1
|
Hampo CC, Schinasi LH, Hoque S. Surviving indoor heat stress in United States: A comprehensive review exploring the impact of overheating on the thermal comfort, health, and social economic factors of occupants. Heliyon 2024; 10:e25801. [PMID: 38371979 PMCID: PMC10873744 DOI: 10.1016/j.heliyon.2024.e25801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/23/2024] [Accepted: 02/02/2024] [Indexed: 02/20/2024] Open
Abstract
In the face of escalating global climate change and the increasing frequency of extreme heat events, the mitigation of building overheating has become an urgent priority. This comprehensive review converges insights from building science and public health domains to offer a thorough understanding of the multifaceted impacts of indoor overheating on occupants. The paper addresses a significant research gap by offering a holistic exploration of indoor overheating of residential buildings and its consequences, with a specific focus on the United States, an economically diverse nation that has been underrepresented in the literature. The review illuminates the effects of overheating on thermal comfort, health, and socio-economic aspects within the built environment. It emphasizes associated repercussions, including heightened cooling energy consumption, increased peak electricity demand, and elevated vulnerability, leading to exacerbated heat-related mortality and morbidity rates, especially among disadvantaged groups. The study concludes that vulnerabilities to these impacts are intricately tied to regional climatic conditions, highlighting the inadequacy of a one-size-fits-all approach. Tailored interventions for each climate zone are deemed necessary, considering the consistent occurrence of indoor temperatures surpassing outdoor levels, known as superheating, which poses distinct challenges. The research underscores the urgency of addressing indoor overheating as a critical facet of public health, acknowledging direct socioeconomic repercussions. It advocates for further research to inform comprehensive policies that safeguard public health across diverse indoor environments.
Collapse
Affiliation(s)
- Chima Cyril Hampo
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, USA
| | - Leah H. Schinasi
- Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Simi Hoque
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, USA
| |
Collapse
|
2
|
Novak R, Robinson JA, Frantzidis C, Sejdullahu I, Persico MG, Kontić D, Sarigiannis D, Kocman D. Integrated assessment of personal monitor applications for evaluating exposure to urban stressors: A scoping review. ENVIRONMENTAL RESEARCH 2023; 226:115685. [PMID: 36921791 DOI: 10.1016/j.envres.2023.115685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/23/2023] [Accepted: 03/11/2023] [Indexed: 06/18/2023]
Abstract
Urban stressors pose a health risk, and individual-level assessments provide necessary and fine-grained insight into exposure. An ever-increasing amount of research literature on individual-level exposure to urban stressors using data collected with personal monitors, has called for an integrated assessment approach to identify trends, gaps and needs, and provide recommendations for future research. To this end, a scoping review of the respective literature was performed, as part of the H2020 URBANOME project. Moreover, three specific aims were identified: (i) determine current state of research, (ii) analyse literature according with a waterfall methodological framework and identify gaps and needs, and (iii) provide recommendations for more integrated, inclusive and robust approaches. Knowledge and gaps were extracted based on a systematic approach, e.g., data extraction questionnaires, as well as through the expertise of the researchers performing the review. The findings were assessed through a waterfall methodology of delineating projects into four phases. Studies described in the papers vary in their scope, with most assessing exposure in a single macro domain, though a trend of moving towards multi-domain assessment is evident. Simultaneous measurements of multiple stressors are not common, and papers predominantly assess exposure to air pollution. As urban environments become more diverse, stakeholders from different groups are included in the study designs. Most frequently (per the quadruple helix model), civil society/NGO groups are involved, followed by government and policymakers, while business or private sector stakeholders are less frequently represented. Participants in general function as data collectors and are rarely involved in other phases of the research. While more active involvement is not necessary, more collaborative approaches show higher engagement and motivation of participants to alter their lifestyles based on the research results. The identified trends, gaps and needs can aid future exposure research and provide recommendations on addressing different urban communities and stakeholders.
Collapse
Affiliation(s)
- Rok Novak
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, 1000, Ljubljana, Slovenia.
| | - Johanna Amalia Robinson
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, 1000, Ljubljana, Slovenia; Center for Research and Development, Slovenian Institute for Adult Education, Ulica Ambrožiča Novljana 5, 1000, Ljubljana, Slovenia
| | - Christos Frantzidis
- Biomedical Engineering & Aerospace Neuroscience (BEAN), Laboratory of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Greece; Greek Aerospace Medical Association and Space Research (GASMA-SR), Greece
| | - Iliriana Sejdullahu
- Ambiente Italia Società a Responsabilità Limitata, Department of Adaptation and Resilience, 20129, Milan, Italy
| | - Marco Giovanni Persico
- Urban Resilience Department, City of Milan, Italy; Postgraduate School of Health Statistics and Biometrics, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Davor Kontić
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia; Centre for Participatory Research, Jožef Stefan Institute, 1000, Ljubljana, Slovenia
| | - Dimosthenis Sarigiannis
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece; HERACLES Research Centre on the Exposome and Health, Center for Interdisciplinary Research and Innovation, 54124, Thessaloniki, Greece; Department of Science, Technology and Society, University School of Advanced Study IUSS, 27100, Pavia, Italy
| | - David Kocman
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia
| |
Collapse
|
3
|
Hassan AM, Nogueira L, Lin YL, Rogers JE, Nori-Sarma A, Offodile AC. Impact of Heatwaves on Cancer Care Delivery: Potential Mechanisms, Health Equity Concerns, and Adaptation Strategies. J Clin Oncol 2023:JCO2201951. [PMID: 37098249 DOI: 10.1200/jco.22.01951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Affiliation(s)
- Abbas M Hassan
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Yu-Li Lin
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jane E Rogers
- Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Amruta Nori-Sarma
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
| | - Anaeze Chidiebele Offodile
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
- Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
4
|
Makris KC, Charisiadis P, Delplancke T, Efthymiou N, Giuliani A. Diurnal Nonlinear Recurrence Metrics of Skin Temperature and Their Association with Metabolic Hormones in Contrasting Climate Settings: A Randomized Cross-Over Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15195. [PMID: 36429912 PMCID: PMC9690349 DOI: 10.3390/ijerph192215195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
The urban overheating phenomenon in Mediterranean cities is a societal challenge with vast implications for the protection of public health. An additional analysis of the pilot TEMP randomized 2 × 2 cross-over trial was set up, using wearable sensor-based skin temperature measurements (n = 14). The study objectives were to: (i) assess the recurrence patterns of skin temperature measurements in individuals spending time in two climatologically contrasting settings (urban versus mountainous), and (ii) evaluate the association between the diurnal nonlinear recurrence quantification analysis (RQA) metrics and metabolic hormone levels. The intervention was a short-term stay (5-7 days) in a mountainous, climate-cooler setting (range 600-900 m altitude), which is about a 1 h drive from the main urban centres of Cyprus. The RQA analysis showed a blunting phenomenon on the nonlinear temporal dynamics of skin temperature time series observed in the urban setting. Compared with the mountainous setting, a more stable (and thus less adaptive) profile of skin temperature dynamics in the urban setting appeared, being less deterministic and with a smaller degree of complexity. No significant (p > 0.05) associations were observed between the leptin or cortisol and any of the skin temperature dynamical descriptors. However, there were marginal associations between the adiponectin and laminarity (beta = 0.24, 95%CI: -0.02, 0.50, p = 0.07) and with determinism (beta = 0.23, 95%CI: -0.037, 0.50, p = 0.09). We found dysregulations in skin temperature temporal dynamics of the study population while residing in the urban setting when compared with the cooler mountainous setting; these dysregulations took the form of reduced cycle duration and complexity, while skin temperature dynamics became less responsive to perturbations and less regular in magnitude. More research is needed to better understand heat stress temporal dynamics and their influence on human health. Trial registration: This trial is registered with ClinicalTrials.gov; number: NCT03625817.
