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Mandal S, Rajiva A, Kloog I, Menon JS, Lane KJ, Amini H, Walia GK, Dixit S, Nori-Sarma A, Dutta A, Sharma P, Jaganathan S, Madhipatla KK, Wellenius GA, de Bont J, Venkataraman C, Prabhakaran D, Prabhakaran P, Ljungman P, Schwartz J. Nationwide estimation of daily ambient PM 2.5 from 2008 to 2020 at 1 km 2 in India using an ensemble approach. PNAS Nexus 2024; 3:pgae088. [PMID: 38456174 PMCID: PMC10919890 DOI: 10.1093/pnasnexus/pgae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/16/2024] [Indexed: 03/09/2024]
Abstract
High-resolution assessment of historical levels is essential for assessing the health effects of ambient air pollution in the large Indian population. The diversity of geography, weather patterns, and progressive urbanization, combined with a sparse ground monitoring network makes it challenging to accurately capture the spatiotemporal patterns of ambient fine particulate matter (PM2.5) pollution in India. We developed a model for daily average ambient PM2.5 between 2008 and 2020 based on monitoring data, meteorology, land use, satellite observations, and emissions inventories. Daily average predictions at each 1 km × 1 km grid from each learner were ensembled using a Gaussian process regression with anisotropic smoothing over spatial coordinates, and regression calibration was used to account for exposure error. Cross-validating by leaving monitors out, the ensemble model had an R2 of 0.86 at the daily level in the validation data and outperformed each component learner (by 5-18%). Annual average levels in different zones ranged between 39.7 μg/m3 (interquartile range: 29.8-46.8) in 2008 and 30.4 μg/m3 (interquartile range: 22.7-37.2) in 2020, with a cross-validated (CV)-R2 of 0.94 at the annual level. Overall mean absolute daily errors (MAE) across the 13 years were between 14.4 and 25.4 μg/m3. We obtained high spatial accuracy with spatial R2 greater than 90% and spatial MAE ranging between 7.3-16.5 μg/m3 with relatively better performance in urban areas at low and moderate elevation. We have developed an important validated resource for studying PM2.5 at a very fine spatiotemporal resolution, which allows us to study the health effects of PM2.5 across India and to identify areas with exceedingly high levels.
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Affiliation(s)
- Siddhartha Mandal
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, New Delhi 110017, India
| | - Ajit Rajiva
- Public Health Foundation of India, New Delhi 110017, India
| | - Itai Kloog
- Department of Environmental, Geoinformatics and Urban Planning Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel
| | - Jyothi S Menon
- Public Health Foundation of India, New Delhi 110017, India
| | - Kevin J Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Heresh Amini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gagandeep K Walia
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, New Delhi 110017, India
| | - Shweta Dixit
- Public Health Foundation of India, New Delhi 110017, India
| | - Amruta Nori-Sarma
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Anubrati Dutta
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, New Delhi 110017, India
| | - Praggya Sharma
- Centre for Chronic Disease Control, New Delhi 110016, India
| | - Suganthi Jaganathan
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, New Delhi 110017, India
- Institute of Environmental Medicine, Karolinska Institute, Stockholm 17177, Sweden
| | - Kishore K Madhipatla
- Center for Atmospheric Particle Sciences, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institute, Stockholm 17177, Sweden
| | - Chandra Venkataraman
- Department of Chemical Engineering, Indian Institute of Technology Bombay, Mumbai 400076, India
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, New Delhi 110017, India
| | - Poornima Prabhakaran
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, New Delhi 110017, India
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institute, Stockholm 17177, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm 18257, Sweden
| | - Joel Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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de Bont J, Nori-Sarma A, Stafoggia M, Banerjee T, Ingole V, Jaganathan S, Mandal S, Rajiva A, Krishna B, Kloog I, Lane K, Mall RK, Tiwari A, Wei Y, Wellenius GA, Prabhakaran D, Schwartz J, Prabhakaran P, Ljungman P. Impact of heatwaves on all-cause mortality in India: A comprehensive multi-city study. Environ Int 2024; 184:108461. [PMID: 38340402 DOI: 10.1016/j.envint.2024.108461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Heatwaves are expected to increase with climate change, posing a significant threat to population health. In India, with the world's largest population, heatwaves occur annually but have not been comprehensively studied. Accordingly, we evaluated the association between heatwaves and all-cause mortality and quantifying the attributable mortality fraction in India. METHODS We obtained all-cause mortality counts for ten cities in India (2008-2019) and estimated daily mean temperatures from satellite data. Our