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Wang S, Li T, Rajagopalan P. Impact of heat exposure on health outcomes among older adults in India: an analysis across ten states. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2025:1-13. [PMID: 39907032 DOI: 10.1080/09603123.2025.2461115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 01/28/2025] [Indexed: 02/06/2025]
Abstract
This study investigates the impact of heat exposure on health outcomes among older adults in 10 Indian states, using data from the Longitudinal Aging Study of India (LASI-Wave I) and climate data from the National Oceanic and Atmospheric Administration (NOAA). Propensity score matching and ordered probit models were employed to control for demographic factors and isolate the effects of heat exposure. Our results show a significant association between heat exposure and worsening self-reported health and mental health, including increased feeling of depression, fatigue, fear, and decreased life satisfaction. The analysis indicates that access to cooling devices mitigates adverse health effects in rural areas, while access to onsite water benefits urban residents. These findings underscore the critical role of housing and environment factors in moderating the health impacts of heat exposure and suggest targeted interventions to protect vulnerable populations.
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Affiliation(s)
- Sijiu Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Tianzi Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Priya Rajagopalan
- School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
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Xia X, Chan KH, Niu Y, Liu C, Guo Y, Ho KF, Yim SHL, Wang B, Doherty A, Avery D, Pei P, Yu C, Sun D, Lv J, Chen J, Li L, Wen P, Wu S, Lam KBH, Kan H, Chen Z. Modelling personal temperature exposure using household and outdoor temperature and questionnaire data: Implications for epidemiological studies. ENVIRONMENT INTERNATIONAL 2024; 192:109060. [PMID: 39401479 PMCID: PMC7616742 DOI: 10.1016/j.envint.2024.109060] [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: 06/25/2024] [Revised: 09/16/2024] [Accepted: 10/06/2024] [Indexed: 10/26/2024]
Abstract
Non-optimal temperature is a leading risk factor for global disease burden. Most epidemiological studies assessed only outdoor temperature, with important uncertainties on personal exposure misclassification. The CKB-Air study measured personal, household (kitchen and living room), and outdoor temperatures in the summer (MAY-SEP 2017) and winter (NOV 2017-JAN 2018) in 477 participants in China. After data cleaning, ∼88,000 person-hours of data were recorded across each microenvironment. Using multivariable linear regression (MLR) and random forest (RF) models, we identified key predictors and constructed personal temperature exposure prediction models. We used generalised additive mixed effect models to examine the relationships of personal and outdoor temperatures with heart rate. The 24-hour mean (SD) personal and outdoor temperatures were 29.2 (3.8) °C and 27.6 (6.4) °C in summer, and 12.0 (4.0) °C and 7.5 (4.2) °C in winter, respectively. The temperatures across microenvironments were strongly correlated (Spearman's ρ: 0.86-0.92) in summer. In winter, personal temperature was strongly related to household temperatures (ρ: 0.74-0.79) but poorly related to outdoor temperature (ρ: 0.30). RF algorithm identified household and outdoor temperatures and study date as top predictors of personal temperature exposure for both seasons, and heating-related factors were important in winter. The final MLR and RF models incorporating questionnaire and device data performed satisfactorily in predicting personal exposure in both seasons (R2summer: 0.92; R2winter: 0.68-0.70). We found consistent U-shaped associations between measured and predicted personal temperature exposures and heart rate (lowest at ∼ 14.5 °C), but a weak positive linear association with outdoor temperature. Personal and outdoor temperatures differ substantially winter, but prediction models incorporating household and outdoor temperatures and questionnaire data performed satisfactorily. Exposure misclassification from using outdoor temperature may produce inappropriate epidemiological findings.
