Xenoestrogens, foreign synthetic chemicals mimicking estrogens, are lurking in our surroundings. Climate change may alter their toxicity and bioavailability. Since xenoestrogens have extremely high lipid solubility and are structurally similar to natural endogenous estrogens, they can bind to estrogen receptors (ERs) -alpha (ER-α) and -beta (ER-β). Scientific evidence accumulated over the past decades have suggested that natural 17β-estradiol (E2; a potent estrogen), via activation of its receptors, plays a pivotal role in regulation of brain development, differentiation, metabolism, synaptic plasticity, neuroprotection, cognition, anxiety, body temperature, feeding and sexual behavior. In the brain, ER-β is predominantly expressed in the various regions, including cerebral cortex and hippocampus, that have been shown to play a key role in cognition. Therefore, disturbances in function of ER-β mediated E2 signaling by xenoestrogens can lead to deleterious effects that potentiate a variety of neurological diseases starting from prenatal to post-menopause in women. The goal of this review is to identify the possible neurological effects of xenoestrogens that can alter estrogen receptor-mediated signaling in the brain during different stages of the female lifespan.
Mass disasters are characterized by a disparity between healthcare demand and supply, which hampers complex therapies like kidney transplantation. Considering the scarcity of publications on previous disasters, we reviewed transplantation practice during the recent coronavirus disease 2019 (COVID-19) pandemic, and dwelled upon this experience to guide transplantation strategies in the future pandemic and non-pandemic catastrophes. We strongly suggest continuing transplantation programs during mass disasters, if medical and logistic operational circumstances are appropriate. Postponing transplantations from living donors and referral of urgent cases to safe regions or hospitals are justified. Specific preventative measures in anticipated disasters (such as vaccination programs during pandemics or evacuation in case of hurricanes or wars) may be useful to minimize risks. Immunosuppressive therapies should consider stratifying risk status and avoiding heavy immune suppression in patients with a low probability of therapeutic success. Discharging patients at the earliest convenience is justified during pandemics, whereas delaying discharge is reasonable in other disasters, if infrastructural damage results in unhygienic living environments for the patients. In the outpatient setting, telemedicine is a useful approach to reduce the patient load to hospitals, to minimize the risk of nosocomial transmission in pandemics and the need for transport in destructive disasters. If it comes down to saving as many lives as possible, some ethical principles may vary in function of disaster circumstances, but elementary ethical rules are non-negotiable. Patient education is essential to minimize disaster-related complications and to allow for an efficient use of healthcare resources.
Emissions abatement efforts in the agriculture, forestry and land-use sector are vital to achieve climate change mitigation targets, but their effects on food security remain poorly understood. Using six global agroeconomic models, this study explores how afforestation, bioenergy and non-CO2 emissions reductions could impact agricultural prices and the risk of hunger under different scenarios. Earlier studies have noted potential adverse impacts of land-related emissions mitigation strategies on food security, particularly due to food price increases-but without distinguishing these strategies’ individual effects under different conditions. Using six global agroeconomic models, we show the extent to which three factors-non-CO2 emissions reduction, bioenergy production and afforestation-may change food security and agricultural market conditions under 2 degrees C climate-stabilization scenarios. Results show that afforestation (often simulated in the models by imposing carbon prices on land carbon stocks) could have a large impact on food security relative to non-CO2 emissions policies (generally implemented as emissions taxes). Respectively, these measures put an additional 41.9 million and 26.7 million people at risk of hunger in 2050 compared with the current trend scenario baseline. This highlights the need for better coordination in emissions reduction and agricultural market management policies as well as better representation of land use and associated greenhouse gas emissions in modelling.
Modern society is characterized by dramatic climate changes and environment changes. There is an intensive use of natural resources and an increase in environmental pollution. The legal framework and its continuous development are essential for the protection of the environment and its sustainable development. The legal framework is a tool for identification and prevention of natural pollution sources, the prevention of environmental threats to the health of the population and the improvement of the quality of life of people in general. The volume of environmental legislation has increased significantly in recent years, but shortcomings in its implementation and enforcement are not sufficient to address environmental issues. The world community has relatively little knowledge of the potential for improving the legal regulation to strengthen environmental security by addressing global environmental risks.
Estimating how many people are food insecure and where they are is of fundamental importance for governments and humanitarian organizations to make informed and timely decisions on relevant policies and programmes. In this study, we propose a machine learning approach to predict the prevalence of people with insufficient food consumption and of people using crisis or above-crisis food-based coping when primary data are not available. Making use of a unique global dataset, the proposed models can explain up to 81% of the variation in insufficient food consumption and up to 73% of the variation in crisis or above food-based coping levels. We also show that the proposed models can nowcast the food security situation in near real time and propose a method to identify which variables are driving the changes observed in predicted trends-which is key to make predictions serviceable to decision-makers. This study presents a machine learning-based methodology to estimate the current state of food insecurity globally using secondary data on economic shocks, extreme weather events and conflicts. By predicting the prevalence of people with insufficient food consumption or at-crisis or above-crisis food-based coping levels when primary data are not available, the proposed model is a valuable tool for food aid efforts.
How climate change is uniquely affecting Indigenous health remains a very less explored area in the existing research literature. The imperative of inclusive climate action to protect indigenous health multiplies manifolds due to their unique vulnerabilities owing to predominant dependence on natural resources and multiple disadvantages faced. The current article attempted to add to the evidence pool regarding climate change impacts on the indigenous population by systematically collecting, processing, and interpreting data as a scoping literature review for effective and inclusive climate policymaking. Twenty-Nine articles of varied study designs were identified employing a systematically organized search strategy using PubMed (Field, MeSH, and advanced search) and Google scholar; relevant data were extracted for further analysis. The Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews (PRISMA-ScR) guidelines were followed. Changing climate scenarios had both direct and indirect health-related impacts on indigenous health, and altered the epidemiological triad for various health-related events, causing the emergence and re-emergence of infectious diseases, and increased prevalence of chronic diseases and mental disorders. An expanded framework was developed showcasing the variability of climate change events, multiple disadvantages, and its impacts on indigenous populations. Few studies also reported a wide range of adaptation responses of indigenous peoples towards climate change. It was substantiated that any climate-change mitigation policy must take into account the trials and tribulations of indigenous communities. Also, due to the complexity and large variability of the impacts and differences in mitigation capabilities, policies should be contextualized locally and tailored to meet the climate need of the indigenous community.
Various stressors including temperature, environmental chemicals, and toxins can have profound impacts on immunity to pathogens. Increased eutrophication near rivers and lakes coupled with climate change are predicted to lead to increased algal blooms. Currently, the effects of cyanobacterial toxins on disease resistance in mammals is a largely unexplored area of research. Recent studies have suggested that freshwater cyanotoxins can elicit immunomodulation through interaction with specific components of innate immunity, thus potentially altering disease susceptibility parameters for fish, wildlife, and human health owing to the conserved nature of the vertebrate immune system. In this study, we investigated the effects of three microcystin congeners (LR, LA, and RR), nodularin-R, and cylindrospermopsin for their ability to directly interact with nine different human Toll-like receptors (TLRs)-key pathogen recognition receptors for innate immunity. Toxin concentrations were verified by LC/MS/MS prior to use. Using an established HEK293-hTLR NF-κB reporter assay, we concluded that none of the tested toxins (29-90 nM final concentration) directly interacted with human TLRs in either an agonistic or antagonistic manner. These results suggest that earlier reports of cyanotoxin-induced NF-κB responses likely occur through different surface receptors to mediate inflammation.