Collapse
Affiliation(s)
- Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
| | - Pantelis Charisiadis
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
| | - Thibaut Delplancke
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
| | - Nikolaos Efthymiou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
| | - Alessandro Giuliani
- Environment and Health Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| |
Collapse
|
5
|
Burke M, Heft-Neal S, Li J, Driscoll A, Baylis P, Stigler M, Weill JA, Burney JA, Wen J, Childs ML, Gould CF. Exposures and behavioural responses to wildfire smoke. Nat Hum Behav 2022; 6:1351-1361. [PMID: 35798884 DOI: 10.1038/s41562-022-01396-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022]
Abstract
Pollution from wildfires constitutes a growing source of poor air quality globally. To protect health, governments largely rely on citizens to limit their own wildfire smoke exposures, but the effectiveness of this strategy is hard to observe. Using data from private pollution sensors, cell phones, social media posts and internet search activity, we find that during large wildfire smoke events, individuals in wealthy locations increasingly search for information about air quality and health protection, stay at home more and are unhappier. Residents of lower-income neighbourhoods exhibit similar patterns in searches for air quality information but not for health protection, spend less time at home and have more muted sentiment responses. During smoke events, indoor particulate matter (PM2.5) concentrations often remain 3-4× above health-based guidelines and vary by 20× between neighbouring households. Our results suggest that policy reliance on self-protection to mitigate smoke health risks will have modest and unequal benefits.
Collapse
Affiliation(s)
- Marshall Burke
- Department of Earth System Science, Stanford University, Stanford, CA, USA.
- Center on Food Security and the Environment, Stanford University, Stanford, CA, USA.
- National Bureau of Economic Research, Cambridge, MA, USA.
| | - Sam Heft-Neal
- Center on Food Security and the Environment, Stanford University, Stanford, CA, USA
| | - Jessica Li
- Center on Food Security and the Environment, Stanford University, Stanford, CA, USA
| | - Anne Driscoll
- Center on Food Security and the Environment, Stanford University, Stanford, CA, USA
| | - Patrick Baylis
- Department of Economics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthieu Stigler
- Center on Food Security and the Environment, Stanford University, Stanford, CA, USA
| | - Joakim A Weill
- Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA, USA
| | - Jennifer A Burney
- Global Policy School, University of California, San Diego, San Diego, CA, USA
| | - Jeff Wen
- Department of Earth System Science, Stanford University, Stanford, CA, USA
| | - Marissa L Childs
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, CA, USA
| | - Carlos F Gould
- Department of Earth System Science, Stanford University, Stanford, CA, USA
| |
Collapse
|
6
|
Uejio CK, Joiner AP, Gonsoroski E, Tamerius JD, Jung J, Moran TP, Yancey AH. The association of indoor heat exposure with diabetes and respiratory 9-1-1 calls through emergency medical dispatch and services documentation. ENVIRONMENTAL RESEARCH 2022; 212:113271. [PMID: 35427590 DOI: 10.1016/j.envres.2022.113271] [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: 11/22/2021] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND People with pre-existing medical conditions, who spend a large proportion of their time indoors, are at risk of emergent morbidities from elevated indoor heat exposures. In this study, indoor heat of structures wherein exposed people received Grady Emergency Services based care in Atlanta, GA, U.S., was measured from May to September 2016. METHOD ology: In this case-control study, analyses were conducted to investigate the effect of indoor heat on the odds of 9-1-1 calls for diabetic (n = 90 cases) and separately, for respiratory (n = 126 cases), conditions versus heat-insensitive emergencies (n = 698 controls). Generalized Additive Models considered both linear and non-linear indoor heat and health outcome associations using thin-plate regression splines. RESULTS Hotter and more humid indoor conditions were non-linearly associated with an increasing likelihood of receiving emergency care for complications of diabetes and severe respiratory distress. Higher heat indices were associated with increased odds of a diabetes (odds ratio for change from 30 to 31 °C: 1.12, 95% CI: 1.08-1.16) or respiratory 9-1-1 medical call versus control (odds ratio for change from 34 to 35 °C: 1.18, 95% CI: 1.09-1.28) call. Both diabetic and respiratory distress patients were more likely to be African-American and/or have comorbidities. CONCLUSIONS In this study, the statistical association of indoor heat exposure with emergency morbidities (diabetic, respiratory) was demonstrated. The study also showcased the value and utility of data gathered by emergency medical dispatch and services from inaccessible private indoor sources (i.e., domiciles) for environmental health.
Collapse
Affiliation(s)
- Christopher K Uejio
- Florida State University, Department of Geography, Bellamy Building, Room 323, 113 Collegiate Loop, PO Box 3062190, Tallahassee, FL, 32306, USA.
| | - Anjni Patel Joiner
- Duke University, Department of Surgery, Division of Emergency Medicine. 2301 Erwin Road, Duke Hospital North, Box 3096, Durham, NC, 27710, USA.
| | - Elaina Gonsoroski
- Florida State University, Department of Geography, Bellamy Building, Room 323, 113 Collegiate Loop, PO Box 3062190, Tallahassee, FL, 32306, USA.
| | - James D Tamerius
- Center of Sustainable Energy, 3980 Sherman St #170, San Diego, CA, 92110, USA.
| | - Jihoon Jung
- University of North Carolina at Chapel Hill, Department of City and Regional Planning, New East Building, CB3140, Chapel Hill, NC, 27599, USA.
| | - Tim P Moran
- Emory University, Department of Emergency Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.
| | - Arthur H Yancey
- Emory University, Department of Emergency Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.
