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Meadows J, Mansour A, Gatto MR, Li A, Howard A, Bentley R. Mental illness and increased vulnerability to negative health effects from extreme heat events: a systematic review. Psychiatry Res 2024; 332:115678. [PMID: 38150812 DOI: 10.1016/j.psychres.2023.115678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 12/29/2023]
Abstract
RATIONALE Across countries, extreme heat events are projected to increase in frequency and intensity because of climate change. Exposure to extreme heat events can have a substantial negative impact on human health, and extant research suggests that individuals with mental illness are particularly vulnerable. To date, there has been no review of evidence regarding this vulnerability to inform response strategies and future research. OBJECTIVE A systematic review was undertaken to investigate mental illness as an effect modifier of the relationship between heat exposure and morbidity or mortality. METHODS Six databases (Medline, Embase, Global Health, PsychInfo, CINAHL and Scopus) were searched for studies published between the years 2000 to 2022. Twenty-two observational studies that met the inclusion criteria were investigated through narrative synthesis. The RoBANS tool, ROBIS and GRADE were used to assess the certainty of evidence including the risk of bias. RESULTS Individuals with mental illness experience worse morbidity and mortality outcomes compared to their counterparts without mental illness in all studies investigating high temperature over a single day. This did not hold for studies examining heatwaves, which reported mixed findings. CONCLUSIONS AND IMPLICATIONS People with diagnosed mental illness should be targeted for policy and service attention during high temperature days. Further research should investigate specific mental illness and adjust for a wider range of confounding factors.
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Affiliation(s)
- Julia Meadows
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Adelle Mansour
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Maria Rosa Gatto
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Ang Li
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Amber Howard
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Rebecca Bentley
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia.
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Dumont CR, Mathis WS. Mapping Heat Vulnerability of a Community Mental Health Center Population. Community Ment Health J 2023; 59:1330-1340. [PMID: 37014585 DOI: 10.1007/s10597-023-01119-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/11/2023] [Indexed: 04/05/2023]
Abstract
Individuals with serious mental illness are vulnerable to extreme heat due to biological, social, and place-based factors. We examine the spatial correlation of prevalence of individuals treated at a community mental health center to heat vulnerability. We applied a heat vulnerability index (HVI) to the catchment of the Connecticut Mental Health Center in New Haven, Connecticut. Geocoded addresses were mapped to correlate patient prevalence with heat vulnerability of census tracts. Census tracts closer to the city center had elevated vulnerability scores. Patient prevalence was positively correlated with HVI score (Pearson's r(44) = 0.67, p < 0.01). Statistical significance persists after correction for spatial autocorrelation (modified t-test p < 0.01). The study indicates that individuals treated at this community mental health center are more likely to live in census tracts with high heat vulnerability. Heat mapping strategies can help communicate risk and target resources at the local scale.
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Affiliation(s)
- Caroline R Dumont
- Department of Psychiatry, School of Medicine, Yale University, Connecticut Mental Health Center, 34 Park Street, 06519, New Haven, CT, USA.
| | - Walter S Mathis
- Department of Psychiatry, School of Medicine, Yale University, Connecticut Mental Health Center, 34 Park Street, 06519, New Haven, CT, USA
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Woodland L, Ratwatte P, Phalkey R, Gillingham EL. Investigating the Health Impacts of Climate Change among People with Pre-Existing Mental Health Problems: A Scoping Review. Int J Environ Res Public Health 2023; 20:ijerph20085563. [PMID: 37107845 PMCID: PMC10138675 DOI: 10.3390/ijerph20085563] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
Climate change is the greatest threat to global public health, although the impacts on mental health are relatively understudied. Furthermore, there is a lack of consensus about the effects of climate change on individuals with pre-existing mental health problems. This review aimed to identify the health impacts of climate change on people with pre-existing mental health problems. The search was conducted across three databases; studies were included if they involved participants who had mental health problem(s) before a climate-driven event and reported on health outcomes post-event. A total of thirty-one studies met the full inclusion criteria. The study characteristics included 6 climate-driven events: heat events, floods, wildfires, wildfire and flood, hurricanes, and droughts, and 16 categories of pre-existing mental health problems, with depression, and non-specified mental health problems being the most common. The majority of the studies (90%, n = 28) suggest an association between the presence of pre-existing mental health problems and the likelihood of adverse health impacts (e.g., increased mortality risk, new symptom presentation, and an exacerbation of symptoms). To mitigate the exacerbation of health inequalities, people with pre-existing mental health problems should be included in adaption guidance and/or plans that mitigate the health impacts of climate change, future policy, reports, and frameworks.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, London SE5 9RJ, UK
- Correspondence:
| | - Priyanjali Ratwatte
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Revati Phalkey
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
| | - Emma L. Gillingham
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
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Minor T, Sugg M, Runkle JD. Short-term exposure to temperature and mental health in North Carolina: a distributed lag nonlinear analysis. Int J Biometeorol 2023; 67:573-586. [PMID: 36779999 DOI: 10.1007/s00484-023-02436-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Adverse mental health outcomes have been associated with high temperatures in studies worldwide. Few studies explore a broad range of mental health outcomes, and to our knowledge, none are specific to NC, USA. This ecological study explored the relationship between ambient temperature and mental health outcomes (suicide, self-harm and suicide ideation, anxiety and stress, mood disorders, and depression) in six urban counties across the state of NC, USA. We applied a quasi-Poisson generalized linear model combined with a distributed lag nonlinear model (DLNM) to examine the short-term effects of daily ambient temperature on emergency admissions for mental health conditions (2016 to 2018) and violent deaths (2004 to 2018). The results were predominately insignificant, with some key exceptions. The county with the greatest temperature range (Wake) displays higher levels of significance, while counties with the lowest temperature ranges (New Hanover and Pitt) are almost entirely insignificant. Self-harm and suicidal ideation peak in the warm months (July) and generally exhibit a protective effect at lower temperatures and shorter lag intervals. Whereas anxiety, depression, and major depressive disorders peak in the cooler months (May and September). Suicide is the only outcome that favored a 20-day lag period in the sensitivity analysis, although the association with temperature was insignificant. Our findings suggest additional research is needed across a suite of mental health outcomes to fully understand the effects of temperatures on mental health.
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Affiliation(s)
- Tyler Minor
- Department of Geography and Planning, Appalachian State University, Boone, NC, USA
| | - Margaret Sugg
- Department of Geography and Planning, Appalachian State University, Boone, NC, USA.
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, NC, USA
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Manware M, Dubrow R, Carrión D, Ma Y, Chen K. Residential and Race/Ethnicity Disparities in Heat Vulnerability in the United States. Geohealth 2022; 6:e2022GH000695. [PMID: 36518814 PMCID: PMC9744626 DOI: 10.1029/2022gh000695] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/03/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Adverse health outcomes caused by extreme heat represent the most direct human health threat associated with the warming of the Earth's climate. Socioeconomic, demographic, health, land cover, and temperature determinants contribute to heat vulnerability; however, nationwide patterns of residential and race/ethnicity disparities in heat vulnerability in the United States are poorly understood. This study aimed to develop a Heat Vulnerability Index (HVI) for the United States; to assess differences in heat vulnerability across geographies that have experienced historical and/or contemporary forms of marginalization; and to quantify HVI by race/ethnicity. Principal component analysis was used to calculate census tract level HVI scores based on the 2019 population characteristics of the United States. Differences in HVI scores were analyzed across the Home Owners' Loan Corporation (HOLC) "redlining" grades, the Climate and Economic Justice Screening Tool (CEJST) disadvantaged versus non-disadvantaged communities, and race/ethnicity groups. HVI scores were calculated for 55,267 U.S. census tracts. Mean HVI scores were 17.56, 18.61, 19.45, and 19.93 for HOLC grades "A"-"D," respectively. CEJST-defined disadvantaged census tracts had a significantly higher mean HVI score (19.13) than non-disadvantaged tracts (16.68). The non-Hispanic African American or Black race/ethnicity group had the highest HVI score (18.51), followed by Hispanic or Latino (18.19). Historically redlined and contemporary CEJST disadvantaged census tracts and communities of color were found to be associated with increased vulnerability to heat. These findings can help promote equitable climate change adaptation policies by informing policymakers about the national distribution of place- and race/ethnicity-based disparities in heat vulnerability.
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Affiliation(s)
- Mitchell Manware
- Department of Social and Behavioral SciencesYale School of Public HealthNew HavenCTUSA
- Yale Center on Climate Change and HealthYale School of Public HealthNew HavenCTUSA
| | - Robert Dubrow
- Yale Center on Climate Change and HealthYale School of Public HealthNew HavenCTUSA
- Department of Environmental Health SciencesYale School of Public HealthNew HavenCTUSA
| | - Daniel Carrión
- Yale Center on Climate Change and HealthYale School of Public HealthNew HavenCTUSA
- Department of Environmental Health SciencesYale School of Public HealthNew HavenCTUSA
| | - Yiqun Ma
- Yale Center on Climate Change and HealthYale School of Public HealthNew HavenCTUSA
- Department of Environmental Health SciencesYale School of Public HealthNew HavenCTUSA
| | - Kai Chen
- Yale Center on Climate Change and HealthYale School of Public HealthNew HavenCTUSA
- Department of Environmental Health SciencesYale School of Public HealthNew HavenCTUSA
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6
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Chen Y, Qin X. The Impact of Extreme Temperature Shocks on the Health Status of the Elderly in China. Int J Environ Res Public Health 2022; 19:15729. [PMID: 36497803 PMCID: PMC9738369 DOI: 10.3390/ijerph192315729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/10/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
With the accelerating process of climate change, long-term exposure to extreme temperatures could threaten individuals' physical health, especially for the vulnerable population. This paper aims to investigate the long-term effects of extreme temperature exposure on the health of the elderly in the context of climate change and aging. Different from most of the existing literature in environmental economics, we define the relative extreme temperature exposure based on the local temperature pattern. By combining a large national household survey and nationwide meteorologic historical data, this study provides empirical evidence that heat exposure days and cold exposure days during the past year both significantly affect the physical health of middle-aged and elderly groups, controlling for city, year, and individual fixed effects. The effect on individual physical health has certain seasonal characteristics and is heterogeneous across populations. Additionally, cooling and heating equipment are effective in alleviating the reverse impact of heat and cold exposure. The estimation is robust and consistent across a variety of temperature measurements and model modifications. Our findings provide evidence of the long-term and accumulative cost of extreme temperature to middle-aged and elderly human capital, contributing to helping the public to better understand the full impact of climate change.
