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Meadows J, Mansour A, Gatto MR, Li A, Howard A, Bentley R. Mental illness and increased vulnerability to negative health effects from extreme heat events: a systematic review. Psychiatry Res 2024; 332:115678. [PMID: 38150812 DOI: 10.1016/j.psychres.2023.115678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 12/29/2023]
Abstract
RATIONALE Across countries, extreme heat events are projected to increase in frequency and intensity because of climate change. Exposure to extreme heat events can have a substantial negative impact on human health, and extant research suggests that individuals with mental illness are particularly vulnerable. To date, there has been no review of evidence regarding this vulnerability to inform response strategies and future research. OBJECTIVE A systematic review was undertaken to investigate mental illness as an effect modifier of the relationship between heat exposure and morbidity or mortality. METHODS Six databases (Medline, Embase, Global Health, PsychInfo, CINAHL and Scopus) were searched for studies published between the years 2000 to 2022. Twenty-two observational studies that met the inclusion criteria were investigated through narrative synthesis. The RoBANS tool, ROBIS and GRADE were used to assess the certainty of evidence including the risk of bias. RESULTS Individuals with mental illness experience worse morbidity and mortality outcomes compared to their counterparts without mental illness in all studies investigating high temperature over a single day. This did not hold for studies examining heatwaves, which reported mixed findings. CONCLUSIONS AND IMPLICATIONS People with diagnosed mental illness should be targeted for policy and service attention during high temperature days. Further research should investigate specific mental illness and adjust for a wider range of confounding factors.
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Affiliation(s)
- Julia Meadows
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Adelle Mansour
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Maria Rosa Gatto
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Ang Li
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Amber Howard
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Rebecca Bentley
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia.
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Oh J, Kim E, Kwag Y, An H, Kim HS, Shah S, Lee JH, Ha E. Heat wave exposure and increased heat-related hospitalizations in young children in South Korea: A time-series study. ENVIRONMENTAL RESEARCH 2024; 241:117561. [PMID: 37951381 DOI: 10.1016/j.envres.2023.117561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Numerous studies have investigated the association between heat wave exposure increased heat-related hospitalizations in the general population. However, little is known about heat-related morbidity in young children who are more vulnerable than the general population. Therefore, we aimed to evaluate the association between hospitalization for heat-related illness in children and heat wave exposure in South Korea. METHODS We used the National Health Insurance Service (NHIS) database, which provides medical records from 2015 to 2019 in South Korea. We defined daily hospitalizations for heat-related illness of children younger than five years during the summer period (June to August). We considered the definition of heat waves considering the absolute temperature and percentile. A total of 12 different heat waves were used. A time-series analysis was used to investigate the association between heat wave exposure and heat-related hospitalization among children younger than five years. We used a two-stage design involving a meta-analysis after modeling by each region. RESULTS We included 16,879 daily heat-related hospitalizations among children younger than five years. Overall, heat wave exposure within two days was most related for heat-related hospitalizations in young children. The relative risk (RR) due to heat wave exposure within two days (lag2) (12 definitions: 70th to 90th percentile of maximum temperature) ranged from 1.038 (95% confidence interval (CI): 0.971, 1.110) to 1.083 (95% CI: 1.036, 1.133). We found that boys were more vulnerable to heat exposure than girls. In addition, we found that urban areas were more vulnerable to heat exposure than rural areas. CONCLUSIONS In our study, heat wave exposure during summer was found to be associated with an increased risk of hospitalization for heat-related illness among children younger than five years. Our findings suggest the need for summer heat wave management and prevention for children.
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Affiliation(s)
- Jongmin Oh
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Republic of Korea; Department of Human Systems Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Republic of Korea
| | - Eunji Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Youngrin Kwag
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyungmi An
- Institute of Convergence Medicine Ewha Womans University Mokdong Hospital, Republic of Korea
| | - Hae Soon Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Surabhi Shah
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Ji Hyen Lee
- Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Republic of Korea; Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
| | - Eunhee Ha
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Republic of Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
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Thomson TN, Rupasinghe R, Hennessy D, Easton M, Stewart T, Mulvenna V. Population vulnerability to heat: A case-crossover analysis of heat health alerts and hospital morbidity data in Victoria, Australia. Aust N Z J Public Health 2023; 47:100092. [PMID: 37852815 DOI: 10.1016/j.anzjph.2023.100092] [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: 05/19/2023] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE From 2010 to 2022, the Victorian Department of Health operated a heat health alert system. We explored whether changes to morbidity occurred during or directly after these alerts, and how this differed for certain population groups. METHODS We used a space-time-stratified case-crossover design and conditional logistic regression to examine the associations between heat health alerts and heat-related and all-cause emergency department (ED) presentations and hospital admissions at the state-wide level, with models created for the whole population and subgroups. Data were included for the warm season (November-March) from 2014 to 2021. RESULTS Increases occurred in heat-related ED presentations (OR 1.73, 95% CI: 1.53-1.96) and heat-related hospital admissions (OR 1.23, 95% CI: 1.16-1.30) on days on or after heat health alerts. Effect sizes were largest for those 65 years and older, Aboriginal and Torres Strait Islander people, and those living in the most disadvantaged areas. CONCLUSIONS We confirm that increases in morbidity occurred in Victoria during heat health alerts and describe which population groups are more likely to require healthcare in a hospital. IMPLICATIONS FOR PUBLIC HEALTH These findings can inform responses before and during periods of extreme heat, data-driven adaptation strategies, and the development of heat health surveillance systems.
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Affiliation(s)
- Tilda N Thomson
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia; Public Health Division, Victorian Department of Health, Melbourne, Australia.
| | - Rayiky Rupasinghe
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Daneeta Hennessy
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Marion Easton
- Public Health Division, Victorian Department of Health, Melbourne, Australia
| | - Tony Stewart
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Vanora Mulvenna
- Public Health Division, Victorian Department of Health, Melbourne, Australia
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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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Mason HM, King JC, Peden AE, Watt K, Bosley E, Fitzgerald G, Nairn J, Miller L, Mandalios N, Franklin RC. Determining the Impact of Heatwaves on Emergency Ambulance Calls in Queensland: A Retrospective Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20064875. [PMID: 36981787 PMCID: PMC10049657 DOI: 10.3390/ijerph20064875] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 06/01/2023]
Abstract
Heatwaves are a significant and growing threat to the health and well-being of the residents of Queensland, Australia. This threat is increasing due to climate change. Excess heat increases the demand for health services, including ambulance calls, and the purpose of this study was to explore this impact across Queensland. A state-wide retrospective analysis of heatwaves and emergency 'Triple Zero' (000) calls to Queensland Ambulance (QAS) from 2010-2019 was undertaken. Call data from the QAS and heatwave data from the Bureau of Meteorology were analysed using a case-crossover approach at the postcode level. Ambulance calls increased by 12.68% during heatwaves. The effect was greatest during low-severity heatwaves (22.16%), followed by severe (14.32%) and extreme heatwaves (1.16%). The impact varied by rurality, with those living in very remote areas and major cities most impacted, along with those of low and middle socioeconomic status during low and severe intensity heat events. Lag effects post-heatwave continued for at least 10 days. Heatwaves significantly increase ambulance call centre workload, so ambulance services must actively prepare resources and personnel to address increases in heatwave frequency, duration, and severity. Communities must be informed of the risks of heatwaves at all severities, particularly low severity, and the sustained risks in the days following a heat event.
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Affiliation(s)
- Hannah M. Mason
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Jemma C. King
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Amy E. Peden
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kerrianne Watt
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
- Information Support, Research & Evaluation, Queensland Ambulance Service, Brisbane, QLD 4031, Australia
| | - Emma Bosley
- Information Support, Research & Evaluation, Queensland Ambulance Service, Brisbane, QLD 4031, Australia
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Gerard Fitzgerald
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - John Nairn
- School of Biological Sciences, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Lauren Miller
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Nicole Mandalios
- Disaster Management Branch, Queensland Health, Brisbane, QLD 4000, Australia
| | - Richard C. Franklin
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia
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Franklin RC, Mason HM, King JC, Peden AE, Nairn J, Miller L, Watt K, FitzGerald G. Heatwaves and mortality in Queensland 2010-2019: implications for a homogenous state-wide approach. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:503-515. [PMID: 36735072 PMCID: PMC9974727 DOI: 10.1007/s00484-023-02430-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 11/10/2022] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. Individuals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk.
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Affiliation(s)
- Richard C Franklin
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia.
| | - Hannah M Mason
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
| | - Jemma C King
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
| | - Amy E Peden
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - John Nairn
- School of Biological Sciences, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Adelaide, SA, Australia
| | - Lauren Miller
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
| | - Kerrianne Watt
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
- Information Support, Research & Evaluation, Queensland Ambulance Service, Brisbane, QLD, Australia
| | - Gerard FitzGerald
- Discipline of Public Health and Tropical Medicine, CPHMVS, James Cook University, Townsville, QLD, 4811, Australia
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Sydney, NSW, Australia
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Arsad FS, Hod R, Ahmad N, Ismail R, Mohamed N, Baharom M, Osman Y, Radi MFM, Tangang F. The Impact of Heatwaves on Mortality and Morbidity and the Associated Vulnerability Factors: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16356. [PMID: 36498428 PMCID: PMC9738283 DOI: 10.3390/ijerph192316356] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND This study aims to investigate the current impacts of extreme temperature and heatwaves on human health in terms of both mortality and morbidity. This systematic review analyzed the impact of heatwaves on mortality, morbidity, and the associated vulnerability factors, focusing on the sensitivity component. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. Four databases (Scopus, Web of Science, EBSCOhost, PubMed) were searched for articles published from 2012 to 2022. Those eligible were evaluated using the Navigation Guide Systematic Review framework. RESULTS A total of 32 articles were included in the systematic review. Heatwave events increased mortality and morbidity incidence. Sociodemographic (elderly, children, male, female, low socioeconomic, low education), medical conditions (cardiopulmonary diseases, renal disease, diabetes, mental disease), and rural areas were crucial vulnerability factors. CONCLUSIONS While mortality and morbidity are critical aspects for measuring the impact of heatwaves on human health, the sensitivity in the context of sociodemographic, medical conditions, and locality posed a higher vulnerability to certain groups. Therefore, further research on climate change and health impacts on vulnerability may help stakeholders strategize effective plans to reduce the effect of heatwaves.