| |
Collapse
|
7
|
Khatana SAM, Werner RM, Groeneveld PW. Association of Extreme Heat and Cardiovascular Mortality in the United States: A County-Level Longitudinal Analysis From 2008 to 2017. Circulation 2022; 146:249-261. [PMID: 35726635 DOI: 10.1161/circulationaha.122.060746] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Extreme-heat events are increasing as a result of climate change. Prior studies, typically limited to urban settings, suggest an association between extreme heat and cardiovascular mortality. However, the extent of the burden of cardiovascular deaths associated with extreme heat across the United States and in different age, sex, or race and ethnicity subgroups is unclear. METHODS County-level daily maximum heat index levels for all counties in the contiguous United States in summer months (May-September) and monthly cardiovascular mortality rates for adults ≥20 years of age were obtained. For each county, an extreme-heat day was identified if the maximum heat index was ≥90 °F (32.2 °C) and in the 99th percentile of the maximum heat index in the baseline period (1979-2007) for that day. Spatial empirical Bayes smoothed monthly cardiovascular mortality rates from 2008 to 2017 were the primary outcome. A Poisson fixed-effects regression model was estimated with the monthly number of extreme-heat days as the independent variable of interest. The model included time-fixed effects and time-varying environmental, economic, demographic, and health care-related variables. RESULTS Across 3108 counties, from 2008 to 2017, each additional extreme-heat day was associated with a 0.12% (95% CI, 0.04%-0.21%; P=0.004) higher monthly cardiovascular mortality rate. Extreme heat was associated with an estimated 5958 (95% CI, 1847-10 069) additional deaths resulting from cardiovascular disease over the study period. In subgroup analyses, extreme heat was associated with a greater relative increase in mortality rates among men compared with women (0.20% [95% CI, 0.07%-0.33%]) and non-Hispanic Black compared with non-Hispanic White adults (0.19% [95% CI, 0.01%-0.37%]). There was a greater absolute increase among elderly adults compared with nonelderly adults (16.6 [95% CI, 14.6-31.8] additional deaths per 10 million individuals per month). CONCLUSIONS Extreme-heat days were associated with higher adult cardiovascular mortality rates in the contiguous United States between 2008 and 2017. This association was heterogeneous among age, sex, race, and ethnicity subgroups. As extreme-heat events increase, the burden of cardiovascular mortality may continue to increase, and the disparities between demographic subgroups may widen.
Collapse
Affiliation(s)
- Sameed Ahmed M Khatana
- Division of Cardiovascular Medicine (S.A.M.K.), University of Pennsylvania, Philadelphia.,Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center (S.A.M.K., P.W.G.), University of Pennsylvania, Philadelphia.,The Leonard Davis Institute of Health Economics (S.A.M.K., R.M.W., P.W.G.), University of Pennsylvania, Philadelphia
| | - Rachel M Werner
- Division of General Internal Medicine (R.M.W., P.W.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.,The Leonard Davis Institute of Health Economics (S.A.M.K., R.M.W., P.W.G.), University of Pennsylvania, Philadelphia.,Center for Health Equity Research and Promotion, Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA (R.M.W., P.W.G.)
| | - Peter W Groeneveld
- Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center (S.A.M.K., P.W.G.), University of Pennsylvania, Philadelphia.,Division of General Internal Medicine (R.M.W., P.W.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.,The Leonard Davis Institute of Health Economics (S.A.M.K., R.M.W., P.W.G.), University of Pennsylvania, Philadelphia.,Center for Health Equity Research and Promotion, Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA (R.M.W., P.W.G.)
| |
Collapse
|
8
|
Lan L, Tang J, Wargocki P, Wyon DP, Lian Z. Cognitive performance was reduced by higher air temperature even when thermal comfort was maintained over the 24-28°C range. INDOOR AIR 2022; 32:e12916. [PMID: 34324229 DOI: 10.1111/ina.12916] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
This study managed to create thermal comfort conditions at three temperatures (24°C-T24, 26°C-T26, and 28°C-T28) by adjusting clothing and air velocity. Thirty-six subjects (18 males and 18 females) were exposed to each of the three conditions for 4.5 h in a design balanced for order of presentation of conditions. During each exposure, they rated the physical environment, their comfort, the intensity of acute subclinical health symptoms, and their mental load, and they performed a number of cognitive tasks. Their physiological reactions were monitored. The subjects rated T24 to be comfortably cool, T26 to be comfortably neutral, and T28 to be comfortably warm. Their self-estimated performance did not differ between conditions but 12 of 14 objective metrics of cognitive performance decreased significantly at the elevated temperatures: compared with T24, their average cognitive performance decreased by 10% at T26 and by 6% at T28. At the elevated temperatures, their parasympathetic nervous system activity (as indicated by PNN50) and their arterial blood oxygen saturation level (SpO2) were both lower, which would be expected to result in reduced cognitive performance. The subjects also rated their acute subclinical health symptoms as more intense and their workload as higher at the elevated temperatures. These results suggest that where cognitive performance is the priority, it is wise to ensure a comfortably cool environment. The present study also supports the use of fans or natural ventilation to reduce the need for mechanical cooling.
Collapse
Affiliation(s)
- Li Lan
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Jieyu Tang
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Pawel Wargocki
- Department of Civil Engineering, International Centre for Indoor Environment and Energy, Technical University of Denmark (DTU), Lyngby, Denmark
| | - David P Wyon
- Department of Civil Engineering, International Centre for Indoor Environment and Energy, Technical University of Denmark (DTU), Lyngby, Denmark
| | - Zhiwei Lian
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
9
|
Constantinou A, Oikonomou S, Konstantinou C, Makris KC. A randomized cross-over trial investigating differences in 24-h personal air and skin temperatures using wearable sensors between two climatologically contrasting settings. Sci Rep 2021; 11:22020. [PMID: 34759278 PMCID: PMC8580978 DOI: 10.1038/s41598-021-01180-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/25/2021] [Indexed: 11/08/2022] Open
Abstract
The influence of elevated air temperatures recorded in various urban microenvironments in adversely impacting biologically relevant disease end points has not yet been extensively tackled. This study is a post hoc analysis of the TEMP pilot trial, a randomized 2 × 2 cross-over trial that examined changes in metabolic and stress hormonal profiles of healthy adults in two settings (urban vs. rural) with distinctly different climatological characteristics during the Mediterranean summer. This analysis aimed to study the association between the 24-h personal air or skin temperature sensor measurements and the diary-based location type (indoors vs. outdoors) in urban (seaside) vs. rural (higher in altitude) microenvironments. Out of 41 eligible participants, a total of 37 participants were included in this post-hoc TEMP trial analysis. Wearable sensors recorded personal air temperature, skin temperature, and activity (as a surrogate marker of physical activity) in each setting, while a time-stamped personal diary recorded the types of indoor or outdoor activities. Temperature peaks during the 24-h sampling period were detected using a peak finding algorithm. Mixed effect logistic regression models were fitted for the odds of participant location (being indoors vs. outdoors) as a function of setting (urban vs. rural) and sensor-based personal temperature data (either raw temperature values or number of temperature peaks). During the study period (July-end of September), median [interquartile range, IQR] personal air temperature in the rural (higher altitude) settings was 1.5 °C lower than that in the urban settings (27.1 °C [25.4, 29.2] vs. 28.6 °C [27.1, 30.5], p < 0.001), being consistent with the Mediterranean climate. Median [IQR] personal air temperature in indoor (micro)environments was lower than those in outdoors (28.0 °C [26.4, 30.3] vs 28.5 °C [26.8, 30.7], p < 0.001). However, median [IQR] skin temperature was higher in indoor (micro)environments vs. outdoors (34.8 °C [34.0, 35.6] and 33.9 °C [32.9, 34.8], p < 0.001) and the number of both personal air and skin temperature peaks was higher indoors compared to outdoors (median [IQR] 3.0 [2.0,4.0] vs 1.0 [1.0,1.3], p < 0.007, for the skin sensors). A significant association between the number of temperature peaks and indoor location types was observed with either the personal air sensor (OR 3.1; 95% CI 1.2-8.2; p = 0.02) or the skin sensor (OR 3.7; 95% CI 1.4-9.9; p = 0.01), suggesting higher number of indoor air temperature fluctuations. Amidst the global climate crisis, more population health studies or personalized medicine approaches that utilize continuous tracking of individual-level air/skin temperatures in both indoor/outdoor locations would be warranted, if we were to better characterize the disease phenotype in response to climate change manifestations.