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Affiliation(s)
- Yanran Chen
- School of Economics, Capital University of Economics and Business, Beijing 100070, China
| | - Xuezheng Qin
- School of Economics, Peking University, Beijing 100871, China
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7
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Ligsay A, Telle O, Paul R. Challenges to Mitigating the Urban Health Burden of Mosquito-Borne Diseases in the Face of Climate Change. Int J Environ Res Public Health 2021; 18:5035. [PMID: 34068688 PMCID: PMC8126106 DOI: 10.3390/ijerph18095035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/22/2021] [Accepted: 05/06/2021] [Indexed: 11/17/2022]
Abstract
Cities worldwide are facing ever-increasing pressure to develop mitigation strategies for all sectors to deal with the impacts of climate change. Cities are expected to house 70% of the world's population by 2050, and developing related resilient health systems is a significant challenge. Because of their physical nature, cities' surface temperatures are often substantially higher than that of the surrounding rural areas, generating the so-called Urban Heat Island (UHI) effect. Whilst considerable emphasis has been placed on strategies to mitigate against the UHI-associated negative health effects of heat and pollution in cities, mosquito-borne diseases have largely been ignored. However, the World Health Organization estimates that one of the main consequences of global warming will be an increased burden of mosquito-borne diseases, many of which have an urban facet to their epidemiology and thus the global population exposed to these pathogens will steadily increase. Current health mitigation strategies for heat and pollution, for example, may, however, be detrimental for mosquito-borne diseases. Implementation of multi-sectoral strategies that can benefit many sectors (such as water, labor, and health) do exist or can be envisaged and would enable optimal use of the meagre resources available. Discussion among multi-sectoral stakeholders should be actively encouraged.
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Affiliation(s)
- Antonio Ligsay
- The Graduate School, University of Santo Tomas, Manila 1008, Philippines;
- Clinical and Health-Related Research, St. Luke’s Medical Center WHQM College of Medicine, Quezon City 1112, Philippines
| | - Olivier Telle
- CNRS, Géographie-Cités, Paris 1 Université Paris-Sorbonne, 75006 Paris, France;
| | - Richard Paul
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, UMR 2000 (CNRS), 75015 Paris, France
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8
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Waugh DW, He Z, Zaitchik B, Peng RD, Diette GB, Hansel NN, Matsui EC, Breysse PN, Breysse DH, Koehler K, Williams D, McCormack MC. Indoor heat exposure in Baltimore: does outdoor temperature matter? Int J Biometeorol 2021; 65:479-488. [PMID: 33089367 DOI: 10.1007/s00484-020-02036-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 10/06/2020] [Accepted: 10/14/2020] [Indexed: 06/11/2023]
Abstract
Heat exposure of a population is often estimated by applying temperatures from outdoor monitoring stations. However, this can lead to exposure misclassification if residents do not live close to the monitoring station and temperature varies over small spatial scales due to land use/built environment variability, or if residents generally spend more time indoors than outdoors. Here, we compare summertime temperatures measured inside 145 homes in low-income households in Baltimore city with temperatures from the National Weather Service weather station in Baltimore. There is a large variation in indoor temperatures, with daily-mean indoor temperatures varying from 10 °C lower to 10 °C higher than outdoor temperatures. Furthermore, there is only a weak association between the indoor and outdoor temperatures across all houses, indicating that the outdoor temperature is not a good predictor of the indoor temperature for the residences sampled. It is shown that much of the variation is due to differences in the availability of air conditioning (AC). Houses with central AC are generally cooler than outdoors (median difference of - 3.4 °C) while those with no AC are generally warmer (median difference of 1.4 °C). For the collection of houses with central or room AC, there is essentially no relationship between indoor and outdoor temperatures, but for the subset of houses with no AC, there is a weak relationship (correlation coefficient of 0.36). The results presented here suggest future epidemiological studies of indoor exposure to heat would benefit from information on the availability of AC within the population.
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Affiliation(s)
- D W Waugh
- Department of Earth and Planetary Sciences, Johns Hopkins University School of Arts and Sciences, Baltimore, MD, USA.
| | - Z He
- Department of Earth and Planetary Sciences, Johns Hopkins University School of Arts and Sciences, Baltimore, MD, USA
| | - B Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University School of Arts and Sciences, Baltimore, MD, USA
| | - R D Peng
- Department of Biostatistics, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - G B Diette
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - N N Hansel
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E C Matsui
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - P N Breysse
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - D H Breysse
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - K Koehler
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - D Williams
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - M C McCormack
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, MD, USA
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Abstract
Australia often experiences natural disasters and extreme weather conditions such as: flooding, sandstorms, heatwaves, and bushfires (also known as wildfires or forest fires). The proportion of the Australian population aged 65 years and over is increasing, alongside the severity and frequency of extreme weather conditions and natural disasters. Extreme heat can affect the entire population but particularly at the extremes of life, and patients with morbidities. Frequently identified as a vulnerable demographic in natural disasters, there is limited research on older adults and their capacity to deal with extreme heat and bushfires. There is a considerable amount of literature that suggests a significant association between mental disorders such as dementia, and increased vulnerability to extreme heat. The prevalence rate for dementia is estimated at 30%by age 85 years, but there has been limited research on the effects extreme heat and bushfires have on individuals living with dementia. This review explores the differential diagnosis of dementia, the Australian climate, and the potential impact Australia's extreme heat and bushfires have on individuals from vulnerable communities including low socioeconomic status Indigenous and Non-Indigenous populations living with dementia, in both metropolitan and rural communities. Furthermore, we investigate possible prevention strategies and provide suggestions for future research on the topic of Australian bushfires and heatwaves and their impact on people living with dementia. This paper includes recommendations to ensure rural communities have access to appropriate support services, medical treatment, awareness, and information surrounding dementia.
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Affiliation(s)
- Taya L Farugia
- Mental Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Carla Cuni-Lopez
- Mental Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Anthony R White
- Mental Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
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Liu X, Tian Z, Sun L, Liu J, Wu W, Xu H, Sun L, Wang C. Mitigating heat-related mortality risk in Shanghai, China: system dynamics modeling simulations. Environ Geochem Health 2020; 42:3171-3184. [PMID: 32350804 PMCID: PMC7518989 DOI: 10.1007/s10653-020-00556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
Numerous studies in epidemiology, meteorology, and climate change research have demonstrated a significant association between abnormal ambient temperature and mortality. However, there is a shortage of research attention to a systematic assessment of potential mitigation measures which could effectively reduce the heat-related morbidity and mortality risks. This study first illustrates a conceptualization of a systems analysis version of urban framework for climate service (UFCS). It then constructs a system dynamics (SD) model for the UFCS and employs this model to quantify the impacts of heat waves on public health system in Shanghai and to evaluate the performances of two mitigation measures in the context of a real heat wave event in July 2013 in the city. Simulation results show that in comparison with the baseline without mitigation measures, if the hospital system could prepare 20% of beds available for emergency response to heat waves once receiving the warning in advance, the number of daily deaths could be reduced by 40-60 (15.8-19.5%) on the 2 days of day 7 and day 8; if increasing the minimum living allowance of 790 RMB/month in 2013 by 20%, the number of daily deaths could be reduced by 50-70 (17.7-21.9%) on the 2 days of day 8 and day 12. This tool can help policy makers systematically evaluate adaptation and mitigation options based on performance assessment, thus strengthening urban resilience to changing climate.
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Affiliation(s)
- Xiaochen Liu
- Shanghai Climate Center, Shanghai Meteorological Services, Shanghai, 200030 China
- Key Laboratory of Cities’ Mitigation and Adaptation to Climate Change in Shanghai, Shanghai, 200092 China
| | - Zhan Tian
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Laixiang Sun
- Department of Geographical Sciences, University of Maryland, College Park, MD 20742 USA
- School of Finance and Management, SOAS University of London, Russell Square, London, WC1H 0XG UK
- International Institute for Applied Systems Analysis (IIASA), 2361 Laxenburg, Austria
| | - Junguo Liu
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Wei Wu
- Shanghai Climate Center, Shanghai Meteorological Services, Shanghai, 200030 China
- Key Laboratory of Cities’ Mitigation and Adaptation to Climate Change in Shanghai, Shanghai, 200092 China
| | - Hanqing Xu
- Key Laboratory of Geographic Information Science (Ministry of Education), East China Normal University, Shanghai, 200241 China
| | - Landong Sun
- Shanghai Climate Center, Shanghai Meteorological Services, Shanghai, 200030 China
- Key Laboratory of Cities’ Mitigation and Adaptation to Climate Change in Shanghai, Shanghai, 200092 China
| | - Chunfang Wang
- Shanghai Center of Disease Prevention and Control, Shanghai, 200336 China
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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. Environ Sci Pollut Res Int 2019; 26:24272-24285. [PMID: 31230236 DOI: 10.1007/s11356-019-05594-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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Jung J, Uejio CK, Duclos C, Jordan M. Using web data to improve surveillance for heat sensitive health outcomes. Environ Health 2019; 18:59. [PMID: 31287016 PMCID: PMC6615306 DOI: 10.1186/s12940-019-0499-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/13/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Elevated and prolonged exposure to extreme heat is an important cause of excess summertime mortality and morbidity. To protect people from health threats, some governments are currently operating syndromic surveillance systems. However, A lack of resources to support time- and labor- intensive diagnostic and reporting processes make it difficult establishing region-specific surveillance systems. Big data created by social media and web search may improve upon the current syndromic surveillance systems by directly capturing people's individual and subjective thoughts and feelings during heat waves. This study aims to investigate the relationship between heat-related web searches, social media messages, and heat-related health outcomes. METHODS We collected Twitter messages that mentioned "air conditioning (AC)" and "heat" and Google search data that included weather, medical, recreational, and adaptation information from May 7 to November 3, 2014, focusing on the state of Florida, U.S. We separately associated web data against two different sources of health outcomes (emergency department (ED) and hospital admissions) and five disease categories (cardiovascular disease, dehydration, heat-related illness, renal disease, and respiratory disease). Seasonal and subseasonal temporal cycles were controlled using autoregressive moving average-generalized autoregressive conditional heteroscedasticity (ARMA-GARCH) and generalized linear model (GLM). RESULTS The results show that the number of heat-related illness and dehydration cases exhibited a significant positive relationship with web data. Specifically, heat-related illness cases showed positive associations with messages (heat, AC) and web searches (drink, heat stroke, park, swim, and tired). In addition, terms such as park, pool, swim, and water tended to show a consistent positive relationship with dehydration cases. However, we found inconsistent relationships between renal illness and web data. Web data also did not improve the models for cardiovascular and respiratory illness cases. CONCLUSIONS Our findings suggest web data created by social medias and search engines could improve the current syndromic surveillance systems. In particular, heat-related illness and dehydration cases were positively related with web data. This paper also shows that activity patterns for reducing heat stress are associated with several health outcomes. Based on the results, we believe web data could benefit both regions without the systems and persistently hot and humid climates where excess heat early warning systems may be less effective.
