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Naser K, Haq Z, Naughton BD. The Impact of Climate Change on Health Services in Low- and Middle-Income Countries: A Systematised Review and Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:434. [PMID: 38673345 PMCID: PMC11050668 DOI: 10.3390/ijerph21040434] [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: 01/15/2024] [Revised: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Aim: The aim of this study was to assess the impact of climate change on health services as categorized by the WHO's Building Blocks for creating Climate-Resilient Health Systems. Objective: The objective was to conduct a systematized review of the published literature concerning the impact of climate change, using a thematic analysis approach to address our aim and identify areas for further research. Design: A search was conducted on 8 February 2022 using the Embase and PubMed research databases. Peer-reviewed scientific studies that were published in English from 2012 to 2022, which described at least one report concerning the impact of climate change on health services in LMICs, were included. Studies were organized based on their key characteristics, which included the date of publication, objective, method, limitations, participants, and geographical focus. The Mixed-Methods Appraisal Tool (MMAT) was used to assess the risk of bias in the included studies. Results: Twenty-three studies were included in this review. Five areas of health services which align with the WHO building blocks framework were impacted by climate change. These health service areas included: (1) Service Delivery, (2) Human Resources, (3) Health Finance, (4) Healthcare Products and Technology, and (5) Leadership and Governance. However, research concerning the impact of climate change on health information systems, which is part of the WHO building blocks framework, did not feature in our study. The climatic effects were divided into three themes: meteorological effects, extreme weather events, and general. The research in this study found that climate change had a detrimental impact on a variety of health services, with service delivery being the most frequently reported. The risk of bias varied greatly between studies. Conclusions: Climate change has negatively impacted health services in a variety of different ways, and without further actions, this problem is likely to worsen. The WHO building blocks have provided a useful lens through which to review health services. We built an aligned framework to describe our findings and to support future climate change impact assessments in this area. We propose that further research concerning the impact of climate change on health information systems would be valuable, as well as further education and responsible policy changes to help build resilience in health services affected by climate change.
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Affiliation(s)
- Kamar Naser
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, D02PN40 Dublin, Ireland
| | - Zaeem Haq
- Save the Children St Vincent House, 30 Orange Street, London WC2H 7HH, UK
| | - Bernard D. Naughton
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, D02PN40 Dublin, Ireland
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, Kings College London, London SE1 9NH, UK
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Oka K, Honda Y, Phung VLH, Hijioka Y. Prediction of climate change impacts on heatstroke cases in Japan's 47 prefectures with the effect of long-term heat adaptation. ENVIRONMENTAL RESEARCH 2023:116390. [PMID: 37302741 DOI: 10.1016/j.envres.2023.116390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/30/2023] [Accepted: 06/09/2023] [Indexed: 06/13/2023]
Abstract
One of the negative consequences of increased air temperatures due to global warming is the associated increase in heat-related mortality and morbidity. Studies that focused on future predictions of heat-related morbidity do not consider the effect of long-term heat adaptation measures, nor do they use evidence-based methods. Therefore, this study aimed to predict the future heatstroke cases for all 47 prefectures of Japan, by considering long-term heat adaptation by translating current geographical differences in heat adaptation to future temporal heat adaptation. Predictions were conducted for age groups of 7-17, 18-64, and ≥65 years. The prediction period was set to a base period (1981-2000), mid-21st century (2031-2050), and the end of the 21st century (2081-2100). We found that the average heatstroke incidence (number of patients with heatstroke transported by ambulance per population) in Japan under five representative climate models and three greenhouse gas (GHG) emissions scenarios increased by 2.92- for 7-17 years, 3.66- for 18-64 years, and 3.26-fold for ≥65 years at the end of the 21st century without heat adaptation. The corresponding numbers were 1.57 for 7-17 years, 1.77 for 18-64 years, and 1.69 for ≥65 years with heat adaptation. Furthermore, the average number of patients with heatstroke transported by ambulance (NPHTA) under all climate models and GHG emissions scenarios increased by 1.02- for 7-17 years, 1.76- for 18-64 years, and 5.50-fold for ≥65 years at the end of 21st century without heat adaptation, where demographic changes were considered. The corresponding numbers were 0.55 for 7-17 years, 0.82 for 18-64 years, and 2.74 for ≥65 years with heat adaptation. The heatstroke incidence, as well as the NPHTA, substantially decreased when heat adaptation was considered. Our method could be applicable to other regions across the globe.
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Affiliation(s)
- Kazutaka Oka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan.
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Vera Ling Hui Phung
- Center for Climate Change Adaptation, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Yasuaki Hijioka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
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Di Napoli C, McGushin A, Romanello M, Ayeb-Karlsson S, Cai W, Chambers J, Dasgupta S, Escobar LE, Kelman I, Kjellstrom T, Kniveton D, Liu Y, Liu Z, Lowe R, Martinez-Urtaza J, McMichael C, Moradi-Lakeh M, Murray KA, Rabbaniha M, Semenza JC, Shi L, Tabatabaei M, Trinanes JA, Vu BN, Brimicombe C, Robinson EJ. Tracking the impacts of climate change on human health via indicators: lessons from the Lancet Countdown. BMC Public Health 2022; 22:663. [PMID: 35387618 PMCID: PMC8985369 DOI: 10.1186/s12889-022-13055-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/22/2022] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND In the past decades, climate change has been impacting human lives and health via extreme weather and climate events and alterations in labour capacity, food security, and the prevalence and geographical distribution of infectious diseases across the globe. Climate change and health indicators (CCHIs) are workable tools designed to capture the complex set of interdependent interactions through which climate change is affecting human health. Since 2015, a novel sub-set of CCHIs, focusing on climate change impacts, exposures, and vulnerability indicators (CCIEVIs) has been developed, refined, and integrated by Working Group 1 of the "Lancet Countdown: Tracking Progress on Health and Climate Change", an international collaboration across disciplines that include climate, geography, epidemiology, occupation health, and economics. DISCUSSION This research in practice article is a reflective narrative documenting how we have developed CCIEVIs as a discrete set of quantifiable indicators that are updated annually to provide the most recent picture of climate change's impacts on human health. In our experience, the main challenge was to define globally relevant indicators that also have local relevance and as such can support decision making across multiple spatial scales. We found a hazard, exposure, and vulnerability framework to be effective in this regard. We here describe how we used such a framework to define CCIEVIs based on both data availability and the indicators' relevance to climate change and human health. We also report on how CCIEVIs have been improved and added to, detailing the underlying data and methods, and in doing so provide the defining quality criteria for Lancet Countdown CCIEVIs. CONCLUSIONS Our experience shows that CCIEVIs can effectively contribute to a world-wide monitoring system that aims to track, communicate, and harness evidence on climate-induced health impacts towards effective intervention strategies. An ongoing challenge is how to improve CCIEVIs so that the description of the linkages between climate change and human health can become more and more comprehensive.
