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Declet-Barreto J, Ruddell BL, Barber JJ, Petitti DB, Harlan SL. A Socio-spatial Model of the Risk of Hospitalization from Vulnerability to High Temperatures. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2025:2025.03.29.24319024. [PMID: 40236419 PMCID: PMC11998821 DOI: 10.1101/2025.03.29.24319024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/17/2025]
Abstract
Urban heat islands and climate change create increasingly hot environments that pose a threat to the health of the public in urban areas throughout the planet. In Maricopa County, Arizona, --- the hottest metropolitan area in the United States---we have previously shown that the effects of heat on mortality are greater in the social and built environments of low-income and communities of color (predominantly Hispanic/Latinx and Black neighborhoods). In this analysis of morbidity data from Maricopa County, we examined the relationship between heat-related hospitalization and summertime daily maximum air temperatures in groups defined at the census block group level as being at high, medium, or low vulnerability based on a Heat Vulnerability Index that was derived from socio-economic and built-environment data. For all three categories of census block group heat vulnerability, we identified 26°C as the daily maximum air temperature threshold beyond which heat-related hospitalization risk increased rapidly with each 1 °C increase in temperature. Compared to this baseline temperature, the relative risk of hospitalization was greatest in the high vulnerability census block groups and least in the low vulnerability census block groups with intermediate increases in the medium vulnerability census block groups. Specifically, with 26°C as the referent, the relative risks of heat-related hospitalization increased from 0.97 at 27°C to 15.71 at 46°C in the low vulnerability group, from 1.03 at 27°C to 53.97 at 46°C in the medium vulnerability group, and from 1.09 at 27°C to 162.46 at 46°C in the high vulnerability group. Our research helps identify areas with high heat population sensitivity and exposure that can be targeted for adaptation with policies and investments, which include, for example, improving public health safety nets and outcomes, access to affordable energy-efficient housing and health care, energy justice, and modifications to cool the urban built environment. Our hospitalization risk estimates can be incorporated into quantitative risk assessments of heat-related morbidity in Maricopa County.
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Affiliation(s)
- Juan Declet-Barreto
- Climate & Energy Program, Union of Concerned Scientists, Washington, DC, USA
| | - Benjamin L Ruddell
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, USA
| | - Jarrett J Barber
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, USA
| | - Diana B Petitti
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
| | - Sharon L Harlan
- Department of Health Sciences and Department of Sociology & Anthropology, Northeastern University, Boston, MA, USA
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
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Ding F, Liu X, Hu Z, Liu W, Zhang Y, Zhao Y, Zhao S, Zhao Y. Association between ambient temperature, PM 2.5 and tuberculosis in Northwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3173-3187. [PMID: 38153391 DOI: 10.1080/09603123.2023.2299236] [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: 07/12/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023]
Abstract
Existing evidence suggested that the risk of tuberculosis (TB) infection was associated to the variations in temperature and PM2.5. A total of 9,111 cases of TB were reported in Ningxia Hui Autonomous Region, China from 2013 to 2015 on a daily basis, and 57.2% of them were male. The TB risk was more prominent for a lower temperature in males (RR of 1.724, 95% CI: 1.241, 2.394), the aged over 64 years (RR of 2.241, 95% CI: 1.554, 3.231), and the high mobility occupation subpopulation (RR of 2.758, 95% CI: 1.745, 4.359). High concentration of PM2.5 showed a short-term effect and was only associated with an increased risk in the early stages of exposure for the female, and aged 36-64 years group. There were 15.06% (1370 cases) of cases of TB may be attributable to the temperature, and 2.94% (268 cases) may be attributable to the increase of PM2.5 exposures. Low temperatures may be associated with significantly increase in the risk of TB, and high PM2.5 concentrations have a short-term association on increasing the risk of TB. Strengthening the monitoring and regular prevention and control of high risk groups will provide scientific guidance to reduce the incidence of TB.
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Affiliation(s)
- Fan Ding
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Xianglong Liu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Zengyun Hu
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, China
| | - Weichen Liu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Yajuan Zhang
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Yi Zhao
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Shi Zhao
- School of Public Health, Tianjin Medical University, Tianjin, China
- Centre for Health Systems and Policy Research, Chinese University of Hong Kong, Hong Kong, China
- CUHK Shenzhen Research Institute, Chinese University of Hong Kong, Shenzhen, China
| | - Yu Zhao
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
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Weitz CA. Coping with extreme heat: current exposure and implications for the future. Evol Med Public Health 2024; 12:eoae015. [PMID: 39359409 PMCID: PMC11445678 DOI: 10.1093/emph/eoae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 07/02/2024] [Indexed: 10/04/2024] Open
Abstract
A preview of how effective behavioral, biological and technological responses might be in the future, when outdoor conditions will be at least 2°C hotter than current levels, is available today from studies of individuals already living in extreme heat. In areas where high temperatures are common-particularly those in the hot and humid tropics-several studies report that indoor temperatures in low-income housing can be significantly hotter than those outdoors. A case study indicates that daily indoor heat indexes in almost all the 123 slum dwellings monitored in Kolkata during the summer were above 41°C (106°F) for at least an hour. Economic constraints make it unlikely that technological fixes, such as air conditioners, will remedy conditions like these-now or in the future. People without access to air conditioning will have to rely on behavioral adjustments and/or biological/physiological acclimatization. One important unknown is whether individuals who have lived their entire lives in hot environments without air conditioning possess natural levels of acclimatization greater than those indicated by controlled laboratory studies. Answering questions about the future will require more studies of heat conditions experienced by individuals, more information on indoor versus outdoor heat conditions, and a greater understanding of the behavioral and biological adjustments made by people living today in extremely hot conditions.
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Affiliation(s)
- Charles A Weitz
- Department of Anthropology, Temple University, Philadelphia, PA 19122, USA
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Navas-Martín MÁ, Cuerdo-Vilches T, López-Bueno JA, Díaz J, Linares C, Sánchez-Martínez G. Human adaptation to heat in the context of climate change: A conceptual framework. ENVIRONMENTAL RESEARCH 2024; 252:118803. [PMID: 38565417 DOI: 10.1016/j.envres.2024.118803] [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: 11/30/2023] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
Climate change is causing serious damage to natural and social systems, as well as having an impact on human health. Among the direct effects of climate change is the rise in global surface temperatures and the increase in the frequency, duration, intensity and severity of heat waves. In addition, understanding of the adaptation process of the exposed population remains limited, posing a challenge in accurately estimating heat-related morbidity and mortality. In this context, this study seeks to establish a conceptual framework that would make it easier to understand and organise knowledge about human adaptation to heat and the factors that may influence this process. An inductive approach based on grounded theory was used, through the analysis of case studies connecting concepts. The proposed conceptual framework is made up of five components (climate change, vulnerability, health risks of heat, axes of inequality and health outcomes), three heat-adaptation domains (physiological, cultural and political), two levels (individual and social), and the pre-existing before a heat event. The application of this conceptual framework facilitates the assistance of decision-makers in planning and implementing effective adaptation measures. Recognizing the importance of addressing heat adaptation as a health problem that calls for political solutions and social changes. Accordingly, this requires a multidisciplinary approach that would foster the participation and collaboration of multiple actors for the purpose of proposing effective measures to address the health impact of the rise in temperature.
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Affiliation(s)
- Miguel Ángel Navas-Martín
- Programme in Biomedical Sciences and Public Health, National University of Distance Education (UNED), Madrid, Spain; National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain.
| | - Teresa Cuerdo-Vilches
- Eduardo Torroja Construction Sciences Institute (IETCC), Spanish National Research Council (CSIC), Madrid, Spain
| | | | - Julio Díaz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
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Kenny GP, Tetzlaff EJ, Journeay WS, Henderson SB, O’Connor FK. Indoor overheating: A review of vulnerabilities, causes, and strategies to prevent adverse human health outcomes during extreme heat events. Temperature (Austin) 2024; 11:203-246. [PMID: 39193048 PMCID: PMC11346563 DOI: 10.1080/23328940.2024.2361223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/07/2024] [Accepted: 05/20/2024] [Indexed: 08/29/2024] Open
Abstract
The likelihood of exposure to overheated indoor environments is increasing as climate change is exacerbating the frequency and severity of hot weather and extreme heat events (EHE). Consequently, vulnerable populations will face serious health risks from indoor overheating. While the relationship between EHE and human health has been assessed in relation to outdoor temperature, indoor temperature patterns can vary markedly from those measured outside. This is because the built environment and building characteristics can act as an important modifier of indoor temperatures. In this narrative review, we examine the physiological and behavioral determinants that influence a person's susceptibility to indoor overheating. Further, we explore how the built environment, neighborhood-level factors, and building characteristics can impact exposure to excess heat and we overview how strategies to mitigate building overheating can help reduce heat-related mortality in heat-vulnerable occupants. Finally, we discuss the effectiveness of commonly recommended personal cooling strategies that aim to mitigate dangerous increases in physiological strain during exposure to high indoor temperatures during hot weather or an EHE. As global temperatures continue to rise, the need for a research agenda specifically directed at reducing the likelihood and impact of indoor overheating on human health is paramount. This includes conducting EHE simulation studies to support the development of consensus-based heat mitigation solutions and public health messaging that provides equitable protection to heat-vulnerable people exposed to high indoor temperatures.
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Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - W. Shane Journeay
- Departments of Medicine and Community Health and Epidemiology, Dalhousie Medicine New Brunswick and Dalhousie University, Saint John, NB, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
- Department of Rehabilitative Care, Providence Healthcare-Unity Health Toronto, Toronto, ON, Canada
| | - Sarah B. Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
- National Collaborating Centre for Environmental Health, Vancouver, BC, Canada
| | - Fergus K. O’Connor
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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Ding H, Ren Q, Wang C, Chen H, Wang Y. Exploring the relationship between land use/land cover and apparent temperature in China (1996-2020): implications for urban planning. Sci Rep 2024; 14:3214. [PMID: 38332171 PMCID: PMC10853208 DOI: 10.1038/s41598-024-53858-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/06/2024] [Indexed: 02/10/2024] Open
Abstract
In recent decades, rising air temperatures (AT) and apparent temperatures (AP) have posed growing health risks. In the context of China's rapid urbanization and global climate change, it is crucial to understand the impact of urban land use/land cover (LULC) changes on AP. This study investigates the spatial distribution and long-term variation patterns of AT and AP, using data from 834 meteorological stations across China from 1996 to 2020. It also explores the relationship between AT, AP, and LULC in the urban core areas of 30 major cities. Study reveals that AT and AP exhibit overall high spatial similarity, albeit with greater spatial variance in AP. Notably, regions with significant disparities between the two have been identified. Furthermore, it's observed that the spatial range of high AP change rates is wider than that of AT. Moreover, the study suggests a potential bivariate quadratic function relationship between ΔT (the difference between AT and AP) and Wa_ratio and Ar_ratio, indicating the presence of a Least Suitable Curve (LSC), [Formula: see text]. Urban LULC planning should carefully avoid intersecting with this curve. These findings can provide valuable insights for urban LULC planning, ultimately enhancing the thermal comfort of urban residents.
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Affiliation(s)
- Han Ding
- College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, China
| | - Qiuru Ren
- College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, China
| | - Chengcheng Wang
- College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, China
| | - Haitao Chen
- College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, China
| | - Yuqiu Wang
- College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, China.
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Lee J, Dessler AE. Future Temperature-Related Deaths in the U.S.: The Impact of Climate Change, Demographics, and Adaptation. GEOHEALTH 2023; 7:e2023GH000799. [PMID: 37588982 PMCID: PMC10426332 DOI: 10.1029/2023gh000799] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/31/2023] [Accepted: 06/19/2023] [Indexed: 08/18/2023]
Abstract
Mortality due to extreme temperatures is one of the most worrying impacts of climate change. In this analysis, we use historic mortality and temperature data from 106 cities in the United States to develop a model that predicts deaths attributable to temperature. With this model and projections of future temperature from climate models, we estimate temperature-related deaths in the United States due to climate change, changing demographics, and adaptation. We find that temperature-related deaths increase rapidly as the climate warms, but this is mainly due to an expanding and aging population. For global average warming below 3°C above pre-industrial levels, we find that climate change slightly reduces temperature-related mortality in the U.S. because the reduction of cold-related mortality exceeds the increase in heat-related deaths. Above 3°C warming, whether the increase in heat-related deaths exceeds the decrease in cold-related deaths depends on the level of adaptation. Southern U.S. cities are already well adapted to hot temperatures and the reduction of cold-related mortality drives overall lower mortality. Cities in the Northern U.S. are not well adapted to high temperatures, so the increase in heat-related mortality exceeds the reduction in cold-related mortality. Thus, while the total number of climate-related mortality may not change much, climate change will shift mortality in the U.S. to higher latitudes.