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Affiliation(s)
- Jihoon Jung
- Department of Geography, Florida State University, 113 Collegiate Loop, Tallahassee, FL 32306 USA
| | - Christopher K. Uejio
- Department of Geography, Florida State University, 113 Collegiate Loop, Tallahassee, FL 32306 USA
| | - Chris Duclos
- Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399 USA
| | - Melissa Jordan
- Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399 USA
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Sugg MM, Dixon PG, Runkle JD. Crisis support-seeking behavior and temperature in the United States: Is there an association in young adults and adolescents? Sci Total Environ 2019; 669:400-411. [PMID: 30884264 DOI: 10.1016/j.scitotenv.2019.02.434] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/27/2019] [Accepted: 02/27/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND Mounting evidence demonstrates the relationship between high temperatures and adverse mental health outcomes. Yet, no study has examined the influence of temperature on crisis support-seeking behavior among youth in large urban areas. METHODS Crisis Text Line (CTL) is a text messaging service that provides crisis interventions for support-seeking individuals for a range of mental-health outcomes in the United States. We applied a distributed lag non-linear modeling technique to assess the short-term impacts of daily maximum and minimum temperature on crisis-related events in four metropolitan locations in the USA. RESULTS There were multiple positive associations in three of the four study locations that demonstrate crisis help-seeking behavior increased during anomalously warm conditions. CONCLUSIONS This study suggests that there is a significant association between high minimum or maximum temperatures and crisis help-seeking behaviors in young adults and adolescents in urban areas in the United States.
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Affiliation(s)
- Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, P.O. Box 32066, Boone, NC 28608, United States of America.
| | - P Grady Dixon
- Werth College of Science, Technology, and Mathematics, Fort Hays State University, 600 Park Street, Hays, KS 67601-4099, United States of America.
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC 28801, United States of America,.
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Carlsen HK, Oudin A, Steingrimsson S, Oudin Åström D. Ambient Temperature and Associations with Daily Visits to a Psychiatric Emergency Unit in Sweden. Int J Environ Res Public Health 2019; 16:E286. [PMID: 30669579 DOI: 10.3390/ijerph16020286] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/28/2018] [Accepted: 01/15/2019] [Indexed: 12/27/2022]
Abstract
High or low ambient temperatures pose a risk factor for the worsening or onset of psychiatric disorders. The aim of this study was to investigate the association between ambient temperature and psychiatric emergency visits in an urban region in a temperate climate. The daily number of visits to a psychiatric emergency room (PEVs) at Sahlgrenska University Hospital, Gothenburg, Sweden and the daily mean temperature were extracted for the study period 1 July 2012 to 31 December 2017. Case-crossover analysis with distributed lag non-linear models was used to analyse the data by season. The warm season was defined as May to August and the cold season as November to February. Shorter lags periods were used for the warm season than the cold season. In the analysis, temperatures at the 95th percentile was associated with 14% (95% confidence interval (CI): 2%, 28%) increase in PEVs at lag 0⁻3 and 22% (95%CI: 6%, 40%) for lags 0⁻14 during the warm season, relative to the seasonal minimum effect temperature (MET). During the cold season temperatures at the 5th percentile were associated with 25% (95% CI: -8%, 13%) and 18% (95% CI: -30%, 98%) increase in PEVs at lags 0⁻14 and 0⁻21 respectively. We observed an increased number of PEVs at high and low temperatures; however, not to a statistically significant extent for low temperatures. Our findings are similar to what has been found for somatic diseases and in studies of other mental health outcomes in regions with more extreme climates. This merits the inclusion of individuals with psychiatric disorders in awareness planning for climate warning systems.
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Kenny GP, Flouris AD, Yagouti A, Notley SR. Towards establishing evidence-based guidelines on maximum indoor temperatures during hot weather in temperate continental climates. Temperature (Austin) 2018; 6:11-36. [PMID: 30906809 PMCID: PMC6422495 DOI: 10.1080/23328940.2018.1456257] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/15/2018] [Indexed: 11/09/2022] Open
Abstract
Rising environmental temperatures represent a major threat to human health. The activation of heat advisories using evidence-based thresholds for high-risk outdoor ambient temperatures have been shown to be an effective strategy to save lives during hot weather. However, although the relationship between weather and human health has been widely defined by outdoor temperature, corresponding increases in indoor temperature during heat events can also be harmful to health especially in vulnerable populations. In this review, we discuss our current understanding of the relationship between outdoor temperature and human health and examine how human health can also be adversely influenced by high indoor temperatures during heat events. Our assessment of the existing literature revealed a high degree of variability in what can be considered an acceptable indoor temperature because there are differences in how different groups of people may respond physiologically and behaviorally to the same living environment. Finally, we demonstrate that both non-physiological (e.g., geographical location, urban density, building design) and physiological (e.g., sex, age, fitness, state of health) factors must be considered when defining an indoor temperature threshold for preserving human health in a warming global climate.
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Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | | | - Sean R. Notley
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Lee S, Lee H, Myung W, Kim EJ, Kim H. Mental disease-related emergency admissions attributable to hot temperatures. Sci Total Environ 2018; 616-617:688-694. [PMID: 29126638 DOI: 10.1016/j.scitotenv.2017.10.260] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The association between high temperature and mental disease has been the focus of several studies worldwide. However, no studies have focused on the mental disease burden attributable to hot temperature. Here, we aim to quantify the risk attributed to hot temperatures based on the exposure-lag-response relationship between temperature and mental diseases. METHOD From data on daily temperature and emergency admissions (EA) for mental diseases collected from 6 major cities (Seoul, Incheon, Daejeon, Daegu, Busan, and Gwangju in South Korea) over a period of 11years (2003-2013), we estimated temperature-disease associations using a distributed lag non-linear model, and we pooled the data by city through multivariate meta-analysis. Cumulative relative risk and attributable risks were calculated for extreme hot temperatures, defined as the 99th percentile relative to the 50th percentile of temperatures. RESULTS The strongest association between mental disease and high temperature was seen within a period of 0-4days of high temperature exposure. Our results reveal that 14.6% of EA for mental disease were due to extreme hot temperatures, and the elderly were more susceptible (19.1%). Specific mental diseases, including anxiety, dementia, schizophrenia, and depression, also showed significant risk attributed to hot temperatures. Of all EA for anxiety, 31.6% were attributed to extremely hot temperatures. CONCLUSIONS High temperature was responsible for an attributable risk for mental disease, and the burden was higher in the elderly. This finding has important implications for designing appropriate public health policies to minimize the impact of high temperature on mental health.
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Affiliation(s)
- Suji Lee
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Hwanhee Lee
- Building 221, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul 151-742, South Korea
| | - Woojae Myung
- School of Medicine, Samsung Medical Center, Department of Psychiatry, Gangnam-gu, Seoul 06351, South Korea
| | - E Jin Kim
- Building 221, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul 151-742, South Korea
| | - Ho Kim
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea; Building 221, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul 151-742, South Korea.
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Gagnon D, Romero SA, Cramer MN, Kouda K, Poh PYS, Ngo H, Jay O, Crandall CG. Age Modulates Physiological Responses during Fan Use under Extreme Heat and Humidity. Med Sci Sports Exerc 2018; 49:2333-2342. [PMID: 28609330 DOI: 10.1249/mss.0000000000001348] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE We examined the effect of electric fan use on cardiovascular and thermoregulatory responses of nine young (26 ± 3 yr) and nine aged (68 ± 4 yr) adults exposed to extreme heat and humidity. METHODS While resting at a temperature of 42°C, relative humidity increased from 30% to 70% in 2% increments every 5 min. On randomized days, the protocol was repeated without or with fan use. HR, core (Tcore) and mean skin (Tsk) temperatures were measured continuously. Whole-body sweat loss was measured from changes in nude body weight. Other measures of cardiovascular (cardiac output), thermoregulatory (local cutaneous and forearm vascular conductance, local sweat rate), and perceptual (thermal and thirst sensations) responses were also examined. RESULTS When averaged over the entire protocol, fan use resulted in a small reduction of HR (-2 bpm, 95% confidence interval [CI], -8 to 3), and slightly greater Tcore (+0.05°C; 95% CI, -0.13 to 0.23) and Tsk (+0.03°C; 95% CI, -0.36 to 0.42) in young adults. In contrast, fan use resulted in greater HR (+5 bpm; 95% CI, 0-10), Tcore (+0.20°C; 95% CI, 0.00-0.41), and Tsk (+0.47°C; 95% CI, 0.18-0.76) in aged adults. A greater whole-body sweat loss during fan use was observed in young (+0.2 kg; 95% CI, -0.2 to 0.6) but not aged (0.0 kg; 95% CI, -0.2 to 0.2) adults. Greater local sweat rate and cutaneous vascular conductance were observed with fan use in aged adults. Other measures of cardiovascular, thermoregulatory, and perceptual responses were unaffected by fan use in both groups. CONCLUSIONS During extreme heat and humidity, fan use elevates physiological strain in aged, but not young, adults.
