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Ocean Observing System Report Card 2023

Stichting Klimaat Psychologie: For sustainable insights and green behavioral change

Climate change vulnerability assessment in mangrove-dependent communities of Manoka Island, littoral region of Cameroon

This study was conducted on Manoka Island (Littoral Region of Cameroon) with the aim of analyzing climate change vulnerability and local adaptation strategies based on the local community’s perceptions and biophysical evidence. We used household surveys, focus group discussions, field observation, GIS, and remote sensing to collect data on variables of exposure, sensitivity, and adaptive capacity. Historical changes in rainfall and temperature, mangrove cover, and the occurrence of extreme climatic events were used as indicators of exposure. Property losses and income structure were used as indicators of sensitivity, while human, natural, social, financial, and physical assets represented adaptive capacity. 89 households were interviewed in the nine settlements of the island. Results show that Manoka Island is experiencing irregular rainfall patterns (with average annual values deviating from the mean by -1.9 to +1.8 mm) and increasing temperature (with annual values deviating from the mean by -1.2 to +3.12). The dynamics of the coastline between 1975 and 2017 using EPR show average setbacks of more than ±3 m/year, with erosion levels varying depending on the period and location. The number of households perceiving extreme climatic events like seasonal variability, flood, and rain storm was higher. From respondents’ perception, housing and health are the sectors most affected by climate change. The reported high dependence of households on fishing for income, their overall low livelihood diversification, and their poor access to climate information reported by 65% of respondents portray their poor adaptive capacity. Local response initiatives are ineffective and include among others constructing buildings on stilts and using car wheels to counter the advancement of seawater inland. The study concludes that households on Manoka Island are vulnerable to the impacts of climate change. Income diversification, mangrove reforestation, the development of sustainable supply chains for wood fuel, and sustainable fish smoking devices are the main pathways for adaptation planning in this area.

Pathogenic Leptospira and water quality in African cities: A case study of Cotonou, Benin

Leptospirosis is a waterborne zoonosis (60,000 infections and 1 million deaths annually). Knowledge about the disease in the urban context is surprisingly rare, especially in Africa. Here, we provide the first study of leptospires in waters within an African city. A simple centrifugation-based method was developed to screen waterborne leptospires from remote or poorly areas. Major ions, trace elements, stable isotopes and pathogenic Leptospira were then seasonally investigated in 193 water samples from three neighborhoods of Cotonou (Benin) with different socio-environmental and hydrographic characteristics. Firstly, no leptospire was detected in tap waters. Secondly, although surface contamination cannot be excluded, one groundwater well was found leptospire positive. Thirdly, pathogenic Leptospira mainly contaminated surface waters of temporary and permanent ponds (9.5% and 27.3% of total prevalence, respectively). Isotopic signatures suggest that leptospires occurred in pond waters formed at the beginning of the rainy season following low to moderate rainfall events. Nevertheless, Leptospira-containing waters possess physico-chemical characteristics that are similar to the spectrum of waters sampled throughout the three sites, thus suggesting that Cotonou waters are widely compatible with Leptospira survival. The frequent contact with water exposes Cotonou inhabitants to the risk of leptospirosis which deserves more attention from public health authorities.

Climate change poses a threat to nutrition and food security in Kilifi County, Kenya

Over the last decades, increased emission of greenhouse gases has led to hot weather extremes, heavy precipitation and worsening of agricultural and ecological droughts. Although Africa’s contribution to climate change is minimal, the continent is especially vulnerable to its effects. This report aims to describe the effect of climate change leading to drought in Kilifi County, Kenya, and the communities’ experiences of this effect on food availability. During their community rotation, residents from a university in Nairobi, Kenya, evaluated changes in weather patterns and nutrition indicators in Kilifi County and conducted focus group discussions (FGDs) with community members and health care stakeholders to explore challenges in access to adequate nutrition and possible local solutions. Kilifi County has one of the highest rates of undernutrition in Kenya, with one in five under-5 children being underweight. County data showed that rainfall in the last 4 years has become increasingly unpredictable, resulting in reduced household milk production, one of the indicators of nutrition security. Three major themes emerged from the FGDs: lack of food variety, collapse of drought mitigating projects and increasing poverty levels. Possible solutions to these problems include promoting alternatives to the current diet that are culturally sensitive and adaptable to recent climate changes, ensuring continuity of agricultural and financial support projects and improved local leadership and governance.

Ecological and seasonal variations and other factors associated with clinical malaria in the central region of Ghana: A cross-sectional study

Background: This study investigated malaria transmission under various contrasting settings in the Central Region, a malaria endemic region in Ghana. Methods: This cross-sectional study was carried out in five randomly selected districts in the Central Region of Ghana. Three of the districts were forested, while the rest was coastal. Study participants were selected to coincide with either the regular rainy or dry season. From each study site, hospital attendees were randomly selected with prior consent. Consciously, study participants were selected in both rainy (September and October, 2020) and dry (November and December, 2020) seasons. Clinical data for each patient was checked for clinical malaria suspicion and microscopic confirmation of malaria. Using SPSS Version 24 (Chicago, IL, USA), bivariate analysis was done to determine the association of independent variables (ecological and seasonal variations) with malaria status. When the overall analysis did not yield significant association, further statistical analysis was performed after stratification of variables (into age and gender) to determine whether any or both of them would significantly associate with the dependent variable. Results: Of the 3993 study participants, 62.5% were suspected of malaria whereas 38.2% were confirmed to have clinical falciparum malaria. Data analysis revealed that in both rainy and dry seasons, malaria cases were significantly higher in forested districts ) than coastal districts (x2 = 217.9 vs x2 = 50.9; p < 0.001). Taken together, the risk of malaria was significantly higher in the dry season (COR = 1.471, p < 0.001) and lower in coastal zones (COR = 0.826, p = 0.007). There was significant reduced risk of participants aged over 39 years of malaria (COR=0.657, p < 0.001). Whereas, in general patients between 10 and 19 years were insignificantly less likely to have malaria (COR = 0.911, p = 0.518) compared to participants aged less than < 10 years, the reverse was observed in coastal districts where patients less than 10 years of age in coastal districts were less likely to have malaria (COR=2.440, p = 0.003). In general, gender did not associate with malaria, but when stratified by study district, the risk of female gender to malaria was significantly higher in Agona Swedru (COR = 5.605, p < 0.001), Assin central (COR = 2.172, p < 0.001), Awutu Senya (COR = 2.410, p < 0.001) and Cape Coast (COR = 3.939, p < 0.001) compared to Abura-Asebu-Kwamankese. Conclusion: This study demonstrated that the predictors of malaria differ from one endemic area to another. Therefore, malaria control interventions such as distribution of long-lasting insecticide treated bed nets, residual spraying with insecticide and mass distribution of antimalaria prophylaxis must be intensified in forested districts in all seasons with particular attention on females. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. CC_BY_NC_ND_4.0

Risk mapping of Indian coastal districts using IPCC-AR5 framework and multi-attribute decision-making approach

Strategic location of coastal areas across the world causes them to be prone to disaster risks. In the global south, the Indian coast is one of the most susceptible to oceanic extreme events, such as cyclones, storm surge and high tides. This study provides an understanding of the risk experienced (currently as well as back in 2001) by the districts along the Indian coastline by developing a quantitative risk index. In the process, it attempts to make a novel contribution to the risk literature by following the definition of risk as a function of hazard, exposure and vulnerability as stated in the most recent (Fifth) assessment report of the Intergovernmental Panel on Climate Change (IPCC). Indicators of bio-physical hazards (such as cyclones, storm surge, tides and precipitation), and socio-economic contributors of vulnerability (such as infrastructure, technology, finance and social nets) and exposure (space), are combined to develop an overall risk index at a fine administrative scale of district-level over the entire coastline. Further, the study employs a multi-attribute decision-making (MADM) method, Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), to combine the contributing indicators and generate indices on hazard, exposure and vulnerability. The product of these three components is thereafter defined as risk. The results suggest that most districts of the eastern coast have higher risk indices compared to those in the west, and the risk has increased since 2001. The higher risk can be attributed to the higher hazard indices in the eastern districts which are aggravated by their higher vulnerability index values. This study is the first effort made to map risk for the entire coastline of India – which in turn has resulted in a new cartographic product at a district-scale. Such assessments and maps have implications for environmental and risk-managers as they can help identify the regions needing adaptive interventions.

Vulnerabilities associated with slow-onset events (SoEs) of climate change: Multi-level analysis in the context of Pakistan

This paper explores physical, psychological, social, and institutional vulnerabilities associated with slow-onset events (SoEs) of climate change. Based on review of interdisciplinary research in the context of Pakistan, this paper reviews the relevance of multi-level vulnerabilities and how they exacerbate impacts of SoEs of climate change. The physical vulnerabilities of climate change have been relatively well researched; however, research on the psychological, social, and institutional vulnerabilities and their intersectional associations with SoEs have been rare. Therefore, this review highlights the need for understanding multi-level vulnerabilities of high-risk groups in Pakistan. This paper emphasizes the need to work with an integrated approach for vulnerabilities of marginalized subgroups such as gender (women’s marginalized status), socio-economic status (lower SES), displacement history, and migration background. Finally, we propose the need for inclusive policy building sensitive to the demands of vulnerable groups in Karachi and elsewhere in Pakistan. We hope that this multilevel and inclusive framework has the potential to guide practitioners, and especially those who are least prepared for the slow-onset events of climate change.

Climate change vulnerability assessment: A case study of south west coastal community of Bangladesh

This study aimed at assessing the Livelihood Vulnerability Index (LVI) using the IPCC framework approach and a modified approach to estimate climate change vulnerability in south-west coastal area of Bangladesh. Nine Upazillas (sub-districts) in the south west coastal community were considered for this study. The major component indices of LVI such as socio-demographic profile, livelihood strategies, social network, health, food, water, natural disaster and climate variability were calculated based on the household survey data. The LVI based on the IPCC approach (LVI-IPCC) in nine upazillas in southwest coastal region of Bangladesh were found within a range of -0.02 to + 0.04 (on the scale of -1 to +1). In the modified approach. the LVI for the nine study areas was found within a wide range from 0.253 to 0.544 (on a scale of 0 to 1). For the LVI-IPCC approach, although the contributing factors (exposure, sensitivity and adaptive capacity) individually show variations in their indices from one to another, no significant variation is observed for the total livelihood index. However, the modified approach shows significant variation in LVI among the studied nine areas. It is concluded that the modified approach is suitable for community or district level assessment, whereas the LVI-IPCC may be suitable for regional level evaluation.

Livelihood and climate vulnerability of coastal communities to natural disaster in south-western Bangladesh

Bangladesh is one of the countries that is most likely to be affected by natural disasters and climate change. However, much less is known about the integrated livelihood and climate vulnerabilities of coastal communities to natural disasters in southwestern Bangladesh. Therefore, this paper proposes a holistic approach to measuring livelihood vulnerability in the southwestern coast of Bangladesh based on primary data from 300 respondents through face-to-face interviews, focus group discussion (FGD), and key informant interviews (KII), and secondary data on rainfall and temperature for the years 2010-2017. This study developed the livelihood vulnerability index (LVI), the climate vulnerability index (CVI), and the LVI-IPCC to estimate climate vulnerability by incorporating 36 indicators of 9 major components under three dimensions. The pragmatic results show that the three coastal unions have different LVI, CVI, and LVI-IPCC values. Still, the households of the Gabura union showed more vulnerability than the rest of the two, with the highest LVI, CVI, and LVI-IPCC values due to their inadequate access to fresh water, limited physical resources, fewest livelihood strategies, the least variety of crops, and worst health conditions. This logical approach may be applied in data-scarce regions to assess vulnerability and evaluate potential policy efficiency for baseline comparison. The study demonstrates that the requirement for focused interventions and context-specific sustainable policies and development approaches should be implemented to lessen the vulnerability of coastal dwellers. These findings have implications for developing and implementing household resilience and climate change adaptation projects by the government, donor organizations, and other pertinent groups in three susceptible unions.

Exploring gender and climate change nexus, and empowering women in the south western coastal region of Bangladesh for adaptation and mitigation

This study has been conducted to identify vulnerabilities and effects of climate change on women in 12 unions in Shyamnagar upazila in the Satkhira district in the Southwestern Coastal Region of Bangladesh (SWCRB). Climate vulnerability and gender inequality may increase due to climate change. Women may, thus, face specific conditions of vulnerability in society and daily livelihood. This paper focuses on investigating factors that influence women’s vulnerability from climate change, their adaptations, and the importance of women empowerment to reduce their inequality in SWCRB. This study also emphasizes gender inequality caused by climate change, and looks at accommodations for women to reduce hostile influences of climate change. From the 9 unions in SWCRB, a total of 320 household respondents were randomly selected to complete a questionnaire. The results of the statistical analysis showed that most of the survey’s perimeter has significant. Interviews, case studies, focus group discussions, workshops, and key informant interviews were also conducted from 12 unions, and it was found that climate change impacts men and women differently, with women being more vulnerable than men. Through case study this paper investigated the main factors influencing the vulnerability of women. In terms of empowerment women may also be well positioned to lead adaptation efforts alongside men, as this analysis represent that gender inequalities are leading by social norms. Women being more vulnerable both in short-term i.e., major natural disasters, cyclones, flood, and long-term i.e., sea level rise, salinity intrusion in water and soil, land erosion, droughts, climatic events, as they enhance gender inequalities. Further, gender inequality is seen in illiteracy, food shortages and poor health conditions, traditional norms, religious taboos, and patriarchy. Moreover, gender-based economic opportunities, women’s mobility, and income are changing, while household authority relations and gender-based socio-economic, cultural, and institutional constraints remain. This study examines the increased vulnerability of women in SWCRB to climate change, which can be mitigated through women empowerment; female involvement with environmentally friendly stoves, rural electrification and renewable energy development, microfinancing, and nakshikantha. (Nakshikantha is a special type of sewing art that is made by creating designs with different types of colored threads on plain stitches). Lastly, women may also lead adaptation efforts alongside men, make decisions, and promote their participation.

At the water’s edge: Coastal settlement, transformative adaptation, and well-being in an era of dynamic climate risk

With accelerating climate change, US coastal communities are experiencing increased flood risk intensity, resulting from accelerated sea level rise and stronger storms. These conditions place pressure on municipalities and local residents to consider a range of new disaster risk reduction programs, climate resilience initiatives, and in some cases transformative adaptation strategies (e.g., managed retreat and relocation from highly vulnerable, low-elevation locations). Researchers have increasingly understood that these climate risks and adaptation actions have significant impacts on the quality of life, well-being, and mental health of urban coastal residents. We explore these relationships and define conditions under which adaptation practices will affect communities and residents. Specifically, we assess climate and environmental stressors, community change, and well-being by utilizing the growing climate change literature and the parallel social science literature on risk and hazards, environmental psychology, and urban geography work, heretofore not widely integrated into work on climate adaptation.

2017 Bangladesh landslides: Physical rehabilitation perspective

PURPOSE: This report describes the general impact and direct health effects including death and traumatic injuries on populations impacted by the 2017 landslides in the affected hilly and coastal districts in southeastern Bangladesh. The medical response including emergency treatment and rehabilitation provided at pre-hospital and hospital care sites is also described. MATERIALS AND METHODS: An electronic literature search of appropriate databases was performed to identify relevant articles on landslides in Bangladesh, Southeast Asia, and other developing countries from 1990-2017. Summary landslide impact data was extracted from official government and non-government reports and injury data from selected district and tertiary level hospitals was reviewed. RESULTS AND CONCLUSIONS: Most fatalities in the 2017 Bangladesh landslides were due to suffocation and asphyxiation from burial. In Rangamati District, 6343 persons with minor injuries were treated in 22 emergency shelters. One hundred fifty-four injuries were treated at Rangamati General Hospital and 12 of the most severely injured persons were referred to regional tertiary Chittagong Medical College Hospital for specialized injury and rehabilitation management. Physical rehabilitation capacity and services in future landslides may be increased by providing rehabilitation technical skills training to responders and augmenting the emergency response with individual rehabilitation specialists and/or teams of rehabilitation professionals.Implications for rehabilitationLandslides may result in significant direct health effects including death and rehabilitation conditions such as severe traumatic physical injuries and less severe musculoskeletal conditions.Pre-hospital and hospital emergency medical response systems may lack capacity to adequately manage the surge of rehabilitation conditions in landslides.Physical rehabilitation treatment capacity in future landslides may be increased by providing rehabilitation technical skills training to responders and augmenting the emergency response structure with individual rehabilitation specialists and/or teams of rehabilitation professionals.Rehabilitation, disability, emergency management, and other stakeholders are advised to employ such training and workforce strategies to reduce rehabilitation-related health effects in Bangladesh and other South-East Asian countries which are heavily impacted by landslides due to seasonal monsoons.

Assessment of health status of newborns discharged from sick newborn care units of the five Cyclone Fani affected districts of Odisha, India

OBJECTIVE: This study was undertaken to assess the health status of newborns discharged from Sick Newborn Care Units (SNCU) of the Cyclone Fani affected districts of Odisha, which is amongst the highest neonatal mortality rate states in the country. METHODS: Cyclone Fani hit the coast of Odisha on May 3, 2019. This cross-sectional study was conducted in 5 districts and targeted the babies discharged from SNCU’s from January to May 2019. A telephonic interview of the caregivers was conducted to assess the health status of the newborns. Data was collected in a web-based portal and analyzed by statistical package for social sciences SPSS (IBM Corp., Armonk, New York, USA). RESULTS: We inquired about 1840 babies during the study period but only 875 babies could be followed up, with the highest proportion of the babies from the most affected district. Out of 875 babies, 111 (12.7%) had 1 or more illnesses during follow up. Distance from the health facility and time constraints were the major reasons for not seeking health care. Of the babies, 35.7% were reported as being underweight. Poor breastfeeding (14.1%) and kangaroo mother care (31.7%) practices were reported. Only 32% of the babies were completely immunized. CONCLUSION: The health status of the babies discharged from the SNCUs was found to be poor. Newborn care can be strengthened by improving home-based and facility-based newborn care.

A survey of post-traumatic stress disorder, anxiety and depression among flood affected populations in Kerala, India

BACKGROUND: Globally, post traumatic stress disorder (PTSD) is one of the most common psychiatric illnesses following a disaster. We aimed to evaluate the relationship between the socio-economic and flood exposure factors with PTSD, depression and anxiety among the flood-affected populations in Kerala, India. METHODS: A cross-sectional household survey was conducted from November 2019 to January 2020 in Kozhikode district of Kerala, India. Adults (≥ 18 years), who were permanent residents and had been directly exposed to the flood, were invited to take part in the study. Individuals with a history of mental health issues and those who had other stressful situations in the past were excluded. The survey questionnaire was based on three screening tools: (1) PTSD Checklist for DSM-5 (PCL-5); (2) patient health questionnaire (PHQ-9); and (3) generalized anxiety disorder (GAD-7). Data included sociodemographic factors and flood exposure variables. The primary outcome variable was psychiatric morbidity (PTSD, anxiety and depression). RESULTS: A total of 276 respondents (150 males/126 females) participated in the study. A significant correlation was observed between total score on PCL-5 and GAD-7 (r=0.339, p=0.001) and PHQ-9 (r=0.262, p=0.001). Females had significantly higher total PTSD symptom severity scores (8.24±5.88 vs. 6.07±5.22; p=0.001), severity of symptoms of intrusion (4.66±3.60 vs. 3.69±3.20; p=0.04), increased level of anxiety (2.54±1.94 vs. 1.79±1.53; p=0.001) and depression (3.02±2.26 vs. 2.04±1.67; p=0.001) compared to males. However, the gender difference for PTSD symptoms disappeared when controlling for age. CONCLUSION: The findings of this survey revealed that the vast majority of respondents (92 percent females and 87 percent males) still had subclinical psychiatric symptoms one year after the flood. Therefore, tailored psychological interventions are warranted to counter the long-lasting impact of flooding on the mental health of individuals.

Bangladesh’s vulnerability to cyclonic coastal flooding

In the Ganges-Brahmaputra-Meghna delta, covering most of Bangladesh, more than 165 million people live in low-lying coasts facing major extreme climatic events, such as cyclones. This article reviews the current scientific literature publications (2007-2020) in order to define vulnerability in the context of coastal Bangladesh facing cyclonic flooding. Based on this review, a new metric, called the socio-spatial vulnerability index (SSVI), is defined as function of both the probability of the cyclonic flood hazard and the sensitivity of delta inhabitants. The main result shows that the districts of Shariatpur, Chandpur and Barisal situated in the tidal floodplain of the Ganges-Brahmaputra-Meghna delta are in the fourth quartile, i.e., highest category, the most vulnerable areas. These districts are very densely populated (from 870 up to 1400 inhabitants per square kilometer) and exposed to inundation hazards with a large number of vulnerability factors. Finally, the delta’s mouth was identified as a very vulnerable area to cyclonic flooding as well.

Assessment of livelihood vulnerability in the riparian region of the Tista River, west Bengal, India

The Tista floodplain is one of the major food baskets of North Bengal and is sensitive to a multitude of issues regarding vulnerability. The riparian areas and the river island or charland of the lower Tista River basin in India, specifically from Sevoke to the Indo-Bangladesh border, generally suffer due to flood-prone, river course shifting, limited livelihood activities, low adaptive capacity, and poor accessibility. The present work is conducted to assess the livelihood vulnerability based on the livelihood vulnerability index (LVI) framework of the agriculture-dependent riparian villages and the charlands of the River Tista in the Jalpaiguri district. Total 337 households of five villages from the Mal and Maynaguri block at the left bank of the Tista River were selected to conduct the field survey. The livelihood vulnerability was assessed based on eight major components (viz., socio-demographic profile, health condition, livelihood strategies, food support, water support, climatic variability, flood hazards, and social safety) and 42 sub-components. The three contributing factors, i.e., adaptive capacity, sensitivity, and exposure, have been combined to calculate the livelihood vulnerability employing the LVI and LVI-IPCC methodologies. The outcome of the study exhibit that LVI scored highest in Premganj Majhiali (0.436), followed by Basusuba (0.403), Uttar Marichbari (0.349), Domohani (0.335), and Chat Rarpur village (0.328). According to the LVI-IPCC results, Basusuba has the most vulnerability (0.015), whereas Domohani has the least (0.007). In terms of flood hazard, variations were noticed based on increasing distance from the river. Lack of adaptive capacity prevailed in the villages with significant flooding events. Building awareness of the inhabitants will be an effective way to improve the adaptive capacity of the rural villagers. Therefore, giving priority to the policies depending on the natural environment of the active flood-prone region would make long-term sustainability.

Evacuation dilemmas of coastal households during Cyclone Amphan and amidst the COVID-19 pandemic: A study of the southwestern region of Bangladesh

Cyclone Amphan battered the coastal communities in the southwestern part of Bangladesh in 2020 during the COVID-19 pandemic. These coastal communities were experiencing such a situation for the first time and faced the dilemma of whether to stay at home and embrace the cyclone or be exposed to the COVID-19 virus in the cyclone shelters by evacuating. This article intends to explore individuals’ decisions regarding whether to evacuate in response to cyclone Amphan and in light of the risks of the COVID-19 pandemic. Consequently, this study investigated evacuation behaviors among the households and explored the impacts of COVID-19 during the evacuation procedures. We conducted household surveys to collect primary information and undertook 378 samples for interviews at a precision level of 0.05 in fourteen villages. Despite the utmost effort of the government, the results demonstrated that 96.6% of people in the coastal area received a cyclone evacuation order before the cyclone’s landfall, and only 42% of people followed the evacuation order. The majority of households chose to stay at home because of fear of COVID-19 exposure in the crowded shelters. Although half of the evacuees were housed in cyclone shelters, COVID-19 preventive measures were apparently not set in place. Thus, this study will assist in crafting future government policies to enhance disaster evacuation plans by providing insights from the pandemic that can inform disaster management plans in the Global South.

Caregiving in U.S. Gulf states during natural disasters and COVID-19

OBJECTIVES: To ascertain common experiences and needs of a diverse group of caregivers challenged by hurricanes/floods and COVID-19. METHODS: In-depth interviews with unpaid caregivers in U.S. Southeast/Gulf Coast states who had experienced caregiving during a natural disaster and during COVID-19. RESULTS: Caregivers report challenges including daily living disruption, altered social supports, complicated health management, additional disaster planning, and emotional/financial impacts. Caregivers suggested helpful resources, policy options, and preparatory tools at individual, local, and health system levels to mediate discontinuity. CONCLUSIONS: Our data describe combined caregiver experiences of hurricanes/floods and the pandemic. Caregivers experience unique burdens related to care recipient diagnosis, location, and veteran status. Access to community supports varies as they manage the tasks required for care recipients’ health and safety. Our findings indicate the need for public health reinforcement of caregiving though caregiver pre-planning and targeted support. Bolstering understanding of communities’ caregiving capacity though first responder trainings and caregiver registries may enhance health and safety.

Community perception and adaptation to climate change in coastal areas of Mexico

Climate change adaptation is an increasingly important topic addressed in the face of the current and expected future impacts by climate change that the social, economic and ecological systems are experiencing worldwide. Despite the advances reported in the literature, adaptation to climate change is still considered a challenge to move from planning to the practical implementation of successful interventions. In this regard, identifying international key barriers, exchanges of experiences and lessons learned may facilitate the progress of the coasts’ sustainable and resilient future. The coast of Mexico is an excellent study area. High population densities occur along the coastal zone, whose main economic activity is related to primary and tertiary sectors. Additionally, a great diversity of coastal ecosystems exists, which are threatened by anthropogenic and hydrometeorological impacts. Under these circumstances, the population is becoming aware of the urgent need to adapt to the consequences of climate change. In this sense, this paper reviews research contributions concerning population perception to climate change and adaptation strategies in Mexico’s coastal zone. The findings highlight critical institutional difficulties and social barriers that have impeded the effective implementation of adaptation strategies to climate change in Mexico and consider steps to address them. However, adaptation strategies that show the prevention culture of some coastal communities have been found and also results of successful projects carried out, especially on mangrove forest and coral reef restoration, which are of essential importance to consider to progress on the path of a successful adaptation to climate change in Mexico.

Breastfeeding, community vulnerability, resilience, and disasters: A snapshot of the United States Gulf Coast

Climate change-induced disasters are increasing in intensity and frequency in the United States. Infant feeding in the aftermath of an extreme event is particularly challenging, especially given large variations in community vulnerability and resilience. The aim of this study was to identify the physical, social, and spatial vulnerabilities of communities along the Gulf Coast and highlight locations where high (or low) breastfeeding initiation rates have the potential to offset (or exacerbate) infant feeding challenges in the wake of a disaster. We structured this study as a retrospective, spatial data analysis of breastfeeding initiation, the risk for extreme events, social vulnerability, and community resilience to uncover locations that may need post-disaster intervention. The results suggested that significant gaps in the geographic distribution of community risk, vulnerability, resilience, and breastfeeding initiation existed. While many metropolitan areas benefitted from high breastfeeding initiation rates, they were also the most “at risk” for disasters. Conversely, many rural communities faced less risk for extreme events but exhibited more social vulnerability and less resilience should a disaster strike. Prioritizing emergency response resources to support infant feeding after a disaster is critically important, but urban and rural communities have divergent profiles that will require variable strategies to ensure recovery. Our results highlight this variability and provide prescriptive guidance regarding where to potentially allocate emergency resources.

Integrated causal-predictive machine learning models for tropical cyclone epidemiology

Strategic preparedness reduces the adverse health impacts of hurricanes and tropical storms, referred to collectively as tropical cyclones (TCs), but its protective impact could be enhanced by a more comprehensive and rigorous characterization of TC epidemiology. To generate the insights and tools necessary for high-precision TC preparedness, we introduce a machine learning approach that standardizes estimation of historic TC health impacts, discovers common patterns and sources of heterogeneity in those health impacts, and enables identification of communities at highest health risk for future TCs. The model integrates (i) a causal inference component to quantify the immediate health impacts of recent historic TCs at high spatial resolution and (ii) a predictive component that captures how TC meteorological features and socioeconomic/demographic characteristics of impacted communities are associated with health impacts. We apply it to a rich data platform containing detailed historic TC exposure information and records of all-cause mortality and cardiovascular- and respiratory-related hospitalization among Medicare recipients. We report a high degree of heterogeneity in the acute health impacts of historic TCs, both within and across TCs, and, on average, substantial TC-attributable increases in respiratory hospitalizations. TC-sustained windspeeds are found to be the primary driver of mortality and respiratory risks.

A policy analysis of preparedness for hurricane evacuations in the United States, 1990 to 2019: Implementation in coastal states

Hurricane or typhoon evacuations in the United States are typically managed by state, territorial, or tribal emergency management officials with federal, state, and local agency operational support. The evacuation process may involve issuing mandatory or “voluntary” evacuation orders to alert the community and mitigate loss of life and injury. We conducted an analysis of state and local hurricane evacuation policies identified through a literature review (January 1990 to June 2019) and key informant interviews with state public health and emergency management officials in Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Texas in October and November 2019. Findings from the literature review show that most gaps in hurricane evacuation preparedness-based on 44 policy-related publications identified in the review-could be categorized into 4 themes: shelters, evacuation decisionmaking, at-risk populations, and transportation. Findings from key informant interviews for 7 states revealed that coastal states have been able to address most of these gaps since Hurricane Katrina in 2005. However, an important remaining gap in preparedness is providing timely warnings to at-risk populations during hurricane evacuations.

Assessment of an evacuation shelter program for people with access and functional needs in Monroe County, Florida during Hurricane Irma

This case study presents an evaluation framework to assess the facilitating and constraining factors that influenced the emergency response, operation, and management of a Special Needs Shelter Program in Monroe County, Florida during Hurricane Irma in 2017. A qualitative analysis of key documents and discussions with agencies directly involved in the Monroe County Special Needs Shelter Program was used to assess four major emergency response processes: notifications and communications, evacuation and transportation, sheltering, and interagency coordination. A critical cross-cutting theme emerged, which was a lack of a common definition for populations with “special needs” across different agencies resulting in uncertainties about who should be admitted to the Special Needs Shelter and have access to their services. We generate public health and emergency management lessons to inform future adaptation, preparedness, and response plans to extreme weather events for populations with access and functional needs in Monroe County and Florida’s coastal communities more broadly.

Growing inequities in mental health crisis services offered to indigent patients in Puerto Rico versus the US states before and after hurricanes Maria and Irma

OBJECTIVE: To assess changes in the availability of mental health crisis services in Puerto Rico relative to US states before and after Hurricanes Maria and Irma. DATA SOURCES/STUDY SETTING: National Mental Health Services Surveys conducted in 2016 and 2020. STUDY DESIGN: Repeated cross-sectional design. The independent variable was mental health facility location in Puerto Rico or a US state. Dependent variables were the availability of three mental health crisis services (psychiatric emergency walk-in services, suicide prevention services, and crisis intervention team services). DATA COLLECTION/EXTRACTION METHODS: The proportion and per 100,000 population rate of facilities offering crisis services were calculated. PRINCIPAL FINDINGS: The availability of crisis services at mental health facilities in Puerto Rico remained stable between 2016 and 2020. These services were offered less at indigent care facilities in Puerto Rico than US states (e.g., 38.2% vs. 49.5% for suicide prevention, p = 0.06) and the magnitude of difference increased following Hurricane Maria. CONCLUSIONS: There are disparities between Puerto Rico and US states in the availability of mental health crisis services for indigent patients.

Physical instability of individuals exposed to storm-induced coastal flooding: Vulnerability of New Yorkers during Hurricane Sandy

Flood risk assessment requires a quantitative understanding of hazards and vulnerability. In the coastal built environment, the human’s vulnerability to combined hazards due to the floodwater and winds is an integral component of flood risks. The present study aims to reveal the human vulnerability to storm-induced coastal flooding, focusing on New York City during Hurricane Sandy. We develop a physics-based model to quantify individuals’ physical vulnerability, both adults and children, to compound hazards of floodwater and winds. The model accounts for the failure of individuals caused by physical instability due to slipping and toppling. The governing equations consider the balance between the driving and resisting forces and moments applied to an individual concurrently exposed to floodwater and winds. We first calibrate the model using existing measurements in the literature and then implement it to study the vulnerability of New York residents in Manhattan to coastal flooding during Hurricane Sandy. Model results indicate that when combined floodwater and wind hazards were at their highest-level during Sandy, the majority of flooded areas were mainly a hazardous zone for adults and either a failure or drowning zone for children. About 5.4% and 47.4% of the total flooded area became a failure zone, and 19.9% and 42.4% became a drowning zone for adults and children, respectively. We conclude that winds can have a significant impact on the physical instability of individuals. For example, model results for children show that neglecting winds results in a reduction of 97.7% in the area of the failure zone.

Toxic floodwaters on the Gulf Coast and beyond: Commentary on the public health implications of chemical releases triggered by extreme weather

Coastal and riverine communities in the United States are largely unprepared for the projected effects of the climate crisis, including more intense storm surges, sea level rise, and increased precipitation. Flooding poses its own hazards, but in recent years, chemical releases triggered by extreme weather, such as hurricanes, have become more frequent, exposing nearby communities to toxic chemicals in the midst of natural disaster. This article reviews the public health implications of chemical releases triggered by extreme weather and provides commentary on possible policy solutions. The Gulf Coast, where there is an abundance of chemical facilities, is particularly vulnerable to these events, one of the latest examples being the August 2020 BioLab chlorine factory fire in Lake Charles, Louisiana, during Hurricane Laura. Low-wealth, Black, and Hispanic communities are disproportionately located near high-risk chemical facilities. The cumulative burden of flooding, toxic chemical releases, and other social stressors borne of systemic racism harms these communities, highlighting a critical environmental injustice. The federal and state governments have failed to develop regulatory safeguards that would prevent chemical releases triggered by extreme storms. State regulators should make facility reporting data available to the public and establish a regulatory regime for aboveground storage tanks. State regulators should also complete an analysis of flood risks to high-risk chemical facilities and impacts on historically disenfranchised communities, require permitted facilities to implement climate-responsive spill preventions practices, and establish a task force that can investigate strategies to prevent climate-driven chemical disaster and engage key stakeholders.

Characterizing baseline legacy chemical contamination in urban estuaries for disaster-research through systematic evidence mapping: A case study

Natural disasters such as floods and hurricanes impact urbanized estuarine environments. Some impacts pose potential environmental and public health risks because of legacy or emerging chemical contamination. However, characterizing the baseline spatial and temporal distribution of environmental chemical contamination before disasters remains a challenge. To address this gap, we propose using systematic evidence mapping (SEM) in order to comprehensively integrate available data from diverse sources. We demonstrate this approach is useful for tracking and clarifying legacy chemical contamination reporting in an urban estuary system. We conducted a systematic search of peer-reviewed articles, government monitoring data, and grey literature. Inclusion/exclusion criteria are used as defined by a Condition, Context, Population (CoCoPop) statement for literature from 1990 to 2019. Most of the peer-reviewed articles reported dioxins/furans or mercury within the Houston Ship Channel (HSC); there was limited reporting of other organics and metals. In contrast, monitoring data from two agencies included 89-280 individual chemicals on a near-annual basis. Regionally, peer-reviewed articles tended to record metals in Lower Galveston Bay (GB) but organics in the HSC, while the agency databases spanned a wider spatial range in GB/HSC. This SEM has shown that chemical data from peer-reviewed and grey literature articles are sparse and inconsistent. Even with inclusion of government monitoring data, full spatial and temporal distributions of baseline levels of legacy chemicals are difficult to determine. There is thus a need to expand the chemical, spatial, and temporal coverage of sampling and environmental data reporting in GB/HSC.