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Affiliation(s)
- Jangho Lee
- Department of Atmospheric SciencesTexas A&M UniversityCollege StationTXUSA
| | - Andrew E. Dessler
- Department of Atmospheric SciencesTexas A&M UniversityCollege StationTXUSA
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Errett NA, Hartwell C, Randazza JM, Nori-Sarma A, Weinberger KR, Spangler KR, Sun Y, Adams QH, Wellenius GA, Hess JJ. Survey of extreme heat public health preparedness plans and response activities in the most populous jurisdictions in the United States. BMC Public Health 2023; 23:811. [PMID: 37138325 PMCID: PMC10154751 DOI: 10.1186/s12889-023-15757-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Increasingly frequent and intense extreme heat events (EHEs) are indicative of climate change impacts, and urban areas' social and built environments increase their risk for health consequences. Heat action plans (HAPs) are a strategy to bolster municipal EHE preparedness. The objective of this research is to characterize municipal interventions to EHEs and compare U.S. jurisdictions with and without formal heat action plans. METHODS An online survey was sent to 99 U.S. jurisdictions with populations > 200,000 between September 2021 and January 2022. Summary statistics were calculated to describe the proportion of total jurisdictions, as well as jurisdictions with and without HAPs and in different geographies that reported engagement in extreme heat preparedness and response activities. RESULTS Thirty-eight (38.4%) jurisdictions responded to the survey. Of those respondents, twenty-three (60.5%) reported the development of a HAP, of which 22 (95.7%) reported plans for opening cooling centers. All respondents reported conducting heat-related risk communications; however, communication approaches focused on passive, technology-dependent mechanisms. While 75.7% of jurisdictions reported having developed a definition for an EHE, less than two-thirds of responding jurisdictions reported any of the following activities: conducting heat-related surveillance (61.1%), implementing provisions for power outages (53.1%), increasing access to fans or air conditioners (48.4%), developing heat vulnerability maps (43.2%), or evaluating activities (34.2%). There were only two statistically significant (p ≥ .05) differences in the prevalence of heat-related activities between jurisdictions with and without a written HAP, possibly attributable to a relatively small sample size: surveillance and having a definition of extreme heat. CONCLUSIONS Jurisdictions can strengthen their extreme heat preparedness by expanding their consideration of at-risk populations to include communities of color, conducting formal evaluations of their responses, and by bridging the gap between the populations determined to be most at-risk and the channels of communication designed to reach them.
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Affiliation(s)
- Nicole A Errett
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA.
| | - Cat Hartwell
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
| | - Juliette M Randazza
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
| | - Amruta Nori-Sarma
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Keith R Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Yuantong Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Quinn H Adams
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Jeremy J Hess
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Emergency Medicine, University of Washington, Seattle, WA, USA
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Guo C, Lanza K, Li D, Zhou Y, Aunan K, Loo BPY, Lee JKW, Luo B, Duan X, Zhang W, Zhang Z, Lin S, Zhang K. Impact of heat on all-cause and cause-specific mortality: A multi-city study in Texas. ENVIRONMENTAL RESEARCH 2023; 224:115453. [PMID: 36773641 DOI: 10.1016/j.envres.2023.115453] [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: 01/16/2023] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Studies on the health effects of heat are particularly limited in Texas, a U.S. state in the top 10 highest number of annual heat-related deaths per capita from 2018 to 2020. This study assessed the effects of heat on all-cause and cause-specific mortality in 12 metropolitan statistical areas (MSAs) across Texas from 1990 to 2011. METHODS First, we determined the heat thresholds for each MSA above which the relation between temperature and mortality is linear. We then conducted a distributed lag non-linear model for each MSA, followed by a random effects meta-analysis to estimate the pooled effects for all MSAs. We repeated this process for each mortality cause and age group to achieve the effect estimates. RESULTS We found a 1 °C temperature increase above the heat threshold is associated with an increase in the relative risk of all-cause mortality of 0.60% (95%CI [0.39%, 0.82%]) and 1.10% (95%CI [0.65%, 1.56%]) for adults older than 75. For each MSA, the relative risk of mortality for a 1 °C temperature increase above the heat threshold ranges from 0.10% (95%CI [0.09%, 0.10%]) to 1.29% (95%CI [1.26%, 1.32%]). Moreover, elevated temperatures showed a slight decrease in cardiovascular mortality (0.37%, 95%CI [-0.35%, 1.09%]) and respiratory disease (1.97%, 95%CI [-0.11%, 4.08%]), however this effect was not considered statistically significant.. CONCLUSION Our study found that high temperatures can significantly impact all-cause mortality in Texas, and effect estimates differ by MSA, age group, and cause of death. Our findings generate critical information on the impact of heat on mortality in Texas, providing insights for policymakers on resource allocation and strategic intervention to reduce heat-related health effects.
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Affiliation(s)
- Chunyu Guo
- Department of Economics, School of Art and Science, University at Albany, State University of New York, Albany, NY, USA
| | - Kevin Lanza
- Department of Epidemiology, Human Genetics, & Environmental Sciences, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX, USA
| | - Dongying Li
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Yuyu Zhou
- Department of Geological and Atmospheric Sciences, Iowa State University, Ames, IA, USA
| | - Kristin Aunan
- CICERO Center for International Climate Research, N-0318, Oslo, Norway
| | - Becky P Y Loo
- Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jason Kai Wei Lee
- Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhengjun Zhang
- Department of Statistics, University of Wisconsin-Madison, WI, USA
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, 12144, USA.
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Rai M, Breitner S, Huber V, Zhang S, Peters A, Schneider A. Temporal variation in the association between temperature and cause-specific mortality in 15 German cities. ENVIRONMENTAL RESEARCH 2023; 229:115668. [PMID: 36958378 DOI: 10.1016/j.envres.2023.115668] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND There is limited evidence of temporal changes in the association between air temperature and the risk of cause-specific cardiovascular [CVD] and respiratory [RD] mortality. METHOD We explored temporal variations in the association between short-term exposures to air temperature and non-accidental and cause-specific CVD and RD mortality in the 15 largest German cities over 24 years (1993-2016) using time-stratified time series analysis. We applied location-specific confounder-adjusted Poisson regression with distributed lag non-linear models with a lag period of 14 days to estimate the temperature-mortality associations. We then pooled the estimates by a multivariate meta-analytical model. We analysed the whole study period and the periods 1993-2004 and 2005-16, separately. We also carried out age- and sex-stratified analysis. Cold and heat effects are reported as relative risk [RR] at the 1st and the 99th temperature percentile, relative to the 25th and the 75th percentile, respectively. RESULT We analysed a total of 3,159,292 non-accidental, 1,063,198 CVD and 183,027 RD deaths. Cold-related RR for CVD mortality was seen to rise consistently over time from 1.04 (95% confidence interval [95% CI] 1.02, 1.06) in the period 1993-2004 to 1.10 (95% CI 1.09, 1.11) in the period 2005-16. A similar increase in cold-related RR was also observed for RD mortality with risk increasing from 0.99 (95% CI 0.96, 1.03) to 1.07 (95% CI 1.03, 1.10). Cold-related ischemic, cerebrovascular, and heart failure mortality risk were seen to be increasing over time. Similarly, COPD, the commonly speculated driver of heat-related RD mortality was found to have a constant heat-related risk over time. Males were increasingly vulnerable to cold with time for all causes of death. Females showed increasing sensitivity to cold for CVD mortality. Our results indicated a significant increased cold and heat vulnerability of the youngest age-groups (<64) to non-accidental and RD mortality, respectively. Similarly, the older age group (>65) were found to have significantly increased susceptibility to cold for CVD mortality. CONCLUSION We found evidence of rising population susceptibility to both heat- and cold-related CVD and RD mortality risk from 1993 to 2016. Climate change mitigation and targeted adaptation strategies might help to reduce the number of temperature-related deaths in the future.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Yan M, Xie Y, Zhu H, Ban J, Gong J, Li T. Cardiovascular mortality risks during the 2017 exceptional heatwaves in China. ENVIRONMENT INTERNATIONAL 2023; 172:107767. [PMID: 36716635 DOI: 10.1016/j.envint.2023.107767] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/11/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Climate change has made disastrous heatwaves more frequent. Heatwave-related health impacts are much more devastating for more intense heatwaves. In the summer of 2017, exceptional heatwaves occurred in many regions, including China. This study aims to evaluate the cardiovascular mortality risk associated with the 2017 exceptional heatwaves and compare the mortality risk of the severe heatwaves with those in other years. Using daily data for a spectrum of cardiovascular mortality and temperature for 102 Chinese counties (2014-2017), we estimated the association between heatwave and mortality by generalized linear mixed-effects models. Compared with matched non-heatwave days, mortality risks on heatwaves days in 2017 increased 27.8% (95% CI, 14.8-42.3%), 26.7% (8.0-48.5%), 30.1% (10.2-53.7%), 27.3% (1.4-59.9%), 32.2% (3.4-68.4%), and 25.2% (1.0-57.7%) for total circulatory diseases, cerebrovascular disease, ischemic heart disease (IHD), acute IHD, chronic IHD, and myocardial infarction. The 2017 exceptional heatwaves impacted ischemic heart disease mortality and myocardial infarction mortality more than heatwaves in 2014-2016. Here we show that the severe heatwaves in 2017 posed catastrophic death threats for those under-studied cardiovascular diseases.
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Affiliation(s)
- Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China; Future Cities Lab, Beihang University, China
| | - Huanhuan Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology and State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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12
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Fang W, Li Z, Gao J, Meng R, He G, Hou Z, Zhu S, Zhou M, Zhou C, Xiao Y, Yu M, Huang B, Xu X, Lin L, Xiao J, Jin D, Qin M, Yin P, Xu Y, Hu J, Liu T, Huang C, Ma W. The joint and interaction effect of high temperature and humidity on mortality in China. ENVIRONMENT INTERNATIONAL 2023; 171:107669. [PMID: 36508749 DOI: 10.1016/j.envint.2022.107669] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Although many studies have reported the mortality effect of temperature, there were few studies on the mortality risk of humidity, let alone the joint effect of temperature and humidity. This study aimed to investigate the joint and interaction effect of high temperature and relative humidity on mortality in China, which will deepen understanding the health risk of mixture climate exposure. METHODS The mortality and meteorological data were collected from 353 locations in China (2013-2017 in Jilin, Hunan, Guangdong and Yunnan provinces, 2009-2017 in Zhejiang province, and 2006-2011 in other Provinces). We defined location-specific daily mean temperature ≥ 75th percentile of distribution as high temperature, while minimum mortality relative humidity as the threshold of high relative humidity. A time-series model with a distributed lag non-linear model was first employed to estimate the location-specific associations between humid-hot events and mortality, then we conducted meta-analysis to pool the mortality effect of humid-hot events. Finally, an additive interaction model was used to examine the interactive effect between high temperature and relative humidity. RESULTS The excess rate (ER) of non-accidental mortality attributed to dry-hot events was 10.18% (95% confidence interval (CI): 8.93%, 11.45%), which was higher than that of wet-hot events (ER = 3.21%, 95% CI: 0.59%, 5.89%). The attributable fraction (AF) of mortality attributed to dry-hot events was 10.00% (95% CI: 9.50%, 10.72%) with higher burden for females, older people, central China, cardiovascular diseases and urban city. While for wet-hot events, AF was much lower (3.31%, 95% CI: 2.60%, 4.30%). We also found that high temperature and low relative humidity had synergistic additive interaction on mortality risk. CONCLUSION Dry-hot events may have a higher risk of mortality than wet-hot events, and the joint effect of high temperature and low relative humidity may be greater than the sum of their individual effects.