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Affiliation(s)
- Daniel Gagnon
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center, Dallas, TX; 2Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute Research Centre, Montréal, QC, CANADA; 3Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC, CANADA; 4Wakayama Medical University, Wakayama, JAPAN; and 5Faculty of Health Sciences, University of Sydney, Lidcombe, AUSTRALIA
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Perčič S, Kukec A, Cegnar T, Hojs A. Number of Heat Wave Deaths by Diagnosis, Sex, Age Groups, and Area, in Slovenia, 2015 vs. 2003. Int J Environ Res Public Health 2018; 15:ijerph15010173. [PMID: 29361792 PMCID: PMC5800272 DOI: 10.3390/ijerph15010173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/05/2018] [Accepted: 01/18/2018] [Indexed: 12/20/2022]
Abstract
Background: Number of deaths increases during periods of elevated heat. Objectives: To examine whether differences in heat-related deaths between 2003 and 2015 occurred in Slovenia. Materials and Methods: We estimated relative risks for deaths for the observed diagnoses, sex, age, and area, as well as 95% confidence intervals and excess deaths associated with heat waves occurring in 2015 and 2003. For comparison between 2015 and 2003, we calculated relative risks ratio and 95% confidence intervals. Results: Statistically significant in 2015 were the following: age group 75+, all causes of deaths (RR = 1.10, 95% CI 1.00–1.22); all population, circulatory system diseases (RR = 1.14, 95% CI 1.01–1.30) and age group 75+, diseases of circulatory system (RR = 1.17, 95% CI 1.01–1.34). Statistically significant in 2003 were the following: female, age group 5–74, circulatory system diseases (RR = 1.69, 95% CI 1.08–2.62). Discussion: Comparison between 2015 and 2003, all, circulatory system diseases (RRR = 1.25, 95% CI 1.01–1.55); male, circulatory system diseases (RRR = 1.85, 95% CI 1.41–2.43); all, age group 75+ circulatory system diseases (RRR = 1.34, 95% CI 1.07–1.69); male, age group 75+, circulatory system diseases (RRR = 1.52, 95% CI 1.03–2.25) and female, age group 75+, circulatory system diseases (RRR = 1.43, 95% CI 1.08–1.89). Conclusions: Public health efforts are urgent and should address circulatory system causes and old age groups.
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Affiliation(s)
- Simona Perčič
- Centre for Environmental Health, National Institute of Public Health Slovenia, Zaloška 29, 1000 Ljubljana, Slovenia.
| | - Andreja Kukec
- Department for Public Health, Medical Faculty, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
| | - Tanja Cegnar
- Slovenian Environment Agency, Vojkova cesta 1b, 1000 Ljubljana, Slovenia.
| | - Ana Hojs
- Centre for Environmental Health, National Institute of Public Health Slovenia, Zaloška 29, 1000 Ljubljana, Slovenia.
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Schmeltz MT, Gamble JL. Risk characterization of hospitalizations for mental illness and/or behavioral disorders with concurrent heat-related illness. PLoS One 2017; 12:e0186509. [PMID: 29036206 DOI: 10.1371/journal.pone.0186509] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 10/03/2017] [Indexed: 01/23/2023] Open
Abstract
Background Many studies have found significant associations between high ambient temperatures and increases in heat-related morbidity and mortality. Several studies have demonstrated that increases in heat-related hospitalizations are elevated among individuals with diagnosed mental illnesses and/or behavioral disorders (MBD). However, there are a limited number of studies regarding risk factors associated with specific mental illnesses that contribute, at least in part, to heat-related illnesses (HRI) in the United States. Objective To identify and characterize individual and environmental risk factors associated with MBD hospitalizations with a concurrent HRI diagnosis. Methods This study uses hospitalization data from the Nationwide Inpatient Sample (2001–2010). Descriptive analyses of primary and secondary diagnoses of MBDs with an HRI were examined. Risk ratios (RR) were calculated from multivariable models to identify risk factors for hospitalizations among patients with mental illnesses and/or behavioral disorders and HRI. Results Nondependent alcohol/drug abuse, dementia, and schizophrenia were among the disorders that were associated with increased frequency of HRI hospitalizations among MBD patients. Increased risk of MBD hospitalizations with HRI was observed for Males (RR, 3.06), African Americans (RR, 1.16), Native Americans (RR, 1.70), uninsured (RR, 1.92), and those 40 years and older, compared to MBD hospitalizations alone. Conclusions Previous studies outside the U.S. have found that dementia and schizophrenia are significant risk factors for HRI hospitalizations. Our results suggest that hospitalizations among substance abusers may also be an important risk factor associated with heat morbidity. Improved understanding of these relative risks could help inform future public health strategies.
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Rocha LA, Fromknecht CQ, Redman SD, Brady JE, Hodge SE, Noe RS. Medicolegal Death Scene Investigations After Natural Disaster- and Weather-Related Events: A Review of the Literature. Acad Forensic Pathol 2017; 7:221-239. [PMID: 28845205 PMCID: PMC5568778 DOI: 10.23907/2017.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/15/2017] [Accepted: 04/15/2017] [Indexed: 10/06/2023]
Abstract
BACKGROUND The number of disaster-related deaths recorded by vital statistics departments often differs from that reported by other agencies, including the National Oceanic and Atmospheric Administration-National Weather Service storm database and the American Red Cross. The Centers for Disease Control and Prevention (CDC) has launched an effort to improve disaster-related death scene investigation reporting practices to make data more comparable across jurisdictions, improve accuracy of reporting disaster-related deaths, and enhance identification of risk and protective factors. We conducted a literature review to examine how death scene data are collected and how such data are used to determine disaster relatedness. METHODS Two analysts conducted a parallel search using Google and Google Scholar. We reviewed published peer-reviewed articles and unpublished documents including relevant forms, protocols, and worksheets from coroners, medical examiners, and death scene investigators. RESULTS We identified 177 documents: 32 published peer-reviewed articles and 145 other documents (grey literature). Published articles suggested no consistent approach for attributing deaths to a disaster. Researchers generally depended on death certificates to identify disaster-related deaths; several studies also drew on supplemental sources, including medical examiner, coroner, and active surveillance reports. CONCLUSIONS These results highlight the critical importance of consistent, accurate data collection during a death investigation. Review of the grey literature found variation in use of death scene data collection tools, indicating the potential for widespread inconsistency in data captured for routine reporting and public health surveillance. Findings from this review will be used to develop guidelines and tools for capturing disaster-related death investigation data.
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Affiliation(s)
| | | | | | | | - Sarah E. Hodge
- NORC at the University of Chicago - Public Health Research
| | - Rebecca S. Noe
- Centers for Disease Control and Prevention - National Center for
Environmental Health
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Hu K, Yang X, Zhong J, Fei F, Qi J. Spatially Explicit Mapping of Heat Health Risk Utilizing Environmental and Socioeconomic Data. Environ Sci Technol 2017; 51:1498-1507. [PMID: 28068073 DOI: 10.1021/acs.est.6b04355] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Extreme heat events, a leading cause of weather-related fatality worldwide, are expected to intensify, last longer, and occur more frequently in the near future. In heat health risk assessments, a spatiotemporal mismatch usually exists between hazard (heat stress) data and exposure (population distribution) data. Such mismatch is present because demographic data are generally updated every couple of years and unavailable at the subcensus unit level, which hinders the ability to diagnose human risks. In the present work, a human settlement index based on multisensor remote sensing data, including nighttime light, vegetation index, and digital elevation model data, was used for heat exposure assessment on a per-pixel basis. Moreover, the nighttime urban heat island effect was considered in heat hazard assessment. The heat-related health risk was spatially explicitly assessed and mapped at the 250 m × 250 m pixel level across Zhejiang Province in eastern China. The results showed that the accumulated heat risk estimates and the heat-related deaths were significantly correlated at the county level (Spearman's correlation coefficient = 0.76, P ≤ 0.01). Our analysis introduced a spatially specific methodology for the risk mapping of heat-related health outcomes, which is useful for decision support in preparation and mitigation of heat-related risk and potential adaptation.
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Affiliation(s)
- Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University , Zhoushan 316021, China
| | - Xuchao Yang
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University , Zhoushan 316021, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jiaguo Qi
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University , Zhoushan 316021, China
- Center for Global Change and Earth Observations, Michigan State University , East Lansing, Michigan 48823, United States
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Ho HC, Knudby A, Walker BB, Henderson SB. Delineation of Spatial Variability in the Temperature-Mortality Relationship on Extremely Hot Days in Greater Vancouver, Canada. Environ Health Perspect 2017; 125:66-75. [PMID: 27346526 PMCID: PMC5226699 DOI: 10.1289/ehp224] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 03/03/2016] [Accepted: 05/25/2016] [Indexed: 05/10/2023]
Abstract
BACKGROUND Climate change has increased the frequency and intensity of extremely hot weather. The health risks associated with extemely hot weather are not uniform across affected areas owing to variability in heat exposure and social vulnerability, but these differences are challenging to map with precision. OBJECTIVES We developed a spatially and temporally stratified case-crossover approach for delineation of areas with higher and lower risks of mortality on extremely hot days and applied this approach in greater Vancouver, Canada. METHODS Records of all deaths with an extremely hot day as a case day or a control day were extracted from an administrative vital statistics database spanning the years of 1998-2014. Three heat exposure and 11 social vulnerability variables were assigned at the residential location of each decedent. Conditional logistic regression was used to estimate the odds ratio for a 1°C increase in daily mean temperature at a fixed site with an interaction term for decedents living above and below different values of the spatial variables. RESULTS The heat exposure and social vulnerability variables with the strongest spatially stratified results were the apparent temperature and the labor nonparticipation rate, respectively. Areas at higher risk had values ≥ 34.4°C for the maximum apparent temperature and ≥ 60% of the population neither employed nor looking for work. These variables were combined in a composite index to quantify their interaction and to enhance visualization of high-risk areas. CONCLUSIONS Our methods provide a data-driven framework for spatial delineation of the temperature--mortality relationship by heat exposure and social vulnerability. The results can be used to map and target the most vulnerable areas for public health intervention. Citation: Ho HC, Knudby A, Walker BB, Henderson SB. 2017. Delineation of spatial variability in the temperature-mortality relationship on extremely hot days in greater Vancouver, Canada. Environ Health Perspect 125:66-75; http://dx.doi.org/10.1289/EHP224.
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Affiliation(s)
- Hung Chak Ho
- Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada
- Institute of Environment, Energy and Sustainability, Chinese University of Hong Kong, Hong Kong
- Address correspondence to H.C. Ho, Institute of Environment, Energy and Sustainability, Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. Telephone: (852) 39435398. , or S.B. Henderson, Environmental Health Services, British Columbia Centre for Disease Control, 655 West 12th Ave., Vancouver, BC V5Z 4R4 Canada. Telephone: 604-707-2449.
| | - Anders Knudby
- Department of Geography, University of Ottawa, Ontario, Canada
| | - Blake Byron Walker
- Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sarah B. Henderson
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Address correspondence to H.C. Ho, Institute of Environment, Energy and Sustainability, Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. Telephone: (852) 39435398. , or S.B. Henderson, Environmental Health Services, British Columbia Centre for Disease Control, 655 West 12th Ave., Vancouver, BC V5Z 4R4 Canada. Telephone: 604-707-2449.
