Studies show that heat waves (HWs) are among the most important atmospheric phenomena that negatively affect human health. This study aims to determine the effects of HWs on hospital admissions (HA) in the Edirne province of Turkey. Polyclinic admission and atmospheric data, including daily maximum temperatures, were used. HW is defined as temperature at the % 90 threshold of daily maximum temperatures that persists for at least 3 consecutive days or more. With this definition, a 6-day HW was detected, and a lag of 3 days was added to this HW. Logarithmic Z test was used for the analysis. As a result of the study, The Risk Ratio (RR) showing the relationship between 9-day HW and HAs was calculated as 1.19 (95% confident interval [CI]: 1.17-1.21, P < .05), and it was determined that there were 2557 extra HAs in total. When HAs were analyzed according to sex, it was observed that female admissions were higher than male admissions. To analyze admissions by age, the data were divided into 3 groups: children (<15 years), adult (15-64 years), and elderly (≥65 years). As a result of the analysis, the highest increase was observed in patients < 15 years of age, and the RR was 1.33 (95% CI: 1.24-1.42 P < .05). When the patient density in polyclinics was analyzed, the Cardiology polyclinic had the highest number of patient admissions with an RR, 1.36 (95% CI: 1.30-1.43 P < .05). The results of this study will guide measures to be taken against HWs.
This study aims to explore the impact of climate change anxiety on various aspects of social work and examine the relationship between anxiety and socio-demographic variables. The study’s participants comprised students enrolled in social work education programs in Turkey. The results suggest that students who are highly anxious about climate change express anxiety regarding various problem areas within social work. The study suggests that anxieties about climate change can potentially lead to anxiety within social work domains, thus exerting a negative impact on social work policy and practices.
OBJECTIVE: The age at menarche varies over time in line with the development level of society. The aim of the present study was to assess and compare secular trends of the age of menarche in Ankara, Turkey. PATIENTS AND METHODS: One thousand thirty-five patients who presented for regular gynecological control were examined retrospectively between 2011 and 2015. The patients were asked when they had experienced their first period. The data were evaluated in 10-year periods (<1964, 1965-1974, 1975-1984, and 1985-2000). The mean age at menarche presents trends that have changed over the years. RESULTS: The mean age at menarche decreased from 13.29 years in < 1964 to 13.24 years in 1965-1974, 13.20 years in 1975-1984, and 13.10 years in 1985-2000. When the < 1964 and 1985-2000 groups were compared, there was a two-fold increase in young age (≤ 11 years) at menarche. CONCLUSIONS: There is a continuing secular trend (a two-fold increase) in earlier age at menarche (i.e., ≤ 11 years). The effects of global warming and rising socioeconomic levels in Turkey may be implicated in the increase in earlier age at menarche.
Diyarbakir city, in the torrid southeast Anatolia region, harbours significant socioeconomic potentials and a population of over 2 million. Climate factors affect human activities in the city due to heat stress in summer which increases with climate change. Therefore, it is important to analyse outdoor human thermal comfort conditions (OHTCCs) to take required actions for the sustainability and improvement of socioeconomic life. This paper evaluates OHTCCs for the city over a 10-year period for rural and semi-urban sites and 5-year period for urban site. Physiological Equivalent Temperature (PET) and RayMan, a bioclimate model, were chosen to determine OHTCCs from meteorological parameters. Results indicate that the frequency of heat stress is higher in urban (32.0%) than that in rural (25.6%) and in semi-urban (23.4%) sites while that of comfortable conditions is highest in urban (17.2%), followed by semi-urban (17.1%) and rural (15.8%) sites. Percentage of the cold stress is lowest (13.6%) in urban, followed by rural (21.4%) and semi-urban (22.4%) sites. High variability of summer heat stress over the sites can be explained by surface characteristics and local air circulation patterns. Semi-urban site provides some advantages for experiencing less heat stress since it has the mixed surface characteristics with vegetated and structured zones which can supply moisture to the environment to moderate OHTCCs. It is suggested that authorities should consider the urban planning and implementation actions to improve physical environment and human quality of life and to ensure the sustainability of economic activities.