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Affiliation(s)
- Wen Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Zhixing Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Jinghua Gao
- School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
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13
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Sinha P, Coville RC, Hirabayashi S, Lim B, Endreny TA, Nowak DJ. Variation in estimates of heat-related mortality reduction due to tree cover in U.S. cities. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 301:113751. [PMID: 34628283 DOI: 10.1016/j.jenvman.2021.113751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/10/2021] [Accepted: 09/11/2021] [Indexed: 06/13/2023]
Abstract
Heat-related mortality is one of the leading causes of weather-related deaths in the United States. With changing climates and an aging population, effective adaptive strategies to address public health and environmental justice issues associated with extreme heat will be increasingly important. One effective adaptive strategy for reducing heat-related mortality is increasing tree cover. Designing such a strategy requires decision-support tools that provide spatial and temporal information about impacts. We apply such a tool to estimate spatially and temporally explicit reductions in temperature and mortality associated with a 10% increase in tree cover in 10 U.S. cities with varying climatic, demographic, and land cover conditions. Two heat metrics were applied to represent tree impacts on moderately and extremely hot days (relative to historical conditions). Increasing tree cover by 10% reduced estimated heat-related mortality in cities significantly, with total impacts generally greatest in the most populated cities. Mortality reductions vary widely across cities, ranging from approximately 50 fewer deaths in Salt Lake City to about 3800 fewer deaths in New York City. This variation is due to differences in demographics, land cover, and local climatic conditions. In terms of per capita estimated impacts, hotter and drier cities experience higher percentage reductions in mortality due to increased tree cover across the season. Phoenix potentially benefits the most from increased tree cover, with an estimated 22% reduction in mortality from baseline levels. In cooler cities such as Minneapolis, trees can reduce mortality significantly on days that are extremely hot relative to historical conditions and therefore help mitigate impacts during heat wave conditions. Recent studies project highest increases in heat-related mortality in the cooler cities, so our findings have important implications for adaptation planning. Our estimated spatial and temporal distributions of mortality reductions for each city provide crucial information needed for promoting environmental justice and equity. More broadly, the methods and model can be applied by both urban planners and the public health community for designing targeted, effective policies to reduce heat-related mortality. Additionally, land use managers can use this information to optimize tree plantings. Public stakeholders can also use these impact estimates for advocacy.
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Affiliation(s)
- Paramita Sinha
- RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709, USA.
| | - Robert C Coville
- USDA Forest Service, Davey Institute, Davey Tree Expert Company, 5 Moon Library, SUNY-ESF, Syracuse, NY, 13210, USA
| | - Satoshi Hirabayashi
- USDA Forest Service, Davey Institute, Davey Tree Expert Company, 5 Moon Library, SUNY-ESF, Syracuse, NY, 13210, USA
| | - Brian Lim
- RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Theodore A Endreny
- Department of Environmental Resources Engineering, SUNY-ESF, Syracuse, NY, 13210, USA
| | - David J Nowak
- USDA Forest Service, 5 Moon Library, SUNY-ESF, Syracuse, NY, 13210, USA
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14
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Iyakaremye V, Zeng G, Yang X, Zhang G, Ullah I, Gahigi A, Vuguziga F, Asfaw TG, Ayugi B. Increased high-temperature extremes and associated population exposure in Africa by the mid-21st century. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 790:148162. [PMID: 34102437 DOI: 10.1016/j.scitotenv.2021.148162] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/11/2021] [Accepted: 05/27/2021] [Indexed: 05/22/2023]
Abstract
Previous studies warned that heat extremes are likely to intensify and frequently occur in the future due to climate change. Apart from changing climate, the population's size and distribution contribute to the total changes in the population exposed to heat extremes. The present study uses the ensemble mean of global climate models from the Coupled Model Inter-comparison Project Phase six (CMIP6) and population projection to assess the future changes in high-temperature extremes and exposure to the population by the middle of this century (2041-2060) in Africa compared to the recent climate taken from 1991 to 2010. Two Shared Socioeconomic Pathways (SSPs), namely SSP2-4.5 and SSP5-8.5, are used. Changes in population exposure and its contributors are quantified at continental and for various sub-regions. The intensity of high-temperature extremes is anticipated to escalate between 0.25 to 1.8 °C and 0.6 to 4 °C under SSP2-4.5 and SSP5-8.5, respectively, with Sahara and West Southern Africa projected to warm faster than the rest of the regions. On average, warm days' frequency is also expected to upsurge under SSP2-4.5 (26-59%) and SSP5-8.5 (30-69%) relative to the recent climate. By the mid-21st century, continental population exposure is expected to upsurge by ~25% (28%) of the reference period under SSP2-4.5|SSP2 (SSP5-8.5|SSP5). The highest increase in exposure is expected in most parts of West Africa (WAF), followed by East Africa. The projected changes in continental exposure (~353.6 million person-days under SSP2-4.5|SSP2 and ~401.4 million person-days under SSP5-8.5|SSP5) are mainly due to the interaction effect. However, the climate's influence is more than the population, especially for WAF, South-East Africa and East Southern Africa. The study findings are vital for climate change adaptation.
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Affiliation(s)
- Vedaste Iyakaremye
- Key Laboratory of Meteorological Disaster of Ministry of Education (KLME), Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD), Nanjing University of Information Science and Technology, Nanjing, China; Rwanda Meteorology Agency, Nyarugenge KN 96 St, Kigali, Rwanda; African Institute for Mathematical Sciences Next Einstein Initiative (AIMS-NEI), KG590 St, Kigali, Rwanda
| | - Gang Zeng
- Key Laboratory of Meteorological Disaster of Ministry of Education (KLME), Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD), Nanjing University of Information Science and Technology, Nanjing, China.
| | - Xiaoye Yang
- Key Laboratory of Meteorological Disaster of Ministry of Education (KLME), Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD), Nanjing University of Information Science and Technology, Nanjing, China
| | - Guwei Zhang
- Key Laboratory of Meteorological Disaster of Ministry of Education (KLME), Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD), Nanjing University of Information Science and Technology, Nanjing, China
| | - Irfan Ullah
- Key Laboratory of Meteorological Disaster of Ministry of Education (KLME), Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD), Nanjing University of Information Science and Technology, Nanjing, China
| | - Aimable Gahigi
- Rwanda Meteorology Agency, Nyarugenge KN 96 St, Kigali, Rwanda
| | - Floribert Vuguziga
- Key Laboratory of Meteorological Disaster of Ministry of Education (KLME), Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD), Nanjing University of Information Science and Technology, Nanjing, China; Rwanda Meteorology Agency, Nyarugenge KN 96 St, Kigali, Rwanda
| | - Temesgen Gebremariam Asfaw
- Institute of Geophysics Space Science and Astronomy, Addis Ababa University, 1176 Addis Ababa, Ethiopia; Institute for Climate and Application Research (ICAR)/CICFEM/KLME/ILCEC, Nanjing University of Information Science and Technology, Nanjing, China
| | - Brian Ayugi
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing 210044, China; Organization of African Academic Doctors (OAAD), Off Kamiti Road, P.O. Box 25305-00100, Nairobi, Kenya
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15
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Kouis P, Psistaki K, Giallouros G, Michanikou A, Kakkoura MG, Stylianou KS, Papatheodorou SI, Paschalidou AΚ. Heat-related mortality under climate change and the impact of adaptation through air conditioning: A case study from Thessaloniki, Greece. ENVIRONMENTAL RESEARCH 2021; 199:111285. [PMID: 34015294 DOI: 10.1016/j.envres.2021.111285] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 04/27/2021] [Accepted: 05/01/2021] [Indexed: 06/12/2023]
Abstract
Climate change is expected to increase heat-related mortality across the world. Health Impact Assessment (HIA) studies are used to quantify the impact of higher temperatures, taking into account the effect of population adaptation. Although air-conditioning (AC) is one of the main drivers of technological adaptation to heat, the health impacts associated with AC-induced air pollution have not been examined in detail. This study uses the city of Thessaloniki, Greece as a case study and aims to estimate the future heat-related mortality, the residential cooling demand, and the adaptation trade-off between averted heat-related and increased air pollution cardiorespiratory mortality. Using temperature and population projections under different Coupled Model Intercomparison Project Phase 6 (CIMP6) Shared Socioeconomic Pathways scenarios (SSPs), a HIA model was developed for the future heat and air pollution cardiorespiratory mortality. Counterfactual scenarios of either black carbon (BC) or natural gas (NG) being the fuel source for electricity generation were included in the HIA. The results indicate that the heat-related cardiorespiratory mortality in Thessaloniki will increase and the excess of annual heat-related deaths in 2080-2099 will range from 2.4 (95% CI: 0.0-20.9) under SSP1-2.6 to 433.7 (95% CI: 66.9-1070) under SSP5-8.5. Population adaptation will attenuate the heat-related mortality, although the latter may be counterbalanced by the higher air pollution-related mortality due to increased AC, especially under moderate SSP scenarios and coal-fired power plants. Future studies examining the health effects of warmer temperatures need to account for the impact of both adaptation and increased penetration and use of AC.
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Affiliation(s)
| | - Kyriaki Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, Greece.
| | - George Giallouros
- Department of Public and Business Administration, University of Cyprus, Nicosia, Cyprus.
| | | | - Maria G Kakkoura
- Medical School, University of Cyprus, Nicosia, Cyprus; Clinical Trial Service Unit and Epidemiological Studies Unit CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Katerina S Stylianou
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | | | - Anastasia Κ Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, Greece.
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16
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Peña-Angulo D, Vicente-Serrano SM, Domínguez-Castro F, Reig-Gracia F, El Kenawy A. The potential of using climate indices as powerful tools to explain mortality anomalies: An application to mainland Spain. ENVIRONMENTAL RESEARCH 2021; 197:111203. [PMID: 33894234 DOI: 10.1016/j.envres.2021.111203] [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: 12/28/2020] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
Changes in the frequency and magnitude of extreme weather events represent one of the key indicators of climate change and variability. These events can have an important impact on mortality rates, especially in the ageing population. This study assessed the spatial and seasonal distributions of mortality rates in mainland Spain and their association with climatic conditions over the period 1979-2016. The analysis was done on a seasonal and annual basis using 79 climatic indices and regional natural deaths data. Results indicate large spatial variability of natural deaths, which is mostly related to how the share of the elderly in the population varied across the studied regions. Spatially, both the highest mortality rates and the largest percentage of elders were found in the northwest areas of the study domain, where an extreme climate prevails, with very cold winters and hot summers. A strong seasonality effect was observed, winter shows more than 10% of natural deaths compared to the rest of the seasons. Also, results suggest a strong relation between climatic indices and natural deaths, albeit with a high spatial and seasonal variability. Climatic indices and natural deaths show a stronger correlation in winter and summer than in spring and autumn.
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Affiliation(s)
- D Peña-Angulo
- Pyrenean Institute of Ecology (IPE), Spanish National Research Council (CSIC), Zaragoza, Spain.
| | - S M Vicente-Serrano
- Pyrenean Institute of Ecology (IPE), Spanish National Research Council (CSIC), Zaragoza, Spain
| | - F Domínguez-Castro
- Aragonese Agency for Research and Development Researcher (ARAID), Zaragoza, Spain; Department of Geography, University of Zaragoza, Zaragoza, Spain
| | - F Reig-Gracia
- Pyrenean Institute of Ecology (IPE), Spanish National Research Council (CSIC), Zaragoza, Spain
| | - A El Kenawy
- Department of Geography, Mansoura University, Mansoura, 35516, Egypt; Department of Geography, Sultan Qaboos University, Al Khoud, Muscat, Oman
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17
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Cao R, Wang Y, Huang J, He J, Ponsawansong P, Jin J, Xu Z, Yang T, Pan X, Prapamontol T, Li G. The Mortality Effect of Apparent Temperature: A Multi-City Study in Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4675. [PMID: 33924779 PMCID: PMC8124769 DOI: 10.3390/ijerph18094675] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/22/2022]
Abstract
(1) Background: The health effect of temperature has become a rising public health topic. The objective of this study is to assess the association between apparent temperature and non-accidental deaths, and the mortality burden attributed to cold and heat temperature; (2) Methods: The daily data on temperature and deaths were collected from 10 cities in Thailand, Korea and China. We fitted a time-series regression with a distributed lag nonlinear model (DLNM) to derive the health risk of temperature for each city and then pooled them to get the overall cumulative risk by multivariate meta-analysis. Additionally, we calculated the attributable fraction of deaths for heat and cold, which was defined as temperatures above and below minimum-mortality temperature (MMT); (3) Results: There are regional heterogeneities in the minimum mortality percentiles (MMP) and attributable fractions for different countries. The MMP varied from about the 5-10th percentile in Thailand to 63-93rd percentile in China and Korea. The attributable fractions of the total deaths due to short-term exposure to temperature in Asia is 7.62%, of which the cold effect (6.44%) is much higher than the heat effect (1.18%); (4) Conclusions: Our study suggested that apparent temperature was associated with an increase in non-accidental mortality. Most of the temperature-related mortality burden was attributable to cold, except for Thailand.