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Affiliation(s)
- Fadly Syah Arsad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Norfazilah Ahmad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Shah Alam 40170, Malaysia
| | - Norlen Mohamed
- Environmental Health Unit, Disease Control Division, Ministry of Health Malaysia, Putrajaya 62590, Malaysia
| | - Mazni Baharom
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Yelmizaitun Osman
- Occupational and Environmental Health Unit, Kelantan State Health Department, Ministry of Health Malaysia, Kota Bharu 15590, Malaysia
| | - Mohd Firdaus Mohd Radi
- Surveillance Unit, Kedah State Health Department, Ministry of Health Malaysia, Alor Setar 05400, Malaysia
| | - Fredolin Tangang
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
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Mason H, C King J, E Peden A, C Franklin R. Systematic review of the impact of heatwaves on health service demand in Australia. BMC Health Serv Res 2022; 22:960. [PMID: 35902847 PMCID: PMC9336006 DOI: 10.1186/s12913-022-08341-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Heatwaves have been linked to increased levels of health service demand in Australia. This systematic literature review aimed to explore health service demand during Australian heatwaves for hospital admissions, emergency department presentations, ambulance call-outs, and risk of mortality. STUDY DESIGN A systematic review to explore peer-reviewed heatwave literature published from 2000 to 2020. DATA SOURCES Articles were reviewed from six databases (MEDLINE, Scopus, Web of Science, PsychINFO, ProQuest, Science Direct). Search terms included: heatwave, extreme heat, ambulance, emergency department, and hospital. Studies were included if they explored heat for a period of two or more consecutive days. Studies were excluded if they did not define a threshold for extreme heat or if they explored data only from workers compensation claims and major events. DATA SYNTHESIS This review was prospectively registered with PROSPERO (# CRD42021227395 ). Forty-five papers were included in the final review following full-text screening. Following a quality assessment using the GRADE approach, data were extracted to a spreadsheet and compared. Significant increases in mortality, as well as hospital, emergency, and ambulance demand, were found across Australia during heatwave periods. Admissions for cardiovascular, renal, respiratory, mental and behavioural conditions exhibited increases during heatwaves. The most vulnerable groups during heatwaves were children (< 18 years) and the elderly (60+). CONCLUSIONS Heatwaves in Australia will continue to increase in duration and frequency due to the effects of climate change. Health planning is essential at the community, state, and federal levels to mitigate the impacts of heatwaves on health and health service delivery especially for vulnerable populations. However, understanding the true impact of heatwaves on health service demand is complicated by differing definitions and methodology in the literature. The Excess Heat Factor (EHF) is the preferred approach to defining heatwaves given its consideration of local climate variability and acclimatisation. Future research should explore evidence-based and spatially relevant heatwave prevention programs. An enhanced understanding of heatwave health impacts including service demand will inform the development of such programs which are necessary to promote population and health system resilience.
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Affiliation(s)
- Hannah Mason
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia
| | - Jemma C King
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia
| | - Amy E Peden
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia.,School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard C Franklin
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia.
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Liu J, Varghese BM, Hansen A, Borg MA, Zhang Y, Driscoll T, Morgan G, Dear K, Gourley M, Capon A, Bi P. Hot weather as a risk factor for kidney disease outcomes: A systematic review and meta-analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 801:149806. [PMID: 34467930 DOI: 10.1016/j.scitotenv.2021.149806] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The occurrence or exacerbation of kidney disease has been documented as a growing problem associated with hot weather. The implementation of effective prevention measures requires a better understanding of the risk factors that increase susceptibility. To fill gaps in knowledge, this study reviews the current literature on the effects of heat on kidney-disease outcomes (ICD-10 N00-N39), including morbidity and mortality. METHODS Databases were systematically searched for relevant literature published between 1990 and 2020 and the quality of evidence evaluated. We performed random effects meta-analysis to calculate the pooled relative risks (RRs) of the association between high temperatures (and heatwaves) and kidney disease outcomes. We further evaluated vulnerability concerning contextual population characteristics. RESULTS Of 2739 studies identified, 91 were reviewed and 82 of these studies met the criteria for inclusion in a meta-analysis. Findings showed that with a 1 °C increase in temperature, the risk of kidney-related morbidity increased by 1% (RR 1.010; 95% CI: 1.009-1.011), with the greatest risk for urolithiasis. Heatwaves were also associated with increased morbidity with a trend observed with heatwave intensity. During low-intensity heatwaves, there was an increase of 5.9% in morbidity, while during high-intensity heatwaves there was a 7.7% increase. There were greater RRs for males, people aged ≤64 years, and those living in temperate climate zones. Similarly, for every 1 °C temperature increase, there was a 3% (RR 1.031; 95% CI: 1.018-1.045) increase in the risk of kidney-related mortality, which also increased during heatwaves. CONCLUSIONS High temperatures (and heatwaves) are associated with an elevated risk of kidney disease outcomes, particularly urolithiasis. Preventive measures that may minimize risks in vulnerable individuals during hot spells are discussed.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Matthew A Borg
- School of Public Health, The University of Adelaide, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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Schanz M, Kimmel M, Büchele G, Lindemann U, Schricker S, Becker C, Alscher MD, Rapp K. Gender-Specific Differences of Renal Heat Tolerance in Older Adults during Heat Waves. Gerontology 2021; 68:1018-1026. [PMID: 34864733 DOI: 10.1159/000520324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Heat waves are known to cause increased morbidity and mortality in susceptible populations like old and functionally impaired people. The objective of the study was to assess renal tubular stress, a predictor for development of acute kidney injury, during heat waves in Central Europe. As a marker of renal tubular stress tissue inhibitor of metalloproteinases-2 [TIMP-2]·insulin-like growth factor binding protein-7 [IGFBP7], a new FDA-cleared renal tubular stress biomarker, was used. MATERIALS AND METHODS 68 residents from facilities of sheltered housing with urine samples collected at heat waves in 2015 and at control visits were included. Urinary [TIMP-2]·[IGFBP7] was compared between the heat waves and the control visits. Multivariate linear models were adjusted for age, frailty index, and functional comorbidity index. RESULTS The median age was 82.0 years, 82.3% were women. The percentage of elevated levels of urinary [TIMP-2]·[IGFBP7] (>0.3 [ng/mL]2/1,000) in the total study population was higher at the heat waves than at the control visits (25.0% vs. 17.7%). The effect of the heat waves on urinary [TIMP-2]·[IGFBP7] was stronger in men than in women: The percentage of elevated levels was 75.0% in men and 14.3% in women. In the multivariate analysis, the mean urinary [TIMP-2]·[IGFBP7] was 0.48 (95% CI 0.25; 0.70) (ng/mL)2/1,000 higher in men than in women. Except gender, a number of additional variables did not show an association with urinary [TIMP-2]·[IGFBP7] at the heat waves or the control visits. CONCLUSIONS At heat waves, urinary [TIMP-2]·[IGFBP7] was elevated and higher in men than in women. This suggests gender-specific differences in renal heat tolerance in older people.
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Affiliation(s)
- Moritz Schanz
- Division of General Internal Medicine and Nephrology, Department of Internal Medicine, Robert-Bosch-Hospital Stuttgart, Stuttgart, Germany
| | - Martin Kimmel
- Division of Nephrology, Department of Internal Medicine, Hypertension and Autoimmune Disorders, Alb-Fils Kliniken, Göppingen, Germany
| | - Gisela Büchele
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Ulrich Lindemann
- Clinic for Geriatric Rehabilitation, Robert-Bosch-Hospital Stuttgart, Stuttgart, Germany
| | - Severin Schricker
- Division of General Internal Medicine and Nephrology, Department of Internal Medicine, Robert-Bosch-Hospital Stuttgart, Stuttgart, Germany
| | - Clemens Becker
- Clinic for Geriatric Rehabilitation, Robert-Bosch-Hospital Stuttgart, Stuttgart, Germany
| | - Mark Dominik Alscher
- Division of General Internal Medicine and Nephrology, Department of Internal Medicine, Robert-Bosch-Hospital Stuttgart, Stuttgart, Germany
| | - Kilian Rapp
- Clinic for Geriatric Rehabilitation, Robert-Bosch-Hospital Stuttgart, Stuttgart, Germany
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11
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Wondmagegn BY, Xiang J, Dear K, Williams S, Hansen A, Pisaniello D, Nitschke M, Nairn J, Scalley B, Xiao A, Jian L, Tong M, Bambrick H, Karnon J, Bi P. Increasing impacts of temperature on hospital admissions, length of stay, and related healthcare costs in the context of climate change in Adelaide, South Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145656. [PMID: 33592481 DOI: 10.1016/j.scitotenv.2021.145656] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND A growing number of studies have investigated the effect of increasing temperatures on morbidity and health service use. However, there is a lack of studies investigating the temperature-attributable cost burden. OBJECTIVES This study examines the relationship of daily mean temperature with hospital admissions, length of hospital stay (LoS), and costs; and estimates the baseline temperature-attributable hospital admissions, and costs and in relation to warmer climate scenarios in Adelaide, South Australia. METHOD A daily time series analysis using distributed lag non-linear models (DLNM) was used to explore exposure-response relationships and to estimate the aggregated burden of hospital admissions for conditions associated with temperatures (i.e. renal diseases, mental health, diabetes, ischaemic heart diseases and heat-related illnesses) as well as the associated LoS and costs, for the baseline period (2010-2015) and different future climate scenarios in Adelaide, South Australia. RESULTS During the six-year baseline period, the overall temperature-attributable hospital admissions, LoS, and associated costs were estimated to be 3915 cases (95% empirical confidence interval (eCI): 235, 7295), 99,766 days (95% eCI: 14,484, 168,457), and AU$159 million (95% eCI: 18.8, 269.0), respectively. A climate scenario consistent with RCP8.5 emissions, and including projected demographic change, is estimated to lead to increases in heat-attributable hospital admissions, LoS, and costs of 2.2% (95% eCI: 0.5, 3.9), 8.4% (95% eCI: 1.1, 14.3), and 7.7% (95% eCI: 0.3, 13.3), respectively by mid-century. CONCLUSIONS There is already a substantial temperature-attributable impact on hospital admissions, LoS, and costs which are estimated to increase due to climate change and an increasing aged population. Unless effective climate and public health interventions are put into action, the costs of treating temperature-related admissions will be high.