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Affiliation(s)
- Claudia Di Napoli
- School of Agriculture, Policy and Development, University of Reading, Reading, UK.
- Department of Geography and Environmental Science, University of Reading, Reading, UK.
| | - Alice McGushin
- Institute for Global Health, University College London, London, UK
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - Sonja Ayeb-Karlsson
- Institute for Risk and Disaster Reduction, University College London, London, UK
- School of Global Studies, University of Sussex, Brighton Falmer, UK
- United Nations University, Institute for Environment and Human Security, Bonn, Germany
| | - Wenjia Cai
- Ministry of Education Key Laboratory for Earth System modeling, Department of Earth System Science, Tsinghua University, Beijing, 100084, China
| | - Jonathan Chambers
- Institute for Environmental Science, University of Geneva, Geneva, Switzerland
| | - Shouro Dasgupta
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK
- Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy
- Università Ca' Foscari, Venice, Italy
| | - Luis E Escobar
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, USA
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
- Institute for Risk and Disaster Reduction, University College London, London, UK
- University of Agder, Kristiansand, Norway
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson, New Zealand
| | - Dominic Kniveton
- School of Global Studies, University of Sussex, Brighton Falmer, UK
| | - Yang Liu
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Zhao Liu
- Ministry of Education Key Laboratory for Earth System modeling, Department of Earth System Science, Tsinghua University, Beijing, 100084, China
| | - Rachel Lowe
- Barcelona Supercomputing Center, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Centre on Climate Change & Planetary Health and Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Celia McMichael
- School of Geography, Earth and Atmospheric Sciences, The University of Melbourne, Melbourne, Australia
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- MRC Unit The Gambia At London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Jan C Semenza
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Liuhua Shi
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Meisam Tabatabaei
- Higher Institution Centre of Excellence (HICoE), Institute of Tropical Aquaculture and Fisheries (AKUATROP), Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
- Henan Province Forest Resources Sustainable Development and High-value Utilization Engineering Research Center, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China
| | - Joaquin A Trinanes
- Department of Electronics and Computer Science, Universidade de Santiago de Compostela, Santiago, Spain
| | - Bryan N Vu
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Chloe Brimicombe
- Department of Geography and Environmental Science, University of Reading, Reading, UK
| | - Elizabeth J Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK
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Climate Disasters and Subjective Well-Being among Urban and Rural Residents in Indonesia. SUSTAINABILITY 2022. [DOI: 10.3390/su14063383] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Climate disasters pose a risk to residents’ well-being globally. However, information about the impact of climate disasters among urban and rural residents remains lacking, especially in Indonesia. This study aims to fill the gap by investigating the impact of climate disaster on subjective well-being based on urban and rural typology model. The data were cross-sectional, involving 7110 Indonesian residents who had experienced climate disasters, 3813 from urban areas and 3297 from rural areas. An ordered probit model was employed to estimate the impact of climate disasters on subjective well-being (i.e., happiness and life satisfaction). In general, the empirical results show that climate disasters do not significantly affect the happiness of Indonesian residents, but they significantly and negatively impact their life satisfaction. Further analysis reveals that climate disasters impact urban and rural residents differently. The subjective well-being of rural residents is more severely affected than those living in urban areas. Further estimation also indicated that climate disaster significantly reduces residents’ subjective well-being at the lowest income level for both rural and urban residents. Our finding confirms that rural residents remain the most vulnerable to the impacts of climate change.
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Risk and Resilience: How Is the Health of Older Adults and Immigrant People Living in Canada Impacted by Climate- and Air Pollution-Related Exposures? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010575. [PMID: 34682320 PMCID: PMC8535805 DOI: 10.3390/ijerph182010575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/02/2021] [Accepted: 10/06/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND In the rapidly shifting Canadian climate, an ageing population, and increased migration, a greater understanding of how local climate and air pollution hazards impact older adults and immigrant populations will be necessary for mitigating and adapting to adverse health impacts. OBJECTIVES To explore the reported health impacts of climate change and air pollution exposures in older adults and immigrant people living in Canada, identify known factors influencing risk and resilience in these populations and gaps in the literature. METHODS We searched for research focused on older adults and immigrants living in Canada, published from 2010 onward, where the primary exposures were related to climate or air pollution. We extracted data on setting, exposures, health outcomes, and other relevant contextual factors. RESULTS AND DISCUSSION We identified 52 eligible studies, most focused in Ontario and Quebec. Older people in Canada experience health risks due to climate and air pollution exposures. The extent of the risk depends on multiple factors. We found little information about the climate- and air pollution-related health impacts experienced by immigrant communities. CONCLUSIONS Further research about climate- and air pollution-related exposures, health, and which factors promote or reduce resiliency in Canada's older adults and immigrant communities is necessary.
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Martins A, Scotto M, Deus R, Monteiro A, Gouveia S. Association between respiratory hospital admissions and air quality in Portugal: A count time series approach. PLoS One 2021; 16:e0253455. [PMID: 34242247 PMCID: PMC8270143 DOI: 10.1371/journal.pone.0253455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/07/2021] [Indexed: 11/25/2022] Open
Abstract
Although regulatory improvements for air quality in the European Union have been made, air pollution is still a pressing problem and, its impact on health, both mortality and morbidity, is a topic of intense research nowadays. The main goal of this work is to assess the impact of the exposure to air pollutants on the number of daily hospital admissions due to respiratory causes in 58 spatial locations of Portugal mainland, during the period 2005-2017. To this end, INteger Generalised AutoRegressive Conditional Heteroskedastic (INGARCH)-based models are extensively used. This family of models has proven to be very useful in the analysis of serially dependent count data. Such models include information on the past history of the time series, as well as the effect of external covariates. In particular, daily hospitalisation counts, air quality and temperature data are endowed within INGARCH models of optimal orders, where the automatic inclusion of the most significant covariates is carried out through a new block-forward procedure. The INGARCH approach is adequate to model the outcome variable (respiratory hospital admissions) and the covariates, which advocates for the use of count time series approaches in this setting. Results show that the past history of the count process carries very relevant information and that temperature is the most determinant covariate, among the analysed, for daily hospital respiratory admissions. It is important to stress that, despite the small variability explained by air quality, all models include on average, approximately two air pollutants covariates besides temperature. Further analysis shows that the one-step-ahead forecasts distributions are well separated into two clusters: one cluster includes locations exclusively in the Lisbon area (exhibiting higher number of one-step-ahead hospital admissions forecasts), while the other contains the remaining locations. This results highlights that special attention must be given to air quality in Lisbon metropolitan area in order to decrease the number of hospital admissions.