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Affiliation(s)
- Ru Cao
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Jie He
- Peking University School of Nursing, 38 Xueyuan Road, Haidian District, Beijing 100191, China;
| | - Pitakchon Ponsawansong
- Environment and Health Research Unit, Research Institute for Health Science, Chiang Mai University, Chiang Mai 50200, Thailand; (P.P.); (T.P.)
| | - Jianbo Jin
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
- Environment and Health Research Unit, Research Institute for Health Science, Chiang Mai University, Chiang Mai 50200, Thailand; (P.P.); (T.P.)
| | - Tippawan Prapamontol
- Environment and Health Research Unit, Research Institute for Health Science, Chiang Mai University, Chiang Mai 50200, Thailand; (P.P.); (T.P.)
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
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18
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Mohammadi D, Zare Zadeh M, Zare Sakhvidi MJ. Short-term exposure to extreme temperature and risk of hospital admission due to cardiovascular diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:344-354. [PMID: 33615930 DOI: 10.1080/09603123.2019.1663496] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/26/2019] [Indexed: 06/12/2023]
Abstract
Objective: Numerous epidemiological studies have reported relevance of morbidity and mortality from cardiovascular diseases with short-term exposure to environmental temperature. In this study, we examined the hypothesis between temperature indices and hospital admission because of cardiovascular diseases. Methods: The daily number of CVDs was obtained from all hospitals of the Sabzevar city. A semi-parametric generalized additive model (GAM) following a quasi-Poisson distribution with distributed lag non-linear model (dlnm) was selected as a modeling framework for time-series analysis. Results: The overall CVD risk comparing the 1st percentile and the 99th percentile relative to the mean temperature (at lag 0) was 1.33 (95% CI, 1.11: 1.61), and 1.34 (95% CI, 1.10: 1.64), respectively. For all indicators, the extremely cold effects persisted for the initial 7 days. Conclusions: Our results suggest that extremely cold and extremely hot temperatures increase the relative risk of cardiovascular diseases.
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Affiliation(s)
- Danial Mohammadi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
| | - Mohammad Zare Zadeh
- Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
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19
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Spangler KR, Wellenius GA. Spatial and intraseasonal variation in changing susceptibility to extreme heat in the United States. Environ Epidemiol 2021; 5:e136. [PMID: 33870011 PMCID: PMC8043727 DOI: 10.1097/ee9.0000000000000136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/15/2021] [Indexed: 12/02/2022] Open
Abstract
Exposure to excessive heat is associated with a higher risk of death. Although the relative risk of death on extreme-heat days has decreased over the past several decades in the United States, the drivers of this decline have not been fully characterized. In particular, while extreme heat earlier in the warm season has been shown to confer greater risk of mortality than exposure later in the season, it is unknown whether this within-season variability in susceptibility has changed over time and whether it is modified by region, climatic changes, or social vulnerability. METHODS We used distributed-lag nonlinear models and meta-regression to estimate the association between ambient maximum daily temperature during the early, late, and overall warm seasons and the relative risk of mortality for two decades, 1973-1982 and 1997-2006, in 186 metropolitan areas in the United States. We assessed changes in relative risk nationally, regionally, and between places with differential changes in early-season relative extreme heat and indicators of social vulnerability. RESULTS Most of the reduction in heat-related mortality nationally between the two decades is driven by decreases in late-season mortality, while substantial early-season risk remains. This difference is most apparent in the Northeast, in cities with greater increases in early-season relative extreme heat, and in places that have become more socially vulnerable. CONCLUSIONS Early-season heat mortality risks have persisted despite overall adaptations, particularly in places with greater warming and increasing social vulnerability. Interventions to reduce heat mortality may need to consider greater applicability to the early warm season.
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Affiliation(s)
- Keith R. Spangler
- Boston University School of Public Health, Department of Environmental Health, Boston, Massachusetts
- Brown University Department of Earth, Environmental, and Planetary Sciences, Providence, Rhode Island
- Brown University School of Public Health, Department of Epidemiology, Providence, Rhode Island; and
- Institute at Brown for Environment and Society, Brown University, Providence, Rhode Island
| | - Gregory A. Wellenius
- Boston University School of Public Health, Department of Environmental Health, Boston, Massachusetts
- Brown University School of Public Health, Department of Epidemiology, Providence, Rhode Island; and
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20
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Abstract
BACKGROUND Air conditioning has been proposed as one of the key factors explaining reductions of heat-related mortality risks observed in the last decades. However, direct evidence is still limited. METHODS We used a multi-country, multi-city, longitudinal design to quantify the independent role of air conditioning in reported attenuation in risk. We collected daily time series of mortality, mean temperature, and yearly air conditioning prevalence for 311 locations in Canada, Japan, Spain, and the USA between 1972 and 2009. For each city and sub-period, we fitted a quasi-Poisson regression combined with distributed lag non-linear models to estimate summer-only temperature-mortality associations. At the second stage, we used a novel multilevel, multivariate spatio-temporal meta-regression model to evaluate effect modification of air conditioning on heat-mortality associations. We computed relative risks and fractions of heat-attributable excess deaths under observed and fixed air conditioning prevalences. RESULTS Results show an independent association between increased air conditioning prevalence and lower heat-related mortality risk. Excess deaths due to heat decreased during the study periods from 1.40% to 0.80% in Canada, 3.57% to 1.10% in Japan, 3.54% to 2.78% in Spain, and 1.70% to 0.53% in the USA. However, increased air conditioning explains only part of the observed attenuation, corresponding to 16.7% in Canada, 20.0% in Japan, 14.3% in Spain, and 16.7% in the USA. CONCLUSIONS Our findings are consistent with the hypothesis that air conditioning represents an effective heat adaptation strategy, but suggests that other factors have played an equal or more important role in increasing the resilience of populations.
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Philipsborn RP, Sheffield P, White A, Osta A, Anderson MS, Bernstein A. Climate Change and the Practice of Medicine: Essentials for Resident Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:355-367. [PMID: 32910006 DOI: 10.1097/acm.0000000000003719] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Despite calls for including content on climate change and its effect on health in curricula across the spectrum of medical education, no widely used resource exists to guide residency training programs in this effort. This lack of resources poses challenges for training program leaders seeking to incorporate evidence-based climate and health content into their curricula. Climate change increases risks of heat-related illness, infections, asthma, mental health disorders, poor perinatal outcomes, adverse experiences from trauma and displacement, and other harms. More numerous and increasingly dangerous natural disasters caused by climate change impair delivery of care by disrupting supply chains and compromising power supplies. Graduating trainees face a knowledge gap in understanding, managing, and mitigating these many-faceted consequences of climate change, which-expected to intensify in coming decades-will influence both the health of their patients and the health care they deliver. In this article, the authors propose a framework of climate change and health educational content for residents, including how climate change (1) harms health, (2) necessitates adaptation in clinical practice, and (3) undermines health care delivery. The authors propose not only learning objectives linked to the Accreditation Council for Graduate Medical Education core competencies for resident education but also learning formats and assessment strategies in each content area. They also present opportunities for implementation of climate and health education in residency training programs. Including this content in residency education will better prepare doctors to deliver anticipatory guidance to at-risk patients, manage those experiencing climate-related health effects, and reduce care disruptions during climate-driven extreme weather events.
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Affiliation(s)
- Rebecca Pass Philipsborn
- R.P. Philipsborn is assistant professor, Department of Pediatrics and Emory Global Health Institute, Emory University, Atlanta, Georgia; ORCID: https://orcid.org/0000-0002-2843-7509
| | - Perry Sheffield
- P. Sheffield is assistant professor, Department of Pediatrics and Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, New York; ORCID: http://orcid.org/0000-0001-9156-1193
| | - Andrew White
- A. White is James P. Keating Professor, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri; ORCID: http://orcid.org/0000-0001-9394-7823
| | - Amanda Osta
- A. Osta is associate professor of internal medicine and pediatrics and division chief for education, Department of Pediatrics, University of Illinois, and was, at the time of this research, director, Pediatric Residency Program, UI Health, Chicago, Illinois
| | - Marsha S Anderson
- M.S. Anderson is professor, Department of Pediatrics, associate director, Pediatric Residency Program, and assistant dean, Longitudinal Curriculum, University of Colorado School of Medicine, Aurora, Colorado
| | - Aaron Bernstein
- A. Bernstein is assistant professor of pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts; ORCID: http://orcid.org/0000-0003-1703-1041
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22
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Pasquini L, van Aardenne L, Godsmark CN, Lee J, Jack C. Emerging climate change-related public health challenges in Africa: A case study of the heat-health vulnerability of informal settlement residents in Dar es Salaam, Tanzania. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 747:141355. [PMID: 32777515 DOI: 10.1016/j.scitotenv.2020.141355] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
Heat has the potential to become one of the most significant public health impacts of climate change in the coming decades. Increases in temperature have been linked to both increasing mortality and morbidity. Cities have been recognized as areas of particular vulnerability to heat's impacts on health, and marginalized groups, such as the poor, appear to have higher heat-related morbidity and mortality. Little research has examined the heat vulnerability of urban informal settlements residents in Africa, even though surface temperatures across Africa are projected to increase at a rate faster than the global average. This paper addresses this knowledge gap through a mixed-methods analysis of the heat-health vulnerability of informal settlement residents in Dar es Salaam, Tanzania. The heat exposure, sensitivity and adaptive capacity of informal settlement residents were assessed through a combination of climate analyses, semi-structured interviews with local government actors and informal settlement residents, unstructured interviews with health sector respondents, a health impacts literature review, and a stakeholder engagement workshop. The results suggest that increasing temperatures due to climate change will likely be a significant risk to human health in Dar es Salaam, even though the city does not reach extreme temperature conditions, because informal settlement residents have high exposure, high sensitivity and low adaptive capacity to heat, and because the heat-health relationship is currently an under-prioritized policy issue. While numerous urban planning approaches can play a key role in increasing the resilience of citizens to heat, Dar es Salaam's past and current growth and development patterns greatly complicate the implementation and enforcement of such approaches. For African cities, the findings highlight an urgent need for more research on the vulnerability and resilience of residents to heat-health impacts, because many African cities are likely to present similar characteristics to those in Dar es Salaam that increase resident's vulnerability.
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Affiliation(s)
- Lorena Pasquini
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa; African Climate and Development Initiative, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
| | - Lisa van Aardenne
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
| | - Christie Nicole Godsmark
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork T12 XF62, Ireland; Environmental Research Institute, University College Cork, Lee Road, Cork T23 XE10, Ireland.
| | - Jessica Lee
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
| | - Christopher Jack
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
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23
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Davis RE, Markle ES, Windoloski S, Houck ME, Enfield KB, Kang H, Balling RC, Kuehl DR, Burton JH, Farthing W, Rubio ER, Novicoff WM. A comparison of the effect of weather and climate on emergency department visitation in Roanoke and Charlottesville, Virginia. ENVIRONMENTAL RESEARCH 2020; 191:110065. [PMID: 32827524 PMCID: PMC7658034 DOI: 10.1016/j.envres.2020.110065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
Compared with mortality, the impact of weather and climate on human morbidity is less well understood, especially in the cold season. We examined the relationships between weather and emergency department (ED) visitation at hospitals in Roanoke and Charlottesville, Virginia, two locations with similar climates and population demographic profiles. Using patient-level data obtained from electronic medical records, each patient who visited the ED was linked to that day's weather from one of 8 weather stations in the region based on each patient's ZIP code of residence. The resulting 2010-2017 daily ED visit time series were examined using a distributed lag non-linear model to account for the concurrent and lagged effects of weather. Total ED visits were modeled separately for each location along with subsets based on gender, race, and age. The relationship between the relative risk of ED visitation and temperature or apparent temperature over lags of one week was positive and approximately linear at both locations. The relative risk increased about 5% on warm, humid days in both cities (lag 0 or lag 1). Cold conditions had a protective effect, with up to a 15% decline on cold days, but ED visits increased by 4% from 2 to 5 days after the cold event. The effect of thermal extremes tended to be larger for non-whites and the elderly, and there was some evidence of a greater lagged response for non-whites in Roanoke. Females in Roanoke were more impacted by winter cold conditions than males, who were more likely to show a lagged response at high temperatures. In Charlottesville, males sought ED attention at lower temperatures than did females. The similarities in the ED response patterns between these two hospitals suggest that certain aspects of the response may be generalizable to other locations that have similar climates and demographic profiles.