Florida’s harmful algal bloom (HAB) problem: Escalating risks to human, environmental and economic health with climate change

Harmful Algal Blooms (HABs) pose unique risks to the citizens, stakeholders, visitors, environment and economy of the state of Florida. Florida has been historically subjected to reoccurring blooms of the toxic marine dinoflagellate Karenia brevis (C. C. Davis) G. Hansen & Moestrup since at least first contact with explorers in the 1500’s. However, ongoing immigration of more than 100,000 people year–1 into the state, elevated population densities in coastal areas with attendant rapid, often unregulated development, coastal eutrophication, and climate change impacts (e.g., increasing hurricane severity, increases in water temperature, ocean acidification and sea level rise) has likely increased the occurrence of other HABs, both freshwater and marine, within the state as well as the number of people impacted by these blooms. Currently, over 75 freshwater, estuarine, coastal and marine HAB species are routinely monitored by state agencies. While only blooms of K. brevis, the dinoflagellate Pyrodinium bahamense (Böhm) Steidinger, Tester, and Taylor and the diatom Pseudo-nitzschia spp. have resulted in closure of commercial shellfish beds, other HAB species, including freshwater and marine cyanobacteria, pose either imminent or unknown risks to human, environmental and economic health. HAB related human health risks can be classified into those related to consumption of contaminated shellfish and finfish, consumption of or contact with bloom or toxin contaminated water or exposure to aerosolized HAB toxins. While acute human illnesses resulting from consumption of brevetoxin-, saxitoxin-, and domoic acid-contaminated commercial shellfish have been minimized by effective monitoring and regulation, illnesses due to unregulated toxin exposures, e.g., ciguatoxins and cyanotoxins, are not well documented or understood. Aerosolized HAB toxins potentially impact the largest number of people within Florida. While short-term (days to weeks) impacts of aerosolized brevetoxin exposure are well documented (e.g., decreased respiratory function for at-risk subgroups such as asthmatics), little is known of longer term (>1 month) impacts of exposure or the risks posed by aerosolized cyanotoxin [e.g., microcystin, β-N-methylamino-L-alanine (BMAA)] exposure. Environmental risks of K. brevis blooms are the best studied of Florida HABs and include acute exposure impacts such as significant dies-offs of fish, marine mammals, seabirds and turtles, as well as negative impacts on larval and juvenile stages of many biota. When K. brevis blooms are present, brevetoxins can be found throughout the water column and are widespread in both pelagic and benthic biota. The presence of brevetoxins in living tissue of both fish and marine mammals suggests that food web transfer of these toxins is occurring, resulting in toxin transport beyond the spatial and temporal range of the bloom such that impacts of these toxins may occur in areas not regularly subjected to blooms. Climate change impacts, including temperature effects on cell metabolism, shifting ocean circulation patterns and changes in HAB species range and bloom duration, may exacerbate these dynamics. Secondary HAB related environmental impacts are also possible due to hypoxia and anoxia resulting from elevated bloom biomass and/or the decomposition of HAB related mortalities. Economic risks related to HABs in Florida are diverse and impact multiple stakeholder groups. Direct costs related to human health impacts (e.g., increased hospital visits) as well as recreational and commercial fisheries can be significant, especially with wide-spread sustained HABs. Recreational and tourism-based industries which sustain a significant portion of Florida’s economy are especially vulnerable to both direct (e.g., declines in coastal hotel occupancy rates and restaurant and recreational users) and indirect (e.g., negative publicity impacts, associated job losses) impacts from HABs. While risks related to K. brevis blooms are established, Florida also remains susceptible to future HABs due to large scale freshwater management practices, degrading water quality, potential transport of HABs between freshwater and marine systems and the state’s vulnerability to climate change impacts.

Coastal cities in the southern US floodplains: An evaluation of environmental equity of flood hazards and social vulnerabilities

Few empirical studies have examined environmental equity (EE) within the context of flooding in the United States (US). This paper explores whether lower-income, minority, and vulnerable communities in cities are disproportionately impacted by flooding, as evidenced by Federal Emergency Management Agency (FEMA) designated flood zones. Tampa and Houston, both coastal cities in the US, were investigated to understand flood risk and related equity issues using Geographical Information System (GIS) and statistical analyses. Both approaches allowed us to extract and integrate information from flood hazard maps with census block group-level sociodemographic data. Dasymetric mapping (i.e., binary mapping approach) was performed to calculate population density. Both correlations and logistic regression were used to examine the relationships between sociodemographic characteristics of population and flood risk associated with FEMA flood zones. Our research findings do not suggest any racial and ethnic disparities; however, a measurable inequity is observed in exposure to flood risk across age groups, education level, and income status. Since these vulnerable groups are often unrecognized in hazard-related policy discourses (i.e., preparedness, response, and recovery), the ramifications of these research findings may have significant impacts on EE research relating to flood hazards and related policy formulations.

Traffic accidents and delays present contrasting pictures of traffic resilience to coastal flooding in the San Francisco Bay Area, USA

Climate change is intensifying coastal floods and increasing the risks of traffic disruption in lowlying, coastal communities. Efforts to understand the differential impacts of traffic disruption on communities have led to the concept of traffic resilience which captures the degree to which a traffic system can recover from disruption. Existing proxies of traffic resilience are focused on quantifying travel time delays but lack the important dimension of road safety. In this study, we quantify traffic resilience in terms of the change in non-highway car and pedestrian accident rates during the 5-10 am period as a result of coastal flooding in the San Francisco Bay Area for the 2020-2040 period. We use a regional traffic model to simulate traffic patterns under a range of coastal flood water levels. We use regressions that relate traffic volumes to historical accident rates to estimate accidents rates in the presence of flooding. Our results show that the flooding of highways forces commuters onto local roads passing through residential communities, causing a spike in accident rates. Unlike delays which increase sharply at the higher water levels considered in this study, we project that region-wide peak-hour accident rates may increase substantially at lower water levels.

Dynamic modeling of sea-level rise impact on coastal flood hazard and vulnerability in New York City’s built environment

There is a consensus that future sea-level rise (SLR) will increase the exposure of population and assets to coastal flooding. However, the extent to which SLR affects flood hazards and human vulnerability to flooding in the built environment is not well understood. This study investigates the effects of future SLR on coastal flood hazards and human vulnerability to flooding in New York City’s built environment. With a focus on a hurricane-induced flood event, we utilize a building-scale hydrodynamic model to simulate flood hazards under different 21st-century SLR scenarios. We further implement a human vulnerability model to reveal how the physical vulnerability of individuals to flooding would respond to the effects of SLR on flood hazards. We find that SLR would result in a substantial increase in not only the floodwater depth but also the floodwater velocity in the study area. For example, under a 1.04 m SLR scenario, the increase in the max floodwater speed exceeds 2.7 m/s (1271%) in 5% of the area that was flooded under the no-SLR scenario (control run). Model results show that, due to nonlinear interactions, the floodwater depth simulated by the hydrodynamic model for a SLR scenario could substantially differ from the depth estimated based on a linear addition of the SLR to the control-run floodwater depth. We find that the effects of SLR on flood hazards would, in turn, substantially affect the extent, intensity, and duration of human physical vulnerability to flooding, which could potentially increase the number of injuries and mortalities.

Quantifying coastal flood vulnerability for climate adaptation policy using principal component analysis

With increasing population growth and urban sprawl, many coastal lowlands are unprecedentedly vulnerable to climate change and its impacts, such as rising sea levels, increasing extreme storm events, and coastal flooding. Quantifying coastal flood vulnerability serves as a tool to identify a system’s weakness, monitor its change, and support making targeted climate adaptation policies. The assessment framework proposed in this research uses principal component analysis (PCA) and a weighting method to build a composite indicator of flood vulnerability index and evaluate the vulnerability for 256 coastal census tracts and 24 municipalities along the coast of Connecticut, USA. The research uses Keiser-Meyer-Olkin (KMO) test and Bartlett’s test of sphericity to test sample adequacy and performs data standardization for all indicators. Through PCA, 30 coastal vulnerability-related indicators were grouped into four major dimensions: hazard exposure, socio-economic, physical/land use and land cover, and natural. The findings highlight the variations of flood vulnerability across highly ur-banized areas, suburban areas, and rural areas; and the gradient from coastal low-elevation region to high-elevation inland area. This variance is unevenly caused by different dimensions although they may trade-off with each other when aggregated, the dominant dimensions play a significant or decisive role in the vulnera-bility assessment. This research built an automatic and objective assessment framework that is flexible enough to be applied at a smaller scale so as to obtain detailed analysis and it can be used as a decision-making support system.

Heat stress in the Caribbean: Climatology, drivers, and trends of human biometeorology indices

Forty years (1980-2019) of reanalysis data were used to investigate climatology and trends of heat stress in the Caribbean region. Represented via the Universal Thermal Climate Index (UTCI), a multivariate thermophysiological-relevant parameter, the highest heat stress is found to be most frequent and geographically widespread during the rainy season (August, September, and October). UTCI trends indicate an increase of more than 0.2 degrees C center dot decade(-1), with southern Florida and the Lesser Antilles witnessing the greatest upward rates (0.45 degrees C center dot decade(-1)). Correlations with climate variables known to induce heat stress reveal that the increase in heat stress is driven by increases in air temperature and radiation, and decreases in wind speed. Conditions of heat danger, as depicted by the heat index (HI), have intensified since 1980 (+1.2 degrees C) and are found to occur simultaneously to conditions of heat stress suggesting a synergy between heat illnesses and physiological responses to heat. This work also includes the analysis of the record-breaking 2020 heat season during which the UTCI and HI achieved above average values, indicating that local populations most likely experienced heat stress and danger higher than the ones they are used to. These findings confirm the gradual intensification of heat stress in the Caribbean and aim to provide a guidance for heat-related policies in the region.

Anticipating and adapting to the future impacts of climate change on the health, security and welfare of low elevation coastal zone (LECZ) communities in southeastern USA

Low elevation coastal zones (LECZ) are extensive throughout the southeastern United States. LECZ communities are threatened by inundation from sea level rise, storm surge, wetland degradation, land subsidence, and hydrological flooding. Communication among scientists, stakeholders, policy makers and minority and poor residents must improve. We must predict processes spanning the ecological, physical, social, and health sciences. Communities need to address linkages of (1) human and socioeconomic vulnerabilities; (2) public health and safety; (3) economic concerns; (4) land loss; (5) wetland threats; and (6) coastal inundation. Essential capabilities must include a network to assemble and distribute data and model code to assess risk and its causes, support adaptive management, and improve the resiliency of communities. Better communication of information and understanding among residents and officials is essential. Here we review recent background literature on these matters and offer recommendations for integrating natural and social sciences. We advocate for a cyber-network of scientists, modelers, engineers, educators, and stakeholders from academia, federal state and local agencies, non-governmental organizations, residents, and the private sector. Our vision is to enhance future resilience of LECZ communities by offering approaches to mitigate hazards to human health, safety and welfare and reduce impacts to coastal residents and industries.

Effects of tidal flooding on estuarine biogeochemistry: Quantifying flood-driven nitrogen inputs in an urban, lower Chesapeake Bay sub-tributary

Sea level rise has increased the frequency of tidal flooding even without accompanying precipitation in many coastal areas worldwide. As the tide rises, inundates the landscape, and then recedes, it can transport organic and inorganic matter between terrestrial systems and adjacent aquatic environments. However, the chemical and biological effects of tidal flooding on urban estuarine systems remain poorly constrained. Here, we provide the first extensive quantification of floodwater nutrient concentrations during a tidal flooding event and estimate the nitrogen (N) loading to the Lafayette River, an urban tidal sub-tributary of the lower Chesapeake Bay (USA). To enable the scale of synoptic sampling necessary to accomplish this, we trained citizen-scientist volunteers to collect 190 flood water samples during a perigean spring tide to measure total dissolved N (TDN), dissolved inorganic N (DIN) and phosphate concentrations, and Enterococcus abundance from the retreating ebb tide while using a phone application to measure the extent of tidal inundation. Almost 95% of Enterococcus results had concentrations that exceeded the standard established for recreational waters (104 MPN 100 mL(-1)). Floodwater dissolved nutrient concentrations were higher than concentrations measured in natural estuarine waters, suggesting floodwater as a source of dissolved nutrients to the estuary. However, only DIN concentrations were statistically higher in floodwater samples than in the estuary. Using a hydrodynamic model to calculate the volume of water inundating the landscape, and the differences between the median DIN concentrations in floodwaters and the estuary, we estimate that 1,145 kg of DIN entered the Lafayette River during this single, blue sky, tidal flooding event. This amount exceeds the annual N load allocation for overland flow established by federal regulations for this segment of the Chesapeake Bay by 30%. Because tidal flooding is projected to increase in the future as sea levels continue to rise, it is crucial we quantify nutrient loading from tidal flooding in order to set realistic water quality restoration targets for tidally influenced water bodies.

Immediate impact of Hurricane Lane on microbiological quality of coastal water in Hilo Bay, Hawaii

Hurricanes and associated stormwater runoff events are expected to greatly impact coastal marine water quality, yet little is known about their immediate effects on microbiological quality of near-shore water. This study sampled Hilo Bay immediately after the impact of Hurricane Lane to understand the spatial and temporal variations of the abundance and diversity of fecal indicator enterococci, common fecal pathogens, and antibiotic resistance genes (ARGs). Water samples from seven sampling sites over 7 days were collected and analyzed, which showed that the overall microbiological water quality parameters [enterococci geometric mean (GM): 6-22 cfu/100 mL] fell within water quality standards and that the temporal dynamics indicated continuing water quality recovery. However, considerable spatial variation was observed, with the most contaminated site exhibiting impaired water quality (GM = 144 cfu/100 mL). The Enterococcus population also showed distinct genotypic composition at the most contaminated site. Although marker genes for typical fecal pathogens (invA for Salmonella, hipO for Campylobacter, mip for Legionella pneumophila, and eaeA for enteropathogenic Escherichia coli) were not detected, various ARGs (ermB, qurS, tetM, blaTEM, and sul1) and integron-associated integrase intI1 were detected at high levels. Understanding the temporal and spatial variation of microbiological water quality at fine granularity is important for balancing economic and recreational uses of coastal water and the protection of public health post the impact of major hurricane events.

A predictive human health risk assessment of non-choleraic Vibrio spp. during hurricane-driven flooding events in coastal South Carolina, USA

Densely populated, low-lying coastal areas are most at-risk for negative impacts from increasing intensity of storm-induced flooding. Due to the effects of global warming and subsequent climate change, coastal temperatures and the magnitude of storm-induced flooding are projected to increase, creating a hospitable environment for the aquatic Vibrio spp. bacteria. A relative risk model analysis was used to determine which census block groups in coastal South Carolina have the highest risk of Vibrio spp. exposure using storm surge flooding as a proxy. Coastal block groups with dense vulnerable sub-populations exposed to storm surge have the highest relative risk, while inland block groups away from riverine-mediated storm surge have the lowest relative risk. As Vibriosis infections may be extremely severe or even deadly, the best methods of infection control will be regular standardized coastal and estuarine water monitoring for Vibrio spp. to enable more informed and timely public health advisories and help prevent future exposure.

Examining the relationship between climate change and vibriosis in the United States: Projected health and economic impacts for the 21st century

BACKGROUND: This paper represents, to our knowledge, the first national-level (United States) estimate of the economic impacts of vibriosis cases as exacerbated by climate change. Vibriosis is an illness contracted through food- and waterborne exposures to various Vibrio species (e.g., nonV. cholerae O1 and O139 serotypes) found in estuarine and marine environments, including within aquatic life, such as shellfish and finfish. OBJECTIVES: The objective of this study was to project climate-induced changes in vibriosis and associated economic impacts in the United States related to changes in sea surface temperatures (SSTs). METHODS: For our analysis to identify climate links to vibriosis incidence, we constructed three logistic regression models by Vibrio species, using vibriosis data sourced from the Cholera and Other Vibrio Illness Surveillance system and historical SSTs. We relied on previous estimates of the cost-per-case of vibriosis to estimate future total annual medical costs, lost income from productivity loss, and mortality-related indirect costs throughout the United States. We separately reported results for V. parahaemolyticus, V. vulnificus, V. alginolyticus, and “V. spp.,” given the different associated health burden of each. RESULTS: By 2090, increases in SST are estimated to result in a 51% increase in cases annually relative to the baseline era (centered on 1995) under Representative Concentration Pathway (RCP) 4.5, and a 108% increase under RCP8.5. The cost of these illnesses is projected to reach $5.2 billion annually under RCP4.5, and $7.3 billion annually under RCP8.5, relative to $2.2 billion in the baseline (2018 U.S. dollars), equivalent to 140% and 234% increases respectively. DISCUSSION: Vibriosis incidence is likely to increase in the United States under moderate and unmitigated climate change scenarios through increases in SST, resulting in a substantial burden of morbidity and mortality, and costing billions of dollars. These costs are mostly attributable to deaths, primarily from exposure to V. vulnificus. Evidence suggests that other factors, including sea surface salinity, may contribute to further increases in vibriosis cases in some regions of the United States and should also be investigated. https://doi.org/10.1289/EHP9999a.

Nested spatial and temporal modeling of environmental conditions associated with genetic markers of Vibrio parahaemolyticus in Washington State pacific oysters

The Pacific Northwest (PNW) is one of the largest commercial harvesting areas for Pacific oysters (Crassostrea gigas) in the United States. Vibrio parahaemolyticus, a bacterium naturally present in estuarine waters accumulates in shellfish and is a major cause of seafood-borne illness. Growers, consumers, and public-health officials have raised concerns about rising vibriosis cases in the region. Vibrio parahaemolyticus genetic markers (tlh, tdh, and trh) were estimated using an most-probable-number (MPN)-PCR technique in Washington State Pacific oysters regularly sampled between May and October from 2005 to 2019 (N = 2,836); environmental conditions were also measured at each sampling event. Multilevel mixed-effects regression models were used to assess relationships between environmental measures and genetic markers as well as genetic marker ratios (trh:tlh, tdh:tlh, and tdh:trh), accounting for variation across space and time. Spatial and temporal dependence were also accounted for in the model structure. Model fit improved when including environmental measures from previous weeks (1-week lag for air temperature, 3-week lag for salinity). Positive associations were found between tlh and surface water temp, specifically between 15 and 26°C, and between trh and surface water temperature up to 26°C. tlh and trh were negatively associated with 3-week lagged salinity in the most saline waters (> 27 ppt). There was also a positive relationship between tissue temperature and tdh, but only above 20°C. The tdh:tlh ratio displayed analogous inverted non-linear relationships as tlh. The non-linear associations found between the genetic targets and environmental measures demonstrate the complex habitat suitability of V. parahaemolyticus. Additional associations with both spatial and temporal variables also suggest there are influential unmeasured environmental conditions that could further explain bacterium variability. Overall, these findings confirm previous ecological risk factors for vibriosis in Washington State, while also identifying new associations between lagged temporal effects and pathogenic markers of V. parahaemolyticus.

Impact of the future coastal water temperature scenarios on the risk of potential growth of pathogenic Vibrio marine bacteria

Vibrio (V), a genus of marine bacteria, are common inhabitants of warm coastal waters and estuaries. Vibrio includes V. parahaemolyticus and V. vulnificus species that can cause human infections through the consumption of contaminated shellfish (as bivalve molluscs). The growth of pathogenic Vibrio is related to ambient water temperature and seems to increase at 15 degrees C and over. The expansion of Vibrio infection outbreak is increasing worldwide due to the increase of the sea surface temperature as a result of ocean warming. Canada’s coast is not an exception to this worldwide Vibrio spread. Faced with this issue, this study focuses on modelling the future potential Vibrio growth risk along the coasts of the St. Lawrence Gulf and Estuary, where the shellfish industry is well developed. This is done using the adequate machine learning model with explanatory variables that include air temperature and wind speed for predicting future water temperatures. Based on the predicted future water temperature scenarios and a threshold of 15 degrees C to determine the conditions favorable to the growth of Vibrio bacteria, we modelled the Vibrio growth risk indicator, i.e. the number of days exceeding the minimum temperature for Vibrio pathogenic growth (15 degrees C), in the horizon 2040-2100. Simulations show that the number of days, where the minimum temperature (15 degrees C) will be reached, will increase spatially and even seasonally and all the shellfish beds would meet the temperature condition for Vibrio growth regardless of the climate scenario (optimistic and pessimistic).

Increased prevalence of indoor Aspergillus and Penicillium species is associated with indoor flooding and coastal proximity: A case study of 28 moldy buildings

Indoor flooding is a leading contributor to indoor dampness and the associated mold infestations in the coastal United States. Whether the prevalent mold genera that infest the coastal flood-prone buildings are different from those not flood-prone is unknown. In the current case study of 28 mold-infested buildings across the U.S. east coast, we surprisingly noted a trend of higher prevalence of indoor Aspergillus and Penicillium genera (denoted here as Asp-Pen) in buildings with previous flooding history. Hence, we sought to determine the possibility of a potential statistically significant association between indoor Asp-Pen prevalence and three building-related variables: (i) indoor flooding history, (ii) geographical location, and (iii) the building’s use (residential versus non-residential). Culturable spores and hyphal fragments in indoor air were collected using the settle-plate method, and corresponding genera were confirmed using phylogenetic analysis of their ITS sequence (the fungal barcode). Analysis of variance (ANOVA) using Generalized linear model procedure (GLM) showed that Asp-Pen prevalence is significantly associated with indoor flooding as well as coastal proximity. To address the small sample size, a multivariate decision tree analysis was conducted, which ranked indoor flooding history as the strongest determinant of Asp-Pen prevalence, followed by geographical location and the building’s use.

Spatial distribution of polycyclic aromatic hydrocarbon contaminants after Hurricane Harvey in a Houston neighborhood

BACKGROUND: Hurricane Harvey made landfall along the Texas Gulf Coast as a Category 4 hurricane on August 25, 2017, producing unprecedented precipitation that devastated coastal areas. Catastrophic flooding in the City of Houston inundated industrial and residential properties resulting in the displacement and transfer of soil, sediment, and debris and heightening existing environmental justice (EJ) concerns. OBJECTIVES: The primary aim of this study was to evaluate the presence, distribution, and potential human health implications of polycyclic aromatic hydrocarbons (PAHs) in a residential neighborhood of Houston, Texas following a major hurricane. METHODS: Concentrations of PAHs in 40 soil samples collected from a residential neighborhood in Houston, Texas were measured. Spatial interpolation was applied to determine the distribution of PAHs. Potential human health risks were evaluated by calculating toxicity equivalency quotients (TEQs) and incremental excess lifetime cancer risk (IELCR). RESULTS: Total priority PAH concentrations varied across samples (range: 9.7 × 10(1) ng/g-1.6 × 10(4) ng/g; mean: 3.0 × 10(3) ng/g ± 3.6 × 10(3) standard deviation). Spatial analysis indicated a variable distribution of PAH constituents and concentrations. The IELCR analysis indicated that nine of the 40 samples were above minimum standards. CONCLUSIONS: Findings from this study highlight the need for fine scale soil testing in residential areas as well as the importance of site-specific risk assessment. COMPETING INTERESTS: The authors declare no competing financial interests.

Climate change affects us in the tropics: Local perspectives on ecosystem services and well-being sensitivity in Southeast Brazil

Inequalities in benefits from ecosystem services (ES) challenge the achievement of sustainability goals, because they increase the vulnerability of socio-ecological systems to climate hazards. Yet the unequal effects of changes in ES, and of climate change more generally, on human well-being (HWB) are still poorly accounted for in decision-making around adaptation, particularly in tropical countries. Here, we investigate these dynamics through the lens of local peoples’ perceptions of ES in relation to human well-being (HWB), and how these are affected by climate change in three distinct regional case studies in the Atlantic Forest in Southeast of Brazil. Through structured questionnaires, we found that the local perceptions of important ES are region-dependent, particularly identifying services regulating local climate and air quality, water flow and quality, food provisioning, and cultural services of landscape esthetics related to forest regeneration. HWB was expressed through material (e.g., economic security, environmental conditions) and higher accounts of non-material (e.g., feelings, health and social connections) dimensions. Specific environmental changes were identified by 95% of those responding, 40% of whom included climate change as one of these. When asked about climate directly, 97% of those responding identified relevant changes in regionally relevant ways. Rising temperatures, unbalanced seasons, altered rainfall patterns, drought, increase of extreme events, and sea level rise are negatively affecting both material and non-material dimensions of HWB across regions. These perceived changes aligned with observed and projected climate changes in the regions. Benefits from ES accrue for HWB at different scales depending on the specific ES and region. For example, crop production by small farmers or exported in sugar cane, water captured for agricultural irrigation or used for urban supplies, and fish resources for local consumption and lifestyle or as a recreational attraction for visitors. Policy choices about such balances will affect local vulnerabilities to the expected future climate and other environmental changes in the region. This place fine-scale observations and the empowerment of local knowledge at the core of policy decisions about adaptation to support a climate-resilient future for traditional communities and small farmers.

Communicating ocean and human health connections: An agenda for research and practice

The emergence of ocean and human health (OHH) science as a distinct scholarly discipline has led to increased research outputs from experts in both the natural and social sciences. Formal research on communication strategies, messaging, and campaigns related to OHH science remains limited despite its importance as part of the social processes that can make knowledge actionable. When utilized to communicate visible, local issues for targeting audiences, OHH themes hold the potential to motivate action in pursuit of solutions to environmental challenges, supplementing efforts to address large-scale, abstract, or politicized issues such as ocean acidification or climate change. Probing peer-reviewed literature from relevant areas of study, this review article outlines and reveals associations between society and the quality of coastal and marine ecosystems, as well as key themes, concepts, and findings in OHH science and environmental communication. Recommendations for future work concerning effective ocean and human health science communication are provided, creating a platform for innovative scholarship, evidence-based practice, and novel collaboration across disciplines.

Micronutrient supply from global marine fisheries under climate change and overfishing

Fish are rich in bioavailable micronutrients, such as zinc and iron, deficiencies of which are a global food security concern.(1)(,)(2) Global marine fisheries yields are threatened by climate change and overfishing,(3)(,)(4) yet understanding of how these stressors affect the nutrients available from fisheries is lacking.(5)(,)(6) Here, using global assessments of micronutrient content(2) and fisheries catch data,(7) we investigate how the vulnerability status of marine fish species(8)(,)(9) may translate into vulnerability of micronutrient availability at scales of both individual species and entire fishery assemblages for 157 countries. We further quantify the micronutrient evenness of catches to identify countries where interventions can optimize micronutrient supply. Our global analysis, including >800 marine fish species, reveals that, at a species level, micronutrient availability and vulnerability to both climate change and overfishing varies greatly, with tropical species displaying a positive co-tolerance, indicating greater persistence to both stressors at a community level.(10) Global fisheries catches had relatively low nutritional vulnerability to fishing. Catches with higher species richness tend to be nutrient dense and evenly distributed but are more vulnerable to climate change, with 40% of countries displaying high vulnerability. Countries with high prevalence of inadequate micronutrient intake tend to have the most nutrient-dense catches, but these same fisheries are highly vulnerable to climate change, with relatively lower capacity to adapt.(11) Our analysis highlights the need to consolidate fisheries, climate, and food policies to secure the sustainable contribution of fish-derived micronutrients to food and nutrition security.

Reshaping ties to land: A systematic review of the psychosocial and cultural impacts of Pacific climate-related mobility

Global inaction on climate change is leading many Pacific peoples towards a reality separated from their ancestral lands. Yet, discussions of climate-related mobility often sideline Pacific understandings of well-being. This systematic qualitative review synthesizes the literature on the psychosocial and cultural impacts of climate-related mobility in the Pacific and outlines the methods employed in this field. We identified 36 relevant empirical studies from online databases and citations covering 28 cases of climate-related mobility. Our approach assessed studies against the Pacific Health Research Guidelines and the Critical Appraisal Skills Programme. We conducted a thematic synthesis of qualitative findings, recognizing social factors influencing acculturation and relationship to land as superordinate themes for both cross-border and internal mobility. Eleven sub-themes were identified as outcomes of cross-border and internal mobility. Overall, climate-related mobility shifted people’s relationships with their homelands, disrupting community and cultural continuities. People resisted disruptions through engaging with cultural practices, values, knowledge, and community life. Yet, even the least disruptive movements caused significant stress, suggesting that Pacific conceptualisations of well-being and land should be considered when developing climate policy.

Climate change, extreme events and mental health in the pacific region

PurposeThis paper aims to address a gap in investigating specific impacts of climate change on mental health in the Pacific region, a region prone to extreme events. This paper reports on a study on the connections between climate change, public health, extreme weather and climate events (EWEs), livelihoods and mental health, focusing on the Pacific region Islands countries. Design/methodology/approachThis paper deploys two main methods. The first is a bibliometric analysis to understand the state of the literature. For example, the input data for term co-occurrence analysis using VOSviewer is bibliometric data of publications downloaded from Scopus. The second method describes case studies, which outline some of the EWEs the region has faced, which have also impacted mental health. FindingsThe results suggest that the increased frequency of EWEs in the region contributes to a greater incidence of mental health problems. These, in turn, are associated with a relatively low level of resilience and greater vulnerability. The findings illustrate the need for improvements in the public health systems of Pacific nations so that they are in a better position to cope with the pressures posed by a changing environment. Originality/valueThis paper contributes to the current literature by identifying the links between climate change, extreme events, environmental health and mental health consequences in the Pacific Region. It calls for greater awareness of the subject matter of mental health among public health professionals so that they may be better able to recognise the symptoms and relate them to their climate-related causes and co-determinant factors.

Corals as canaries in the coalmine: Towards the incorporation of marine ecosystems into the ‘One Health’ concept

‘One World – One Health’ is a developing concept which aims to explicitly incorporate linkages between the environment and human society into wildlife and human health care. Past work in the field has concentrated on aspects of disease, particularly emerging zoonoses, and focused on terrestrial systems. Here, we argue that marine environments are crucial components of the ‘One World – One Health’ framework, and that coral reefs are the epitome of its underlying philosophy. That is, they provide vast contributions to a wide range of ecosystem services with strong and direct links to human well-being. Further, the sensitivity of corals to climate change, and the current emergence of a wide range of diseases, make coral reefs ideal study systems to assess links, impacts, and feedback mechanisms that can affect human and ecosystem health. There are well established protocols for monitoring corals, as well as global networks of coral researchers, but there remain substantial challenges to understanding these complex systems, their health and links to provisioning of ecosystem services. We explore these challenges and conclude with a look at how developing technology offers potential ways of addressing them. We argue that a greater integration of coral reef research into the ‘One World – One Health’ framework will enrich our understanding of the many links within, and between, ecosystems and human society. This will ultimately support the development of measures for improving the health of both humans and the environment.

Harmful algal blooms and their eco-environmental indication

Harmful algal blooms (HABs) in freshwater lakes and oceans date back to as early as the 19th century, which can cause the death of aquatic and terrestrial organisms. However, it was not until the end of the 20th century that researchers had started to pay attention to the hazards and causes of HABs. In this study, we analyzed 5720 published literatures on HABs studies in the past 30 years. Our review presents the emerging trends in the past 30 years on HABs studies, the environmental and human health risks, prevention and control strategies and future developments. Therefore, this review provides a global perspective of HABs and calls for immediate responses.

Climate change impacts on microbiota in beach sand and water: Looking ahead

Beach sand and water have both shown relevance for human health and their microbiology have been the subjects of study for decades. Recently, the World Health Organization recommended that recreational beach sands be added to the matrices monitored for enterococci and Fungi. Global climate change is affecting beach microbial contamination, via changes to conditions like water temperature, sea level, precipitation, and waves. In addition, the world is changing, and humans travel and relocate, often carrying endemic allochthonous microbiota. Coastal areas are amongst the most frequent relocation choices, especially in regions where desertification is taking place. A warmer future will likely require looking beyond the use of traditional water quality indicators to protect human health, in order to guarantee that waterways are safe to use for bathing and recreation. Finally, since sand is a complex matrix, an alternative set of microbial standards is necessary to guarantee that the health of beach users is protected from both sand and water contaminants. We need to plan for the future safer use of beaches by adapting regulations to a climate-changing world.

Current trends and new challenges in marine phycotoxins

Marine phycotoxins are a multiplicity of bioactive compounds which are produced by microalgae and bioaccumulate in the marine food web. Phycotoxins affect the ecosystem, pose a threat to human health, and have important economic effects on aquaculture and tourism worldwide. However, human health and food safety have been the primary concerns when considering the impacts of phycotoxins. Phycotoxins toxicity information, often used to set regulatory limits for these toxins in shellfish, lacks traceability of toxicity values highlighting the need for predefined toxicological criteria. Toxicity data together with adequate detection methods for monitoring procedures are crucial to protect human health. However, despite technological advances, there are still methodological uncertainties and high demand for universal phycotoxin detectors. This review focuses on these topics, including uncertainties of climate change, providing an overview of the current information as well as future perspectives.

Potential for nontuberculous mycobacteria proliferation in natural and engineered water systems due to climate change: A literature review

Nontuberculous mycobacterial (NTM) infections are costly, difficult to treat, and increasing in prevalence. Given this, there is a desire to understand the potential relationships between NTM in water sources and climate change stressors. To address this need, a critical literature review was performed. Connections were made between NTM fate and transport, climate change, engineering decisions, and societal changes, and uncertainties highlighted. Environmental conditions discussed with respect to NTM risk included changing temperature, humidity, salinity, rainfall, and extreme weather events. NTM risk was then considered under climate/societal scenarios described by Intergovernmental Panel on Climate Change (IPCC) scientists. Findings indicate that the resilience of NTM under a variety of environmental conditions (e.g., warm temperatures, eutrophication) may increase their net prevalence in water environments under climate change, increasing exposure. Water management decisions may also influence exposure to NTM as water scarcity is expected to result in increased reliance on reclaimed water. Water managers may control risk of exposure through innovative water treatment processes and equitable water management decisions, turning towards an integrated One Water approach to reduce and/or mitigate the impacts of de facto reuse. Future research recommendations are provided including studies into potential changes to NTM fate and transport in uniquely impacted climates (e.g., boreal regions), and investigations into the relative risk of managed aquifer recharge as compared to no action.