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Affiliation(s)
- Xi Xia
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; School of Public Health, Shaanxi University of Chinese Medicine, Xi'an, China; The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yitong Guo
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Steve Hung Lam Yim
- Asian School of the Environment, Nanyang Technological University, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Earth Observatory of Singapore, Nanyang Technological University, Singapore
| | - Baihan Wang
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Aiden Doherty
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK; National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospital NHS Foundation Trust, John Racliffe Hospital, Oxford, UK
| | - Daniel Avery
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Canqing Yu
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Dianjianyi Sun
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Jun Lv
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Junshi Chen
- China National Center For Food Safety Risk Assessment, Beijing, China
| | - Liming Li
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Peng Wen
- Maiji Center for Disease Control and Prevention, Gansu, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China.
| | - Kin Bong Hubert Lam
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Children's Hospital of Fudan university, National Center for Children's Health, Shanghai, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Weitz CA. Coping with extreme heat: current exposure and implications for the future. Evol Med Public Health 2024; 12:eoae015. [PMID: 39359409 PMCID: PMC11445678 DOI: 10.1093/emph/eoae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 07/02/2024] [Indexed: 10/04/2024] Open
Abstract
A preview of how effective behavioral, biological and technological responses might be in the future, when outdoor conditions will be at least 2°C hotter than current levels, is available today from studies of individuals already living in extreme heat. In areas where high temperatures are common-particularly those in the hot and humid tropics-several studies report that indoor temperatures in low-income housing can be significantly hotter than those outdoors. A case study indicates that daily indoor heat indexes in almost all the 123 slum dwellings monitored in Kolkata during the summer were above 41°C (106°F) for at least an hour. Economic constraints make it unlikely that technological fixes, such as air conditioners, will remedy conditions like these-now or in the future. People without access to air conditioning will have to rely on behavioral adjustments and/or biological/physiological acclimatization. One important unknown is whether individuals who have lived their entire lives in hot environments without air conditioning possess natural levels of acclimatization greater than those indicated by controlled laboratory studies. Answering questions about the future will require more studies of heat conditions experienced by individuals, more information on indoor versus outdoor heat conditions, and a greater understanding of the behavioral and biological adjustments made by people living today in extremely hot conditions.
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Affiliation(s)
- Charles A Weitz
- Department of Anthropology, Temple University, Philadelphia, PA 19122, USA
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Navarrete-Valladares C, Sandoval-Díaz J, Sandoval-Obando E. Experience and local memory of older people in the face of disasters: a systematic review. Front Public Health 2023; 11:1163561. [PMID: 37293609 PMCID: PMC10246736 DOI: 10.3389/fpubh.2023.1163561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/28/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction The increase in population aging establishes new risk scenarios in the face of the intensification of disasters due to climate change; however, previous experiences and collective memory would generate opportunities for older people to acquire adaptive and coping capacities in the face of these events. Objective To analyze the theoretical-methodological characteristics presented by the studies carried out between the years 2012 and 2022 about the experience and collective memory of the older adult in the face of climate change. Method A systematic literature review (SLR) was carried out following the guidelines of the PRISMA statement. The databases consulted were Web of Science, Scopus, EBSCO host, and Redalyc, selecting 40 articles in Spanish, English, and Portuguese. Results The importance of experience and collective memory in the face of disasters as an adaptive factor in older people was identified. In addition, sharing experiences allows them to give new meaning to what happened, emphasizing confidence in their personal resources and self-management capacity and fostering perceived empowerment. Discussion It is essential that in future studies the knowledge provided by the older adult can be privileged, recognizing the importance of their life histories and favoring the active role in their development and wellbeing.