Collapse
Affiliation(s)
- Andria Constantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Stavros Oikonomou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Corina Konstantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
| |
Collapse
|
10
|
O’Lenick CR, Baniassadi A, Michael R, Monaghan A, Boehnert J, Yu X, Hayden MH, Wiedinmyer C, Zhang K, Crank PJ, Heusinger J, Hoel P, Sailor DJ, Wilhelmi OV. A Case-Crossover Analysis of Indoor Heat Exposure on Mortality and Hospitalizations among the Elderly in Houston, Texas. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:127007. [PMID: 33300819 PMCID: PMC7727721 DOI: 10.1289/ehp6340] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Despite the substantial role indoor exposure has played in heat wave-related mortality, few epidemiological studies have examined the health effects of exposure to indoor heat. As a result, knowledge gaps regarding indoor heat-health thresholds, vulnerability, and adaptive capacity persist. OBJECTIVE We evaluated the role of indoor heat exposure on mortality and morbidity among the elderly (≥65 years of age) in Houston, Texas. METHODS Mortality and emergency hospital admission data were obtained through the Texas Department of State Health Services. Summer indoor heat exposure was modeled at the U.S. Census block group (CBG) level using building energy models, outdoor weather data, and building characteristic data. Indoor heat-health associations were examined using time-stratified case-crossover models, controlling for temporal trends and meteorology, and matching on CBG of residence, year, month, and weekday of the adverse health event. Separate models were fitted for three indoor exposure metrics, for individual lag days 0-6, and for 3-d moving averages (lag 0-2). Effect measure modification was explored via stratification on individual- and area-level vulnerability factors. RESULTS We estimated positive associations between short-term changes in indoor heat exposure and cause-specific mortality and morbidity [e.g., circulatory deaths, odds ratio per 5°C increase=1.16 (95% CI: 1.03, 1.30)]. Associations were generally positive for earlier lag periods and weaker across later lag periods. Stratified analyses suggest stronger associations between indoor heat and emergency hospital admissions among African Americans compared with Whites. DISCUSSION Findings suggest excess mortality among certain elderly populations in Houston who are likely exposed to high indoor heat. We developed a novel methodology to estimate indoor heat exposure that can be adapted to other U.S. LOCATIONS In locations with high air conditioning prevalence, simplified modeling approaches may adequately account for indoor heat exposure in vulnerable neighborhoods. Accounting for indoor heat exposure may improve the estimation of the total impact of heat on health. https://doi.org/10.1289/EHP6340.
Collapse
Affiliation(s)
- Cassandra R. O’Lenick
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado, USA
| | - Amir Baniassadi
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona, USA
- Harvard University, Cambridge, Massachusetts, USA
| | - Ryan Michael
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado, USA
| | | | - Jennifer Boehnert
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado, USA
| | - Xiao Yu
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Mary H. Hayden
- University of Colorado-Colorado Springs, Colorado Springs, Colorado, USA
| | | | - Kai Zhang
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
- Southwest Center for Occupational and Environmental Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Peter J. Crank
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona, USA
| | - Jannik Heusinger
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona, USA
| | - Paige Hoel
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado, USA
- University of California, Los Angeles, Los Angeles, USA
| | - David J. Sailor
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona, USA
| | - Olga V. Wilhelmi
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado, USA
| |
Collapse
|
11
|
Dwelling Characteristics Influence Indoor Temperature and May Pose Health Threats in LMICs. Ann Glob Health 2020; 86:91. [PMID: 32832385 PMCID: PMC7413138 DOI: 10.5334/aogh.2938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Shelter and safe housing is a basic human need that brings about a sense of ownership, self-sufficiency, and citizenship. Millions of people around the world live in inadequate dwellings in unhealthy areas, such as urban slums. These dwellings may experience indoor temperatures that impact inhabitants’ health. Indoor dwelling temperatures vary depending on many factors including geographic location, such as inland versus coastal. In an era of climate change, understanding how dwelling characteristics influence indoor temperature is important, especially in low- and middle-income countries, to protect health. Objective: To assess indoor temperature in low-cost dwellings located in a coastal setting in relation to dwelling characteristics. Methods: Indoor temperature and relative humidity loggers were installed from 1 June 2017 to 15 May 2018 in 50 dwellings in two settlements in a coastal town on the east coast of South Africa. Ambient outdoor temperature data were obtained from the national weather service, indoor temperature data were converted into apparent temperature, and heat index calculations were made to consider possible heat-health risks. A household questionnaire and dwelling observation assessment were administered. A mixed-effects linear regression model was constructed to consider the impact of dwelling characteristics on indoor apparent temperature. Findings: Among 17 dwellings with all data sets, indoor temperatures were consistently higher than, and well correlated (r = 0.92) with outdoor temperatures. Average differences in indoor and outdoor temperatures were about 4°C, with statistically significant differences in percentage difference of indoor/outdoor between seasons (p < 0.001). Heat indices for indoor temperatures were exceeded mostly in summer, thereby posing possible health risks. Dwellings with cement floors were statistically significantly cooler than any other floor type across all seasons. Conclusions: Low-cost dwellings experienced temperatures indoors higher than outdoor temperatures in part due to floor type. These results help inform interventions that consider housing and human health (n = 289).
Collapse
|
12
|
A Review of the Relation between Household Indoor Temperature and Health Outcomes. ENERGIES 2020. [DOI: 10.3390/en13112881] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This paper provides a review of research that addresses the relationship between indoor temperatures and health outcomes, taking into consideration studies that focus heat or cold exposure within the household context. It aims to extend previous research by considering both indoor temperatures from existing housing, and empirical studies that focus on energy efficiency measures and subsequent health impacts. To achieve this aim, a literature review was undertaken, combining engineering and health databases. The review established that, overall, inadequate indoor temperatures are associated with poor health status, whereas energy efficiency measures have been associated to improved indoor temperatures and occupant’s health namely regarding cardiovascular, respiratory and mental health disorders. These health conditions are among the most prevalent non-communicable diseases (NCD). The review also highlighted the need for more empirical studies with an extended timeframe to deal with climate change challenges. It underlined the potential advantages of the convergence between health and energy efficiency studies, for better modelling and planning.