main extreme heatwave was defined as two-consecutive days with an intensity above the 97th annual percentile. We estimated city-specific heatwave associations through generalised additive Poisson regression models, and meta-analysed the associations. We reported effects as the percentage change in daily mortality, with 95% confidence intervals (CI), comparing heatwave vs non-heatwave days. We further evaluated heatwaves using different percentiles (95th, 97th, 99th) for one, two, three and five-consecutive days. We also evaluated the influence of heatwave duration, intensity and timing in the summer season on heatwave mortality, and estimated the number of heatwave-related deaths. FINDINGS Among ∼ 3.6 million deaths, we observed that temperatures above 97th percentile for 2-consecutive days was associated with a 14.7 % (95 %CI, 10.3; 19.3) increase in daily mortality. Alternative heatwave definitions with higher percentiles and longer duration resulted in stronger relative risks. Furthermore, we observed stronger associations between heatwaves and mortality with higher heatwave intensity. We estimated that around 1116 deaths annually (95 %CI, 861; 1361) were attributed to heatwaves. Shorter and less intense definitions of heatwaves resulted in a higher estimated burden of heatwave-related deaths. CONCLUSIONS We found strong evidence of heatwave impacts on daily mortality. Longer and more intense heatwaves were linked to an increased mortality risk, however, resulted in a lower burden of heatwave-related deaths. Both definitions and the burden associated with each heatwave definition should be incorporated into planning and decision-making processes for policymakers.
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Affiliation(s)
- Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Amruta Nori-Sarma
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, United States
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service /ASL Roma 1, Rome, Italy
| | - Tirthankar Banerjee
- Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India
| | - Vijendra Ingole
- Office for National Statistics, Wales, Newport, United Kingdom
| | - Suganthi Jaganathan
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Chronic Disease Control, New Delhi, India; Ashoka University, Sonipat, India
| | - Siddhartha Mandal
- Centre for Chronic Disease Control, New Delhi, India; Ashoka University, Sonipat, India
| | - Ajit Rajiva
- Centre for Chronic Disease Control, New Delhi, India; Ashoka University, Sonipat, India
| | | | - Itai Kloog
- Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin Lane
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, United States
| | - Rajesh K Mall
- DST-Mahamana Center of Excellence in Climate Change Research, Institute of Environment and Sustainable Futures Collaborative, New Delhi, India
| | | | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gregory A Wellenius
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, United States
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India; Ashoka University, Sonipat, India
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Poornima Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India; Ashoka University, Sonipat, India
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
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Nori-Sarma A, Anderson GB, Rajiva A, ShahAzhar G, Gupta P, Pednekar MS, Son JY, Peng RD, Bell ML. The impact of heat waves on mortality in Northwest India. Environ Res 2019; 176:108546. [PMID: 31247430 DOI: 10.1016/j.envres.2019.108546] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/16/2019] [Accepted: 06/17/2019] [Indexed: 06/09/2023]
Abstract
Heat waves are anticipated to worsen with climate change. India, an understudied area with >15% of the world's population, commonly experiences temperature extremes and already resembles potential future climates of more temperate regions. Registry data from local municipal corporations and government offices were collected and translated, yielding daily all-cause mortality for 4 communities in Northwest India for all or part of the period 2000-2012. Heat waves were defined as ≥2 days with local temperature ≥97th percentile for that community. An alternate definition matching that used by the Indian Meteorological Department was also developed, to enhance policy relevance. Community-specific average daily maximum temperature over the entire record ranged from 32.5 to 34.2 °C (90.5-93.6 °F). Across communities, total mortality increased 18.1% during heat wave days compared with non-heat-wave days [95% confidence interval (CI): -5.3%, 47.3%], with the highest risk in Jaipur (29.9% [95% CI: 24.6%, 34.9%]). Evidence of effect modification by heat wave characteristics (intensity, duration, and timing in season) was limited. Findings indicate health risks associated with heat waves in communities with high baseline temperatures. Results can inform heat wave-health assessments in temperate regions in future, and improve our understanding of temperature-health associations under climate change. Further investigation of potential effect modification by heat wave characteristics is needed.