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Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Erin S Markle
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Sara Windoloski
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Margaret E Houck
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Kyle B Enfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois, Champaign-Urbana, IL, USA.
| | - Robert C Balling
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA.
| | - Damon R Kuehl
- Department of Emergency Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - John H Burton
- Department of Emergency Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Wilson Farthing
- Department of Emergency Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Edmundo R Rubio
- Section of Pulmonology, Critical Care, Sleep and Environmental Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Wendy M Novicoff
- Departments of Public Health Sciences and Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
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24
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Cao Z, Wu Z, Li S, Guo G, Song S, Deng Y, Ma W, Sun H, Guan W. Explicit Spatializing Heat-Exposure Risk and Local Associated Factors by coupling social media data and automatic meteorological station data. ENVIRONMENTAL RESEARCH 2020; 188:109813. [PMID: 32574855 DOI: 10.1016/j.envres.2020.109813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/24/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
Extremely high temperatures, a major cause for weather-related public health issues, are projected to intensify and become more frequent. To mitigate the adverse effects, a low-cost and effective risk assessment method should be developed. Therefore, we applied automatic meteorological station data and population mobility data to develop a high spatiotemporal resolution temperature risk assessment method. The population mobility analysis results showed the working/residential complex pattern in Tianhe District, with hotspots of spatial clustering located in the north, southwest, and southeast of the study area. Taking the population mobility patterns into consideration, high-temperature risk assessment results with a resolution of 100 m were obtained. The total mortality cases in 2014 and 2015 were used to validate this result. The validation showed that the total mortality in the high-temperature risk areas accounted for over 36% of that in Tianhe District. Thus, the method introduced in this study is capable of reflecting weather-related risk. Furthermore, the high-temperature risk assessment results showed that most of the risky areas were located in the southwest of the study area. Two peak times of the risk areas were determined, being before dawn and in the evening. Compared with the risk areas during weekdays, those at weekends expanded. In addition, we used the geographically weighted regression model to investigate the potential influencing factors. Individual factor contributed more than 22.4% to the spatial distribution of heat exposure. Catering services, transportation services, and living services were higher than others, with mean R2 values of 0.28, 0.23, and 0.25, respectively. More than 47.9% of spatial distribution of heat exposure was attributed to joint function of influencing factors, with global R2 ranged from 0.23 to 0.34. Our research introduces a spatial-specific method to quantitatively assess high-temperature risk. Moreover, the mechanisms behind the spatial distribution of the high-temperature risk were discussed. The theoretical and management implications can help urban designers and energy governors to develop useful strategies to mitigate weather-related public health risks.
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Affiliation(s)
- Zheng Cao
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China; Guangdong Province Engineering Technology Research Center for Geographical Conditions Monitoring and Comprehensive Analysis, Guangzhou 510006, China; Southern Marine Science and Engineering Guangdong Laboratory (Guangzhou), Guangzhou 511458, China
| | - Zhifeng Wu
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China; Guangdong Province Engineering Technology Research Center for Geographical Conditions Monitoring and Comprehensive Analysis, Guangzhou 510006, China; Southern Marine Science and Engineering Guangdong Laboratory (Guangzhou), Guangzhou 511458, China.
| | - Shaoying Li
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China; Guangdong Province Engineering Technology Research Center for Geographical Conditions Monitoring and Comprehensive Analysis, Guangzhou 510006, China; Southern Marine Science and Engineering Guangdong Laboratory (Guangzhou), Guangzhou 511458, China
| | - Guanhua Guo
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China; Guangdong Province Engineering Technology Research Center for Geographical Conditions Monitoring and Comprehensive Analysis, Guangzhou 510006, China
| | - Song Song
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China; Guangdong Province Engineering Technology Research Center for Geographical Conditions Monitoring and Comprehensive Analysis, Guangzhou 510006, China; Southern Marine Science and Engineering Guangdong Laboratory (Guangzhou), Guangzhou 511458, China
| | - Yujiao Deng
- Ecological Meteorological Center of Guangdong Province, Guangzhou 510080, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Hui Sun
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China; Guangdong Province Engineering Technology Research Center for Geographical Conditions Monitoring and Comprehensive Analysis, Guangzhou 510006, China
| | - Wenchuan Guan
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China; Guangdong Province Engineering Technology Research Center for Geographical Conditions Monitoring and Comprehensive Analysis, Guangzhou 510006, China
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25
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Fonseca-Rodríguez O, Sheridan SC, Lundevaller EH, Schumann B. Hot and cold weather based on the spatial synoptic classification and cause-specific mortality in Sweden: a time-stratified case-crossover study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1435-1449. [PMID: 32328787 PMCID: PMC7445203 DOI: 10.1007/s00484-020-01921-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/12/2020] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
The spatial synoptic classification (SSC) is a holistic categorical assessment of the daily weather conditions at specific locations; it is a useful tool for assessing weather effects on health. In this study, we assessed (a) the effect of hot weather types and the duration of heat events on cardiovascular and respiratory mortality in summer and (b) the effect of cold weather types and the duration of cold events on cardiovascular and respiratory mortality in winter. A time-stratified case-crossover design combined with a distributed lag nonlinear model was carried out to investigate the association of weather types with cause-specific mortality in two southern (Skåne and Stockholm) and two northern (Jämtland and Västerbotten) locations in Sweden. During summer, in the southern locations, the Moist Tropical (MT) and Dry Tropical (DT) weather types increased cardiovascular and respiratory mortality at shorter lags; both hot weather types substantially increased respiratory mortality mainly in Skåne. The impact of heat events on mortality by cardiovascular and respiratory diseases was more important in the southern than in the northern locations at lag 0. The cumulative effect of MT, DT and heat events lagged over 14 days was particularly high for respiratory mortality in all locations except in Jämtland, though these did not show a clear effect on cardiovascular mortality. During winter, the dry polar and moist polar weather types and cold events showed a negligible effect on cardiovascular and respiratory mortality. This study provides valuable information about the relationship between hot oppressive weather types with cause-specific mortality; however, the cold weather types may not capture sufficiently effects on cause-specific mortality in this sub-Arctic region.
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Affiliation(s)
- Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden.
| | - Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH, 44242, USA
| | | | - Barbara Schumann
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden
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Interactive Effect of Diurnal Temperature Range and Temperature on Mortality, Northeast Asia. Epidemiology 2020; 30 Suppl 1:S99-S106. [PMID: 31181012 DOI: 10.1097/ede.0000000000000997] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The diurnal temperature range (DTR) represents temperature variability within a day and has been reported as a potential risk factor for mortality. Previous studies attempted to identify the role of temperature in the DTR-mortality association, but results are inconclusive. The aim of this study was to investigate the interactive effect of temperature and DTR on mortality using a multicountry time series analysis. METHODS We collected time series data for mortality and weather variables for 57 communities of three countries (Taiwan, Korea, and Japan) in Northeast Asia (1972-2012). Two-stage time series regression with a distributed lag nonlinear model and meta-analysis was used to estimate the DTR-mortality association changing over temperature strata (six strata were defined based on community-specific temperature percentiles). We first investigated the whole population and then, the subpopulations defined by temperature distribution (cold and warm regions), sex, and age group (people <65 and ≥65 years of age), separately. RESULTS The DTR-mortality association changed over temperature strata. The relative risk (RR) of mortality for 10°C increase in DTR was larger for high-temperature strata compared with cold-temperature strata (e.g., = 1.050; 95% confidence interval [CI] = 1.040, 1.060 at extreme-hot stratum and RR = 1.040; 95% CI = 1.031, 1.050 at extreme-cold stratum); extreme-hot and -cold strata were defined as the days with daily mean temperature above 90th and below 10th percentiles each community's temperature distribution. Such increasing pattern was more pronounced in cold region and in people who were 65 years or older. CONCLUSIONS We found evidence that the DTR-related mortality may increase as temperature increases.
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Aklilu D, Wang T, Amsalu E, Feng W, Li Z, Li X, Tao L, Luo Y, Guo M, Liu X, Guo X. Short-term effects of extreme temperatures on cause specific cardiovascular admissions in Beijing, China. ENVIRONMENTAL RESEARCH 2020; 186:109455. [PMID: 32311528 DOI: 10.1016/j.envres.2020.109455] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/21/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
Extreme temperature-related cardiovascular diseases (CVDs) have become a growing public health concern. However, the impact of temperature on the cause of specific CVDs has not been well studied in the study area. The objective of this study was to assess the impact of temperature on cause-specific cardiovascular hospital admissions in Beijing, China. We obtained data from 172 large general hospitals from the Beijing Public Health Information Center Cardiovascular Case Database and China. Meteorological Administration covering 16 districts in Beijing from 2013 to 2017. We used a time-stratified case crossover design with a distributed lag nonlinear model (DLNM) to derive the impact of temperature on CVD in hospitals back to 27 days on CVD admissions. The temperature data were stratified as cold (extreme and moderate ) and hot (moderate and extreme ). Within five years (January 2013-December 2017), a total of 460,938 (male 54.9% and female 45.1%) CVD admission cases were reported. The exposure-response relationship for hospitalization was described by a "J" shape for the total and cause-specific. An increase in the six-day moving average temperature from moderate hot (30.2 °C) to extreme hot (36.9 °C) resulted in a significant increase in CVD admissions of 16.1%(95% CI = 12.8%-28.9%). However, the effect of cold temperature exposure on CVD admissions over a lag time of 0-27 days was found to be non significant, with a relative risk of 0.45 (95% CI = 0.378-0.55) for extreme cold (-8.5 °C)and 0.53 (95% CI = 0.47-0.60) for moderate cold (-5.6 °C). The results of this study indicate that exposure to extremely high temperatures is highly associated with an increase in cause-specific CVD admissions. These finding may guide to create and raise awareness of the general population, government and private sectors regarding on the effects of current weather conditions on CVD.
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Affiliation(s)
- Deginet Aklilu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Tianqi Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Commission of Health and Family Planning Information Center, China
| | - Endwoke Amsalu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Wei Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Zhiwei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Moning Guo
- Beijing Municipal Commission of Health and Family Planning Information Center, China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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28
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Samuelson H, Baniassadi A, Lin A, Izaga González P, Brawley T, Narula T. Housing as a critical determinant of heat vulnerability and health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 720:137296. [PMID: 32325550 DOI: 10.1016/j.scitotenv.2020.137296] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 06/11/2023]
Abstract
Municipalities use Heat Vulnerability Indices (HVIs) to quantify and map relative distribution of risks to human health in the event of a heatwave. These maps ostensibly allow public agencies to identify the highest-risk neighborhoods, and to concentrate emergency planning efforts and resources accordingly (e.g., to establish the locations of cooling centers). The method of constructing an HVI varies by municipality, but common inputs include demographic variables such as age and income - and to some extent, metrics such as land cover. However, taking demographic data as a proxy for heat vulnerability may provide an incomplete or inaccurate assessment of risk. A critical limitation in HVIs may be a lack of focus on housing characteristics and how they mediate indoor heat exposure. To provide an objective assessment of this limitation, we first reviewed HVIs in the literature and those published or commissioned by municipalities. We subsequently verified that most of these HVIs excluded housing factors. Next, to scope the potential consequences, we used physics-based simulations of housing prototypes (46,000 housing permutations per city) to estimate the variation in indoor heat exposure within high-vulnerability neighborhoods in Boston and Phoenix. The results show that by excluding building-level determinants of exposure, HVIs fail to capture important components of heat vulnerability. Moreover, we demonstrate how these maps currently overlook important nuances regarding the impact of building age and air conditioning functionality. Finally, we discuss the challenges of implementing housing stock characteristics in HVIs and propose methods for overcoming these challenges.
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Affiliation(s)
- Holly Samuelson
- Harvard Graduate School of Design, Department of Architecture, Cambridge, MA, USA.
| | - Amir Baniassadi
- Harvard Graduate School of Design, Department of Architecture, Cambridge, MA, USA
| | - Anne Lin
- Harvard Graduate School of Design, Department of Urban Planning and Design, Cambridge, MA, USA; Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA
| | - Pablo Izaga González
- Harvard Graduate School of Design, Department of Architecture, Cambridge, MA, USA
| | - Thomas Brawley
- University of California, College of Environmental Design, Berkeley, CA, USA; University of California, College of Natural Resources, Berkeley, CA, USA
| | - Tushar Narula
- University of California, College of Environmental Design, Berkeley, CA, USA
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Spangler KR, Wellenius GA. Spatial patterns of recent US summertime heat trends: Implications for heat sensitivity and health adaptations. ENVIRONMENTAL RESEARCH COMMUNICATIONS 2020; 2:035002. [PMID: 34296061 PMCID: PMC8294661 DOI: 10.1088/2515-7620/ab7abb] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Heat is known to cause illness and death not only at extreme temperatures, but also at moderate levels. Although substantial research has shown how summer time temperature distributions have changed over recent decades in the United States, less is known about how the heat index-a potentially more health-applicable metric of heat-has similarly evolved over this period. Moreover, the extent to which these distributional changes have overlapped with indicators of social vulnerability has not been established, despite the applicability of co-varying climatic and sociodemographic characteristics to heat-related health adaptations. Presented here is an analysis of trends in the median, 95th percentile, and 'warm-tail spread' (i.e., intra-seasonal range between the upper extreme and median) of warm-season (May-September) maximum heat index between 1979and 2018 across the conterminous US. Using40 years of data from the North American Regional Reanalysis dataset, it is shown that most of the US has experienced statistically significant positive trends in summertime heat, and that both the magnitude of trends and the shape of the frequency distributions of these measures vary regionally. Comparisons with data from the Social Vulnerability Index show that the most socially vulnerable counties appear to be warming faster than the least vulnerable, but that opposite patterns hold for trends in warm-tail spread. These findings may be applicable to further studies on climate change, heat adaptations, and environmental justice in the US.