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Affiliation(s)
- Ana Martins
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA) and Department of Electronics, Telecommunications and Informatics (DETI), University of Aveiro, Aveiro, Portugal
| | - Manuel Scotto
- Center for Computational and Stochastic Mathematics (CEMAT), Department of Mathematics, IST, University of Lisbon, Lisbon, Portugal
| | - Ricardo Deus
- Instituto Português do Mar e da Atmosfera, I.P. (IPMA, I.P.), Lisbon, Portugal
| | - Alexandra Monteiro
- CESAM, Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - Sónia Gouveia
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA) and Department of Electronics, Telecommunications and Informatics (DETI), University of Aveiro, Aveiro, Portugal
- Center for R&D in Mathematics and Applications (CIDMA), University of Aveiro, Aveiro, Portugal
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Nagai K, Suzuki H, Ueda A, Agar JWM, Itsubo N. Assessment of environmental sustainability in renal healthcare. J Rural Med 2021; 16:132-138. [PMID: 34239623 PMCID: PMC8249367 DOI: 10.2185/jrm.2020-049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/12/2021] [Indexed: 11/27/2022] Open
Abstract
The health effects of climate change are becoming increasingly important; there are direct effects from heatwaves and floods, and indirect effects from the altered distribution of infectious diseases and changes in crop yield. Ironically, the healthcare system itself carries an environmental burden, contributing to environmental health impacts. Life cycle assessment is a widely accepted and well-established method that quantitatively evaluates environmental impact. Given that monetary evaluations have the potential to motivate private companies and societies to reduce greenhouse gas emissions using market mechanisms, instead of assessing the carbon footprint alone, we previously developed a life cycle impact assessment method based on an endpoint that integrates comprehensive environmental burdens into a single index-the monetary cost. Previous investigations estimated that therapy for chronic kidney disease had a significant carbon footprint in the healthcare sector. We have been aiming to investigate on the environmental impact of chronic kidney disease based on field surveys from the renal department in a hospital and several health clinics in Japan. To live sustainably, it is necessary to establish cultures, practices, and research that aims to conserve resources to provide environmentally friendly healthcare in Japan.
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Affiliation(s)
- Kei Nagai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Hiroaki Suzuki
- Faculty of Environmental and Information Studies, Tokyo City University, Japan
| | - Atsushi Ueda
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan.,Department of Nephrology, Hitachi General Hospital, Japan
| | - John W M Agar
- Department of Renal Medicine, University Hospital Geelong, Australia
| | - Norihiro Itsubo
- Faculty of Environmental and Information Studies, Tokyo City University, Japan
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Royé D, Sera F, Tobías A, Lowe R, Gasparrini A, Pascal M, de'Donato F, Nunes B, Teixeira JP. Effects of Hot Nights on Mortality in Southern Europe. Epidemiology 2021; 32:487-498. [PMID: 33935136 DOI: 10.1097/ede.0000000000001359] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is strong evidence concerning the impact of heat stress on mortality, particularly from high temperatures. However, few studies to our knowledge emphasize the importance of hot nights, which may prevent necessary nocturnal rest. OBJECTIVES In this study, we use hot-night duration and excess to predict daily cause-specific mortality in summer, using multiple cities across Southern Europe. METHODS We fitted time series regression models to summer cause-specific mortality, including natural, respiratory, and cardiovascular causes, in 11 cities across four countries. We included a distributed lag nonlinear model with lags up to 7 days for hot night duration and excess adjusted by daily mean temperature. We summarized city-specific associations as overall-cumulative exposure-response curves at the country level using meta-analysis. RESULTS We found positive but generally nonlinear associations between relative risk (RR) of cause-specific mortality and duration and excess of hot nights. RR of duration associated with nonaccidental mortality in Portugal was 1.29 (95% confidence interval [CI] = 1.07, 1.54); other associations were imprecise, but we also found positive city-specific estimates for Rome and Madrid. Risk of hot-night excess ranged from 1.12 (95% CI = 1.05, 1.20) for France to 1.37 (95% CI = 1.26, 1.48) for Portugal. Risk estimates for excess were consistently higher than for duration. CONCLUSIONS This study provides new evidence that, over a wider range of locations, hot night indices are strongly associated with cause-specific deaths. Modeling the impact of thermal characteristics during summer nights on mortality could improve decisionmaking for preventive public health strategies.