Background. Occupations undertaken in natural environments can positively impact physical and mental health, improve cognitive functioning, contribute spiritual and cultural benefits, and increase belonging, self-worth, and the meaningfulness of occupations. However, occupational opportunities in healthy natural spaces are inequitably distributed; and the deleterious effects of climate change and environmental degradation are borne disproportionately by socioeconomically disadvantaged people. Purposes. To highlight evidence that occupational engagement in nature is a determinant of health, foreground environmental injustices and identify some implications for occupational therapy. Key issues. Cross-disciplinary, cross-cultural research and critical environmental justice scholarship indicate that healthy nature is an inequitably distributed determinant of occupation, wellbeing, and human health. This merits critical attention from occupational therapy. Implications. By researching, identifying, and addressing occupational and health inequities arising from environmental degradation, climate change and inequitable access to health-promoting natural environments occupational therapists could contribute valuable, occupational perspectives to initiatives addressing human rights and environmental justice.
A relationship between the occurrence of spontaneous pneumothorax (SP) and meteorological factors has been observed but with contradictory results. The objectives of this systematic review was to synthesis the current body of evidence to the relationships between the occurrence of SP and environmental determinants such as meteorological factors and air pollutants. We conducted a systematic search of MEDLINE, Scopus, Cochrane Library and gray literature from inception up to 31st December 2020, to find published scientific research articles based on the following eligibility criteria: original studies and population-based articles describing the relationship between meteorological factors or air pollutants and the occurrence of SP. For the meta-analysis, studies involving a quantitative analysis of the exposure variable (atmospheric pressure, temperature, humidity and wind speed) and the impact of the occurrence of SP with comparable methodology were selected. General characteristics and methodological information for each study were assessed. The quality was evaluated according to the Newcastle-Ottawa Scale. Fourty four and 13 studies were respectively included in the qualitative and quantitative analyses. The variability of the study design with moderate quality and the different measurements of the exposure variables highlight the contrasting results. The results of the meta-analyses are in favor of a higher temperature observed in the day with SP than in the days without SP (maximum: MD 0.25 (-0.08, 0.58) p = 0.14; I(2) = 26%, p = 0.21; mean: MD 0.22 (-0.15, 0.59) p = 0.24; I(2) = 45%, p = 0.07). The small number of studies focused on air pollution did not allow us to conclude to determine the potential impact of exposure to air pollutants on the occurrence of SP. Meteorological conditions seem to be related to SP occurrence, especially increased temperature.
Air pollution is the major environmental pollution that contains different types of gases, dust particles, small molecules, etc. Smoke and other hazardous gases, such as carbon, sulfur, and nitrogen oxides, are the primary causes of air pollution. Otherwise, air pollution is the contaminated air that poisonous effect on people’s health. Most air pollution is affected by auto-rickshaw drivers. Auto drivers doing very stressful works which have been associated with environmental interaction factors. So the auto drivers are working within the environment, auto drivers are exposed to climate changes and poor road conditions. So the drivers are exposed to air pollution, dust, droplets, job insecurity, noise and vibration, business demands, damage to equipment, an excessive number of stops, schedule -related pressure, among others. Drivers’ social role is also reflected in the responsibility of passengers and pedestrians ‘lives and other vehicles.
Climate change has been described as one of the greatest threats to people and the planet. Its impacts affect virtually the entire spectrum of internationally recognised human rights as well as the environment in and of itself. In relation to human rights, there is a growing consensus that companies should exercise human rights due diligence in order to identify and prevent their actual and potential adverse impacts. However, the relevance and implications of the concept of the due diligence have not yet fully been analysed in relation to climate change. In this paper, we explore the concept of risk-based due diligence, which builds on the concept of human rights due diligence but extends it to other areas such as the environment. Through a review of recent regulatory developments as well as case-law and other grievances, we analyse the three facets of risk-based due diligence for climate change-prevention, mitigation and remediation. We consider both the short term as well as the longer-term human rights and environmental implications of companies’ climate-related impacts, as well as those resulting from the company’s contributions to the green transition. We argue that risk-based due diligence offers an under-explored but important dual function: providing the operational means through which companies can identify and address the climate-related human rights and environmental impacts with which they may be involved, whilst also taking into consideration the human rights implications of their climate mitigation strategies and contributions to the just transition.
Precipitation extremes and associated hazards often cause agricultural losses and infrastructure damage and even exert negative impacts on human health. It is thus crucial to assess future changes in precipitation extremes and exposure under future warming scenarios to improve the mitigation of climate change. On the basis of Coupled Model Intercomparison Project phase 6 simulations, we find that occurring probabilities of precipitation extremes that exceed the 99th percentile threshold are projected to increase over global lands in the coming century, especially under the no-mitigation scenario of SSP5-8.5. Under this scenario, by the end of this century, occurrences of aggregations of precipitation extremes over global lands are expected to increase by approximately 1.8 times. Increases are also expected even if early mitigation is conducted via SSP1-2.6. Accordingly, global aggregate exposure would increase by at least 50% in the future under SSP5-8.5. Changes in precipitation extremes will exert a substantial influence on population exposure, of which contribution will be up to 46% under SSP5-8.5 by the end of this century. The future maximum centers of exposure are concentrated over East Asia, South Asia, the Mediterranean basin, and eastern North America, as in the current state. However, the rapid increase in population over some parts of Africa plays a larger role than climate change and significantly increases the exposure in these regions. As a result, regions of Africa will become other high-exposure global centers in the future. Climate change mitigation should be thus the key policy response to reduce population exposure in the future over most global regions.
This paper examines the relationship between gender justice and climate change, arguing that, to meaningfully address the issues that arise in this context, it is imperative to engage not only with matters of principle, but also with the practicalities of gender exclusion in respect of climate change itself and the praxis of global climate governance. The discussion briefly considers key gendered societal and scientific contexts that form part of the complex substrate that situates climate change in reality, academic and political debate, and which ground and shape the global climate change regime. These considerations explain why, while there is now a systemic acknowledgment of the need to act on gender issues in principle in the UNFCCC regime, the effectiveness of recently adopted strategies is not a given, and more profoundly, it behoves us to consider how their efficacy might be improved as we seek to mature global climate governance.
It is well known that pandemics not only change people’s social habits but have also changed most activities related to energy consumption, especially industry and transport. Over the past year, a plethora of case studies have been published mapping the environmental impacts in specific locations in terms of changes in wastewater composition, noise, solar radiation and more. However, policymakers are demanding a global perspective and are looking for a synthesis of all these reports that will indicate whether, or to what extent, these changes interact with global climate change. The most urgent question is whether artificially inducing such a pandemic could be justified, given the loss of human life and economic losses. Robust analysis on air pollutants such as PM2.5, PM10, NOx, SO2, CO, O3 and NH3 confirmed significant improvement in air quality indicators especially in India and China. The study indicates that key hypotheses can be confirmed or refuted, but further measurements are needed.
