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Investigating the association between temperature and hospital admissions for major psychiatric diseases: A study in Greece

Evidence has emerged regarding the role of seasonality and several meteorological parameters on bipolar disorder, schizophrenia and depression. We investigated the relationship between ambient and apparent temperature and hospital admissions of major psychiatric diseases in a psychiatric clinic of a General Hospital situated in Northern Greece during 2013-19. Temperature data was provided by the National Observatory of Athens and diagnosis for psychotic, schizophrenic, manic and bipolar and unipolar depression were retrieved from medical records. A total of 783 admissions were recorded. Poisson regression models adjusted for time trends were applied to analyze the impact of temperature on monthly admissions. A summer peak was observed for the bipolar disorder, irrespectively of substance/alcohol use status. Seasonality emerged also for psychotic and schizophrenic patients with a through in winter. An increase of 1 °C in either ambient or apparent temperature was associated with an increase 1-2% in the monthly admissions in most outcomes under investigation. Alcohol and drug abuse did not modify this effect. Although our results indicate effects of temperature on psychiatric admissions, they are not consistent across subgroups populations and need to be replicated by other methodologically superior studies.

Environmental fate of trace elements in depositional sediments after flashflood events: The case of mandra town in Greece

Flash floods are one of the harshest natural hazards, having a wide range of substantial impacts for human and environmental health in the short-term and long-term. On 15 November 2017, a high-intensity storm caused a catastrophic flash flood event in the town of Mandra, a western, outer suburb of the Athens Metropolitan Area in Greece. In this study, we determine the aqua regia extractable concentrations of trace elements in residual sediments and associated soils after the flash flood and evaluate the fractionation of contaminants in geochemical compartments. Geochemical data are coupled with physicochemical parameter measurements and mineralogy to identify possible factors explaining the variability of trace element concentrations, while a dilute acid extraction is used to monitor changes of the reactive fraction of the trace elements over the term of 1 year following the flood event. Aqua regia concentrations in flood-deposited sediments reached values of 1 mg/kg (Cd), 24 mg/kg (Co), 183 mg/kg (Cr), 599mg/kg (Cu), 1080 mg/kg (Mn), 195 mg/kg (Ni), 122 mg/kg (Pb) and 945 mg/kg (Zn). Multivariate statistical techniques classified the elements according to their natural or anthropogenic origin. Trace elements of geogenic origin (As, Co, Cr, Mn, Ni) dominate in flood deposited material. The cluster of anthropogenic elements (Cd, Cu, Pb, Zn,) shows significant correlation with total organic carbon and magnetic susceptibility, while a significant seasonal variation has been observed for total organic carbon, Cd and Mn contents in the deposited sediments. Results allow a better understanding of the distribution of elements in the surface cover during and after catastrophic events in urban areas and provide useful information on the long-term exposure of the residents.

Numerical investigation of atmosphere-fire interactions during high-impact wildland fire events in Greece

This study investigated two high-impact wildland fire events that took place on 23 July 2018 in Attica Region, Central Greece during extreme prevailing weather conditions. The tragic aftermath was 102 life losses in MATI fire event, the largest number of deaths from a fire event in history of the country. The synoptic analysis revealed the presence of a positively tilted trough over the Central Mediterranean and Balkans, propagating eastwards and interacting with the subtropical jet, resulting in a strong westerly flow over Greece. Several surface stations in the wider area recorded wind gusts exceeding 20 m s(-1) between 12:00 and 17:30 UTC. The online coupled atmosphere-fire model WRF-SFIRE was utilized in order to simulate these extreme fire events and to investigate the role of the complex terrain to the mean flow and fire behavior. The numerical simulations revealed the presence of induced orographic waves, paths of high winds on the lee-slopes, transient resemblance of a hydraulic jump downstream of Penteli Mt. (MATI), while indicated a downward transport of energy and momentum during the maximum wind speed occurrences. The turbulent and dynamically unstable conditions on the lee-slopes of Gerania Mts. (KINETA) and Penteli Mt. contributed to the flow kinetic energy. Quite different influences of topography in each fire event were found, where the isolated Gerania Mts. contributed to warmer, drier and windier conditions leeward, while Penteli Mt. had a lesser impact on atmospheric variables downstream.