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Affiliation(s)
- Dominic Royé
- From the Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Aurelio Tobías
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Rachel Lowe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | | | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - Joao Paulo Teixeira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
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Qiu C, Ji JS, Bell ML. Effect modification of greenness on temperature-mortality relationship among older adults: A case-crossover study in China. ENVIRONMENTAL RESEARCH 2021; 197:111112. [PMID: 33838131 PMCID: PMC8343965 DOI: 10.1016/j.envres.2021.111112] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 03/20/2021] [Accepted: 03/28/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Climate change exacerbates temperature-related mortality, but effects may vary by geographic characteristics. We hypothesize that higher greenness may mitigate temperature-related mortality, and that the effect may vary in different areas. OBJECTIVE We examined how mortality among older adults in China was associated with temperature for 2000-2014, and how geolocation and residential greenness may modulate this association. METHODS We used health data from the China Longitudinal Healthy Longevity Survey (CLHLS), and meteorological data from the Global Surface Summary of Day (GSOD) product by National Climate Data Center. We used a case-crossover study design with distributed nonlinear modeling to estimate mortality risks in relation to temperature, and stratified analysis by quartile of greenness. Greenness was estimated by Normalized Difference Vegetation Index (NDVI) from remote-sensed imagery. In addition to the national analysis, we also assessed three provinces (Jiangsu, Guangdong, and Liaoning) to examine differences by climatic regions. RESULTS Extreme temperatures had a significant association with higher mortality, with regional differences. Findings from the national analysis suggest that individuals in the lowest quartile of greenness exposure had a ratio of relative risks (RRR) of 1.38 (0.79, 2.42) for mortality risk on extreme hot days at the 95th percentile compared to those at the 50th percentile, compared to those in the highest quartile, which means those residing in the lowest quartile of greenness had a 38% higher RR than those residing in the highest quartile of greenness, where RR refers to the risk of mortality on days at the 95th percentile of temperature compared to days at the 50th percentile. The RRR for the highest to lowest quartiles of greenness for mortality risk on extreme cold days at the 5th percentile compared to the 50th percentile was 2.08 (0.12, 36.2). In Jiangsu and Guangdong provinces, both the heat effects and cold effects were the lowest in the highest greenness quartile, and the results in Liaoning province were not statistically significant, indicating different regional effects of greenness on modulating the temperature-mortality relationship. DISCUSSION We elucidated one pathway through which greenness benefits health by decreasing impact from extreme high temperatures. The effects of greenness differed by climatic regions. Policymakers should consider vegetation in the context of climate change and health.
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Affiliation(s)
- Chengcheng Qiu
- School of Public Health, Yale University, New Haven, CT, USA
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China; Nicholas School of the Environment, Duke University, Durham, NC, USA.
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
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Iira T, Ruth ML, Hannele T, Jouni J, Lauri K. Finnish nurses' perceptions of the health impacts of climate change and their preparation to address those impacts. Nurs Forum 2021; 56:365-371. [PMID: 33330979 DOI: 10.1111/nuf.12540] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/01/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Climate change has a direct and indirect impact on human health that include health impacts from rising temperatures and poor air quality. This challenges the health sector in many ways. Nurses should be aware of these health effects and the patients who are particularly vulnerable to the health impacts caused by climate change. PURPOSE The objective of the study was to identify the health issues that Finnish registered nurses associate with climate change and to determine nurses' perception of their preparation to address the health impacts of climate change. METHODS A qualitative descriptive study was conducted through semi-structured focus group interviews. RESULTS Nurses reported observing changes in health of their patient populations. The nurses attributed some changes in their patients' health to climate change. Interviewed nurses felt that climate change was not adequately addressed in their basic nursing education and in staff development. CONCLUSIONS It is important to include climate change and its impact on human health in the nurses' curriculum and in continuing education for practicing nurses.
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Affiliation(s)
- Tiitta Iira
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - McDermott-Levy Ruth
- Center for Global & Public Heatlh, M. Louise Fitzpatrick, College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Turunen Hannele
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Jaakkola Jouni
- Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kuosmanen Lauri
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Lee CH, Lin SH, Kao CL, Hong MY, Huang PC, Shih CL, Chuang CC. Impact of climate change on disaster events in metropolitan cities -trend of disasters reported by Taiwan national medical response and preparedness system. ENVIRONMENTAL RESEARCH 2020; 183:109186. [PMID: 32078825 DOI: 10.1016/j.envres.2020.109186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Taiwan is geographically located in a zone that is vulnerable to earthquakes, typhoons, floods, and landslide hazards and has experienced various disasters. Six Regional Emergency Medical Operation Centers (REMOCs) are integrated and administered by the Ministry of Health and Welfare (MOHW) to be responsible for emergency situations during disastrous events, such as the emission of chemical toxicants, traffic accidents, industrial materials containment, and typhoons. OBJECTIVE To analyze events reported by the six REMOCs during the 2014 to 2018 for the government policy reference. METHODS Data were collected from injured and death toll reports provided by local designated hospitals in the emergency medical reporting system. Disaster events were categorized into three categories: natural disaster (NDs), disasters associated with technology (DTs), and disasters associated with security/violence/others (DSVOs). The three categories were further subdivided into sub-categories. Variables considered for trend analyses included the number of wounded and deaths, event characteristics, date/time, and triage. The frequency of disaster events among the six REMOCs was compared using the chi-square test. We used the global information system (GIS) to describe the distribution of events in Taiwan metropolitan cities. The α-level was set at 0.05. RESULTS Of 580 events during the study period, the distribution of disaster characteristics in the jurisdictions of the six REMOCs were different. The majority of disaster events were DTs (64.5%), followed by NDs (24.5%) and DSVOs (11.0%). Events for the three disaster categories in the six REMOCs were different (χ2-test, p < 0.001). Furthermore, for the Taipei branch (Northern Taiwan), other NDs, especially heatwaves and cold spells, were most reported in New Taipei City (92.2%) and showed an increasing annual trend; for the Kaohsiung branch (Southern Taiwan), DT events were the most reported, especially in Kaohsiung City; and for the Taichung branch (Central Taiwan), DSVOs were the most reported, especially in Taichung City. CONCLUSION Our data revealed that extreme weather precautions reported in the Taipei branch were increasing. Disaster characteristics were different in each metropolitan city. Upgrading the ability to respond to natural disasters is ineluctable.
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Affiliation(s)
- Chung-Hsun Lee
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Shih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chia-Lung Kao
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Ming-Yuan Hong
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Po-Chang Huang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chung-Liang Shih
- Department of Medical Affairs, Ministry of Health and Welfare, Taipei City, Taiwan.
| | - Chia-Chang Chuang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Abstract
A clinical ethics fit for the Anthropocene-our current geological era in which human activity is the primary determinant of environmental change-needs to incorporate environmental ethics to be fit for clinical practice. Conservationist Aldo Leopold's essay 'The Land Ethic' is probably the most widely-cited source in environmental philosophy; but Leopold's work, and environmental ethics generally, has made little impression on clinical ethics. The Land Ethic holds that "A thing is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise." I argue that a Land Ethic helps to re-frame problems in clinical ethics that more common philosophical approaches struggle to handle, and that it can be incorporated into clinical ethics without succumbing to "environmental fascism". I motivate viewing problems in clinical ethics from the perspective of the 'integrity of the biotic community', then illustrate how this perspective can offer guidance where more commonly-invoked theories-such as consequentialism and Kantian-inspired approaches-struggle, using antimicrobial resistance in nosocomial infection as a case study. The Land Ethic equips us to understand human values as arising within and inseparable from a social-ecological context, and by treating communities (both human and biotic) as valuable in themselves rather than just through the aggregate welfare of their individual participants, we can avoid problems with the 'repugnant conclusion' and utility monster that plague utilitarian accounts.