Future scenarios of risk of vibrio infections in a warming planet: A global mapping study

BACKGROUND: Infections caused by non-cholera Vibrio species have undergone a global expansion over the past few decades reaching new areas of the world that were previously considered adverse for these organisms. The geographical extent of the expansion has not been uniform, and some areas have shown a rapid increase in infections. METHODS: We applied a new generation of models combining climate, population, and socioeconomic projections to map future scenarios of distribution and season suitability for pathogenic Vibrio. We used the Coupled Model Intercomparison Project 6 framework. Three datasets were used: Geophysical Fluid Dynamics Laboratory’s CM4.0 sea surface temperature and sea surface salinity; the coastline length dataset from the World Resources Institute; and Inter-Sectoral Impact Model Intercomparison Project 2b annual global population data. Future projections were used up to the year 2100 and historical simulations from 1850 to 2014. We also project human population at risk under different shared socioeconomic pathways worldwide. FINDINGS: Projections showed that coastal areas suitable for Vibrio could cover 38000 km of new coastal areas by 2100 under the most unfavourable scenario with an expansion rate of season suitability in these regions of around 1 month every 30 years. Population at risk in suitable regions almost doubled from 1980 to 2020 (from 610 million to 1100 million under the scenario of medium challenges to mitigation and adaptation, shared socioeconomic pathway 2-4.5), although the increment will be more moderate in the future and stabilises after 2050 at 1300 million. Finally, we provide the first global estimate for Vibrio infections, with values around half a million of cases worldwide in 2020. INTERPRETATION: Our projections anticipated an expansion of both the temporal and spatial disease burden for Vibrio infections, in particular at high latitudes of the northern hemisphere. However, the largest extent occurred from 1980 to 2020 and a more moderate increase is expected for the future. The most positive outcome is that the projections showed that Vibrio morbidity will remain relatively stable over the coming decades.

Geo-hydrological events and temporal trends in CAPE and TCWV over the main cities facing the Mediterranean Sea in the period 1979-2018

The Mediterranean region is regarded as the meeting point between Europe, Africa and the Middle East. Due to favourable climatic conditions, many civilizations have flourished here. Approximately, about half a billion people live in the Mediterranean region, which provides a key passage for trading between Europe and Asia. Belonging to the middle latitude zone, this region experiences high meteorological variability that is mostly induced by contrasting hot and cold air masses that generally come from the west. Due to such phenomenon, this region is subject to frequent intensive precipitation events. Besides, in this complex physiographic and orographic region, human activities have contributed to enhance the geo-hydrologic risk. Further, in terms of climate change, the Mediterranean is a hot spot, probably exposing it to future damaging events. In this framework, this research focuses on the analysis of precipitation related events recorded in the EM-DAT disasters database for the period 1979-2018. An increasing trend emerges in both event records and related deaths. Then a possible linkage with two meteorological variables was investigated. Significant trends were studied for CAPE (Convective Available Potential Energy) and TCWV (Total Column Water Vapor) data, as monthly means in 100 km(2) cells for 18 major cities facing the Mediterranean Sea. The Mann-Kendall trend test, Sen’s slope estimation and the Hurst exponent estimation for the investigation of persistency in time series were applied. The research provides new evidence and quantification for the increasing trend of climate related disasters at the Mediterranean scale: recorded events in 1999-2018 are about four times the ones in 1979-1998. Besides, it relates this rise with the trend of two meteorological variables associated with high intensity precipitation events, which shows a statistically significative increasing trend in many of the analysed cities facing the Mediterranean Sea.

First characterization of ostreopsis cf. Ovata (dinophyceae) and detection of ovatoxins during a multispecific and toxic ostreopsis bloom on French Atlantic coast

Blooms of the benthic toxic dinoflagellate genus Ostreopsis have been recorded more frequently during the last two decades, particularly in warm temperate areas such as the Mediterranean Sea. The proliferation of Ostreopsis species may cause deleterious effects on ecosystems and can impact human health through skin contact or aerosol inhalation. In the eastern Atlantic Ocean, the toxic O. cf. ovata has not yet been reported to the north of Portugal, and the only species present further north was O. cf. siamensis, for which the toxic risk is considered low. During summer blooms of unidentified Ostreopsis species on the French Basque coast (Atlantic) in 2020 and 2021, people suffered from irritations and respiratory disorders, and the number of analyzed cases reached 674 in 2021. In order to investigate the causes, sampling was carried out during summer 2021 to (i) taxonomically identify Ostreopsis species present using a molecular approach, (ii) isolate strains from the bloom and culture them, and (iii) characterize the presence of known toxins which may be involved. For the first time, this study reports the presence of both O. cf. siamensis and O. cf. ovata, for which the French Basque coast is a new upper distribution limit. Furthermore, the presence of ovatoxins a, b, c, and d in the environmental sample and in a cultivated strain in culture confirmed the toxic nature of the bloom and allowed identifying O. cf. ovata as the producer. The present data identify a new health risk in the area and highlight the extended distribution of some harmful dinoflagellates, presumably in relation to climate change.

Characterisation and toxicological activity of three different pseudo-nitzschia species from the northern Adriatic Sea (Croatia)

Diatoms of the genus Pseudo-nitzschia are cosmopolitans spread in seas and oceans worldwide, with more than 50 described species, dozens of which have been confirmed to produce domoic acid (DA). Here, we characterized and investigated the toxicological activity of secondary metabolites excreted into the growth media of different Pseudo-nitzschia species sampled at various locations in the northern Adriatic Sea (Croatia) using human blood cells under in vitro conditions. The results revealed that three investigated species of the genus Pseudo-nitzschia were capable of producing DA indicating their toxic potential. Moreover, toxicological data suggested all three Pseudo-nitzschia species can excrete toxic secondary metabolites into the surrounding media in addition to the intracellular pools of DA, raising concerns regarding their toxicity and environmental impact. In addition, all three Pseudo-nitzchia species triggered oxidative stress, one of the mechanisms of action likely responsible for the DNA damage observed in human blood cells. In line with the above stated, our results are of great interest to environmental toxicologists, the public and policy makers, especially in light of today’s climate change, which favours harmful algal blooms and the growth of DA producers with a presumed negative impact on the public health of coastal residents.

Method to identify the likelihood of death in residential buildings during coastal flooding

Tools exist to predict fatalities related to floods, but current models do not focus on fatalities in buildings. For example, Storm Xynthia in France in 2010 resulted in 41 drowning deaths inside buildings. Therefore, there has been increasing recognition of the risk of people becoming trapped in buildings during floods. To identify buildings which could expose their occupants to a risk of death in the case of flooding, we propose the use of the extreme vulnerability index (VIE index), which identifies which buildings are at greatest risk of trapping people during floods. In addition, the “mortality function method” is used to further estimate the expected number of fatalities based on (1) groups of vulnerable people (e.g., aged or disabled), (2) the location of buildings in relation to major watercourses, and (3) the configuration of buildings (e.g., single or multiple entries and single or multiple stories). The overall framework is derived from case studies from Storm Xynthia which give a deterministic approach for deaths inside buildings for coastal floods, which is suited for low-lying areas protected by walls or sandy barriers. This methodology provides a tool which could help make decisions for adaptation strategy implementation to preserve human life.

Climate change mitigation: Thermal comfort improvement in Mediterranean social dwellings through dynamic test cells modelling

Global warming will lead to adverse consequences for human health and well-being. This research ought to determine whether passive low-cost strategies freely controlled by users (ventilation strategies, solar shadings or window operation) could be applied in low-income dwellings to meet acceptable thermal comfort to retrofit the Mediterranean social housing stock of southern Spain towards climate change. On-site measurements registered in some test cells (controlled environment with no users’ influence) were used to calibrate dynamic energy simulation models. The impact of several future periods, climate zones of southern Spain and orientations on thermal comfort was assessed. The results show that climate change triggers a more significant increase in outdoor temperatures in summer than in winter. Should ventilation be kept to minimum and blinds opened during daytime in winter, higher comfort would be achieved, with great differences between orientations and south reporting the best results. The higher the outdoor temperatures due to climate change, the higher the percentage of comfort hours (i.e. 23-68% in the present and 50-75% in 2080). In summer, natural night ventilation and blinds closed during daytime lead to the best comfort result, with negligible temperature differences between orientations. Future climate change scenarios worsen the percentage of comfort hours (i.e. 96-100% in the present, while up to 17% in 2080). Mechanical ventilation and blind aperture schedules were found to have the highest influence on overheating discomfort. Likewise, mechanical and natural ventilation schedules had the highest impact on undercooling discomfort.

A practical approach to the evaluation of local urban overheating – A coastal city case-study

In response to urbanization and global warming, which amplify heatwave effects and might lead to urban heat stress, this paper proposes a practical approach to characterize the local microclimate at the neigh-borhood scale. In this approach, the local urban climate is described using suitable indicators, to support the ecodistrict design process or refurbishment. Experimental and numerical results illustrate the approach in a case study of a French coastal city, La Rochelle. In the first step, we set up urban and rural weather stations to characterize the local urban climate over a summer period and to identify local tem-perature differences. The measurements highlighted a daytime urban cooling effect due to the local sea breeze. While the Urban Weather Generator (UWG) simulation tool used for this study does not capture coastal effects, the results were consistent with the urban heat island (UHI) measurements. We proposed two indicators to quantify the local climate modifications: local UHI and overheating intensity. The parameters of the adaptation strategies were assessed through a sensitivity analysis for these two indi-cators. For this case-study, we identified vegetation cover, building height and road albedo as key param-eters that can be used to mitigate local overheating. (c) 2021 Elsevier B.V. All rights reserved.

Prioritization of resilience initiatives for climate-related disasters in the metropolitan city of Venice

Increases in the magnitude and frequency of climate and other disruptive factors are placing environmental, economic, and social stresses on coastal systems. This is further exacerbated by land use transformations, urbanization, over-tourism, sociopolitical tensions, technological innovations, among others. A scenario-informed multicriteria decision analysis (MCDA) was applied in the Metropolitan City of Venice integrating qualitative (i.e., local stakeholder preferences) and quantitative information (i.e., climate-change projections) with the aim of enhancing system resilience to multiple climate-related threats. As part of this analysis, different groups of local stakeholders (e.g., local authorities, civil protection agencies, SMEs, NGOs) were asked to identify critical functions that needs to be sustained. Various policy initiatives were considered to support these critical functions. The MCDA was used to rank the initiatives across several scenarios describing main climate threats (e.g., storm surges, floods, heatwaves, drought). We found that many climate change scenarios were considered to be disruptive to stakeholders and influence alternative ranking. The management alternatives acting on physical domain generally enhance resilience across just a few scenarios while cognitive and informative initiatives provided resilience enhancement across most scenarios considered. With uncertainty of multiple stressors along with projected climate variability, a portfolio of cognitive and physical initiatives is recommended to enhance resilience.

The current situation and potential effects of climate change on the microbial load of marine bivalves of the Greek coastlines: An integrative review

Global warming affects the aquatic ecosystems, accelerating pathogenic microorganisms’ and toxic microalgae’s growth and spread in marine habitats, and in bivalve molluscs. New parasite invasions are directly linked to oceanic warming. Consumption of pathogen-infected molluscs impacts human health at different rates, depending, inter alia, on the bacteria taxa. It is therefore necessary to monitor microbiological and chemical contamination of food. Many global cases of poisoning from bivalve consumption can be traced back to Mediterranean regions. This article aims to examine the marine bivalve’s infestation rate within the scope of climate change, as well as to evaluate the risk posed by climate change to bivalve welfare and public health. Biological and climatic data literature review was performed from international scientific sources, Greek authorities and State organizations. Focusing on Greek aquaculture and bivalve fisheries, high-risk index pathogenic parasites and microalgae were observed during summer months, particularly in Thermaikos Gulf. Considering the climate models that predict further temperature increases, it seems that marine organisms will be subjected in the long term to higher temperatures. Due to the positive linkage between temperature and microbial load, the marine areas most affected by this phenomenon are characterized as ‘high risk’ for consumer health.

Dinophysis spp. Abundance and toxicity events in South Cornwall, U.K.: Interannual variability and environmental drivers at three coastal sites

Dinophysis is a genus of dinoflagellates with the potential to cause diarrhoeic Shellfish Poisoning (DSP) in humans. The lipophilic toxins produced by some species of Dinophysis spp. can accumulate within shellfish flesh even at low cell abundances, and this may result in the closure of a shellfish farm if toxins exceed the recommended upper limit. Over the period 2014 to 2020 inclusive there were several toxic events along the South West coast of U.K. related to Dinophysis spp. The Food Standards Agency (FSA) monitoring programme measure Dinophysis cell abundances and toxin concentration within shellfish flesh around the coasts of England and Wales, but there are few schemes routinely measuring the environmental parameters that may be important drivers for these Harmful Algal Blooms (HABs). This study uses retrospective data from the FSA monitoring at three sites on the south Cornwall coast as well as environmental data from some novel platforms such as coastal WaveRider buoys to investigate potential drivers and explore whether either blooms or toxic events at these sites can be predicted from environmental data. Wind direction was found to be important in determining whether a bloom develops at these sites, and low air temperature in June was associated with low toxicity in the shellfish flesh. Using real time data from local platforms may help shellfish farmers predict future toxic events and minimise financial loss.

Harmful algal blooms and their effects in coastal seas of Northern Europe

Harmful algal blooms (HAB) are recurrent phenomena in northern Europe along the coasts of the Baltic Sea, Kattegat-Skagerrak, eastern North Sea, Norwegian Sea and the Barents Sea. These HABs have caused occasional massive losses for the aquaculture industry and have chronically affected socioeconomic interests in several ways. This status review gives an overview of historical HAB events and summarises reports to the Harmful Algae Event Database from 1986 to the end of year 2019 and observations made in long term monitoring programmes of potentially harmful phytoplankton and of phycotoxins in bivalve shellfish. Major HAB taxa causing fish mortalities in the region include blooms of the prymnesiophyte Chrysochromulina leadbeateri in northern Norway in 1991 and 2019, resulting in huge economic losses for fish farmers. A bloom of the prymesiophyte Prymnesium polylepis (syn. Chrysochromulina polylepis) in the Kattegat-Skagerrak in 1988 was ecosystem disruptive. Blooms of the prymnesiophyte Phaeocystis spp. have caused accumulations of foam on beaches in the southwestern North Sea and Wadden Sea coasts and shellfish mortality has been linked to their occurrence. Mortality of shellfish linked to HAB events has been observed in estuarine waters associated with influx of water from the southern North Sea. The first bloom of the dictyochophyte genus Pseudochattonella was observed in 1998, and since then such blooms have been observed in high cell densities in spring causing fish mortalities some years. Dinoflagellates, primarily Dinophysis spp., intermittently yield concentrations of Diarrhetic Shellfish Toxins (DST) in blue mussels, Mytilus edulis, above regulatory limits along the coasts of Norway, Denmark and the Swedish west coast. On average, DST levels in shellfish have decreased along the Swedish and Norwegian Skagerrak coasts since approximately 2006, coinciding with a decrease in the cell abundance of D. acuta. Among dinoflagellates, Alexandrium species are the major source of Paralytic Shellfish Toxins (PST) in the region. PST concentrations above regulatory levels were rare in the Skagerrak-Kattegat during the three decadal review period, but frequent and often abundant findings of Alexandrium resting cysts in surface sediments indicate a high potential risk for blooms. PST levels often above regulatory limits along the west coast of Norway are associated with A. catenella (ribotype Group 1) as the main toxin producer. Other Alexandrium species, such as A. ostenfeldii and A. minutum, are capable of producing PST among some populations but are usually not associated with PSP events in the region. The cell abundance of A. pseudogonyaulax, a producer of the ichthyotoxin goniodomin (GD), has increased in the Skagerrak-Kattegat since 2010, and may constitute an emerging threat. The dinoflagellate Azadinium spp. have been unequivocally linked to the presence of azaspiracid toxins (AZT) responsible for Azaspiracid Shellfish Poisoning (AZP) in northern Europe. These toxins were detected in bivalve shellfish at concentrations above regulatory limits for the first time in Norway in blue mussels in 2005 and in Sweden in blue mussels and oysters (Ostrea edulis and Crassostrea gigas) in 2018. Certain members of the diatom genus Pseudo-nitzschia produce the neurotoxin domoic acid and analogs known as Amnesic Shellfish Toxins (AST). Blooms of Pseudo-nitzschia were common in the North Sea and the Skagerrak-Kattegat, but levels of AST in bivalve shellfish were rarely above regulatory limits during the review period. Summer cyanobacteria blooms in the Baltic Sea are a concern mainly for tourism by causing massive fouling of bathing water and beaches. Some of the cyanobacteria produce toxins, e.g. Nodularia spumigena, producer of nodularin, which may be a human health problem and cause occasional dog mortalities. Coastal and shelf sea regions in northern Europe provide a key supply of seafood, socioeconomic well-being and ecosystem services. I

Assessing pollen extreme events over a Mediterranean site: Role of local surface meteorology

The presence of very high pollen levels in the atmosphere is associated with a strong impact on health and a worsening of symptoms in people who already have a respiratory disease. However, there is no specification on the aerobiological, environmental and meteorological factors that allow for characterizing a pollen event as of great magnitude due to the significant impact it can cause on the population and the environment. This work proposes criteria to typify the levels of atmospheric pollen as an extreme pollen event (EPE), and aims to determine the meteorological variables that can affect the presence and permanence of high pollen concentrations over a period of time. To address this goal, the quasi-climatological pollen dataset recorded in Granada (Southeastern Spain) during the period 1992-2019, has been used. On the daily accumulated pollen concentrations, the 95th, 97th and 99th percentiles were calculated. Spearman’s correlation between the pollen con-centration exceeding the proposed thresholds (C (> P95), C (> P97), C (> P99)) and surface meteorological variables recorded during up to five days before the event were established in order to identify the meteorological conditions that might affect the EPEs. As for the number of days with values higher than the established percentiles, it has been seen that in the case of total pollen and Olea, Cupressaceae and Pinus, there is a robust monotonically ascending trend throughout the study period. Regarding meteorological variables, relative humidity and 24-h accumulated precipitation are shown as the two most influential variables up to three days before the event, although temperatures, visibility and wind direction also show a correlation with some pollen types. The criteria proposed in this work allow us for classifying high levels of pollen as an EPE, and lay the foundations of these extreme events in a context of climate change in which they will become more frequent.

Understandings, practices and human-environment relationships – A meta-ethnographic analysis of local and indigenous climate change adaptation and mitigation strategies in selected Pacific Island states

Local and Indigenous knowledge systems worldwide indicate adaptation and mitigation strategies to climate change. Particularly in regions that are massively affected by climatic changes, such as the Pacific Island States, there is a need for increased and combined research on the role which these knowledge systems can play internationally. For this reason, this article provides a synthesis of empirical results and approaches to local and Indigenous climate change adaptation and mitigation strategies in selected South Pacific Island States by using a meta-ethnographic approach. The reviewed literature is associated with the sub-disciplinary perspective of the Anthropology of Climate Change. The results of the meta-ethnographic analysis are discussed based on three thematic focal points: First, the empirical ground of local understandings of climate change and its theoretical conceptualization(s) are constituted. Second, the results of practices for adaptation to climate change are synthesized and presented in detail throughout one example. Third, the synthesis of climate change mitigation practices is outlined with a specific focus on human-environment relationships.

Exploring the health impacts of climate change in subsistence fishing communities throughout micronesia: A narrative review

For many people living in low-income coastal communities, marine resources provide a crucial source of animal protein and are of major nutritional importance. However, because of various human-induced pressures, such as overfishing and poor resource management, marine resources are deteriorating at an unprecedented rate. Climate change effects this dynamic by contributing directly to marine resource deterioration and acting as an effect multiplier, worsening already-present problems in the systems. This deterioration threatens the viability of marine resources to support future food security demands and presents multiple health implications for coastal communities that rely upon these resources. This research used a narrative review to explore how the impacts of climate change are projected to impact human health and sustainable development throughout subsistence fishing communities. A case study approach focusing on the Pacific Ocean region of Micronesia was conducted to provide a practical indication of the future scenario applicable to other geographical regions across the globe. The results indicate that climate change is likely to exacerbate adverse health outcomes such as food insecurity, ciguatera fish poisoning, heatstroke, and mental health problems and that climate change may lead to the deterioration of traditional cultural practices. As the climate crisis is happening now and will be an issue extending into the foreseeable future, it is necessary to implement adaptation strategies, funding, and governance to limit global emissions, preserve marine resources, and support human well-being. Therefore, this research details adaptation strategies, such as diversifying fish catch and reviving traditional postharvest preservation methods, that may help communities adapt to climate change.

Climate change and rural vulnerability in Vietnam: An analysis of livelihood vulnerability index

Vietnam is a densely populated country, with the majority of its impoverished people living in rural areas. These people lack facilities and means of self-protection against risks, especially natural disasters related to climate change. Therefore, it is necessary to study the livelihood vulnerability under climate change in rural regions of Vietnam. The study was based on the original Livelihood Vulnerability Index (LVI) and LVI-IPCC (the Intergovernmental Panel on Climate Change) combined with the use of dataset from the Vietnam Access to Resources Household Survey (VARHS) in 2018. by using the dataset from the Vietnam Access to Resources Household Survey (VARHS) in 2018. The database is composed of 1,852 rural households in 12 provinces in Vietnam and considers socio-demographic profile, livelihood, health, food, social networks, water status, natural disasters, and climate variability. The results show that the North Central and South Central Coasts are the most vulnerable regions, with a lower LVI score (0.261) but higher LVI-IPCC score (0.012); this is mainly due to higher exposure to disasters-such as floods, sea storms, and tropical depressions-which heavily affect people’s livelihood. The Red River Delta, the Northern Midlands and Mountains, and the Central Highlands are moderately vulnerable. Moreover, the research outcome indicates that the Red River Delta and the Mekong River Delta were more vulnerable in terms of the sensitivity factor due to a higher vulnerability score on food and water components, especially drought and saltwater intrusions

Plant debris are hotbeds for pathogenic bacteria on recreational sandy beaches

On recreational sandy beaches, there are guidelines for the management of bacterial pollution in coastal waters regarding untreated sewage, urban wastewater, and industrial wastewater. However, terrestrial plant debris on coastal beaches can be abundant especially after floods and whilst it has rarely been considered a concern, the bacterial population associated with this type of pollution from the viewpoint of public health has not been adequately assessed. In this study, microbes associated with plant debris drifting onto Kizaki Beach in Japan were monitored for 8 months throughout the rainy season, summer, typhoon season, and winter. Here we show that faecal-indicator bacteria in the plant debris and sand under the debris were significantly higher than the number of faecal bacteria in the sand after a 2015 typhoon. When we focused on specific pathogenic bacteria, Brevundimonas vesicularis and Pseudomonas alcaligenes were commonly detected only in the plant debris and sand under the debris during the survey period. The prompt removal of plant debris would therefore help create safer beaches.

Health inequality among fishery workers during climate change: A national population-based and retrospective longitudinal cohort study

Background: Owing to specific working environments, it is important to attain sustainable development goals for the health of fishery workers during climate change. Fishery workers have a hazardous working environment, leading to specific injuries and fatal events. However, limited studies have investigated the health status of fishery workers through long-term longitudinal follow-up and compared it with that of farmers and employed workers with similar socioeconomic status. Methods: The Longitudinal Health Insurance Database 2000, a subset of the Taiwan National Health Insurance Research Database was used for this retrospective cohort study. Only fishery workers, farmers, and employed workers were included. Based on the majority of causes of death and related diseases, participants newly diagnosed with 18 diseases, classified into cardiometabolic diseases, mental illness, chronic kidney disease, infection, and malignancy, were included. Participants with an old diagnosis of these diseases were excluded. All included participants were followed up from 1 July 2000 to the diagnosis and withdrawal date, or 31 December 2012, whichever occurred first. Due to the substantial difference in the baseline demographics, we executed a cohort study with propensity score-matched and applied the Cox model to explore the participants’ health status. Results: After matching, there were negligible differences in the baseline demographics of fishery workers, farmers, and employed workers. Compared to farmers and employed workers, fishery workers were more frequently diagnosed with 11 and 14 diseases, respectively, such as hypertension (hazard ratio [HR]: 1.11, p < 0.01), diabetes (HR: 1.21, p < 0.001), dyslipidemia (HR: 1.18, p < 0.001), depression (HR: 1.38, p < 0.001), peptic ulcer (HR: 1.17, p < 0.001), chronic viral hepatitis (HR: 2.06, p < 0.001), hepatocellular carcinoma (HR: 1.67, p < 0.001), and total malignancy (HR: 1.26, p < 0.001). Conclusions: Compared to farmers and employed workers, fishery workers were more impacted by cardiometabolic diseases, mental illness, infection, and malignancy. Therefore, it is imperative to specifically focus on health policies for fishery workers, such as providing curable antiviral treatment and initiating culture-tailored health promotion programs, to mitigate health inequality.

Planned relocation and health: A case study from Fiji

In Fiji, low-lying coastal villages are beginning to retreat and relocate in response to coastal erosion, flooding and saltwater intrusion. Planned relocation is considered a last resort as a form of adaptation to the impacts of climatic and environmental change. The health impacts of planned relocation are poorly understood. This paper draws on data from multi-year research with residents of the iTaukei (Indigenous) Fijian village of Vunidogoloa. We used qualitative research methods to examine experiences of planned relocation, including residents’ accounts of their health and quality of life. In-depth interviews and group discussions were conducted with villagers living in a site of relocation, at four points in time (2015, 2016, 2019, and 2020). Twenty-seven people in Vunidogoloa, Fiji, participated in in-depth interviews, several on more than one occasion. Six group discussions with between eight to twelve participants were also conducted. Qualitative analytic software (NVivo) was used to analyse interview transcripts and identify themes. Villagers report both health benefits and challenges following planned relocation. Key facilitators for good health include movement away from some environmental risks to health, adequate drinking water and sanitation, food security including through farms and kitchen gardens, livelihood opportunities, improved access to schools and health services, and appropriate housing design. However, residents also refer to unanticipated risks to health including increased consumption of packaged goods and alcohol, disruptions to social structures and traditional values, and disrupted place attachment following movement away from a coastal site of belonging with consequences for mental wellbeing. Therefore, planned relocation has altered the social determinants of health in complex ways, bringing both health opportunities and risks. These results highlight the need for context-specific planning and adaptation programs that include meaningful involvement of community members in ongoing decision making, and call for an understanding of diverse social determinants of health that emerge and evolve in contexts of planned relocation.

Prevalence and spatial heterogeneity of Trichomonas vaginalis infection among the female population and association with climate in Guangxi Zhuang autonomous region, Southern China

BACKGROUND: Two cervical cancer screening (CCS) projects have been ongoing for years in Guangxi Zhuang autonomous region (Guangxi), and some Trichomonas vaginalis infection (TVI) cases have been found as an opportunistic finding. This study aimed to identify the high-risk population and expound the spatial epidemiological features of TVI in Guangxi. METHODS: This study was based on CCS from 2012 to 2019. Adjusted odds ratio (AOR), and spatial analyses were used to identify the high-risk subgroups, as well as to depict the spatial epidemiological feature and its relationship with meteorological factors. RESULTS: The infection rate of TVI was 0.38% in 873,880 samples. Significant association with a high risk of TVI was found in the following: females aged 40-49 years (aOR=4.464; 95% CI, 3.359-5.932; p<0.001), aged 50-59 years (aOR=3.169; 95% CI, 2.370-4.237; p<0.001), from urban (aOR=1.577; 95% CI, 1.471-1.691; p<0.001), from minority areas (aOR=1.183; 95% CI, 1.060-1.320; p=0.003), areas with GPD <41,500 CNY (aOR=1.191; 95% CI, 1.106-1.282; p<0.001), and inland areas (aOR=1.520; 95% CI, 1.339-1.726; p<0.001). Counties with higher infection rate were concentrated in northwest Guangxi's mountainous area (Z-score=3.9656, p<0.001), in the upper reaches of the Hongshui River and Yu River, and with a significant spatial autocorrelation (Moran's I=0.581, p=0.002). Spatial error model showed significantly negative regressions among temperature (B=-0.295, p=0.002), annual temperature range (B=-0.295, p=0.002), and TVI spatial distribution. CONCLUSION: The spatial clustering and disparity of TVI in northwest Guangxi warrant further study, and meteorological conditions may play an important role in TVI in northwest Guangxi.

Climate change, mental health and wellbeing: Privileging pacific peoples’ perspectives – phase one

Impacts of climate change in the Pacific are far reaching and include effects on mental health and wellbeing. Pacific concepts around the interrelation of these global giants are yet to be described. The aim of this study was to seek consensus amongst Pacific mental health and/or climate change experts on key principles underpinning mental health and wellbeing, and climate change, and the intersection of the two, for Pacific peoples. The Delphi method included forming a panel of 70 experts. Two rounds of online questionnaires sought their views on mental health and wellbeing, and climate change and the impact upon Pacific peoples. Of the panel 86% identified with one or more Pacific ethnicities. Six themes emerged, 92% of items reached consensus and 36% reached strong consensus of >95%. Recurring subthemes included culture and spirituality, family and community, connection to ancestors, connection to the environment, resilience, disasters, livelihoods, government, education, workforce, migration and stigma. This is the first time these concepts have been explored and described for, and by Pacific peoples in this format. It is a necessary first step towards development of responses in preparedness of mental health services, in the Pacific region, and Aotearoa New Zealand.

Impact of coastal disasters on women in urban slums: A new index

Coastal hazards, particularly cyclones, floods, erosion and storm surges, are emerging as a cause for major concern in the coastal regions of Vijayawada, Andhra Pradesh, India. Serious coastal disaster events have become more common in recent decades, triggering substantial destruction to the low-lying coastal areas and a high death toll. Further, women living in informal and slum housing along the Vijayawada coastline of Andhra Pradesh (CAP), India, suffer from multiple social, cultural and economic inequalities as well. These conditions accelerate and worsen women’s vulnerability among this coastal population. The existing literature demonstrates these communities’ susceptibility to diverse coastal disasters but fails to offer gender-specific vulnerability in urban informal housing in the Vijayawada area. Accordingly, the current study developed a novel gender-specific Women’s Coastal Vulnerability Index (WCVI) to assess the impact of coastal disasters on women and their preparedness in Vijayawada. Field data was collected from over 300 women through surveys (2) and workshops (2) between November 2018 and June 2019, and Arc-GIS tools were used to generate vulnerability maps. Results show that women are more vulnerable than men, with a higher death rate during coastal disaster strikes. The current study also found that gender-specific traditional wear is one of the main factors for this specific vulnerability in this area. Furthermore, the majority of the women tend to be located at home to care for the elders and children, and this is associated with more fatalities during disaster events. Homes, particularly for the urban poor, are typically very small and located in narrow and restricted sites, which are a barrier for women to escape from unsafe residential areas during disasters. Overall, the research reveals that most of the coastal disaster events had a disproportionately negative impact on women. The results from this present study offer valuable information to aid evidence-based policy- and decision-makers to improve existing or generate innovative policies to save women’s lives and improve their livelihood in coastal areas.

Urban flood risks and emerging challenges in a Chinese delta: The case of the Pearl River Delta

By the 2050s, more than 120 million people are predicted to settle in the Pearl River Delta (PRD), which covers large coastal cities such as Guangzhou, Shenzhen and Hong Kong. Cities in the PRD are vitally important to China in relation to their socio-economic contributions. From recent evidence, this strongly urbanized area is vulnerable to, and currently facing bigger incidences of, coastal and urban flooding. Flood risk is growing in low-lying coastal areas due to rapid urbanization and increasing flood hazards exacerbated by climate change. Frequent intensive rainstorms, sea-level rise, typhoons and surges threaten large populations and their economic assets, causing severe socio-economic and ecological impacts in the PRD cities. Current flood risk management (FRM) in the delta is still predominately focused on using traditional techno-fixes and infrastructure paradigms, lacking sufficient strategic planning and flood protection to develop adequate flood resilience. Recent urban floods, enhanced by storm surges and intensive rainstorms, have affected multiple PRD cities and drawn attention to flood risk as a major challenge in the PRD’s coastal cities. This review encourages development of long-term FRM practices with provincial and municipal authorities working together more closely to develop better-integrated regional FRM strategies for the PRD.

Households’ perceptions and socio-economic determinants of climate change awareness: Evidence from Selangor Coast Malaysia

Households living in the close vicinity of shoreline are constantly threatened by various climate change impacts. Community awareness towards climate change is a subject of considerable study as adequate knowledge is a preliminary step for adaptation decision making. An important question is how coastal communities perceive climatic variation, sea level rise and coastal hazard impacts and the socio-economic factors that affect their level of awareness. Thus, this research measures the level of awareness and the factors influencing it based on a household survey (n = 1016) that was conducted 10 critically eroded coastal areas in Selangor. Descriptive statistical analysis reveals that more than half of the households have high level of awareness about climatic variation and sea level, however, there is moderate awareness about the coastal hazard impacts such as human causalities and disease transmission. Even though households are more aware of direct coastal hazard impact such as damages to properties and disruption of daily activities. An independent sample T test indicates that respondents who are male, at working age, educated, involve in natural resource dependent occupations, and had prior exposure to extreme coastal hazards have higher levels of awareness. Research indicated about 55% of all sampled households reflected awareness of climate change, 60% households were aware of sea level rise and 47% households were aware of coastal hazard impact. This study recommends that households in Selangor coast need capacity building and climate change awareness initiatives which would assist household to build adaptive capacity, increase resilience and reduce vulnerability to climate change.

Cooling power of sea breezes and its inland penetration in dry-summer Adelaide, Australia

Extreme high-temperature events pose a threat to human beings on Earth. In coastal cities, the sea breeze is widely known as a prevailing wind that can cool the near-surface air. However, the cumulative cooling effect and its attenuation process during the sea breeze penetration have not been well investigated. In this study, we analyze sea breeze cooling capacity (SBCC) and propose a new method in estimating the penetration distance of sea breeze cooling in metropolitan Adelaide during summer using data from the Adelaide urban heat island monitoring network. The results show that during a sea breeze day, wind direction rapidly changes from southeast to southwest in the morning, and it gradually returns to southeast in the afternoon. It takes 67 min on average for the sea breeze cooling fronts to penetrate inside metropolitan Adelaide. The SBCC value is 21.3 degrees C h per event averaged spatially in Adelaide summer. During the penetration process, the SBCC values decrease at a rate of 0.7 and 0.9 degrees C h per kilometer from coast to inland on an average sea breeze day and a hot sea breeze day, respectively. Correspondingly, the mean cooling penetration distances are 42 and 29 km along the prevailing wind path. A multiple linear regression analysis indicates that the distance from the coast and elevation at the onshore point together explain 88% of the spatial variability of the temporally average SBCC in the study area. The spatial pattern and penetration distance of the cumulative sea breeze cooling effect contribute to a better understanding of this common cooling source for heat mitigation in coastal cities where a large number of people reside.