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Affiliation(s)
- Amruta Nori-Sarma
- Yale School of Forestry & Environmental Studies, New Haven, CT, USA.
| | - G Brooke Anderson
- Department of Environmental & Radiological Health Sciences, Colorado State University, Ft. Collins, CO, USA
| | - Ajit Rajiva
- Yale School of Forestry & Environmental Studies, New Haven, CT, USA
| | | | - Prakash Gupta
- Healis-Sekhsaria Institute of Public Health, Navi Mumbai, Maharashtra, India
| | - Mangesh S Pednekar
- Healis-Sekhsaria Institute of Public Health, Navi Mumbai, Maharashtra, India
| | - Ji-Young Son
- Yale School of Forestry & Environmental Studies, New Haven, CT, USA
| | - Roger D Peng
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michelle L Bell
- Yale School of Forestry & Environmental Studies, New Haven, CT, USA
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Nori-Sarma A, Benmarhnia T, Rajiva A, Azhar GS, Gupta P, Pednekar MS, Bell ML. Advancing our Understanding of Heat Wave Criteria and Associated Health Impacts to Improve Heat Wave Alerts in Developing Country Settings. Int J Environ Res Public Health 2019; 16:ijerph16122089. [PMID: 31200449 PMCID: PMC6617133 DOI: 10.3390/ijerph16122089] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/01/2019] [Accepted: 06/07/2019] [Indexed: 11/24/2022]
Abstract
Health effects of heat waves with high baseline temperatures in areas such as India remain a critical research gap. In these regions, extreme temperatures may affect the underlying population’s adaptive capacity; heat wave alerts should be optimized to avoid continuous high alert status and enhance constrained resources, especially under a changing climate. Data from registrars and meteorological departments were collected for four communities in Northwestern India. Propensity Score Matching (PSM) was used to obtain the relative risk of mortality and number of attributable deaths (i.e., absolute risk which incorporates the number of heat wave days) under a variety of heat wave definitions (n = 13) incorporating duration and intensity. Heat waves’ timing in season was also assessed for potential effect modification. Relative risk of heat waves (risk of mortality comparing heat wave days to matched non-heat wave days) varied by heat wave definition and ranged from 1.28 [95% Confidence Interval: 1.11–1.46] in Churu (utilizing the 95th percentile of temperature for at least two consecutive days) to 1.03 [95% CI: 0.87–1.23] in Idar and Himmatnagar (utilizing the 95th percentile of temperature for at least four consecutive days). The data trended towards a higher risk for heat waves later in the season. Some heat wave definitions displayed similar attributable mortalities despite differences in the number of identified heat wave days. These findings provide opportunities to assess the “efficiency” (or number of days versus potential attributable health impacts) associated with alternative heat wave definitions. Findings on both effect modification and trade-offs between number of days identified as “heat wave” versus health effects provide tools for policy makers to determine the most important criteria for defining thresholds to trigger heat wave alerts.
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Affiliation(s)
- Amruta Nori-Sarma
- Yale School of Forestry & Environmental Studies, New Haven, CT 06511, USA.
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health and Scripps Institute of Oceanography, University of California at San Diego, La Jolla, CA 92093, USA.
| | - Ajit Rajiva
- Yale School of Forestry & Environmental Studies, New Haven, CT 06511, USA.
| | | | - Prakash Gupta
- Healis-Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra 400 701, India.
| | - Mangesh S Pednekar
- Healis-Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra 400 701, India.
| | - Michelle L Bell
- Yale School of Forestry & Environmental Studies, New Haven, CT 06511, USA.