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Ding N, Berry HL, Bennett CM. The Importance of Humidity in the Relationship between Heat and Population Mental Health: Evidence from Australia. PLoS One 2016; 11:e0164190. [PMID: 27727320 PMCID: PMC5058549 DOI: 10.1371/journal.pone.0164190] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 09/21/2016] [Indexed: 01/08/2023] Open
Abstract
Despite many studies on the effects of heat on mental health, few studies have examined humidity. In order to investigate the relationship among heat, humidity and mental health, we matched data from the Social, Economic and Environmental Factors (SEEF) project with gridded daily temperature and water vapour pressure data from the Australian Bureau of Meteorology. Logit models were employed to describe the associations among heat (assessed using temperature, °C), humidity (assessed using vapour pressure, hPa) and two measures of mental health, (i) high or very high distress (assessed using K10 scores ≥ 22) and (ii) having been treated for depression or anxiety. We found a one-unit increase in temperature and vapour pressure was associated with an increase in the occurrence of high or very high distress by 0.2% (p < 0.001, 99% CI: 0.1–0.3%) and 0.1% (p < 0.001, 99% CI: 0.0–0.3%) respectively. However, when humidity rose to the 99th percentile of the sample, the estimated marginal effect of heat was more than doubled (0.5%, p < 0.001, 99% CI: 0.2–0.7%). Neither heat nor humidity was related to having been treated for depression or anxiety in the last month. Humidity compounds the negative association between hot weather and mental health and thus should be taken into account when reforming the health care system to respond to the challenge of climate change.
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Affiliation(s)
- Ning Ding
- Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China
- * E-mail:
| | - Helen L. Berry
- ANU Climate Change Institute, The Australian National University, Acton, Australia
| | - Charmian M. Bennett
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, Australia
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Misslin R, Telle O, Daudé E, Vaguet A, Paul RE. Urban climate versus global climate change-what makes the difference for dengue? Ann N Y Acad Sci 2016; 1382:56-72. [PMID: 27197685 DOI: 10.1111/nyas.13084] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 03/18/2016] [Accepted: 04/07/2016] [Indexed: 12/18/2022]
Abstract
The expansion in the geographical distribution of vector-borne diseases is a much emphasized consequence of climate change, as are the consequences of urbanization for diseases that are already endemic, which may be even more important for public health. In this paper, we focus on dengue, the most widespread urban vector-borne disease. Largely urban with a tropical/subtropical distribution and vectored by a domesticated mosquito, Aedes aegypti, dengue poses a serious public health threat. Temperature plays a determinant role in dengue epidemic potential, affecting crucial parts of the mosquito and viral life cycles. The urban predilection of the mosquito species will further exacerbate the impact of global temperature change because of the urban heat island effect. Even within a city, temperatures can vary by 10 °C according to urban land use, and diurnal temperature range (DTR) can be even greater. DTR has been shown to contribute significantly to dengue epidemic potential. Unraveling the importance of within-city temperature is as important for dengue as for the negative health consequences of high temperatures that have thus far been emphasized, for example, pollution and heat stroke. Urban and landscape planning designed to mitigate the non-infectious negative effects of temperature should additionally focus on dengue, which is currently spreading worldwide with no signs of respite.
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Affiliation(s)
- Renaud Misslin
- Centre National de la Recherche Scientifique, UMR 6266 IDEES, Rouen, France
| | - Olivier Telle
- Centre des Sciences Humaines, UMIFRE 20 CNRS-MAE, Delhi, India.,Centre National de la Recherche Scientifique, UMR 8504 Geographie-cités, Paris, France
| | - Eric Daudé
- Centre des Sciences Humaines, UMIFRE 20 CNRS-MAE, Delhi, India
| | - Alain Vaguet
- Centre National de la Recherche Scientifique, UMR 6266 IDEES, Rouen, France
| | - Richard E Paul
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, Paris, France.,Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, Paris, France
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Abstract
This review provides an in-depth update on the impact of heat stress on cerebrovascular functioning. The regulation of cerebral temperature, blood flow, and metabolism are discussed. We further provide an overview of vascular permeability, the neurocognitive changes, and the key clinical implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced peripheral resistance secondary to skin vasodilatation. Therefore, when hyperthermia is combined with conditions that increase cardiovascular strain, for example, orthostasis or dehydration, the inability to preserve cerebral perfusion pressure further reduces CBF. A reduced cerebral perfusion pressure is in turn the primary mechanism for impaired tolerance to orthostatic challenges. Any reduction in CBF attenuates the brain's convective heat loss, while the hyperthermic-induced increase in metabolic rate increases the cerebral heat gain. This paradoxical uncoupling of CBF to metabolism increases brain temperature, and potentiates a condition whereby cerebral oxygenation may be compromised. With levels of experimentally viable passive hyperthermia (up to 39.5-40.0 °C core temperature), the associated reduction in CBF (∼ 30%) and increase in cerebral metabolic demand (∼ 10%) is likely compensated by increases in cerebral oxygen extraction. However, severe increases in whole-body and brain temperature may increase blood-brain barrier permeability, potentially leading to cerebral vasogenic edema. The cerebrovascular challenges associated with hyperthermia are of paramount importance for populations with compromised thermoregulatory control--for example, spinal cord injury, elderly, and those with preexisting cardiovascular diseases.
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Affiliation(s)
- Anthony R Bain
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
| | - Lars Nybo
- Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Philip N Ainslie
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
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Christenson M, Geiger SD, Phillips J, Anderson B, Losurdo G, Anderson HA. Heat Vulnerability Index Mapping for Milwaukee and Wisconsin. J Public Health Manag Pract 2017; 23:396-403. [PMID: 26910864 DOI: 10.1097/PHH.0000000000000352] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Extreme heat waves elevate the population's risk for heat-related morbidity and mortality, specifically for vulnerable groups such as older adults and young children. In this context, we developed 2 Heat Vulnerability Indices (HVIs), one for the state of Wisconsin and one for the Milwaukee metropolitan area. OBJECTIVE Through the creation of an HVI, state and local agencies will be able to use the indices as a planning tool for extreme heat events. DESIGN Data used for the HVIs were grouped into 4 categories: (1) population density; (2) health factors; (3) demographic and socioeconomic factors; and (4) natural and built environment factors. These categories were mapped at the Census block group level. MAIN OUTCOME MEASURES Unweighted z-score data were used to determine index scores, which were then mapped by quantiles ranging from "high" to "low" vulnerability. RESULTS Statewide, Menominee County exhibited the highest vulnerability to extreme heat. Milwaukee HVI findings indicated high vulnerability in the city's inner core versus low vulnerability along the lakeshore. CONCLUSION Visualization of vulnerability could help local public health agencies prepare for future extreme heat events.
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Ho HC, Knudby A, Xu Y, Hodul M, Aminipouri M. A comparison of urban heat islands mapped using skin temperature, air temperature, and apparent temperature (Humidex), for the greater Vancouver area. Sci Total Environ 2016; 544:929-38. [PMID: 26706765 DOI: 10.1016/j.scitotenv.2015.12.021] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 12/01/2015] [Accepted: 12/04/2015] [Indexed: 05/11/2023]
Abstract
Apparent temperature is more closely related to mortality during extreme heat events than other temperature variables, yet spatial epidemiology studies typically use skin temperature (also known as land surface temperature) to quantify heat exposure because it is relatively easy to map from satellite data. An empirical approach to map apparent temperature at the neighborhood scale, which relies on publicly available weather station observations and spatial data layers combined in a random forest regression model, was demonstrated for greater Vancouver, Canada. Model errors were acceptable (cross-validated RMSE=2.04 °C) and the resulting map of apparent temperature, calibrated for a typical hot summer day, corresponded well with past temperature research in the area. A comparison with field measurements as well as similar maps of skin temperature and air temperature revealed that skin temperature was poorly correlated with both air temperature (R(2)=0.38) and apparent temperature (R(2)=0.39). While the latter two were more similar (R(2)=0.87), apparent temperature was predicted to exceed air temperature by more than 5 °C in several urban areas as well as around the confluence of the Pitt and Fraser rivers. We conclude that skin temperature is not a suitable proxy for human heat exposure, and that spatial epidemiology studies could benefit from mapping apparent temperature, using an approach similar to the one reported here, to better quantify differences in heat exposure that exist across an urban landscape.
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Affiliation(s)
- Hung Chak Ho
- Department of Geography, Simon Fraser University, Burnaby, BC, Canada.
| | - Anders Knudby
- Department of Geography, University of Ottawa, Ottawa, ON, Canada
| | - Yongming Xu
- School of Geography and Remote Sensing, Nanjing University of Information Science & Technology, Nanjing, China
| | - Matus Hodul
- Department of Geography, Simon Fraser University, Burnaby, BC, Canada
| | - Mehdi Aminipouri
- Department of Geography, Simon Fraser University, Burnaby, BC, Canada
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Abstract
BACKGROUND Tibet is especially vulnerable to climate change due to the relatively rapid rise of temperature over past decades. The effects on mortality and morbidity of extreme heat in Tibet have been examined in previous studies; no heat adaptation initiatives have yet been implemented. We estimated heat vulnerability of urban and rural populations in 73 Tibetan counties and identified potential areas for public health intervention and further research. METHODS According to data availability and vulnerability factors identified previously in Tibet and elsewhere, we selected 10 variables related to advanced age, low income, illiteracy, physical and mental disability, small living spaces and living alone. We separately created and mapped county-level cumulative heat vulnerability indices for urban and rural residents by summing up factor scores produced by a principal components analysis (PCA). RESULTS For both study populations, PCA yielded four factors with similar structure. The components for rural and urban residents explained 76.5 % and 77.7 % respectively of the variability in the original vulnerability variables. We found spatial variability of heat vulnerability across counties, with generally higher vulnerability in high-altitude counties. Although we observed similar median values and ranges of the cumulative heat vulnerability index values among urban and rural residents overall, the pattern varied strongly from one county to another. CONCLUSIONS We have developed a measure of population vulnerability to high temperatures in Tibet. These are preliminary findings, but they may assist targeted adaptation plans in response to future rapid warming in Tibet.
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Affiliation(s)
- Li Bai
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, P. R. China.
| | - Alistair Woodward
- School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, P. R. China.
- Shandong University Climate Change and Health Center, 44 WenHua Road, Jinan, 250012, Shangdong, P. R. China.