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Affiliation(s)
- Keith R Spangler
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI, United States of America
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
- Institute at Brown for Environment and Society, Brown University, Providence, RI, United States of America
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
- Current address: Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
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Majeed H, Coles JG, Moore GWK. Influence of Atlantic and Pacific Sea Surface Temperatures on Heat-Related Mortality in the United States. GEOHEALTH 2020; 4:e2019GH000220. [PMID: 32159050 PMCID: PMC7007073 DOI: 10.1029/2019gh000220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 05/14/2023]
Abstract
The frequency and magnitude of extreme summer temperature events in the United States have increased in the past few decades. Long-term exposure to extreme summer temperatures can be detrimental to human health, due to potential risks of dehydration and thermoregulation strains on the cardiovascular system, which may often lead to heat-related mortality (HRM). The summer climate of the United States is influenced by variability in Atlantic and Pacific sea surface temperatures, driven in part by Atlantic Multidecadal Oscillation (AMO) and El-Nino Southern Oscillation (ENSO), respectively. However, the influence of AMO and ENSO on HRM in the United States has not been investigated. Here the longest time series of HRM spanning the past five decades is analyzed in relation with AMO and ENSO. We find that HRM doubled in the early-1990s, coinciding with the positive phase of the AMO. Furthermore, we note a positive association between the variability in HRM and summer temperatures across all regions of the United States, with the strongest association found over the Southern United States. Therefore, this research suggests that variability in Atlantic and Pacific sea surface temperatures has both a nationwide and regional impact on HRM in the United States. Hence, by understanding variability in sea surface temperatures, the future burden of heat-attributed emergencies during extreme summer temperature events can be reduced not only for the United States, but also worldwide.
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Affiliation(s)
- Haris Majeed
- Institute of Medical SciencesUniversity of TorontoTorontoOntarioCanada
| | - John G. Coles
- Division of Cardiovascular SurgeryThe Hospital for Sick ChildrenToronto, OntarioCanada
| | - G. W. K. Moore
- Department of PhysicsUniversity of TorontoTorontoOntarioCanada
- Department of Chemical and Physical SciencesUniversity of Toronto MississaugaMississaugaOntarioCanada
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Ho HC, Wong MS. Urban environmental influences on the temperature-mortality relationship associated mental disorders and cardiorespiratory diseases during normal summer days in a subtropical city. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:24272-24285. [PMID: 31230236 DOI: 10.1007/s11356-019-05594-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 05/27/2019] [Indexed: 06/09/2023]
Abstract
Temperature is associated with mortality risk across cities. However, there is lack of study investigating the summer effect on mortality associated with mental/behavioral disorders, especially in cities with subtropical climate. In addition, summer mortality in subtropical cities is different from tropical cities, and previous studies have not investigated the urban environmental inequality on heat mortality associated with mental/behavioral disorders. A register-based study was developed to estimate the temperature effects on decedents on days with 50th percentile of average daily temperature between 2007 and 2014 in Hong Kong (n = 133,359). Poisson regression was firstly applied to estimate the incidence rate ratio (IRR) from the summer temperature effects on all-cause mortality, cardiovascular mortality, respiratory mortality, and mortality associated with mental/behavioral disorders. For a 1 °C increase in average temperature on days with temperature ≥ 24.51 °C, IRRs of mortality associated with mental and behavioral disorders on lag 0 and lag 1 days were 1.033 [1.004, 1.062] and 1.030 [1.002, 1.060], while temperature effects on cardiovascular mortality and respiratory mortality during normal summer days (not extreme heat events) were not significant. A further investigation with linear regression has shown that decedents with mental/behavioral disorders on higher temperature days resided in areas with lower percentage of sky view, lower percentage of vegetation cover, higher level of neighborhood-level PM2.5, higher level of neighborhood-level NO, and higher level of neighborhood-level black carbon (BC). In order to develop protocols for community healthcare based on the "Leaving no one behind" scheme documented in the 2016 Sustainable Development Goals report of the United Nations, it is necessary to include heat effects on mental/behavioral disorders, especially people with dementia, for community planning and healthcare development.
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Affiliation(s)
- Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
- Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
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McDonald RI, Kroeger T, Zhang P, Hamel P. The Value of US Urban Tree Cover for Reducing Heat-Related Health Impacts and Electricity Consumption. Ecosystems 2019. [DOI: 10.1007/s10021-019-00395-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gifford RM, Todisco T, Stacey M, Fujisawa T, Allerhand M, Woods DR, Reynolds RM. Risk of heat illness in men and women: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2019; 171:24-35. [PMID: 30641370 DOI: 10.1016/j.envres.2018.10.020] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 05/13/2023]
Abstract
BACKGROUND Heat illness (HI) is a growing global concern; its incidence has risen dramatically across the world in recent years. The individual factors whereby elevated core temperature produces HI are not well-understood. Given known physiological differences between men and women pertaining to temperature regulation, we hypothesized that women would be at increased risk of HI than men. OBJECTIVES We aimed to determine the relative risk of HI in women compared with men through an exhaustive literature review and meta-analysis. METHODS We search PubMed and Ovid Medline databases from inception to Apr 2017. Search terms included all permutations of sex and heat illness (including heatstroke and exertional heat illness) with no language restrictions. We included adult or adolescent human data reporting comparable male and female HI rates. One reviewer identified and screened titles and abstracts. Two independent reviewers applied eligibility criteria. Disagreements were resolved with a third reviewer. RESULTS Of 5888 articles identified by searches, 36 were included in the systematic review and 22 in the meta-analysis. The mean (standard deviation) quality score was 3.31(1.25)/5. Overall the rate among women was consistently lower than men across the lifespan. The male: female pooled IRR was 2.28 (p < 0.001, 95% CI: 1.66-3.16). There was modest heterogeneity (between-studies variance (τ2) = 0.02). The rates did not differ significantly when corrected for severity or occupation. DISCUSSION The rate of HI was significantly increased in men compared with women. Risk for HI might be conferred by psychological and behavioral factors rather than physiological ones. Further research is required to delineate which groups are at greatest risk, leading to the development of mitigation strategies against HI. OTHER No funding was received. The authors acknowledge the support of the UK Women in Ground Close Combat Review. The Study was registered with PROSPREO CRD42017064739.
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Affiliation(s)
- Robert M Gifford
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Department of Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - T Todisco
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - M Stacey
- Department of Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - T Fujisawa
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - M Allerhand
- Centre for Statistics, School of Mathematics, University of Edinburgh, Edinburgh, UK
| | - D R Woods
- Department of Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK; Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK; Northumbria and Newcastle NHS Trusts, Wansbeck General and Royal Victoria Infirmary, Newcastle, UK; University of Newcastle, Newcastle upon Tyne, UK
| | - R M Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
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Vaidyanathan A, Saha S, Vicedo-Cabrera AM, Gasparrini A, Abdurehman N, Jordan R, Hawkins M, Hess J, Elixhauser A. Assessment of extreme heat and hospitalizations to inform early warning systems. Proc Natl Acad Sci U S A 2019; 116:5420-5427. [PMID: 30833395 PMCID: PMC6431221 DOI: 10.1073/pnas.1806393116] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Heat early warning systems and action plans use temperature thresholds to trigger warnings and risk communication. In this study, we conduct multistate analyses, exploring associations between heat and all-cause and cause-specific hospitalizations, to inform the design and development of heat-health early warning systems. We used a two-stage analysis to estimate heat-health risk relationships between heat index and hospitalizations in 1,617 counties in the United States for 2003-2012. The first stage involved a county-level time series quasi-Poisson regression, using a distributed lag nonlinear model, to estimate heat-health associations. The second stage involved a multivariate random-effects meta-analysis to pool county-specific exposure-response associations across larger geographic scales, such as by state or climate region. Using results from this two-stage analysis, we identified heat index ranges that correspond with significant heat-attributable burden. We then compared those with the National Oceanic and Atmospheric Administration National Weather Service (NWS) heat alert criteria used during the same time period. Associations between heat index and cause-specific hospitalizations vary widely by geography and health outcome. Heat-attributable burden starts to occur at moderately hot heat index values, which in some regions are below the alert ranges used by the NWS during the study time period. Locally specific health evidence can beneficially inform and calibrate heat alert criteria. A synchronization of health findings with traditional weather forecasting efforts could be critical in the development of effective heat-health early warning systems.
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Affiliation(s)
- Ambarish Vaidyanathan
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341;
| | - Shubhayu Saha
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341
| | - Ana M Vicedo-Cabrera
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | | | | | - Michelle Hawkins
- National Weather Service, National Oceanic and Atmospheric Administration, Silver Spring, MD 20910
| | - Jeremy Hess
- Center for Health and the Global Environment, University of Washington, Seattle, WA 98105
| | - Anne Elixhauser
- Agency for Healthcare Research and Quality, Rockville, MD 20852
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Temporal Trends in Heat-Related Mortality: Implications for Future Projections. ATMOSPHERE 2018. [DOI: 10.3390/atmos9100409] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
High temperatures have large impacts on premature mortality risks across the world, and there is concern that warming temperatures associated with climate change, and in particular larger-than-expected increases in the proportion of days with extremely high temperatures, may lead to increasing mortality risks. Comparisons of heat-related mortality exposure-response functions across different cities show that the effects of heat on mortality risk vary by latitude, with more pronounced heat effects in more northerly climates. Evidence has also emerged in recent years of trends over time in heat-related mortality, suggesting that in many locations, the risk per unit increase in temperature has been declining. Here, I review the emerging literature on these trends, and draw conclusions for studies that seek to project future impacts of heat on mortality. I also make reference to the more general heat-mortality literature, including studies comparing effects across locations. I conclude that climate change projection studies will need to take into account trends over time (and possibly space) in the exposure response function for heat-related mortality. Several potential methods are discussed.
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Oudin Åström D, Ebi KL, Vicedo-Cabrera AM, Gasparrini A. Investigating changes in mortality attributable to heat and cold in Stockholm, Sweden. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:1777-1780. [PMID: 29748912 PMCID: PMC6132879 DOI: 10.1007/s00484-018-1556-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/22/2018] [Accepted: 04/25/2018] [Indexed: 05/27/2023]
Abstract
Projections of temperature-related mortality rely upon exposure-response relationships using recent data. Analyzing long historical data and trends may extend knowledge of past and present impacts that may provide additional insight and improve future scenarios. We collected daily mean temperatures and daily all-cause mortality for the period 1901-2013 for Stockholm County, Sweden, and calculated the total attributable fraction of mortality due to non-optimal temperatures and quantified the contribution of cold and heat. Total mortality attributable to non-optimal temperatures varied between periods and cold consistently had a larger impact on mortality than heat. Cold-related attributable fraction (AF) remained stable over time whereas heat-related AF decreased. AF on cold days remained stable over time, which may indicate that mortality during colder months may not decline as temperatures increase in the future. More research is needed to enhance estimates of burdens related to cold and heat in the future.
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Affiliation(s)
- Daniel Oudin Åström
- Occupational and Environmental Medicine, Umeå University, 90187, Umeå, Sweden.
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Ana Maria Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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The Impact of Heat Waves on Emergency Department Admissions in Charlottesville, Virginia, U.S.A. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071436. [PMID: 29986505 PMCID: PMC6068980 DOI: 10.3390/ijerph15071436] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 11/24/2022]
Abstract
Heat waves have been linked to increases in emergency-related morbidity, but more research is needed on the demographic and disease-specific aspects of these morbidities. Using a case-crossover approach, over 700,000 daily emergency department hospital admissions in Charlottesville, Virginia, U.S.A. from 2005–2016 are compared between warm season heat wave and non-heat wave periods. Heat waves are defined based on the exceedance, for at least three consecutive days, of two apparent temperature thresholds (35 °C and 37 °C) that account for 3 and 6% of the period of record. Total admissions and admissions for whites, blacks, males, females, and 20–49 years old are significantly elevated during heat waves, as are admissions related to a variety of diagnostic categories, including diabetes, pregnancy complications, and injuries and poisoning. Evidence that heat waves raise emergency department admissions across numerous demographic and disease categories suggests that heat exerts comorbidity influences that extend beyond the more well-studied direct relationships such as heat strokes and cardiac arrest.
