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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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Osborne NJ, Amoatey P, Selvey L, Phung D. Temporal changes in temperature-related mortality in relation to the establishment of the heat-health alert system in Victoria, Australia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02691-9. [PMID: 38709342 DOI: 10.1007/s00484-024-02691-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/08/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
Extreme heat alerts are the most common form of weather forecasting services used in Australia, yet very limited studies have documented their effectiveness in improving health outcomes. This study aimed to examine the temporal changes in temperature-related mortality in relation to the activation of the heat-health alert and response system (HARS) in the State of Victoria, Australia. We examined the relationship between temperatures and mortality using quasi-Poisson regression and the distributed lag non-linear model (dlnm) and compared the temperature-mortality association between the two periods: period 1- prior-HARS (1992-2009) and period 2- post-HARS (2010-2019). Since the HARS heavily weights heatwave effects, we also compared the main effects of heatwave events between the two periods. The heatwaves were defined for three levels, including 3 consecutive days at 97th, 98th, and 99th percentiles. We also controlled the potential confounding effect of seasonality by including a natural cubic B-spline of the day of the year with equally spaced knots and 8 degrees of freedom per year. The exposure-response curve reveals the temperature mortality was reduced in period 2 in comparison with period 1. The relative risk ratios (RRR) of Period 2 over Period 1 were all less than one and gradually decreased from 0.86 (95% CI, 0.72-1.03) to 0.64 (95% CI, 0.33-1.22), and the differences in attributable risk percent increased from 13.2 to 25.3%. The reduction in the risk of heatwave-related deaths decreased by 3.4% (RRp1 1.068, 95% CI, 1.024-1.112 versus RRp2 1.034, 95% CI, 0.986-1.082) and 10% (RRp1 1.16, 95% CI, 1.10-1.22 versus RRp2 1.06, 95% CI, 1.002-1.119) for all groups of people. The study indicated a decrease in heat-related mortality following the operation of HARS in Victoria under extreme heat and high-intensity heatwaves conditions. Further studies could investigate the extent of changes in mortality among populations of differing socio-economic groups during the operation of the heat-health alert system.
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Affiliation(s)
- Nicholas J Osborne
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
- Queensland Alliance for Environmental Health Sciences, University of Queensland, 266 Herston Rd, 4006, Herston, QLD, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
- European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Patrick Amoatey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Linda Selvey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Dung Phung
- School of Public Health, University of Queensland, Brisbane, QLD, Australia.
- Queensland Alliance for Environmental Health Sciences, University of Queensland, 266 Herston Rd, 4006, Herston, QLD, Australia.
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Peden AE, Mason HM, King JC, Franklin RC. Examining the relationship between heatwaves and fatal drowning: a case study from Queensland, Australia. Inj Prev 2024; 30:7-13. [PMID: 37678903 DOI: 10.1136/ip-2023-044938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Globally, drowning is a leading cause of injury-related harm, which is heavily impacted by environmental conditions. In Australia, fatal unintentional drowning peaks in summer, yet the impact of prolonged periods of hot weather (heatwave) on fatal drowning has not previously been explored. METHODS Using a case-crossover approach, we examined the difference in drowning risk between heatwave and non-heatwave days for the Australian state of Queensland from 2010 to 2019. Heatwave data, measured by the excess heat factor, were acquired from the Bureau of Meteorology. Incidence rate ratios (IRRs) were calculated by sex, age of drowning decedent, category of drowning incident (International Classification of Diseases-10 codes) and heatwave severity. Excess drowning mortality during heatwaves was also calculated. RESULTS Analyses reveal increased fatal drowning risk during heatwave for males (IRR 1.22, 95% CI 0.92 to 1.61), people aged 65+ years (IRR 1.36, 95% CI 0.83 to 2.24), unintentional drowning (IRR 1.28, 95% CI 0.98 to 1.69) and during severe heatwaves (IRR 1.26, 95% CI0.88 to 1.82). There were 13 excess drowning deaths due to heatwave over the study period. DISCUSSION The findings confirm an increased risk of fatal drowning during heatwaves. With increased likelihood and severity of heatwaves, this information should be used to inform drowning prevention, in particular the timing of public awareness campaigns and patrolling of supervised aquatic locations. CONCLUSIONS Water safety and patrolling organisations, as well as first responders, need to prepare for more drowning deaths during heatwave conditions. In addition, drowning prevention education ahead of heatwaves is needed for recreational swimmers, and older people, particularly those with comorbidities which may be further exacerbated by a heatwave.