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Isaksen TB, Fenske RA, Hom EK, Ren Y, Lyons H, Yost MG. Increased mortality associated with extreme-heat exposure in King County, Washington, 1980-2010. Int J Biometeorol 2016; 60:85-98. [PMID: 25956805 PMCID: PMC4845914 DOI: 10.1007/s00484-015-1007-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 04/21/2015] [Accepted: 04/28/2015] [Indexed: 05/23/2023]
Abstract
Extreme heat has been associated with increased mortality, particularly in temperate climates. Few epidemiologic studies have considered the Pacific Northwest region in their analyses. This study quantified the historical (May to September, 1980-2010) heat-mortality relationship in the most populous Pacific Northwest County, King County, Washington. A relative risk (RR) analysis was used to explore the relationship between heat and all-cause mortality on 99th percentile heat days, while a time series analysis, using a piece-wise linear model fit, was used to estimate the effect of heat intensity on mortality, adjusted for temporal trends. For all ages, all causes, we found a 10% (1.10 (95% confidence interval (CI), 1.06, 1.14)) increase in the risk of death on a heat day versus non-heat day. When considering the intensity effect of heat on all-cause mortality, we found a 1.69% (95% CI, 0.69, 2.70) increase in the risk of death per unit of humidex above 36.0°C. Mortality stratified by cause and age produced statistically significant results using both types of analyses for: all-cause, non-traumatic, circulatory, cardiovascular, cerebrovascular, and diabetes causes of death. All-cause mortality was statistically significantly modified by the type of synoptic weather type. These results demonstrate that heat, expressed as humidex, is associated with increased mortality on heat days, and that risk increases with heat's intensity. While age was the only individual-level characteristic found to modify mortality risks, statistically significant increases in diabetes-related mortality for the 45-64 age group suggests that underlying health status may contribute to these risks.
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Affiliation(s)
- Tania Busch Isaksen
- Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234, Seattle, WA, 98195, USA.
| | - Richard A Fenske
- Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234, Seattle, WA, 98195, USA
| | - Elizabeth K Hom
- Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234, Seattle, WA, 98195, USA
- Department of Epidemiology, University of Washington, Box 357234, Seattle, WA, 98195, USA
| | - You Ren
- Department of Statistics, University of Washington, Box 357234, Seattle, WA, 98195, USA
| | - Hilary Lyons
- Department of Statistics, University of Washington, Box 357234, Seattle, WA, 98195, USA
| | - Michael G Yost
- Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234, Seattle, WA, 98195, USA
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Takahashi N, Nakao R, Ueda K, Ono M, Kondo M, Honda Y, Hashizume M. Community trial on heat related-illness prevention behaviors and knowledge for the elderly. Int J Environ Res Public Health 2015; 12:3188-214. [PMID: 25789456 PMCID: PMC4377959 DOI: 10.3390/ijerph120303188] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 11/27/2022]
Abstract
This study aims to explore whether broadcasting heat health warnings (HHWs), to every household and whether the additional home delivery of bottled water labeled with messages will be effective in improving the behaviors and knowledge of elderly people to prevent heat-related illness. A community trial on heat-related-illness-prevention behaviors and knowledge for people aged between 65 and 84 years was conducted in Nagasaki, Japan. Five hundred eight subjects were selected randomly from three groups: heat health warning (HHW), HHW and water delivery (HHW+W), and control groups. Baseline and follow-up questionnaires were conducted in June and September 2012, respectively. Of the 1524 selected subjects, the 1072 that completed both questionnaires were analyzed. The HHW+W group showed improvements in nighttime AC use (p = 0.047), water intake (p = 0.003), cooling body (p = 0.002) and reduced activities in heat (p = 0.047) compared with the control, while the HHW group improved hat or parasol use (p = 0.008). An additional effect of household water delivery was observed in water intake (p = 0.067) and cooling body (p = 0.095) behaviors. HHW and household bottled water delivery improved heat-related-illness-prevention behaviors. The results indicate that home water delivery in addition to a HHW may be needed to raise awareness of the elderly.
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Affiliation(s)
- Noriko Takahashi
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
- National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo 157-8535, Japan.
| | - Rieko Nakao
- Department of Nursing, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan.
| | - Kayo Ueda
- The National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Masaji Ono
- The National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Masahide Kondo
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Masahiro Hashizume
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
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Culqui DR, Diaz J, Simón F, Tobías A, Linares C. Evaluation of the plan for surveillance and controlling of the effects of heat waves in Madrid. Int J Biometeorol 2014; 58:1799-802. [PMID: 24077674 DOI: 10.1007/s00484-013-0731-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/28/2013] [Accepted: 08/30/2013] [Indexed: 05/08/2023]
Abstract
This paper presents evaluation of a plan for surveillance of and controlling the effects of heat-related mortality (PSCEHW), implemented in Madrid in 2004 through a time series analysis conducted with ARIMA modeling. From the public health point of view, prevention plans should be implemented as adaptive measures to heat waves. In 2003, the impact attributable to the heat wave was an increase in mortality per °C of 22.39 %. All heat waves since 2003 have been of lower intensity, and yet, in 2005 there was a heat wave of lower intensity that had a greater impact, i.e. an increase in mortality per °C of 45.71 %. With the methodology used here, we cannot say whether implementation of PSCEHW has resulted in a decrease of mortality attributable to high temperatures in the city of Madrid.
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Affiliation(s)
- Dante R Culqui
- Epidemiology Program Field, Epidemiology National Center, Carlos III Health Institute, Madrid, Spain,
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32
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Abstract
Adaptation to increasing extreme heat in a changing climate requires a precise understanding of who is most vulnerable to the health effects of extreme heat. The evidence for race, ethnicity, income, education and occupation, at the individual and area levels, as indicators of vulnerability is reviewed. The evidence for the social, behavioral and technological mechanisms by which racial and socioeconomic disparities in vulnerability exist is also reviewed. These characteristics include cardiorespiratory, renal and endocrine comorbidities; cognitive, mental or physical disabilities; medication use; housing characteristics; neighborhood characteristics such as urban heat islands, crime and safety; social isolation; and individual behaviors such as air conditioning use, opening windows and using fans and use of cooler public spaces. Pre-existing and future research identifying these more proximal indicators of vulnerability will provide information that is more generalizable across locations and time to aid in identifying who to target for prevention of heat-associated morbidity and mortality.
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Affiliation(s)
- Carina J Gronlund
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, 734-615-9215
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Herbst J, Mason K, Byard RW, Gilbert JD, Charlwood C, Heath KJ, Winskog C, Langlois NE. Heat-related deaths in Adelaide, South Australia: Review of the literature and case findings – An Australian perspective. J Forensic Leg Med 2014; 22:73-8. [DOI: 10.1016/j.jflm.2013.12.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 10/31/2013] [Accepted: 12/07/2013] [Indexed: 11/30/2022]
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Wang X, Lavigne E, Ouellette-kuntz H, Chen BE. Acute impacts of extreme temperature exposure on emergency room admissions related to mental and behavior disorders in Toronto, Canada. J Affect Disord 2014; 155:154-61. [PMID: 24332428 DOI: 10.1016/j.jad.2013.10.042] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 10/22/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to assess the effects of extreme ambient temperature on hospital emergency room visits (ER) related to mental and behavioral illnesses in Toronto, Canada. METHODS A time series study was conducted using health and climatic data from 2002 to 2010 in Toronto, Canada. Relative risks (RRs) for increases in emergency room (ER) visits were estimated for specific mental and behavioral diseases (MBD) after exposure to hot and cold temperatures while using the 50th percentile of the daily mean temperature as reference. Poisson regression models using a distributed lag non-linear model (DLNM) were used. We adjusted for the effects of seasonality, humidity, day-of-the-week and outdoor air pollutants. RESULTS We found a strong association between MBD ER visits and mean daily temperature at 28°C. The association was strongest within a period of 0-4 days for exposure to hot temperatures. A 29% (RR=1.29, 95% CI 1.09-1.53) increase in MBD ER vists was observed over a cumulative period of 7 days after exposure to high ambient temperature (99th percentile vs. 50th percentile). Similar associations were reported for schizophrenia, mood, and neurotic disorers. No significant associations with cold temperatures were reported. LIMITATIONS The ecological nature and the fact that only one city was investigated. CONCLUSIONS Our findings suggest that extreme temperature poses a risk to the health and wellbeing for individuals with mental and behavior illnesses. Patient management and education may need to be improved as extreme temperatures may become more prevalent with climate change.
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Affiliation(s)
- Xiang Wang
- Public Health Agency of Canada, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Environmental Issues Division, Canada; Faculty of Medicine, Department of Community Health and Epidemiology, Queen's University, Canada.
| | - Eric Lavigne
- Public Health Agency of Canada, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Environmental Issues Division, Canada.
| | - Hélène Ouellette-kuntz
- Faculty of Medicine, Department of Community Health and Epidemiology, Queen's University, Canada; Department of Psychiatry, Queen's University, Canada.
| | - Bingshu E Chen
- Faculty of Medicine, Department of Community Health and Epidemiology, Queen's University, Canada.
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35
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Abstract
BACKGROUND Extremes of temperature have been associated with short-term increases in daily mortality. We identified subpopulations with increased susceptibility to dying during temperature extremes, based on personal demographics, small-area characteristics, and preexisting medical conditions. METHODS We examined Medicare participants in 135 US cities and identified preexisting conditions based on hospitalization records before their deaths, from 1985 to 2006. Personal characteristics were obtained from the Medicare records, and area characteristics were assigned based on zip code of residence. We conducted a case-only analysis of over 11 million deaths and evaluated modification of the risk of dying associated with extremely hot days and extremely cold days, continuous temperatures, and water vapor pressure. Modifiers included preexisting conditions, personal characteristics, zip code-level population characteristics, and land cover characteristics. For each effect modifier, a city-specific logistic regression model was fitted and then an overall national estimate was calculated using meta-analysis. RESULTS People with certain preexisting conditions were more susceptible to extreme heat, with an additional 6% (95% confidence interval = 4%-8%) increase in the risk of dying on an extremely hot day in subjects with previous admission for atrial fibrillation, an additional 8% (4%-12%) in subjects with Alzheimer disease, and an additional 6% (3%-9%) in subjects with dementia. Zip code level and personal characteristics were also associated with increased susceptibility to temperature. CONCLUSIONS We identified several subgroups of the population who are particularly susceptible to temperature extremes, including persons with atrial fibrillation.