Integrated analyses of fecal indicator bacteria, microbial source tracking markers, and pathogens for Southeast Asian beach water quality assessment

The degradation of coastal water quality from fecal pollution poses a health risk to visitors at recreational beaches. Fecal indicator bacteria (FIB) are a proxy for fecal pollution; however the accuracy of their representation of fecal pollution health risks at recreational beaches impacted by non-point sources is disputed due to non-human derivation. This study aimed to investigate the relationship between FIB and a range of culturable and molecular-based microbial source tracking (MST) markers and pathogenic bacteria, and physicochemical parameters and rainfall. Forty-two marine water samples were collected from seven sampling stations during six events at two tourist beaches in Thailand. Both beaches were contaminated with fecal pollution as evident from the GenBac3 marker at 88%-100% detection and up to 8.71 log(10) copies/100 mL. The human-specific MST marker human polyomaviruses JC and BK (HPyVs) at up to 4.33 log(10) copies/100 mL with 92%-94% positive detection indicated that human sewage was likely the main contamination source. CrAssphage showed lower frequencies and concentrations; its correlations with the FIB group (i.e., total coliforms, fecal coliforms, and enterococci) and GenBac3 diminished its use as a human-specific MST marker for coastal water. Human-specific culturable AIM06 and SR14 bacteriophages and general fecal indicator coliphages also showed less sensitivity than the human-specific molecular assays. The applicability of the GenBac3 endpoint PCR assay as a lower-cost prescreening step prior to the GenBac3 qPCR assay was supported by its 100% positive predictive value, but its limited negative predictive values required subsequent qPCR confirmation. Human enteric adenovirus and Vibrio cholerae were not found in any of the samples. The HPyVs related to Vibrio parahaemolyticus, Vibrio vulnificus, and 5-d rainfall records, all of which were more prevalent and concentrated during the wet season. More monitoring is therefore recommended during wet periods. Temporal differences but no spatial differences were observed, suggesting the need for a sentinel site at each beach for routine monitoring. The exceedance of FIB water quality standards did not indicate increased prevalence or concentrations of the HPyVs or Vibrio spp. pathogen group, so the utility of FIB as an indicator of health risks at tropical beaches maybe challenged. Accurate assessment of fecal pollution by incorporating MST markers could lead to developing a more effective water quality monitoring plan to better protect human health risks in tropical recreational beaches.

Over 30 years of HABs in the Philippines and Malaysia: What have we learned?

In the Southeast Asian region, the Philippines and Malaysia are two of the most affected by Harmful Algal Blooms (HABs). Using long-term observations of HAB events, we determined if these are increasing in frequency and duration, and expanding across space in each country. Blooms of Paralytic Shellfish Toxin (PST)-producing species in the Philippines did increase in frequency and duration during the early to mid-1990s, but have stabilized since then. However, the number of sites affected by these blooms continue to expand though at a slower rate than in the 1990s. Furthermore, the type of HABs and causative species have diversified for both toxic blooms and fish kill events. In contrast, Malaysia showed no increasing trend in the frequency of toxic blooms over the past three decades since Pyrodinium bahamense was reported in 1976. However, similar to the Philippines, other PST producers such as Alexandrium minutum and Alexandrium tamiyavanichii have become a concern. No amnesic shellfish poisoning (ASP) has been confirmed in either Philippines or Malaysia thus far, while ciguatera fish poisoning cases are known from the Philippines and Malaysia but the causative organisms remain poorly studied. Since the 1990s and early 2000s, recognition of the distribution of other PST-producing species such as species of Alexandrium and Gymnodinium catenatum in Southeast Asia has grown, though there has been no significant expansion in the known distributions within the last decade. A major more recent problem in the two countries and for Southeast Asia in general are the frequent fish-killing algal blooms of various species such as Prorocentrum cordatum, Margalefidinium polykrikoides, Chattonella spp., and unarmored dinoflagellates (e.g., Karlodinium australe and Takayama sp.). These new sites affected and the increase in types of HABs and causative species could be attributed to various factors such as introduction through mariculture and eutrophication, and partly because of increased scientific awareness. These connections still need to be more concretely investigated. The link to the El Niño Southern Oscillation (ENSO) should also be better understood if we want to discern how climate change plays a role in these patterns of HAB occurrences.

A climate-driven model for predicting the level of Vibrio parahaemolyticus in oysters harvested from Taiwanese farms using elastic net regularized regression

This study aimed at, and developed, a climate-driven model for predicting the abundance of V. parahaemolyticus in oysters based on the local climatological and environmental conditions in Taiwan. The predictive model was constructed using the elastic net machine learning method, and the most influential predictors were evaluated using a permutation-based approach. The abundance of V. parahaemolyticus in oysters in different seasons, time horizons, and representative concentration pathways (RCPs) were predicted using the Elastic-net machine learning model. The results showed: (1) the variation in wind speed or gust wind speed, sea surface temperature, precipitation, and pH influenced the prediction of V. parahaemolyticus concentration in oysters, and (2) the level of V. parahaemolyticus in oysters in Taiwan was projected to be increased by 40-67% in the near future (2046-2065) and by 39-86% by the end of twentieth-century (2081-2100) if the global temperature continues to increase due to climate change. The findings in this study may be used as inputs for quantifying the V. parahaemolyticus infection risk from eating this seafood in Taiwan.

Distribution of bacterial concentration and viability in atmospheric aerosols under various weather conditions in the coastal region of China

Airborne bacteria have an important role in atmospheric processes and human health. However, there is still little information on the transmission and distribution of bacteria via the airborne route. To characterize the impact of foggy, haze, haze-fog (HF) and dust days on the concentration and viability of bacteria in atmospheric aerosols, size-segregated bioaerosol samples were collected in the Qingdao coastal region from March 2018 to February 2019. The total airborne microbes and viable/non-viable bacteria in the bioaerosol samples were measured using an epifluorescence microscope after staining with DAPI (4′, 6-diamidino-2-phenylindole) and a LIVE/DEAD® BacLight Bacterial Viability Kit. The average concentrations of total airborne microbes on haze and dust days were 6.75 × 10(5) and 1.03 × 10(6) cells/m(3), respectively, which increased by a factor of 1.3 and 2.5 (on average), respectively, relative to those on sunny days. The concentrations of non-viable bacteria on haze and dust days increased by a factor of 1.2 and 3.6 (on average), respectively, relative to those on sunny days. In contrast, the concentrations of viable bacteria on foggy and HF days were 7.13 × 10(3) and 5.74 × 10(3) cells/m(3), decreases of 38% and 50%, respectively, compared with those on sunny days. Foggy, haze, dust and HF days had a significant effect on the trend of the seasonal variation in the total airborne microbes and non-viable bacteria. Bacterial viability was 20.8% on sunny days and significantly higher than the 14.1% on foggy days, 11.2% on haze days, 8.6% during the HF phenomenon and 6.1% on dust days, indicating that special weather is harmful to some bacterial species. Correlation analysis showed that the factors that influenced the bacterial concentration and viability depended on different weather conditions. The main influential factors were temperature, NO(2) and SO(2) concentrations on haze days, and temperature, particulate matter (PM(2.5)) and NO(2) concentrations on foggy days. The median size of particles containing viable bacteria was 1.94 μm on sunny days and decreased to 1.88 μm and 1.74 μm on foggy and haze days, respectively, but increased to 2.18 μm and 2.37 μm on dust and HF days, respectively.

Climate change and mental health impacts among Dalit communities in southwestern Bangladesh

Research and Action Agenda on Climate Change and Mental Health for Small Farmers and Fisher Peoples

Proyecto AdaptaClima | Intercambio de experiencias entre los proyectos regionales AdaptaClima y ACC río Uruguay

VCH Chief Medical Health Officer Report 2023: Protecting Population Health in a Climate Emergency

Predicting exposure to pathogens and AMR

Real-time risk mapping to inform river users

A pilot study for the One Health Living Lab

Evaluating a bathing water quality app

A tool to support local climate adaptations

Where the Water Meets the Land – A Coastal Digital Elevation Model Framework

Climate change and public health indicators: scoping review

Climate change and health resilience actions in São Tomé and Príncipe

EU/CARIFORUM Caribbean Climate Change and Health Leaders Fellowship Training Program

Human Climate Horizons (HCH)

Sea-Level Rise: Checklists to Assess Vulnerabilities in Health Care Facilities in the Context of Climate Change

Societal implications of a changing Arctic Ocean

The Arctic Ocean is undergoing rapid change: sea ice is being lost, waters are warming, coastlines are eroding, species are moving into new areas, and more. This paper explores the many ways that a changing Arctic Ocean affects societies in the Arctic and around the world. In the Arctic, Indigenous Peoples are again seeing their food security threatened and cultural continuity in danger of disruption. Resource development is increasing as is interest in tourism and possibilities for trans-Arctic maritime trade, creating new opportunities and also new stresses. Beyond the Arctic, changes in sea ice affect mid-latitude weather, and Arctic economic opportunities may re-shape commodities and transportation markets. Rising interest in the Arctic is also raising geopolitical tensions about the region. What happens next depends in large part on the choices made within and beyond the Arctic concerning global climate change and industrial policies and Arctic ecosystems and cultures.

Review of the evidence for oceans and human health relationships in Europe: A systematic map

BACKGROUND: Globally, there is increasing scientific evidence of critical links between the oceans and human health, with research into issues such as pollution, harmful algal blooms and nutritional contributions. However, Oceans and Human Health (OHH) remains an emerging discipline. As such these links are poorly recognized in policy efforts such as the Sustainable Development Goals, with OHH not included in either marine (SDG14) or health (SDG3) goals. This is arguably short-sighted given recent development strategies such as the EU Blue Growth Agenda. OBJECTIVES: In this systematic map we aim to build on recent efforts to enhance OHH in Europe by setting a baseline of existing evidence, asking: What links have been researched between marine environments and the positive and negative impacts to human health and wellbeing? METHODS: We searched eight bibliographic databases and queried 57 organizations identified through stakeholder consultation. Results include primary research and systematic reviews which were screened double blind against pre-defined inclusion criteria as per a published protocol. Studies were limited to Europe, US, Australia, New Zealand and Canada. Data was extracted according to a stakeholder-defined code book. A narrative synthesis explores the current evidence for relationships between marine exposures and human health outcomes, trends in knowledge gaps and change over time in the OHH research landscape. The resulting database is available on the website of the Seas, Oceans and Public Health in Europe website (https://sophie2020.eu/). RESULTS: A total of 1,542 unique articles were included in the database, including those examined within 56 systematic reviews. Research was dominated by a US focus representing 50.1% of articles. A high number of articles were found to link: marine biotechnology and cardiovascular or immune conditions, consumption of seafood and cardiovascular health, chemical pollution and neurological conditions, microbial pollution and gastrointestinal or respiratory health, and oil industry occupations with mental health. A lack of evidence relates to direct impacts of plastic pollution and work within a number of industries identified as relevant by stakeholders. Research over time is dominated by marine biotechnology, though this is narrow in focus. Pollution, food and disease/injury research follow similar trajectories. Wellbeing and climate change have emerged more recently as key topics but lag behind other categories in volume of evidence. CONCLUSIONS: The evidence base for OHH of relevance to European policy is growing but remains patchy and poorly co-ordinated. Considerable scope for future evidence synthesis exists to better inform policy-makers, though reviews need to better incorporate complex exposures. Priorities for future research include: proactive assessments of chemical pollutants, measurable impacts arising from climate change, effects of emerging marine industries, and regional and global assessments for OHH interactions. Understanding of synergistic effects across multiple exposures and outcomes using systems approaches is recommended to guide policies within the Blue Growth Strategy. Co-ordination of research across Europe and dedicated centres of research would be effective first steps.

Lionfish envenomation in Caribbean and Atlantic waters: Climate change and invasive species

The concept of emerging diseases is well understood; however, the concept of emerging injuries is not. We describe the introduction of two species of lionfish, native to the Indian and Pacific Oceans, into the warm shallow coastal waters of the Western Atlantic Ocean and the Caribbean Sea. Lionfish thrive in the same coastal waters that attract recreational swimmers, snorkelers, and divers. Because lionfish have ornate colors, people often swim close to have a better look. Lionfish have venomous spines and, in a defensive reaction, frequently envenomate curious humans. The fish are voracious predators and disrupt the coral ecosystems of the Atlantic. Furthermore, their range is spreading through a combination of lack of natural predators and the expansion of hospitable warm waters into higher latitudes as part of climate change.

A review of the environmental trigger and transmission components for prediction of cholera

Climate variables influence the occurrence, growth, and distribution of Vibrio cholerae in the aquatic environment. Together with socio-economic factors, these variables affect the incidence and intensity of cholera outbreaks. The current pandemic of cholera began in the 1960s, and millions of cholera cases are reported each year globally. Hence, cholera remains a significant health challenge, notably where human vulnerability intersects with changes in hydrological and environmental processes. Cholera outbreaks may be epidemic or endemic, the mode of which is governed by trigger and transmission components that control the outbreak and spread of the disease, respectively. Traditional cholera risk assessment models, namely compartmental susceptible-exposed-infected-recovered (SEIR) type models, have been used to determine the predictive spread of cholera through the fecal-oral route in human populations. However, these models often fail to capture modes of infection via indirect routes, such as pathogen movement in the environment and heterogeneities relevant to disease transmission. Conversely, other models that rely solely on variability of selected environmental factors (i.e., examine only triggers) have accomplished real-time outbreak prediction but fail to capture the transmission of cholera within impacted populations. Since the mode of cholera outbreaks can transition from epidemic to endemic, a comprehensive transmission model is needed to achieve timely and reliable prediction with respect to quantitative environmental risk. Here, we discuss progression of the trigger module associated with both epidemic and endemic cholera, in the context of the autochthonous aquatic nature of the causative agent of cholera, V. cholerae, as well as disease prediction.

Scrambling for safety in the eye of Dorian: Mental health consequences of exposure to a climate-driven hurricane

As climate change alters the behavior of Atlantic hurricanes, these storms are trending stronger, wetter, and slower moving over coastal and island populations. Hurricane Dorian exemplified all three attributes. Dorian’s destructive passage over the Abaco Islands, Bahamas, on September 1, 2019, exposed residents of its capital, Marsh Harbour, to a prolonged encounter with the storm’s core. After Dorian’s fierce front eyewall and towering storm surge tore apart shanty town habitats and eviscerated concrete homesites, residents desperately sought refuge during the brief respite when Dorian’s eye passed directly overhead. The category 5 winds then resumed abruptly and Dorian continued its relentless destruction. This article focuses on the storm’s mental health consequences, drawing on observations of on-site clinicians as well as findings from previous research on the mental health effects of Atlantic hurricanes and the transformation of hurricane hazards resulting from climate change. To protect island and coastal populations against climate-driven storms, disaster planning policy should emphasize resilience-focused prevention and mitigation strategies. In the aftermath of these events, health system response should include community outreach, case finding, and evidence-based interventions that optimize the use of mental health professionals.

Review: The nexus of climate change, food and nutrition security and diet-related non-communicable diseases in Pacific Island Countries and Territories

Climate change and non-communicable diseases (NCDs) are two of the most important global health challenges of this century. Pacific island countries and territories (PICTs) are particularly vulnerable to the adverse impacts of climate change and face an increasingly high burden of NCDs. This review synthesizes the evidence for the links between climate change, food and nutrition security (FNS) and NCDs in the Pacific region and outlines the possible implications of these relationships. A comprehensive search was performed on global databases including PubMed, SCOPUS and ScienceDirect, the grey literature and reference lists. Four dominant pathways between climate change, FNS and NCDs emerged from the literature: the impact of climate change on agriculture, fisheries, migration and humanitarian food assistance. These pathways, if not addressed, are likely to lead to impaired FNS and an increased burden of NCDs in PICTs. There is little doubt that Pacific nations will experience adverse impacts of climate change exacerbating existing health risks and other socio-cultural, political and economic drivers of food and nutrition insecurity and NCDs. Further research is needed to strengthen the evidence and develop integrated, context-specific solutions. It is, however, imperative to take action to address these issues via a cross-sectoral, no-regrets, health-in-all-policies approach.

Mitigating the twin threats of climate-driven Atlantic hurricanes and COVID-19 transmission

The co-occurrence of the 2020 Atlantic hurricane season and the ongoing coronavirus disease 2019 (COVID-19) pandemic creates complex dilemmas for protecting populations from these intersecting threats. Climate change is likely contributing to stronger, wetter, slower-moving, and more dangerous hurricanes. Climate-driven hazards underscore the imperative for timely warning, evacuation, and sheltering of storm-threatened populations – proven life-saving protective measures that gather evacuees together inside durable, enclosed spaces when a hurricane approaches. Meanwhile, the rapid acquisition of scientific knowledge regarding how COVID-19 spreads has guided mass anti-contagion strategies, including lockdowns, sheltering at home, physical distancing, donning personal protective equipment, conscientious handwashing, and hygiene practices. These life-saving strategies, credited with preventing millions of COVID-19 cases, separate and move people apart. Enforcement coupled with fear of contracting COVID-19 have motivated high levels of adherence to these stringent regulations. How will populations react when warned to shelter from an oncoming Atlantic hurricane while COVID-19 is actively circulating in the community? Emergency managers, health care providers, and public health preparedness professionals must create viable solutions to confront these potential scenarios: elevated rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19, and the resurgence of COVID-19 cases among hurricane evacuees who shelter together.

Marine harmful algal blooms and human health: A systematic scoping review

Exposure to harmful algal blooms (HABs) can lead to well recognised acute patterns of illness in humans. The objective of this scoping review was to use an established methodology and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting framework to map the evidence for associations between marine HABs and observed both acute and chronic human health effects. A systematic and reproducible search of publications from 1985 until May 2019 was conducted using diverse electronic databases. Following de-duplication, 5301 records were identified, of which 380 were included in the final qualitative synthesis. The majority of studies (220; 57.9%) related to Ciguatera Poisoning. Anecdotal and case reports made up the vast majority of study types (242; 63.7%), whereas there were fewer formal epidemiological studies (35; 9.2%). Only four studies related to chronic exposure to HABs. A low proportion of studies reported the use of human specimens for confirmation of the cause of illness (32; 8.4%). This study highlighted gaps in the evidence base including a lack of formal surveillance and epidemiological studies, limited use of toxin measurements in human samples, and a scarcity of studies of chronic exposure. Future research and policy should provide a baseline understanding of the burden of human disease to inform the evaluation of the current and future impacts of climate change and HABs on human health.

Marsh migration, climate change, and coastal resilience: Human dimensions considerations for a fair path forward

Coastal regions worldwide will be dramatically reshaped by the impacts of sea-level rise. Of particular concern are impacts on coastal wetlands, the loss of which would have consequences for both human and ecological communities. The future of many coastal wetlands will depend greatly on their capacities to migrate into uplands. Coastal resilience work within wetland sciences has increasingly focused on developing strategies to promote marsh migration into rural uplands; however, less attention has been given to the impacts that migrating marshes have on people in these landscapes. In this paper, we share rural perspectives and experiences with marsh migration through three case-studies from collaborative research with rural, low-lying communities on the Chesapeake Bay, USA. These case-studies demonstrate the complexities of the challenges facing rural communities as a result of marsh migration, and reveal important issues of equity and injustice that need attention in future coastal resilience work. We draw upon a socio-ecological systems (SES) approach to highlight potential human-ecological misalignments that emerge with marsh migration and to offer future research questions to inform socially-just and resilient wetland migration planning in rural coastal areas.

Human health and ocean pollution

BACKGROUND: Pollution – unwanted waste released to air, water, and land by human activity – is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood. GOALS: (1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health. METHODS: Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention. ENVIRONMENTAL FINDINGS: Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources – coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths. ECOSYSTEM FINDINGS: Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the Vibrio species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks. HUMAN HEALTH FINDINGS: Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants in utero to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children’s risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals – phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them

Climate change for coastal areas: Risks, adaptation and acceptability

Climate change, mental health, and well-being for Pacific peoples: A literature review

In this literature review, we analyze existing research on climate change and its impact on mental health and well-being, primarily among Pacific Islanders. To compensate for a lack of research in this area, we also address some of the projected mental health implications resulting from disasters linked to climate change, such as flooding, hurricanes, and cyclones. This broader scope enables the identification of areas where more research into mental health concerns related to climate change in the Pacific is needed. In closing, we provide recommendations for further research into the mental health and well-being of Pacific peoples and suggest ways to develop resilience to the effects of climate change.

Coastal climate change adaptation and disaster risk reduction: A review of policy, programme and practice for sustainable planning outcomes

Climate change and disaster risk are serious concerns considering the vulnerability of coastal areas and cities to various climate-disaster threats. Hence, the urban populace and planning stakeholders are grappling with the challenges of seeking ways to integrate adaptation measures into human livelihoods and planning systems. However, the synergy between climate change adaptation (CCA) and disaster risk reduction (DRR) remains fragmented and vague. Therefore, this review highlighted recent theoretical and practical methodologies for sustainable planning outcomes in relation to CCA and DRR themes. This paper provides a new model, Problem analysis model (PAM), designed to analyse Origin-Cause-Effect (impacts)-Risks identification and Answers to climate-related disaster at the local or community level. Lastly, three identified enablers were extensively discussed (policy, programme and practice) as a step towards the model implementation and to improve sustainable planning outcomes.

Mapping risk factors to climate change impacts using traditional ecological knowledge to support adaptation planning with a Native American Tribe in Louisiana

Indigenous communities are often on the front-lines of climate change, and for tribes such as the Pointe-au-Chien Indian Tribe (PACIT) that make their homes and livelihoods in the dynamic landscapes of Coastal Louisiana (USA), sea-level rise, subsidence, and land loss are very real reminders of why they must continue to hone their adaptive capacity that has evolved over many generations and continues to evolve as the pace of change quickens. PACIT members have an inherited wisdom about their surrounding environment and continue to build on that body of observational knowledge that is passed from generation to generation to sustain themselves in this dynamic landscape. This knowledge is woven through their culture and is sometimes referred to as traditional ecological knowledge (TEK). The PACIT and other Indigenous communities around the world are using creative strategies to adapt to the impacts of climate change that include partnering with researchers to combine their TEK with science in approaches to enhance strategies dealing with climate change impacts, mitigation, and adaptation. Tribes and other Indigenous communities often have a strong connection to place that helps to inspire innovative ideas to promote greater sustainability of vulnerable ecosystems and the communities that depend on them, but not the institutional support to implement them. Overcoming this barrier requires a better understanding of their perception of the issues and what they prioritize in sustaining their cultures and the ecosystems on which they depend. Better inclusion of their knowledge into applied research is necessary to support these communities in their efforts to make sure their knowledge is recognized, understood, and valued in environmental management applications. The primary goal for this study was to develop a decision-support tool that aids the PACIT in assessing local ecological change and associated risks to the Tribe’s resilience. Using remote sensing datasets and geographic information systems (GIS) processes to represent aspects of the Tribe’s TEK to achieve this goal, we developed methods for producing interactive maps that reflect local perceptions of landscape features within the Tribe’s ecosystem-dependent livelihood base that contribute most to the community’s physical vulnerability to coastal hazards. This case study is offered to consider how Indigenous communities like the PACIT are shaping their own coastal hazards mitigation planning efforts in line with their unique needs, cultural practices, and values. The results of this study can provide relevant insight to applied environmental scientists and others working with Indigenous communities that are facing similar circumstances around the world.

Black carbon and other air pollutants in Italian ports and coastal areas: Problems, solutions and implications for policies

Featured Application The data and analysis can be applied to shipping emissions issues at five governmental levels: local (ports and port cities), subnational regional (port authorities), national (Italy and other countries), international regional (European Union and Mediterranean Sea coastal areas), and global (IMO). Ships’ emissions of air pollutants pose problems for local and regional public health and agricultural production, as well as global climate change. The Italian government’s endorsement in 2019 of the creation of a Mediterranean Emission Control Area is a reflection of increasing concern about the emissions. Also, ongoing developments in the International Maritime Organization and in the European Union add to the Italian government’s maritime shipping agenda and increase its complexity and uncertainty. In that context, this review paper addresses two central questions: What are the consequences for human health and agricultural production of ships’ emissions in Italian ports and coastal areas? How can their emissions be reduced? The approach to these questions is inter-disciplinary. It applies the results of studies in atmospheric chemistry and physics; maritime shipping engineering; public health; agriculture; economics; and international law and policymaking to assess current and prospective policy issues in Italy. The principal conclusions are that: (1) Black carbon emissions are threats to human health and agricultural production in Italy, as well as to the global climate. (2) It is important that black carbon emissions receive more serious attention in policymaking processes in order to reflect the significant analytic progress that has been made in terms of understanding the problems it poses and the technological and policy solutions. (3) There are cost-effective, emission-reducing measures that are readily available, as well as other measures needing more time before full-scale implementation. (4) Although existing multi-level governance systems pose complex analytic and policymaking challenges, they also offer opportunities to institute new policies with significant short-term and long-term co-benefits from reductions in emissions.

Building resilience to mosquito-borne diseases in the Caribbean

Small island developing states in the Caribbean are among the most vulnerable countries on the planet to climate variability and climate change. In the last 3 decades, the Caribbean region has undergone frequent and intense heat waves, storms, floods, and droughts. This has had a detrimental impact on population health and well-being, including an increase in infectious disease outbreaks. Recent advances in climate science have enhanced our ability to anticipate hydrometeorological hazards and associated public health challenges. Here, we discuss progress towards bridging the gap between climate science and public health decision-making in the Caribbean to build health system resilience to extreme climatic events. We focus on the development of climate services to help manage mosquito-transmitted disease epidemics. There are numerous areas of ongoing biological research aimed at better understanding the direct and indirect impacts of climate change on the transmission of mosquito-borne diseases. Here, we emphasise additional factors that affect our ability to operationalise this biological understanding. We highlight a lack of financial resources, technical expertise, data sharing, and formalised partnerships between climate and health communities as major limiting factors to developing sustainable climate services for health. Recommendations include investing in integrated climate, health and mosquito surveillance systems, building regional and local human resource capacities, and designing national and regional cross-sectoral policies and national action plans. This will contribute towards achieving the Sustainable Development Goals (SDGs) and maximising regional development partnerships and co-benefits for improved health and well-being in the Caribbean.

Weather-related subjective well-being in patients with coronary artery disease

One of the particularly vulnerable groups for adverse weather conditions is people with heart disease. Most of the studies analyzed the association between certain weather conditions and increased mortality, morbidity, hospital admissions, calls, or visits to the emergency department and used as statistical data. This study evaluated associations between daily weather conditions and daily weather-related well-being in patients with coronary artery disease (CAD). From June 2008 to October 2012, a total of 865 consecutive patients with CAD (mean age 60 years; 30% of women) were recruited from the cardiac rehabilitation program at the Hospital Palanga Clinic, Lithuania. To evaluate the well-being, all patients filled in Palanga self-assessment diary for weather sensitivity every day from 8 to 21 days (average 15 ± 3 days) about their well-being (psychological, cardiac, and physical symptoms) on the last day. The weather data was recorded in the database eight times every day with a 3-hour interval using the weather station “Vantage Pro2 Plus” which was located in the same Clinic. The daily averages of the eight time records for weather parameters were calculated and were linked to the same-day diary data. We found that the well-being of patients with CAD was associated with weather parameters; specifically, general well-being was better within the temperature range 9-15 °C and worse on both sides of this range. Worsened general well-being was also associated with higher relative humidity and lower atmospheric pressure. Weather parameters can explain from 3 to 8% of the variance of well-being in patients with CAD.

When rebuilding no longer means recovery: The stress of staying put after Hurricane Sandy

After a disaster, it is common to equate repopulation and rebuilding with recovery. Numerous studies link post-disaster relocation to adverse social, economic, and health outcomes. However, there is a need to reconsider these relationships in light of accelerating climate change and associated social and policy shifts in the USA, including the rising cost of flood insurance, the challenge of obtaining aid to rebuild, and growing interest in “managed retreat” from places at greatest risk. This article presents data from a survey of individuals who opted either to rebuild in place or relocate with the help of a voluntary home buyout after Hurricane Sandy. Findings show those who lived in buyout-eligible areas and relocated were significantly less likely to report worsened stress than those who rebuilt in place. This suggests access to a government-supported voluntary relocation option may, under certain circumstances, lessen the negative mental health consequences associated with disaster-related housing damage.

The long goodbye on a disappearing, ancestral island: A just retreat from Isle de Jean Charles

Climate change will necessitate evermore frequent and complex managed retreats in the future, and drafting policies that are equitable and just for those residents who are relocating will be essential. The USA’s first federally funded, community-scale, climate-driven resettlement is currently underway in coastal Louisiana. In January 2016, the U.S. Department of Housing and Urban Development (HUD) awarded the state of Louisiana $48.3 million to plan, design, and implement a structured, just, and scalable resettlement with former and current Isle de Jean Charles residents. Most Island households are multi-generational and directly descended from Jean Marie Naquin, after whose father the Island is named. Using interviews, ethnographic data, and policy documents, this paper will delineate and analyze the dimensions of sense of place, which, in this case, prompted policy changes dramatically different from standard relocation policies: assurance that the properties and land from which residents are departing will remain in their possession as long as the land remains. For most Island residents, this was non-negotiable. The intangible connection to place-feelings of belonging, lifestyle, family connections, and culture-plays a central role in many families’ decision to stay or go. The choice to relocate is rooted in this complex entanglement of identity, familial ties, land loss, historical and current marginalization, and a way of life passed on by multiple generations. In forthcoming community resettlements, continued access and ownership of the properties being left behind should be considered as a critical component for planning just retreats.

The role of multiple stressors in adaptation to climate change in the Canadian Arctic

Climate change is occurring at accelerated rates in the Arctic, and its impacts are being experienced by human communities in the context of other environmental and societal stressors. This paper argues that an assessment of human vulnerability to climate change requires knowledge of these stressors, including the interactions among them that influence people’s sensitivity to climate risks and adaptability. This paper examines the role of multiple stressors in adaptation to climate change through a case study of Paulatuk, Northwest Territories, Canada. It is based on collaborative research involving semi-structured interviews with 28 participants, participant observation, and analysis of secondary sources of information. In the context of subsistence harvesting, climatic stressors have affected access to, and the availability of, some fish and wildlife and are making travel conditions more unpredictable and dangerous. These stressors are being experienced at the same time as societal stressors such as financial and social barriers to participating in subsistence, challenges with local schooling, lifestyle changes, housing shortage and overcrowding, and addiction. Many of the coping strategies used by people in Paulatuk to deal with stressors involve trade-offs, such as leaving the community for school or leaving school to participate in subsistence and switching species harvested in response to a decline in one species, which has undermined resilience to other stressors. This research demonstrates the need to consider the role of pre-existing environmental and societal stressors and diversity within communities in climate change adaptation planning in the Arctic.

Trend analysis of cold extremes in South Africa: 1960-2016

Extreme cold events (“cold waves”) have disastrous impacts on ecosystem and human health. Evidence shows that these events will still occur under current increasing mean temperatures. Little research has been done on extreme cold events, especially in developing countries such as South Africa. These events pose a significant threat due to the low adaptive capacity, urgent development needs and relatively inadequate infrastructure in South Africa. This study presents annual and seasonal, spatial and temporal trend analyses of extreme cold temperature events for the period 1960-2016. We apply the World Meteorological Organisation Commission for Climatology and Indices Expert Team on Sector-Specific Climate Indices (ET-SCI) to South Africa for the first time, with comparison to the World Meteorological Organisation Expert Team on Climate Change Detection (ETCCDI) indices previously used in South Africa. The extreme cold indices are calculated using the RClimDex and ClimPACT, respectively. Trends were calculated using the non-parametric Mann-Kendall test, Spearman Rank Correlation Coefficient and Sen’s slope estimates. A decreasing trend is found for annual cold spell duration and cold wave frequency, at rates of 0.10 days.day(-1) and 0.02 events.day(-1), respectively. Seasonally, coldest day temperatures increased in autumn, with increases of 0.02 degrees C.day(-1) for the period 1960-2016. Regionally, increasing trends in annual cold spell duration days were evident in stations located in the Western Cape, Eastern Cape, North-West Province, at a rate of 0.03 days.day(-1). Increasing trends in cold waves were observed for stations in Northern Cape, Gauteng, KwaZulu-Natal and the Eastern Cape Province, at a rate of 0.01 events.day(-1). These results contribute to the awareness and recognition of the incidence and duration of cold extreme events in South Africa, seeing that studies suggest that anomalously cold events may persist in a warming world.

The effect of meteorological variables on spontaneous pneumothorax in two regions with different altitudes

Spontaneous pneumothorax (SP) is defined as the presence of free air inside the pleural space. Many studies have reported that meteorological variables may trigger SP, but the mechanism is unknown. The aim of this study was to compare the effects of meteorological variables on the development of SP in two regions with different altitudes. The study was conducted in the Çanakkale (2 m above sea level) and the Erzurum region (1758 m). A total of 494 patients with SP who presented to the hospitals of the two regions between January 2011 and December 2016 were included in the study. The meteorological variables used included ambient temperature, atmospheric pressure, relative humidity, precipitation amount, wind speed, and wind direction (as north and south). The total 2192 days were divided into two as days with and without an SP case presentation. A 4-day period prior to the day a case presented was compared with the other days without any cases to investigate the presence of any lagged effect. Statistical significance was accepted at p?<?0.05. Comparison of these two regions showed a significant difference between them. The meteorological variables of the regions that affect SP development were found to be low mean minimum temperature, high daily temperature change, low precipitation, low wind speed and north winds for Erzurum, and only rainy days for Çanakkale. The results have demonstrated that cold weather, sudden temperature changes, north winds, and low wind speed are risk factors for the development of SP at high altitudes.

Summer UTCI variability in Poland in the twenty-first century

The paper analyses the temporal and spatial variability of the Universal Thermal Climate Index (UTCI) in Poland in summer. Summer is the season with the highest intensity of tourism traffic that is why it is important to determine biometeorological conditions, especially in popular tourist destinations such as coastal, mountain and urban areas, in the times of climate changes. The analysis was based on data from 18 stations of IMGW-PIB (Institute of Meteorology and Water Management-National Research Institute), distributed evenly in the territory of the country, and representing all eight bioclimatic regions. The data include air temperature, relative humidity, wind velocity and cloudiness at 12 UTC from summer months: June, July and August from the years 2001-2018. Thermoneutral zone was the most frequently occurring UTCI class in Poland. It was recorded during 56-75% of summer days (with the exception of mountain stations, where it occurred on 30-35% of days). Moderate heat stress is the second most frequently occurring category with a frequency from 18 to 29% with the exception of mountain and coastal areas. Extreme and very strong cold stress occurred particularly in high mountain stations, and was sporadically observed at the coast of the Baltic Sea; however, the occurrence of such conditions decreases, which if favourable for beach tourism. No cases of extreme heat stress were recorded in any of the stations. The most unfavourable bioclimatic conditions were characteristic of the Upland Region (IV), represented by Kraków and Sandomierz, where very strong heat stress occurred with a 10% frequency. This is a limitation for urban tourism in those regions. The highest UTCI values were recorded in Kraków on 17 July 2007 and 29 July 2005. The highest number of cases with strong and very strong heat stress was recorded in 2015 as a consequence of the heat wave observed in Poland in the first half of August. In the majority of the analysed stations, in the second half of the analysed period (2010-2018), an increase in the number of days with strong and very strong heat stress was observed in comparison with the first half of period (2001-2009). The highest frequency of such days was observed in July. Based on the data, there are 4 potential periods of occurrence of such days, with two most intense being 26. July-13 August and 14-22 July.