Understanding periods of the year associated with higher risk for falling and less physical activity may guide fall prevention and activity promotion for older adults. We examined the relationship between weather and seasons on falls and physical activity in a three-year cohort of older adults with glaucoma. Participants recorded falls information via monthly calendars and participated in four one-week accelerometer trials (baseline and per study year). Across 240 participants, there were 406 falls recorded over 7569 person-months, of which 163 were injurious (40%). In separate multivariable regression models incorporating generalized estimating equations, temperature, precipitation, and seasons were not significantly associated with the odds of falling, average daily steps, or average daily active minutes. However, every 10 °C increase in average daily temperature was associated with 24% higher odds of a fall being injurious, as opposed to non-injurious (p = 0.04). The odds of an injurious fall occurring outdoors, as opposed to indoors, were greater with higher average temperatures (OR per 10 °C = 1.46, p = 0.03) and with the summer season (OR = 2.69 vs. winter, p = 0.03). Falls and physical activity should be understood as year-round issues for older adults, although the likelihood of injury and the location of fall-related injuries may change with warmer season and temperatures.
BACKGROUND: nationally determined contributions (NDCs) serve to meet the goals of the Paris Agreement of staying “well below 2°C”, which could also yield substantial health co-benefits in the process. However, existing NDC commitments are inadequate to achieve this goal. Placing health as a key focus of the NDCs could present an opportunity to increase ambition and realise health co-benefits. We modelled scenarios to analyse the health co-benefits of NDCs for the year 2040 for nine representative countries (ie, Brazil, China, Germany, India, Indonesia, Nigeria, South Africa, the UK, and the USA) that were selected for their contribution to global greenhouse gas emissions and their global or regional influence. METHODS: Modelling the energy, food and agriculture, and transport sectors, and mortality related to risk factors of air pollution, diet, and physical activity, we analysed the health co-benefits of existing NDCs and related policies (ie, the current pathways scenario) for 2040 in nine countries around the world. We compared these health co-benefits with two alternative scenarios, one consistent with the goal of the Paris Agreement and the Sustainable Development Goals (ie, the sustainable pathways scenario), and one in line with the sustainable pathways scenario, but also placing health as a central focus of the policies (ie, the health in all climate policies scenario). FINDINGS: Compared with the current pathways scenario, the sustainable pathways scenario resulted in an annual reduction of 1·18 million air pollution-related deaths, 5·86 million diet-related deaths, and 1·15 million deaths due to physical inactivity, across the nine countries, by 2040. Adopting the more ambitious health in all climate policies scenario would result in a further reduction of 462 000 annual deaths attributable to air pollution, 572 000 annual deaths attributable to diet, and 943 000 annual deaths attributable to physical inactivity. These benefits were attributable to the mitigation of direct greenhouse gas emissions and the commensurate actions that reduce exposure to harmful pollutants, as well as improved diets and safe physical activity. INTERPRETATION: A greater consideration of health in the NDCs and climate change mitigation policies has the potential to yield considerable health benefits as well as achieve the “well below 2°C” commitment across a range of regional and economic contexts. FUNDING: This work was in part funded through an unrestricted grant from the Wellcome Trust (award number 209734/Z/17/Z) and supported by an Engineering and Physical Sciences Research Council grant (grant number EP/R035288/1).
The objective of this article is to examine the role of doctors and health professionals in communicating the health impacts of climate change and exploring how achieving climate objectives is co-beneficial to public health objectives. This article identifies the main interpretative frameworks for climate change communication identified in the literature, contextualizes the challenge of climate communication in the field of public health, and analyses the element of trust, without which the communication process is likely to fail. Awareness-raising strategies must therefore create appropriate contexts that allow the public to perceive climate change as a relevant and immediate issue. Further, to be properly considered, such information must be issued from a source the public trusts. After providing a general framework within which to examine the role of doctors and health professionals in climate communication, message content is examined along with trust in message sources and in the medical profession, and the perceptions among and training of medical professionals concerning the climate challenge are considered.The literature reviewed in this article represents the body of climate change communication research related to the role of the doctor, an area of growing interest. This review provides a timely and complete analysis of the literature on the subject with the goal of starting a necessary, but too-long postponed, multidisciplinary dialogue.
The purpose of the present paper is to disentangle the mechanisms that connect climate change-induced disasters, inequality and vulnerability by accounting for both directions of causality. We do so by means of a simultaneous equations approach on a panel of 149 countries from 1992 to 2018. The empirical analysis reveals that countries with higher levels of income inequality suffer greater damages when hit by a natural disaster. At the same time, inequality is found to increase the number of people affected by disasters. Our analysis discloses the existence of a vicious cycle that keeps some countries stuck in a disasters-inequality trap.
By some counts, up to 98% of environmental news stories are negative in nature. Implicit in this number is the conventional wisdom among many communicators that increasing people’s understanding, awareness, concern or even fear of climate change are necessary precursors for action and behavior change. In this article we review scientific theories of mind and brain that explain why this conventional view is flawed. In real life, the relationship between beliefs and behavior often goes in the opposite direction: our actions change our beliefs, awareness and concerns through a process of self-justification and self-persuasion. As one action leads to another, this process of self-persuasion can go hand in hand with a deepening engagement and the development of agency-knowing how to act. One important source of agency is learning from the actions of others. We therefore propose an approach to climate communication and storytelling that builds people’s agency for climate action by providing a wide variety of stories of people taking positive action on climate change. Applied at scale, this will shift the conceptualization of climate change from ‘issue-based’ to ‘action-based’. It will also expand the current dominant meanings of ‘climate action’ (i.e. ‘consumer action’ and ‘activism’) to incorporate all relevant practices people engage in as members of a community, as professionals and as citizens. We close by proposing a systematic approach to get more reference material for action-based stories from science, technology and society to the communities of storytellers-learning from health communication and technologies developed for COVID-19.
Climate change arguably represents one of the greatest global health threats of our time. Health professionals can advocate for global efforts to reduce emissions and protect people from climate change; however, evidence of their willingness to do so remains scarce. In this Viewpoint, we report findings from a large, multinational survey of health professionals (n=4654) that examined their views of climate change as a human health issue. Consistent with previous research, participants in this survey largely understood that climate change is happening and is caused by humans, viewed climate change as an important and growing cause of health harm in their country, and felt a responsibility to educate the public and policymakers about the problem. Despite their high levels of commitment to engaging in education and advocacy on the issue, many survey participants indicated that a range of personal, professional, and societal barriers impede them from doing so, with time constraints being the most widely reported barrier. However, participants say various resources-continuing professional education, communication training, patient education materials, policy statements, action alerts, and guidance on how to make health-care workplaces sustainable-can help to address those barriers. We offer recommendations on how to strengthen and support health professional education and advocacy activities to address the human health challenges of climate change.
Water is an essential nutrient that has primarily been considered in terms of its physiological necessity. But reliable access to water in sufficient quantities and quality is also critical for many nutrition-related behaviors and activities, including growing and cooking diverse foods. Given growing challenges to water availability and safety, including climate change, pollution, and infrastructure degradation, a broader conceptualization of water and its diverse uses is needed to sustainably achieve global nutrition targets. Therefore, we review empirical and qualitative evidence describing the linkages between water security (the reliable availability, accessibility, and quality of water for all household uses) and nutrition. Primary linkages include water security for drinking, food production and preparation, infant and young child feeding, and limiting exposure to pathogens and environmental toxins. We then identify knowledge gaps within each linkage and propose a research agenda for studying water security and nutrition going forward, including the concurrent quantification of both food and water availability, accessibility, use, and stability. By making explicit the connections between water security and nutritional well-being, we aim to promote greater collaboration between the nutrition and water, sanitation, and hygiene sectors. Interdisciplinary policies and programs that holistically address the water-nutrition nexus, versus those that focus on water and nutrition independently, are likely to significantly advance our ability to ensure equitable access to healthy foods and safe water for all.