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Affiliation(s)
- Berhanu Y Wondmagegn
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia; College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Keith Dear
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Alana Hansen
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Monika Nitschke
- South Australian Department of Health and Wellbeing, Adelaide, South Australia, Australia.
| | - John Nairn
- Australian Bureau of Meteorology, South Australia, Australia.
| | - Ben Scalley
- Metropolitan Communicable Disease Control, Department of Health WA, Perth, Western Australia, Australia.
| | - Alex Xiao
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Department of Health WA, Perth, Western Australia, Australia.
| | - Michael Tong
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia.
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12
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A Comparative Assessment of Cooling Center Preparedness across Twenty-Five U.S. Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094801. [PMID: 33946281 PMCID: PMC8125005 DOI: 10.3390/ijerph18094801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 01/14/2023]
Abstract
Cooling centers have played a significant role in reducing the risks of adverse health impacts of extreme heat exposure. However, there have been no comparative studies investigating cooling center preparedness in terms of population coverage, location efficiency, and population coverage disparities among different subpopulation groups. Using a catchment area method with a 0.8 km walking distance, we compared three aspects of cooling center preparedness across twenty-five cities in the U.S. We first calculated the percentage of the population covered by a single cooling center for each city. Then, the extracted values were separately compared to the city's heat indexes, latitudes, and spatial patterns of cooling centers. Finally, we investigated population coverage disparities among multiple demographics (age, race/ethnicity) and socioeconomic (insurance, poverty) subpopulation groups by comparing the percentage of population coverage between selected subpopulation groups and reference subpopulation groups. Our results showed that cooler cities, higher latitude cities, and cities with dispersed cooling centers tend to be more prepared than warmer cities, lower latitude cities, and cities with clustered cooling centers across the U.S. Moreover, older people (≥65) had 9% lower population coverage than younger people (≤64). Our results suggest that the placement of future cooling centers should consider both the location of other nearby cooling centers and the spatial distribution of subpopulations to maximize population coverage and reduce access disparities among several subpopulations.
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13
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Thermal Personalities of Older People in South Australia: A Personas-Based Approach to Develop Thermal Comfort Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228402. [PMID: 33202798 PMCID: PMC7698095 DOI: 10.3390/ijerph17228402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
An important consideration for future age-friendly cities is that older people are able to live in housing appropriate for their needs. While thermal comfort in the home is vital for the health and well-being of older people, there are currently few guidelines about how to achieve this. This study is part of a research project that aims to improve the thermal environment of housing for older Australians by investigating the thermal comfort of older people living independently in South Australia and developing thermal comfort guidelines for people ageing-in-place. This paper describes the approach fundamental for developing the guidelines, using data from the study participants' and the concept of personas to develop a number of discrete "thermal personalities". Hierarchical Cluster Analysis (HCA) was implemented to analyse the features of research participants, resulting in six distinct clusters. Quantitative and qualitative data from earlier stages of the project were then used to develop the thermal personalities of each cluster. The thermal personalities represent different approaches to achieving thermal comfort, taking into account a wide range of factors including personal characteristics, ideas, beliefs and knowledge, house type, and location. Basing the guidelines on thermal personalities highlights the heterogeneity of older people and the context-dependent nature of thermal comfort in the home and will make the guidelines more user-friendly and useful.
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14
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Shin JY, Kim KR, Ha JC. Intensity-duration-frequency relationship of WBGT extremes using regional frequency analysis in South Korea. ENVIRONMENTAL RESEARCH 2020; 190:109964. [PMID: 32739268 DOI: 10.1016/j.envres.2020.109964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
The risk levels of heat-related extreme events need to be estimated for prediction and real-time monitoring to mitigate their impacts on air quality, public health, the ecosystem, and critical infrastructure. Many countries have adopted meteorological variable base thresholds for assessing the risk level of heat-related extreme events. These thresholds provide an approximate risk level for a specific event but do not consider its intensity and duration in the risk assessment. The current study provides a statistical tool to assess the risk of heat-related extreme events while concurrently considering their intensities and durations based on the wet-bulb globe temperature (WBGT). To this end, the intensity-duration-frequency (IDF) relationship of the extreme WBGT in South Korea was derived. Regional frequency analysis was employed to understand the IDF relationship. Return levels of heat-related extreme events in South Korea were calculated and their characteristics were investigated based on the annual maximum WBGT observations. The results showed that the IDF relationship could provide the risks of heat-related extreme events while concurrently considering their intensities and durations. The extreme WBGT in South Korea was used to categorize two regions such as coastal and inland based on their statistical characteristics. The return levels of the annual maximum WBGT events were found to vary largely by location. The return levels corresponding to 32 °C with 3-h duration for stations in the coastal and inland regions ranged from 1- to 100-years and 3- to 1000-years, respectively. Mean values of return levels for heatwave events in Seoul, Incheon, Daejon, Gwangju, Daegu, and Busan were 2.8-, 8.4-, 15.3-, 2.8-, 1.6-, and 2.2-years, respectively. The return levels of heatwaves for the warmer cities are smaller than those for cooler cities. The return levels of the heatwave events in South Korea showed a significant increasing trend in several cities, supporting the notion that the impact of heatwave events on South Korea might become more severe in the future.
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Affiliation(s)
- Ju-Young Shin
- Applied Meteorology Research Division, National Institute of Meteorological Sciences, South Korea
| | - Kyu Rang Kim
- Applied Meteorology Research Division, National Institute of Meteorological Sciences, South Korea.
| | - Jong-Chul Ha
- Applied Meteorology Research Division, National Institute of Meteorological Sciences, South Korea
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15
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Wu Y, Wang X, Wu J, Wang R, Yang S. Performance of heat-health warning systems in Shanghai evaluated by using local heat-related illness data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 715:136883. [PMID: 32006779 DOI: 10.1016/j.scitotenv.2020.136883] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/18/2020] [Accepted: 01/21/2020] [Indexed: 05/13/2023]
Abstract
In response to more frequent heatwaves, various regional or national heat-health warning systems (HHWSs) have been developed recently as adaptation measures. A wide range of methodologies have been utilized to issue warnings, as there is no universal definition of "heat event" or "heatwave", nor are there quantified thresholds of human-health tolerance to extreme weather. The performance of these warning systems has rarely been evaluated with actual heat-health data, especially the morbidity data, in regions with severe impact. In this study, we assessed the performance of the Shanghai HHWS based on heat-related illness data collected by the Chinese Center for Disease Control and Prevention (China CDC) and then conducted a comparative analysis among the Shanghai HHWS, the China Meteorological Administration HHWS, the Chinese national standard for heatwave indexes, the heat index adopted by the USA's National Weather Service and the definition suggested by the World Meteorological Organization to understand their potential performance for application in Shanghai and to evaluate the temperature thresholds and different meteorological indices employed. The results show that: 1) during the research period, 50% of heat-related illnesses and 58.2% of heat-related deaths in Shanghai occurred on dates that had no heat warnings; 2) for the current threshold (35 °C), the single metric of temperature outperformed the temperature-duration two-parameter method; 3) different from existing studies, while infants and seniors are deemed as vulnerable population groups to heat, young and middle-aged males were found to suffer more heat-related illnesses in hot weather. More detailed analyses reveal that the performance of heat-health warning systems needs to be evaluated and revised periodically, and warning thresholds utilized must be localized to reflect public tolerance to heat and to address the vulnerability of target population groups. Temperature is the dominant threshold in heat-related morbidity and mortality analysis. While a decrease in the temperature threshold would definitely increase the warning frequency and socioeconomic costs, it might also cause warning fatigue. The trade-off between these two aspects is essential for decision-makers and other stakeholders in HHWS design and improvement.