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Affiliation(s)
- Antonella Zanobetti
- Harvard School of Public Health, Department of Environmental Health, Boston, MA, USA
| | - Marie S. O’Neill
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI
| | - Carina J. Gronlund
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI
| | - Joel D Schwartz
- Harvard School of Public Health, Department of Environmental Health, Boston, MA, USA
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Kravchenko J, Abernethy AP, Fawzy M, Lyerly HK. Minimization of heatwave morbidity and mortality. Am J Prev Med 2013; 44:274-82. [PMID: 23415125 DOI: 10.1016/j.amepre.2012.11.015] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 09/07/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
Abstract
Global climate change is projected to increase the frequency and duration of periods of extremely high temperatures. Both the general populace and public health authorities often underestimate the impact of high temperatures on human health. To highlight the vulnerable populations and illustrate approaches to minimization of health impacts of extreme heat, the authors reviewed the studies of heat-related morbidity and mortality for high-risk populations in the U.S. and Europe from 1958 to 2012. Heat exposure not only can cause heat exhaustion and heat stroke but also can exacerbate a wide range of medical conditions. Vulnerable populations, such as older adults; children; outdoor laborers; some racial and ethnic subgroups (particularly those with low SES); people with chronic diseases; and those who are socially or geographically isolated, have increased morbidity and mortality during extreme heat. In addition to ambient temperature, heat-related health hazards are exacerbated by air pollution, high humidity, and lack of air-conditioning. Consequently, a comprehensive approach to minimize the health effects of extreme heat is required and must address educating the public of the risks and optimizing heatwave response plans, which include improving access to environmentally controlled public havens, adaptation of social services to address the challenges required during extreme heat, and consistent monitoring of morbidity and mortality during periods of extreme temperatures.
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Affiliation(s)
- Julia Kravchenko
- Duke Clinical Research Institute, Duke University Medical Center, Duke University, Durham, NC 27710, USA.
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Price K, Perron S, King N. Implementation of the Montreal heat response plan during the 2010 heat wave. Can J Public Health 2013; 104:e96-100. [PMID: 23618220 [PMID: 23618220 DOI: 10.1007/bf03405667] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The objective of this paper is to describe Montreal's heat response plan and its application during the July 2010 heat wave. PARTICIPANTS AND SETTING The Montreal heat response plan is designed to ensure the surveillance of weather and health indicators during the summer season and to coordinate actions to be undertaken during this period to reduce morbidity and mortality due to heat, particularly when weather thresholds are reached or an increase in health indicators is observed. It was developed to coordinate and apply intervention measures on the Island of Montreal and has been in effect since 2004. INTERVENTION In the beginning of July 2010, Montreal experienced a heat wave that lasted 5 days. During this period, health indicators such as total mortality, prehospital emergency transports, calls to the health information line and hospital admissions were monitored by the Montreal public health surveillance system. The decision to implement emergency interventions and actions performed by regional and local public health and municipal partners (intervention level) was made following attainment of a predetermined weather threshold and increases in health indicators. The significant increase in daily observed mortality from all causes and in particular people dying at home or in the community prompted the Director of public health to conduct a chart review of all people deceased from July 5 to July 11, 2010 to determine cause of death and underlying health conditions. OUTCOME During the heat wave, there were 304 reported deaths from all causes in Montreal residents, of which 106 were probably or possibly heat-related. Major underlying health conditions in heat-related deaths included cardiovascular problems and mental health illness. Furthermore, in the case of people with mental illness who died during the heat wave, the chart review revealed that many were contacted 24 hours prior to their death by health care professionals, family members, neighbours or friends. CONCLUSION Following the 2010 heat wave, the Montreal heat response plan and heat surveillance system were updated to include initiatives to better communicate preventive measures to the vulnerable populations and to intervene earlier during a heat wave.
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Sung TI, Chen MJ, Su HJ. A positive relationship between ambient temperature and bipolar disorder identified using a national cohort of psychiatric inpatients. Soc Psychiatry Psychiatr Epidemiol 2013; 48:295-302. [PMID: 22763494 DOI: 10.1007/s00127-012-0542-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 06/15/2012] [Indexed: 01/14/2023]
Abstract
OBJECTIVE This study characterizes the positive relationship between daily temperature and bipolar disorder in a cohort of Taiwanese psychiatric inpatients. METHODS Meteorological data, provided by the Central Weather Bureau (CWB) of Taiwan, were interpolated to create representative estimates of mean diurnal temperatures for 352 townships. Psychiatric inpatient admissions enrolled in the national health-care insurance system were retrieved from the 1996-2007 Psychiatric Inpatient Medical Claim (PIMC) dataset. The generalized linear mixed models with Poisson distribution were used to evaluate the relative risks of mean diurnal temperature with respect to increased admissions for bipolar disorder, while adjusting for internal correlations and demographic covariates. RESULTS Increased relative risks of bipolar disorder admissions were associated with the increasing trends of temperature over 24.0 °C (50th ‰), especially for adults and females. The highest daily diurnal temperatures above 30.7 °C (99th ‰) had the greatest risks of bipolar hospitalizations. CONCLUSION Understanding the increase of bipolar disorder admissions occurring in extreme heat is important in the preparation and prevention of massive recurrences of bipolar episodes.
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Affiliation(s)
- Tzu-I Sung
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Rd, Tainan 704, Taiwan
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Abstract
This review is intended to alert health professionals to the particular vulnerability of persons with mental health problems or taking certain medications to heat-related illness, a threat that is increasing due to climate change. It reviews epidemiology, physiology and clinical features of heat-related illness. For acute medical management, it refers readers to existing guidelines and recommendations. It reviews risk and protective factors. Finally, it presents preventive strategies that may help reduce the impact of heat-related illness in this population.
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Affiliation(s)
- Stephen Vida
- Département de psychiatrie, Centre universitaire de santé McGill, Institut national de santé publique du Quéebec, 2010-2011
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40
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Buscail C, Upegui E, Viel JF. Mapping heatwave health risk at the community level for public health action. Int J Health Geogr 2012; 11:38. [PMID: 22974194 PMCID: PMC3517403 DOI: 10.1186/1476-072x-11-38] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 09/10/2012] [Indexed: 11/28/2022] Open
Abstract
Background Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. Results The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution) acquired during a localized heatwave (June 2001) was used to estimate land surface temperature (LST) and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence). Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R2 = 0.87) and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions) were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000) yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north–south central band. Another sensitivity analysis gave a very high correlation between 2000 and 2001 risk indices (r = 0.98, p < 10-12). Conclusions Building on previous work, we developed a reproducible method that can provide guidance for local planners in developing more efficient climate impact adaptations. We recommend, however, using the health risk index together with hazard and vulnerability indices to implement tailored programs because exposure to heat and vulnerability do not require the same prevention strategies.
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Affiliation(s)
- Camille Buscail
- Department of Epidemiology and Public Health, University Hospital, Rennes, France
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Abstract
BACKGROUND Heatwaves are hot weather events, which breach regional or national thresholds, that last for several days. They are likely to occur with increasing frequency in some parts of the world. The potential consequences were illustrated in Europe in August 2003 when there were an estimated 30,000 excess deaths due to a heatwave. Electric fans might be used with the intention of reducing the adverse health effects of a heatwave. Fans do not cool the ambient air but can be used to draw in cooler air from outside when placed at an open window. The aim of the fans would be to increase heat loss by increasing the efficiency of all normal methods of heat loss, but particularly by evaporation and convection methods. However, it should be noted that increased sweating can lead to dehydration and electrolyte imbalances if these fluids and electrolytes are not replaced quickly enough. Research has also identified important gaps in knowledge about the use of fans, which might lead to their inappropriate use. OBJECTIVES To determine whether the use of electric fans contributes to, or impedes, heat loss at high ambient temperatures during a heatwave, and to contribute to the evidence base for the public health impacts of heatwaves. SEARCH METHODS We sought unpublished and published studies that had been published in any language. The review team were able to assess studies reported in English, Chinese, Dutch, French and German; and reports in other languages would have been translated into English as necessary. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, the Indian biomedical literature (IndMED and MedIND) and databases of Chinese literature (Chinese Journal Net and Digital Periodical of WanFang Data). The most recent electronic searches were done in April 2012. We also checked the reference lists of relevant articles and the websites of relevant national and international organisations, and consulted with researchers and policy makers with experience in strategies to manage heatwaves to identify additional studies. The titles and abstracts from each search were checked independently by two review authors. The full text articles that we retrieved were checked independently by at least two authors for their relevance and for references to potentially eligible studies. SELECTION CRITERIA Randomised trials and other experimental designs, such as interrupted time series and controlled before-and-after studies, comparing the use of electric fans with no fans during a heatwave were eligible for this review. The electric fans could be hand-held (battery operated), portable or mounted on the wall or ceiling, or in a window. We sought interventions delivered to anyone for whom a heatwave was likely to have serious adverse health impacts. This would include people of all ages but with a particular focus on some groups (for example older people). Populations from high-, middle- and low-income countries were eligible for the review. DATA COLLECTION AND ANALYSIS If we had identified eligible studies, they would have been assessed independently by at least two review authors and data would have been extracted on the characteristics of the study, its participants and interventions, as well as the effects on health outcomes. The primary outcomes were mortality, hospital admission and other contacts with healthcare services. MAIN RESULTS We did not identify any eligible studies despite the extensive searching and correspondence with several experts in this topic area. We identified retrospective, observational studies, usually with a case-control design, that investigated the association between the use of electric fans and health outcomes, including death. The results of these studies were mixed. Some studies found that the use of fans was associated with better health outcomes, others found the reverse. AUTHORS' CONCLUSIONS The evidence we identified does not resolve uncertainties about the health effects of electric fans during heatwaves. Therefore, this review does not support or refute the use of electric fans during a heatwave. People making decisions about electric fans should consider the current state of the evidence base, and they might also wish to make themselves aware of local policy or guidelines when making a choice about whether or not to use or supply electric fans. The main implication of this review is that high quality research is needed to resolve the long standing and ongoing uncertainty about the benefits and harms of using electric fans during a heatwave, for example randomised trials comparing the health effects in people with electric fans to those in people without them.