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Lee W, Choi HM, Lee JY, Kim DH, Honda Y, Kim H. Temporal changes in mortality impacts of heat wave and cold spell in Korea and Japan. ENVIRONMENT INTERNATIONAL 2018; 116:136-146. [PMID: 29679776 DOI: 10.1016/j.envint.2018.04.017] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 05/27/2023]
Abstract
Investigating how well people adapt to heat waves and cold spells has been an important issue under climate change. Also, most of previous studies focused only on the mortality risks for heat waves or cold spells for certain time period not considering its temporal changes and increasing frequencies. This study investigated the change in risks of mortality from heat waves and cold spells over time, and estimated the temporal changes in mortality burden attributed to heat waves and cold spells in Korea and Japan. We collected time-series data covering mortality and weather variables from 53 communities in the two countries from 1992 to 2015. Two-stage time-series regression with a time-varying distributed lag model and meta-analysis was used to assess the impacts of heat waves and cold spells by period (1990s, 2000s, and 2010s). In total population, the risks of heat waves have decreased over time; however their mortality burden increased in the 2010s compared to the 2000s with increasing frequency. On the other hand, the risk and health burden of cold spells have increased over the decades. Our findings showed that the future mortality burden of heat waves and cold spells might not decrease, when considering their changes in risks and frequencies.
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Affiliation(s)
- Whanhee Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hayon Michelle Choi
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jae Young Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Da Hye Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
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Zhang Y, Yu Y, Peng M, Meng R, Hu K, Yu C. Temporal and seasonal variations of mortality burden associated with hourly temperature variability: A nationwide investigation in England and Wales. ENVIRONMENT INTERNATIONAL 2018; 115:325-333. [PMID: 29626694 DOI: 10.1016/j.envint.2018.03.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/24/2018] [Accepted: 03/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sudden temperature change may elevate short-term mortality and remains an important global health threat in the context of climate change. To date, however, little available temperature-mortality evidence has taken into account both intra- and inter-day temperature variability (TV), thus largely limiting the comprehensive understanding of mortality burden due to unstable weather. Moreover, seasonal and temporal patterns in TV-mortality associations were sparsely discussed, nationally and regionally. OBJECTIVES We aimed to assess the nationwide association of all-cause mortality with hourly temperature variability (HTV), quantify HTV-attributable mortality, and further explore the temporal and seasonal variations of mortality burden due to HTV in United Kingdom. METHODS Fourteen-year time-series data on temperature and mortality were collected from 10 regions in England and Wales during 1993-2006, totally including 7,573,716 all-cause deaths. HTV was calculated from the standard deviation of hourly temperature records within two neighboring days. A three-stage analytic approach was adopted to assess HTV-associated mortality burden. We first applied a time-series quasi-Poisson regression to estimate region-specific HTV-mortality associations, then pooled these associations at the national level using a multivariate meta-analysis, and finally estimated the HTV-attributable mortality fraction and illustrated its seasonal and temporal variations by conducting season- and period-specific analyses based on time-varying distributed lag models. RESULTS We found strong evidence that large HTV exposure elevated short-term mortality risk in England and Wales, with a pooled estimate of 1.13% (95% confidence interval (CI): 0.88, 1.39) associated with a 1-°C increase in HTV. During the whole study period, HTV accounted for a national average attributable fraction of 2.52% (95% empirical confidence interval (eCI): 2.27, 2.76) of the total deaths. This HTV-attributable mortality estimate showed a significant temporal decrease (p < 0.001) from 2.72% (95% eCI: 2.58, 2.87) in 1993-99 to 2.28% (95% eCI: 2.13, 2.43) in 2000-06. Additionally, clear seasonal variations were observed for HTV-attributable mortality burden, with the largest estimate of 3.08% (95% eCI: 2.80, 3.38) in summer, followed by 2.71% (95% eCI: 2.44, 2.98) in spring, 2.40% (95% eCI: 2.16, 2.63) in autumn, and 2.00% (95% eCI: 1.81, 2.20) in winter. CONCLUSIONS Despite clear evidence observed for the reduction, mortality burden caused by temperature variability remained a great public health threat, especially in warm seasons. It highlighted the importance of specific interventions targeted to unstable weather as well as temperature extremes, so as to reduce climate-related mortality burden.
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Affiliation(s)
- Yunquan Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China.
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, China
| | - Minjin Peng
- Department of Infection Control, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Runtang Meng
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China
| | - Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China; Global Health Institute, Wuhan University, 8 Donghunan Road, Wuhan 430072, China.
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Kalkstein AJ, Kalkstein LS, Vanos JK, Eisenman DP, Grady Dixon P. Heat/mortality sensitivities in Los Angeles during winter: a unique phenomenon in the United States. Environ Health 2018; 17:45. [PMID: 29724242 PMCID: PMC5934864 DOI: 10.1186/s12940-018-0389-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/25/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Extreme heat is often associated with elevated levels of human mortality, particularly across the mid-latitudes. Los Angeles, CA exhibits a unique, highly variable winter climate, with brief periods of intense heat caused by downsloping winds commonly known as Santa Ana winds. The goal is to determine if Los Angeles County is susceptible to heat-related mortality during the winter season. This is the first study to specifically evaluate heat-related mortality during the winter for a U.S. city. METHODS Utilizing the Spatial Synoptic Classification system in Los Angeles County from 1979 through 2010, we first relate daily human mortality to synoptic air mass type during the winter season (December, January, February) using Welch's t-tests. However, this methodology is only somewhat effective at controlling for important inter- and intra-annual trends in human mortality unrelated to heat such as influenza outbreaks. As a result, we use distributed lag nonlinear modeling (DLNM) to evaluate if the relative risk of human mortality increases during higher temperatures in Los Angeles, as the DLNM is more effective at controlling for variability at multiple temporal scales within the human mortality dataset. RESULTS Significantly higher human mortality is uncovered in winter when dry tropical air is present in Los Angeles, particularly among those 65 years and older (p < 0.001). The DLNM reveals the relative risk of human mortality increases when above average temperatures are present. Results are especially pronounced for maximum and mean temperatures, along with total mortality and those 65 + . CONCLUSIONS The discovery of heat-related mortality in winter is a unique finding in the United States, and we recommend stakeholders consider warning and intervention techniques to mitigate the role of winter heat on human health in the County.
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Affiliation(s)
- Adam J. Kalkstein
- Department of Geography and Environmental Engineering, Center for Languages, Cultures, and Regional Studies, United States Military Academy, 745 Brewerton Rd; 6th Floor, West Point, NY 10996 USA
| | - Laurence S. Kalkstein
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL USA
| | - Jennifer K. Vanos
- Scripps Institution of Oceanography & School of Medicine, University of California San Diego, La Jolla, CA USA
| | - David P. Eisenman
- UCLA Center for Public Health and Disasters, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - P. Grady Dixon
- Department of Geosciences, Fort Hays State University, Hays, KS USA
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Chung Y, Yang D, Gasparrini A, Vicedo-Cabrera AM, Fook Sheng Ng C, Kim Y, Honda Y, Hashizume M. Changing Susceptibility to Non-Optimum Temperatures in Japan, 1972-2012: The Role of Climate, Demographic, and Socioeconomic Factors. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:057002. [PMID: 29727132 PMCID: PMC6071988 DOI: 10.1289/ehp2546] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 05/13/2023]
Abstract
BACKGROUND Previous studies have shown that population susceptibility to non-optimum temperatures has changed over time, but little is known about the related time-varying factors that underlie the changes. OBJECTIVE Our objective was to investigate the changing population susceptibility to non-optimum temperatures in 47 prefectures of Japan over four decades from 1972 to 2012, addressing three aspects: minimum mortality temperature (MMT) and heat- and cold-related mortality risks. In addition, we aimed to examine how these aspects of susceptibility were associated with climate, demographic, and socioeconomic variables. METHODS We first used a two-stage time-series design with a time-varying distributed lag nonlinear model and multivariate meta-analysis to estimate the time-varying MMT, heat- and cold-related mortality risks. We then applied linear mixed effects models to investigate the association between each of the three time-varying aspects of susceptibility and various time-varying factors. RESULTS MMT increased from 23.2 [95% confidence interval (CI): 23, 23.6] to 28.7 (27.0, 29.7) °C. Heat-related mortality risk [relative risk (RR) for the 99th percentile of temperature vs. the MMT] decreased from 1.18 (1.15, 1.21) to 1.01 (0.98, 1.04). Cold-related mortality risk (RR for the first percentile vs. the MMT) generally decreased from 1.48 (1.41, 1.54) to 1.35 (1.32, 1.40), with the exception of a few eastern prefectures that showed increased risk. The changing patterns in all three aspects differed by region, sex, and causes of death. Higher mean temperature was associated (p<0.01) with lower heat risk, whereas higher humidity was associated with higher cold risk. A higher percentage of elderly people was associated with a higher cold risk, whereas higher economic strength of the prefecture was related to lower cold risk. CONCLUSIONS Population susceptibility to heat has decreased over the last four decades in Japan. Susceptibility to cold has decreased overall except for several eastern prefectures where it has either increased or remained unchanged. Certain climate, demographic, and socioeconomic factors explored in the current study might underlie this changing susceptibility. https://doi.org/10.1289/EHP2546.
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Affiliation(s)
- Yeonseung Chung
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Daewon Yang
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Antonio Gasparrini
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ana M Vicedo-Cabrera
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Fook Sheng Ng
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Masahiro Hashizume
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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Riley K, Wilhalme H, Delp L, Eisenman DP. Mortality and Morbidity during Extreme Heat Events and Prevalence of Outdoor Work: An Analysis of Community-Level Data from Los Angeles County, California. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040580. [PMID: 29570664 PMCID: PMC5923622 DOI: 10.3390/ijerph15040580] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 02/07/2023]
Abstract
Heat is a well-recognized hazard for workers in many outdoor settings, yet few investigations have compared the prevalence of outdoor work at the community level and rates of heat-related mortality and morbidity. This analysis examines whether heat-related health outcomes occur more frequently in communities with higher proportions of residents working in construction, agriculture, and other outdoor industries. Using 2005–2010 data from Los Angeles County, California, we analyze associations between community-level rates of deaths, emergency department (ED) visits, and hospitalizations during summer heat events and the prevalence of outdoor work. We find generally higher rates of heat-related ED visits and hospitalizations during summer heat events in communities with more residents working outdoors. Specifically, each percentage increase in residents working in construction resulted in an 8.1 percent increase in heat-related ED visits and a 7.9 percent increase in heat-related hospitalizations, while each percentage increase in residents working in agriculture and related sectors resulted in a 10.9 percent increase in heat-related ED visits. The findings suggest that outdoor work may significantly influence the overall burden of heat-related morbidity at the community level. Public health professionals and healthcare providers should recognize work and employment as significant heat risk factors when preparing for and responding to extreme heat events.
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Affiliation(s)
- Kevin Riley
- UCLA Labor Occupational Safety and Health Program, Los Angeles, CA 90095, USA.
| | - Holly Wilhalme
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
| | - Linda Delp
- UCLA Labor Occupational Safety and Health Program, Los Angeles, CA 90095, USA.
| | - David P Eisenman
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90024, USA.
- Center for Public Health and Disasters, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA 90024, USA.
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Lee W, Choi HM, Kim D, Honda Y, Guo YLL, Kim H. Temporal changes in morality attributed to heat extremes for 57 cities in Northeast Asia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 616-617:703-709. [PMID: 29103641 DOI: 10.1016/j.scitotenv.2017.10.258] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 06/07/2023]
Abstract
Recent studies have reported that heat-related mortality decreased by adaptation during decades. However, since the frequency of extreme heat events is increasing, it is difficult to conclude with certainty that the heat mortality burden is decreasing. To examine temporal changes in mortality attributed to heat extremes in Northeast Asia, we collected temperature and mortality data covering the years 1972-2012 from 57 cities of 3 countries (Taiwan, Korea, and Japan) in Northeast Asia. Poisson regression curves were fitted to the data from each city. The temporal changes in heat-mortality association were estimated with a time-varying distributed lag non-linear model. Heat extremes were defined as temperatures greater than the 97.5th percentiles of city-specific average temperatures. Attributable deaths were calculated considering temporal variations in exposure and relative risk. The estimates were then pooled through meta-analysis. The results show that the mortality risk on extreme heat days declined during the study period in all countries. However, as summer temperatures in Japan have shown more heat extremes over time, the mortality risk attributed to heat increased during 2003-2012 (0.32%) compared with 1972-1981 (0.19%). Thus, to assess the total health burden due to heat extremes related to climate change, public health strategies should focus on the temporal variation in heat-mortality association as well as changes in the distribution of heat extremes overtime.