Collapse
|
13
|
Xu R, Li S, Guo S, Zhao Q, Abramson MJ, Li S, Guo Y. Environmental temperature and human epigenetic modifications: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 259:113840. [PMID: 31884209 DOI: 10.1016/j.envpol.2019.113840] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/26/2019] [Accepted: 12/16/2019] [Indexed: 05/28/2023]
Abstract
The knowledge about the effects of environmental temperature on human epigenome is a potential key to understand the health impacts of temperature and to guide acclimation under climate change. We performed a systematic review on the epidemiological studies that have evaluated the association between environmental temperature and human epigenetic modifications. We identified seven original articles on this topic published between 2009 and 2019, including six cohort studies and one cross-sectional study. They focused on DNA methylation in elderly people (blood sample) or infants (placenta sample), with sample size ranging from 306 to 1798. These studies were conducted in relatively low temperature setting (median/mean temperature: 0.8-13 °C), and linear models were used to evaluate temperature-DNA methylation association over short period (≤28 days). It has been reported that short-term ambient temperature could affect global human DNA methylation. A total of 15 candidate genes (ICAM-1, CRAT, F3, TLR-2, iNOS, ZKSCAN4, ZNF227, ZNF595, ZNF597, ZNF668, CACNA1H, AIRE, MYEOV2, NKX1-2 and CCDC15) with methylation status associated with ambient temperature have been identified. DNA methylation on ZKSCAN4, ICAM-1 partly mediated the effect of short-term cold temperature on high blood pressure and ICAM-1 protein (related to cardiovascular events), respectively. In summary, epidemiological evidence about the impacts of environment temperature on human epigenetics remains scarce and limited to short-term linear effect of cold temperature on DNA methylation in elderly people and infants. More studies are needed to broaden our understanding of temperature related epigenetic changes, especially under a changing climate.
Collapse
Affiliation(s)
- Rongbin Xu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shuai Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, 3052, Australia
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| |
Collapse
|
14
|
Is There a Need to Integrate Human Thermal Models with Weather Forecasts to Predict Thermal Stress? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224586. [PMID: 31752444 PMCID: PMC6888075 DOI: 10.3390/ijerph16224586] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/15/2019] [Accepted: 11/17/2019] [Indexed: 12/22/2022]
Abstract
More and more people will experience thermal stress in the future as the global temperature is increasing at an alarming rate and the risk for extreme weather events is growing. The increased exposure to extreme weather events poses a challenge for societies around the world. This literature review investigates the feasibility of making advanced human thermal models in connection with meteorological data publicly available for more versatile practices and a wider population. By providing society and individuals with personalized heat and cold stress warnings, coping advice and educational purposes, the risks of thermal stress can effectively be reduced. One interesting approach is to use weather station data as input for the wet bulb globe temperature heat stress index, human heat balance models, and wind chill index to assess heat and cold stress. This review explores the advantages and challenges of this approach for the ongoing EU project ClimApp where more advanced models may provide society with warnings on an individual basis for different thermal environments such as tropical heat or polar cold. The biggest challenges identified are properly assessing mean radiant temperature, microclimate weather data availability, integration and continuity of different thermal models, and further model validation for vulnerable groups.
Collapse
|
15
|
Tham S, Thompson R, Landeg O, Murray KA, Waite T. Indoor temperature and health: a global systematic review. Public Health 2019; 179:9-17. [PMID: 31707154 DOI: 10.1016/j.puhe.2019.09.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/25/2019] [Accepted: 09/06/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The objective of this study was to identify and appraise evidence on the direct and indirect impacts of high indoor temperatures on health; the indoor temperature threshold at which the identified health impacts are observed; and to summarise the evidence for establishing a maximum indoor temperature threshold for health. STUDY DESIGN This is a systematic literature review and narrative synthesis. METHODS A review of the published literature using MEDLINE, EMBASE, Global Health, PsycINFO, Maternity and Infant Care, Cochrane Library, CINAHL and GreenFILE databases was conducted. The search criteria were kept broad to capture evidence from all countries and contexts; no date or study design limits were applied, except English language limits. We included studies that specifically measured indoor temperature and examined its effect on physical or mental health outcomes. Evidence was graded using the National Institutes of Health framework. RESULTS Twenty-two articles were included in the review, including 11 observational, seven cross-sectional and three longitudinal cohort studies and one prospective case-control study. Eight main health effects were described: respiratory, blood pressure, core temperature, blood glucose, mental health and cognition, heat-health symptoms, physical functioning and influenza transmission. Five studies found respiratory symptoms worsened in warm indoor environments, with one reporting indoor temperatures higher than 26 °C, which was associated with increased respiratory distress calls being made to paramedics (odds ratio = 1.63, P = 0.056). Core symptoms of schizophrenia and dementia were found to be significantly exacerbated by indoor heat (the latter above a 26 °C cumulative exposure threshold). The absorption of insulin doses in people with type one diabetes was also significantly accelerated in hot indoor environments. Only five studies reported the temperatures at which health outcomes worsened, with thresholds ranging between 26 °C and 32 °C. However, owing to insufficient data and the heterogeneity of the included studies (design, population, setting, exposure measures, outcomes and location), meta-analysis and an upper threshold determination was not feasible. CONCLUSIONS High indoor temperatures affect aspects of human health, with the strongest evidence for respiratory health, diabetes management and core schizophrenia and dementia symptoms. Exacerbation of symptoms in warm indoor environments has clinical relevance to at-risk groups and those caring for them. Care staff and facility managers need to be vigilant of high temperatures in care environments and should incorporate indoor overheating into their risk management and sustainability and/or climate change adaptation plans. The indoor temperature threshold at which adverse effects begin to occur remains unclear as studies seldom report the exposure-response relationship over a temperature continuum. Until there is extensive scientific data to support a maximum indoor temperature threshold, 26 °C may be the most suitable indoor temperature for at-risk groups in keeping with the existing guidance documents.
Collapse
Affiliation(s)
- S Tham
- Centre for Environmental Policy, Imperial College London, 16-18 Princes Gardens, London, SW7 1NE, UK.
| | - R Thompson
- Public Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London, SE1 8UG, UK.
| | - O Landeg
- Public Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London, SE1 8UG, UK.
| | - K A Murray
- Department of Infectious Disease Epidemiology and Grantham Institute - Climate Change and the Environment, Imperial College London, Exhibition Road, South Kensington, London, SW7 2AZ, UK.
| | - T Waite
- Public Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London, SE1 8UG, UK.
| |
Collapse
|
16
|
O'Lenick CR, Wilhelmi OV, Michael R, Hayden MH, Baniassadi A, Wiedinmyer C, Monaghan AJ, Crank PJ, Sailor DJ. Urban heat and air pollution: A framework for integrating population vulnerability and indoor exposure in health risk analyses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 660:715-723. [PMID: 30743957 DOI: 10.1016/j.scitotenv.2019.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/15/2018] [Accepted: 01/01/2019] [Indexed: 05/07/2023]
Abstract
Urban growth and climate change will exacerbate extreme heat events and air pollution, posing considerable health challenges to urban populations. Although epidemiological studies have shown associations between health outcomes and exposures to ambient air pollution and extreme heat, the degree to which indoor exposures and social and behavioral factors may confound or modify these observed effects remains underexplored. To address this knowledge gap, we explore the linkages between vulnerability science and epidemiological conceptualizations of risk to propose a conceptual and analytical framework for characterizing current and future health risks to air pollution and extreme heat, indoors and outdoors. Our framework offers guidance for research on climatic variability, population vulnerability, the built environment, and health effects by illustrating how health data, spatially resolved ambient data, estimates of indoor conditions, and household-level vulnerability data can be integrated into an epidemiological model. We also describe an approach for characterizing population adaptive capacity and indoor exposure for use in population-based epidemiological models. Our framework and methods represent novel resources for the evaluation of health risks from extreme heat and air pollution, both indoors and outdoors.