Study on influence of prior recognition of flooding state on evacuation behavior

In recent years, disasters have caused extensive water damage in various parts of Japan. Flooded evacuation routes and ineffective hazard maps commonly constrain evacuees’ behavior, which results in casualties. In this study, storm surge flooding analysis was carried out using OpenFOAM, which is a computational fluid dynamics software that monitors flooding state as a function of time, and evacuation simulations using a multi-agent system that considers evacuation behavior knowing the flooding state established by the flooding analysis. In some of the scenarios, many residents were caught in the flooding and could not be evacuated. Additional evacuation simulations revealed that evacuation behavior is more effective if residents have advance knowledge of the area expected to flood. Identifying these flood hazard areas and recognizing these areas in advance as impassable enables evacuees to avoid flood hazard areas; consequently, there is a decrease in the number of evacuees who get caught in the flooding. Anticipating the area expected to be flooded suggests the best evacuation locations and routes. Using these simulation results with useful hazard maps and disaster education, residents will correctly recognize the risk of a storm surge disaster and prepare for it, which will assist recovery. Finally, our analytical and simulation approach to disaster management is amenable to long-term planning for disaster-resistant cities.

Scenario-based economic and societal risk assessment of storm flooding in Shanghai

Purpose Quantitative and spatial-explicit flood risk information is of great importance for strengthening climate change adaptation and flood resilience. Shanghai is a coastal megacity at large estuary delta with rising flood risks. This study aims to quantify the overall economic-societal risks of storm flooding and their spatial patterns in Shanghai. Design/methodology/approach Based on multiple storm flood scenarios at different return periods, as well as fine-scale data sets including gridded GDP, gridded population and vector land-use, a probabilistic risk model incorporating geographic information system is used to assess the economic-societal risks of flooding and their spatial distributions. Findings Our results show that, from 1/200 to 1/5,000-year floods, the exposed assets will increase from USD 85.4bn to USD 657.6bn, and the direct economic losses will increase from USD 3.06bn to USD 52bn. The expected annual damage (EAD) of assets is around USD 84.36m. Hotpots of EAD are mainly distributed in the city center, the depressions along the upper Huangpu River in the southwest, the north coast of Hangzhou Bay, and the confluence of the Huangpu River and Yangtze River in the northeast. From 1/200 to 1/5,000-year floods, the exposed population will rise from 280 thousand to 2,420 thousand, and the estimated casualties will rise from 299 to 1,045. The expected annual casualties (EAC) are around 2.28. Hotspots of casualties are generally consistent with those of EAD. Originality/value In contrast to previous studies that focus on a single flood scenario or a particular type of flood exposure/risk in Shanghai, the findings contribute to an understanding of overall flood risks and their spatial patterns, which have significant implications for cost-benefit analysis of flood resilience strategies.

Quality assessment of harvested rainwater and seasonal variations in the southwest coastal area, Bangladesh

Secure potable water is indispensable to life. The presence of salinity in potable water has become a serious problem worldwide and it is essential to ensure secure potable water, particularly in the coastal areas of Bangladesh. In this work, 48 (forty-eight) harvested rainwater samples were assessed from Upazila (sub-district) of Mongla and Sarankhola, Bagerhat district, Bangladesh during the monsoon (May) and post-monsoon (October) periods. The objective was to examine the effect of seasonal variations on the quality of harvested rainwater. The harvested rainwater was analyzed for fecal coliform, total coliform, lead (Pb), zinc (Zn), pH, and turbidity. The mean pH in monsoon and post-monsoon periods was 6.93 and 7.24, respectively, which was within both the WHO guideline and Bangladesh Drinking Standard. In the monsoon season, turbidity levels in samples met the Bangladesh water quality standard but 10% of the harvested rainfall samples had Pb levels that exceeded the WHO drinking water limit. The turbidity of harvested rainwater in post-monsoon exceeded the WHO and Bangladesh Drinking Standard by 21% (10 out of 48) and 6% (3 out of 48), respectively. The fecal coliform of harvested rainwater exceeded both WHO and Bangladesh Drinking Standard by 56% (27 out of 48) and 67% (32 out of 48) in the monsoon and post-monsoon, correspondingly. Conversely, total coliform of harvested rainwater exceeded both the WHO and Bangladesh Drinking Standard by 67% (32 out of 48) and 79% (38 out of 48), accordingly in the monsoon and post-monsoon seasons. The Zn was below the WHO and Bangladesh Drinking Standard but Pb exceeded the WHO guideline in the monsoon and post-monsoon by 15% (7 out of 48) and 17% (8 out of 48), respectively. Pb is toxic to humans and children are especially vulnerable. The harvested rainwater should be treated effectively to reduce the toxicity and danger posed by Pb, fecal coliform, and total coliform before it is fit for drinking purposes.

Multi-dimensional parametric coastal flood risk assessment at a regional scale using GIS

Coastal floods are the most prominent natural disaster causing severe damages to the local communities regarding food security, economy and shelter. Risks can be defined by physiographical sensitivity and vulnerability associated with socio-economic, demographic and infrastructure aspects of the region. Population with poor socio-economic status and high dependence on natural resources for livelihood in coastal dwellings of rural India are extremely vulnerable to flood hazards. Policy formulation to reduce coastal flood risks necessitates quantifying hazard vulnerability at an administrative scale. In this context, we propose a method for evaluating the coastal flood risk of an island located in the habited part of Sundarbans, West Bengal. Extending up to 282 sq. km, Sagar Island has been a keystone in harbouring and supporting both local and migrant population since the 1880s. Land-use classification of the island indicates an increase of 1.7% to 3.6% in the built-up class, almost double in the past eight years (2012-2020). A considerable rise in area under the water bodies is also seen from 6.6 to 8.6%, signifying fair evidence of a coastal breach. Flood risk assessment of Sagar Island was carried out using high spatial resolution data from Indian remote sensing satellites and census data. This assessment was performed by modifying the established MCDA technique considering the data limitations and accounting accessibility to infrastructure as a novel variable to a multi-dimensional framework. The framework maps spatial vulnerability of the region using sub-factors such as socio-demographic, economic, infrastructure and accessibility. The exposure profile of the area is drawn with the help of topographic factors and classified land-use results. Literature evidence was used to develop classification rules for data standardization from very high to very low based on their flood sensitivity. Further, the factors and sub-factors were ranked using AHP by a panel of experts belonging to diverse fields such as disaster management, regional planning, environment, hydrology and social science. The weighted sum technique was used to quantify total vulnerability and exposure parameters, respectively. The total risk map generated is the product of the hazard and vulnerability map of the region. The findings reveal the dominance of economic and accessibility parameters in defining the vulnerability of the regional population towards coastal flood risks. Proximity to coastline and tidal creeks enhances disaster sensitivity due to frequent inundation, erosion, saltwater intrusion and complete submergence of land area. Water bodies engulfing the coastline emerge as a serious threat to sustenance given the present rate of submergence of about 6 m/year. The research highlights the pressing need for grassroots development through social and economic upliftment. It also advocates the undeniable need for proactive adaptation such as flood resilient housing and coastline protection by stabilizing sandbars and planting/nurturing/maintaining native species (mangroves).

Natural disasters, population displacement and health emergencies: Multiple public health threats in Mozambique

In early 2019, following the 2015-2016 severe drought, the provinces of Sofala and Cabo Delgado, Mozambique, were hit by Cyclones Idai and Kenneth, respectively. These were the deadliest and most destructive cyclones in the country’s history. Currently, these two provinces host tens of thousands of vulnerable households due to the climatic catastrophes and the massive influx of displaced people associated with violent terrorist attacks plaguing Cabo Delgado. The emergence of the COVID-19 pandemic added a new challenge to this already critical scenario, serving as a real test for Mozambique’s public health preparedness. On the planetary level, Mozambique can be viewed as a ‘canary in the coal mine’, harbingering to the world the synergistic effects of co-occurring anthropogenic and natural disasters. Herein, we discuss how the COVID-19 pandemic has accentuated the need for an effective and comprehensive public health response in a country already deeply impacted by health problems associated with natural disasters and population displacement.

Maintaining quality of care among dialysis patients in affected areas after Typhoon Morakot

Natural disasters have negative health impacts on patients who need dialysis in affected areas. Severely affected areas are usually rural, with limited basic infrastructure and a population without optimal dialysis-specific care after a disaster. A population-based longitudinal case-cohort study enrolled 715,244 adults from the National Health Insurance Registry who lived in areas affected by a major natural disaster, Typhoon Morakot, in 2009. The observation period was from 2008 to 2011. A total of 13,268 patients (1.85%) had a history of end-stage renal disease (ESRD). Of the ESRD patients, 1264 patients (9.5%) received regular dialysis. Only eight patients missed dialysis sessions in the first month after the disaster. Compared to the moderately affected areas, the incidences of acute cerebrovascular and cardiovascular diseases were higher in patients in severely affected areas. Male dialysis patients aged 45-75 years had a higher mortality rate than that of the general population. Among the affected adults receiving regular dialysis, patients with diabetes (adjusted hazard ratio (aHR): 1.58, 95% confidence interval (CI): 1.20-2.08) or a history of cerebrovascular disease (aHR: 1.58, 95% CI: 1.12-2.21), chronic obstructive pulmonary disease (COPD) or asthma (aHR: 1.99, 95% CI: 1.24-3.17) in moderately affected areas had significantly elevated mortality rates. Additionally, among dialysis patients living in severely affected areas, those with a history of cerebrovascular disease (aHR: 4.52 95% CI: 2.28-8.79) had an elevated mortality rate. Early evacuation plans and high-quality, accessible care for cardiovascular and cerebrovascular diseases are essential to support affected populations before and after disasters to improve dialysis patients’ health outcomes.

Mercury consumption and human health: Linking pollution and social risk perception in the southeastern United States

The study of the relationships between freshwater organisms, pollution and public awareness has been little researched. The public’s perception of risk from pollution is a fundamental component in determining consumer behavior and promoting healthy habits. For instance, understanding how consumers perceive the risks associated with pollution can help with adoption of safe behaviors to reduce the health hazard associated with pollutant exposure. This study focused on the southeastern United States, a region predicted to be exposed to high mercury stress by increasing mercury deposition and methylation. First, we placed our study region in the world map of regions more prone to suffer from increasing mercury stress in a climate change scenario. Second, mercury levels in fish tissues was quantified by direct mercury analyzer (DMA). Third, we explored human fish consumption habits and risk social perception, including willingness to adapt fish consumption based on two future hypothetical scenarios of mercury stress. From a global perspective, our analysis demonstrates that the southern US is one of five world areas of greatest conservation concern for mercury stress. In this region, the average mono-methyl mercury concentration in fish tissues exceeded the limits considered safe for human consumption. Even though many in the local population were aware of the health hazards associated with fish consumption, only women of reproductive age were willing to adopt safe consumption habits. Altogether, these results show how bringing together field data, social perceptions, and consumption habits can help in designing an adaptive strategy to confront mercury pollution. Although our results are for the United States, other world regions prone to suffer increasing mercury stress have been identified and should be the focus of future studies and prescriptions.

Livelihood vulnerability and adaptability of coastal communities to extreme drought and salinity intrusion in the Vietnamese Mekong Delta

Many deltas worldwide have increasingly faced extreme drought and salinity intrusion, which have adversely affected millions of coastal inhabitants in terms of lives and property. The Vietnamese Mekong Delta (VMD) is considered one of the world?s most vulnerable regions to drought and saline water intrusion, especially in the context of climate change. This study aims to assess livelihood vulnerability and adaptation of the coastal people of the VMD under the impacts of drought and saltwater intrusion. A multi-disciplinary approach was applied, including desktop literature reviews, field surveys, interviews, and focus group discussions with 120 farmers and 30 local officials in two representative hamlets of Soc Trang, a coastal province of the VMD. A vulnerability assessment tool in combination with a sustainable livelihood framework was used to evaluate livelihood vulnerability using the five capital resources to indicate the largest effects of drought and salinity intrusion on the migration of local young people to large cities for adaptation. Livelihood Vulnerability Indexes revealed higher vulnerability in terms of the five capitals of coastal communities living in Nam Chanh hamlet compared to Soc Leo. Results of interviews with officials indicated an optimized mechanism between social organizations and local communities before, at the time, and after being impacted by the drought and salinity intrusion. Our findings contribute evidence-based knowledge to decision-makers to enable coastal communities in the VMD and other deltas worldwide to effectively adapt to the impacts of drought and salinity intrusion.

In harm’s way: Non-migration decisions of people at risk of slow-onset coastal hazards in Bangladesh

Non-migration is an adaptive strategy that has received little attention in environmental migration studies. We explore the leveraging factors of non-migration decisions of communities at risk in coastal Bangladesh, where exposure to both rapid- and slow-onset natural disasters is high. We apply the Protection Motivation Theory (PMT) to empirical data and assess how threat perception and coping appraisal influences migration decisions in farming communities suffering from salinization of cropland. This study consists of data collected through quantitative household surveys (n?=?200) and semi-structured interviews from four villages in southwest coastal Bangladesh. Results indicate that most respondents are unwilling to migrate, despite better economic conditions and reduced environmental risk in other locations. Land ownership, social connectedness, and household economic strength are the strongest predictors of non-migration decisions. This study is the first to use the PMT to understand migration-related behaviour and the findings are relevant for policy planning in vulnerable regions where exposure to climate-related risks is high but populations are choosing to remain in place.

Incorporating stakeholders’ preferences into a multi-criteria framework for planning large-scale Nature-Based Solutions

Hydro-meteorological risks are a growing issue for societies, economies and environments around the world. An effective, sustainable response to such risks and their future uncertainty requires a paradigm shift in our research and practical efforts. In this respect, Nature-Based Solutions (NBSs) offer the potential to achieve a more effective and flexible response to hydro-meteorological risks while also enhancing human well-being and biodiversity. The present paper describes a new methodology that incorporates stakeholders’ preferences into a multi-criteria analysis framework, as part of a tool for selecting risk mitigation measures. The methodology has been applied to Tamnava river basin in Serbia and Nangang river basin in Taiwan within the EC-funded RECONECT project. The results highlight the importance of involving stakeholders in the early stages of projects in order to achieve successful implementation of NBSs. The methodology can assist decision-makers in formulating desirable benefits and co-benefits and can enable a systematic and transparent NBSs planning process.

Indigenous Peoples and climate-induced relocation in Latin America and the Caribbean: Managed retreat as a tool or a threat?

Climate-induced relocation is expected to become an adaptive response for one sector of the society that is otherwise already in a vulnerable situation and often living in remote areas, that is, Indigenous Peoples. Several Latin American countries have referred to planned relocation or managed retreat as one of their adaptation strategies within their Nationally Determined Contributions to the United Nations Framework Convention on Climate Change. However, a gap in academic analysis exists regarding not only the potential impacts but also the consequences of climate-induced planned relocations both in the broader context of Latin America and in the specific case of Indigenous Peoples living in that region. In addition, academia has so far underexplored the adverse impacts of managed retreat on Indigenous Peoples, such as the loss of a sense of community, culture, and traditional knowledge. Against this background, this article offers an overview on two key cases of climate-induced (planned) relocation of Indigenous Peoples in Latin America and the Caribbean (the Gunayala people in the San Blás archipelago in Panama and the case of the densely Indigenous-inhabited Mexican state of Chiapas), explores whether managed retreat has been or may become a tool or a threat, and provides a list of specific policy recommendations to be taken into consideration in similar cases.

Influence of the seasonality and of urban variables in the BTEX and PM(2.5) atmospheric levels and risks to human health in a tropical coastal city (Fortaleza, CE, Brazil)

The International Agency for Research on Cancer (IARC) classifies benzene in group 1 (carcinogenic to humans). Particulate matter (PM) has recently also been classified in this category. This was an advance toward prioritizing the monitoring of particles in urban areas. The aim of the present study was to assess levels of PM(2.5) and BTEX (benzene, toluene, ethylbenzene, and xylene), the influence of meteorological variables, the planetary boundary layer (PBL), and urban variables as well as risks to human health in the city of Fortaleza, Brazil, in the wet and dry periods. BTEX compounds were sampled using the 1501 method of NIOSH and determined by GC-HS-PID/FID. PM(2.5) was monitored using an air sampling pump with a filter holder and determined by the gravimetric method. Average concentrations of BTEX ranged from 1.6 to 45.5 ?g m(-3), with higher values in the wet period, which may be explained by the fact that annual distribution is influenced by meteorological variables and the PBL. PM(2.5) levels ranged from 4.12 to 33.0 ?g m(-3) and 4.18 to 86.58 ?g m(-3) in the dry and wet periods, respectively. No seasonal pattern was found for PM(2.5), probably due to the influence of meteorological variables, the PBL, and urban variables. Cancer risk ranged from 2.46E(-04) to 4.71E(-03) and 1.72E(-04) to 2.01E(-03) for benzene and from 3.07E(-06) to 7.04E(-05) and 3.08E(-06) to 2.85E(-05) for PM(2.5) in the wet and dry periods, respectively. Cancer risk values for benzene were above the acceptable limit established by the international regulatory agency in both the dry and wet periods. The results obtained of the noncarcinogenic risks for the compounds toluene, ethylbenzene, and xylene were within the limits of acceptability. The findings also showed that the risk related to PM is always greater among smokers than nonsmokers.

Identifying and mitigating risks to completion of small grant climate change adaptation projects: Evidence from the Pacific

Over recent decades, substantial funding from a variety of sources has been directed towards climate change adaptation projects in Pacific Island countries. There remains, however, considerable uncertainty about which factors influence adaptation project completion, as a pre-cursor to effective adaptation. In this study, we empirically establish the links between project attributes (duration, funding, cash co-financing, in-kind contributions, location, and adaptation approach) and whether a project is likely to complete or be terminated. We examine this issue by developing a logistic regression model to predict the probability of completion for small-scale climate change adaptation projects using a new dataset of 190 projects in the South Pacific (with end dates ranging from November 1995 to May 2016) that were financed through the Global Environment Facility Small Grants Programme. Empirical results suggest that all else equal, such a project was more likely to complete if it was shorter, received more co-financing cash input and in-kind support from other donors and project partners, was explicitly targeted towards climate change adaptation, focused on a single adaptation approach, and was undertaken in Micronesia or Fiji. Our results can be used to help funders and project proponents design projects to mitigate the risks of non-completion, particularly in high-risk settings. These findings should not be misinterpreted to undermine the importance of continued investment in adaptation projects across the whole of South Pacific region.

Flood risk influenced by the compound effect of storm surge and rainfall under climate change for low-lying coastal areas

Under climate change, compound flooding has resulted in severe disasters in coastal areas around the world. In this study, an integrated framework is proposed to determine the range of compound flood risk without the requirement of joint probability analysis between storm surge and rainfall. In the framework, the flood risks are analyzed under four extreme scenarios with/without the compound effect of storm surge and rainfall in the past and the future. From the end of the 20th century to the middle of the 21st century, the worst scenario shows that the flood area significantly increases by 92% for the low-lying coastal areas in southwest Taiwan under the compound effect of storm surge and rainfall if they are fully correlated. In the most optimistic scenario, the flood area slightly increases by 15% without compound effect (only storm surge is considered). To coastal flooding, the synchronization of storm surge and rainfall contributes much more than the climate-induced amplification of individual factors. When storm surge and rainfall happen at the same time, the extent and duration of flooding increase simultaneously under the influence of pluvial and surge-induced flooding. Risk analysis shows an obvious increase of risk level for villages originally at low risks, which require integrated countermeasures against the consequence brought by compound flooding in the future. The framework can be applied in other low-lying coastal areas to quantify the potential impacts on human and environment caused by compound flooding under climate change.

Flooding trends and their impacts on coastal communities of Western Cape Province, South Africa

Climate change-induced extreme weather events have been at their worst increase in the past decade (2010-2020) across Africa and globally. This has proved disruptive to global socio-economic activities. One of the challenges that has been faced in this regard is the increased coastal flooding of cities. This study examined the trends and impacts of coastal flooding in the Western Cape province of South Africa. Making use of archival climate data and primary data from key informants and field observations, it emerged that there is a statistically significant increase in the frequency of flooding and consequent human and economic losses from such in the coastal cities of the province. Flooding in urban areas of the Western Cape is a factor of human and natural factors ranging from extreme rainfall, usually caused by persistent cut off-lows, midlatitude cyclones, cold fronts and intense storms. Such floods become compounded by poor drainage caused by vegetative overgrowth on waterways and land pollution that can be traced to poor drainage maintenance. Clogging of waterways and drainage systems enhances the risk of flooding. Increased urbanisation, overpopulation in some areas and non-adherence to environmental laws results in both the affluent and poor settling on vulnerable ecosystems. These include coastal areas, estuaries, and waterways, and this worsens the risk of flooding. The study recommends a comprehensive approach to deal with factors that increase the risk of flooding as informed by the provisions of both the Sustainable Development Goals framework and the Sendai Framework for Disaster Risk Reduction 2015-2030 in a bid to de-risking human settlement in South Africa.

Do hazard mitigation plans represent the resilience priorities of residents in vulnerable Texas coastal counties?

Hazard mitigation plans (HMP) inform residents and policymakers of the risks a community is vulnerable to, as well as prioritize measures implemented to minimize hazard damage. HMP development emphasizes the importance of creating plans with a strong fact base and analysis of risk exposure, while also facilitating participatory planning with residents. This paper discusses the intersection of citizen perception of extreme heat risk, policy implementation concerning extreme heat risk and actual extreme heat risk exposure in four coastal counties in Texas, Brazoria, Cameron, Galveston and Nueces Counties. Through surveying county residents and analyzing the counties’ HMPs, it was observed that residents perceive extreme heat risk as very high but HMPs have very little information on extreme heat mitigation. By examining three major components of hazard mitigation planning (actual/projected risk exposure, policy implementation and citizen perception), planners can better understand possible disconnects and fallacies that decrease the efficacy of mitigation plans. As HMPs are updated, officials should ensure that resident perceptions, which may change over time and as the result of specific events, are reflected.

Contribution of elevation and residential proximity to the coast in explaining geographic variations in hip fracture incidence. A Norwegian Epidemiologic Osteoporosis Studies (NOREPOS) study

A higher risk of hip fracture was found in areas of Norway at higher elevation and farther from the coast. However, the previously seen county variations could not be explained by these geographical factors. INTRODUCTION: Norway is an elongated country extending north of the Arctic Circle with substantial coast-inland variation in topography and climate. Differences in hip fracture incidence between counties and a distinct seasonal variation have previously been shown. The aim of the current study was to explore these variations further by considering associations of height above sea level (elevation) and distance to the coast with hip fracture incidence. METHODS: All patients with hip fractures admitted to Norwegian hospitals in the period 2009-2018 were included. Individual residential elevation and distance to the coast was calculated in Geographic Information Systems and combined with individual-level population data on all Norwegians 50 years of age or older during the observation period, including hospital information on fractures. Age-standardized incidences rate and incidence rate ratios with 95% confidence intervals (IRR, 95% CI) according to elevation and coastal proximity were estimated. The associations were tested using Poisson models adjusting for sex, urban/rural location of residency, country of birth, and season of hip fracture occurrence. RESULTS: From 2009 to 2018, there were 85,776 first hip fractures. There was an increasing risk with higher residential elevation (above versus below mean) for women: IRR?=?1.04, 95% CI: 1.02, 1.05), but not for men (IRR?=?1.00, 95% CI: 0.97, 1.02). Incidence of hip fracture increased with distance from the coast. Women residing the farthest away from the coast (above versus below mean distance) had a higher age-adjusted incidence of hip fracture compared to those living closer to the coast (IRR?=?1.04 (95% CI: 1.02, 1.06), whereas no association was found in men (IRR?=?1.00 (95% CI: 1.00, 1.01). Combining elevation and distance to coast showed a higher incidence in women living at high elevation far from the coast compared with women living at low elevation near the coast (IRR?=?1.07, 95% CI: 1.04, 1.10). A similar result was found in men but only for hip fractures occurring during March-May (IRR?=?1.07, 95% CI: 1.00, 1.15). The previously shown patterns of county differences and seasonal variations were unchanged when considering geography. CONCLUSION: We found a somewhat higher incidence of hip fracture in inland residents living in areas of high elevation, as compared to those living in more coastal proximity; however, the geographic variation did not explain county and seasonal differences in fracture incidence in Norway. More in-depth analyses on temperature and climate factors may give further clues.

Coping and adaptation in response to environmental and climatic stressors in Caribbean coastal communities

Cumulative and synergistic impacts from environmental pressures, particularly in low-lying tropical coastal regions, present challenges for the governance of ecosystems, which provide natural resource-based livelihoods for communities. Here, we seek to understand the relationship between responses to the impacts of El Niño and La Niña events and the vulnerability of mangrove-dependent communities in the Caribbean region of Colombia. Using two case study sites, we show how communities are impacted by, and undertake reactive short-term responses to, El Niño and La Niña events, and how such responses can affect their adaptive capacity to progressive environmental deterioration. We show that certain coping measures to climate variability currently deliver maladaptive outcomes, resulting in circumstances that could contribute to system ‘lock-in’ and engender undesirable ecological states, exacerbating future livelihood vulnerabilities. We highlight the significant role of social barriers on vulnerabilities within the region, including perceptions of state abandonment, mistrust and conflicts with authorities. Opportunities to reduce vulnerability include enhancing the communities’ capacity to adopt more positive and preventative responses based on demonstrable experiential learning capacity. However, these will require close cooperation between formal and informal organisations at different levels, and the development of shared coherent adaptation strategies to manage the complexity of multiple interacting environmental and climatic pressures.

Detection and correlation analysis of shellfish pathogens in Dadeng Island, Xiamen

Food poisoning is caused by pathogenic bacteria in water and aquatic products, especially bivalves (e.g., oysters, clams), which can bioaccumulate pathogenic bacteria. Polluted water and aquatic products thus pose a serious threat to human health and safety. In this study, the types of pathogenic bacteria in water samples and shellfish collected from the Dadeng offshore area in Xiamen were examined. We also analyzed the relationships between dominant pathogens and major climate and water quality parameters. Our objective was to provide reference data that may be used to help prevent bacterial infections and to improve aquatic food hygiene in Xiamen and its surrounding areas to safe levels, thus ensuring the health of Xiamen residents. We found that the main pathogenic bacteria were Vibrio and Bacillus, with the dominant pathogen being Vibrio parahaemolyticus. Physical and chemical indexes (water temperature, salinity, pH, dissolved oxygen, and turbidity) of water bodies and the 3-day accumulated rainfall were found to be important factors affecting the occurrence and abundance of V. parahaemolyticus.

Cascading loss and loss risk multipliers amid a changing climate in the Pacific Islands

Human society has experienced, and will continue to experience, extensive loss and damage from worsening anthropogenic climate change. Despite our natural tendencies to categorise and organise, it can be unhelpful to delineate clean boundaries and linear understandings for complex and messy concepts such as loss and damage. Drawing on the perspectives of 42 local and regional Pacific Islander stakeholders, an underexplored resource for understanding loss and damage, we explore the complexity and interconnectedness of non-economic loss and damage (NELD). According to participants, Pacific Islander worldviews, knowledge systems and cosmologies often make it difficult to separate and evaluate NELD independently, challenging the nomenclature of NELD categories developed through international mechanisms. Instead, NELD understandings are often centred on the interdependencies between losses, including the cascading flow-on effects that can occur and the nature of some losses as risk multipliers (i.e. one loss creating the risk for further losses). Most notably, losses to biodiversity, ecosystem services and land are critically linked to, and have cascading effects on, livelihoods, knowledge, ways of life, wellbeing, and culture and heritage. We argue that loss and damage is not always absolute, and that there are NELD that are arguably reparable. Concerning, however, is that biodiversity loss, as a risk multiplier, was considered the least reparable by participants. We put forward that NELD understandings must consider interconnectivity, and that biodiversity and ecosystem conservation and restoration must be the focus for interventions to prevent irreparable and cascading losses from climate change in the Pacific Islands.

Changes in climatic patterns and tourism and their concomitant effect on drinking water transfers into the region of South Aegean, Greece

Global warming is already having a negative impact on vital sectors on which human development depends, such as water resource availability. In this study, the changes and abrupt change timing of climatic extreme indices, aridity and drought over the Region of South Aegean are captured using the Mann-Kendall and Pettitt tests, while the latter variables are correlated with the water volume transported by ships to the region as well as the relevant costs. The region’s climate is shifting to warmer conditions with less precipitation, since significantly positive trends were noted with regard to the number of tropical nights, warm nights, warm days, the warm spell duration index and the diurnal temperature range; significant negative trends were observed in relation to the number of cool nights, cool days and the cold spell duration index, with the change-point year for the latter variables being 2006. Inaddition, 7/11 precipitation related indices exhibited a downward trend, while significantly negative trends were observed with regard to the number of consecutive dry days, with the timing of the abrupt change being 2001. The Aridity Index (AI) reveals that the region’s climate characterization is changing from dry and sub-humid to semi-arid conditions, whilst the Reconnaissance Drought Index standardized (RDI(st)) and the Standardized Precipitation Index (SPI) indices suggests an amplification of drought phenomena over the Region. The tourism variables illustrated a significant positive trend, with the timing of the abrupt change being registered during 2006-2009, whilst the correlation analysis between tourism variables and water transfers implies that the surge on water transfer by ships to the Region occurred between 1998 and 2008. This can be mainly attributed to the changes in climate patterns. The correlation analysis documents a strong positive correlation between the water transfer dataset and the diurnal temperature range, and a moderately negative association with the precipitation related indices, annual precipitation, drought phenomena and aridity with 7/11.

Climate change in rural Pakistan: Evidence and experiences from a people-centered perspective

Pakistan is home to a wide range of geographical landscapes, each of which faces different climate change impacts and challenges. This article presents findings from a National Geographic Society funded project, which employed a people-centered, narratives-based approach to study climate impacts and adaptation strategies of people in 19 rural study sites in four provinces of Pakistan (N = 108). The study looked at six climate-related stressors-changes in weather patterns, floods, Glacial Lake Outburst Floods, drought, heat waves, and sea-level rise-in the coastal areas of Sindh, the desert of Thar, the plains of Punjab, and the mountains of Hunza, Gilgit, and Chitral. Speaking to people at these frontlines of climate change revealed much about climate suffering and trauma. Not only is the suffering induced by losses and damages to property and livelihood, but climate impacts also take a heavy toll on people’s psycho-social wellbeing, particularly when they are displaced from their homes. The findings further demonstrate that people try to adapt in various ways, for instance by altering their agricultural practices, but they face severe barriers to effective adaptation action. Understanding people’s perceptions of climate change and incorporating their recommendations in adaptation planning can help policy-makers develop a more participatory, inclusive, and holistic climate resilience framework for the future.

Beyond virology: Environmental constraints of the first wave of COVID-19 cases in Italy

Global warming and air pollution affect the transmission pathway and the survival of viruses, altering the human immune system as well. The first wave of the COVID-19 pandemic dramatically highlights the key roles of climate and air chemistry in viral epidemics. The elongated form of the Italian peninsula and the two major islands (the largest in Europe) is a perfect case study to assess some of these key roles, as the fate of the virus is mirroring the industrialization in the continental part of our country. Fine particulate matter (PM(2.5)), geography, and climate explain what is happening in Italy and support cleaner air actions to address efficiently other outbreaks. Besides the environmental factors, future works should also address the genetic difference among individuals to explain the spatial variability of the human response to viral infections.

Assessment of the Baltic Sea climate change impact on health

Student morbidity during adaptation to the weather and climate conditions of the Baltic Sea is evaluated from 2012 to 2017 in this study. The research used the Steadman apparent temperature method to analyse the health impact of physical factors and investigated student morbidity in three Kaliningrad universities that had different percentage responses to the local climate change. Apparent temperatures (T) with different combinations of meteorological parameters significantly deviated from monthly average temperatures. For the average temperature and maximum wind speed, apparent temperatures were found to be negative from September to March. In January and February, they were 7.8-16.8 times lower than the average T. With humidity (e.g., RH) unchanged, different combinations of physical factor posed no danger to a person dressed for the weather conditions. In January, at the minimum T and maximum wind speed (Uh), frostbite was possible after 20-30 of exposure. Apparent T close to the threshold value was observed in December and February. The climate of the Kaliningrad enclave is not the best for human health conditions. In the winter, there are serious risks of frostbite in uncovered parts of the body when threshold conditions were not met. Results suggested that disease susceptibility in non-local students representing all the universities was 1.2-1.7 times higher than these of locals students. Also, a relationship between morbidity and percentage of non-local students is obtained, suggesting that the weather and climate conditions will likely adversely affect human health during climate change adaptation that can likely increase the morbidity rate, particularly among the students.

A comparative analysis of large-scale flood disasters: The human suffering exacerbation processes in three metropolitan areas

The purpose of this study is to analyze and compare the human suffering exacerbation processes in the coastal metropolitan areas of Nagoya, New Orleans and Metro Manila caused by 1959 Typhoon Isewan, 2005 Hurricane Katrina and 2009 Tropical Storm Ondoy, respectively, in order to understand disasters. The research method applied was firstly to create a timeline of each disaster process with disaster responses by referring to newspapers, literature, and others, then the facts were categorized with similar social conditions and government responses to establish a hypothesis. Field surveys were conducted to verify the hypothesis. The research outcome shows the human suffering exacerbation processes of these three large-scale disasters can be seen that the pattern of the process is the same; however, the duration and content of each disaster are quite different. These differences mainly depend on social backgrounds, disaster subculture, and disaster management by local and national governments. Based on the above research findings, a useful view for disaster investigation and disaster management is clarified, along with the possible contributions of disaster countermeasures’ timeline development, especially for the disaster management in metropolitan areas.

Water scarcity and challenges for access to safe water: A case of Bangladesh’s coastal area vulnerable to climate change

Existing efforts to ensure safe water access in coastal Bangladesh are challenged by increasing freshwater salinity. This research explored/explores safe water consumption choices in coastal Bangladesh, which data are scarce to date, using a mixed-methods approach. In 2014, a cross-sectional survey was conducted in southwestern coastal Bangladesh (n=261) and data was generated on water supply and consumption. Data collection also involved 29 in-depth interviews of household care givers and focus group discussions were performed with three community groups. Descriptive statistics were applied to analyse quantitative data and thematic analysis was used for qualitative data. The survey showed that 60% of the study population used tube well water while 40% used pond water for drinking. It was observed that for cooking purposes, the use of pond water was slightly higher than the tube well water. Only 13% of the respondents mentioned that their drinking water tasted salty whereas 6% of the respondents reported health problem (diarrhoea, dysentery, gastric issues and skin problems) after using these water sources. The qualitative data reveals that water available for drinking and cooking is causing a serious threat to this coastal community, particularly during the dry season. In-depth assessments indicated that drinking water choices were less driven by concerns for health than practical issues such as travel distance and time taken and taste. The palatability of water was an important determinant of choice for drinking and other domestic uses. Furthermore, the utility of alternative options for safe drinking water is driven by beliefs and traditions and source maintenance. Given the increasing salinisation of freshwaters in many low-lying countries and likely exacerbation related to climate change-induced sea level rise, therefore, promotion of low saline drinking water along with salt reducing interventions consider that community beliefs and practices must be a made priority.