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Affiliation(s)
- Alistair Wardrope
- University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
- The Rotherham NHS Foundation Trust, Moorgate Road, Rotherham, S60 2UD, UK.
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Godsmark CN, Irlam J, van der Merwe F, New M, Rother HA. Priority focus areas for a sub-national response to climate change and health: A South African provincial case study. ENVIRONMENT INTERNATIONAL 2019; 122:31-51. [PMID: 30573189 DOI: 10.1016/j.envint.2018.11.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/26/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The intersection of health and climate change is often absent or under-represented in sub-national government strategies. This analysis of the literature, using a new methodological framework, highlights priority focus areas for a sub-national government response to health and climate change, using the Western Cape (WC) province of South Africa as a case study. METHODS A methodological framework was created to conduct a review of priority focus areas relevant for sub-national governments. The framework encompassed the establishment of a Project Steering Group consisting of relevant, sub-national stakeholders (e.g. provincial officials, public and environmental health specialists and academics); an analysis of local climatic projections as well as an analysis of global, national and sub-national health risk factors and impacts. RESULTS Globally, the discussion of health and climate change adaptation strategies in sub-national, or provincial government is often limited. For the case study presented, multiple health risk factors were identified. WC climatic projections include a warmer and potentially drier future with an increased frequency and intensity of extreme weather events. WC government priority focus areas requiring further research on health risk factors include: population migration and environmental refugees, land use change, violence and human conflict and vulnerable groups. WC government priority focus areas for further research on health impacts include: mental ill-health, non-communicable diseases, injuries, poisonings (e.g. pesticides), food and nutrition insecurity-related diseases, water- and food-borne diseases and reproductive health. These areas are currently under-addressed, or not addressed at all, in the current provincial climate change strategy. CONCLUSIONS Sub-national government adaptation strategies often display limited discussion on the health and climate change intersect. The methodological framework presented in this case study can be globally utilized by other sub-national governments for decision-making and development of climate change and health adaptation strategies. Additionally, due to the broad range of sectoral issues identified, a primary recommendation from this study is that sub-national governments internationally should consider a "health and climate change in all policies" approach when developing adaptation and mitigation strategies to address climate change.
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Affiliation(s)
- Christie Nicole Godsmark
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - James Irlam
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa; Primary Health Care Directorate, University of Cape Town, South Africa
| | - Frances van der Merwe
- Department of Environmental Affairs and Development Planning, Western Cape Government, South Africa
| | - Mark New
- African Climate and Development Initiative, University of Cape Town, Cape Town, South Africa; School of International Development, University of East Anglia, Norwich, UK
| | - Hanna-Andrea Rother
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa.
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Associations between Knowledge of the Causes and Perceived Impacts of Climate Change: A Cross-Sectional Survey of Medical, Public Health and Nursing Students in Universities in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122650. [PMID: 30486282 PMCID: PMC6313669 DOI: 10.3390/ijerph15122650] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/16/2018] [Accepted: 11/22/2018] [Indexed: 11/16/2022]
Abstract
This study aimed to measure the knowledge and perceptions of medical, public health, and nursing students about climate change and its impacts, and to identify associations between the knowledge and perceptions. Data were from a nationwide cross-sectional survey of 1387 students sampled in five different regional universities in China (April–May 2017). The knowledge and perceptions of the participants were collected by self-administered questionnaires. We found that most respondents believed that climate change is generally “bad” (83%) and bad for human health (88%), while 67% believed that climate change is controllable. The vast majority of respondents acknowledged illness conditions resulting from poor air quality (95%), heat stress (93%), and extreme weather events (91%) as potential impacts of climate change. Nevertheless, only 39% recognized malnutrition as a consequence of food deprivation resulting from climate change. Around 58% of respondents could correctly identify the causes of climate change. The knowledge of the causes of climate change was not associated with the ability to recognize the health consequences of climate change. However, the knowledge of causes of climate change was a significant predictor of increased awareness of the negative impacts of climate change between the medical and nursing students, although this was not the case among their public health counterparts. Poor knowledge about the causes of climate change is evident among students in China. They are able to recognize the direct links between weather events and health, but less likely to understand the consequences involving complicated pathways. Research and training into the underlying mechanisms of health impacts of climate change needs to be strengthened.
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Błażejczyk A, Błażejczyk K, Baranowski J, Kuchcik M. Heat stress mortality and desired adaptation responses of healthcare system in Poland. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:307-318. [PMID: 28864962 DOI: 10.1007/s00484-017-1423-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 05/09/2017] [Accepted: 08/07/2017] [Indexed: 05/06/2023]
Abstract
Heat stress is one of the environmental factors influencing the health of individuals and the wider population. There is a large body of research to document significant increases in mortality and morbidity during heat waves all over the world. This paper presents key results of research dealing with heat-related mortality (HRM) in various cities in Poland which cover about 25% of the country's population. Daily mortality and weather data reports for the years 1991-2000 were used. The intensity of heat stress was assessed by the universal thermal climate index (UTCI). The research considers also the projections of future bioclimate to the end of twenty-first century. Brain storming discussions were applied to find necessary adaptation strategies of healthcare system (HCS) in Poland, to minimise negative effects of heat stress. In general, in days with strong and very strong heat stress, ones must expect increase in mortality (in relation to no thermal stress days) of 12 and 47%, respectively. Because of projected rise in global temperature and heat stress frequency, we must expect significant increase in HRM to the end of twenty-first century of even 165% in comparison to present days. The results of research show necessity of urgent implementation of adaptation strategies to heat in HCS.