Collapse
Affiliation(s)
- Cassandra R O'Lenick
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA.
| | - Olga V Wilhelmi
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Ryan Michael
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Mary H Hayden
- University of Colorado-Colorado Springs, Colorado Springs, CO, USA
| | - Amir Baniassadi
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA
| | | | | | - Peter J Crank
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - David J Sailor
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| |
Collapse
|
17
|
Hu L, Wilhelmi OV, Uejio C. Assessment of heat exposure in cities: Combining the dynamics of temperature and population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 655:1-12. [PMID: 30469055 DOI: 10.1016/j.scitotenv.2018.11.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 06/09/2023]
Abstract
Urban populations are typically subject to higher outdoor heat exposure than nearby rural areas due to the urban heat island (UHI) effect. Excessive Heat Events (EHEs) further amplify heat stress imposed on city dwellers. Heat exposure largely depends on the spatial and temporal distribution of temperature and population, however, few studies considered their concurrent variations. To better characterize exposure to heat in the context of long-term urban climatology and during excessive heat events, this study focuses on the dynamics of ambient temperature and population and proposes an open-data-based approach for spatiotemporal analysis of urban exposure to heat by using air temperature estimated from satellite observations and commute-adjusted diurnal population calculated primarily on the Census Transportation Planning Products. We use the metropolitan area of Chicago, U.S.A. as a case study to analyze the urban heat pattern changes during EHEs and their influence on population heat exposure diurnally. The intra-urban spatiotemporal analysis reveals that the population's exposure to heat changes fast as the nighttime temperature increases and the EHEs increase the spatial exposure impact due to the ubiquitous higher nocturnal temperature over the Chicago metropolitan area. "Hotspots" associated with a higher temperature and greater number of urban residents are identified in the heat exposure map. Meanwhile, the spatial extent of high ambient exposure areas varies diurnally. Our study contributes to a better understanding of the dynamic heat exposure patterns in urban areas. The approaches presented in this article can be used for informing heat mitigation as well as emergency response strategies at specific times and locations.
Collapse
Affiliation(s)
- Leiqiu Hu
- Department of Atmospheric Science, University of Alabama in Huntsville, Huntsville, AL 35805, USA.
| | - Olga V Wilhelmi
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO 80307, USA.
| | - Christopher Uejio
- Department of Geography, Florida State University, Tallahassee, FL 32306, USA.
| |
Collapse
|
18
|
Lundgren Kownacki K, Gao C, Kuklane K, Wierzbicka A. Heat Stress in Indoor Environments of Scandinavian Urban Areas: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E560. [PMID: 30769945 PMCID: PMC6406735 DOI: 10.3390/ijerph16040560] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/05/2019] [Accepted: 02/10/2019] [Indexed: 01/02/2023]
Abstract
Climate change increases the risks of heat stress, especially in urban areas where urban heat islands can develop. This literature review aims to describe how severe heat can occur and be identified in urban indoor environments, and what actions can be taken on the local scale. There is a connection between the outdoor and the indoor climate in buildings without air conditioning, but the pathways leading to the development of severe heat levels indoors are complex. These depend, for example, on the type of building, window placement, the residential area's thermal outdoor conditions, and the residents' influence and behavior. This review shows that only few studies have focused on the thermal environment indoors during heat waves, despite the fact that people commonly spend most of their time indoors and are likely to experience increased heat stress indoors in the future. Among reviewed studies, it was found that the indoor temperature can reach levels 50% higher in °C than the outdoor temperature, which highlights the importance of assessment and remediation of heat indoors. Further, most Heat-Health Warning Systems (HHWS) are based on the outdoor climate only, which can lead to a misleading interpretation of the health effects and associated solutions. In order to identify severe heat, six factors need to be taken into account, including air temperature, heat radiation, humidity, and air movement as well as the physical activity and the clothes worn by the individual. Heat stress can be identified using a heat index that includes these six factors. This paper presents some examples of practical and easy to use heat indices that are relevant for indoor environments as well as models that can be applied in indoor environments at the city level. However, existing indexes are developed for healthy workers and do not account for vulnerable groups, different uses, and daily variations. As a result, this paper highlights the need for the development of a heat index or the adjustment of current thresholds to apply specifically to indoor environments, its different uses, and vulnerable groups. There are several actions that can be taken to reduce heat indoors and thus improve the health and well-being of the population in urban areas. Examples of effective measures to reduce heat stress indoors include the use of shading devices such as blinds and vegetation as well as personal cooling techniques such as the use of fans and cooling vests. Additionally, the integration of innovative Phase Change Materials (PCM) into facades, roofs, floors, and windows can be a promising alternative once no negative health and environmental effects of PCM can be ensured.
Collapse
Affiliation(s)
- Karin Lundgren Kownacki
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, 221 00 Lund, Sweden.
| | - Chuansi Gao
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, 221 00 Lund, Sweden.
| | - Kalev Kuklane
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, 221 00 Lund, Sweden.
| | - Aneta Wierzbicka
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, 221 00 Lund, Sweden.
| |
Collapse
|
19
|
Sugg MM, Fuhrmann CM, Runkle JD. Temporal and spatial variation in personal ambient temperatures for outdoor working populations in the southeastern USA. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:1521-1534. [PMID: 29802500 DOI: 10.1007/s00484-018-1553-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/19/2018] [Accepted: 02/21/2018] [Indexed: 05/21/2023]
Abstract
Excessive ambient temperature exposure can result in significant morbidity and mortality, especially among vulnerable occupational groups like outdoor workers. Average temperatures in the USA are projected to increase in frequency and intensity, placing future worker populations at greater risk for unhealthy levels of exposure. Unlike previous research focused on aggregate-level temperature exposures from in situ weather station data, this study will measure location-based personal ambient temperatures (PAT) at the individual-level by piloting the use of wearable sensor technology. A total of 66 outdoor workers in three geographically and climatologically diverse regions in the Southeast USA were continuously sampled during the workday for a 1-week period throughout July 11 to August 8 2016. Results indicate significant worker variation in temperature exposure within and between study locations; with PAT characterized by less pronounced variability as workers moved between indoor and outdoor environments. Developed land covers, a factor often associated with higher temperatures, were poorly correlated with PAT. Future analysis should focus on a worker's physiological response to PAT and mapping of spatial patterns of PAT for a larger worker population to produce innovative and targeted heat prevention programs.