Climate change and thermal comfort in top tourist destinations-The case of Santorini (Greece)

The Mediterranean area is one of the most visited tourist destinations of the world, but it has also been recognized as one of the most vulnerable to climate change areas worldwide with respect to increased thermal risk. The study focuses on a top worldwide tourist destination of the Mediterranean, Santorini Island in Greece, and aims to assess the past, present and future thermal environment in the island based on the advanced Universal Thermal Climate Index (UTCI). The study utilizes historical observations capturing past (late 19th to early 20th century) and more recent (1982-2019) time periods, while future projections are realized based on four regional climate models (RCMs) under the weak mitigation scenario (RCP4.5) and the non-mitigation scenario with high emissions (RCP8.5). The frequency of cold stress conditions at midday decreases during winter and early spring months by up to 19.8% (January) in the recent period compared to the historical one, while heat stress conditions increase in summer by up to 22.4% (August). Future projections suggest progressive shifts of the UTCI towards higher values in the future and an increase in the exposure time under heat stress depending on the RCM and adopted scenario. The increase in moderate and strong heat stress conditions is mainly expected during the summer months (June, July, August); nevertheless, a noticeable increase is also foreseen in September and May. The highest occurrences of favorable (no thermal stress) conditions are also projected to shift by one month, from June to May and from September to October, in the future.

Defining heatwaves with respect to human biometeorology. The case of Attica Region, Greece

To date, due to climate change, heatwaves are more frequent, with greater intensity and duration resulting in deleterious impacts on human health. To be able to manage heatwaves and quantify the impacts on human health, it is crucial to define them and implement policy preventive measures. However, heatwaves are relative to the climate of a location: The same meteorological conditions can constitute a heatwave in one place but not in another. Due to different climatic conditions, social characteristics, and adaptation, heatwaves should be defined on a local scale, which poses difficulties when it comes to comparison of different definitions. The aim of the present study is to define heatwaves, implementing robust statistical analysis for three different indicators (temperature, physiological equivalent temperature (PET), and universal thermal climate index (UTCI)) for three causes of mortality (i.e., cardiological and respiratory mortality and cardiorespiratory mortality) using Attica (Greece) as a case study. Our results define a heatwave for Attica as a period of at least 3 days when the mean temperature is higher than the 97.5th percentile. Afterwards, we encapsulate the harvesting effect by implementing robust statistical analysis, using the Superposed Epoch analysis. Consequently, quantifying heatwaves is crucial so as to create early warning systems and prevent avoidable mortality.

Heat-related mortality under climate change and the impact of adaptation through air conditioning: A case study from Thessaloniki, Greece

Climate change is expected to increase heat-related mortality across the world. Health Impact Assessment (HIA) studies are used to quantify the impact of higher temperatures, taking into account the effect of population adaptation. Although air-conditioning (AC) is one of the main drivers of technological adaptation to heat, the health impacts associated with AC-induced air pollution have not been examined in detail. This study uses the city of Thessaloniki, Greece as a case study and aims to estimate the future heat-related mortality, the residential cooling demand, and the adaptation trade-off between averted heat-related and increased air pollution cardiorespiratory mortality. Using temperature and population projections under different Coupled Model Intercomparison Project Phase 6 (CIMP6) Shared Socioeconomic Pathways scenarios (SSPs), a HIA model was developed for the future heat and air pollution cardiorespiratory mortality. Counterfactual scenarios of either black carbon (BC) or natural gas (NG) being the fuel source for electricity generation were included in the HIA. The results indicate that the heat-related cardiorespiratory mortality in Thessaloniki will increase and the excess of annual heat-related deaths in 2080-2099 will range from 2.4 (95% CI: 0.0-20.9) under SSP1-2.6 to 433.7 (95% CI: 66.9-1070) under SSP5-8.5. Population adaptation will attenuate the heat-related mortality, although the latter may be counterbalanced by the higher air pollution-related mortality due to increased AC, especially under moderate SSP scenarios and coal-fired power plants. Future studies examining the health effects of warmer temperatures need to account for the impact of both adaptation and increased penetration and use of AC.