Vietnam climate change and health vulnerability and adaptation assessment, 2018

BACKGROUND: The Global Climate Risk Index 2020 ranked Vietnam as the sixth country in the world most affected by climate variability and extreme weather events over the period 1999-2018. Sea level rise and extreme weather events are projected to be more severe in coming decades, which, without additional action, will increase the number of people at risk of climate-sensitive diseases, challenging the health system. This article summaries the results of a health vulnerability and adaptation (V&A) assessment conducted in Vietnam as evidences for development of the National Climate Change Health Adaptation Plan to 2030. METHODS: The assessment followed the first 4 steps outlined in the World Health Organization’s Guidelines in conducting “Vulnerability and Adaptation Assessments.” A framework and list of indicators were developed for semi-quantitative assessment for the period 2013 to 2017. Three sets of indicators were selected to assess the level of (1) exposure to climate change and extreme weather events, (2) health sensitivity, and (3) adaptation capacity. The indicators were rated and analyzed using a scoring system from 1 to 5. RESULTS: The results showed that climate-sensitive diseases were common, including dengue fever, diarrheal, influenza, etc, with large burdens of disease that are projected to increase. From 2013 to 2017, the level of “exposure” to climate change-related hazards of the health sector was “high” to “very high,” with an average score from 3.5 to 4.4 (out of 5.0). For “health sensitivity,” the scores decreased from 3.8 in 2013 to 3.5 in 2017, making the overall rating as “high.” For “adaptive capacity,” the scores were from 4.0 to 4.1, which meant adaptive capacity was “very low.” The overall V&A rating in 2013 was “very high risk” (score 4.1) and “high risk” with scores of 3.8 in 2014 and 3.7 in 2015 to 2017. CONCLUSIONS: Adaptation actions of the health sector are urgently needed to reduce the vulnerability to climate change in coming decades. Eight adaptation solutions, among recommendations of V&A assessment, were adopted in the National Health Climate Change Adaptation Plan.

Tropical cyclones and risk of preterm birth: A retrospective analysis of 20 million births across 378 US counties

BACKGROUND: The public health impacts of tropical cyclones (TCs) are expected to increase due to the continued growth of coastal populations and the increasing severity of these events. However, the impact of TCs on pregnant women, a vulnerable population, remains largely unknown. We aimed to estimate the association between prenatal exposure to TCs and risk of preterm birth in the eastern United States (US) and to assess whether the association varies by individual- and area-level characteristics. METHODS: We included data on 19,529,748 spontaneous singleton births from 1989 to 2002 across 378 US counties. In each county, we classified days as exposed to a TC when TC-associated peak sustained winds at the county’s population-weighted center were >17.2 m/s (gale-force winds or greater). We defined preterm birth as births delivered prior to 37 completed weeks of gestation. We used distributed lag log-linear mixed-effects models to estimate the relative risk (RR) and absolute risk difference (ARD) for TC exposure by comparing preterm births occurring in TC-periods (from 2 days before to 30 days after the TC’s closest approach to the county’s population center) to matched non-TC periods. We conducted secondary analyses using other wind thresholds (12 m/s and 22 m/s) and other exposure metrics: county distance to storm track (30 km, 60 km, and 100 km) and cumulative rainfall within the county (75 mm, 100 mm, and 125 mm). RESULTS: During the study period, there were 1,981,797 (10.1%) preterm births and 58 TCs that affected at least one US county on which we had birth data. The risk of preterm birth was positively associated with TC exposure defined as peak sustained wind speed >17.2 m/s (gale-force winds or greater) [RR: 1.01 (95% CI: 0.99, 1.03); ARD: 9 (95% CI: -7, 25) per 10,000 pregnancies], distance to storm track <60 km [RR: 1.02 (95% CI: 1.01, 1.04); ARD: 23 (95% CI: 9, 38) per 10,000 pregnancies], and cumulative rainfall >100 mm [RR: 1.04 (95% CI: 1.02, 1.06); ARD: 36 (95% CI: 16, 56) per 10,000 pregnancies]. Results were comparable when considering other wind, distance, or rain thresholds. The association was more pronounced among early preterm births and mothers living in more socially vulnerable counties but did not vary across strata of other hypothesized risk factors. CONCLUSIONS: Maternal exposure to TC was associated with a higher risk of preterm birth. Our findings provide initial evidence that severe storms may trigger preterm birth.

Understanding associations between Hurricane Harvey exposure and mental health symptoms among greater Houston-area residents

OBJECTIVE: Hurricane Harvey made landfall on August 25, 2017 and resulted in widespread flooding in Houston and the surrounding areas. This study aimed to explore the associations between exposure to Hurricane Harvey and various mental health symptoms. METHODS: Self-reported demographics, hurricane exposure, and mental health symptomatology were obtained from residents of the greater Houston area through convenience sampling for a pilot study, 5 months after the storm from January 25-29, 2018 (N = 161). RESULTS: Increased hurricane exposure score was significantly associated with increased odds for probable depression, probable anxiety, and probable posttraumatic stress disorder after adjusting for other factors associated with mental health. No significant associations were found between demographic characteristics and risk of mental health difficulties. CONCLUSIONS: Mental health difficulties associated with exposure to Hurricane Harvey were still present 5 months after the storm. Future disaster response programs should focus on providing long-term mental health services to hurricane survivors.

Thermal thresholds heighten sensitivity of West Nile virus transmission to changing temperatures in coastal California

Temperature is widely known to influence the spatio-temporal dynamics of vector-borne disease transmission, particularly as temperatures vary across critical thermal thresholds. When temperature conditions exhibit such ‘transcritical variation’, abrupt spatial or temporal discontinuities may result, generating sharp geographical or seasonal boundaries in transmission. Here, we develop a spatio-temporal machine learning algorithm to examine the implications of transcritical variation for West Nile virus (WNV) transmission in the Los Angeles metropolitan area (LA). Analysing a large vector and WNV surveillance dataset spanning 2006-2016, we found that mean temperatures in the previous month strongly predicted the probability of WNV presence in pools of Culex quinquefasciatus mosquitoes, forming distinctive inhibitory (10.0-21.0°C) and favourable (22.7-30.2°C) mean temperature ranges that bound a narrow 1.7°C transitional zone (21-22.7°C). Temperatures during the most intense months of WNV transmission (August/September) were more strongly associated with infection probability in Cx. quinquefasciatus pools in coastal LA, where temperature variation more frequently traversed the narrow transitional temperature range compared to warmer inland locations. This contributed to a pronounced expansion in the geographical distribution of human cases near the coast during warmer-than-average periods. Our findings suggest that transcritical variation may influence the sensitivity of transmission to climate warming, and that especially vulnerable locations may occur where present climatic fluctuations traverse critical temperature thresholds.

The impacts of climate variability on cholera cases in Malaysia

Introduction: Altered weather patterns and changes in precipitation, temperature and humidity resulting from climate change could affect the distribution and incidence of cholera. This study is to quantify climate-induced increase in morbidity rates of cholera. Material and Methods: Monthly cholera cases and monthly temperature, precipitation, and relative humidity data from 2004 to 2014 were obtained from the Malaysian Ministry of Health and Malaysian Meteorological Department, respectively. Poisson generalized linear models were developed to quantify the relationship between meteorological parameters and the number of reported cholera cases. Results: The findings revealed that the total number of cholera cases in Malaysia during the 11 year study period was 3841 cases with 32 deaths. Out of these, 45.1% of the cases were among children below 12 years old and 75% of the cases were from Sabah. Temperature and precipitation gave significant impact on the cholera cases in Sabah, (p<0.001) while precipitation were significant in Terengganu (p<0.001), and Sarawak (p=0.013). Monthly lag temperature data at Lag 0, 1, and 2 months were associated with the cholera cases in Sabah (p<0.001). The change in odds of having cholera cases were by the factor of 3.5 for every 1 degrees C increase in temperature. However, the contribution of rainfall was very mild, whereby an increase of 1 mm in precipitation will increase the excess risk of cholera by up to 0.8%. Conclusion: This study concludes that climate does influence the number of cholera cases in Malaysia.

The environmental health impact of Hurricane Katrina on New Orleans

Hurricane Katrina caused unprecedented flood damage to New Orleans, Louisiana, and has been the costliest hurricane in US history. We analyzed the environmental and public health outcomes of Hurricane Katrina by using Internet searches to identify epidemiological, sociodemographic, and toxicological measurements provided by regulatory agencies.Atmospheric scientists have now warned that global warming will increase the proportion of stronger hurricanes (categories 4-5) by 25% to 30% compared with weaker hurricanes (categories 1-2).With the new $14.6 billion Hurricane Storm Damage Risk Reduction System providing a 100-year storm surge-defensive wall across the Southeast Louisiana coast, New Orleans will be ready for stronger storms in the future.

Tale of two neighbourhoods: Biophysical and socio-economic vulnerability to climate change in Pinellas County, Florida

Defining vulnerability and identifying vulnerable areas and populations is critical to climate adaptation and resilience. Neighbourhoods are not homogeneous in terms of their socio-economic and physical vulnerability to flooding and other climate related impacts resulting in diverse challenges. Working with communities to better identify their concerns, liabilities, and strengths in the face of climate challenges will help build resiliency for all residents of the Tampa Bay area. This research identifies the weaknesses in knowledge, preparedness and ability to adapt in two communities in Pinellas County, Florida: examining a neighbourhood that is socio-economically vulnerable and a neighbourhood that experiences only physical (locational) vulnerability. We also identify opportunities for inclusive disaster planning, climate adaptation plans and to increase resiliency through long-term interactions between residents, community leaders, and local officials.

Self-rated mental and physical health of U.S. Gulf Coast residents

Repeated exposure to hurricanes and tropical storms likely impacts the mental and physical health of populations living along the U.S. Gulf Coast. In this study, the self-rated physical and mental health of residents in the U.S. Gulf Coast was estimated and factors associated with differences in self-rated health were identified. The 12-item Short Form Health Survey (SF-12) was administered online to a sample of 3030 residents of the U.S. Gulf Coast in December 2017. Responses were scored to calculate mental component summary scores and physical component summary scores. Multiple linear regression models were fitted to identify predictors of self-rated health among the residents. Residents of U.S. Gulf Coast States have poorer self-rated physical and mental health compared to the U.S. population. Women and respondents reporting higher perception of flood risk had worse self-rated mental health, while hurricane evacuees, adults of at least 25 years of age, those with self-reported hurricane damage, and respondents reporting higher perception of surge risk had worse self-rated physical health. Residents of U.S. Gulf Coast States have poorer self-rated health compared to national standards. These findings may have practical implications for hurricane-associated physical and mental health services planning and delivery.

Reanalysis of the 2000 Rift Valley fever outbreak in southwestern Arabia

The first documented Rift Valley hemorrhagic fever outbreak in the Arabian Peninsula occurred in northwestern Yemen and southwestern Saudi Arabia from August 2000 to September 2001. This Rift Valley fever outbreak is unique because the virus was introduced into Arabia during or after the 1997-1998 East African outbreak and before August 2000, either by wind-blown infected mosquitos or by infected animals, both from East Africa. A wet period from August 2000 into 2001 resulted in a large number of amplification vector mosquitoes, these mosquitos fed on infected animals, and the outbreak occurred. More than 1,500 people were diagnosed with the disease, at least 215 died, and widespread losses of domestic animals were reported. Using a combination of satellite data products, including 2 x 2 m digital elevation images derived from commercial satellite data, we show rainfall and potential areas of inundation or water impoundment were favorable for the 2000 outbreak. However, favorable conditions for subsequent outbreaks were present in 2007 and 2013, and very favorable conditions were also present in 2016-2018. The lack of subsequent Rift Valley fever outbreaks in this area suggests that Rift Valley fever has not been established in mosquito species in Southwest Arabia, or that strict animal import inspection and quarantine procedures, medical and veterinary surveillance, and mosquito control efforts put in place in Saudi Arabia following the 2000 outbreak have been successful. Any area with Rift Valley fever amplification vector mosquitos present is a potential outbreak area unless strict animal import inspection and quarantine proceedures are in place.

Quasi-experimental evaluation of text-based crisis patterns in youth following Hurricane Florence in the Carolinas, 2018

IMPORTANCE: Crisis text lines have proven to be an effective and low-cost means for delivering texting-based mental health support to youth. Yet there has been limited research examining the use of these services in capturing the psychological impact on youth affected by a weather-related disaster. OBJECTIVE: This ecologic study examined changes in help-seeking behavior for adolescents and young adults in North and South Carolina, USA, before and after Hurricane Florence (2018). DESIGN AND MAIN OUTCOMES: A retrospective, interrupted time-series design was used to examine pre- and post-hurricane changes in crisis text volume among youth help seekers in the Carolinas for the following outcomes: (1) text for any reason; (2) stress & anxiety; (3) depression; and (4) suicidal thoughts. RESULTS: Results showed an immediate and sustained increase in crisis texts for stress/anxiety and suicidal thoughts in the six weeks following Florence. Overall, an immediate 15% increase in crisis texts for anxiety/stress (SE = 0.05, p = .005) and a 17% increase in suicidal thoughts (SE = 0.07, p = .02) occurred during the week of the storm. Text volume for anxiety/stress increased 17% (SE = 0.08, p = .005) and 23% for suicidal ideation (SE = 0.08, p = .01) in the 6-week post-hurricane period. Finally, forecast models revealed observed text volume for all mental health outcomes was higher than expected in the 6 weeks post-Florence. CONCLUSIONS AND RELEVANCE: A low-cost, crisis texting platform provided 24/7 mental health support available to young people in the Carolinas impacted by Hurricane Florence. These findings highlight a new application for text-based crisis support services to address the mental health consequences in youth following a weather-related disaster, as well as the potential for these types of crisis platforms to measure situational awareness in impacted communities.

Random forest classification to determine environmental drivers and forecast paralytic shellfish toxins in Southeast Alaska with high temporal resolution

Paralytic shellfish poison toxins (PSTs) produced by the dinoflagellate in the genus Alexandrium are a threat to human health and subsistence lifestyles in Southeast Alaska. It is important to understand the drivers of Alexandrium blooms to inform shellfish management and aquaculture, as well as to predict trends of PST in a changing climate. In this study, we aggregate environmental data sets from multiple agencies and tribal partners to model and predict concentrations of PSTs in Southeast Alaska from 2016 to 2019. We used daily PST concentrations interpolated from regularly sampled blue mussels (Mytilus trossulus) analyzed for total PSTs using a receptor binding assay. We then created random forest models to classify shellfish above and below a threshold of toxicity (80 µg 100 g(-1)) and used two methods to determine variable importance. We obtained a multivariate model with key variables being sea surface temperature, salinity, freshwater discharge, and air temperature. We then used a similar model trained using lagged environmental variables to hindcast out-of-sample (OOS) shellfish toxicities during April-October in 2017, 2018, and 2019. Hindcast OOS accuracies were low (37-50%); however, we found forecasting using environmental variables may be useful in predicting the timing of early summer blooms. This study reinforces the efficacy of machine learning to determine important drivers of harmful algal blooms, although more complex models incorporating other parameters such as toxicokinetics are likely needed for accurate regional forecasts.

Occurrence of domoic acid and cyclic imines in marine biota from Lebanon-Eastern Mediterranean Sea

Marine biotoxins are naturally existing chemicals produced by toxic algae and can accumulate in marine biota. When consumed with seafood, these phycotoxins can cause human intoxication with symptoms varying from barely-noticed illness to death depending on the type of toxin and its concentration. Recently, the occurrence of marine biotoxins has been given special attention in the Mediterranean as it increased in frequency and severity due to anthropogenic pressures and climate change. Up to our knowledge, no previous study reported the presence of lipophilic toxins (LTs) and cyclic imines (CIs) in marine biota in Lebanon. Hence, this study reports LTs and CIs in marine organisms: one gastropod (Phorcus turbinatus), two bivalves (Spondylus spinosus and Patella rustica complex) and one fish species (Siganus rivulatus), collected from various Lebanese coastal areas. The results show values below the limit of detection (LOD) for okadaic acid, dinophysistoxin-1 and 2, pectenotoxin-1 and 2, yessotoxins, azaspiracids and saxitoxins. The spiny oyster (S. spinosus) showed the highest levels of domoic acid (DA; 3.88 mg kg(-1)), gymnodimine (GYM-B) and spirolide (SPX) (102.9 and 15.07 ?g kg(-1), respectively) in congruence with the occurrence of high abundance of Pseudo-nitzchia spp., Gymnodinium spp., and Alexandrium spp. DA levels were below the European Union (EU) regulatory limit, but higher than the Lowest Observed Adverse Effect Level (0.9 ?g g(-1)) for neurotoxicity in humans and lower than the Acute Reference Dose (30 ?g kg(-1) bw) both set by the European Food Safety Authority (EFSA, 2009). Based on these findings, it is unlikely that a health risk exists due to the exposure to these toxins through seafood consumption in Lebanon. Despite this fact, the chronic toxicity of DA, GYMs and SPXs remains unclear and the effect of the repetitive consumption of contaminated seafood needs to be more investigated.

Mortality during Hurricane Sandy: The effects of waterfront flood protection on Staten Island, New York

Hard defenses, such as levees or land berms, are often considered the most effective approach to reduce flood risk. This study reveals a potential increase in mortality when hard protections cannot defend a location against low-probability, extreme flood events. Staten Island, New York, suffered devastating damage from Hurricane Sandy, including 23 fatalities, of which 18 occurred in the neighborhoods along the island’s eastern shore. This study demonstrates that the elevated berm along the eastern shore may have contributed to the concentration of fatalities in the area by increasing the speed at which seawater rose, causing some people to be trapped in places where they could not escape rising waters. The study uses a hydrodynamic model to simulate Hurricane Sandy flood conditions, providing water depth, rise rate, and velocity. Statistical analyses show that water rise rate influences mortality, while other flood characteristics and several demographic and socioeconomic factors do not. A model experiment that qualitatively examines flood conditions in the presence of a lower discontinuous berm that historically existed at the location in Midland Beach finds that the increased height and continuity of the berm increased probability of mortality by worsening the water rise rate during Sandy by about 50%. The potential increase in mortality needs to be taken into account when designing coastal protections. If a protection strategy does not prevent low-probability, extreme floods, then there is a trade-off between protection against more frequent floods and increased risk of mortality during extreme floods.

Modeling the time-lag effect of sea surface temperatures on ciguatera poisoning in the South Pacific: Implications for surveillance and response

Ciguatera poisoning (CP), arising from ciguatoxins produced by toxic dinoflagellate Gambierdiscus, is one of the most common food-borne diseases in the South Pacific. Climate change as well as its related events have been hypothesized to a higher abundance and wider presence of toxic dinoflagellates, hence a higher risk of the disease. Yet existing studies assessing the relationship between climate factors and CP are limited or based on old data. In this study, we used prewhitened cross-correlation analysis and auto-regressive integrated moving-average (ARIMA) modeling to develop predictive models of monthly CP incidence in Cook Islands and French Polynesia, two ciguatera-endemic regions in the South Pacific, utilizing the latest epidemiological data. Results reveal the significant time-lagged associations between the monthly CP incidence rate and several indicators relating to sea surface temperature (SST). In particular, SST anomaly is proven to be a strong positive predictor of an increased ciguatera incidence for both countries. If these time-lags can be supported by more investigations, it will allow health authorities to take appropriate actions, to limit or avoid an epidemic risk, especially on high-risk climate scenarios.

Modelling geographical accessibility to support disaster response and rehabilitation of a healthcare system: An impact analysis of cyclones Idai and Kenneth in Mozambique

OBJECTIVES: Modelling and assessing the loss of geographical accessibility is key to support disaster response and rehabilitation of the healthcare system. The aim of this study was therefore to estimate postdisaster travel times to functional health facilities and analyse losses in accessibility coverage after Cyclones Idai and Kenneth in Mozambique in 2019. SETTING: We modelled travel time of vulnerable population to the nearest functional health facility in two cyclone-affected regions in Mozambique. Modelling was done using AccessMod V.5.6.30, where roads, rivers, lakes, flood extent, topography and land cover datasets were overlaid with health facility coordinates and high-resolution population data to obtain accessibility coverage estimates under different travel scenarios. OUTCOME MEASURES: Travel time to functional health facilities and accessibility coverage estimates were used to identify spatial differences between predisaster and postdisaster geographical accessibility. RESULTS: We found that accessibility coverage decreased in the cyclone-affected districts, as a result of reduced travel speeds, barriers to movement, road constraints and non-functional health facilities. In Idai-affected districts, accessibility coverage decreased from 78.8% to 52.5%, implying that 136?941 children under 5 years of age were no longer able to reach the nearest facility within 2?hours travel time. In Kenneth-affected districts, accessibility coverage decreased from 82.2% to 71.5%, corresponding to 14?330 children under 5 years of age having to travel >2?hours to reach the nearest facility. Damage to transport networks and reduced travel speeds resulted in the most substantial accessibility coverage losses in both Idai-affected and Kenneth-affected districts. CONCLUSIONS: Postdisaster accessibility modelling can increase our understanding of spatial differences in geographical access to care in the direct aftermath of a disaster and can inform targeting and prioritisation of limited resources. Our results reflect opportunities for integrating accessibility modelling in early disaster response, and to inform discussions on health system recovery, mitigation and preparedness.

More exposed but also more vulnerable? Climate change, high intensity precipitation events and flooding in Mediterranean Spain

Purpose The purpose of this paper is to examine the role of high intensity precipitation events in increasing the vulnerability to floods in Mediterranean Spain. Precipitation intensity in this area appears to have augmented in the last two decades in association with warming trends of the Mediterranean Sea. At the same time, intense urbanization processes, occupying and transforming flood prone land, have produced an important increase in exposure. The main objective is to assess whether higher intensity precipitation and changing patterns in exposure aggravate vulnerability to floods. Design/methodology/approach In this paper, vulnerability is understood as the result of the interrelationships between exposure, sensitivity, impacts and adaptive capacity. Consequently, methods used involved the compilation and analysis of published and unpublished precipitation data, population and land use data, data on insurance claims, and media sources related to those variables. Findings Changes toward episodes of more intense precipitation in the expanding urban areas of Mediterranean Spain increase exposure but not necessarily vulnerability, at least in terms of human deaths. However, adaptative capacity needs to be formulated. Actions that attempt to absorb and eventually reuse flood flows (as the flood park in Alicante) appear to be more effective than traditional hydraulic solutions (as in Majorca). Originality/value The paper provides a systematic and coherent approach to vulnerability analysis taking into account the changing dynamics of its components. Especially, it signals the limits of current adaptive approaches to flooding and advocates for changes toward a more circular and less linear approach to urban drainage.

Major storms, rising tides, and wet feet: Adapting to flood risk in the Philippines

This research examines flood risk and adaption to it, including the possibility of out-migration, in two flood-prone coastal locations in the Philippines through the lens of Protection Motivation Theory. Much of the country is at risk of coastal flooding due to sea-level rise and from severe weather-related events. The data analyzed were obtained in 2016 and 2018 from focus group discussions with local residents, individual interviews with local government officials, and field observations. Residents’ and officials’ reports reveal a number of consistent themes in both places and over time, with some important differences. Both locations were grappling with regular minor to moderate flooding in 2016, as well as with occasional severe flooding. Respondents reported serious economic, health, and safety threats associated with flooding events. Recent infrastructure improvements appear to have reduced routine flood risk in one location, but considerable risk from major storms remains in both places. While some housing has been abandoned because of flood damage, and while some better-off residents have moved away, most are not currently considering retreat as a near-term solution. Instead, most people are adapting in place and attempting to devise strategies to mitigate flood risk in their communities.

Isolation and characterization of potentially pathogenic Vibrio species in a temperate, higher latitude hotspot

The recent emergence of Vibrio infections at high latitudes represents a clear human health risk attributable to climate change. Here, we investigate the population dynamics of three Vibrio species: Vibrio parahaemolyticus, Vibrio vulnificus and Vibrio cholerae within a British coastal estuarine site, with contrasting salinity and temperature regimes during an intense heatwave event. Water samples were collected weekly through the summer of 2018 and 2019 and filtered using membrane filtration and subsequently grown on selective media. Suspected vibrios were confirmed using a conventional species-specific PCR assay and further analysed for potential pathogenic markers. Results showed that Vibrio parahaemolyticus, Vibrio vulnificus and Vibrio cholerae were present at high concentrations throughout both years, with their populations at substantially greater abundances corresponding to conditions of higher water temperatures during the heatwave of 2018 and at lower salinity sites, which is comparable to the results of previous studies. A subset of strains isolated during the extreme heatwave event in 2018 (46 Vibrio parahaemolyticus, 11 Vibrio cholerae and 4 Vibrio vulnificus) were genomically sequenced. Analysis of these 63 sequenced strains revealed a broad phenotypic and genomic diversity of strains circulating in the environment. An analysis of pathogenicity attributes identified a broad array of virulence genes across all three species, including a variety of genes associated with human disease. This study highlights the importance of the need for an increased Vibrio spp. surveillance system in temperate regions and the potential impact warming events such as heatwaves may have on the abundance of potentially pathogenic bacteria in the environment.

Increased medical visits and mortality among adults with Cardiovascular Diseases in severely affected areas after Typhoon Morakot

Natural disasters have negative health impacts on chronic diseases in affected populations. Severely affected areas are usually rural areas with limited basic infrastructure and a population have that has limited access to optimal healthcare after a disaster. Patients with cardiovascular diseases are required to maintain quality care, especially after disasters. A population-based case-control study enrolled adults from the National Health Insurance Registry who had ischemic heart disease and cerebrovascular disease histories and lived in the area affected by Typhoon Morakot in 2009. Monthly medical visits for acute cerebrovascular and ischemic heart diseases markedly increased at approximately 1-2 months after the typhoon. Survival analysis during the two years following the typhoon indicated a significant increase in mortality in adults with an acute ischemic heart disease history who lived in the severely affected area. Mortality hazard analysis showed that among affected adults with previous cerebrovascular diseases and acute ischemic heart diseases, patients with diabetes (adjusted hazard ratio [HR]: 1.3-1.7), Chronic Kidney Disease (CKD) (adjusted HR: 2.0-2.7), chronic obstructive pulmonary diseases (COPD) and asthma (adjusted HR: 1.7-2.1), liver cirrhosis (adjusted HR: 2.3-3.3) and neoplasms (adjusted HR: 1.1-2.1) had significantly increased mortality rates. Consequently, high-quality and accessible primary healthcare plans should be made available to maintain and support affected populations after disasters.

Impact of meteorological factors on the occurrence of acute aortic dissection in Fujian Province, China: A single-center seven-year retrospective study

BACKGROUND: The aim of this study was to investigate the correlation between meteorological factors and the occurrence of acute aortic dissection (AAD) in Fujian Province, China. METHODS: The clinical data of 2004 patients diagnosed with AAD in our hospital and the relevant local meteorological data from January 2013 to November 2019 were retrospectively analyzed. RESULTS: The incidence of AAD had a clear tendency toward concentration, and the corresponding peak in terms of the occurrence date was from January 13 to 14. The average minimum temperature, the average maximum temperature, and the average daily temperature differences on the “day with AAD” were significantly lower than those on the “day without AAD”. From 5?days to 3?days before AAD onset, the average daily temperature difference showed a downward trend, but statistical analysis showed that the average minimum, average maximum and average daily temperature differences were not significantly different from the values 5?days to 0?days before AAD onset. CONCLUSIONS: The incidence of AAD is related to the season and month. The lowest average temperature may increase the incidence of AAD in patients with complicated cardiovascular diseases.

Impact of climate variability and abundance of mosquitoes on Dengue Transmission in Central Vietnam

Dengue fever is an important arboviral disease in many countries. Its incidence has increased during the last decade in central Vietnam. Most dengue studies in Vietnam focused on the northern area (Hanoi) and southern regions but not on central Vietnam. Dengue transmission dynamics and relevant environmental risk factors in central Vietnam are not understood. This study aimed to evaluate spatiotemporal patterns of dengue fever in central Vietnam and effects of climatic factors and abundance of mosquitoes on its transmission. Dengue and mosquito surveillance data were obtained from the Department of Vector Control and Border Quarantine at Nha Trang Pasteur Institute. Geographic Information System and satellite remote sensing techniques were used to perform spatiotemporal analyses and to develop climate models using generalized additive models. During 2005-2018, 230,458 dengue cases were reported in central Vietnam. Da Nang and Khanh Hoa were two major hotspots in the study area. The final models indicated the important role of Indian Ocean Dipole, multivariate El Niño-Southern Oscillation index, and vector index in dengue transmission in both regions. Regional climatic variables and mosquito population may drive dengue transmission in central Vietnam. These findings provide important information for developing an early dengue warning system in central Vietnam.

Impact of heat exposure on health during a warm period in Cyprus

People exposed to heat experience symptoms of varying severity, from mild manifestations to heat stroke. Due to global warming, interest in the impact of heat exposure on human health has been increasing. This study investigated the association between outdoor thermal conditions and heat-related symptoms experienced by pedestrians in a temperate-Mediterranean and hot semi-arid climate. In the study, pedestrians participated in questionnaire-based surveys at outdoor sites in Cyprus in summer and autumn 2019 while the weather conditions at the sites were recorded. In the surveys, pedestrians reported whether they had experienced heat-related symptoms. The physiologically equivalent temperature (PET) was used to estimate the effect of the thermal environment. Statistical analyses of the data included the use of multivariable logistic regression models. In total, 1880 individuals (999 males, 54.2%; mean age +/- standard deviation 38.4 +/- 18.4 years) responded to the surveys of heat-related symptoms. An increase of 1 degrees C in air temperature (adjusted odds ratio (aOR): 1.10, 95% confidence interval (CI): 1.04-1.16) or PET (aOR: 1.04, 95% CI: 1.01-1.07) was associated with an elevated probability of reporting heat-related symptoms. The magnitude of the association of PET with the reporting of heat-related symptoms was found to be higher for nonpermanent residents in Cyprus (aOR: 1.11, 95% CI: 1.02-1.21). Females were more likely than males to report heat-related symptoms (aOR: 2.36, 95% CI: 1.82-3.06). Visiting the monitoring site for work (aOR: 1.69, 95% CI: 1.26-2.26) or reporting a medical history of respiratory disease (aOR: 3.60, 95% CI: 2.39-5.42) were associated with an increased likelihood of reporting heat-related symptoms. The thermal conditions and participant characteristics were associated with increased reporting of heat-related symptoms during non-heat-wave but warm periods in Cyprus. These results could have implications for adaptation measures, healthcare delivery, and public health services.

Impact of heavy rains of 2018 in western Japan: Disaster-induced health outcomes among the population of Innoshima Island

Southwestern Japan suffered its worst rains in 2018 causing floods and mudslides, claiming 225 lives and forcing millions for evacuations. Referred as “Heisei san-j?-nenshichi-gatsug?u”, the disaster was the result of incessant precipitation caused by the interaction of typhoon “Prapiroon” with the seasonal rain front “Baiu”. The present epidemiological study aims to investigate disaster-induced health issues in 728 residents of Innoshima island in the Hiroshima Prefecture by comparing their clinical data in pre-disaster (2017) and disaster-hit (2018) years which was obtained from annual health screening. Comparison of data showed a significant increase in the urine protein concentration in victims following the disaster. Probing further into the household conditions, showed that a total of 59,844 households were affected with water outage during the heavy rains, which was accompanied by severe damage of sewerage pipelines with complete recovery process taking two weeks. This two weeks of the crisis forced victims to refrain from using restrooms which in turn led to infrequent urination, thereby explaining the increased urine protein concentration in victims following the disaster. The present study addresses the acute health implications caused by the water crisis and serves as a precautionary measure for disaster management council to provide enhanced aftercare services in victims in further events of natural disasters.

Hurricanes Harvey, Irma, and Maria: Exploring the role of home-based care programs

OBJECTIVE: The aim of this study is to determine the response of home-based primary care programs to the fall 2017 Atlantic hurricane season. METHODS: This study examines the experiences of 9 Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) programs in their responses to Hurricanes Harvey, Irma, and Maria. Thirty-four phone interviews with HBPC leadership and staff were conducted from April to July 2018. RESULTS: The total census of impacted HBPC programs was 3118. No program reported loss of life due to these hurricanes. Early preparedness was key to an effective program response. Response included prompt tracking of the patients. In the most affected areas, respondents noted limited resources to support basic patient needs. CONCLUSIONS: Medically complex patients served by programs such as the VHA’s HBPC program represent a subset of the population, yet they have an outsized impact on health care resources that could be exacerbated by inadequate disaster preparedness. HBPC programs serve a unique role in supporting the “older old.” They are tasked with supporting disaster preparedness activities of patients. Understanding what is involved in actualizing their requirements shows communities how to effectively engage with these programs.

Framework for a community health observing system for the Gulf of Mexico region: Preparing for future disasters

The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.

Health consequences of drought in the WHO Eastern Mediterranean Region: Hotspot areas and needed actions

BACKGROUND: Over the past four decades, drought episodes in the Eastern Mediterranean Region (EMR) of the of the World Health Organization (WHO) have gradually become more widespread, prolonged and frequent. We aimed to map hotspot countries and identified key strategic actions for health consequences. METHODS: We reviewed scientific literature and WHO EMR documentation on trends and patterns of the drought health consequences from 1990 through 2019. Extensive communication was also carried out with EMR WHO country offices to retrieve information on ongoing initiatives to face health consequences due to drought. An index score was developed to categorize countries according vulnerability factors towards drought. RESULTS: A series of complex health consequences are due to drought in EMR, including malnutrition, vector-borne diseases, and water-borne diseases. The index score indicated how Afghanistan, Yemen and Somalia are “hotspots” due to poor population health status and access to basic sanitation as well as other elements such as food insecurity, displacement and conflicts/political instability. WHO country offices effort is towards enhancing access to water and sanitation and essential healthcare services including immunization and psychological support, strengthening disease surveillance and response, and risk communication. CONCLUSIONS: Drought-related health effects in the WHO EMR represent a public health emergency. Strengthening mitigation activities and additional tailored efforts are urgently needed to overcome context-specific gaps and weaknesses, with specific focus on financing, accountability and enhanced data availability.

Evidence for the range expansion of ciguatera in French Polynesia: A revisit of the 2009 mass-poisoning outbreak in Rapa Island (Australes Archipelago)

Ciguatera poisoning (CP) results from the consumption of seafood contaminated with ciguatoxins (CTXs). This disease is highly prevalent in French Polynesia with several well-identified hotspots. Rapa Island, the southernmost inhabited island in the country, was reportedly free of CP until 2007. This study describes the integrated approach used to investigate the etiology of a fatal mass-poisoning outbreak that occurred in Rapa in 2009. Symptoms reported in patients were evocative of ciguatera. Several Gambierdiscus field samples collected from benthic assemblages tested positive by the receptor binding assay (RBA). Additionally, the toxicity screening of ?250 fish by RBA indicated ?78% of fish could contain CTXs. The presence of CTXs in fish was confirmed by liquid chromatography tandem mass spectrometry (LC-MS/MS). The potential link between climate change and this range expansion of ciguatera to a subtropical locale of French Polynesia was also examined based on the analysis of temperature time-series data. Results are indicative of a global warming trend in Rapa area. A five-fold reduction in incidence rates was observed between 2009 and 2012, which was due in part to self-regulating behavior among individuals (avoidance of particular fish species and areas). Such observations underscore the prominent role played by community outreach in ciguatera risk management.