Collapse
Affiliation(s)
- Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, P.O. Box 32066,, Boone, NC, 28608, USA.
| | - Christopher M Fuhrmann
- Department of Geosciences, Mississippi State University, P.O. Box 5448, Mississippi State, MS, 39762, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue,, NC, Asheville, 28801, USA
| |
Collapse
|
20
|
Kuras ER, Richardson MB, Calkins MM, Ebi KL, Hess JJ, Kintziger KW, Jagger MA, Middel A, Scott AA, Spector JT, Uejio CK, Vanos JK, Zaitchik BF, Gohlke JM, Hondula DM. Opportunities and Challenges for Personal Heat Exposure Research. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:085001. [PMID: 28796630 PMCID: PMC5783663 DOI: 10.1289/ehp556] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 01/17/2017] [Accepted: 01/20/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Environmental heat exposure is a public health concern. The impacts of environmental heat on mortality and morbidity at the population scale are well documented, but little is known about specific exposures that individuals experience. OBJECTIVES The first objective of this work was to catalyze discussion of the role of personal heat exposure information in research and risk assessment. The second objective was to provide guidance regarding the operationalization of personal heat exposure research methods. DISCUSSION We define personal heat exposure as realized contact between a person and an indoor or outdoor environment that poses a risk of increases in body core temperature and/or perceived discomfort. Personal heat exposure can be measured directly with wearable monitors or estimated indirectly through the combination of time-activity and meteorological data sets. Complementary information to understand individual-scale drivers of behavior, susceptibility, and health and comfort outcomes can be collected from additional monitors, surveys, interviews, ethnographic approaches, and additional social and health data sets. Personal exposure research can help reveal the extent of exposure misclassification that occurs when individual exposure to heat is estimated using ambient temperature measured at fixed sites and can provide insights for epidemiological risk assessment concerning extreme heat. CONCLUSIONS Personal heat exposure research provides more valid and precise insights into how often people encounter heat conditions and when, where, to whom, and why these encounters occur. Published literature on personal heat exposure is limited to date, but existing studies point to opportunities to inform public health practice regarding extreme heat, particularly where fine-scale precision is needed to reduce health consequences of heat exposure. https://doi.org/10.1289/EHP556.
Collapse
Affiliation(s)
- Evan R Kuras
- Center for Policy Informatics, Arizona State University , Phoenix, Arizona, USA
- Department of Environmental Conservation, University of Massachusetts , Amherst, Massachusetts, USA
| | - Molly B Richardson
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University , Blacksburg, Virginia, USA
| | - Miriam M Calkins
- Department of Environmental and Occupational Health Sciences, University of Washington , Seattle, Washington, USA
| | - Kristie L Ebi
- Department of Environmental and Occupational Health Sciences, University of Washington , Seattle, Washington, USA
- Department of Global Health, University of Washington , Seattle, Washington, USA
| | - Jeremy J Hess
- Department of Environmental and Occupational Health Sciences, University of Washington , Seattle, Washington, USA
- Department of Global Health, University of Washington , Seattle, Washington, USA
- Department of Medicine, University of Washington , Seattle, Washington, USA
| | - Kristina W Kintziger
- Department of Public Health, University of Tennessee , Knoxville, Tennessee, USA
| | - Meredith A Jagger
- Public Health Division, Oregon Health Authority , Portland, Oregon, USA
| | - Ariane Middel
- School of Geographical Sciences and Urban Planning, Arizona State University , Tempe, Arizona, USA
| | - Anna A Scott
- Department of Earth and Planetary Sciences, Johns Hopkins University , Baltimore, Maryland, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington , Seattle, Washington, USA
- Department of Medicine, University of Washington , Seattle, Washington, USA
| | - Christopher K Uejio
- Department of Geography, Florida State University , Tallahassee, Florida, USA
| | - Jennifer K Vanos
- Department of Family Medicine and Public Health, University of California , San Diego, La Jolla, California, USA
| | - Benjamin F Zaitchik
- School of Geographical Sciences and Urban Planning, Arizona State University , Tempe, Arizona, USA
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University , Blacksburg, Virginia, USA
| | - David M Hondula
- Center for Policy Informatics, Arizona State University , Phoenix, Arizona, USA
- School of Geographical Sciences and Urban Planning, Arizona State University , Tempe, Arizona, USA
| |
Collapse
|
21
|
Quinn A, Shaman J. Health symptoms in relation to temperature, humidity, and self-reported perceptions of climate in New York City residential environments. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1209-1220. [PMID: 28108783 PMCID: PMC5479711 DOI: 10.1007/s00484-016-1299-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/13/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
Little monitoring has been conducted of temperature and humidity inside homes despite the fact that these conditions may be relevant to health outcomes. Previous studies have observed associations between self-reported perceptions of the indoor environment and health. Here, we investigate associations between measured temperature and humidity, perceptions of indoor environmental conditions, and health symptoms in a sample of New York City apartments. We measured temperature and humidity in 40 New York City apartments during summer and winter seasons and collected survey data from the households' residents. Health outcomes of interest were (1) sleep quality, (2) symptoms of heat illness (summer season), and (3) symptoms of respiratory viral infection (winter season). Using mixed-effects logistic regression models, we investigated associations between the perceptions, symptoms, and measured conditions in each season. Perceptions of indoor temperature were significantly associated with measured temperature in both the summer and the winter, with a stronger association in the summer season. Sleep quality was inversely related to measured and perceived indoor temperature in the summer season only. Heat illness symptoms were associated with perceived, but not measured, temperature in the summer season. We did not find an association between any measured or perceived condition and cases of respiratory infection in the winter season. Although limited in size, the results of this study reveal that indoor temperature may impact sleep quality, and that thermal perceptions of the indoor environment may indicate vulnerability to heat illness. These are both important avenues for further investigation.
Collapse
Affiliation(s)
- Ashlinn Quinn
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| |
Collapse
|
22
|
Quinn A, Kinney P, Shaman J. Predictors of summertime heat index levels in New York City apartments. INDOOR AIR 2017; 27:840-851. [PMID: 28107558 PMCID: PMC5812346 DOI: 10.1111/ina.12367] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 01/11/2017] [Indexed: 05/30/2023]
Abstract
During heat waves, fatal overexposure to heat most often occurs at home. It is not known how factors such as building size, floor level, and different types of air conditioning (AC) contribute to excess indoor heat. We monitored indoor temperature and humidity in 36 apartments in New York City during summers 2014 and 2015 and used these values to calculate the indoor heat index (HI). We investigated the role of AC type and building-level factors on indoor HI using multilevel regression models. Thirty-four of 36 homes had AC. Central and ductless AC types were associated with the coolest indoor conditions; homes with window and portable AC were significantly warmer. Apartments on the top floor of a building were significantly hotter during heat advisory periods than other apartments regardless of the presence of AC. High indoor HI levels persisted in some homes for approximately 1 day following the end of the two heat advisory periods. We provide concrete evidence of higher heat levels in top floor apartments and in homes with certain types of AC. High heat levels that persist indoors after outdoor heat has subsided may present an underappreciated public health risk.