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Affiliation(s)
- Anna Błażejczyk
- Bioklimatologia, Laboratory of Bioclimatology and Environmental Ergonomics, Łukowska 17/55, 04-133, Warsaw, Poland.
| | - Krzysztof Błażejczyk
- Institute of Geography and Spatial Organization, Polish Academy of Sciences, Twarda 51/55, 00-818, Warsaw, Poland
| | - Jarosław Baranowski
- Institute of Geography and Spatial Organization, Polish Academy of Sciences, Twarda 51/55, 00-818, Warsaw, Poland
| | - Magdalena Kuchcik
- Institute of Geography and Spatial Organization, Polish Academy of Sciences, Twarda 51/55, 00-818, Warsaw, Poland
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Ehelepola NDB, Ariyaratne K, Jayaratne A. The association between local meteorological changes and exacerbation of acute wheezing in Kandy, Sri Lanka. Glob Health Action 2018; 11:1482998. [PMID: 29912647 PMCID: PMC7011946 DOI: 10.1080/16549716.2018.1482998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/22/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Severe wheezing is a common medical emergency. Past studies have demonstrated associations between exacerbation of wheezing and meteorological factors and atmospheric pollution. There are no past studies from Sri Lanka that analyzed correlation between daily multiple meteorological variables and exacerbation of wheezing. OBJECTIVES To determine the correlations between daily counts of patients nebulized at the Outpatient Department (OPD) of Teaching Hospital - Kandy (THK) and local meteorological variables, and to explore the utility of that information. DESIGN We considered daily counts of patients nebulized at the OPD of THK as an indicator of exacerbations of wheezing in the population catered to by this hospital. We determined the correlations between daily counts of patients nebulized at OPD and the following meteorological variables for four years: daily rainfall, minimum temperature, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours, daytime humidity, nighttime humidity, barometric pressure and visibility. We utilized wavelet time series method for data analysis. RESULTS All nine meteorological parameters studied were correlated with the daily counts of patients nebulized with average lag periods ranging from 5 to 15 days. Peaks of daily rainfall, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours and daytime humidity were followed by peaks of counts of patients nebulized (positive correlations). Troughs of minimum temperature, nighttime humidity, barometric pressure and visibility were followed by peaks of patients nebulized (negative correlations). CONCLUSIONS The THK shall expect more patients with acute wheezing after extremes of weather. Minimum temperature has been consistently correlated with the exacerbation of respiratory symptoms in the past studies in other countries as well. Hence, prescribing the inhalation of more drugs on unusually cold days (prophylactically) may help prevent acute exacerbation of wheezing in patients on treatment for asthma and COPD.
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Affiliation(s)
- N. D. B. Ehelepola
- Department of Medicine, The Teaching (General) Hospital–Kandy, Kandy, Sri Lanka
| | | | - Amithe Jayaratne
- Department of Medicine, The Teaching (General) Hospital–Kandy, Kandy, Sri Lanka
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Arbuthnott KG, Hajat S. The health effects of hotter summers and heat waves in the population of the United Kingdom: a review of the evidence. Environ Health 2017; 16:119. [PMID: 29219088 PMCID: PMC5773858 DOI: 10.1186/s12940-017-0322-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
It is widely acknowledged that the climate is warming globally and within the UK. In this paper, studies which assess the direct impact of current increased temperatures and heat-waves on health and those which project future health impacts of heat under different climate change scenarios in the UK are reviewed.This review finds that all UK studies demonstrate an increase in heat-related mortality occurring at temperatures above threshold values, with respiratory deaths being more sensitive to heat than deaths from cardiovascular disease (although the burden from cardiovascular deaths is greater in absolute terms). The relationship between heat and other health outcomes such as hospital admissions, myocardial infarctions and birth outcomes is less consistent. We highlight the main populations who are vulnerable to heat. Within the UK, these are older populations, those with certain co-morbidities and those living in Greater London, the South East and Eastern regions.In all assessments of heat-related impacts using different climate change scenarios, deaths are expected to increase due to hotter temperatures, with some studies demonstrating that an increase in the elderly population will also amplify burdens. However, key gaps in knowledge are found in relation to how urbanisation and population adaptation to heat will affect health impacts, and in relation to current and future strategies for effective, sustainable and equitable adaptation to heat. These and other key gaps in knowledge, both in terms of research needs and knowledge required to make sound public- health policy, are discussed.
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Affiliation(s)
- Katherine G Arbuthnott
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon, OX11 0RQ, UK.
| | - Shakoor Hajat
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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18
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Royé D. The effects of hot nights on mortality in Barcelona, Spain. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:2127-2140. [PMID: 28852883 DOI: 10.1007/s00484-017-1416-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/14/2017] [Accepted: 07/20/2017] [Indexed: 05/23/2023]
Abstract
Heat-related effects on mortality have been widely analyzed using maximum and minimum temperatures as exposure variables. Nevertheless, the main focus is usually on the former with the minimum temperature being limited in use as far as human health effects are concerned. Therefore, new thermal indices were used in this research to describe the duration of night hours with air temperatures higher than the 95% percentile of the minimum temperature (hot night hours) and intensity as the summation of these air temperatures in degrees (hot night degrees). An exposure-response relationship between mortality due to natural, respiratory, and cardiovascular causes and summer night temperatures was assessed using data from the Barcelona region between 2003 and 2013. The non-linear relationship between the exposure and response variables was modeled using a distributed lag non-linear model. The estimated associations for both exposure variables and mortality shows a relationship with high and medium values that persist significantly up to a lag of 1-2 days. In mortality due to natural causes, an increase of 1.1% per 10% (CI95% 0.6-1.5) for hot night hours and 5.8% per each 10° (CI95% 3.5-8.2%) for hot night degrees is observed. The effects of hot night hours reach their maximum with 100% and lead to an increase by 9.2% (CI95% 5.3-13.1%). The hourly description of night heat effects reduced to a single indicator in duration and intensity is a new approach and shows a different perspective and significant heat-related effects on human health.
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Affiliation(s)
- D Royé
- GeoBioMet, Department of Geography, Urbanism and Spatial Planning, University of Cantabria, Avda. los Castros, 39005, Santander, Spain.
- Department of Geography, University of Santiago de Compostela, La Coruña, Spain.