(1) Background: The developmental origins of health and disease (DOHaD) hypothesis links adverse fetal exposures with developmental mal-adaptations and morbidity later in life. Short- and long-term exposures to air pollutants are known contributors to health outcomes; however, the potential for developmental health effects of air pollution exposures during gestation or early-childhood have yet to be reviewed and synthesized from a DOHaD lens. The objective of this study is to summarize the literature on cardiovascular and metabolic, respiratory, allergic, and neuropsychological health outcomes, from prenatal development through early childhood, associated with early-life exposures to outdoor air pollutants, including traffic-related and wildfire-generated air pollutants. (2) Methods: We conducted a search using PubMed and the references of articles previously known to the authors. We selected papers that investigated health outcomes during fetal or childhood development in association with early-life ambient or source-specific air pollution exposure. (3) Results: The current literature reports that prenatal and early-childhood exposures to ambient and traffic-related air pollutants are associated with a range of adverse outcomes in early life, including cardiovascular and metabolic, respiratory and allergic, and neurodevelopmental outcomes. Very few studies have investigated associations between wildfire-related air pollution exposure and health outcomes during prenatal, postnatal, or childhood development. (4) Conclusion: Evidence from January 2000 to January 2022 supports a role for prenatal and early-childhood air pollution exposures adversely affecting health outcomes during development. Future studies are needed to identify both detrimental air pollutants from the exposure mixture and critical exposure time periods, investigate emerging exposure sources such as wildfire, and develop feasible interventional tools.
Health professionals have the potential to address the health threats posed by climate change in many ways. This study sought to understand the factors that influence health professionals’ willingness to engage in climate advocacy. We hypothesized and tested a model with six antecedent factors predicting willingness to engage in advocacy for strengthening global commitments to the Paris Agreement. Using survey data from members of health professional associations in 12 nations (n = 3,977), we tested the hypothesized relationships with structural equation modeling. All of the hypothesized relationships were confirmed. Specifically, higher rates of perceived expert consensus about human-caused climate change predicted greater climate change belief certainty and belief in human causation. In turn, all three of these factors, including higher levels of perceived health harms from climate change, positively predicted affective involvement with the issue. Affective involvement positively predicted the feeling that health professionals have a responsibility to deal with climate change. Lastly, this sense that climate advocacy is a responsibility of health professionals strongly predicted willingness to advocate. As a unique study of predictors of health professionals’ willingness to advocate for climate change, our findings provide unique insight into how an influential set of trusted voices might be activated to address what is arguably the world’s most pressing public health threat. Limitations of the study and suggestions for future research are presented, and implications for message development are discussed.
One Health faces enormous pressure and challenges as it attempts to mitigate dynamic, surprising and complex global events that threaten the health and sustainability of human and animal populations and the biosphere. One Health practitioners and researchers need every advantage to developing working solutions to the world’s imminent complex issues. Heath promotion and harm reduction, interrelated approaches that have seen much success over decades of use in global public health, may be important models to consider. Both use an upstream socioecological determinant of health approach to reach beyond the health sector in all health efforts, and encourage active community participation and empowerment to attain and sustain human and ecological health. This scoping review of 411 documents, believed to be the first to relate health promotion and harm reduction to One Health, searched self-declared One Health research literature for evidence of health promotion and harm reduction policies, principles and methodologies. It sought to answer the questions: “What is the scope of practice of One Health in self-declared One Health publications?” and “Are attributes of health promotion and harm reduction found in self-declared One Health-reviewed research literature?” Over half of the papers revealed no health promotion or harm reduction attributes while 7% were well-endowed with these attributes. These 7% of papers focused on deep-seated, complex health issues with systemic knowledge gaps and decision-making issues revolving around specific population vulnerabilities, social inequities and competing stakeholders. Implementing ‘on the ground change’ was a common theme in the strongest health promotion/harm reduction papers we identified. Alternatively, papers lacking health promotion or harm reduction attributes focused on managing proximate risks, primarily for infectious diseases. The addition of health promotion and harm reduction to One Health practices may help the field rise to the growing expectations for its involvement in complex global issues like pandemics and climate change.
Global warming in the twenty-first century has gradually made high temperatures a major threat to the global population. Health problems associated with extreme temperatures have become a growing public health concern worldwide. This study aimed to estimate road injuries stratified by sex, age, geographic location, and sociodemographic status attribute to high, low, and non-optimal temperatures in 21 regional and global. We used the Global Burden of Disease (GBD) Study Results Tool to examine the age-standardized death rates (ASDR) and disability-adjusted life years (DALYs) due to road injuries in 2019 by Joinpoint regression. In addition, we reported high, low, and non-optimal temperature exposures for road injuries across different groups by gender, age, region, and disease. Moreover, we examined temporal trends in the burden of road disease caused by high, low, and non-optimum temperatures from 1990 to 2019. Trend analyzes were conducted for five sociodemographic index (SDI) regions. Globally, both ASDR and DALY declined from 1990 to 2019, with average annual percent change (AAPC) values of - 1.3% and - 1.2%, respectively. In 2019, the indicators (death and DALYs) steadily declined, while SDI quintile increased in most regions. Road injuries related to death and DALYs rate attributed to high temperatures were 0.17 and 8.50, respectively, in 2019. From 1990 to 2019, DALYs for road injuries caused by low temperatures showed the most significant upward trend in most regions, especially in low-latitude countries. This study provides a comprehensive understanding of the road injury burden caused by high, low, and non-optimum temperatures, which remains high in regions with low SDI. Therefore, special attention should be paid to road injuries in poor countries or in areas with extreme temperatures.
The multifactorial process of ageing is one of the biggest biological and medical challenges of the 21st century with age-related conditions such as cardiovascular diseases, neurodegeneration and cancer being among the leading causes of death among industrialized countries. Rather than one single causative factor, a range of environmental, demographic, biological, behavioral and social factors determine the development and onset of age-related diseases (ARDs). While it remains a challenge to assess the cumulative effect of environmental influences on human ageing, growing evidence indicates that both ARDs and non-pathological ageing processes are driven by environmental influences. The present review takes a closer look at the different environmental factors including air, climate, water, soil, urban green, social and individual environments and their influence on common ARDs and other life-limiting pathologies. It is of major public health relevance, to understand the interactions between these factors to develop preventive strategies both at individual and societal level to support healthy ageing.
There is growing awareness of the impact health technologies can have on the environment and the negative consequences of these environmental impacts on human health. However, health system decision-makers may lack the expertise, data, or resources to incorporate environmental considerations when making decisions about the adoption and use of health technologies. In this article, we describe how health technology assessment (HTA) is evolving to address climate change by providing health system decision-makers with the information they can use to reduce the impact of health care systems on the environment. Our objective is to consider approaches for including the environment domain when conducting an HTA-in particular, the use of the deliberative process-and for determining when the domain should be included. We explore the challenges of gathering the relevant data necessary to assess the environmental impact of a health technology, and we describe a “triage” approach for determining when an in-depth environmental impact assessment is warranted. We also summarize related initiatives from HTA agencies around the world.