Cholera risk: A machine learning approach applied to essential climate variables

Oceanic and coastal ecosystems have undergone complex environmental changes in recent years, amid a context of climate change. These changes are also reflected in the dynamics of water-borne diseases as some of the causative agents of these illnesses are ubiquitous in the aquatic environment and their survival rates are impacted by changes in climatic conditions. Previous studies have established strong relationships between essential climate variables and the coastal distribution and seasonal dynamics of the bacteria Vibrio cholerae, pathogenic types of which are responsible for human cholera disease. In this study we provide a novel exploration of the potential of a machine learning approach to forecast environmental cholera risk in coastal India, home to more than 200 million inhabitants, utilising atmospheric, terrestrial and oceanic satellite-derived essential climate variables. A Random Forest classifier model is developed, trained and tested on a cholera outbreak dataset over the period 2010-2018 for districts along coastal India. The random forest classifier model has an Accuracy of 0.99, an F1 Score of 0.942 and a Sensitivity score of 0.895, meaning that 89.5% of outbreaks are correctly identified. Spatio-temporal patterns emerged in terms of the model’s performance based on seasons and coastal locations. Further analysis of the specific contribution of each Essential Climate Variable to the model outputs shows that chlorophyll-a concentration, sea surface salinity and land surface temperature are the strongest predictors of the cholera outbreaks in the dataset used. The study reveals promising potential of the use of random forest classifiers and remotely-sensed essential climate variables for the development of environmental cholera-risk applications. Further exploration of the present random forest model and associated essential climate variables is encouraged on cholera surveillance datasets in other coastal areas affected by the disease to determine the model’s transferability potential and applicative value for cholera forecasting systems.

Climate change adaptation policies of Vietnam in the Mekong Delta

If the alarming climate change and sea-level rise scenario occurs without coping solutions, it will greatly affect the socio-economic development and the environment of the the Mekong River Delta region. Recognizing this, the Government has soon developed both policies and action plans to adapt to climate change for the region. However, the policies and programs to cope with climate change are still inadequate and limited. In order to complete the climate change adaptation policies in the Mekong Delta in the current context, the Government and localities in the region need to implement more comprehensive and practical solutions for it.

An empirical analysis of association between socioeconomic factors and communities’ exposure to natural hazards

In today’s urban environments with complex design and configurations, heterogeneous spatial clusters of communities with different socioeconomic characteristics may result in disproportionate exposure of some groups of citizens to natural hazards. The objective of this study was to compare the associations between communities’ socioeconomic characteristics and exposure to different types of natural hazards in New York City (NYC) to examine whether commonly accepted indicators of social vulnerability are associated with similar levels of exposure across various natural hazards. First, we collected socioeconomic data (e.g., population, median income, unemployment rate) at a zip code level of granularity provided by the United States Census Bureau. Next, we identified and gathered spatial data for coastal storms, flooding, extreme heat, and pandemic disease in NYC. We then conducted a pairwise Kendall’s tau-b test to compare the associations. The outcomes showed that the significance and direction of the associations depend on the type of natural hazard. Particularly, the results indicated that zip codes with lower socioeconomic factors and greater percentage of minority ethnicities are exposed disproportionately to extreme heat and COVID-19. On the other hand, zip codes with higher percentage of areas prone to flooding have relatively higher socioeconomic factors. Furthermore, the results did not show any statistically significant association between socioeconomic factors and exposure to coastal storm inundations. The outcomes of this study will help decision makers design and implement better optimized and effective emergency preparedness plans by prioritizing their target areas based on socioeconomic factors in order to enhance social justice.

Assessing United States county-level exposure for research on tropical cyclones and human health

BACKGROUND: Tropical cyclone epidemiology can be advanced through exposure assessment methods that are comprehensive and consistent across space and time, as these facilitate multiyear, multistorm studies. Further, an understanding of patterns in and between exposure metrics that are based on specific hazards of the storm can help in designing tropical cyclone epidemiological research. OBJECTIVES: a) Provide an open-source data set for tropical cyclone exposure assessment for epidemiological research; and b) investigate patterns and agreement between county-level assessments of tropical cyclone exposure based on different storm hazards. METHODS: We created an open-source data set with data at the county level on exposure to four tropical cyclone hazards: peak sustained wind, rainfall, flooding, and tornadoes. The data cover all eastern U.S. counties for all land-falling or near-land Atlantic basin storms, covering 1996-2011 for all metrics and up to 1988-2018 for specific metrics. We validated measurements against other data sources and investigated patterns and agreement among binary exposure classifications based on these metrics, as well as compared them to use of distance from the storm’s track, which has been used as a proxy for exposure in some epidemiological studies. RESULTS: Our open-source data set was typically consistent with data from other sources, and we present and discuss areas of disagreement and other caveats. Over the study period and area, tropical cyclones typically brought different hazards to different counties. Therefore, when comparing exposure assessment between different hazard-specific metrics, agreement was usually low, as it also was when comparing exposure assessment based on a distance-based proxy measurement and any of the hazard-specific metrics. DISCUSSION: Our results provide a multihazard data set that can be leveraged for epidemiological research on tropical cyclones, as well as insights that can inform the design and analysis for tropical cyclone epidemiological research. https://doi.org/10.1289/EHP6976.

Advancing the toxics mobility inventory: Development and application of a toxics mobility vulnerability index to Harris County, Texas

Harris County, Texas, is home to thousands of documented sources of environmental pollution. It is also highly vulnerable to impacts from natural hazards, including floods. Building on the Toxics Mobility Inventory (TMI), this article discusses how the authors developed a Toxics Mobility Vulnerability Index (TMVI) and applied it to Harris County to assess potential exposure risks to residents from the transfer of toxic materials during flood events. The TMI concept was operationalized and standardized by combining multiple spatial data sets to simultaneously evaluate various factors in the weather hazards-extant toxics-social vulnerability nexus (e.g., floodplain area, industrial land use, social vulnerability measures). Findings indicated hot spots of vulnerability to hazard-induced toxics transfer concentrated in Northeast Houston US Census tracts in Harris County. The main drivers of increased risk in these areas include the proportion of the area that is impervious surface, consistently high social vulnerabilities, and poor health. However, the most vulnerable areas also have overlapping exposure to both industrial land use and floodplains. Assessing the contribution of a set of industrial land use, social vulnerability, natural hazard, emergency response, and topography variables in a single index on the same spatial scale (e.g., US Census tract) provides detailed information for policy makers tasked with mitigating risk. Applying tools such as the TMVI to highly vulnerable urban and coastal locations may help identify changes needed for preparedness and mitigation planning and highlight areas where limited resources for investment- and policy-related remediation should be focused, both before and after disasters.

Puerto Rico Disaster Decision Support Tool (DDST)

HAZUS-MH: Estimating potential losses from disasters

Climate models suggest warming-induced wind shear changes could impact hurricane development intensity

On the role of the Atlantic Ocean in exacerbating Indian heat waves

Potentially human pathogenic Vibrio spp. in a coastal transect: Occurrence and multiple virulence factors

Health consequences of thick forest fire smoke to healthy residents in Riau, Indonesia: A cross-sectional study

Exploring mental health needs and services among affected population in a cyclone affected area in costal Bangladesh: A qualitative case study

Examining harmful algal blooms through a disaster risk management lens: A case study of the 2015 U.S. West Coast domoic acid event

Examining the association between apparent temperature and incidence of acute excessive drinking in Shenzhen, China

Developing an adaptive pathway to mitigate air pollution risk for vulnerable groups in South Korea

Developing a multi-facet social vulnerability measure for flood disasters at the micro-level assessment

Coronavirus pandemic versus temperature in the context of Indian subcontinent: A preliminary statistical analysis

Climate variability, socio-ecological factors and dengue transmission in tropical Queensland, Australia: A Bayesian spatial analysis

Climate change impacts and adaptations on health of Internally Displaced People (IDP): An exploratory study on coastal areas of Bangladesh

Climate change and public health: A study of vector-borne diseases in Odisha, India

Climate change as an involuntary exposure: A comparative risk perception study from six countries across the global development gradient

COVID-19 pandemic, dengue epidemic, and climate change vulnerability in Bangladesh: Scenario assessment for strategic management and policy implications

Application of QMRA to MAR operations for safe agricultural water reuses in coastal areas

Aquaculture at the crossroads of global warming and antimicrobial resistance

Why despite the lower prevalence, is asthma more severe in the semiarid region?

Viral dispersal in the coastal zone: A method to quantify water quality risk

Tropical cyclone risk assessment using geospatial techniques for the eastern coastal region of Bangladesh

The impact of heat exposure on reduced gestational age in pregnant women in North Carolina, 2011-2015

The effects of infrastructure service disruptions and socio-economic vulnerability on hurricane recovery

Survey and genetic characterization of Vibrio cholerae in Apalachicola Bay, Florida (2012-2014)

Spatiotemporal analysis of influenza morbidity and its association with climatic and housing conditions in Ecuador

Spatial paleopathology: A geographic approach to the etiology of cribrotic lesions in the prehistoric Andes

Severe salinity contamination in drinking water and associated human health hazards increase migration risk in the southwestern coastal part of Bangladesh

Risk to residents, infrastructure, and water bodies from flash floods and sediment transport

Psychiatric morbidity in December 2015 flood-affected population in Tamil Nadu, India

Potential impacts of climate-related decline of seafood harvest on nutritional status of coastal First Nations in British Columbia, Canada

Physical, chemical, and microbial quality of floodwaters in Houston following Hurricane Harvey

Paediatric dengue infection in Cirebon, Indonesia: A temporal and spatial analysis of notified dengue incidence to inform surveillance

Measuring the potential for toxic exposure from storm surge and sea-level rise: Analysis of coastal Virginia

Managed retreat as a strategy for climate change adaptation in small communities: Public health implications

Linking water infrastructure, public health, and sea level rise: Integrated assessment of flood resilience in coastal cities

Influence of weather conditions on the onset of spontaneous pneumothorax in the region of Sousse (Tunisia): Analysis of time series

Impacts of historical warming on marine fisheries production

Impacts of sea level rise and storm surge in Yeosu, Korea

Impact of place identity, self-efficacy and anxiety state on the relationship between coastal flooding risk perception and the willingness to cope

Imagining disasters in the era of climate change: Is Japan’s seawall a new Maginot Line?

Health implications of drinking water salinity in coastal areas of Bangladesh

Health vulnerability to flood-induced risks of households in flood-prone informal settlements in the coastal city of Mombasa, Kenya

Forecast: Increasing mental health consequences from Atlantic hurricanes throughout the 21st century

Forecasting seasonal Vibrio parahaemolyticus concentrations in New England shellfish

Extreme weather, chemical facilities, and vulnerable communities in the U.S. Gulf Coast: A disastrous combination

Exploring flood-related unintentional fatal drowning of children and adolescents aged 0-19 years in Australia

Epidemiologic, entomologic, and virologic factors of the 2014-15 Ross River Virus outbreak, Queensland, Australia

Emerging neglected helminthiasis and determinants of multiple helminth infections in flood-prone township in Myanmar

Effects of seasonal changes in temperature and humidity on incidence of necrotizing soft tissue infections in Halifax, Canada, 2001-2015

Ecological niche models for sand fly species and predicted distribution of Lutzomyia longipalpis (Diptera: Psychodidae) and visceral leishmaniasis in Bahia state, Brazil

Disaster risk resilience in Colima-Villa de Alvarez, Mexico: Application of the resilience index to flash flooding events

Divers risk accelerated fatigue and core temperature rise during fully-immersed exercise in warmer water temperature extremes

Culture-Documented invasive mold infections at MD Anderson cancer center in Houston, Texas, pre- and post-Hurricane Harvey

Combining water fraction and DEM-based methods to create a coastal flood map: A case study of Hurricane Harvey

Coastal flooding and frontline health care services: Challenges for flood risk resilience in the English health care system

Climate-related uncertainties in urban exposure to sea level rise and storm surge flooding: A multi-temporal and multi-scenario analysis

Climate change, environmental stress and loss of livelihoods can push people towards illegal activities: A case study from coastal Bangladesh

Assessing spatial flood vulnerability at Kalapara Upazila in Bangladesh using an analytic hierarchy process

Assessment of 2010 flood disaster causes and damages in district Muzaffargarh, Central Indus Basin, Pakistan

An evaluation and monetary assessment of the impact of flooding on subjective well-being across genders in Vietnam

A comparison of the geographic patterns of HIV prevalence and hurricane events in the United States

Well-being and mental health impact of household flooding in Guyana, the Caribbean

The effect of seasonal floods on health: Analysis of six years of national health data and flood maps

Spatio-temporal heterogeneity of malaria morbidity in Ghana: Analysis of routine health facility data

Spatial variation of heat-related morbidity: A hierarchical Bayesian analysis in multiple districts of the Mekong delta region

Short-term effects of heat on mortality and effect modification by air pollution in 25 Italian cities

Projections of rising heat stress over the western Maritime Continent from dynamically downscaled climate simulations

Prospects of pond ecosystems as resource base towards community based adaptation (CBA) to climate change in coastal region of Bangladesh

Psychological health challenges of the hill-tracts region for climate change in Bangladesh

Public health and mental health implications of environmentally induced forced migration

Possible impacts of sea level rise on disease transmission and potential adaptation strategies, a review

Ocean warming and acidification affect the nutritional quality of the commercially-harvested turbinid snail Turbo militaris

Multi-hazard risk assessment of coastal vulnerability from tropical cyclones – A gis based approach for the Odisha Coast

Multiple stressors and benthic harmful algal blooms (BHABs): Potential effects of temperature rise and nutrient enrichment

Modeling environmentally mediated rotavirus transmission: The role of temperature and hydrologic factors

Living in a multi-stressors environment: An integrated biomarker approach to assess the ecotoxicological response of meagre (Argyrosomus regius) to venlafaxine, warming and acidification

Is extreme climate or moderate climate more conducive to longevity in China?

Influence of weather on seizure frequency – Clinical experience in the emergency room of a tertiary hospital

Increasing probability of heat-related mortality in a Mediterranean city due to urban warming

Improved fisheries management could offset many negative effects of climate change

Improving public health readiness for sea level rise: A new initiative in Coastal Virginia

Impact of tropical cyclone track change on regional air quality

Impact of climate change on Vibrio vulnificus abundance and exposure risk

Hurricane Harvey links to ocean heat content and climate change adaptation

Highly infectious diseases in the Mediterranean Sea area: Inventory of isolation capabilities and recommendations for appropriate isolation

Host and parasite thermal ecology jointly determine the effect of climate warming on epidemic dynamics

Heavy metal contamination near industrial estate areas in Phra Nakhon Si Ayutthaya Province, Thailand and human health risk assessment

Hands-on experience of crowdsourcing for flood risks. An android mobile application tested in Frederikssund, Denmark

Harmful algal blooms and climate change: Exploring future distribution changes

Governance matters: Climate change, corruption, and livelihoods in Bangladesh

Getting more out of storm surge forecasts: Emergency support personnel needs in North Carolina

Global change in marine aquaculture production potential under climate change

Fostering coastal resilience to climate change vulnerability in Bangladesh, Brazil, Cameroon and Uruguay: A cross-country comparison

Framework for mapping the drivers of coastal vulnerability and spatial decision making for climate-change adaptation: A case study from Maharashtra, India

Fast adjustments of the Asian summer monsoon to anthropogenic aerosols

Extreme temperature events on the Iberian Peninsula: Statistical trajectory analysis and synoptic patterns

Exploring trade-offs in climate change response in the context of Pacific Island fisheries

Extending resilience assessment to dynamic system modeling: Perspectives on human dynamics and climate change research

Exacerbation of the 2013-2016 Pan-Caribbean drought by anthropogenic warming

Estimated incidence rate of multiple sclerosis and its relationship with geographical factors in Isfahan province between the years 2001 and 2014

Epidemic dynamics of Vibrio parahaemolyticus illness in a hotspot of disease emergence, Galicia, Spain

Environmental and ecological effects of climate change on venomous marine and amphibious species in the wilderness

Environmental heat exposure and heat-related symptoms in United States Coast Guard Deepwater Horizon disaster responders

Elements of fishing community resilience to climate change in the coastal zone of Bangladesh

Effects of organic pollutants on bacterial communities under future climate change scenarios

Effects of prenatal exposure to air pollution on preeclampsia in Shenzhen, China

Effectiveness assessment of risk reduction measures at coastal areas using a decision support system: Findings from Emma storm

Ecological niche modeling predicting the potential distribution of Leishmania vectors in the Mediterranean basin: Impact of climate change

Economic and sociocultural impacts of fisheries closures in two fishing-dependent communities following the massive 2015 U.S. West Coast harmful algal bloom

Dynamic adaptive pathways in downscaled climate change scenarios

Dinophysis acuta in Scottish coastal waters and its influence on diarrhetic shellfish toxin profiles

Disparities of population exposed to flood hazards in the United States

Conjunction of factors triggering waves of seasonal influenza

Community resilience to floods in the coastal zone for disaster risk reduction

Climate change vulnerability assessment and adaptation of Bangladesh: Mechanisms, notions and solutions

Climate change, water scarcity, and health adaptation in Southwestern Coastal Bangladesh

Climate change and food security: A Sri Lankan perspective

Characterization of particulate matter and black carbon over Bay of Bengal during summer monsoon: Results from the OMM cruise experiment

Building capacity on ecosystem-based adaptation strategy to cope with extreme events and sea-level rise on the Uruguayan coast

Association between precipitation and diarrheal disease in Mozambique

Association between salinity and hospital admission for hypertension: An ecological case-control study in the Mekong Delta Region in Vietnam

Assessment of temperature and ultraviolet radiation effects on sunburn incidence at an inland U.S. Beach: A cohort study

Analyzing regional climate change in Africa in a 1.5, 2, and 3 degrees C global warming world

An investigation of coastal vulnerability and internal consistency of local perceptions under climate change risk in the southwest part of Bangladesh

An assessment of climate change and health vulnerability and adaptation in Dominica

Algal bloom expansion increases cyanotoxin risk in food

Adversity of prolonged extreme cold exposure among adult clients diagnosed with coronary artery diseases: A primer for recommending community health nursing intervention

Aging in flood-prone coastal areas: Discerning the health and well-being risk for older residents

Vulnerability to impacts of climate change on marine fisheries and food security

Variable virulence of Biotype 3 vibrio vulnificus due to MARTX toxin effector domain composition

Vulnerability index and climate change: An analysis in Cuddalore District of Tamil Nadu, India

Urban development and pedestrian thermal comfort in Melbourne

Urban heat island and overheating characteristics in Sydney, Australia. An analysis of multiyear measurements

Urban resilience to future urban heatwaves under a climate change scenario: A case study for Porto urban area (Portugal)

The evolution of temperature extremes in the Gasp, peninsula, Quebec, Canada (1974-2013)

The fiscal cost of hurricanes: Disaster aid versus social insurance

Synergies between urban heat island and heat waves in Athens (Greece), during an extremely hot summer (2012)

Temperature and rainfall trends in northern Australia 1911-2013: Implications for human activity and regional development

Soil lead and children’s blood lead disparities in pre- and post-Hurricane Katrina New Orleans (USA)

Socio-economic vulnerability due to climate change: Deriving indicators for fishing communities in Mumbai

Socioeconomic and environmental determinants of dengue transmission in an urban setting: An ecological study in Noumea, New Caledonia

Relationships between floods and social fragmentation: A case study of Chiayi, Taiwan

Relationship between long-term flooding and serious mental illness after the 2011 flood in Thailand

Racial coastal formation: The environmental injustice of colorblind adaptation planning for sea-level rise

Rapid attribution of the August 2016 flood-inducing extreme precipitation in south Louisiana to climate change

Quantifying and predicting the contribution of sea-level rise to shoreline change in Ghana: Information for coastal adaptation strategies

Quantifying resilience and uncertainty in coastal flooding events: Framework for assessing urban vulnerability

Q fever in an endemic region of North Queensland, Australia: A 10 year review

Projection of climate change-induced sea-level rise for the coasts of Tamil Nadu and Puducherry, India using SimCLIM: A first step towards planning adaptation policies

Property destruction, human losses and economic paralysis: Impact flood in Kelantan

Probabilistic life-cycle cost-benefit analysis of portfolios of buildings under flood hazard

Profiling urban vulnerabilities to climate change: An indicator-based vulnerability assessment for European cities

Physicochemical factors influence the abundance and culturability of human enteric pathogens and fecal indicator organisms in estuarine water and sediment

People of the whales: Climate change and cultural resilience amond Inupiat of Arctic Alaska

Paracas dust storms: Sources, trajectories and associated meteorological conditions

Ocean warming since 1982 has expanded the niche of toxic algal blooms in the North Atlantic and North Pacific oceans

Oceanic meteorological conditions influence incidence of aneurysmal subarachnoid hemorrhage

Operationalizing safe operating space for regional social-ecological systems

Not waving, drowning: Can local government policies on climate change adaptation and disaster resilience make a difference?

Multi-dimensional coping and adaptation strategies of small-scale fishing communities of Bangladesh to climate change induced stressors

Modelling dengue fever risk in the state of Yucatan, Mexico using regional-scale satellite-derived sea surface temperature

Modelling malaria incidence by an autoregressive distributed lag model with spatial component

Modelling the association of dengue fever cases with temperature and relative humidity in Jeddah, Saudi Arabia-A generalised linear model with break-point analysis

Mapping the coastal risk for the next century, including sea level rise and changes in the coastline: application to Charlestown RI, USA

Malaria early warning tool: Linking inter-annual climate and malaria variability in Northern Guadalcanal, Solomon Islands

Long-term dust aerosol production from natural sources in Iceland

Integrative assessment of climate change for fast-growing urban areas: Measurement and recommendations for future research

Individual adaptive capacity of small-scale fishermen living in vulnerable areas towards the climate change in Malaysia

Income inequality and urban vulnerability to flood hazard in Brazil

Increasing risk over time of weather-related hazards to the European population: A data-driven prognostic study

Impacts of the 2014 severe drought on the Microcystis bloom in San Francisco Estuary

Incidence of gastrointestinal illness following wet weather recreational exposures: Harmonization of quantitative microbial risk assessment with an epidemiologic investigation of surfers

Impact of hurricane exposure on reproductive health outcomes, Florida, 2004

Humidity may modify the relationship between temperature and cardiovascular mortality in Zhejiang Province, China

Healthcare waste management during disasters and its effects on climate change: Lessons from 2010 earthquake and cholera tragedies in Haiti

Fatalities in wildland fires from 1945 to 2015 in Sardinia (Italy)

Exposure to environmental microbiota explains persistent abdominal pain and irritable bowel syndrome after a major flood

Environmental indicators of oyster norovirus outbreaks in coastal waters

Emotion, coping, and climate change in Island Nations: Implications for environmental justice

Effects of climate change on coral grouper (Plectropomus spp.) and possible adaptation options

Drinking water salinity and raised blood pressure: Evidence from a cohort study in coastal Bangladesh

Decision processes and determinants of hospital evacuation and shelter-in-place during Hurricane Sandy

Defying the odds: Climate variability, asset adaptation and food security nexus in the delta state of Nigeria

Climate change-induced increases in precipitation are reducing the potential for solar ultraviolet radiation to inactivate pathogens in surface waters

Climate change from the lens of Malolos children: Perception, impact and adaptation

Climate change impacts on bromide, trihalomethane formation, and health risks at coastal groundwater utilities

Climate change and marine fisheries: Least developed countries top global index of vulnerability

Characterization of urban heat and exacerbation: Development of a heat island index for California

Challenges of climate change impacts on urban water quality management and planning in coastal towns of Bangladesh

Bringing future climatic change into water resources management practice today

Assessing risks from cyclones for human lives and livelihoods in the coastal region of Bangladesh

Assessment of challenges faced by the coastal women due to the impact of climatic change in selected coastal districts of Tamil Nadu, India

Assessing climate driven malaria variability in Ghana using a regional scale dynamical model

An uncertainty-based framework to quantifying climate change impacts on coastal flood vulnerability: Case study of New York City

Analysis and prediction of a catastrophic Indian coastal heat wave of 2015

Adaptation or conflict? Responses to climate change in water management in Bangladesh

Safe emergency evacuation of a Tertiary Care Hospital during the “once in a century” floods in Chennai, India

What happened to our environment and mental health as a result of Hurricane Sandy?

Aquatic food security: Insights into challenges and solutions from an analysis of interactions between fisheries, aquaculture, food safety, human health, fish and human welfare, economy and environment

We are not all the same!: Comparative climate change vulnerabilities among fishers in Old Harbour Bay, Jamaica

Wet bulb globe temperature across Western Turkey according to the ENSEMBLES project

Vulnerability to climate change of surface water resources of coastal areas of Sindh, Pakistan

Water quality changes at an Outstanding Florida Water: Influence of stochastic events and climate variability

Vibrio bacteria in raw oysters: Managing risks to human health

Vulnerability and adaptation assessment a way forward for sustainable sectoral development in the purview of climate variability and change: Insights from the coast of Tamil Nadu, India

Vulnerability of coastal communities from storm surge and flood disasters

Vulnerability of families and households to natural hazards: A case study of storm surge flooding in Sarasota County, Florida

Using socioeconomic and fisheries involvement indices to understand Alaska fishing community well-being

Understanding the influence of climate change on the embodied energy of water supply

Time trend of malaria in relation to climate variability in Papua New Guinea

The geography of mental health and general wellness in Galveston Bay after Hurricane Ike: A spatial epidemiologic study with longitudinal data

The effect of extreme weather conditions on commercial fishing activities and vessel incidents in Atlantic Canada

Temporal and spatial patterns in utilization of mental health services during and after Hurricane Sandy: emergency department and inpatient hospitalizations in New York City

Spatial shift in the utilization of mental health services after Hurricane Sandy among New York City residents enrolled in Medicaid

Simulation of sea level rise and its impacts on the western coastal area of Saudi Arabia

Salt intake and health risk in climate change vulnerable coastal Bangladesh: What role do beliefs and practices play?

Sea level rise impacts on rice production: the Ebro Delta as an example

Risk assessment of excessive CO2 emission on diatom heavy metal consumption

Risk to water security for small islands: An assessment framework and application

Riverine fishers’ knowledge of extreme climatic events in the Brazilian Amazonia

Resilience of cassava (Manihot esculenta Crantz) to salinity: Implications for food security in low-lying regions

Quantitative microbial risk assessment combined with hydrodynamic modelling to estimate the public health risk associated with bathing after rainfall events

Projecting marine fish production and catch potential in Bangladesh in the 21st century under long-term environmental change and management scenarios

Population vulnerability to storm surge flooding in coastal Virginia, USA

Planning adaptation to climate change in fast-warming marine regions with seafood-dependent coastal communities

Multi-hazard risk assessment of two Hong Kong districts

Modification of heat-related mortality in an elderly urban population by vegetation (urban green) and proximity to water (urban blue): Evidence from Lisbon, Portugal

Millions projected to be at risk from sea-level rise in the continental United States

Measuring the storm: methods of quantifying hurricane exposure with pregnancy outcomes

Marine microalgae: Climate, energy, and food security from the sea

Job and residential location changes responding to floods and cyclones: An analysis based on a cross-nested logit model

Integrating desalination to reservoir operation to increase redundancy for more secure water supply

Insights in public health: Climate change: A public health challenge and opportunity for Hawai’i

Integrated assessment of social and environmental sustainability dynamics in the Ganges-Brahmaputra-Meghna delta, Bangladesh

Indicators of climate change and social vulnerability in fishing dependent communities along the Eastern and Gulf Coasts of the United States

Impacts of climatic variability on Vibrio parahaemolyticus outbreaks in Taiwan

Impact of climate change on salinization of coastal water resources

High summer temperatures and mortality in Estonia

Hell and high water: Diminished septic system performance in coastal regions due to climate change

Heat wave-associated vibriosis, Sweden and Finland, 2014

Health and climate benefits of offshore wind facilities in the Mid-Atlantic United States

Forecasting paediatric malaria admissions on the Kenya Coast using rainfall

Fisheries management approaches as platforms for climate change adaptation: Comparing theory and practice in Australian fisheries

Exposure to flood hazards in Miami and Houston: Are Hispanic immigrants at greater risk than other social groups?

Exertional heat illness and acute injury related to ambient wet bulb globe temperature

Effects of the 2008 flood on economic performance and food security in Yemen: A simulation analysis

El Nino, climate, and cholera associations in Piura, Peru, 1991-2001: A wavelet analysis

El Nino-based malaria epidemic warning for Oromia, Ethiopia, from August 2016 to July 2017

Effect of salinity on food security in the context of interior coast of Bangladesh

Economic impact of climate change and climate change adaptation strategies for fisheries sector in Solomon Islands: Implication for food security

Effect of climate factors on the childhood pneumonia in Papua New Guinea: A time-series analysis

Drinking water vulnerability to climate change and alternatives for adaptation in coastal South and South East Asia

Disasters, migrations, and the unintended consequences of urbanization: What’s the harm in getting out of harm’s way?

Determinants of climate change awareness level in upper Nyakach Division, Kisumu County, Kenya

Community-based adaptation research in the Canadian Arctic

Comparing vulnerability and adaptive capacity to climate change in individuals of coastal Dominican Republic

Climate-induced human displacement: A case study of Cyclone Aila in the south-west coastal region of Bangladesh

Climate influence on Vibrio and associated human diseases during the past half-century in the coastal North Atlantic

Climate change threats to two low-lying South African coastal towns: Risks and perceptions

Climate change trends in Malta and related beliefs, concerns and attitudes toward adaptation among Gozitan farmers

Climate change but not unemployment explains the changing suicidality in Thessaloniki Greece (2000-2012)

Climate change impact: The experience of the coastal areas of Bangladesh affected by cyclones Sidr and Aila

Cholera in Cameroon, 2000-2012: Spatial and temporal analysis at the operational (health district) and sub climate levels

Characterizing the impact of extreme heat on mortality, Karachi, Pakistan, June 2015

Associations between malaria and local and global climate variability in five regions in Papua New Guinea

Assessment of the impacts of climate change and brackish irrigation water on rice productivity and evaluation of adaptation measures in Ca Mau province, Vietnam

Assessment of water resources availability and groundwater salinization in future climate and land use change scenarios: A case study from a coastal drainage basin in Italy

Assessing potential impacts of sea level rise on public health and vulnerable populations in southeast Florida and providing a framework to improve outcomes

Assessing relative vulnerability to sea-level rise in the western part of the Mekong River Delta in Vietnam

Assessing the impact of air pollution on grain yield of winter wheat – a case study in the North China Plain

A climate-based prediction model in the high-risk clusters of the Mekong Delta region, Vietnam: Towards improving dengue prevention and control

Where does climate fit? Vulnerability to climate change in the context of multiple stressors in Funafuti, Tuvalu

Weather variability in urban Philippines: A gender analysis of household impacts

Variability of human-biometeorological conditions in Gdansk

Variation in admission rates of acute coronary syndrome patients in coronary care unit according to different seasons

Vulnerability and adaptation to climate change on the South Australian coast: A coastal community perspective

Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities

Use of prospective hospital surveillance data to define spatiotemporal heterogeneity of malaria risk in coastal Kenya

Using bio-optical parameters as a tool for detecting changes in the phytoplankton community (SW Portugal)

Trends in water level and flooding in Dhaka, Bangladesh and their impact on mortality

The use of participatory modeling to promote social learning and facilitate community disaster planning

The individual, the government and the global community: Sharing responsibility for health post-2015 in Vanuatu, a small island developing state

The emergence of Vibrio pathogens in Europe: Ecology, evolution, and pathogenesis (Paris, 11-12th March 2015)

Temporal and spatial patterns of diarrhoea in the Mekong Delta area, Vietnam

Survey on antimicrobial resistance patterns in Vibrio vulnificus and Vibrio cholerae non-O1/non-O139 in Germany reveals carbapenemase-producing Vibrio cholerae in coastal waters

Spatio-temporal analysis of the relationship between climate and hand, foot, and mouth disease in Shandong province, China, 2008-2012

Spatiotemporal analysis of climate variability impacts on malaria prevalence in Ghana

Subjectivity and the politics of transformation in response to development and environmental change

Slow adaptation in the face of rapid warming leads to collapse of the Gulf of Maine cod fishery

Rising temperatures may increase growth rates and microcystin production in tropical Microcystis species

Residence and job location change choice behavior under flooding and cyclone impacts in Bangladesh

Recovery migration after Hurricanes Katrina and Rita: Spatial concentration and intensification in the migration system

Promoting community for disaster risk reduction

Protective factors for mental health and well-being in a changing climate: Perspectives from Inuit youth in Nunatsiavut, Labrador

Predicting clinically diagnosed dysentery incidence obtained from monthly case reporting based on meteorological variables in Dalian, Liaoning Province, China, 2005-2011 using a developed model

Present-day and future climate pathways affecting Alexandrium blooms in Puget Sound, WA, USA

Perceptions of risk among households in two Australian coastal communities

Occurrence and prevalence of fish-borne Anisakis larvae in the spotted mackerel Scomber australasicus from Taiwanese waters

Migration or forced displacement?: The complex choices of climate change and disaster migrants in Shishmaref, Alaska and Nanumea, Tuvalu

Mapping climate change-caused health risk for integrated city resilience modeling

Measuring the vulnerability of marine social-ecological systems: A prerequisite for the identification of climate change adaptations

Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007

Living with floods and coping with vulnerability

Influence of climate change and meteorological factors on Houston’s air pollution: Ozone a case study

Influences of ambient air pollutants and meteorological conditions on ozone variations in Kaohsiung, Taiwan

Indirect consequences of extreme weather and climate events and their associations with physical health in coastal Bangladesh: A cross-sectional study

Human lives at risk because of eustatic sea level rise and extreme coastal flooding in the twenty-first century

I-C-SEA Change: A participatory tool for rapid assessment of vulnerability of tropical coastal communities to climate change impacts

Households’ perception and livelihood vulnerability to climate change in a coastal area of Akwa Ibom State, Nigeria

Future sea changes: Indigenous women’s preferences for adaptation to climate change on South Goulburn Island, Northern Territory (Australia)

Flood risk and adaptation strategies under climate change and urban expansion: A probabilistic analysis using global data

Flood warnings in coastal areas: How do experience and information influence responses to alert services?