Seasonal variation and epidemiological parameters in children from Greece with type 1 diabetes mellitus (T1DM)

BACKGROUND: A positive correlation between T1DM onset and winter has been suggested by several studies. We investigated the seasonal variation of T1DM diagnosis and epidemiological parameters in children from Western Greece with T1DM. METHODS: One hundred and five patients, 44 males, aged 1-16 years were studied. The month of the diagnosis, the order of birth, gestational age, birth weight, the mode of delivery, parental age and pubertal status were recorded from the patients’ files. RESULTS: The mean age at diagnosis was 8.1 ± 4.0 years. The majority of the studied patients were diagnosed during the period of October-March. The majority were born at full term, 11.7% were preterm babies and 52.3% were first born. The mean birth weight was 3266 ± 596 g. 60% were born by vaginal delivery. The majority of the patients were prepubertal at diagnosis. CONCLUSIONS: Our results are in agreement with the reported seasonal variation of T1DM onset in other regions of Greece and Europe. The positive correlation between T1DM presentation and colder temperatures may be explained by factors such as viral infections. This is the first report on epidemiological parameters that may be related to T1DM presentation in Western Greece. The study of such parameters extends the understanding on the disease as a whole. IMPACT: A seasonality of the T1DM diagnosis is shown, with a predominance of the colder months of the year. This is in agreement with previous reports from other countries. Our findings confirm previously reported data and add to the existing knowledge on T1DM in general. Additionally, this is one of the few reports on the incidence and epidemiology of T1DM in Greece and the first in the region of Western Greece. Safer and more accurate conclusions can be drawn with regards to the possible causes and predisposing factors of T1DM by the assessment of statistical data from different populations throughout the world. This offers a better understanding of T1DM and may also contribute to the identification of factors that may reduce the incidence of the disease in the future.

Mortality due to circulatory causes in hot and cold environments in Greece

Ambient temperature can affect the survival rate of humans. Studies have shown a relationship between ambient temperature and mortality rate in hot and cold environments. This effect of ambient temperature on mortality seems to be more pronounced in older people. The aim of this study is to examine the effects of thermal stress on cardiovascular mortality and the associated relative risk per degree Celsius in Greek individuals ≥70 years old. Mortality data 1999-2012 were matched with the midday temperature. The present study found a higher circulatory mortality when ambient temperature is below or above the temperature range 6 to 39 °C.

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.

Detection of SARS-CoV-2 in wastewater raises public awareness of the effects of climate change on human health: The experience from Thessaloniki, Greece

Mosquito Alert

Zero regrets: scaling up action on climate change mitigation and adaptation for health in the WHO European Region, second edition. Key messages from the Working Group on Health in Climate Change

Climate change and health: the national policy overview in Europe

Map viewer: Accessibility of hospitals in Europe

Map viewer: Availability of urban green spaces to vulnerable groups

Map viewer: Exposure of vulnerable groups and social infrastructure to climate-related risks

Climate change as a threat to health and well-being in Europe: focus on heat and infectious diseases

Human Climate Horizons (HCH)

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.

Air quality and meteorological patterns of an early spring heatwave event in an industrialized area of Attica, Greece

Heatwaves-excessively hot ambient conditions that are considered a serious threat to human health-are often associated with poor air quality. The aim of this study was to examine the impact of an early heatwave episode in an industrialized plain in the eastern Mediterranean region (Thriasio, Greece) on human thermal discomfort and urban air quality. The heatwave occurred in mid (15-20) May 2020, shortly after some of the restrictions that were improsed to halt the spread of coronavirus disease 2019 (COVID-19) in Greece were lifted (on 4 May). The discomfort index (DI) and the daily air quality index (DAQI) were calculated on an hourly basis throughout spring 2020 (March, April, May) using data from two stations that measure meteorological parameters and air pollutant concentrations in the Thriasio Plain. The analysis showed that the air temperature increased during 7-17 May to levels that were more than 10 °C above the monthly average value (25.8 °C). The maximum measured air temperature was 38 °C (on 17 May). The results showed a high level of thermal discomfort. The DI exceeded the threshold of 24 °C for several hours during 13-20 May. Increased air pollution levels were also identified. The average DAQI was estimated as 0.83?±?0.1 and 1.14?±?0.2 at two monitoring stations in the region of interest during the heatwave. Particulate matter (diameter < 10 ?m) appeared to contribute significantly to the poor air quality. Significant correlations between the air temperature, DI, and AQSI were also identified.