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Affiliation(s)
- Yaqiao Wu
- Key Laboratory of Environmental Change and Natural Disaster, Ministry of Education, Beijing Normal University, Beijing 100875, China; Academy of Disaster Reduction and Emergency Management, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China; School of Government, Beijing Normal University, Beijing 100875, China
| | - Xiaoye Wang
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jingyan Wu
- Key Laboratory of Environmental Change and Natural Disaster, Ministry of Education, Beijing Normal University, Beijing 100875, China; Academy of Disaster Reduction and Emergency Management, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
| | - Rui Wang
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Saini Yang
- Key Laboratory of Environmental Change and Natural Disaster, Ministry of Education, Beijing Normal University, Beijing 100875, China; Academy of Disaster Reduction and Emergency Management, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
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16
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Cui Y, Ai S, Liu Y, Qian ZM, Wang C, Sun J, Sun X, Zhang S, Syberg KM, Howard S, Qin L, Lin H. Hourly associations between ambient temperature and emergency ambulance calls in one central Chinese city: Call for an immediate emergency plan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 711:135046. [PMID: 31812379 DOI: 10.1016/j.scitotenv.2019.135046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Most studies examining the short-term effects of temperature on health were based on the daily scale, few were at the hourly level. Revealing the relationship between unfavorable temperatures on an hourly basis and health is conducive to the development of more accurate extreme temperature early warning systems and reasonable dispatch of ambulances. METHODS Hourly data on temperature, air pollution (including PM2.5, O3, SO2 and NO2) and emergency ambulance calls (EACs) for all-cause, cardiovascular and respiratory diseases from January 16, 2014 to December 31, 2016 were obtained from Luoyang, China. A distributed lag non-linear model (DLNM) was used to assess the association between hourly temperature and ambulance calls after adjusting for potential confounding factors. The fractions of EACs attributable to non-optimum temperatures were also estimated. RESULTS Hourly temperature was associated with increased ambulance calls with a varying lag pattern. Extreme hot temperature (>32.1 °C) was positively associated with all-cause, cardiovascular diseases at lag 0-30 h and lag 0-9 h, while no significant effects were found for respiratory morbidity. Extreme cold temperature (<-2.5 °C) was positively associated with all-cause, cardiovascular and respiratory morbidity at lag 56-157 h, 50-145 h and 123-170 h. An overall EACs fraction of 6.84% [Backward estimate, 95% confidence interval (CI): 5.01%, 8.59%] could be attributed to non-optimum temperatures, and more contributions were caused by cold [Backward estimate: 6.06% (95% CI: 5.10%, 8.48%)] than by heat [Backward estimate: 0.79% (95% CI: 0.12%, 1.45%)]. CONCLUSIONS Extreme hot temperature may lead to increased ambulance calls within a few hours, while extreme cold temperature may not increase ambulance calls until more than 2 days later. Effective measures, such as forming hourly temperature warning standards, optimizing ambulance services at extreme temperatures, etc., should be taken to reduce the unfavorable temperature - associated EACs burden.
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Affiliation(s)
- Yingjie Cui
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Siqi Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuying Liu
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhengmin Min Qian
- Department of Epidemiology & Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Jia Sun
- Department of Epidemiology & Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Xiangyan Sun
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Kevin M Syberg
- Department of Health Management & Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Steven Howard
- Department of Health Management & Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Lijie Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Does Particulate Matter Modify the Short-Term Association between Heat Waves and Hospital Admissions for Cardiovascular Diseases in Greater Sydney, Australia? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183270. [PMID: 31492044 PMCID: PMC6765779 DOI: 10.3390/ijerph16183270] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/25/2022]
Abstract
Little is known about the potential interactive effects of heat waves and ambient particulate matter on cardiovascular morbidity. A time-stratified case-crossover design was used to examine whether particulate matter (PM10) modifies the association between heat waves and emergency hospital admissions for six cardiovascular diseases in Greater Sydney, Australia during the warm season for 2001–2013. We estimated and compared the effect of heat waves on high- and low-level PM10 days at lag0–lag2, adjusting for dew-point temperature, ambient ozone, ambient nitrogen dioxide, and public holidays. We also investigated the susceptibility of both younger (0–64 years) and older populations (65 years and above), and tested the sensitivity of three heat wave definitions. Stronger heat wave effects were observed on high- compared to low-level PM10 days for emergency hospital admissions for cardiac arrest for all ages combined, 0–64 years and 65 years and above; conduction disorders for 0–64 years; and hypertensive diseases for all ages combined and 0–64 years. Overall, we found some evidence to suggest that PM10 may modify the association between heat waves and hospital admissions for certain cardiovascular diseases, although our findings largely differed across disease, age group, lag, and heat wave definition.
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Kim JH, Ryoo HW, Moon S, Jang TC, Jin SC, Mun YH, Do BS, Lee SB, Kim JY. Determining the correlation between outdoor heatstroke incidence and climate elements in Daegu metropolitan city. Yeungnam Univ J Med 2019; 36:241-248. [PMID: 31620639 PMCID: PMC6784657 DOI: 10.12701/yujm.2019.00248] [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: 04/25/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 11/06/2022] Open
Abstract
Background Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS). Methods We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression. Results Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102-3.017). The most suitable cutoff point for MHI by Youden's index was 30.0°C (sensitivity, 77.4%; specificity, 73.7%). Conclusion Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was 30.0°C.
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Affiliation(s)
- Jung Ho Kim
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sungbae Moon
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae Chang Jang
- Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Sang Chan Jin
- Department of Emergency Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - You Ho Mun
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Soo Do
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sam Beom Lee
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jong-yeon Kim
- Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
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A Survey of Rural Residents' Perception and Response to Health Risks from Hot Weather in Ethnic Minority Areas in Southwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122190. [PMID: 31234271 PMCID: PMC6616902 DOI: 10.3390/ijerph16122190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/31/2019] [Accepted: 06/19/2019] [Indexed: 12/05/2022]
Abstract
Ethnic minority areas in southwestern China are facing frequent high-temperature heatwaves. The health risk perceptions and responses of the local residents need to be investigated in order to formulate public policies to mitigate the impacts of climate change on health. In this study, a household survey was conducted in Pengshui Miao and Tujia Autonomous County of Chongqing from January to February 2019. A total of 624 local residents were sampled using the multi-stage sampling method. We used multivariate logistic regression models to explore the factors affecting risk perceptions and responses with regard to hot weather. The results showed that despite a relatively high level of risk perception, the study population had a very low level of willingness to see a doctor (24.4%), especially ethnic minority residents (17.5%). In particular, 80% of residents were aware of climate warming and 79% of residents were aware of the health risks of hot weather. Almost all survey participants reported a response to hot weather, with more than half of the participants stating that they would go somewhere cooler (58.5%) and drink more water (56.3%). Compared with the Han Chinese, ethnic minority participants had a higher perception of warm temperature (p <0.001) and associated health risks (p <0.001) but a lower perception of physical discomfort (p <0.001) and aggravated diseases (p = 0.001). The logistic models indicated that ethnic minority, residence time, outdoor working hours, and health status can significantly influence perceptions and subsequently significantly affect coping behaviors. In conclusion, our findings provide significant implications for the development of policies and health education and promotion programs for ethnic minorities in southwest China to aid them in maintaining good health during future hot weather events.
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Budhathoki NK, Zander KK. Socio-Economic Impact of and Adaptation to Extreme Heat and Cold of Farmers in the Food Bowl of Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1578. [PMID: 31064089 PMCID: PMC6539874 DOI: 10.3390/ijerph16091578] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 12/16/2022]
Abstract
Farmers worldwide have to deal with increasing climate variability and weather extremes. Most of the previous research has focused on impacts on agricultural production, but little is known about the related social and economic impacts on farmers. In this study, we investigated the social and economic impact of extreme weather events (EWE) on farmers in Nepal, and explored how they coped with and adapted to heat waves and cold spells between 2012 and 2017. To address these aims, we conducted a survey of 350 farms randomly selected from the Bardiya and Banke districts of the Terai lowlands of Nepal. They were specifically asked to rate the impacts of extreme temperatures, as well as their effect on labour productivity and collective farmer health, and the detailed preventative measures they had implemented. About 84% of the farmers self-reported moderate or severe heat stress during the last five years, and about 85%, moderate or severe cold stress. Likewise, the majority of respondents reported that both farmer health and labour productivity had been compromised by EWEs. Productivity loss had a strong association with the perceived levels of heat and cold stress, which, in turn, were more likely to be reported by farmers with previous EWE experience. Potentially due to the increased care required during EWEs, those farmers with livestock reported increased heat and cold stress, as, surprisingly, did those who had implemented adaptation measures. Farmers seemed to be less prepared for potential threats of cold spells than heat waves, and therefore less likely to adopt coping strategies, since these are a recent phenomenon. This study identified some limitations. The cross sectional and self-reported data, as a common source of information to estimate health impact, level of heat/cold stress and labour productivity loss. Community-based education/community engagement programs could be developed to facilitate proactive adaptation.
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Affiliation(s)
- Nanda Kaji Budhathoki
- Northern Institute, Charles Darwin University, Ellengowan Drive, Brinkin 0909, Darwin NT, Australia.
| | - Kerstin K Zander
- Northern Institute, Charles Darwin University, Ellengowan Drive, Brinkin 0909, Darwin NT, Australia.
- German Development Institute, 53113 Bonn, Germany.
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Borg M, Nitschke M, Williams S, McDonald S, Nairn J, Bi P. Using the excess heat factor to indicate heatwave-related urinary disease: a case study in Adelaide, South Australia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:435-447. [PMID: 30687904 DOI: 10.1007/s00484-019-01674-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016-1.076), urolithiasis (IRR 1.106, 95% 1.046-1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258-1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048-1.133) and AKI (IRR 1.335, 95% CI 1.204-1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.
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Affiliation(s)
- Matthew Borg
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Monika Nitschke
- SA Health, Government of South Australia, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Stephen McDonald
- The Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - John Nairn
- South Australian State Office, Bureau of Meteorology, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia.