Urbanization and Sustainable Development Goals (SDGs) are important global issues in the current “Anthropocene”. Climate change and the COVID-19 pandemic have exacerbated global urban problems and hindered the ability to meet SDGs on time, while the broad interlinkages between urbanization and the SDGs remain poorly understood. This study shows that among the interlinkages of urbanization with 17 SDGs, synergies are observed with 151 targets (89%), among which 67 (40%) have stronger synergies, and trade-offs are observed with 66 targets (39%), among which 31 (18%) have stronger trade-offs. Furthermore, the synergies and trade-offs between urbanization and the achievement of SDGs are specifically analyzed based on four fundamental interaction fields: (a) public health and social welfare equality; (b) energy consumption and economic growth; (c) natural resource use and ecological/environmental impacts; and (d) international cooperation for development. Finally, based on these analyses, we propose four recommendations for sustainable urbanization, including (a) shared well-being and spatial justice for urban and rural residents; (b) guiding green and low-carbon urban development; (c) building resilient cities; and (d) promoting multilateral cooperation in cities, which can contribute to the achievement of SDGs by 2030.
Air contamination is mainly induced by human activity and environmental pollution. Consumption of Air pollution in fewer amounts leads to a significant range of harmful effects on public safety. Nevertheless, with the accelerated pace of economic growth and modernization and the high quantity of electricity need results in huge amounts of pollutants and waste creates significant air pollution. The latest research has shown that because humans only use a tiny part of their day to drive, their constant air quality intake is primarily attributed to the commuting microenvironment. The nature of life on this planet is dependent on clean air. This article presents the literature to include a review of the effect on different facets of human existence of air emissions. The effect is narrowly classified into health and climate change. The study shows that air contamination has a broad variety of consequences, from infectious illnesses and life-threatening disorders and the breakdown of particular organ systems and psychological health. There is no question that this problem has to be addressed with the utmost focus. Such results should be used to prompt further work and to deliver clean air initiatives to officials.
BACKGROUND: The working population is exposed daily to unavoidable climatic conditions due to their occupational settings. Effects of the weather such as rain, heat, and air pollution may increase the risk of diseases, injuries, accidents, and even death during labor. OBJECTIVE: This paper aims to summarize the impacts of climate change on workers’ health, safety and performance, identifying the risks, affected workplaces and the range of methodological approaches used to assess this problem. METHODS: A thorough systematic mapping was conducted in seven scientific international databases: Emerald, IEEE Xplore, Science Direct, Scielo, Scopus, SpringerLink, and Web of Science. Three research questions guided the extraction process resulting in 170 articles regarding the impacts of climate change on occupational health and safety. RESULTS: We found an accentuated trend in observational studies applying primary and secondary data collection. Many studies focused on the association between rising temperatures and occupational hazards, mainly in outdoor work settings such as agriculture. The variation of temperature was the most investigated impact of climate change. CONCLUSIONS: We established a knowledge base on how to explore the impacts of climate change on workers’ well-being and health. Researchers and policymakers benefit from this review, which explores the suitable methods found in the literature and highlights the most recurring risks and their consequences to occupational health and safety.
Climate change has drastically altered precipitation patterns across the globe and has caused an increase in rainfall variability, including the incidence of extreme rainfall events such as droughts and floods. Exploiting the exogenous variation in rainfall to which children were exposed during the nine months in utero, we find that rainfall variability adversely affects the anthropometric status of children under five years of age in 55 low and middle-income countries. Moreover, the consequences of fetal exposure to rainfall variability are strongly apparent in the child’s first year of life and linger to some extent at later ages. Our heterogeneity analyses further show that children of disadvantaged backgrounds, such as poor and uneducated households, are especially vulnerable to rainfall variability during gestation. CO 2021 Elsevier Ltd. All rights reserved.
As climate change escalates, there is a need for proper planning of future use of water resources. The occurrence of prolonged droughts and fluctuation of weather patterns can lead to serious water scarcity issues. Process integration techniques have been widely used for water management in the process plants. This paper extends the insight-based and mathematical programming techniques of process integration to incorporate health aspects in water management. In particular, health quality index is used as a quality metric in considering water recovery in a system of processes. The consideration of health aspects is important for cases involving direct contact of human body with water, such as in water recreational activities. In addition, multi-period planning (MPP) is also considered in this work, where water recovery takes place across different periods. A representative water park case study is used to illustrate the applicability of the proposed method.
Purpose of Review To summarize the most up-to-date literature on allergic diseases with an emphasis on understanding the increase in prevalence of allergic diseases. Recent Findings As atopy continues to rise, there is increasing evidence that genetic factors in addition to environmental factors contribute to the development of allergic disease. There is research to support that worsening air pollution and climate change as well as lifestyle changes such as an increase in saturated fats and sugars in the diet, antibiotic use, changes in the gut microbiome, and a shift towards a more sterile, more urbanized environment could all increase the likelihood of developing allergic diseases. While the options available for management of allergic diseases are increasing and improving, the prevalence of allergic disease continues to rise. Further investigation of how we can influence the changes in our environment leading to increases in atopy as well as the genetics involved is crucial in order to prevent the development of allergic diseases.
While the sociology of disasters was slow to incorporate the study of inequality in analyses, recent research in the field has centered the study of inequality. Powered by changing empirical terrain in the form of climate change and by theoretically engagement with other sociological subfields, our article showcases how this research analyzes inequality by tracing three research motifs of scale, time, and feedbacks. Using a data set of nearly 200 articles published in the field including all 57 articles published in 10 generalist sociology journals from 2008 to 2020, we relate this perspective on scale, time, and feedbacks to eight primary areas of work in the sociology of disasters: (1) community, social capital, and resilience; (2) migration and displacement; (3) race; (4) gender; (5) intersectionality; (6) health and wellness; (7) governance and policy; and (8) environment and climate change. Our discussion champions future research on feedbacks by providing a theoretical backing with social theory on relational inequality as well as by substantiating it empirically with the eight areas of research.
BACKGROUND: As climate change worsens, the frequency and intensity of natural disasters continues to increase. These extreme weather events particularly affect the physical and mental health of vulnerable groups such as mothers and infants. From low-income to high income countries, poorly organised disaster response can negatively impact infant and young child feeding practices. AIM: To examine challenges and supportive strategies for infant and young child feeding during natural disasters to inform further research and guide disaster recommendations and practice. METHODS: A comprehensive search strategy explored the electronic databases PubMed, CINAHL and Cochrane Library. Screening, data extraction and analysis were conducted using Covidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). Studies were analysed using thematic analysis. FINDINGS: This review included 13 studies (4 mixed methods, 1 critical ethnography, 2 quasi-experimental studies, 4 descriptive studies, 1 qualitative study, 1 evidence gap map analysis). Breastfeeding facilitators during natural disaster contexts are privacy for breastfeeding, community and family support, adaptation of professional breastfeeding support to the local context and pre-existing breastfeeding practice. Breastfeeding challenges during natural disasters include decreased breastfeeding self-efficacy, lack of knowledge and resources and over-reliance on formula baby milks. Formula baby milk feeding challenges during natural disasters are the lack of access to resources required for hygienic formula baby milk preparation as well as the lack of availability of formula baby milk in some contexts. CONCLUSION: This systematic integrative review demonstrates that interventions which facilitate optimal infant and young child feeding in natural disaster contexts must be culturally and socially appropriate; increasing women’s knowledge of optimal breastfeeding and safe formula baby milk feeding practices as well as breastfeeding self-efficacy.
