resuscitation was initiated within 1 min and defibrillation performed within 3 min, full neurological recovery was achieved at 1-month and 1-year post-SCA in 95.5.% and 95.5% of cases, respectively. CONCLUSIONS The RMAEDS successfully treated patients with SCA during road and long-distance races yielding a high survival rate and favourable neurological outcomes. These findings support rapid intervention and the proper placement of healthcare teams along the race course to initiate chest compressions within 1 min and perform defibrillation within 3 min.
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Affiliation(s)
- Hideharu Tanaka
- Department of Sports Medicine, Kokushikan University, Tama, Tokyo, Japan
- Research Institute of Disaster Management and EMS, Kokushikan University, Tama, Tokyo, Japan
- Graduate School of Emergency Medical System, Kokushikan University, Tama, Tokyo, Japan
| | - Tomoya Kinoshi
- Department of Sports Medicine, Kokushikan University, Tama, Tokyo, Japan
- Research Institute of Disaster Management and EMS, Kokushikan University, Tama, Tokyo, Japan
- Graduate School of Emergency Medical System, Kokushikan University, Tama, Tokyo, Japan
| | - Shota Tanaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Tama, Tokyo, Japan
- School of Medicine, Tokai University, Isehara, Kanagawa, Japan
| | - Ryo Sagisaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Tama, Tokyo, Japan
- Department of Integrated Science and Engineering for Sustainable Societies, Chuo University, Bunkyo-ku, Tokyo, Japan
| | - Hiroyuki Takahashi
- Department of Sports Medicine, Kokushikan University, Tama, Tokyo, Japan
- Research Institute of Disaster Management and EMS, Kokushikan University, Tama, Tokyo, Japan
- Graduate School of Emergency Medical System, Kokushikan University, Tama, Tokyo, Japan
| | - Etsuko Sone
- Research Institute of Disaster Management and EMS, Kokushikan University, Tama, Tokyo, Japan
| | - Takahiro Hara
- Graduate School of Emergency Medical System, Kokushikan University, Tama, Tokyo, Japan
| | - Yui Takeda
- Department of Sports and Health Management, Jobu University, Isesaki, Gunma, Japan
| | - Hiroshi Takyu
- Department of Sports Medicine, Kokushikan University, Tama, Tokyo, Japan
- Graduate School of Emergency Medical System, Kokushikan University, Tama, Tokyo, Japan
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[Medical emergencies during running events]. Notf Rett Med 2021; 26:189-198. [PMID: 34873391 PMCID: PMC8637507 DOI: 10.1007/s10049-021-00959-w] [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] [Accepted: 10/14/2021] [Indexed: 11/17/2022]
Abstract
Hintergrund Die Anzahl an kurz- und langstreckigen Laufveranstaltungen in Deutschland nimmt zu. Laufen als Breitensport wird von einer Vielzahl an Personen unterschiedlicher Altersklassen, Risikogruppen und Professionalisierungsgrade betrieben, woraus ein breites Spektrum medizinischer Notfälle resultiert. Ziel der Arbeit Der vorliegende Beitrag erläutert die Inzidenz, Pathophysiologie und Therapie relevanter Notfallbilder bei Laufveranstaltungen. Ziel ist die Optimierung der Arbeitsabläufe des Rettungsdienstpersonals. Material und Methoden Es erfolgte eine Literaturrecherche in PubMed. Ergebnisse Anstrengungsassoziierte Muskelkrämpfe, gastrointestinale Symptome, Kollaps, Kompartmentsyndrom und Tendinopathien sind häufige Erscheinungsbilder und resultieren meist aus akuter oder chronischer Überanstrengung. Der Kreislaufstillstand bzw. plötzliche Herztod ist ein seltenes Ereignis bei Laufveranstaltungen. Bewusstseinsstörungen und generalisierte Krampfanfälle sind schwerwiegende Komplikationen. Disseminierte intravasale Koagulopathie, belastungsinduzierte Hyponatriämie, Hitzschlag, Rhabdomyolyse und thromboembolische Ereignisse sind mit hoher Morbidität und Mortalität verbunden. Substanzen zur Erhöhung der Schmerzschwelle und leistungssteigernde Substanzen sind unter Läufern stark verbreitet und gehen mit einer hohen Rate an Nebenwirkungen einher. Diskussion Unspezifische Symptome wie Erbrechen, Fieber, Kollaps, Muskelschmerzen, Übelkeit, und Schwäche sind die führenden Symptome bei Laufveranstaltungen. Eine sorgfältige Anamnese ist wegweisend für eine zielgerichtete klinische Therapie. Präklinisch steht eine Symptomkontrolle im Mittelpunkt. Das Flüssigkeitsmanagement stellt eine besondere Herausforderung dar.