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Affiliation(s)
| | - José Sandoval-Díaz
- Centro de Estudios Ñuble, Universidad del Bío-Bío, Chillán, Chile y Centro Interuniversitario de Envejecimiento Saludable (CIES), Chillán, Chile
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Liu S, Wen D, Feng C, Yu C, Gu Z, Wang L, Zhang Z, Li W, Wu S, Liu Y, Duan C, Zhuang R, Xue L. Alteration of gut microbiota after heat acclimation may reduce organ damage by regulating immune factors during heat stress. Front Microbiol 2023; 14:1114233. [PMID: 36910226 PMCID: PMC9995595 DOI: 10.3389/fmicb.2023.1114233] [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: 12/02/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Heat-related illnesses can lead to morbidity, which are anticipated to increase frequency with predictions of increased global surface temperatures and extreme weather events. Although heat acclimation training (HAT) could prevent heat-related diseases, the mechanisms underlying HAT-promoting beneficial changes in organ function, immunity, and gut microbes remain unclear. Methods In the current study, we recruited 32 healthy young soldiers and randomly divided them into 4 teams to conduct HATs for 10 days: the equipment-assisted training team at high temperature (HE); the equipment-assisted training team under normal hot weather (NE); the high-intensity interval training team at high temperature (HIIT), and the control team without training. A standard heat tolerance test (HTT) was conducted before (HTT-1st) and after (HTT-2nd) the training to judge whether the participants met the heat acclimation (HA) criteria. Results We found that the participants in both HE and NE teams had significantly higher acclimation rates (HA/total population) than whom in the HIIT team. The effects of HAT on the participants of the HE team outperformed that of the NE team. In the HA group, the differences of physiological indicators and plasma organ damage biomarkers (ALT, ALP, creatinine, LDH, α-HBDH and cholinesterase) before and after HTT-2nd were significantly reduced to those during HTT-1st, but the differences of immune factors (IL-10, IL-6, CXCL2, CCL4, CCL5, and CCL11) elevated. The composition, metabolism, and pathogenicity of gut microbes changed significantly, with a decreased proportion of potentially pathogenic bacteria (Escherichia-Shigella and Lactococcus) and increased probiotics (Dorea, Blautia, and Lactobacillus) in the HA group. Training for a longer time in a high temperature and humidity showed beneficial effects for intestinal probiotics. Conclusion These findings revealed that pathogenic gut bacteria decrease while probiotics increase following HA, with elevated immune factors and reduced organ damage during heat stress, thereby improving the body's heat adaption.
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Affiliation(s)
- Shanshou Liu
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Dongqing Wen
- Air Force Medical Center, Fourth Military Medical University, Beijing, China
| | - Chongyang Feng
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chaoping Yu
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Zhao Gu
- Air Force Medical Center, Fourth Military Medical University, Beijing, China
| | - Liping Wang
- Air Force Medical Center, Fourth Military Medical University, Beijing, China
| | - Zhixiang Zhang
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Wenpeng Li
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Shuwen Wu
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yitian Liu
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chujun Duan
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Ran Zhuang
- Department of Immunology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Lihao Xue
- Air Force Medical Center, Fourth Military Medical University, Beijing, China
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Mukhopadhyay B, Weitz CA. Heat Exposure, Heat-Related Symptoms and Coping Strategies among Elderly Residents of Urban Slums and Rural Vilages in West Bengal, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12446. [PMID: 36231746 PMCID: PMC9564637 DOI: 10.3390/ijerph191912446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
The impact of heat stress among the elderly in India-particularly the elderly poor-has received little or no attention. Consequently, their susceptibility to heat-related illnesses is virtually unknown, as are the strategies they use to avoid, or deal with, the heat. This study examined perceptions of comfort, heat-related symptoms, and coping behaviors of 130 elderly residents of Kolkata slums and 180 elderly residents of rural villages south of Kolkata during a 90-day period when the average 24-h heat indexes were between 38.6 °C and 41.8 °C. Elderly participants in this study reported being comfortable under relatively warm conditions-probably explained by acclimatization to the high level of experienced heat stress. The prevalence of most heat-related symptoms was significantly greater among elderly women, who also were more likely to report multiple symptoms and more severe symptoms. Elderly women in the rural villages were exposed to significantly hotter conditions during the day than elderly men, making it likely that gender differences in symptom frequency, number and severity were related to gender differences in heat stress. Elderly men and elderly village residents made use of a greater array of heat-coping behaviors and exhibited fewer heat-related symptoms than elderly women and elderly slum residents. Overall, heat measurements and heat-related symptoms were less likely to be significant predictors of most coping strategies than personal characteristics, building structures and location. This suggests that heat-coping behaviors during hot weather were the result of complex, culturally influenced decisions based on many different considerations besides just heat stress.
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Affiliation(s)
- Barun Mukhopadhyay
- Biological Anthropology Unit, Indian Statistical Institute, Kolkata 700 108, India
- Indian Anthropological Society, Kolkata 700 019, India
| | - Charles A. Weitz
- Department of Anthropology, Temple University, Philadelphia, PA 19122, USA
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