Crimean-Congo Hemorrhagic Fever continues to be an important public health problem by expanding its borders. To evaluate the temporal trend, seasonality, and relationship with the climatic factors of Crimean-Congo Hemorrhagic Fever. Study data included cases treated in two different tertiary healthcare institutions between 2012 and 2021. The demographic characteristics of the cases and the dates of admission to the hospital were determined, and they were matched with the average of the measurements (temperature, cumulative precipitation, relative humidity, wind speed) of two different meteorology stations in the study area. By calculating the crude incidence rates, the trend in years was investigated. Estimates were created by removing the incidence rates, seasonality, and trend components using the additive decomposition technique. The temporal relationship between incidence rates and climatic factors was evaluated with the help of the Autoregressive Distributed Lag Bound Test. Toda Yamamoto test was used for causality verification. The mean age of the cases (n = 974) included in the study was 47.6 ± 17.7 years, and the majority (57.3%) were in the group above 45 years of age. 56.6% of the cases were male and there was a male predominance in all age groups. Incidence rates ranged from 5.5 to 23.1/100,000 over the ten-year period and there was a significant upward trend (R(2) = 0.691, p = 0.003). Cases of Crimean-Congo Hemorrhagic Fever that started in March, peaked in July and ended in October, showed a clear seasonality. A cointegration relationship was observed between case incidence rates and air temperature, cumulative precipitation, and relative humidity (p < 0.05 for all). Climatic factors can only indirectly affect the occurrence of Crimean-Congo Hemorrhagic Fever cases. However, climatic conditions that become progressively more favorable for vector ticks lead to the spread of the disease. The control measures to be taken should be prepared by considering the changing climatic conditions and prioritizing the risk groups. There is a need for information and awareness-raising studies about climate change and the growing dangers associated with it, also outside of endemic regions.
Cities are highly vulnerable areas affected by climate change. For sustainable urbanization, it is of great importance to determine the thermal conditions in cities and to make predictions for the future. Therefore, in this study, the spatial distribution of the thermal comfort conditions in the city of Diyarbakir, located in the southeastern Turkey, during the hot period of the year is explained and predictions for the future are made. In the study, measurement data from meteorological stations and the data of the SSP-2 and SSP-5 scenarios were used. Thermal comfort conditions were determined according to the PET (physiological equivalent temperature) index using RayMan software. The ArcGIS 10.5 program was used for defining the spatial distribution of thermal comfort conditions. As a result of the study, it is seen that the areas with dense construction and a low amount of green area in the old urbanized area, which is the central business district (CBD), have uncomfortable conditions. It is predicted that uncomfortable areas will increase in the near and distant future and threaten human health. For climate-resilient, healthy, and comfortable cities that can adapt to adverse effects of climate change, urban design and planning should be carried out with a holistic perspective.
Leishmaniasis epidemiology is currently undergoing substantial transformations in both Turkey and Europe, signifying potential implications for public health. This review analyzes the evolving patterns within Turkey and their potential ramifications for Europe. Within Turkey, the dynamics of leishmaniasis are undergoing noteworthy alterations, manifesting in a rise in cutaneous leishmaniasis (CL) cases and the emergence of Leishmania major and Leishmania donovani. These transformations are predominantly driven by factors such as the distribution of vectors, human activities, climate fluctuations, and migration. Across Europe, particularly in countries within the Mediterranean basin, leishmaniasis is endemic, primarily attributed to Leishmania infantum. Recent evidence suggests a resurgence of the disease even in previously non-endemic areas, propelled by climate change, urbanization, and migration. The changing landscape of leishmaniasis in Turkey carries direct implications for Europe. The presence and distribution of Leishmania tropica, L. major, and L. donovani raise concerns regarding cross-border transmission. Turkey’s strategic position along migration routes further compounds the risk, alongside the facilitative effects of climate change and host mobility. Embracing a One Health approach with public awareness campaigns should be a priority. To ensure the protection of public health in Europe, it is imperative to adopt a proactive approach by establishing robust surveillance mechanisms, implementing preventive measures, and cultivating collaboration with Turkey. The invaluable experience, strategic geographical location, and well-established infrastructure of Turkey make this collaboration crucial in effectively addressing the evolving dynamics of leishmaniasis and its potential impacts on Europe.