Exploring the climate change concerns of striped catfish producers in the Mekong Delta, Vietnam

Evaluation of networks of plans and vulnerability to hazards and climate change: A resilience scorecard

Evidence of viral dissemination and seasonality in a Mediterranean river catchment: Implications for water pollution management

Examining the public health implications of drinking water-related behaviours and perceptions: A face-to-face exploratory survey of residents in eight coastal communities in British Columbia and Nova Scotia

Emergence of human resilience in coastal ecosystems under environmental change

Effects of ocean acidification on temperate coastal marine ecosystems and fisheries in the northeast Pacific

Effects of ocean warming on growth and distribution of dinoflagellates associated with ciguatera fish poisoning in the Caribbean

Effects of global warming on vibrio ecology

Effect of ambient heat on all-cause mortality in the coastal city of Surat, India

Dynamics of disaster-induced risk in southwestern coastal Bangladesh: an analysis on tropical Cyclone Aila 2009

Disentangling the effects of feedback structure and climate on Poaceae annual airborne pollen fluctuations and the possible consequences of climate change

Do global warming-induced circulation pattern changes affect temperature and precipitation over Europe during summer?

Downscaling river discharge to assess the effects of climate change on cholera outbreaks in the Bengal Delta

Disasters and climate change in the Pacific: Adaptive capacity of humanitarian response organizations

Coping with coastal risk and vulnerabilities in Bangladesh

Coastal climate change and aging communities in Atlantic Canada: A methodological overview of community asset and social vulnerability mapping

Community responses and adaptation strategies toward flood hazard in Jakarta, Indonesia

Climate change, extreme events and increased risk of salmonellosis in Maryland, USA: Evidence for coastal vulnerability

Climate change, fish catch and premix fuel supply to fishermen for sustainable livelihoods of coastal people in the central region of Ghana

Climate variability and human migration in the Netherlands, 1865-1937

Climate change influences on environment as a determinant of Indigenous health: Relationships to place, sea ice, and health in an Inuit community

Climate change and health on the U.S. gulf coast: Public health adaptation is needed to address future risks

Climate change and migration: law and policy perspectives in Bangladesh

Climate change and parasite transmission: How temperature affects parasite infectivity via predation on infective stages

Climate change awareness, coping mechanisms and adaptation in poor rural coastal communities, Ben Tre Province, Vietnam

Climate change and coastal aquaculture farmers’ risk perceptions: Experiences from Bangladesh and Denmark

Caribbean heat threatens health, well-being and the future of humanity

Characterization of a recent malaria outbreak in the autonomous indigenous region of Guna Yala, Panama

Assessment of the climate change impacts on fecal coliform contamination in a tidal estuarine system

Assessment of climate change impacts on water quantity and quality of the multi-river Vistula Lagoon catchment

Assessing barriers to adaptation to climate change in coastal Tanzania: Does where you live matter?

Assessing the bio-psychosocial correlates of flood impacts in coastal areas of Lagos, Nigeria

Adaptation analysis for environmental change in coastal communities

A global map of suitability for coastal Vibrio cholerae under current and future climate conditions

A case-crossover study of temperature and infant mortality in California

Climate change and public health in North Carolina: A unique state offers a unique perspective

Vulnerability of fishery-based livelihoods to the impacts of climate variability and change: Insights from coastal Bangladesh

Vulnerability of rural livelihoods to multiple stressors: A case study from the southwest coastal region of Bangladesh

Urgency for sustainable development in coastal urban areas with reference to weather pattern, land use, and water quality

The occurrence of melioidosis is related to different climatic conditions in distinct topographical areas of Taiwan

The Burden of climate-related conditions among laborers at Al-Razi Health Centre, Bahrain

The adoption of a Climate Disaster Resilience Index in Chennai, India

The association of weather and bathing water quality on the incidence of gastrointestinal illness in the west of Scotland

Stakeholder perceptions of ecosystem service declines in Milne Bay, Papua New Guinea: Is human population a more critical driver than climate change?

Spatial trend, environmental and socioeconomic factors associated with malaria prevalence in Chennai

Social indicators of vulnerability for fishing communities in the Northern Gulf of California, Mexico: Implications for climate change

Social and spatial inequities in exposure to flood risk in Miami, Florida

Risks and political responses to climate change in Brazilian coastal cities

Recovery migration to the city of New Orleans after hurricane Katrina: A migration systems approach

Progress, decline, and the public uptake of climate science

Predicted altitudinal shifts and reduced spatial distribution of Leishmania infantum vector species under climate change scenarios in Colombia

Possible effects of vaccination and environmental changes on the presence of disease in northern Spanish fish farms

Observed magnified runoff response to rainfall intensification under global warming

Monitoring toxic Ostreopsis cf. ovata in recreational waters using a qPCR based assay

Modelling the influence of climate change on the chemical concentrations in the Baltic Sea region with the POPCYCLING-Baltic model

Migrating to tackle climate variability and change? Insights from coastal fishing communities in Bangladesh

Migration from atolls as climate change adaptation: Current practices, barriers and options in Solomon Islands

Marine aerosol as a possible source for endotoxins in coastal areas

Lessons raised by the major 2010 dengue epidemics in the French West Indies

Interaction between land-use change, flooding and human health in metro Vancouver, Canada

Indigenous community health and climate change: Integrating biophysical and social science indicators

Increased risk of heat waves in Florida: Characterizing changes in bivariate heat wave risk using extreme value analysis

Impacts of flooding on coastal fishing folks and risk adaptation behaviours in Epe, Lagos State

How much salt do adults consume in climate vulnerable coastal Bangladesh?

Hydrological and water quality impact assessment of a Mediterranean limno-reservoir under climate change and land use management scenarios

Heat-related illness in Jinshan District of Shanghai: A retrospective analysis of 70 patients

Future nutrient load scenarios for the Baltic Sea due to climate and lifestyle changes

Future oceanic warming and acidification alter immune response and disease status in a commercial shellfish species, Mytilus edulis L

Gauging the impact of climate change on food crops production in Mauritius An econometric approach

Genetic and phenotypic analysis of Vibrio cholerae non-O1, non-O139 isolated from German and Austrian patients

Extreme temperature days and their potential impacts on southern Europe

Evacuation as a climate adaptation strategy for environmental justice communities

Egypt’s economic vulnerability to climate change

El Ni–o Southern Oscillation and Leptospirosis outbreaks in New Caledonia

Determinants of climate change adaptation strategies used by fish farmers in Epe local government area of Lagos State, Nigeria

Cyclones in a changing climate: The case of Bangladesh

Coastal bathing water quality and climate change – A new information and simulation system for new challenges

Coastal flood damage and adaptation costs under 21st century sea-level rise

Community-based climate change adaptation strategies for integrated prawn-fish-rice farming in Bangladesh to promote social-ecological resilience

Climate change awareness and strategies for communicating the risk of coastal flooding: A Canadian Maritime case example

Ciguatera fish poisoning and climate change: Analysis of national poison center data in the United States, 2001-2011

Assessing vulnerability to climate change impacts in Cambodia, the Philippines and Vietnam: An analysis at the commune and household level

Assessment of the health impacts of climate change in Kiribati

Analyzing and visualizing the synergistic impact mechanisms of climate change related costs

Anthropogenic nutrients and harmful algae in coastal waters

An assessment of Dinophysis blooms in the coastal Arabian Sea

An integrated methodology to assess future water resources under land use and climate change: An application to the Tahadart drainage basin (Morocco)

Air quality and seasonal variations in consultations for respiratory, allergic, dermatological and gastrointestinal diseases in Bahrain, 2007

Adaptation strategies followed by the livestock rearers of Coastal Odisha and West Bengal to cope up with climate change

Adaptation strategies to climatic variability: A case study of small-scale farmers in rural Mexico

Adapting the built environment: The role of gender in shaping vulnerability and resilience to climate extremes in Dhaka

A spatiotemporal approach for determining disaster-risk potential based on damage consequences of multiple hazard events

A multidisciplinary study on the effects of climate change in the northern Adriatic Sea and the Marche region (central Italy)

A rising tide in Bangladesh: Livelihood adaptation to climate stress

A computational simulation model for understanding the correlation of climate change and population migration

Weather-driven variation in dengue activity in Australia examined using a process-based modeling approach

Traditional coping strategies and disaster response: Examples from the South Pacific region

Uncertainty in future regional sea level rise due to internal climate variability

Spatiotemporal model or time series model for assessing city-wide temperature effects on mortality?

Relationship between heat index and mortality of 6 major cities in Taiwan

Predicting the impact of climate change on threatened species in UK waters

Modelling the impacts of climate change on surface runoff in small Mediterranean catchments: Empirical evidence from Greece

Invasive grasses, climate change, and exposure to storm-wave overtopping in coastal dune ecosystems

Hospital admissions as a function of temperature, other weather phenomena and pollution levels in an urban setting in China

Hydrologic response to climate change and human activities in a subtropical coastal watershed of southeast China

Health cobenefits and transportation-related reductions in greenhouse gas emissions in the San Francisco Bay area

Gastrointestinal illness among triathletes swimming in non-polluted versus polluted seawater affected by heavy rainfall, Denmark, 2010-2011

Experimental and natural warming elevates mercury concentrations in estuarine fish

Cool and dry weather enhances the effects of air pollution on emergency IHD hospital admissions

Ecological consequences of body size decline in harvested fish species: Positive feedback loops in trophic interactions amplify human impact

Climate change and eutrophication induced shifts in northern summer plankton communities

Attributing mortality from extreme temperatures to climate change in Stockholm, Sweden

Assessment of climate change impacts on flooding vulnerability for lowland management in southwestern Taiwan

The impact of climate change on tribal communities in the US: Displacement, relocation, and human rights

Megacities in the coastal zone: Using a driver-pressure-state-impact-response framework to address complex environmental problems

Uncertainties in measuring populations potentially impacted by sea level rise and coastal flooding

Use of traditional environmental knowledge to assess the impact of climate change on subsistence fishing in the James Bay Region of Northern Ontario, Canada

The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994-2008

The consequences of climate change at an avian influenza ‘hotspot’

Risk communication: Climate change as a human-health threat, a survey of public perceptions in Malta

Seroprevalence and national distribution of human toxoplasmosis in Mexico: Analysis of the 2000 and 2006 National Health Surveys

Prevalence of tick borne encephalitis virus in tick nymphs in relation to climatic factors on the southern coast of Norway

Projection of economic impacts of climate change in sectors of Europe based on bottom up analysis: Human health

Nature and extent of population displacement due to climate change triggered disasters in south-western coastal region of Bangladesh

Marine downscaling of a future climate scenario in the North Sea and possible effects on dinoflagellate harmful algal blooms

Mental health effects of Hurricane Sandy: Characteristics, potential aftermath, and response

Mapping vulnerability to climate change and its repercussions on human health in Pakistan

Impact of environmental changes and human-related factors on the potential malaria vector, Anopheles labranchiae (Diptera: Culicidae), in Maremma, Central Italy

High CO2 and silicate limitation synergistically increase the toxicity of Pseudo-nitzschia fraudulenta

Future climate change driven sea-level rise: Secondary consequences from human displacement for island biodiversity

Heat and health in Adelaide, South Australia: Assessment of heat thresholds and temperature relationships

Environmental drivers of Ross River virus in southeastern Tasmania, Australia: Towards strengthening public health interventions

Early detection of ecosystem regime shifts: A multiple method evaluation for management application

Effect of the interaction between outdoor air pollution and extreme temperature on daily mortality in Shanghai, China

Contribution of climate and air pollution to variation in coronary heart disease mortality rates in England

Climate-based models for understanding and forecasting dengue epidemics

Climate change and health and social care: Defining future hazard, vulnerability and risk for infrastructure systems supporting older people’s health care in England

Climate change and temperature rise: Implications on food- and water-borne diseases

Climate change impacts on natural toxins in food production systems, exemplified by deoxynivalenol in wheat and diarrhetic shellfish toxins

Changing climate, changing health, changing stories’ profile: Using an EcoHealth approach to explore impacts of climate change on Inuit Health

Assessment of the risk of malaria re-introduction in the Maremma plain (Central Italy) using a multi-factorial approach

Atlantic hurricanes and associated insurance loss potentials in future climate scenarios: Limitations of high-resolution AGCM simulations

Air temperature-related human health outcomes: Current impact and estimations of future risks in Central Italy

Ambient temperature and biomarkers of heart failure: A repeated measures analysis

Analysis of the El Nino/La Nina-Southern Oscillation variability and malaria in the Estado Sucre, Venezuela

A multiplex qPCR targeting hepato- and neurotoxigenic cyanobacteria of global significance

Coastal resource degradation in the tropics: Does the tragedy of the commons apply for coral reefs, mangrove forests and seagrass beds

The role of interactions in a world implementing adaptation and mitigation solutions to climate change

Projecting future heat-related mortality under climate change scenarios: A systematic review

Putting vulnerability to climate change on the map: A review of approaches, benefits, and risks

What effect will a few degrees of climate change have on human heat balance? Implications for human activity

Worldwide trend of atmospheric mercury since 1995

Understanding the demographic implications of climate change: Estimates of localized population predictions under future scenarios of sea-level rise

Time series analysis of dengue incidence in Guadeloupe, French West Indies: Forecasting models using climate variables as predictors

Tracking deaths related to Hurricane Ike, Texas, 2008

Trophic interactions between viruses, bacteria and nanoflagellates under various nutrient conditions and simulated climate change

Typhoon-related leptospirosis and melioidosis, Taiwan, 2009

Three linked risks for development in the Pacific Islands: Climate change, disasters and conflict

The influence of climate variables on dengue in Singapore

The influence of geographic and climate factors on the timing of dengue epidemics in Peru, 1994-2008

The PREVIEW global risk data platform: A geoportal to serve and share global data on risk to natural hazards

Short-term effect of fine particulate matter (PM2.5) and ozone on daily mortality in Lisbon, Portugal

Resilience to climate change impacts: A review of flood mitigation policy in Queensland, Australia

Quantifying the health impacts of future changes in temperature in California

Projected evolution of California’s San Francisco Bay-Delta-river system in a century of climate change

Physical and economic consequences of climate change in Europe

Prediction as an impediment to preparedness: Lessons from the US Hurricane and Earthquake Research Enterprises

National and regional impacts of climate change on malaria by 2030

Past trends and future scenarios for environmental conditions favoring the accumulation of paralytic shellfish toxins in Puget Sound shellfish

Multi-decadal responses of a cod (Gadus morhua) population to human-induced trophic changes, fishing, and climate

Mediterranean climate is associated with early age at menopause and low high-density lipoprotein in postmenopausal women

Long-term shifts in abundance and distribution of a temperate fish fauna: A response to climate change and fishing practices

Increasing potential risk of a global aquatic invader in Europe in contrast to other continents under future climate change

Impact of heat on mortality in 15 European cities: Attributable deaths under different weather scenarios

Humanitarian assistance and disaster relief aboard the USNS Mercy (TAH-19)

Generation of priority research questions to inform conservation policy and management at a national level

Extreme value indicators in highly resolved climate change simulations for the Jordan River area

Estimation of the economic impact of temperature changes induced by a shutdown of the thermohaline circulation: An application of FUND

Examining the long-term racial disparities in health and economic conditions among Hurricane Katrina survivors: Policy implications for Gulf Coast recovery

Experience of Hurricane Katrina and reported intimate partner violence

Extreme air pollution events from bushfires and dust storms and their association with mortality in Sydney, Australia 1994-2007

Emotions, trust, and perceived risk: A+E4316ffective and cognitive routes to flood preparedness behavior

Environmental- and injury-related epidemic-assistance investigations, 1946-2005

Drinking water salinity and maternal health in coastal Bangladesh: Implications of climate change

Does mosquito control have an effect on mosquito-borne disease? The case of Ross River virus disease and mosquito management in Queensland, Australia

Dealing with drought: Small farmers and environmental hazards in southern St. Elizabeth, Jamaica

Decomposing the association of completed suicide with air pollution, weather, and unemployment data at different time scales

Combined effects of Hurricane Katrina and Hurricane Gustav on the mental health of mothers of small children

Climate change, precipitation and impacts on an estuarine refuge from disease

Climate change-related impacts in the San Diego region by 2050

Climate variability and the outbreaks of cholera in Zanzibar, East Africa: A time series analysis

Climate change and health effects in Northwest Alaska

Climate and solar signals in property damage losses from hurricanes affecting the United States

Climate change and consequences in the Arctic: Perception of climate change by the Nenets people of Vaigach Island

Can increases in temperature stimulate blooms of the toxic benthic dinoflagellate Ostreopsis ovata?

Causes of death and demographic characteristics of victims of meteorological disasters in Korea from 1990 to 2008

Apparent temperature and cause-specific mortality in Copenhagen, Denmark: A case-crossover analysis

Adaptation to flood risks in Ho Chi Minh City, Vietnam

Ambient temperature, air pollution, and heart rate variability in an aging population

An evaluation of spatial distribution of Crimean-Congo hemorrhagic fever with geographical information systems (GIS), in Samsun and Amasya region

A method for building community resilience to climate change in emerging coastal cities

Pinning down vulnerability: From narratives to numbers

Safety in the Heat: A comprehensive program for prevention of heat illness among workers in Abu Dhabi, United Arab Emirates

Building responsiveness to climate change through community based adaptation in Bangladesh

Climate change impacts and adaptation in cities: a review of the literature

Conflict and social vulnerability to climate change: Lessons from Gaza

The role of proteomics in the study of the influence of climate change on seafood products

Update on methodologies available for ciguatoxin determination: Perspectives to confront the onset of ciguatera fish poisoning in Europe

Ciguatera fish poisoning and sea surface temperatures in the Caribbean Sea and the West Indies

A human health perspective on climate change: A report outlining the research needs on the human health effects of climate change. 22 April 2010

Two millennia of North Atlantic seasonality and implications for Norse colonies

Understanding the relationship among urbanisation, climate change and human health: A case study in Xiamen

Understanding the varied response of the extratropical storm tracks to climate change

Towards pro-poor adaptation to climate change in the urban centres of low- and middle-income countries

The impact of heat waves on mortality in 9 European cities: Results from the EuroHEAT project

The impact of socio-economics and climate change on tropical cyclone losses in the USA

The health impacts of heat waves in five regions of New South Wales, Australia: A case-only analysis

The RISKMED project: Philosophy, methods and products

The aesthetics of water and land: A promising concept for managing scarce water resources under climate change

The effects of summer temperature, age and socioeconomic circumstance on acute myocardial infarction admissions in Melbourne, Australia

Temperature, comfort and pollution levels during heat waves and the role of sea breeze

Temperatures and cyclones strongly associated with economic production in the Caribbean and Central America

The 2007 San Diego wildfire impact on the emergency department of the University of California, San Diego Hospital System

Spatiotemporal distribution of malaria and the association between its epidemic and climate factors in Hainan, China

Summer heat and mortality in New York City: How hot is too hot?

Simulation of global warming effect on outdoor thermal comfort conditions

Size distribution and chemical composition of airborne particles in south-eastern Finland during different seasons and wildfire episodes in 2006

Seasonal pollen distribution in the atmosphere of Hobart, Tasmania: Preliminary observations and congruence with flowering phenology

Revisiting the association between sea surface temperature and the epidemiology of fish poisoning in the South Pacific: reassessing the link between ciguatera and climate change

Sea-level-rise disaster in Micronesia: Sentinel event for climate change?

Recent environmental changes and filamentous algal mats in shallow bays on the Swedish west coast – A result of climate change?

Resilience after Hurricane Katrina among pregnant and postpartum women

Prioritizing environmental health risks in the UAE

Putting adaptive capacity into the context of people’s lives: A case study of two flood-prone communities in Puerto Rico

Prevalence and consequences of disaster-related illness and injury from Hurricane Ike

Malaria resurgence risk in southern Europe: Climate assessment in an historically endemic area of rice fields at the Mediterranean shore of Spain

Management of blood system in disasters

Mediterranean weather conditions and exacerbations of multiple sclerosis

Investigation of climate change in Iran

Livelihood diversification in tropical coastal communities: A network-based approach to analyzing ‘livelihood landscapes’

Locally acquired dengue – Key West, Florida, 2009-2010

Increasing contaminant burdens in an arctic fish, burbot (Lota lota), in a warming climate

Individual actual or perceived property flood risk: Did it predict evacuation from Hurricane Isabel in North Carolina, 2003?

Intense winter atmospheric pollution episodes affecting the Western Mediterranean

Heat impact on schoolchildren in Cameroon, Africa: Potential health threat from climate change

How inequitable is the global distribution of responsibility, capability, and vulnerability to climate change: A comprehensive indicator-based assessment

Habitat degradation and fishing effects on the size structure of coral reef fish communities

Harmful algae and their potential impacts on desalination operations off southern California

From past to better public health programme planning for possible future global threats: Case studies applied to infection control

Global and local atmospheric pollution evaluation and control. Challenges for a small island and for developing countries

Evidence for a novel marine harmful algal bloom: Cyanotoxin (microcystin) transfer from land to sea otters

Effects of weather variability on infectious gastroenteritis

Emergency department patient presentations during the 2009 heatwaves in Adelaide

Dengue dynamics in Binh Thuan province, southern Vietnam: Periodicity, synchronicity and climate variability

Disaster disparities and differential recovery in New Orleans

Cod Gadus morhua and climate change: Processes, productivity and prediction

Community assessment for public health emergency response following Hurricane Ike–Texas, 25-30 September 2008

Crucial knowledge gaps in current understanding of climate change impacts on coral reef fishes

Cyclone disaster vulnerability and response experiences in coastal Bangladesh

Climate change: Tropical cyclones in the mix

Changes in dengue risk potential in Hawaii, USA, due to climate variability and change

Body size-dependent responses of a marine fish assemblage to climate change and fishing over a century-long scale

Assessment of heat-related health impacts in Brisbane, Australia: Comparison of different heatwave definitions

Atlantic hurricanes and climate change: Projection of a peak month in a future record hurricane season

A track-relative climatology of Eglin Air Force Base hurricanes in a variable climate

Chapter 4: Infrastructure impacts and adaptation challenges

Overview of health considerations within national adaptation programmes of action for climate change in least developed countries and small island states

Ready for change: Preparing public health agencies for the impacts of climate change. A climate masters guide for the public health sector

Rethinking ecosystem resilience in the face of climate change

Strengthening the link between climate change adaptation and national development plans: Lessons from the case of population in National Adaptation Programmes of Action (NAPAs)

Early responses to climate change: An analysis of seven US state and local climate adaptation planning initiatives

Climate change and health: A Native American perspective

Climate change policy responses for Canada’s Inuit population: The importance of and opportunities for adaptation

Climate change, uncertainty, and resilient fisheries: Institutional responses through integrative science

Potential costs and benefits of adaptation options: A review of existing literature

A press database on natural risks and its application in the study of floods in Northeastern Spain

Accelerating loss of seagrasses across the globe threatens coastal ecosystems

Climate change health preparedness in Oregon: An assessment of awareness, preparation and resource needs for potential public health risks associated with climate change

Weather and air pollution as triggers of severe headaches

Using remote sensing to assess potential impacts of hurricanes on mosquito habitat formation: Investigating the mechanisms for interrelationship between climate and the incidence of vector-borne diseases

Travelling and hunting in a changing Arctic: Assessing Inuit vulnerability to sea ice change in Igloolik, Nunavut

Tropical cyclone losses in the USA and the impact of climate change – A trend analysis based on data from a new approach to adjusting storm losses

Typologies of crop-drought vulnerability: An empirical analysis of the socio-economic factors that influence the sensitivity and resilience to drought of three major food crops in China (1961-2001)

The relationship of short-term air pollution and weather to ED visits for asthma in Japan

Transfer of climate knowledge via a regional climate-change management body to support vulnerability, impact assessments and adaptation measures

The impact of smoke on respiratory hospital outcomes during the 2002-2003 bushfire season, Victoria, Australia

The changing face of trauma: New Orleans before and after Hurricane Katrina

Suspended sediment, nitrogen and phosphorus concentrations and exports during storm-events to the Tuross Estuary, Australia

Roadmap to assess the economic cost of climate change with an application to hurricanes in the United States

Serious emotional disturbance among youths exposed to Hurricane Katrina 2 years postdisaster

Risk and protective factors in the development of post-traumatic stress disorder symptoms among a cohort of students in two tertiary institutions post Hurricane Ivan

Protecting health from climate change: Preparedness of medical interns

Potential impact of global climate change on diarrhoeal disease in Mexico

Predictability of swimming prohibitions by observational parameters: A proactive public health policy, Stamford, Connecticut, 1989-2004

Origins of the Moken Sea Gypsies inferred from mitochondrial hypervariable region and whole genome sequences

Postpartum mental health after Hurricane Katrina: A cohort study

Potential for chemical mixture exposures and health risks in New Orleans Post-Hurricane Katrina

Multiyear climate variability and dengue–El Nino southern oscillation, weather, and dengue incidence in Puerto Rico, Mexico, and Thailand: A longitudinal data analysis

Modeling responses of coupled social-ecological systems of the Gulf of California to anthropogenic and natural perturbations

Leptospirosis in the Asia Pacific region

Local and global effects of climate on dengue transmission in Puerto Rico

Improved water quality can ameliorate effects of climate change on corals

Hurricane Ike rapid needs assessment – Houston, Texas, September 2008

Identification of anthropogenic effects and seasonality on water quality in Daya Bay, South China Sea

Identifying reefs of hope and hopeful actions: Contextualizing environmental, ecological, and social parameters to respond effectively to climate change

Impact of temperature variability on cholera incidence in southeastern Africa, 1971-2006

Houston’s medical disaster response to Hurricane Katrina: Part 1: The initial medical response from Trauma Service Area Q

Houston’s medical disaster response to Hurricane Katrina: Part 2: Transitioning from emergency evacuee care to community health care

High temperature and hospitalizations for cardiovascular and respiratory causes in 12 European cities

Global climate change and wound care: Case study of an off-season vibrio alginolyticus infection in a healthy man

FerryMon: Ferry-based monitoring and assessment of human and climatically driven environmental change in the Albemarle-Pamlico Sound system

Fleeing the storm(s): An examination of evacuation behavior during Florida’s 2004 hurricane season

Extensive drought negates human influence on nutrients and water quality in estuaries

Feasible adaptation strategies for increased risk of flooding in cities due to climate change

Effects of the El Nino-Southern Oscillation on dengue epidemics in Thailand, 1996-2005

Effects on health of volunteers deployed during a disaster

Disaster-related injuries in the period of recovery: The effect of prolonged displacement on risk of injury in older adults

Collapse and recovery in a remote small island-A tale of adaptive cycles or downward spirals?

Cyclonic and anthropogenic influences on tern populations

Climate change-induced migration in the Pacific Region: Sudden crisis and long-term developments

Climate variability and increase in intensity and magnitude of dengue incidence in Singapore

Climate change and health in sub-Saharan Africa: A case-based perspective

Climate change and heat-related mortality in six cities part 2: Climate model evaluation and projected impacts from changes in the mean and variability of temperature with climate change

Climate change kills at least 300 000 every year

Climate and wildfire area burned in western U.S. ecoprovinces, 1916-2003

Atlantic hurricanes and climate over the past 1,500 years

Analysis of airborne Betula pollen in Finland; A 31-year perspective

Accelerated warming and emergent trends in fisheries biomass yields of the world’s large marine ecosystems

Air pollution and hospital admissions for myocardial infarction in a tropical city: Kaohsiung, Taiwan

Ambient temperature and mortality: An international study in four capital cities of East Asia

The role of local institutions in adaptation to climate change

Assessing the potential consequences of climate destabilization in Latin America

Microbial oceanography in a sea of opportunity

Provision of a wildfire risk map: Informing residents in the wildland urban interface

Shipping emissions: From cooling to warming of climates – and reducing impacts on health

Centers for Oceans and Human Health: A unified approach to the challenge of harmful algal blooms

Warming of the Indian Ocean threatens eastern and southern African food security but could be mitigated by agricultural development

Trends in mental illness and suicidality after Hurricane Katrina

Unjust waters: Climate change, flooding and the urban poor in Africa

The impact of extreme flooding events and anthropogenic stressors on the macrobenthic communities’ dynamics

The impact of the Tsunami on hospitalizations at the tertiary care hospital in the Southern Province of Sri Lanka

Socio-demographic and climatic factors as correlates of Mediterranean spotted fever (MSF) in northern Sardinia

Sustaining a healthy human-walrus relationship in a dynamic environment: Challenges for comanagement

Resource loss, coping, alcohol use, and posttraumatic stress symptoms among survivors of Hurricane Katrina: A cross-sectional study

Seasonality and climatic associations with violent and nonviolent suicide: A population-based study

Post-Katrina mortality in the greater New Orleans area, Louisiana

Malaria transmission pattern resilience to climatic variability is mediated by insecticide-treated nets

Mental health outcomes in police personnel after Hurricane Katrina

Mortality surveillance: 2004 to 2005 Florida hurricane-related deaths

Integrating human and ecological risk assessment: Application to the cyanobacterial harmful algal bloom problem

Living with sea-level rise and climate change: A case study of the Netherlands

High-resolution spatiotemporal weather models for climate studies

How many walked through the door?: The effect of hurricane Katrina evacuees on Houston emergency departments

Hurricane Katrina deaths, Louisiana, 2005

Epidemiological survey of Vibrio vulnificus infection in Japan between 1999 and 2003

Epidemiology of asthma mortality in Cuba and its relation to climate, 1989 to 2003

Evaluation of post-Katrina flooded soils for contaminants and toxicity to the soil invertebrates Eisenia fetida and Caenorhabditis elegans

Evolving need for alternative triage management in public health emergencies: A Hurricane Katrina case study

Family context of mental health risk in Tsunami affected mothers: Findings from a pilot study in Sri Lanka

Health impacts of large-scale floods: Governmental decision-making and resilience of the citizens

Economy-wide impacts of climate change: A joint analysis for sea level rise and tourism

Environmental signatures associated with cholera epidemics

Epidemiologic tools to investigate oceans and public health

Disruption of existing mental health treatments and failure to initiate new treatment after Hurricane Katrina

Climate influence on dengue epidemics in Puerto Rico

Comparison of storm intensity and application timing on modeled transport and fate of six contaminants

Burden of disease and health status among Hurricane Katrina-displaced persons in shelters: A population-based cluster sample

Chief complaints, diagnoses, and medications prescribed seven weeks post-Katrina in New Orleans

Chronic disease and related conditions at emergency treatment facilities in the New Orleans area after Hurricane Katrina

Climate and prevalence of atopic eczema in 6- to 7-year-old school children in Spain. ISAAC phase III

Climate change and Caribbean hurricanes

Climate change and postglacial human dispersals in southeast Asia

Association of early annual peak influenza activity with El Nino southern oscillation in Japan

A stochastic model for ecological systems with strong nonlinear response to environmental drivers: Application to two water-borne diseases

Meeting report. Workshop: Environmental change and infectious disease, Stockholm, 29-30 March 2007

Why different interpretations of vulnerability matter in climate change discourses

Evolution of a Mediterranean coastal zone: Human impacts on the marine environment of Cape Creus

Vulnerability to climate variability and change in East Timor

Weather conditions associated with the potential for pollen recirculation in a coastal area

A report accepted by Working Group II of the Intergovernmental Panel on Climate Change but not approved in detail: Technical Summary

The quest for safe drinking water: An example from Guinea-Bissau (West Africa)

The rising tide: Assessing the risks of climate change and human settlements in low elevation coastal zones

Vibrio parahaemolyticus strains isolated during investigation of the summer 2006 seafood related diarrhea outbreaks in two regions of Chile

The impact of a series of hurricanes on the visits to two central Florida Emergency Departments

The incidence of asthmatic attacks in Barbados

Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions

Smartbay, Ireland: Design and planning for a cabled ocean observatory off the west coast of Ireland

Recovering from Hurricane Mitch: Household and place in predicting Honduran child nutritional status

Regional-scale climate-variability synchrony of cholera epidemics in West Africa

Mental health service use among Hurricane Katrina survivors in the eight months after the disaster

Mobilizing mobile medical units for hurricane relief: The United States Public Health Service and Broward County Health Department response to hurricane Wilma, Broward County, Florida

News, social capital and health in the context of Katrina

Pilot-study on GIS-based risk modelling of a climate warming induced tertian malaria outbreak in Lower Saxony (Germany)

Impact of a category-3 hurricane on the need for surgical hospital care

Impacts of Hurricanes Katrina and Rita on the microbial landscape of the New Orleans area

Kidney patient care in disasters: Lessons from the hurricanes and earthquake of 2005

Health concerns of women and infants in times of natural disasters: Lessons learned from Hurricane Katrina

Human responses to Middle Holocene climate change on California’s Channel Islands

Hurricane Katrina’s impact on the care of survivors with chronic medical conditions

Exposure to hurricane-related stressors and mental illness after Hurricane Katrina

From large-scale climate change to socio-economic losses: The case of hurricanes in the U.S.

Dietary variation and stress among prehistoric Jomon foragers from Japan

Disaster preparedness: Occupational and environmental health professionals’ response to Hurricanes Katrina and Rita

Distributions of pharmaceuticals in an urban estuary during both dry- and wet-weather conditions

Climate niches of tick species in the mediterranean region: Modeling of occurrence data, distributional constraints, and impact of climate change

Assessment of the water quality and ecosystem health of the Great Barrier Reef (Australia): Conceptual models

Characteristic air temperature distributions observed in summer and winter in urban area in Japan

Chronic disease and disasters medication demands of Hurricane Katrina evacuees

Climate change and desertification vulnerability in Southern Italy

Climate change and fisheries: Assessing the economic impact in Iceland and Greenland

Climate change and heat-related mortality in six cities part 1: Model construction and validation

Climate change and the emergence of Vibrio vulnificus disease in Israel

Climate change influence on POPs distribution and fate: A case study

Aerosolized red-tide toxins (brevetoxins) and asthma

African Americans’ decisions not to evacuate New Orleans before Hurricane Katrina: A qualitative study

Ambient biomass smoke and cardio-respiratory hospital admissions in Darwin, Australia

Adaptation to climate trends: Lessons from the Argentine experience

Climate and on-farm risk factors associated with Giardia duodenalis cysts in storm runoff from California coastal dairies

New Zealand risk management approach for toxic cyanobacteria in drinking water

A 1-year study of the epidemiology of hepatitis A virus in Tunisia

A decrease in the proportion of infections by pandemic Vibrio parahaemolyticus in Hat Yai Hospital, southern Thailand

A knowledge, attitude and practices study of the issues of climate change/variability impacts and public health in Trinidad and Tobago, and St Kitts and Nevis

A mobile medical care approach targeting underserved populations in post-Hurricane Katrina Mississippi

Health, the Global Ocean and Marine Resources

Climate Change and Health in Small Island Developing States: A WHO special initiative, Pacific island countries and areas

Climate Change and Health: Improving Resilience and Reducing Risks

Climate Change and Human Health Scenario in South and Southeast Asia

Living with Climate Change: How Communities Are Surviving and Thriving in a Changing Climate

The human cost of weather related disasters: 1995-2015

global megatrend update 9: Increasingly severe consequences of climate change

The Garnaut Review 2011: australia in the global response to climate change

Climate change, impacts and vulnerability in Europe 2012

Pacific islands action plan on climate change and health

Sustainable Tourism – promoting environmental public health

Beneficial effects of marine and coastal settings on health and well-being (United Kingdom)

Assessment of exposure to methylmercury from fish and seafood on the Croatian coast