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19
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Ebi KL, Ogden NH, Semenza JC, Woodward A. Detecting and Attributing Health Burdens to Climate Change. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:085004. [PMID: 28796635 PMCID: PMC5783629 DOI: 10.1289/ehp1509] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/31/2017] [Accepted: 04/17/2017] [Indexed: 05/03/2023]
Abstract
BACKGROUND Detection and attribution of health impacts caused by climate change uses formal methods to determine a) whether the occurrence of adverse health outcomes has changed, and b) the extent to which that change could be attributed to climate change. There have been limited efforts to undertake detection and attribution analyses in health. OBJECTIVE Our goal was to show a range of approaches for conducting detection and attribution analyses. RESULTS Case studies for heatwaves, Lyme disease in Canada, and Vibrio emergence in northern Europe highlight evidence that climate change is adversely affecting human health. Changes in rates and geographic distribution of adverse health outcomes were detected, and, in each instance, a proportion of the observed changes could, in our judgment, be attributed to changes in weather patterns associated with climate change. CONCLUSIONS The results of detection and attribution studies can inform evidence-based risk management to reduce current, and plan for future, changes in health risks associated with climate change. Gaining a better understanding of the size, timing, and distribution of the climate change burden of disease and injury requires reliable long-term data sets, more knowledge about the factors that confound and modify the effects of climate on health, and refinement of analytic techniques for detection and attribution. At the same time, significant advances are possible in the absence of complete data and statistical certainty: there is a place for well-informed judgments, based on understanding of underlying processes and matching of patterns of health, climate, and other determinants of human well-being. https://doi.org/10.1289/EHP1509.
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Affiliation(s)
- Kristie L Ebi
- Department of Global Health, University of Washington , Seattle, Washington, USA
| | - Nicholas H Ogden
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada , Saint-Hyacinthe, Quebec, Canada
| | - Jan C Semenza
- Stockholm Environmental Institute , Stockholm, Sweden
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Watts N, Adger WN, Ayeb-Karlsson S, Bai Y, Byass P, Campbell-Lendrum D, Colbourn T, Cox P, Davies M, Depledge M, Depoux A, Dominguez-Salas P, Drummond P, Ekins P, Flahault A, Grace D, Graham H, Haines A, Hamilton I, Johnson A, Kelman I, Kovats S, Liang L, Lott M, Lowe R, Luo Y, Mace G, Maslin M, Morrissey K, Murray K, Neville T, Nilsson M, Oreszczyn T, Parthemore C, Pencheon D, Robinson E, Schütte S, Shumake-Guillemot J, Vineis P, Wilkinson P, Wheeler N, Xu B, Yang J, Yin Y, Yu C, Gong P, Montgomery H, Costello A. The Lancet Countdown: tracking progress on health and climate change. Lancet 2017; 389:1151-1164. [PMID: 27856085 DOI: 10.1016/s0140-6736(16)32124-9] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 10/10/2016] [Accepted: 10/19/2016] [Indexed: 11/15/2022]
Abstract
The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration between academic institutions and practitioners across the world. It follows on from the work of the 2015 Lancet Commission, which concluded that the response to climate change could be "the greatest global health opportunity of the 21st century". The Lancet Countdown aims to track the health impacts of climate hazards; health resilience and adaptation; health co-benefits of climate change mitigation; economics and finance; and political and broader engagement. These focus areas form the five thematic working groups of the Lancet Countdown and represent different aspects of the complex association between health and climate change. These thematic groups will provide indicators for a global overview of health and climate change; national case studies highlighting countries leading the way or going against the trend; and engagement with a range of stakeholders. The Lancet Countdown ultimately aims to report annually on a series of indicators across these five working groups. This paper outlines the potential indicators and indicator domains to be tracked by the collaboration, with suggestions on the methodologies and datasets available to achieve this end. The proposed indicator domains require further refinement, and mark the beginning of an ongoing consultation process-from November, 2016 to early 2017-to develop these domains, identify key areas not currently covered, and change indicators where necessary. This collaboration will actively seek to engage with existing monitoring processes, such as the UN Sustainable Development Goals and WHO's climate and health country profiles. The indicators will also evolve over time through ongoing collaboration with experts and a range of stakeholders, and be dependent on the emergence of new evidence and knowledge. During the course of its work, the Lancet Countdown will adopt a collaborative and iterative process, which aims to complement existing initiatives, welcome engagement with new partners, and be open to developing new research projects on health and climate change.
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Affiliation(s)
- Nick Watts
- Institute for Global Health, University College London, London, UK.
| | - W Neil Adger
- Geography, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Yuqi Bai
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Peter Byass
- Epidemiology & Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Diarmid Campbell-Lendrum
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Peter Cox
- College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Michael Depledge
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Anneliese Depoux
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Paris Descartes, Paris, France
| | - Paula Dominguez-Salas
- Department of Production and Population Health, Royal Veterinary College, London, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Antoine Flahault
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Paris Descartes, Paris, France
| | - Delia Grace
- Food Safety and Zoonoses Program, International Livestock Research Institute, Nairobi, Kenya
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Andy Haines
- NIHR Health Protection Research Unit in Environmental Change and Health and Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Anne Johnson
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Ilan Kelman
- Institute for Global Health and UCL Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health and Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Lu Liang
- School of Forestry and Natural Resources, University of Arkansas at Monticello, Monticello, AR, USA
| | - Melissa Lott
- Institute for Sustainable Resources, University College London, London, UK
| | - Robert Lowe
- Energy Institute, University College London, London, UK
| | - Yong Luo
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Georgina Mace
- Department of Genetics, Evolution and Environment, University College London, London, UK
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Karyn Morrissey
- European Centre for Environment & Human Health, University of Exeter, Exeter, UK
| | - Kris Murray
- Grantham Institute-Climate Change and the Environment, Imperial College London, London, UK
| | - Tara Neville
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Maria Nilsson
- Epidemiology & Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tadj Oreszczyn
- Bartlett School of Environment, Energy and Resources, RCUK Centre for Energy Epidemiology, University College London, London, UK
| | | | | | - Elizabeth Robinson
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Stefanie Schütte
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Paris Descartes, Paris, France
| | - Joy Shumake-Guillemot
- WHO/WMO Joint Climate and Health Office, World Meteorological Organization, Geneva, Switzerland
| | - Paolo Vineis
- MRC/PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Paul Wilkinson
- NIHR Health Protection Research Unit in Environmental Change and Health and Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Nicola Wheeler
- Institute for Global Health, University College London, London, UK
| | - Bing Xu
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Jun Yang
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Yongyuan Yin
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Chaoqing Yu
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Peng Gong
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Hugh Montgomery
- Institute for Human Health and Performance, Division of Medicine, University College London, London, UK
| | - Anthony Costello
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
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Heaviside C, Tsangari H, Paschalidou A, Vardoulakis S, Kassomenos P, Georgiou KE, Yamasaki EN. Heat-related mortality in Cyprus for current and future climate scenarios. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 569-570:627-633. [PMID: 27376918 DOI: 10.1016/j.scitotenv.2016.06.138] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/17/2016] [Accepted: 06/17/2016] [Indexed: 05/28/2023]
Abstract
Extreme temperatures have long been associated with adverse health impacts, ranging from minor illness, to increased hospitalizations and mortality. Heat-related mortality during summer months is likely to become an increasing public health problem in future due to the effects of climate change. We performed a health impact assessment for heat-related mortality for the warm months of April-September for the years 2004 to 2009 inclusive, for the city of Nicosia and for Cyprus as a whole, based on separately derived exposure-response functions. We further estimated the potential future heat-related mortality by including climate projections for southern Europe, which suggest changes in temperature of between 1°C and 5°C over the next century. There were 32 heat-related deaths per year in Cyprus over the study period. When adding the projected increase in temperature due to climate change, there was a substantial increase in mortality: for a 1°C increase in temperature, heat related mortality in Cyprus was estimated to double to 64 per year, and for a 5°C increase, heat-related mortality was expected to be 8 times the baseline rate for the warm season (281 compared with 32). This analysis highlights the importance of preparing for potential health impacts due to heat in Cyprus, particularly under a changing climate.