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Kotani K, Ueda K, Seposo X, Ono M, Honda A, Takano H. [Effect of City-Specific Characteristics on Association between Heat and Ambulance Dispatches]. Nihon Eiseigaku Zasshi 2019; 74:n/a. [PMID: 31875633 DOI: 10.1265/jjh.19007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In this multicity study, we aimed to elucidate the city-specific factors affecting the association of high ambient temperature with ambulance dispatches due to acute illnesses. METHODS We used the data of ambulance dispatches in 27 cities in Japan with more than 500,000 population excluding Tokyo, from May to September from 2012 to 2015. We included patients 20 years and older (≥20 years) and stratified them into three age groups (20-59, 60-79, and ≥80 years). We explored the city-specific pattern of the daily relative temperature (in temperature percentiles) and the risk of ambulance dispatches for each age group using a distributed lag nonlinear model and estimated the city-specific relative risks of ambulance dispatches at the 95/99 percentile temperature compared with the 77.6 percentile temperature defined as the reference temperature (Tref). Then, the estimates were combined by performing meta-analyses for each age group. We also applied meta-regression models to explore whether the city-specific characteristics modified the association of temperature with ambulance dispatches. RESULTS The relative risks of the 95th percentile with respect to Tref were 1.14 (95% confidence interval (CI): 1.12, 1.16), 1.16 (95% CI: 1.13, 1.20), 1.13 (95% CI: 1.10, 1.16), and 1.13 (95% CI: 1.00, 1.16), for all-age (≥20) and age-stratified groups (20-59, 60-79, and ≥80 years), respectively. We observed a higher relative risk for the ≥20 years age group in the cities with higher proportions of single-elderly, single-mother, and single-father households. We also found that the relative risk for the 20-59 years age group was higher in the cities with a higher proportion of blue-collar workers. CONCLUSIONS The present study provides insights into city-specific characteristics modifying heat-related health effects.
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Affiliation(s)
- Kazuya Kotani
- Department of Environmental Engineering, Kyoto University
| | - Kayo Ueda
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
| | - Xerxes Seposo
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
| | - Masaji Ono
- National Institute for Environmental Studies
| | - Akiko Honda
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
| | - Hirohisa Takano
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
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Ye H, Ma J, Wu Y, Zhang Y. Perceptions of Health Risks from Hot Weather, and Coping Behaviors among Ethnic Minority Groups in Mountain Areas of China: A Case Study in the Tujia and Miao Autonomous Prefecture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112498. [PMID: 30413074 PMCID: PMC6266458 DOI: 10.3390/ijerph15112498] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 11/16/2022]
Abstract
Limited research focuses on risk perceptions of hot weather among ethnic minority groups in remote mountain areas of China. Adopting a multi-stage sampling method, this study received completed questionnaires from 643 participates in Enshi Tujia and Miao Autonomous Prefecture of China in 2017 and 2018. We used multivariate logistic regression models to explore the factors affecting risk perceptions and coping behaviors with regards to hot weather. Results showed that despite a relatively high level of risk perception, the study population in the mountain areas of China had a very low level of preparedness in responding to the risks from heat, and a lack of professional health knowledge in general. In particular, 61.3% (95% CI: 57.1%−5.6%) of the participants felt increasing temperatures in recent years, 73.2% (95% CI: 69.3%−7.0%) thought extreme high temperatures would be a health threat, and 61.3% (95% CI: 57.1%−5.4%) reported physical discomfort during hot weather. However, only 12% (95% CI: 9.5%−4.5%) had the information or knowledge to stay healthy during the extreme high temperatures, and only 24.2% had (95% CI: 20.8%−7.6%) preparation. The logistic regression models suggested that ethnic group, health status, marital status, gender, and employment could affect their perceptions, which could significantly affect the adoption of coping behaviors. In conclusion, our findings have significant implications for developing policies and health education and promotion programs for ethnic minorities in remote regions to maintain good health during hot weather.
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Affiliation(s)
- Hui Ye
- School of Public Management, South-Central University for Nationalities, Wuhan 430074, China.
| | - Juan Ma
- School of Public Management, South-Central University for Nationalities, Wuhan 430074, China.
| | - Yang Wu
- School of Public Management, South-Central University for Nationalities, Wuhan 430074, China.
| | - Ying Zhang
- School of Public Health, University of Sydney, Sydney, NSW 2006, Australia.
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Varghese BM, Hansen A, Nitschke M, Nairn J, Hanson-Easey S, Bi P, Pisaniello D. Heatwave and work-related injuries and illnesses in Adelaide, Australia: a case-crossover analysis using the Excess Heat Factor (EHF) as a universal heatwave index. Int Arch Occup Environ Health 2018; 92:263-272. [DOI: 10.1007/s00420-018-1376-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/29/2018] [Indexed: 01/04/2023]
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What Can We Learn about Workplace Heat Stress Management from a Safety Regulator Complaints Database? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030459. [PMID: 29509710 PMCID: PMC5877004 DOI: 10.3390/ijerph15030459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 11/16/2022]
Abstract
Heat exposure can be a health hazard for many Australian workers in both outdoor and indoor situations. With many heat-related incidents left unreported, it is often difficult to determine the underlying causal factors. This study aims to provide insights into perceptions of potentially unsafe or uncomfortably hot working conditions that can affect occupational health and safety using information provided by the public and workers to the safety regulator in South Australia (SafeWork SA). Details of complaints regarding heat exposure to the regulator's "Help Centre" were assembled in a dataset and the textual data analysed thematically. The findings showed that the majority of calls relate to indoor work environments such as kitchens, factories, and warehouses. The main themes identified were work environment, health effects, and organisational issues. Impacts of hot working conditions ranged from discomfort to serious heat-related illnesses. Poor management practices and inflexibility of supervisors featured strongly amongst callers' concerns. With temperatures predicted to increase and energy prices escalating, this timely study, using naturalistic data, highlights accounts of hot working conditions that can compromise workers' health and safety and the need for suitable measures to prevent heat stress. These could include risk assessments to assess the likelihood of heat stress in workplaces where excessively hot conditions prevail.
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26
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Borg M, Bi P, Nitschke M, Williams S, McDonald S. The impact of daily temperature on renal disease incidence: an ecological study. Environ Health 2017; 16:114. [PMID: 29078794 PMCID: PMC5659014 DOI: 10.1186/s12940-017-0331-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/12/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND Extremely high temperatures over many consecutive days have been linked to an increase in renal disease in several cities. This is becoming increasingly relevant with heatwaves becoming longer, more intense, and more frequent with climate change. This study aimed to extend the known relationship between daily temperature and kidney disease to include the incidence of eight temperature-prone specific renal disease categories - total renal disease, urolithiasis, renal failure, acute kidney injury (AKI), chronic kidney disease (CKD), urinary tract infections (UTIs), lower urinary tract infections (LUTIs) and pyelonephritis. METHODS Daily data was acquired for maximum, minimum and average temperature over the period of 1 July 2003 to 31 March 2014 during the warm season (October to March) in Adelaide, South Australia. Data for daily admissions to all metropolitan hospitals for renal disease, including 83,519 emergency department admissions and 42,957 inpatient admissions, was also obtained. Renal outcomes were analyzed using time-stratified negative binomial regression models, with the results aggregated by day. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated for associations between the number of admissions and daily temperature. RESULTS Increases in daily temperature per 1 °C were associated with an increased incidence for all renal disease categories except for pyelonephritis. Minimum temperature was associated with the greatest increase in renal disease followed by average temperature and then maximum temperature. A 1°C increase in daily minimum temperature was associated with an increase in daily emergency department admissions for AKI (IRR 1.037, 95% CI: 1.026-1.048), renal failure (IRR 1.030, 95% CI: 1.022-1.039), CKD (IRR 1.017, 95% CI: 1.001-1.033) urolithiasis (IRR 1.015, 95% CI: 1.010-1.020), total renal disease (IRR 1.009, 95% CI: 1.006-1.011), UTIs (IRR 1.004, 95% CI: 1.000-1.007) and LUTIs (IRR 1.003, 95% CI: 1.000-1.006). CONCLUSIONS An increased frequency of renal disease, including urolithiasis, acute kidney injury and urinary tract infections, is predicted with increasing temperatures from climate change. These results have clinical and public health implications for the management of renal diseases and demand tailored health services. Future research is warranted to analyze individual renal diseases with more comprehensive information regarding renal risk factors, and studies examining mortality for specific renal diseases.
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Affiliation(s)
- Matthew Borg
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Monika Nitschke
- SA Health, Government of South Australia, Adelaide, South Australia Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Stephen McDonald
- The Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia Australia
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Nitschke M, Krackowizer A, Hansen AL, Bi P, Tucker GR. Heat Health Messages: A Randomized Controlled Trial of a Preventative Messages Tool in the Older Population of South Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090992. [PMID: 28858262 PMCID: PMC5615529 DOI: 10.3390/ijerph14090992] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 11/16/2022]
Abstract
This study explores the efficacy of providing targeted information to older individuals to prevent adverse health outcomes during extreme heat. Participants ≥65 years of age (n = 637) were recruited from previous population-based studies and randomized into intervention and control groups. The intervention group received evidence-based information leaflets and summarised "Beat the Heat" tips. Post summer 2013-2014, participants responded to questions about their behaviours and their health experiences. Chi square analysis and risk ratios (RR) were used to determine the difference in effects. Responses were received from 216 intervention subjects and 218 controls. Behaviour modification during extreme heat was similar in both groups except for significant increases in the use of cooling systems and the use of a wet cloth to cool the skin in the intervention group. Both actions were recommended in the information package. More people in the intervention group also claimed to have had adequate heat health information. After adjusting for confounders, the RR for self-reported heat stress experienced during summer 2014 indicated a 63% (RR 0.37; 95% CI: 0.22-0.63) reduction in the intervention group compared to the control group. Access to intensive prevention information may have contributed to this positive outcome, indicating the potential usefulness of targeted heat-health information for seniors.
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Affiliation(s)
- Monika Nitschke
- Department for Health and Ageing, 11 Hindmarsh Square, Adelaide, SA 5000, Australia.
| | | | - Alana L Hansen
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Graeme R Tucker
- Department for Health and Ageing, 11 Hindmarsh Square, Adelaide, SA 5000, Australia.