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Iyer V, Choudhury N, Rajiva A, Cottagiri SA, Sharma A, Mavalankar D. Laboratory Capacity for Surveillance of Infectious Diseases in Gujarat: Quantity, Quality, Effects and Way Forward. Health (London) 2019. [DOI: 10.4236/health.2019.117079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Venugopal V, Chinnadurai J, Lucas R, Vishwanathan V, Rajiva A, Kjellstrom T. The Social Implications of Occupational Heat Stress on Migrant Workers Engaged in Public Construction: A Case Study from Southern India. ACTA ACUST UNITED AC 2016. [DOI: 10.18848/2154-8587/cgp/v07i02/25-36] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
INTRODUCTION Increasing heat waves-particularly in urban areas where construction is most prevalent, highlight a need for heat exposure assessment of construction workers. This study aims to characterize the effects of heat on construction workers from a site in Gandhinagar. MATERIALS AND METHODS This study involved a mixed methods approach consisting of a cross sectional survey with anthropometric measurements (n = 219) and four focus groups with construction workers, as well as environmental measurements of heat stress exposure at a construction site. Survey data was collected in two seasons i.e., summer and winter months, and heat illness and symptoms were compared between the two time periods. Thematic coding of focus group data was used to identify vulnerability factors and coping mechanisms of the workers. Heat stress, recorded using a wet bulb globe temperature monitor, was compared to international safety standards. RESULTS The survey findings suggest that heat-related symptoms increased in summer; 59% of all reports in summer were positive for symptoms (from Mild to Severe) as compared to 41% in winter. Focus groups revealed four dominant themes: (1) Non-occupational stressors compound work stressors; (2) workers were particularly attuned to the impact of heat on their health; (3) workers were aware of heat-related preventive measures; and (4) few resources were currently available to protect workers from heat stress. Working conditions often exceed international heat stress safety thresholds. Female workers and new employees might be at increased risk of illness or injury. CONCLUSION This study suggests significant health impacts on construction workers from heat stress exposure in the workplace, showed that heat stress levels were higher than those prescribed by international standards and highlights the need for revision of work practices, increased protective measures, and possible development of indigenous work safety standards for heat exposure.
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Affiliation(s)
- Priya Dutta
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Ajit Rajiva
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Dileep Andhare
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Gulrez Shah Azhar
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Abhiyant Tiwari
- Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India
| | - Perry Sheffield
- Department of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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Azhar GS, Mavalankar D, Nori-Sarma A, Rajiva A, Dutta P, Jaiswal A, Sheffield P, Knowlton K, Hess JJ. Heat-related mortality in India: excess all-cause mortality associated with the 2010 Ahmedabad heat wave. PLoS One 2014; 9:e91831. [PMID: 24633076 PMCID: PMC3954798 DOI: 10.1371/journal.pone.0091831] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 02/15/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8 °C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality. METHODS We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1-31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations. RESULTS The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths). In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest "summer" months of April (r = 0.69, p<0.001), May (r = 0.77, p<0.001), and June (r = 0.39, p<0.05). During a period of more intense heat (May 19-25, 2010), mortality rate ratios were 1.76 [95% CI 1.67-1.83, p<0.001] and 2.12 [95% CI 2.03-2.21] applying reference periods (May 12-18, 2010) from various years. CONCLUSION The May 2010 heat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures prevail through much of April-June.
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Affiliation(s)
- Gulrez Shah Azhar
- Indian Institute of Public Health, Ahmedabad, Gujarat, India
- Public Health Foundation of India, New Delhi, India
- * E-mail:
| | - Dileep Mavalankar
- Indian Institute of Public Health, Ahmedabad, Gujarat, India
- Public Health Foundation of India, New Delhi, India
| | - Amruta Nori-Sarma
- Indian Institute of Public Health, Ahmedabad, Gujarat, India
- Columbia Mailman School of Public Health, New York, New York, United States of America
| | - Ajit Rajiva
- Indian Institute of Public Health, Ahmedabad, Gujarat, India
| | - Priya Dutta
- Indian Institute of Public Health, Ahmedabad, Gujarat, India
| | - Anjali Jaiswal
- Natural Resources Defense Council, New York, New York, United States of America
| | - Perry Sheffield
- Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Kim Knowlton
- Columbia Mailman School of Public Health, New York, New York, United States of America
- Natural Resources Defense Council, New York, New York, United States of America
| | - Jeremy J. Hess
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Department of Environmental Health, Emory University School of Public Health, Atlanta, Georgia, United States of America
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