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Gerasimuk D, Malchrowicz-Mośko E, Stanula A, Bezuglov E, Achkasov E, Swinarew A, Waśkiewicz Z. Age-Related Differences in Motivation of Recreational Runners, Marathoners, and Ultra-Marathoners. Front Psychol 2021; 12:738807. [PMID: 34803819 PMCID: PMC8604017 DOI: 10.3389/fpsyg.2021.738807] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: This study was aimed to investigate the influence of age on the motivations of various types of runners, namely, marathoners, ultra-marathoners, and non-starters. Methods: A total of 1,537 runners including 380 women (24.7%) and 1,157 men (75.3%) took part in the diagnostic survey and completed the motivations of marathoners’ scales questionnaire (MOMS). The effect sizes were estimated. Results: The article presents several statistically significant differences in the impact of age on the motivations of runners in different categories and compares the motivations of marathon runners, ultramarathon runners, and non-starters. The results show that young non-starters decide to run for personal goal achievement, and for both marathon and ultramarathon runners, recognition and competition are important. However, for older people in all groups (non-starters, marathoners, and ultramarathoners), personal goal achievement is of the least importance. Among the oldest runners, the most important motives were self-esteem for non-starters and health orientation for marathoners and ultramarathoners.
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Affiliation(s)
- Dagmara Gerasimuk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Ewa Malchrowicz-Mośko
- Faculty of Sport Sciences, Eugeniusz Piasecki Academy of Physical Education, Poznań, Poland
| | - Arkadiusz Stanula
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Eduard Bezuglov
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Evgenij Achkasov
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrzej Swinarew
- Institute of Materials Science, Faculty of Computer Science and Materials Science, University of Silesia, Chorzów, Poland
| | - Zbigniew Waśkiewicz
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.,Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Hodgson JR, Chapman L, Pope FD. The Diamond League athletic series: does the air quality sparkle? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1427-1442. [PMID: 33760979 PMCID: PMC7988253 DOI: 10.1007/s00484-021-02114-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/08/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Urban air pollution can have negative short- and long-term impacts on health, including cardiovascular, neurological, immune system and developmental damage. The irritant qualities of pollutants such as ozone (O3), nitrogen dioxide (NO2) and particulate matter (PM) can cause respiratory and cardiovascular distress, which can be heightened during physical activity and particularly so for those with respiratory conditions such as asthma. Previously, research has only examined marathon run outcomes or running under laboratory settings. This study focuses on elite 5-km athletes performing in international events at nine locations. Local meteorological and air quality data are used in conjunction with race performance metrics from the Diamond League Athletics series to determine the extent to which elite competitors are influenced during maximal sustained efforts in real-world conditions. The findings from this study suggest that local meteorological variables (temperature, wind speed and relative humidity) and air quality (ozone and particulate matter) have an impact on athletic performance. Variation between finishing times at different race locations can also be explained by the local meteorology and air quality conditions seen during races.
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Affiliation(s)
- James R Hodgson
- School of Geography, Earth and Environmental Sciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Lee Chapman
- School of Geography, Earth and Environmental Sciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Francis D Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
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