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Affiliation(s)
- Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
| | - Hannah M Mason
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
| | - Jemma Chandal King
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
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Lung SCC, Liou ML, Yeh JCJ, Hwang JS. A pilot heat-health warning system co-designed for a subtropical city. PLoS One 2023; 18:e0294281. [PMID: 37948468 PMCID: PMC10637700 DOI: 10.1371/journal.pone.0294281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
Significant heat-related casualties underlie the urgency of establishing a heat-health warning system (HHWS). This paper presents an evidence-based pilot HHWS developed for Taipei City, Taiwan, through a co-design process engaging stakeholders. In the co-design process, policy concerns related to biometeorology, epidemiology and public health, and risk communication aspects were identified, with knowledge gaps being filled by subsequent findings. The biometeorological results revealed that Taipei residents were exposed to wet-bulb globe temperature (WBGT) levels of health concern for at least 100 days in 2016. The hot spots and periods identified using WBGT would be missed out if using temperature, underlining the importance of adopting an appropriate heat indicator. Significant increases in heat-related emergency were found in Taipei at WBGT exceeding 36°C with reference-adjusted risk ratio (RaRR) of 2.42, taking 30°C as the reference; and residents aged 0-14 had the highest risk enhancement (RaRR = 7.70). As for risk communication, occurring frequency was evaluated to avoid too frequent warnings, which would numb the public and exhaust resources. After integrating knowledge and reconciling the different preferences and perspectives, the pilot HHWS was co-implemented in 2018 by the science team and Taipei City officials; accompanying responsive measures were formulated for execution by ten city government departments/offices. The results of this pilot served as a useful reference for establishing a nationwide heat-alert app in 2021/2022. The lessons learnt during the interactive co-design processes provide valuable insights for establishing HHWSs worldwide.
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Affiliation(s)
- Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan
- Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan
| | - Ming-Lone Liou
- Graduate Institute of Environmental Engineering, National Taiwan University, Taipei, Taiwan
| | - Jou-Chen Joy Yeh
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan
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Xu R, Yu P, Liu Y, Chen G, Yang Z, Zhang Y, Wu Y, Beggs PJ, Zhang Y, Boocock J, Ji F, Hanigan I, Jay O, Bi P, Vargas N, Leder K, Green D, Quail K, Huxley R, Jalaludin B, Hu W, Dennekamp M, Vardoulakis S, Bone A, Abrahams J, Johnston FH, Broome R, Capon T, Li S, Guo Y. Climate change, environmental extremes, and human health in Australia: challenges, adaptation strategies, and policy gaps. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100936. [PMID: 38116505 PMCID: PMC10730315 DOI: 10.1016/j.lanwpc.2023.100936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 12/21/2023]
Abstract
Climate change presents a major public health concern in Australia, marked by unprecedented wildfires, heatwaves, floods, droughts, and the spread of climate-sensitive infectious diseases. Despite these challenges, Australia's response to the climate crisis has been inadequate and subject to change by politics, public sentiment, and global developments. This study illustrates the spatiotemporal patterns of selected climate-related environmental extremes (heatwaves, wildfires, floods, and droughts) across Australia during the past two decades, and summarizes climate adaptation measures and actions that have been taken by the national, state/territory, and local governments. Our findings reveal significant impacts of climate-related environmental extremes on the health and well-being of Australians. While governments have implemented various adaptation strategies, these plans must be further developed to yield concrete actions. Moreover, Indigenous Australians should not be left out in these adaptation efforts. A collaborative, comprehensive approach involving all levels of government is urgently needed to prevent, mitigate, and adapt to the health impacts of climate change.
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Affiliation(s)
- Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yanming Liu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Zhengyu Yang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yiwen Zhang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Paul J. Beggs
- Faculty of Science and Engineering, School of Natural Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jennifer Boocock
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7005, Australia
| | - Fei Ji
- NSW Department of Planning and Environment, Sydney, NSW 2150, Australia
| | - Ivan Hanigan
- WHO Collaborating Centre for Climate Change and Health Impact Assessment, School of Population Health, Curtin University, Perth, WA 6102, Australia
| | - Ollie Jay
- Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Nicole Vargas
- Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- School of Medicine and Psychology, College of Health & Medicine, The Australian National University, Canberra, ACT 2601, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Donna Green
- School of Biological, Earth & Environmental Sciences, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Katie Quail
- School of Biological, Earth & Environmental Sciences, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Rachel Huxley
- Faculty of Health, Deakin University, Melbourne, VIC 3125, Australia
| | - Bin Jalaludin
- School of Population Health, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Wenbiao Hu
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Martine Dennekamp
- Environment Protection Authority Victoria, Melbourne, VIC 3053, Australia
| | - Sotiris Vardoulakis
- Healthy Environments And Lives (HEAL) National Research Network, College of Health and Medicine, The Australian National University, Canberra, ACT 2601, Australia
| | - Angie Bone
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Jonathan Abrahams
- Monash University Disaster Resilience Initiative, Melbourne, VIC 3800, Australia
| | - Fay H. Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7005, Australia
| | - Richard Broome
- The New South Wales Ministry of Health, Sydney, NSW 2065, Australia
| | - Tony Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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