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Zhang Y, Nitschke M, Krackowizer A, Dear K, Pisaniello D, Weinstein P, Tucker G, Shakib S, Bi P. Risk factors for deaths during the 2009 heat wave in Adelaide, Australia: a matched case-control study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:35-47. [PMID: 27221967 DOI: 10.1007/s00484-016-1189-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 03/18/2016] [Accepted: 05/08/2016] [Indexed: 05/24/2023]
Abstract
The extreme heat wave in Australia in 2009 resulted in significantly increased number of daily deaths. The circumstances that lead to deaths during extreme heat have not been explored before in Australia. This study aims to identify the individual and community risk factors for deaths during this extreme heat wave in Adelaide. A matched case-control study was conducted. Cases were those who died in the Adelaide metropolitan area during the heat wave period. For each case, two community controls were randomly selected, matched by age and gender. Face-to-face or telephone interviews were conducted to collect data of demographic information, living environment, social support, health status and behavioural changes during the heat wave. Descriptive analysis, as well as simple and multiple conditional logistic regressions were performed. In total, 82 deaths and 164 matched community controls were included in the analysis, with a median age of 77.5 (range 26.6-100.7). The multiple logistic regression model indicated that, compared with controls, the risk of death during the heat wave was significantly increased for people living alone (AOR = 42.31, 95 % CI 2.3, 792.8) or having existing chronic heart disease (AOR = 22.4, 95 % CI 1.7, 303.0). In addition, having air conditioning in bedrooms (AOR = 0.004, 95 % CI 0.00006, 0.28) and participating in social activities more than once a week (AOR = 0.011, 95 % CI 0.0004, 0.29) indicated significant protective effects. We have identified factors that could significantly impact on the likelihood of deaths during heat waves. Our findings could assist in the development of future intervention programs and policies to reduce mortality associated with a warmer climate.
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Affiliation(s)
- Ying Zhang
- School of Public Health, China Studies Centre, University of Sydney, Sydney, NSW, Australia.
| | - Monika Nitschke
- South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia
| | - Antoinette Krackowizer
- School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Keith Dear
- Global Health Institute, Duke University and Duke Kunshan University, Kunshan, China
| | - Dino Pisaniello
- School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Philip Weinstein
- School of Biological Sciences, University of Adelaide, Adelaide, Australia
| | - Graeme Tucker
- South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia
| | - Sepehr Shakib
- Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, Australia
| | - Peng Bi
- School of Population Health, University of Adelaide, Adelaide, South Australia, Australia.
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Zander KK, Moss SA, Garnett ST. Drivers of self-reported heat stress in the Australian labour force. ENVIRONMENTAL RESEARCH 2017; 152:272-279. [PMID: 27816864 DOI: 10.1016/j.envres.2016.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/25/2016] [Indexed: 06/06/2023]
Abstract
Heat stress causes reductions in well-being and health. As average annual temperatures increase, heat stress is expected to affect more people. While most research on heat stress has explored how exposure to heat affects functioning of the human organism, stress from heat can be manifest long before clinical symptoms are evident, with profound effects on behavior. Here we add to the little research conducted on these subclinical effects of environmental heat using results from an Australian-wide cross-sectional study of nearly 2000 respondents on their self-reported level of heat stress. Slightly less than half (47%) of the respondents perceived themselves as at least sometimes, often or very often stressed by heat during the previous 12 months. Health status and smoking behavior had the expected impact on self-reported perceived heat stress. There were also regional differences with people living in South Australia, Victoria and New South Wales most likely to have reported to have felt heat stressed. People generally worried about climate change, who had been influenced by recent heat waves and who thought there was a relationship between climate change and health were also more likely to have been heat stressed. Surprisingly average maximum temperatures did not significantly explain heat stress but stress was greater among people who perceived the day of the survey as hotter than usual. Currently heat stress indices are largely based on monitoring the environment and physical limitations to people coping with heat. Our results suggest that psychological perceptions of heat need to be considered when predicting how people will be affected by heat under climate change and when developing heat relief and climate change adaptation plans, at work, at home or in public spaces. We further conclude that the perception of temperature and heat stress complements measures that assess heat exposure and heat strain.
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Affiliation(s)
- Kerstin K Zander
- Northern Institute, Charles Darwin University, Darwin, Northern Territory, Australia.
| | - Simon A Moss
- School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Stephen T Garnett
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Darwin, Northern Territory, Australia
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Hatvani-Kovacs G, Belusko M, Skinner N, Pockett J, Boland J. Drivers and barriers to heat stress resilience. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 571:603-614. [PMID: 27432732 DOI: 10.1016/j.scitotenv.2016.07.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/01/2016] [Accepted: 07/04/2016] [Indexed: 06/06/2023]
Abstract
Heatwaves are the most dangerous natural hazard to health in Australia. The frequency and intensity of heatwaves will increase due to climate change and urban heat island effects in cities, aggravating the negative impacts of heatwaves. Two approaches exist to develop population heat stress resilience. Firstly, the most vulnerable social groups can be identified and public health services can prepare for the increased morbidity. Secondly, the population level of adaptation and the heat stress resistance of the built environment can be increased. The evaluation of these measures and their efficiencies has been fragmented across research disciplines. This study explored the relationships between the elements of heat stress resilience and their potential demographic and housing drivers and barriers. The responses of a representative online survey (N=393) about heat stress resilience at home and work from Adelaide, South Australia were analysed. The empirical findings demonstrate that heat stress resistant buildings increased adaptation capacity and decreased the number of health problems. Air-conditioning increased dependence upon it, limited passive adaptation and only people living in homes with whole-house air-conditioning had less health problems during heatwaves. Tenants and respondents with pre-existing health conditions were the most vulnerable, particularly as those with health conditions were not aware of their vulnerability. The introduction of an Energy Performance Certificate is proposed and discussed as an effective incentive to increase the heat stress resistance of and the general knowledge about the built environment.
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Affiliation(s)
- Gertrud Hatvani-Kovacs
- School of Information Technology & Mathematical Sciences, University of South Australia, Mawson Lakes Campus, Mawson Lakes, South Australia, Australia.
| | - Martin Belusko
- Barbara Hardy Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, South Australia, Australia.
| | - Natalie Skinner
- School of Management, University of South Australia, City West Campus, Adelaide, South Australia, Australia.
| | - John Pockett
- Barbara Hardy Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, South Australia, Australia.
| | - John Boland
- Centre for Industrial and Applied Mathematics, University of South Australia, Mawson Lakes Campus, Mawson Lakes, South Australia, Australia.
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Zhang J, Liu S, Han J, Zhou L, Liu Y, Yang L, Zhang J, Zhang Y. Impact of heat waves on nonaccidental deaths in Jinan, China, and associated risk factors. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1367-75. [PMID: 26749223 DOI: 10.1007/s00484-015-1130-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 12/22/2015] [Accepted: 12/24/2015] [Indexed: 05/18/2023]
Abstract
An ecological study and a case-crossover analysis were conducted to evaluate the impact of heat waves on nonaccidental deaths, and to identify contributing factors of population vulnerability to heat-related deaths in Jinan, China. Daily death data and meteorological data were collected for summer months (June to August) of 2012-2013. Excess mortality was calculated and multivariate linear regression models were used to assess the increased risk of heat waves on deaths. Univariate and multivariate logistic regression models were performed to estimate the odd ratios (ORs) of risk factors and their 95 % confidence intervals (CIs). Overall, heat waves were related to 24.88 % excess deaths of total nonaccidental deaths and 31.33 % excess deaths of circulatory diseases, with an OR of 16.07 (95 % CI 8.80-23.33) for total nonaccidental deaths and 12.46 (95 % CI 7.39-17.53) for deaths of circulatory diseases. The case-crossover analysis indicated that older people were more likely to die during heat waves (OR = 1.233, 95 % CI 1.076-1.413) and more deaths occurred outside a hospital during heat waves (OR = 1.142, 95 % CI 1.006-1.296). In conclusion, heat waves have caused excess deaths and significantly increased the risk of circulatory deaths. The risk factors identified in our study have implications for public health interventions to reduce heat-related mortality during extreme heat events.
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Affiliation(s)
- Jun Zhang
- Jinan municipal center for disease control and prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China.
| | - Shouqin Liu
- Jinan municipal center for disease control and prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Jing Han
- Jinan municipal center for disease control and prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Lin Zhou
- Jinan municipal center for disease control and prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Yueling Liu
- Jinan municipal center for disease control and prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Liu Yang
- Jinan municipal center for disease control and prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Ji Zhang
- Jinan municipal center for disease control and prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China.
| | - Ying Zhang
- Sydney School of Public Health/China Studies Center, The University of Sydney, Sydney, NSW 2006, Australia.
- School of Public Health/Climate and Health Research Center, Shandong University, Shandong, China.
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Hot of Not: Physiological versus Meteorological Heatwaves-Support for a Mean Temperature Threshold. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080753. [PMID: 27472348 PMCID: PMC4997439 DOI: 10.3390/ijerph13080753] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 11/17/2022]
Abstract
The aim of this study was to determine whether a revised heat warning threshold provides an enhanced predictive tool for increases in Emergency Department heat-related presentations in Canberra, Australia. All Emergency Department triage records containing the word “heat”, as well as those diagnosing a heat related illness for the summer periods 2013/2014, 2014/2015, and 2015/2016 were searched. Then a medical record review was conducted to confirm that the patient’s presentation was related to environmental heat, which was defined by the final clinical diagnosis, presentation complaint and details of the patient’s treatment. Researchers then compared this presentation data, to a mean threshold formula. The mean threshold formula included the past three consecutive daily mean temperatures and the last measured temperature upon presentation. This formula was designed to take into account the variance of night-time lows, with concurrent daily ambient temperatures, and was used to determine whether there was a correlation between heat-related presentations and increasing mean temperatures. Heat-related presentations appeared to occur when the mean threshold temperature reached 25 °C (77 °F), with significant increases when the mean threshold reached 30 °C (86 °F). These results confirm that a mean temperature of 30 °C corresponds to a relevant local public health heat-related threat.