Tourism is one of the most vulnerable sectors to climate change since outdoor leisure activities are only possible in appropriate climate conditions for them. Among several climate or weather-related factors effective on tourist satisfaction, the concept of outdoor thermal comfort conditions gains importance with climate change because it is the combined effect of all atmospheric conditions on human body. Therefore, tourism-climate indices to reflect the favourability of destinations begin to include this parameter as a component. Mediterranean basin harbours world famous summer and cultural tourism destinations among others and climate change is expected to impact the region which covers the third largest primary destination of Turkey. The aim of this study is to analyse human thermal comfort conditions in the southwest part of Turkey, world-famous summer tourism region using Physiologically Equivalent Temperature (PET) and Mean Radiant Temperature (Tmrt) values and Geographic Information System (GIS) as a tool to show their spatial distribution as a component of tourism climate indices. As the result of the study, the most influential factors on human thermal comfort conditions in the region are mean radiant temperature, moisture content, air movement and increasing dense urbanisation in 12 districts, where meteorological measurements were taken. As the result of the study, suggestions were proposed to reduce the effect of higher PET and Tmrt values on tourists in the study.
Purpose It is known that the incidence of paediatric orthopaedic trauma peaks in the summer months as a result of increased and uncontrolled physical activity. The aim of this study was to review the experience of a single centre with paediatric orthopaedic traumas and determine the relationship between the severity and the variations in the incidence of traumas in relation to the seasons and temperatures during the study period. Materials and Methods A single institutional review of the historical data of all patients aged 0-16 years who presented for orthopaedic trauma between January 2018 and December 2020 in the emergency department of Level 1 tertiary orthopaedic trauma centre was conducted. 65,182 paediatric orthopaedic trauma cases had been retrieved from the hospital data base during the 3 -year study period. We classified the traumas according to the variants of the patients’ and by holidays, seasons, school days and weekends, months and in which part of the body it occurred. Results After excluding the summer vacation, 77% of paediatric orthopaedic trauma patients attended to the hospital on weekdays and 23% on weekends. While it was observed that hot weather had a statistically positive effect on trauma attendance, rainy weather had an negative effect (p < 0.05). Trauma attendances were found to be statistically higher in summer months, except for injuries that may occur with indoor activities such as metacarpal fracture, phalanx fracture and pulled elbow (p < 0.05). Conclusion Orthopaedic trauma at a Level 1 tertiary health care trauma center do vary significantly with the weather and are highest in the summer season. Therefore, it should focus more attention on preventive strategies for paediatric trauma in the summer season.
We aimed to investigate the relation between air pollution and the number of daily hospitalizations due to pneumonia, asthma, bronchitis in children aged 0-18 in Bursa city of Turkey, between the years 2013-2018. The daily values of air pollutants (PM10, SO2, NO2, NOx, CO, and O3) from 2013 until 2018, were obtained. Adjusted Quasi-Poisson regression models including distributed lags, controlled for climate variables were used for data analysis. Increases in SO2, ozone, PMs, and nitrogen oxides were associated with pneumonia hospitalizations, increases in SO2 NOx and PMs were associated with asthma hospitalizations, and increases in SO2 and ozone were associated with bronchitis hospitalizations. Male hospitalization was related with SO2, ozone, and NOx; while female hospitalization was only related with SO2. This study showed that short-term exposure to air pollution is associated with an increased risk of pneumonia, asthma, and bronchitis hospitalization among children in Bursa.
AIM: Studies fall short when it comes to determining the relationship between thermal comfort and cardiovascular diseases. Studies examining the relationship between thermal comfort conditions and human health in Turkey, located in the transition zone of air masses at mid-latitudes, are quite limited. This is the first study conducted in Turkey that deals with thermal comfort conditions and CVDs, which is the leading cause of death. This study aimed to examine the relationship between thermal comfort conditions and CVDs of Amasya, a medium-sized exemplary Turkish city. SUBJECT AND METHODS: To determine the thermal comfort conditions in the study area between 2014-2019, the physiologically equivalent temperature (PET) index obtained from the Rayman model, which uses hourly air temperature (ºC), relative humidity (%), wind speed (m/s), and cloud cover (octa) data, was used. The relationship between PET values and CVDs was determined by Pearson correlation analysis and linear regression analysis. RESULTS: The study indicated a negative, high, and moderate correlation between PET values and cardiovascular diseases (p < 0.001). The results show that when PET values increase by 1 ºC, patient admissions will decrease by about 104 to 108 patients (-104.737 to -108.619 units.). CONCLUSION: These results can be informative and guiding for both the protection of public health and studies on climate change and human health.