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Affiliation(s)
- Clare Heaviside
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, United Kingdom
| | | | - Anastasia Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, GR-68200 Orestiada, Greece
| | - Sotiris Vardoulakis
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, United Kingdom
| | - Pavlos Kassomenos
- Laboratory of Meteorology, Department of Physics, University of Ioannina, GR-45110 Ioannina, Greece
| | - Kyriakos E Georgiou
- Cyprus Centre for European and International Affairs, University of Nicosia, Nicosia, Cyprus
| | - Edna N Yamasaki
- University of Nicosia, 46 Makedonitissas Ave, 1700 Nicosia, Cyprus
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Evaluation of an Early-Warning System for Heat Wave-Related Mortality in Europe: Implications for Sub-seasonal to Seasonal Forecasting and Climate Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:206. [PMID: 26861369 PMCID: PMC4772226 DOI: 10.3390/ijerph13020206] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/01/2016] [Indexed: 12/16/2022]
Abstract
Heat waves have been responsible for more fatalities in Europe over the past decades than any other extreme weather event. However, temperature-related illnesses and deaths are largely preventable. Reliable sub-seasonal-to-seasonal (S2S) climate forecasts of extreme temperatures could allow for better short-to-medium-term resource management within heat-health action plans, to protect vulnerable populations and ensure access to preventive measures well in advance. The objective of this study is to assess the extent to which S2S climate forecasts could be incorporated into heat-health action plans, to support timely public health decision-making ahead of imminent heat wave events in Europe. Forecasts of apparent temperature at different lead times (e.g., 1 day, 4 days, 8 days, up to 3 months) were used in a mortality model to produce probabilistic mortality forecasts up to several months ahead of the 2003 heat wave event in Europe. Results were compared to mortality predictions, inferred using observed apparent temperature data in the mortality model. In general, we found a decreasing transition in skill between excellent predictions when using observed temperature, to predictions with no skill when using forecast temperature with lead times greater than one week. However, even at lead-times up to three months, there were some regions in Spain and the United Kingdom where excess mortality was detected with some certainty. This suggests that in some areas of Europe, there is potential for S2S climate forecasts to be incorporated in localised heat-health action plans. In general, these results show that the performance of this climate service framework is not limited by the mortality model itself, but rather by the predictability of the climate variables, at S2S time scales, over Europe.
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24
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Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, Chaytor S, Colbourn T, Collins M, Cooper A, Cox PM, Depledge J, Drummond P, Ekins P, Galaz V, Grace D, Graham H, Grubb M, Haines A, Hamilton I, Hunter A, Jiang X, Li M, Kelman I, Liang L, Lott M, Lowe R, Luo Y, Mace G, Maslin M, Nilsson M, Oreszczyn T, Pye S, Quinn T, Svensdotter M, Venevsky S, Warner K, Xu B, Yang J, Yin Y, Yu C, Zhang Q, Gong P, Montgomery H, Costello A. Health and climate change: policy responses to protect public health. Lancet 2015; 386:1861-914. [PMID: 26111439 DOI: 10.1016/s0140-6736(15)60854-6] [Citation(s) in RCA: 740] [Impact Index Per Article: 82.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Nick Watts
- Institute for Global Health, University College London, London, UK.
| | - W Neil Adger
- Geography, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Paolo Agnolucci
- Institute for Sustainable Resources, University College London, London, UK
| | - Jason Blackstock
- Department of Science, Technology, Engineering and Public Policy, University College London, London, UK
| | - Peter Byass
- Centre for Global Health Research, Umea University, Umea, Sweden
| | - Wenjia Cai
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Sarah Chaytor
- Public Policy, University College London, London, UK
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Mat Collins
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Adam Cooper
- Department of Science, Technology, Engineering and Public Policy, University College London, London, UK
| | - Peter M Cox
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Joanna Depledge
- Department of Politics and International Studies, University of Cambridge, Cambridge, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Victor Galaz
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Michael Grubb
- Institute for Sustainable Resources, University College London, London, UK
| | - Andy Haines
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Alasdair Hunter
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Xujia Jiang
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Moxuan Li
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Lu Liang
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Melissa Lott
- Institute for Sustainable Resources, University College London, London, UK
| | - Robert Lowe
- Energy Institute, University College London, London, UK
| | - Yong Luo
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Georgina Mace
- Centre for Biodiversity and Environment Research, University College London, London, UK
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Maria Nilsson
- Centre for Global Health Research, Umea University, Umea, Sweden
| | | | - Steve Pye
- Energy Institute, University College London, London, UK
| | - Tara Quinn
- Environment and Sustainability Institute, University of Exeter, Exeter, UK
| | - My Svensdotter
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | - Sergey Venevsky
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Koko Warner
- UN University Institute for Environment and Human Security, Bonn, Germany
| | - Bing Xu
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Jun Yang
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Yongyuan Yin
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Chaoqing Yu
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Qiang Zhang
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Peng Gong
- Centre for Earth System Science, Tsinghua University, Haidian, Beijing, China
| | - Hugh Montgomery
- Institute for Human Health and Performance, University College London, London, UK
| | - Anthony Costello
- Institute for Global Health, University College London, London, UK
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