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Nitschke M, Tucker G, Hansen A, Williams S, Zhang Y, Bi P. Evaluation of a heat warning system in Adelaide, South Australia, using case-series analysis. BMJ Open 2016; 6:e012125. [PMID: 27436672 PMCID: PMC4964181 DOI: 10.1136/bmjopen-2016-012125] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Heatwave warning systems aim to assist in reducing health effects during extreme heat. Evaluations of such systems have been limited. This study explored the effect of a heatwave warning programme on morbidity and mortality in Adelaide, South Australia, by comparing extreme events in 2009 and 2014, the latter with exposure to the preventive programme. METHODS The health outcomes during the two heatwaves were compared using the incidence rate ratios (IRRs) of daily ambulance call-outs, emergency presentations and mortality data during the heatwaves compared with non-heatwave periods during the warm seasons. Excess or reduced numbers of cases were calculated and the differences in cases between the two heatwaves were estimated. RESULTS IRRs for total ambulance call-outs and emergency presentations were lower during the 2014 heatwaves compared with the 2009 event. The estimated differences in health-specific outcomes between 2009 and 2014 were statistically significant with 207 (59%) for cardiac-related call-outs, 134 (30%) for renal and 145 (56%) for heat-related emergency presentations. Mortality was not reduced in 2014. There were an estimated 34.5 excess deaths in 2009 and 38.2 in 2014. CONCLUSIONS Morbidity outcomes were reduced significantly during the 2014 event. The fact that cardiac, renal and heat-related diagnoses were significantly reduced is likely to be associated with the intervention in 2014, which comprised a public warning through media and intense preventive measures directed to individual populations at risk. Further analysis of risk factors of mortality during heatwaves should be explored.
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Affiliation(s)
- Monika Nitschke
- Public Health Services, Department for Health and Ageing, Adelaide, South Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Graeme Tucker
- Epidemiology, Department for Health and Ageing, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Alana Hansen
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Ying Zhang
- International Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Kalisch Ellett LM, Pratt NL, Le Blanc VT, Westaway K, Roughead EE. Increased risk of hospital admission for dehydration or heat-related illness after initiation of medicines: a sequence symmetry analysis. J Clin Pharm Ther 2016; 41:503-7. [DOI: 10.1111/jcpt.12418] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/14/2016] [Indexed: 11/28/2022]
Affiliation(s)
- L. M. Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute; School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
| | - N. L. Pratt
- Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute; School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
| | - V. T. Le Blanc
- Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute; School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
| | - K. Westaway
- Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute; School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
| | - E. E. Roughead
- Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute; School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
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Zhang Y, Nitschke M, Krackowizer A, Dear K, Pisaniello D, Weinstein P, Tucker G, Shakib S, Bi P. Risk factors of direct heat-related hospital admissions during the 2009 heatwave in Adelaide, Australia: a matched case-control study. BMJ Open 2016; 6:e010666. [PMID: 27256088 PMCID: PMC4893849 DOI: 10.1136/bmjopen-2015-010666] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The extreme heatwave of 2009 in South Australia dramatically increased morbidity, with a 14-fold increase in direct heat-related hospitalisation in metropolitan Adelaide. Our study aimed to identify risk factors for the excess morbidity. DESIGN A matched case-control study of risk factors was conducted. SETTING Patients and matched community controls were interviewed to gather data on demographics, living environment, social support, health status and behaviour changes during the heatwave. PARTICIPANTS Cases were all hospital admissions with heat-related diagnoses during the 5-day heatwave in 2009. Controls were randomly selected from communities. OUTCOME MEASURES Descriptive analyses, simple and multiple conditional logistic regressions were performed. Adjusted ORs (AORs) were estimated. RESULTS In total, 143 hospital patients and 143 matched community controls were interviewed, with a mean age of 73 years (SD 21), 96% European ethnicity, 63% retired, 36% with high school or higher education, and 8% institutional living. The regression model indicated that compared with the controls, cases were more likely to have heart disease (AOR=13.56, 95% CI 1.27 to 144.86) and dementia (AOR=26.43, 95% CI 1.99 to 350.73). The protective factors included higher education level (AOR=0.48, 95% CI 0.23 to 0.99), having air-conditioner in the bedroom (AOR=0.12, 95% CI 0.02 to 0.74), having an emergency button (AOR=0.09, 95% CI 0.01 to 0.96), using refreshment (AOR=0.10, 95% CI 0.01 to 0.84), and having more social activities (AOR=0.11, 95% CI 0.02 to 0.57). CONCLUSIONS Pre-existing heart disease and dementia significantly increase the risk of direct heat-related hospitalisations during heatwaves. The presence of an air-conditioner in the bedroom, more social activities, a higher education level, use of emergency buttons and refreshments reduce the risk during heatwaves.
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Affiliation(s)
- Ying Zhang
- School of Public Health, China Studies Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Monika Nitschke
- South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia
| | | | - Keith Dear
- Global Health Institute, Duke University and Duke Kunshan University, Shanghai, China
| | - Dino Pisaniello
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Philip Weinstein
- School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Graeme Tucker
- South Australian Department for Health and Ageing (DHA), Adelaide, South Australia, Australia
| | - Sepehr Shakib
- Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Petrou I, Dimitriou K, Kassomenos P. Distinct atmospheric patterns and associations with acute heat-induced mortality in five regions of England. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1413-1424. [PMID: 25605407 DOI: 10.1007/s00484-014-0951-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 11/17/2014] [Accepted: 12/22/2014] [Indexed: 06/04/2023]
Abstract
The main objective of this paper was to identify possible acute heat-induced summer mortality in five regions of England namely the Yorkshire and the Humber, West Midlands, North East, North West and South East regions and reveal associations with specific air flows. For this purpose, backward air mass trajectories corresponding to daily episodes of increased temperatures were produced and divided to clusters, in order to define atmospheric pathways associated with warm air mass intrusions. A statistically significant at 95 % confidence interval increase in daily total mortality (DTMORT) was observed during the selected episodes at all five regions and thus, heat-induced mortality was indicated. The calculated raise was more intense in the West Midlands, North West and South East regions, whereas the results in the North East and Yorkshire and the Humber regions were less evident. Large fractions of thermal episodes, elevated average temperature values and higher average DTMORT levels were primarily associated with the short-medium range South West (SW) and/or East-South East (E-SE) trajectory clusters, suggesting relations among heat-induced mortality and specific atmospheric circulations. Short-medium length of SW and E-SE airflows, calculated by an application of Haversine formula along the centroid trajectory of each cluster, implies the arrival of slow moving air masses. Atmospheric stagnation could enhance human thermal stress due to low wind speed.
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Affiliation(s)
- Ilias Petrou
- Laboratory of Meteorology, Department of Physics, University of Ioannina, 45 110, Ioannina, Greece
| | - Konstantinos Dimitriou
- Laboratory of Meteorology, Department of Physics, University of Ioannina, 45 110, Ioannina, Greece.
| | - Pavlos Kassomenos
- Laboratory of Meteorology, Department of Physics, University of Ioannina, 45 110, Ioannina, Greece
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Schmeltz MT, Sembajwe G, Marcotullio PJ, Grassman JA, Himmelstein DU, Woolhandler S. Identifying individual risk factors and documenting the pattern of heat-related illness through analyses of hospitalization and patterns of household cooling. PLoS One 2015; 10:e0118958. [PMID: 25742021 PMCID: PMC4351173 DOI: 10.1371/journal.pone.0118958] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 01/26/2015] [Indexed: 11/20/2022] Open
Abstract
Background As climate change increases the frequency and intensity of extreme heat events researchers and public health officials must work towards understanding the causes and outcomes of heat-related morbidity and mortality. While there have been many studies on both heat-related illness (HRI), there are fewer on heat-related morbidity than on heat-related mortality. Objective To identify individual and environmental risk factors for hospitalizations and document patterns of household cooling. Methods We performed a pooled cross-sectional analysis of secondary U.S. data, the Nationwide Inpatient Sample. Risk ratios were calculated from multivariable models to identify risk factors for hospitalizations. Hierarchical modeling was also employed to identify relationships between individual and hospital level predictors of hospitalizations. Patterns of air conditioning use were analyzed among the vulnerable populations identified. Results Hospitalizations due to HRI increased over the study period compared to all other hospitalizations. Populations at elevated risk for HRI hospitalization were blacks, males and all age groups above the age of 40. Those living in zip-codes in the lowest income quartile and the uninsured were also at an increased risk. Hospitalizations for HRI in rural and small urban clusters were elevated, compared to urban areas. Conclusions Risk factors for HRI include age greater than 40, male gender and hospitalization in rural areas or small urban clusters. Our analysis also revealed an increasing pattern of HRI hospitalizations over time and decreased association between common comorbidities and heat illnesses which may be indicative of underreporting.