An applied epidemiology course for doctor of nursing practice students was revised to include a module on the impact of climate change on population health. The Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model of instructional design is a gold standard framework for creating course content and guided the module development. A nurse content expert discussed the environmental impacts of climate change on health using literature, actual clinical scenarios, and the application of epidemiologic data. Topics included safeguarding workers and vulnerable populations within the context of the coronavirus disease 2019 pandemic. Students posted reflections on their understanding of module content in response to structured prompts electronically in the learning management system for review by the faculty. Faculty evaluation of responses identified the need to further develop and integrate environmental epidemiology and climate change content more fully within the doctor of nursing practice curriculum.(c) 2021 Elsevier Inc. All rights reserved.
INTRODUCTION: Despite climate change being recognised as the greatest health threat of the 21st century, current medical education curricula do not reflect the urgency of the climate crisis. Preparing for climate-related health repercussions requires educational institutions to disseminate planetary health knowledge in a systematic way. We sought to evaluate the extent of the literature on the inclusion of planetary health in undergraduate and postgraduate medical education to guide curricular development. METHODS AND ANALYSIS: A scoping review is being undertaken with a search strategy developed with a health sciences librarian. The search strategy was run on the following databases from inception to 22 June 2021: Medline, Embase, APA PsycINFO, CINAHL, Global Health, Scopus. This scoping review is being conducted as per methodology that has been previously outlined. Studies that discuss the implementation of planetary health education within undergraduate and postgraduate medical education will be included, whether they discuss formal inclusion or supplemental courses. To supplement our database search, data from the Health and Environment Adaptive Task Force’s National Report on Planetary Health Education, the Planetary Health Report Card and the Association for Medical Education in Europe Consensus Statement on Planetary Health and Education for Sustainable Healthcare will be included. As we anticipate varying methodologies, the data analysis will consist of both a quantitative and a qualitative component. Outcomes will be categorised within the domains of the Planetary Health Education Framework, which incorporates concepts of systems thinking, social justice and interconnection within nature as they apply to education for planetary health. ETHICS AND DISSEMINATION: As no intervention or patient recruitment will be required, research ethics board approval is not applicable. We plan to disseminate our results via publication in a peer-reviewed journal or conference presentation. TRIAL REGISTRATION NUMBER: This protocol has been registered in Open Science Framework (10.17605/OSF.IO/7M6GZ).
Limiting global temperature increases to 1.5 degrees C while respecting ‘the right to health’ requires substantial reductions in Short-Lived Climate Pollutants (SLCPs), including methane, black carbon and hydrofluorocarbons, and co-emitted air pollutants. This study evaluates the inclusion of SLCP and air pollutant mitigation within Nationally Determined Contributions (NDCs) that were submitted between 2015 and 2022. Between pre- and post-2020 NDCs, explicit reference to SLCPs and air pollutant mitigation as priorities more than doubled, indicating a rise in policy attention to these pollutants. There was also a large increase in the percentage of countries including methane and HFCs within the scope of their overall GHG reduction targets, and three countries include explicit black carbon reduction targets. With respect to policy, there was a 45% increase in the number of specific mitigation measures included in NDCs post-2020. Hence, the number of countries with implicit reductions in SLCPs and other air pollutants covered in their NDCs is now also substantially larger compared to pre-2020, due to greater inclusion of mitigation measures that reduce SLCPs and air pollutants alongside (other) GHGs. Key policy insights Local benefits for human health from air pollution improvements is a key priority for more countries in post-2020 NDCs compared to earlier NDC reporting. Many countries now include specific mitigation measures in NDCs that can simultaneously reduce SLCPs and co-emitted air pollutants alongside GHGs, helping to achieve local air quality and health improvements. To demonstrate the achievement of local air pollutant and SLCP reductions, countries focusing on NDC implementation should ensure air pollutants and SLCPs are integrated into climate change monitoring frameworks. Post-2020 NDCs provide many clear examples of how inclusion of SLCPs and air pollutants can both increase climate change mitigation ambition and achieve local development benefits, which could be adopted in other countries.
BACKGROUND: Climate change and air pollution are two major societal problems. Their complex interplay calls for an advanced evaluation framework that can support decision making. Previous assessments have looked at the co-benefits of climate policies for air pollution, but few have optimised air pollution benefits. In our study, we lay out a modelling framework that internalises air pollution’s economic impacts on human mortality, while considering climate constraints and aerosol feedback. METHODS: We developed a modelling framework based on an integrated assessment model (World Induced Technical Change Hybrid [WITCH]) designed to assess optimal climate change mitigation policies. We included structural and end-of-pipe measures in a detailed process integrated assessment model, that is hard-linked to air pollution and climate models. We analysed a large set of baseline scenarios, including five shared socioeconomic pathways (SSPs). SSP scenarios were also tested with three different levels of value per statistical life, and were combined with the Paris Agreement temperature targets (TTs), focusing on the 2°C and 1·5°C TTs by the end of the century. FINDINGS: We found that, in the baseline scenarios, where no policies are applied, the number of annual premature deaths grew before declining slightly to 4·45 (range 3·86-6·11) million annual premature deaths by 2050. Reaching the Paris Agreement TT decreases mortality by approximately 0·47 million premature deaths by 2050 (up to 1·28 million premature deaths in SSP3 -1·5°C) with respect to the baseline. We showed that welfare-maximising policies accounting for air pollution benefits reduces premature mortality by 1·62 million deaths annually. This is three times greater than the co-benefits of climate policies. China is the region where most of the avoided mortality is possible, whereas the reforming economies (ie, non-EU eastern European countries, including Russia) region has the greatest welfare benefits. We find that global and regional welfare increases when air pollution impacts are internalised, with no negative repercussions on global inequality. INTERPRETATION: Air pollution control strategies are found to be an important complement to structural emission reductions. Accounting for air pollution impacts reduces climate mitigation costs and inequality and increases global and regional welfare. Results are robust to a broad set of scenarios and assumptions, including debated normative choices on how to value improved health. FUNDING: EU Commission projects: INNOPATHS, NAVIGATE, ENGAGE, and COMMIT.
During the last few years, nuclear energy has received great attention due to the increase in climate change awareness. According to the Paris agreement, global temperature is to be kept below 2 degrees C and preferably below 1.5 degrees C by 2050. This approach has been substantially confirmed in the recent COP 26 in Glasgow. This research investigates the effects of integrating SMR nuclear power plants (small modular reactors) into the Nordhaus Dynamic Integrated Climate Economy (DICE) model for reducing the CO2 emissions in the atmosphere by substituting all existing fossil-fueled power plants (FPPP). The software is based on the VENSIM dynamic systems modeling platform. Simulations were carried out from the year 2019 to 2100 using 10-year increments. Several scenarios were thus simulated replacing roughly 70,000 FPPPs operating at this time in the world. Simulations indicate a CO2 reduction of approximately 12.63% relative to the initial conditions used and using 87,830 SMR core units of 80 MWe electric each to meet such demand. The DICE model further predicts the cost of climate damage impacting the upper ocean and atmospheric temperatures, and the deep ocean temperature as USD 1.515 trillion (US Dollar; (US) trillion = 1,000,000,000,000 (1 x 10(12))) by the end of this century. From a modified section of the model, a cost of USD 1.073 trillion is predicted as the toll on human health costs. This is thus equal to a USD 2.59 trillion loss in the economy.