Collapse
Affiliation(s)
- Ashlinn Quinn
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York NY, 10032, USA
| | - Patrick Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York NY, 10032, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York NY, 10032, USA
| |
Collapse
|
23
|
Tamerius J, Ojeda S, Uejio CK, Shaman J, Lopez B, Sanchez N, Gordon A. Influenza transmission during extreme indoor conditions in a low-resource tropical setting. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:613-622. [PMID: 27562031 DOI: 10.1007/s00484-016-1238-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/10/2016] [Accepted: 08/15/2016] [Indexed: 06/06/2023]
Abstract
Influenza transmission occurs throughout the planet across wide-ranging environmental conditions. However, our understanding of the environmental factors mediating transmission is evaluated using outdoor environmental measurements, which may not be representative of the indoor conditions where influenza is transmitted. In this study, we examined the relationship between indoor environment and influenza transmission in a low-resource tropical population. We used a case-based ascertainment design to enroll 34 households with a suspected influenza case and then monitored households for influenza, while recording indoor temperature and humidity data in each household. We show that the indoor environment is not commensurate with outdoor conditions and that the relationship between indoor and outdoor conditions varies significantly across homes. We also show evidence of influenza transmission in extreme indoor environments. Specifically, our data suggests that indoor environments averaged 29 °C, 18 g/kg specific humidity, and 68 % relative humidity across 15 transmission events observed. These indoor settings also exhibited significant temporal variability with temperatures as high as 39 °C and specific and relative humidity increasing to 22 g/kg and 85 %, respectively, during some transmission events. However, we were unable to detect differences in the transmission efficiency by indoor temperature or humidity conditions. Overall, these results indicate that laboratory studies investigating influenza transmission and virus survival should increase the range of environmental conditions that they assess and that observational studies investigating the relationship between environment and influenza activity should use caution using outdoor environmental measurements since they can be imprecise estimates of the conditions that mediate transmission indoors.
Collapse
Affiliation(s)
- James Tamerius
- Department of Geographical and Sustainability Sciences, University of Iowa, 316 Jessup Hall, Iowa City, IA, 52242, USA.
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Christopher K Uejio
- Department of Geography and Program in Public Health, Florida State University, Tallahassee, FL, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey Shaman
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Brenda Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Aubree Gordon
- Department of Geography and Program in Public Health, Florida State University, Tallahassee, FL, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
24
|
Garcia F, Shendell DG, Madrigano J. Relationship among environmental quality variables, housing variables, and residential needs: a secondary analysis of the relationship among indoor, outdoor, and personal air (RIOPA) concentrations database. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:513-525. [PMID: 27572236 DOI: 10.1007/s00484-016-1229-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 03/11/2016] [Accepted: 08/01/2016] [Indexed: 06/06/2023]
Abstract
Retrospective descriptive secondary analyses of data from relationships of indoor, outdoor, and personal air (RIOPA) study homes (in Houston, Texas; Los Angeles County, California; and, Elizabeth, New Jersey May 1999-February 2001) were conducted. Data included air exchange rates, associations between indoor and outdoor temperature and humidity, and calculated apparent temperature and humidex. Analyses examined if study homes provided optimum thermal comfort for residents during both heating and cooling seasons when compared to current American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standards 62/62.1 and 55. Results suggested outdoor temperature, humidex, and apparent temperature during the cooling season potentially served as indicators of indoor personal exposure to parameters of thermal comfort. Outdoor temperatures, humidex, and apparent temperature during the cooling season had statistically significant predictive abilities in predicting indoor temperature. During the heating season, only humidex in Texas and combined data across study states were statistically significant, but with weaker to moderate predicative ability. The high degree of correlation between outdoor and indoor environmental variables provided support for the validity of epidemiologic studies of weather relying on temporal comparisons. Results indicated most RIOPA study residents experienced thermal comfort; however, many values indicated how several residents may have experienced some discomfort depending on clothing and indoor activities. With climate change, increases in temperature are expected, with more days of extreme heat and humidity and, potentially harsher, longer winters. Homes being built or modernized should be created with the appropriate guidelines to provide comfort for residents daily and in extreme weather events.
Collapse
Affiliation(s)
- Fausto Garcia
- Center for School and Community-Based Research and Education (CSCBRE), Rutgers School of Public Health (SPH), 335 George Street, Suite 2200, New Brunswick, NJ, 08903-2688, USA
- Teaneck (NJ) Health Department, Teaneck, NJ, USA
| | - Derek G Shendell
- Center for School and Community-Based Research and Education (CSCBRE), Rutgers School of Public Health (SPH), 335 George Street, Suite 2200, New Brunswick, NJ, 08903-2688, USA.
- Department of Environmental and Occupational Health (ENOH), SPH, 3rd Fl. SPH Bldg, Piscataway, NJ, 08854, USA.
- Environmental and Occupational Health Science Institute (EOHSI), Exposure Measurement and Assessment Division, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ, 08854, USA.
- Department of Environmental and Occupational HealthRutgers School of Public Health, 683 Hoes Lane West, 3rd Floor, Piscataway, NJ, 08854, USA.
| | - Jaime Madrigano
- Center for School and Community-Based Research and Education (CSCBRE), Rutgers School of Public Health (SPH), 335 George Street, Suite 2200, New Brunswick, NJ, 08903-2688, USA
- Department of Environmental and Occupational Health (ENOH), SPH, 3rd Fl. SPH Bldg, Piscataway, NJ, 08854, USA
| |
Collapse
|
25
|
Lee M, Shi L, Zanobetti A, Schwartz JD. Study on the association between ambient temperature and mortality using spatially resolved exposure data. ENVIRONMENTAL RESEARCH 2016; 151:610-617. [PMID: 27611992 PMCID: PMC5071163 DOI: 10.1016/j.envres.2016.08.029] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 05/03/2023]
Abstract
There are many studies that have posited an association between extreme temperature and increased mortality. However, most studies use temperature at a single station per city as the reference point to analyze deaths. This leads to exposure misclassification and usually the exclusion of exurban, small town, and rural populations. In addition, few studies control for confounding by PM2.5, which is expected to induce upward bias. The high-resolution temperature and PM2.5 data at a resolution of 1km2 were derived from satellite images and other land use sources. To capture the nonlinear association of temperature with mortality we fit a piecewise linear spline function for temperature, with a change in slope at -1°C and 28°C, the temperature threshold at which mortality in Georgia, North Carolina, and South Carolina increases due to cold and heat, respectively. We conducted stratified analyses by age group, sex, race, education, and urban vs nonurban, as well as sensitivity analyses of different temperature threshold and covariate sets. We found a 0.19% (95% CI=-0.98, 1.34%) increase in mortality for each 1°C decrease in temperature below -1°C and a 2.05% (95% CI=0.87, 3.24%) increase in mortality for each 1°C increase in temperature above 28°C, a 79.8% larger effect size for heat compared to the station-based metric. The effect estimates relying on the monitoring stations were 0.09% (95% CI=-0.79, 0.95%) and 1.14% (95% CI=0.08, 1.57%) for the equivalent temperature changes. The estimates were not confounded by PM2.5. Children under 15 years of age had the largest percentage increase per 1°C increase in temperature (8.19%, 95% CI=-0.38 to 17.49%) followed by Blacks (4.35%, 95% CI=2.22 to 6.53%). Higher education was a protective factor for the effect of extreme temperature on mortality. There was a suggestion that people in less urban areas were more susceptible to extreme temperature. The relationship between temperature and mortality was stronger when using exposure data with more spatial variability than using exposure data based on existing monitors alone.
Collapse
Affiliation(s)
- Mihye Lee
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Liuhua Shi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| |
Collapse
|
26
|
Seltenrich N. Between Extremes: Health Effects of Heat and Cold. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:A275-80. [PMID: 26523798 PMCID: PMC4629728 DOI: 10.1289/ehp.123-a275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
|