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Affiliation(s)
- Michael T. Schmeltz
- School of Public Health, City University of New York (CUNY), New York, United States of America
- * E-mail:
| | - Grace Sembajwe
- School of Public Health, City University of New York (CUNY), New York, United States of America
- Hunter College, City University of New York (CUNY), New York, United States of America
| | - Peter J. Marcotullio
- Hunter College, City University of New York (CUNY), New York, United States of America
- CUNY Institute for Sustainable Cities, New York, United States of America
| | - Jean A. Grassman
- School of Public Health, City University of New York (CUNY), New York, United States of America
- Health and Nutrition Sciences, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, United States of America
| | - David U. Himmelstein
- School of Public Health, City University of New York (CUNY), New York, United States of America
- Hunter College, City University of New York (CUNY), New York, United States of America
| | - Stephanie Woolhandler
- School of Public Health, City University of New York (CUNY), New York, United States of America
- Hunter College, City University of New York (CUNY), New York, United States of America
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Bai L, Ding G, Gu S, Bi P, Su B, Qin D, Xu G, Liu Q. The effects of summer temperature and heat waves on heat-related illness in a coastal city of China, 2011-2013. ENVIRONMENTAL RESEARCH 2014; 132:212-9. [PMID: 24815333 DOI: 10.1016/j.envres.2014.04.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/31/2014] [Accepted: 04/02/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Devastating health effects from recent heat waves in China have highlighted the importance of understanding health consequences from extreme heat stress. Despite the increasing mortality from extreme heat, very limited studies have quantified the effects of summer extreme temperature on heat-related illnesses in China. METHODS The associations between extreme heat and daily heat-related illnesses that occurred in the summers of 2011-2013 in Ningbo, China, have been examined, using a distributed lag non-linear model (DLNM) based on 3862 cases. The excess morbidities of heat-related illness during each heat wave have been calculated separately and the cumulative heat wave effects on age-, sex-, and cause-specific illnesses in each year along lags have been estimated as well. RESULTS After controlling the effect of relative humidity, it is found that maximum temperature, rather than heat index, was a better predictor of heat-related illnesses in summers. A positive association between maximum temperatures and occurrence of heat-related diseases was apparent, especially at short lag effects. Six heat waves during the period of 2011-2013 were identified and all associated with excess heat-related illnesses. Relative to the average values for the corresponding periods in 2011 and 2012, a total estimated 679 extra heat-related illnesses occurred during three heat waves in 2013. The significant prolonged heat wave effects on total heat-related illnesses during heat waves in three study years have also been identified. The strongest cumulative effect of heat waves was on severe heat diseases in 2013, with a 10-fold increased risk. More males than females, individuals with more severe forms of illness, were more affected by the heat. However, all age groups were vulnerable. CONCLUSIONS Recent heat waves had a substantial and delayed effect on heat illnesses in Ningbo. Relevant active well-organized public health initiatives should be implemented to reduce the adverse effects of heat extremes on the illnesses.
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Affiliation(s)
- Li Bai
- State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China.
| | - Gangqiang Ding
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Shaohua Gu
- State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China.
| | - Peng Bi
- School of Population Health, University of Adelaide, South Australia 5005, Australia.
| | - Buda Su
- National Climate Center, Beijing 100081, China.
| | - Dahe Qin
- National Climate Center, Beijing 100081, China.
| | - Guozhang Xu
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China.
| | - Qiyong Liu
- State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China; Shandong University Climate Change and Health Center, Jinan 250100, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China.
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Gronlund CJ. Racial and socioeconomic disparities in heat-related health effects and their mechanisms: a review. CURR EPIDEMIOL REP 2014; 1:165-173. [PMID: 25512891 DOI: 10.1007/s40471-014-0014-4] [Citation(s) in RCA: 154] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adaptation to increasing extreme heat in a changing climate requires a precise understanding of who is most vulnerable to the health effects of extreme heat. The evidence for race, ethnicity, income, education and occupation, at the individual and area levels, as indicators of vulnerability is reviewed. The evidence for the social, behavioral and technological mechanisms by which racial and socioeconomic disparities in vulnerability exist is also reviewed. These characteristics include cardiorespiratory, renal and endocrine comorbidities; cognitive, mental or physical disabilities; medication use; housing characteristics; neighborhood characteristics such as urban heat islands, crime and safety; social isolation; and individual behaviors such as air conditioning use, opening windows and using fans and use of cooler public spaces. Pre-existing and future research identifying these more proximal indicators of vulnerability will provide information that is more generalizable across locations and time to aid in identifying who to target for prevention of heat-associated morbidity and mortality.
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Affiliation(s)
- Carina J Gronlund
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, 734-615-9215
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Hansen A, Nitschke M, Saniotis A, Benson J, Tan Y, Smyth V, Wilson L, Han GS, Mwanri L, Bi P. Extreme heat and cultural and linguistic minorities in Australia: perceptions of stakeholders. BMC Public Health 2014; 14:550. [PMID: 24889099 PMCID: PMC4107973 DOI: 10.1186/1471-2458-14-550] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 05/23/2014] [Indexed: 11/10/2022] Open
Abstract
Background Despite acclimatisation to hot weather, many individuals in Australia are adversely affected by extreme heat each summer, placing added pressure on the health sector. In terms of public health, it is therefore important to identify vulnerable groups, particularly in the face of a warming climate. International evidence points to a disparity in heat-susceptibility in certain minority groups, although it is unknown if this occurs in Australia. With cultural diversity increasing, the aim of this study was to explore how migrants from different cultural backgrounds and climate experiences manage periods of extreme heat in Australia. Methods A qualitative study was undertaken across three Australian cities, involving interviews and focus groups with key informants including stakeholders involved in multicultural service provision and community members. Thematic analysis and a framework approach were used to analyse the data. Results Whilst migrants and refugees generally adapt well upon resettlement, there are sociocultural barriers encountered by some that hinder environmental adaptation to periods of extreme heat in Australia. These barriers include socioeconomic disadvantage and poor housing, language barriers to the access of information, isolation, health issues, cultural factors and lack of acclimatisation. Most often mentioned as being at risk were new arrivals, people in new and emerging communities, and older migrants. Conclusions With increasing diversity within populations, it is important that the health sector is aware that during periods of extreme heat there may be disparities in the adaptive capacity of minority groups, underpinned by sociocultural and language-based vulnerabilities in migrants and refugees. These factors need to be considered by policymakers when formulating and disseminating heat health strategies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Peng Bi
- Discipline of Public Health, The University of Adelaide, Level 8, Hughes Building, Mail Drop DX650 207, Adelaide, South Australia 5005, Australia.
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Hansen A, Bi P, Pisaniello D, Nitschke M, Tucker G, Newbury J, Kitson A, Dal Grande E, Avery J, Zhang Y, Kelsall L. Heat-health behaviours of older people in two Australian states. Australas J Ageing 2014; 34:E19-25. [PMID: 24621214 DOI: 10.1111/ajag.12134] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM A major heatwave occurred in Australia in early 2009 with considerable and varied health impacts in South Australia (SA) and Victoria. The aim of this study was to investigate the heat-adaptive behaviours of older people in these states. METHODS A computer-assisted telephone survey of 1000 residents of SA and Victoria aged 65 years or older was conducted at the end of summer 2010-2011. RESULTS The majority of respondents reported undertaking heat-adaptive behaviours. In SA, there was a significantly higher proportion of households with air conditioning compared to Victoria, and a higher recall of heat-health messages. In both states, self-reported morbidity during heatwaves was higher in women, persons with poorer health and those with cardiovascular conditions. CONCLUSION An increase in global temperatures in conjunction with an ageing population is a concern for public health. Our findings suggest acclimatisation to hot weather may influence behaviours and health outcomes in older people.
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Affiliation(s)
- Alana Hansen
- Discipline of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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Environmental temperature and thermal indices: what is the most effective predictor of heat-related mortality in different geographical contexts? ScientificWorldJournal 2014; 2014:961750. [PMID: 24523657 PMCID: PMC3910390 DOI: 10.1155/2014/961750] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 10/18/2013] [Indexed: 11/17/2022] Open
Abstract
The aim of this study is to identify the most effective thermal predictor of heat-related very-elderly mortality in two cities located in different geographical contexts of central Italy. We tested the hypothesis that use of the state-of-the-art rational thermal indices, the Universal Thermal Climate Index (UTCI), might provide an improvement in predicting heat-related mortality with respect to other predictors. Data regarding very elderly people (≥75 years) who died in inland and coastal cities from 2006 to 2008 (May–October) and meteorological and air pollution were obtained from the regional mortality and environmental archives. Rational (UTCI) and direct thermal indices represented by a set of bivariate/multivariate apparent temperature indices were assessed. Correlation analyses and generalized additive models were applied. The Akaike weights were used for the best model selection. Direct multivariate indices showed the highest correlations with UTCI and were also selected as the best thermal predictors of heat-related mortality for both inland and coastal cities. Conversely, the UTCI was never identified as the best thermal predictor. The use of direct multivariate indices, which also account for the extra effect of wind speed and/or solar radiation, revealed the best fitting with all-cause, very-elderly mortality attributable to heat stress.
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Hansen A, Bi L, Saniotis A, Nitschke M. Vulnerability to extreme heat and climate change: is ethnicity a factor? Glob Health Action 2013; 6:21364. [PMID: 23899408 PMCID: PMC3728476 DOI: 10.3402/gha.v6i0.21364] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/21/2013] [Accepted: 06/27/2013] [Indexed: 01/28/2023] Open
Abstract
Background With a warming climate, it is important to identify sub-populations at risk of harm during extreme heat. Several international studies have reported that individuals from ethnic minorities are at increased risk of heat-related illness, for reasons that are not often discussed. Objective The aim of this article is to investigate the underpinning reasons as to why ethnicity may be associated with susceptibility to extreme heat, and how this may be relevant to Australia’s population. Design Drawing upon literary sources, the authors provide commentary on this important, yet poorly understood area of heat research. Results Social and economic disparities, living conditions, language barriers, and occupational exposure are among the many factors contributing to heat-susceptibility among minority ethnic groups in the United States. However, there is a knowledge gap about socio-cultural influences on vulnerability in other countries. Conclusion More research needs to be undertaken to determine the effects of heat on tourists, migrants, and refugees who are confronted with a different climatic environment. Thorough epidemiological investigations of the association between ethnicity and heat-related health outcomes are required, and this could be assisted with better reporting of nationality data in health statistics. Climate change adaptation strategies in Australia and elsewhere need to be ethnically inclusive and cognisant of an upward trend in the proportion of the population who are migrants and refugees.
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Affiliation(s)
- Alana Hansen
- Discipline of Public Health, University of Adelaide, Adelaide, Australia.
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