İpsala district located in the northwest of Turkey is an intensive agricultural area, where paddy cultivation has been carried out for more than 50 years. The main source for drinking water in the area is groundwater. Since large amounts of agrochemicals are applied to the paddy fields, groundwater in the study area can be contaminated with toxic metal (loid)s (TMs). In this study, levels of eight TMs in the drinking water samples taken from the district and its 22 villages in the dry and wet seasons were measured and compared with drinking water quality guidelines. In addition, non-carcinogenic and carcinogenic health risks, and pollution status of TMs were assessed. The mean values of Cd, Ni, Cu, Zn, Mn, Pb, As and Cr in both seasons were below the drinking water limits. High clay content and low infiltration rate of the soils in the study area may have caused low TM concentrations. The TMs levels were higher in the wet season due to high rainfall intensity. Metal pollution indices indicated that groundwater quality is suitable for potable uses. All hazard quotient and hazard index results for children and adults in both seasons were lower than the acceptable risk level of 1. Carcinogenic risk results of As and Cr in both seasons were within or below the acceptable risk range. These findings revealed that the TMs in the drinking water would not pose health risks to the local residents.
OBJECTIVE: Cutaneous larva migrans (CLM) is a parasitic disease seen in people in contact with soil in tropical countries. Almost all cases reported in regions without a tropical climate have a history of travel to a tropical region. AIM: In our study, we aimed to investigate the effect of climate change on CLM cases and the demographic characteristics of these cases. For this purpose, the climate information of the period in which we determined the case series and the characteristics of the patients were investigated. MATERIAL AND METHOD: The study was designed retrospectively. Patient files and pre- and post-treatment photographic archives were reviewed retrospectively. In addition, the region’s weather history over the last 50 years was examined. RESULTS: The records of patients diagnosed with CLM in 2018 were reviewed retrospectively. In total, 22 cases were detected. The common feature of all cases was that they worked as tea pickers. After examining the weather conditions of the period when the cases were commonly reported, it was determined that there was a sharp temperature increase compared with previous years. CONCLUSION: Due to climate change, an increase in the number of CLM cases is observed in non-tropical regions. Since it is considered a disease-specific to tropical regions, the diagnosis may be overlooked in cases outside these regions. However, CLM should be kept in mind as a diagnostic possibility by clinicians practicing in non-tropical regions as well, especially when treating patients who work with soil, such as tea harvesters.
BACKGROUND: The emergence of tick-borne disease is increasing because of the effects of the temperature rise driven by global warming. In Turkey, 19 pathogens transmitted by ticks to humans and animals have been reported. Based on this, this study aimed to investigate tick-borne pathogens including Hepatozoon spp., Theileria spp., Babesia spp., Anaplasma spp., Borrelia spp., and Bartonella spp. in tick samples (n = 110) collected from different hosts (dogs, cats, cattle, goats, sheep, and turtles) by molecular methods. METHODS: To meet this objective, ticks were identified morphologically at the genus level by microscopy; after DNA isolation, each tick sample was identified at the species level using the molecular method. Involved pathogens were then investigated by PCR method. RESULTS: Seven different tick species were identified including Rhipicephalus sanguineus, R. turanicus, R. bursa, Hyalomma marginatum, H. anatolicum, H. aegyptium, and Haemaphysalis erinacei. Among the analyzed ticks, Hepatozoon spp., Theileria spp., Babesia spp., and Anaplasma spp. were detected at rates of 6.36%, 16.3%, 1.81%, and 6.36%, respectively while Borrelia spp. and Bartonella spp. were not detected. Hepatozoon spp. was detected in R. sanguineus ticks while Theileria spp., Babesia spp., and Anaplasma spp. were detected in R. turanicus and H. marginatum. According to the results of sequence analyses applied for pathogen positive samples, Hepatozoon canis, Theileria ovis, Babesia caballi, and Anaplasma ovis were identified. CONCLUSION: Theileria ovis and Anaplasma ovis were detected for the first time to our knowledge in H. marginatum and R. turanicus collected from Turkey, respectively. Also, B. caballi was detected for the first time to our knowledge in ticks in Turkey.