Climate crisis is obviously an international problem that requires concerted actions by all regions and countries in the world. In the recent years, many various national and international organisations launched specific ini-tiatives for counteracting progress of climate change and environmental degradation, which are based on sus-tainability. Currently, one of the most important concepts for the implementation of the sustainable development (SD) principles is a green deal. In the available literature, there are no works that present a comprehensive description of various approaches for implementing the green deal, in various regions and countries of the world. Therefore, this paper presents a comprehensive inventory of the definitions of green deal concepts and Green Deal Strategies (GDSs) that were launched at the national, international and European levels in the 21st century. This paper also underlines the importance of the green deal in post-COVID recovery plans in various regions of the world. In general, the green deal could be defined as a strategy for mobilisation of whole community and enterprises to create clean and green economy through implementation of pro-environmental solutions in various sectors, which take into account the three aspirations of sustainable development -the well-being of people, the environment and economic sustainability. The reviewed concepts of “green deal”, “green new deal”, “global green new deal” and “European Green Deal” refer to various sets of policies that aim to make systemic changes to protect the planet. So far, the GDSs were launched at the national (United States, United Kingdom, South Korea), European (European Green Deal) and international (United Nations) levels. In the following years, the further regions and countries move toward rebuilding their economies after COVID-19, and there is strong need to include green solutions in post-COVID recovery plans. The GDS can play a strategic role in ‘greening’ of recovered economies.
The worrying environmental situation and increased public awareness in recent years have led many countries to take measures to reduce negative impacts on the environment. The European Union (EU) has been one of the most active in environmental protection with the formulation of policies aimed at preserving the health and well-being of citizens and protecting natural resources. One of the objectives of environmental policies is to make the economy of its member states more environmentally friendly, although this requires finding solutions to major challenges such as climate change, the scarcity of natural resources, the emission of polluting gases, and unsustainable consumption and production. This article reviews the main policies that have been implemented in the EU to reduce environmental problems and the scope of climate change conferences. It offers solutions to promote sustainability that could be adopted by companies, individuals, and governmental institutions to jointly contribute to achieving a more sustainable world, where problems such as climate change or the emission of polluting gases are minimized. The aim is to follow the principles of the Circular Economy and the European Green Deal.
Climate change poses a multifaceted, complex, and existential threat to human health and well-being, but efforts to communicate these threats to the public lag behind what we know how to do in communication research. Effective communication about climate change’s health risks can improve a wide variety of individual and population health-related outcomes by: (1) helping people better make the connection between climate change and health risks and (2) empowering them to act on that newfound knowledge and understanding. The aim of this manuscript is to highlight communication methods that have received empirical support for improving knowledge uptake and/or driving higher-quality decision making and healthier behaviors and to recommend how to apply them at the intersection of climate change and health. This expert consensus about effective communication methods can be used by healthcare professionals, decision makers, governments, the general public, and other stakeholders including sectors outside of health. In particular, we argue for the use of 11 theory-based, evidence-supported communication strategies and practices. These methods range from leveraging social networks to making careful choices about the use of language, narratives, emotions, visual images, and statistics. Message testing with appropriate groups is also key. When implemented properly, these approaches are likely to improve the outcomes of climate change and health communication efforts.
Asthma is a complex syndrome with multiple phenotypes and endotypes. Asthma exacerbations are not only the clearest indictor of the morbidity of asthma and of the risk for mortality due to asthma, but also comprise a significant amount of the cost to care for poorly controlled asthma. There continues to be significant disparity in the prevalence, mortality, and morbidity due to asthma. Patients with asthma who suffer recurrent exacerbations are considered to have exacerbation-prone asthma (EPA). Efforts to characterize patients with frequent exacerbations show that the etiology is likely multifactorial. Research to determine the intrinsic risk factors for EPA include studies of both genetic and inflammatory biomarkers. External factors contributing to exacerbations have been extensively reviewed and include viral infection, environmental exposures, air pollution, and psychosocial and economic barriers to optimizing health. It is likely that EPA occurs when patients who have an increased underlying intrinsic/biological risk are placed in a given exposome (environments with a variety of exposures and triggers including allergens, pollution, stress, barriers, and occupational exposures). It is the social construct combined with underlying biology that frequently drives an EPA phenotype.
The ‘alarm clock’ for human beings in the era of climate medicine has rung. Original diseases have appeared, that could not be explained and attributed to common causes, which are suggested to be linked to global warming and environmental factors. Such an indolent disease is the chronic kidney disease of unknown cause (CKDu), introduced also as Mesoamerican or Uddanam nephropathy. Scientists equate the climate impact on kidneys with the canary in the coal mine; coal miners used to carry caged canaries with them, so that if poisonous gases, such as methane or carbon monoxide leaked into the mine-shaft, the gases would kill the canary before killing the miners; similarly, kidneys are injured before devastating and lethal complications occur in humans. In some regions of Central America, the deaths due to chronic kidney disease increased by 177% with a death toll being as high as over 20,000. It was first documented in animals that periodic heat and dehydration have a major role in causing chronic kidney disease. Based on that observation, it is advocated that young male agricultural workers in Central America and South Asia, develop renal disease by getting exposed to extreme heat repeatedly. The clinico-pathological characteristics of this type of kidney injury, do not belong to an existing classification, even though a form of tubulo-interstitial renal disease has been proposed. In this review, we will discuss about CKDu, its epidemiology and pathophysiological mechanisms, clinical presentation and diagnostic biomarkers and examine potential therapeutic options.
Purpose of Review This review aims to identify the evidence for the assessment of the effectiveness and feasibility of multi-sectoral climate adaptation for food security and malnutrition. This review and the assessments of the evidence inform the contents and confidence statements in section “multi-sectoral adaptation for malnutrition” and in the Executive Summary of the IPCC AR6 WGII Chapter 7: Health Wellbeing and Changing Community Structure. Recent Findings A review of adaptation for food security and nutrition FSN in West Africa concluded that food security and nutrition and climate adaptation are not independent goals, but often go under different sectors. The Summary Most of the adaptation categories identified here are highly effective in reducing climate risks to food security and malnutrition, and the implementation is moderately or highly feasible. Categories include improved access to (1) sustainable, affordable, and healthy diets from climate-resilient, nutrition-sensitive agroecological food systems; (ii) health care (including child, maternal, and reproductive), nutrition services, water and sanitation; (iii) anticipatory actions, adoption of the IPC classification, EW-EA systems; and (iv) nutrition-sensitive adaptive social protection. Risk reduction, such as weather-related insurance, and risk management are moderately effective and feasible due to economic and institutional barriers. Women and girls’ empowerment, enhanced education, rights-based approaches, and peace building are highly relevant enablers for implementation of the adaptation options.
Risks brought by climate change are inevitable obstacles to global development. Clarifying the features of climate change risks helps us to further understand and cope with climate change. There lacks a systematic review of climate change risks in terms of feature extraction and classification. The bibliometric analysis can be used to analyze and extract climate change risk features. The literature in the field of climate change was searched in the Web of Science database. Coauthors, citations, bibliographic coupling, co-citations, and keyword co-occurrence were analyzed. From five dimensions including nature, politics, economy, society, and culture, the risk features of climate change were extracted and summarized. Through text mining and cluster analysis, the climate change risk feature system was established, which is embodied in five different aspects: ecosystem and sustainability; uncertainty, vulnerability, and efficiency; behavior and decision-making; governance and management; and adaptation and mitigation. The feature system reflects that the current climate change risk presents strong variability and that the risk boundary is gradually blurred. The areas affected by risk are expanding and deepening. The strategies and governance for addressing risks are gradually diversified. This research contributes to the domain of climate change risk identification and assessment. The features of climate change indicate that we need to adjust policymaking and managerial practices for climate change in the future. Interdisciplinary cooperation, human cognition and preferences, public participation in global governance, and other unnatural factors related to climate change should be strengthened with a more positive attitude.