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Affiliation(s)
- Saurabh Gupta
- Ambition Health Private LimitedPublic Health, Epidemiology and Biostatistics120, Good Earth City CentreSector 50GurgaonIndia122018
| | - Catriona Carmichael
- Centre for Radiation, Chemicals and Environmental HazardsExtreme Events and Health Protection SectionHealth Protection Agency151 Buckingham Palace RoadLondonUKSW1W 9SZ
| | - Christina Simpson
- Health CanadaClimate Change and Health Office269 Laurier Ave. WRoom 9‐077OttawaONCanadaK1A 0K9
| | - Mike J Clarke
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences, Block B, Royal Victoria HospitalGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Claire Allen
- Evidence Aid1st Floor, Gibson Building (c/o CEBM)Radcliffe Observatory QuarterOxfordUKOX2 6GG
| | - Yang Gao
- Hong Kong Baptist UniversityDepartment of Physical EducationKowloonHong Kong
| | - Emily Y Y Chan
- The Chinese University of Hong KongCERT‐CUHK‐Oxford University Centre for Disaster and Medical Humanitarian ResponseCERT‐CUHK‐Oxford UniversitySchool of Public Health and Primary CareShatinNew TerritoriesHong Kong
| | - Virginia Murray
- Centre for Radiation, Chemicals and Environmental HazardsExtreme Events and Health Protection SectionHealth Protection Agency151 Buckingham Palace RoadLondonUKSW1W 9SZ
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Palmiere C, Mangin P. Hyperthermia and postmortem biochemical investigations. Int J Legal Med 2012; 127:93-102. [DOI: 10.1007/s00414-012-0722-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/24/2012] [Indexed: 12/22/2022]
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Abstract
BACKGROUND Climate change is expected to have significant effects on human health, partly through an increase in extreme events such as heatwaves. People with mental illness may be at particular risk. AIMS To estimate risk conferred by high ambient temperature on patients with psychosis, dementia and substance misuse. METHOD We applied time-series regression analysis to data from a nationally representative primary care cohort study. Relative risk of death per 1°C increase in temperature was calculated above a threshold. RESULTS Patients with mental illness showed an overall increase in risk of death of 4.9% (95% CI 2.0-7.8) per 1°C increase in temperature above the 93rd percentile of the annual temperature distribution. Younger patients and those with a primary diagnosis of substance misuse demonstrated greatest mortality risk. CONCLUSIONS The increased risk of death during hot weather in patients with psychosis, dementia and substance misuse has implications for public health strategies during heatwaves.
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Affiliation(s)
- Lisa A Page
- Mental Health Liaison Team, Royal Sussex County Hospital, Sussex Partnership NHS Foundation Trust, London, UK.
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Gupta S, Murray V, Clarke MJ, Carmichael C, Allen C, Simpson C. Electric fans for reducing adverse health impacts in heatwaves. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009888] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ruttan T, Stolz U, Jackson-vance S, Parks B, Keim SM. Validation of a Temperature Prediction Model for Heat Deaths in Undocumented Border Crossers. J Immigr Minor Health 2013; 15:407-14. [DOI: 10.1007/s10903-012-9619-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schaffer A, Muscatello D, Broome R, Corbett S, Smith W. Emergency department visits, ambulance calls, and mortality associated with an exceptional heat wave in Sydney, Australia, 2011: a time-series analysis. Environ Health 2012; 11:3. [PMID: 22273155 PMCID: PMC3292446 DOI: 10.1186/1476-069x-11-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 01/24/2012] [Indexed: 05/18/2023]
Abstract
BACKGROUND From January 30-February 6, 2011, New South Wales was affected by an exceptional heat wave, which broke numerous records. Near real-time Emergency Department (ED) and ambulance surveillance allowed rapid detection of an increase in the number of heat-related ED visits and ambulance calls during this period. The purpose of this study was to quantify the excess heat-related and all-cause ED visits and ambulance calls, and excess all-cause mortality, associated with the heat wave. METHODS ED and ambulance data were obtained from surveillance and administrative databases, while mortality data were obtained from the state death registry. The observed counts were compared with the average counts from the same period from 2006/07 through 2009/10, and a Poisson regression model was constructed to calculate the number of excess ED visits, ambulance and deaths after adjusting for calendar and lag effects. RESULTS During the heat wave there were 104 and 236 ED visits for heat effects and dehydration respectively, and 116 ambulance calls for heat exposure. From the regression model, all-cause ED visits increased by 2% (95% CI 1.01-1.03), all-cause ambulance calls increased by 14% (95% CI 1.11-1.16), and all-cause mortality increased by 13% (95% CI 1.06-1.22). Those aged 75 years and older had the highest excess rates of all outcomes. CONCLUSIONS The 2011 heat wave resulted in an increase in the number of ED visits and ambulance calls, especially in older persons, as well as an increase in all-cause mortality. Rapid surveillance systems provide markers of heat wave impacts that have fatal outcomes.
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Affiliation(s)
- Andrea Schaffer
- Centre for Epidemiology and Research, New South Wales Department of Health, Sydney, Australia
| | - David Muscatello
- Centre for Epidemiology and Research, New South Wales Department of Health, Sydney, Australia
| | - Richard Broome
- Environmental Health Branch, New South Wales Department of Health, Sydney, Australia
| | - Stephen Corbett
- Centre for Population Health, Sydney West Area Health Service, Sydney, Australia
| | - Wayne Smith
- Environmental Health Branch, New South Wales Department of Health, Sydney, Australia
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Huang C, Barnett AG, Wang X, Vaneckova P, FitzGerald G, Tong S. Projecting future heat-related mortality under climate change scenarios: a systematic review. Environ Health Perspect 2011; 119:1681-90. [PMID: 21816703 PMCID: PMC3261978 DOI: 10.1289/ehp.1103456] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 08/04/2011] [Indexed: 05/04/2023]
Abstract
BACKGROUND Heat-related mortality is a matter of great public health concern, especially in the light of climate change. Although many studies have found associations between high temperatures and mortality, more research is needed to project the future impacts of climate change on heat-related mortality. OBJECTIVES We conducted a systematic review of research and methods for projecting future heat-related mortality under climate change scenarios. DATA SOURCES AND EXTRACTION A literature search was conducted in August 2010, using the electronic databases PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 through July 2010. DATA SYNTHESIS Fourteen studies fulfilled the inclusion criteria. Most projections showed that climate change would result in a substantial increase in heat-related mortality. Projecting heat-related mortality requires understanding historical temperature-mortality relationships and considering the future changes in climate, population, and acclimatization. Further research is needed to provide a stronger theoretical framework for projections, including a better understanding of socioeconomic development, adaptation strategies, land-use patterns, air pollution, and mortality displacement. CONCLUSIONS Scenario-based projection research will meaningfully contribute to assessing and managing the potential impacts of climate change on heat-related mortality.
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Affiliation(s)
- Cunrui Huang
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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Abstract
This paper summarizes environmental investigations (n = 458) conducted during the first 60 years of the epidemic-assistance investigation program at the Centers for Disease Control and Prevention. These investigations were grouped into 10 categories: toxic chemicals (n = 102), indoor air quality and outdoor air toxics (n = 21), new or rare epidemic diseases and unexplained syndromes (n = 29), natural disasters (n = 81), terrorism and unintentional human-made disasters (n = 9), substance use and abuse (n = 13), environmental aspects of infectious disease (n = 132), those affecting neonates and infants (n = 11), violence and injuries (n = 51), and miscellaneous (n = 9). Among the most important or prominent were studies of lead and arsenic toxicity at smelters, mercury in paint and beauty creams, dioxin in waste oil in Missouri, polychlorinated biphenyls and multiple other toxic chemicals, global pesticide poisoning outbreaks, hepatic angiosarcoma among vinyl chloride workers, toxic oil syndrome in Spain, eosinophilia-myalgia syndrome from contaminated L-tryptophan, diethylene glycol poisoning in Haiti, aflatoxicosis in Kenya, Gulf War illness among veterans, impact and needs assessments during natural disasters (e.g., Hurricane Katrina (2005) and the Mount St. Helens volcano eruptions (1980)), risk factors for heat-related mortality, domestic and international terrorist attacks, Parkinsonism related to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine in California, and unintentional injury- and violence-related events.
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Affiliation(s)
- Henry Falk
- Office of Deputy Director for Non-Communicable Diseases, Injury, and Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS F-64, Atlanta, GA 30333, USA.
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Tomlinson CJ, Chapman L, Thornes JE, Baker CJ. Including the urban heat island in spatial heat health risk assessment strategies: a case study for Birmingham, UK. Int J Health Geogr 2011; 10:42. [PMID: 21682872 PMCID: PMC3141360 DOI: 10.1186/1476-072x-10-42] [Citation(s) in RCA: 195] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 06/17/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Heatwaves present a significant health risk and the hazard is likely to escalate with the increased future temperatures presently predicted by climate change models. The impact of heatwaves is often felt strongest in towns and cities where populations are concentrated and where the climate is often unintentionally modified to produce an urban heat island effect; where urban areas can be significantly warmer than surrounding rural areas. The purpose of this interdisciplinary study is to integrate remotely sensed urban heat island data alongside commercial social segmentation data via a spatial risk assessment methodology in order to highlight potential heat health risk areas and build the foundations for a climate change risk assessment. This paper uses the city of Birmingham, UK as a case study area. RESULTS When looking at vulnerable sections of the population, the analysis identifies a concentration of "very high" risk areas within the city centre, and a number of pockets of "high risk" areas scattered throughout the conurbation. Further analysis looks at household level data which yields a complicated picture with a considerable range of vulnerabilities at a neighbourhood scale. CONCLUSIONS The results illustrate that a concentration of "very high" risk people live within the urban heat island, and this should be taken into account by urban planners and city centre environmental managers when considering climate change adaptation strategies or heatwave alert schemes. The methodology has been designed to be transparent and to make use of powerful and readily available datasets so that it can be easily replicated in other urban areas.
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Affiliation(s)
- Charlie J Tomlinson
- School of Civil Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Uejio CK, Wilhelmi OV, Golden JS, Mills DM, Gulino SP, Samenow JP. Intra-urban societal vulnerability to extreme heat: the role of heat exposure and the built environment, socioeconomics, and neighborhood stability. Health Place 2010; 17:498-507. [PMID: 21216652 DOI: 10.1016/j.healthplace.2010.12.005] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Revised: 10/05/2010] [Accepted: 12/01/2010] [Indexed: 12/13/2022]
Abstract
Extreme heat is an important weather hazard associated with excess mortality and morbidity. We determine the relative importance of heat exposure and the built environment, socioeconomic vulnerability, and neighborhood stability for heat mortality (Philadelphia, PA, USA) or heat distress (Phoenix, AZ, USA), using an ecologic study design. We use spatial Generalized Linear and Mixed Models to account for non-independence (spatial autocorrelation) between neighboring census block groups. Failing to account for spatial autocorrelation can provide misleading statistical results. Phoenix neighborhoods with more heat exposure, Black, Hispanic, linguistically and socially isolated residents, and vacant households made more heat distress calls. Philadelphia heat mortality neighborhoods were more likely to have low housing values and a higher proportion of Black residents. Our methodology can identify important risk factors and geographic areas to target interventions.
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Affiliation(s)
- Christopher K Uejio
- Nelson Institute Center for Sustainability and the Global Environment, University of Wisconsin-Madison, 1710 University Ave. #246, Madison, WI 53726, USA.
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