The environmental pollution caused by climate change and global warming pose significant risks to health. This raises the question how environmental disturbances can affect health expenditures. Based on this, this study examines the asymmetric effect of environmental quality on health expenditures in Türkiye using the non-linear ARDL (NARDL) model for the 1975-2019 period. In addition to environmental quality, natural resources, economic growth, and trade openness variables are also included in the health expenditure model. The findings support the existence of an asymmetric cointegration relationship between the series. The findings also indicate that positive environmental pollution shocks affect health expenditures positively in the long run, while negative environmental pollution shocks do not have a statistically significant effect on health expenditures. Positive and negative natural resource shocks affect health expenditures negatively in the long run. Despite the effect of positive economic growth shocks on health expenditures is positive but statistically insignificant, the effect of negative economic growth shocks is positive and significant. Besides, positive trade openness shocks have a negative effect on health expenditures and negative trade openness shocks have a positive effect. The findings prove that the steps to be taken to protect the environment in the current period will increase the effectiveness of health expenditures in the future. This situation has a guiding feature for policy-makers in terms of policy decisions.
Vector-borne zoonotic diseases (VBZDs) are a major problem for public health and animal welfare all over the world. In recent years, there has been an alarming increase in VBZDs, mainly caused by new or re-emerging arboviruses, bacteria and parasites. The World Health Organization enumerated 10 threats to global health for 2019, notably emphasizing climate change and emerging pathogens as growing priorities. It is important to review potential threats and develop new control programs for rising threats against human health and safety. Changes in host and vector population diversity and density may affect pathogen transmission patterns and influence VBZD emergence processes. In addition to environmental and climate-related changes, human and animal migratory patterns pose future threats. The geographic location and habitat features of Turkey support the establishment of many arthropod species as vectors of various diseases. To date, a total of 107 zoonotic infections have been reported originating from Turkey. Arthropods transmit 19 of 107 such infections, including 2 mosquito-borne, 9 tick-borne, 1 sandfly-borne, 3 flea-borne, 1 simuliid-borne, 1 mite-borne and 2 fly-borne diseases. In this review, we focus on the present status of knowledge on VBZDs as a rising threat to public health in Turkey to provide a foundation for future control efforts.
Urbanization models that do not comply with the planning criteria are affecting human lives. In urban areas, street trees have positive contributions to the ecosystem and human thermal comfort. In this study, the thermal comfort of the main streets that connect people to each other and provide access and transportation has been thermally explored. Cumhuriyet Street, which is one of the vibrant streets in Erzurum, was selected as a case study scenario in the winter and summer periods in 2018 by using the ENVI-met V. 4.4.2 winter model. A different green scenario is proposed, and the best thermal comfort scenario in both seasons is determined. The results show that, in the summer period, the air temperature of the greener street scenario is about 1.0 °C cooler than the existing condition and about 2.0 °C warmer in the winter period. Physiological equivalent temperature (PET) value was better in narrow canyon streets in winter months, but in wide canyon streets in summer months. The green scenarios of wide canyon streets positively affect the outdoor thermal comfort in both seasons. These results clearly imply that green streets are an appropriate strategy for city streets that suffer from discomfort levels in cold winter and hot summer periods. It has been concluded that it is possible to increase thermal comfort through improvement in the open space in street and more suitable plant preferences for livable urbanization. Planning streets in a new city characterized by summer and winter seasons should take into consideration an accurate decision for providing a thermal comfort level and healthy urbanization.