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Affiliation(s)
- Whanhee Lee
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hayon Michelle Choi
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Dahye Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University, Taipei, Taiwan
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
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Lundgren-Kownacki K, Hornyanszky ED, Chu TA, Olsson JA, Becker P. Challenges of using air conditioning in an increasingly hot climate. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:401-412. [PMID: 29289994 PMCID: PMC5854721 DOI: 10.1007/s00484-017-1493-z] [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: 07/08/2016] [Revised: 10/17/2017] [Accepted: 12/11/2017] [Indexed: 05/14/2023]
Abstract
At present, air conditioning (AC) is the most effective means for the cooling of indoor space. However, its increased global use is problematic for various reasons. This paper explores the challenges linked to increased AC use and discusses more sustainable alternatives. A literature review was conducted applying a transdisciplinary approach. It was further complemented by examples from cities in hot climates. To analyse the findings, an analytical framework was developed which considers four societal levels-individual, community, city, and national. The main challenges identified from the literature review are as follows: environmental, organisational, socio-economical, biophysical and behavioural. The paper also identifies several measures that could be taken to reduce the fast growth of AC use. However, due to the complex nature of the problem, there is no single solution to provide sustainable cooling. Alternative solutions were categorised in three broad categories: climate-sensitive urban planning and building design, alternative cooling technologies, and climate-sensitive attitudes and behaviour. The main findings concern the problems arising from leaving the responsibility to come up with cooling solutions entirely to the individual, and how different societal levels can work towards more sustainable cooling options. It is concluded that there is a need for a more holistic view both when it comes to combining various solutions as well as involving various levels in society.
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Affiliation(s)
| | | | - Tuan Anh Chu
- Department of Architecture, Lund University, Lund, Sweden
| | | | - Per Becker
- Division of Risk Management and Societal Safety, Lund University, Lund, Sweden
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45
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Vicedo-Cabrera AM, Sera F, Guo Y, Chung Y, Arbuthnott K, Tong S, Tobias A, Lavigne E, de Sousa Zanotti Stagliorio Coelho M, Hilario Nascimento Saldiva P, Goodman PG, Zeka A, Hashizume M, Honda Y, Kim H, Ragettli MS, Röösli M, Zanobetti A, Schwartz J, Armstrong B, Gasparrini A. A multi-country analysis on potential adaptive mechanisms to cold and heat in a changing climate. ENVIRONMENT INTERNATIONAL 2018; 111:239-246. [PMID: 29272855 DOI: 10.1016/j.envint.2017.11.006] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Temporal variation of temperature-health associations depends on the combination of two pathways: pure adaptation to increasingly warmer temperatures due to climate change, and other attenuation mechanisms due to non-climate factors such as infrastructural changes and improved health care. Disentangling these pathways is critical for assessing climate change impacts and for planning public health and climate policies. We present evidence on this topic by assessing temporal trends in cold- and heat-attributable mortality risks in a multi-country investigation. METHODS Trends in country-specific attributable mortality fractions (AFs) for cold and heat (defined as below/above minimum mortality temperature, respectively) in 305 locations within 10 countries (1985-2012) were estimated using a two-stage time-series design with time-varying distributed lag non-linear models. To separate the contribution of pure adaptation to increasing temperatures and active changes in susceptibility (non-climate driven mechanisms) to heat and cold, we compared observed yearly-AFs with those predicted in two counterfactual scenarios: trends driven by either (1) changes in exposure-response function (assuming a constant temperature distribution), (2) or changes in temperature distribution (assuming constant exposure-response relationships). This comparison provides insights about the potential mechanisms and pace of adaptation in each population. RESULTS Heat-related AFs decreased in all countries (ranging from 0.45-1.66% to 0.15-0.93%, in the first and last 5-year periods, respectively) except in Australia, Ireland and UK. Different patterns were found for cold (where AFs ranged from 5.57-15.43% to 2.16-8.91%), showing either decreasing (Brazil, Japan, Spain, Australia and Ireland), increasing (USA), or stable trends (Canada, South Korea and UK). Heat-AF trends were mostly driven by changes in exposure-response associations due to modified susceptibility to temperature, whereas no clear patterns were observed for cold. CONCLUSIONS Our findings suggest a decrease in heat-mortality impacts over the past decades, well beyond those expected from a pure adaptation to changes in temperature due to the observed warming. This indicates that there is scope for the development of public health strategies to mitigate heat-related climate change impacts. In contrast, no clear conclusions were found for cold. Further investigations should focus on identification of factors defining these changes in susceptibility.
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Affiliation(s)
- Ana M Vicedo-Cabrera
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Francesco Sera
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yeonseung Chung
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Katherine Arbuthnott
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Children's Medical Center, Shanghai Jiao-Tong University, Shanghai, China; School of Public Health and Institute of Environment and Population Health, Anhui Medical University, Hefei, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Eric Lavigne
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | | | | | | | - Ariana Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, United Kingdom
| | - Masahiro Hashizume
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ben Armstrong
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Wang Y, Nordio F, Nairn J, Zanobetti A, Schwartz JD. Accounting for adaptation and intensity in projecting heat wave-related mortality. ENVIRONMENTAL RESEARCH 2018; 161:464-471. [PMID: 29220799 DOI: 10.1016/j.envres.2017.11.049] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 11/06/2017] [Accepted: 11/28/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND How adaptation and intensity of heat waves affect heat wave-related mortality is unclear, making health projections difficult. METHODS We estimated the effect of heat waves, the effect of the intensity of heat waves, and adaptation on mortality in 209 U.S. cities with 168 million people during 1962-2006. We improved the standard time-series models by incorporating the intensity of heat waves using excess heat factor (EHF) and estimating adaptation empirically using interactions with yearly mean summer temperature (MST). We combined the epidemiological estimates for heat wave, intensity, and adaptation with the Coupled Model Intercomparison Project Phase 5 (CMIP5) multi-model dataset to project heat wave-related mortality by 2050. RESULTS The effect of heat waves increased with its intensity. Adaptation to heat waves occurred, which was shown by the decreasing effect of heat waves with MST. However, adaptation was lessened as MST increased. Ignoring adaptation in projections would result in a substantial overestimate of the projected heat wave-related mortality (by 277-747% in 2050). Incorporating the empirically estimated adaptation into projections would result in little change in the projected heat wave-related mortality between 2006 and 2050. This differs regionally, however, with increasing mortality over time for cities in the southern and western U.S. but decreasing mortality over time for the north. CONCLUSIONS Accounting for adaptation is important to reduce bias in the projections of heat wave-related mortality. The finding that the southern and western U.S. are the areas that face increasing heat-related deaths is novel, and indicates that more regional adaptation strategies are needed.
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Affiliation(s)
- Yan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francesco Nordio
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - John Nairn
- Australian Bureau of Meteorology, Adelaide, South Australia, Australia; University of Adelaide, Adelaide, South Australia, Australia
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Heat Exposure and the General Public: Health Impacts, Risk Communication, and Mitigation Measures. SPRINGERBRIEFS IN MEDICAL EARTH SCIENCES 2018. [DOI: 10.1007/978-3-319-75889-3_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Wang F, Wang J, Gelfand A, Li F. Accommodating the ecological fallacy in disease mapping in the absence of individual exposures. Stat Med 2017; 36:4930-4942. [PMID: 28929501 DOI: 10.1002/sim.7494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 06/22/2017] [Accepted: 08/24/2017] [Indexed: 11/08/2022]
Abstract
In health exposure modeling, in particular, disease mapping, the ecological fallacy arises because the relationship between aggregated disease incidence on areal units and average exposure on those units differs from the relationship between the event of individual incidence and the associated individual exposure. This article presents a novel modeling approach to address the ecological fallacy in the least informative data setting. We assume the known population at risk with an observed incidence for a collection of areal units and, separately, environmental exposure recorded during the period of incidence at a collection of monitoring stations. We do not assume any partial individual level information or random allocation of individuals to observed exposures. We specify a conceptual incidence surface over the study region as a function of an exposure surface resulting in a stochastic integral of the block average disease incidence. The true block level incidence is an unavailable Monte Carlo integration for this stochastic integral. We propose an alternative manageable Monte Carlo integration for the integral. Modeling in this setting is immediately hierarchical, and we fit our model within a Bayesian framework. To alleviate the resulting computational burden, we offer 2 strategies for efficient model fitting: one is through modularization, the other is through sparse or dimension-reduced Gaussian processes. We illustrate the performance of our model with simulations based on a heat-related mortality dataset in Ohio and then analyze associated real data.
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Affiliation(s)
- Feifei Wang
- School of Statistics, Renmin University of China, Beijing, 100872, China
| | - Jian Wang
- Guanghua School of Management, Peking University, Beijing, 100871, China
| | - Alan Gelfand
- Department of Statistical Science, Duke University, Durham, NC 27708, USA
| | - Fan Li
- Department of Statistical Science, Duke University, Durham, NC 27708, USA
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49
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Mozzini C, Xotta G, Garbin U, Pasini AMF, Cominacini L. Non-Exertional Heatstroke: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1058-1065. [PMID: 28974669 PMCID: PMC5637572 DOI: 10.12659/ajcr.905701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 07/13/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Heatstroke (HS) is a life-threatening condition characterized by an elevation of the core body temperature above 40°C, central nervous system dysfunction, and possible multi-organ failure. HS can trigger systemic inflammation, disseminated intravascular coagulation (DIC), rhabdomyolysis, cerebral edema and seizures, pulmonary edema, heart dysfunctions, and renal and hepatic failure. CASE REPORT We report the case of a 41-year-old Romanian woman with a history of alcoholism who developed HS after arriving by bus in Verona, Italy in June 2016. The patient developed consecutive multi-organ dysfunction, including liver and renal failure, rhabdomyolysis, DIC, and arrhythmia. The patient was successfully treated with conservative measures. After 17 days, she recovered completely. CONCLUSIONS The exact mechanism of HS-related multiple organ dysfunction is not completely understood and its pathogenesis is complex. It involves inflammation, oxidative stress, endoplasmic reticulum (ER) stress, and mitochondrial dysfunction. Development of a model in which chronic alcohol abuse alters oxidative, inflammatory, and ER stress response could also be a conceivable solution to the positive prognosis of severe HS patients, in which liver failure has a prominent role.
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50
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Gosling SN, Hondula DM, Bunker A, Ibarreta D, Liu J, Zhang X, Sauerborn R. Adaptation to Climate Change: A Comparative Analysis of Modeling Methods for Heat-Related Mortality. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:087008. [PMID: 28885979 PMCID: PMC5783656 DOI: 10.1289/ehp634] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/15/2016] [Accepted: 10/24/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to "adaptation uncertainty" (i.e., the inclusion/exclusion of adaptation modeling) relative to using multiple climate models and emissions scenarios. OBJECTIVES This study had three aims: a) Compare the range in projected impacts that arises from using different adaptation modeling methods; b) compare the range in impacts that arises from adaptation uncertainty with ranges from using multiple climate models and emissions scenarios; c) recommend modeling method(s) to use in future impact assessments. METHODS We estimated impacts for 2070-2099 for 14 European cities, applying six different methods for modeling adaptation; we also estimated impacts with five climate models run under two emissions scenarios to explore the relative effects of climate modeling and emissions uncertainty. RESULTS The range of the difference (percent) in impacts between including and excluding adaptation, irrespective of climate modeling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities, the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modeling and emissions uncertainty. CONCLUSIONS Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modeling. We recommend absolute threshold shifts and reductions in slope. https://doi.org/10.1289/EHP634.
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Affiliation(s)
- Simon N Gosling
- School of Geography, University of Nottingham , Nottingham, United Kingdom
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University , Tempe, Arizona, USA
| | - Aditi Bunker
- Network Aging Research, University of Heidelberg , Heidelberg, Germany
- Institute of Public Health, University of Heidelberg , Heidelberg, Germany
| | - Dolores Ibarreta
- European Commission, Joint Research Centre (JRC), Seville, Spain
| | - Junguo Liu
- School of Environmental Science and Engineering, South University of Science and Technology of China, Shenzhen, China
| | - Xinxin Zhang
- School of Nature Conservation, Beijing Forestry University , Beijing, China
| | - Rainer Sauerborn
- Institute of Public Health, University of Heidelberg , Heidelberg, Germany
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