Projected future temporal trends of two different Urban Heat Islands in Athens (Greece) under three climate change scenarios: A statistical approach

This is the first study to look at future temporal urban heath island (UHI) trends of Athens (Greece) under different UHI intensity regimes. Historical changes in the Athens UHI, spanning 1971-2016, were assessed by contrasting two air temperature records from stable meteorological stations in contrasting urban and rural settings. Subsequently, we used a five-member regional climate model (RCM) sub-ensemble from EURO-CORDEX with a horizontal resolution of 0.11 degrees (similar to 12 x 12 km) to simulate air temperature data, spanning the period 1976-2100, for the two station sites. Three future emissions scenarios (RCP2.6, RCP4.5, and RCP8.5) were implanted in the simulations after 2005 covering the period 2006-2100. Two 20-year historical reference periods (1976-1995 and 1996-2015) were selected with contrasting UHI regimes; the second period had a stronger intensity. The daily maximum and minimum air temperature data (T(max)and T-min) for the two reference periods were perturbed to two future periods, 2046-2065 and 2076-2095, under the three RCPs, by applying the empirical quantile mapping (eqm) bias-adjusting method. This novel approach allows us to assess future temperature developments in Athens under two UHI intensity regimes that are mainly forced by differences in air pollution and heat input. We found that the future frequency of days with T-max> 37 degrees C in Athens was only different from rural background values under the intense UHI regime. Thus, the impact of heatwaves on the urban environment of Athens is dependent on UHI intensity. There is a large increase in the future frequency of nights with T-min> 26 degrees C in Athens under all UHI regimes and climate scenarios; these events remain comparatively rare at the rural site. This large urban amplification of the frequency of extremely hot nights is likely caused by air pollution. Consequently, local mitigation policies aimed at decreasing urban atmospheric pollution are expected to be highly effective in reducing urban temperatures and extreme heat events in Athens under future climate change scenarios. Such policies directly have multiple benefits, including reduced electricity (energy) needs, improved living quality and strong health advantages (heat- and pollution-related illness/deaths).

Psychosocial vulnerability and demographic characteristics in extreme flash floods: The case of Mandra 2017 flood in Greece

On lifestyle trends, health and mosquitoes: Formulating welfare levels for control of the Asian tiger mosquito in Greece

Heat waves occurrence and outdoor workers’ self-assessment of heat stress in Slovenia and Greece

Exploring public preferences, priorities, and policy perspectives for controlling invasive mosquito species in Greece

Impact of meteorological factors on the emergence of bronchiolitis in north-western Greece

Urban area response to flash flood-triggering rainfall, featuring human behavioral factors: The case of 22 October 2015 in Attica, Greece

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

Seasonal differences in thermal sensation in the outdoor urban environment of Mediterranean climates – the example of Athens, Greece

Mortality associated with high ambient temperatures, heatwaves, and the urban heat island in Athens, Greece

Flood fatalities in Greece: 1970-2010

Identification of climatic factors affecting the epidemiology of human West Nile virus infections in northern Greece

Have flood mortality qualitative characteristics changed during the last decades? The case study of Greece

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

Analysis of forest fire fatalities in Greece: 1977-2013

An aggregate of four anthrax cases during the dry summer of 2011 in Epirus, Greece

Seasonal variations of allergenic pollen in a Mediterranean region – Alexandroupolis, north-east Greece

Estimating the non-market benefits of climate change adaptation of river ecosystem services: A choice experiment application in the Aoos basin, Greece

Effect of climate change projections on forest fire behavior and values-at-risk in southwestern Greece

Prognosis of maximum daily surface ozone concentration within the greater Athens, urban area, Greece

Effect of seasonal fluctuation of ambient temperature on fatigue in multiple sclerosis patients living in Attica, Greece

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

Time trends in pediatric hospitalizations for varicella infection are associated with climatic changes: A 22-year retrospective study in a tertiary Greek referral center

Ticks parasitizing humans in Greece

Seasonal variation of type 1 diabetes mellitus diagnosis in Greek children

Psychological distress following wildfires disaster in a rural part of Greece: A case-control population-based study

Human discomfort due to environmental conditions in urban Thessaloniki, Greece. Part III. Combined effect of temperature and humidity

Heat waves observed in 2007 in Athens, Greece: Synoptic conditions, bioclimatological assessment, air quality levels and health effects

Hospital admissions and air mass types in Athens, Greece

Effects of air pollution and meteorological parameters on human health in the city of Athens, Greece

Environmental damage costs from airborne pollution of industrial activities in the greater Athens, Greece area and the resulting benefits from the introduction of BAT

Long-term trends in atmospheric pollen levels in the city of Thessaloniki, Greece

South-East European Multi-Hazard Early Warning Advisory System