In addition to several negative environmental effects, climate change, which reduces bioclimatic comfort levels especially in urban areas, also has economic implications, especially in cities where the economic structure is tourism-oriented. Considering most of the tourism practices are based on outdoor activities in cities such as Antalya, it is of great importance to determine bioclimatic comfort level as well as the attitudes of people toward climate change who live in those conditions to be able to take proper precautions in terms of tourism and urban planning. Therefore, the purpose of this study was to reveal the bioclimatic comfort conditions of Antalya city center, and a comprehensive questionnaire was conducted with the people living in the area questioning the opinions on reasons and consequences of climate change, perceivable effects of climate change in Antalya, and suggestions to prevent or reduce the adverse effects. The areas with appropriate bioclimatic comfort conditions were determined and mapped via geographical information systems using temperature and relative humidity data of the years between 1960 and 2018. The data gathered via questionnaires were analyzed using confirmatory factor analysis, regression, correlation, and structural equation modelling via SPSS and AMOS software. According to the results, it was determined that in some parts of city center the bioclimatic comfort conditions decreased to levels that could reach harmful dimensions for human health and the analysis of the questionnaires revealed that people living in that area state that the effects of climate change are perceivable as the precipitation seasons have become irregular. According to the participants, it was determined that a 1-unit increase in environmental measures causes a decrease of 0.136 units in disasters (R(2)?=?1.1%). In comparison, 1-unit increase of Administrative Precautions will cause 0.030 units decrease in effects of climate change on vital needs (R(2)?=?1.4%). These analysis results show that the respondents expect the disaster scenarios to decrease when environmental measures are increased.
The disclosed study undertook a ‘human centred-approach’ that ascertained and categorised environmental human thermophysiological risk factors by relating them to the human biometeorological system through the use of three widely utilised energy balance model (EBM) indices, the physiologically equivalent temperature (PET), the modified PET, and the universal thermal climate index (UTCI). The disclosed assessment was carried out over the past decade (i.e., 2010-2019) with a 3-h temporal resolution for the case of Ankara through two WMO meteorological stations to compare both local urban and peri-urban environmental conditions. The study recognised extreme annual variability of human physiological stress (PS) during the different seasons as a result of the biometeorological processing of the singular variables, which in the case of average PET for both stations, varied by up to 75 °C between the winter and summer for the same annual dataset (2012). In addition, all EBMs indicated higher heat stress within the city centre that were conducive of both urban extreme heatwaves and very hot days during the summer months, with extreme heat stress levels lasting for longer than a week with PET values reaching a maximum of 48 °C. Similar cold extremes were found for the winter months, with PET values reaching -?30 °C, and average PS levels varying lower in the case of the peri-urban station. Graphical abstract.
BACKGROUND: Since fungi spores have high concentrations in the atmosphere during most of the year, they have an important place in respiratory allergies. In this regard, the preparation of calendars showing fungi spore loads for residential areas has much importance in the treatment of the patients. The first aim of this study was to present the airborne fungal spore research results from Eastern Anatolia in Turkey. Then, the mold spores’ relationships with the meteorological parameters and skin prick test results were also evaluated. The presence of fungal spores was investigated using a volumetric spore trap in 2018 year. METHODS: In this study, fungal spores within the atmosphere of the Elaz?? city of Turkey was measured through the volumetric method, using a Lanzoni VPPS 2000 device (VPPS 2000 Lanzoni, Bologna, Italy), in 2018 year. Annual data of temperature, humidity, precipitation and wind speed were used for comparing meteorological data with airborne fungal spore counts. In addition, 637 children who were admitted to a pediatric allergy clinic with allergic complaints were enrolled in the study. RESULTS: A total of 145,099 spores/m(3) and 20 fungal taxa belonging to the molds were recorded. Ustilago was the predominant genus (18.10%), followed by Oidium (18.01%), Drechslera (12.82%), and Fusarium (11.60%), which were the most common fungal spores found in Elazig’s atmosphere. The total mold spores in the atmosphere reached the highest level, with 28,153 spores/m(3), in July (mid-summer). Moreover, we found a positive correlation between the mold spores and the temperature, but negative correlations with the humidity and wind speed. In the skin prick tests in the children with allergic complaints, we detected sensitization to Alternaria alternata in 4.4%, Cladosporium herbarum in 3.0%, Penicillium notatum in 1.4%, and Aspergillus fumigatus in 1.1%. Additionally, there was no correlation between fungal spore concentration in the atmosphere with fungal spores sensitization in the skin prick test. CONCLUSIONS: This study was the first aerofungal survey of the Eastern Anatolia region in Turkey; therefore, new information has been introduced in the field of aerobiology in Turkey.