Background: Mycotoxins are toxins produced by toxigenic fungi and are potentially present in different feed and foodstuffs, including animal products, with the latter typically resulting from carry-over from feedstuffs. These toxins have been linked to various human health issues, including reduced immunity and liver cancer. The production of these toxins is dependent on several factors, including weather conditions like temperature and precipitation, which in turn may be influenced by climate change. Scope and approach: This review undertakes a systematic approach to identify scientific studies that assess mycotoxin production in feed and cereals which may be influenced by weather variables or climate change scenarios. It also looks at human health risk assessments carried out in the past 20 years related to mycotoxins detected in animal products and the degree to which climate change influences are captured in these risk assessments. Key findings and conclusions: This review presents a state of the art with regards to risk assessment and modelling approaches to managing mycotoxin contamination in the light of climate change influences. There are very limited human health risk assessments looking at mycotoxin contamination of animal products under climate change influences, whereas a few predictive crop-toxin models considered future climate change scenarios. Predictive crop-toxin models can be used in conjunction with health risk assessments to evaluate mycotoxin risk in animal products under future climate change scenarios. The review identifies scientific gaps including the need for better integration of mycotoxin predictive models, risk assessment and climate change variables to better understand potential climate change influences on food safety.
The unadjusted intake of food constitutes a real challenge for the several sustainability dimensions. In this perspective, the main objectives of this research are to characterise the current contexts of food security, its relationship with sustainability, and identify proposals and actions that may support the design of more adjusted policies in the future. In addition, it is intended to assess if the food security pillars properly address the sustainability goals and if the evolution of undernutrition is accompanied by sustainable frameworks. In this way, statistical information from the FAOSTAT database was considered for the several dimensions of food security over the period 2000-2020. These data were analysed through factor-cluster approaches and panel data methodologies, namely those related to quantile regressions. As main insights, we may refer that undernutrition is more impacted by the availability of food and nutrients and political stability than by the level of GDP-Gross Domestic Product (except for the extreme cases). This means that the level of development is not the primary explanation for the problems of nutrition. The main focus of the national and international policies must be to improve the agrifood supply chains and to support political stability, in order to mitigate undernutrition worldwide and ensure a global access to sustainable and healthy diets. In addition, it is suggested to rethink the four pillars of food security (availability, access, utilisation and stability), in order to encompass other dimensions, such as climate change.
Food security is related to human wellbeing and sustainable development and an important guarantee for world peace. In the context of global climate change, increased food demand, resource depletion, conflicts, and frequent public health emergencies, food security is widely seen as one of the top challenges. Food security research has obvious interdisciplinary characteristics, involving a wide range of fields. We analyzed the literature on food security in the Web of Science core collection from 1991 to 2021, using bibliometric methods with the aid of the Biblioshiny software package. By collecting, screening, analyzing, and visually expressing the literature data, the following conclusions were drawn: (1) In the past 30 years, the annual number of publications on food security increased. The period can be divided into three stages: 1991-2003 as the budding period, 2004-2012 as the development period, and 2013-2020 as the high-yield and active period. The top three journals discussing food security issues are Food Security, Sustainability, and Food Policy, and these journals focus on the publication of comprehensive views from interdisciplinary perspectives. (2) Studies on food security cover 138 countries or regions. The top three countries in terms of the number of published articles are the United States, the United Kingdom, and China. Among the top 20 countries in terms of the number of published articles, European countries are highlighted. (3) Climate change, food security, agriculture, policy, and management are the other high-frequency keywords in the field of food security; climate change occurred 321 times. The word sub-Saharan Africa also occurred more frequently, indicating that food security in sub-Saharan Africa has attracted wide attention. (4) The food security theme mapping clearly showed the research status and future development trends of various topics in the field. Currently, food production, climate change, and sustainable development are the most popular themes. Research on food sovereignty, ecological agriculture, child obesity, and other aspects is an emerging field. (5) We predict that in the future, the field of food security may focus on the expansion and improvement of the food security evaluation system, the balance between sustainable development and food security goals, the improvement of agricultural production and management efficiency, and the research on government policies and strategies. Our results provide a reference for grasping the current situation, key research direction, and development trend in the field of food security.
The world food supply depends on a diminishing list of plant crops and animal livestock to not only feed the ever-growing human population but also improve its nutritional state and lower the disease burden. Over the past century or so, technological advances in agricultural and food processing have helped reduce hunger and poverty but have not adequately addressed sustainability targets. This has led to an erosion of agricultural biodiversity and balanced diets and contributed to climate change and rising rates of chronic metabolic diseases. Modern food supply chains have progressively lost dietary fiber, complex carbohydrates, micronutrients, and several classes of phytochemicals with high bioactivity and nutritional relevance. This review introduces the concept of agricultural food systems losses and focuses on improved sources of agricultural diversity, proteins with enhanced resilience, and novel monitoring, processing, and distribution technologies that are poised to improve food security, reduce food loss and waste, and improve health profiles in the near future.
Rice is the staple diet to half of the world’s population, being a major source of carbohydrates, vitamins, and some essential elements. However, rice naturally contains low amounts of essential minerals such as iron (Fe) and zinc (Zn), which are drastically decreased after milling. Thus, populations that consume mostly rice may have micronutrient deficiency, which is associated with different diseases. On the other hand, rice irrigated by flooding has a high ability to accumulate arsenic (As) in the grain. Therefore, when rice is grown in areas with contaminated soil or irrigation water, it represents a risk factor for consumers, since As is associated with cancer and other diseases. Different strategies have been used to mitigate micronutrient deficiencies such as Fe and Zn and to prevent As from entering the food chain. Each strategy has its positive and its negative sides. The development of genetically biofortified rice plants with Fe and Zn and with low As accumulation is one of the most promising strategies, since it does not represent an additional cost for farmers, and gives benefits to consumers as well. Considering the importance of genetic improvement (traditional or molecular) to decrease the impact of micronutrient deficiencies such as Fe and Zn and contamination with As, this review aimed to summarize the major efforts, advances, and challenges for genetic biofortification of Fe and Zn and decrease in As content in rice grains.
In this study, we evaluated the effects of geo-climatic parameters and other potential risk factors on the prevalence of chronic toxoplasmosis (CT) in pregnant women. We searched PubMed/MEDLINE, Web of Science, EMBASE, Scopus, and SciELO databases for seroepidemiological studies published between January 1988, and February 2021. We performed meta-analysis and meta-regression by using a random effect model to synthesize data. A total of 360 eligible datasets, including 1,289,605 pregnant women from 94 countries, were included in this study. The highest and lowest prevalence rates were estimated for latitudes of 0-10° (49.4%) and ≥50° (26.8%); and for the longitude of 80-90° (44.2%) and 110-120° (7.8%), respectively. Concerning climatic parameters, the highest and lowest prevalence rates were estimated in regions with the mean relative humidities of >80% (46.6%) and <40% (27.0); annual precipitation between 1000 and 1500 mm (39.2%) and 250-500 mm (26.8%); and mean annual temperature of 20-30 °C (36.5%), and <7 °C (24.9%), respectively. Meta-regression analyses indicated significant increasing trends in prevalence of CT in pregnant women with decrease in geographical latitude (coefficient, = -0.0035), and geographical longitudes (C = -0.0017). While it was positively associated (P < 0.01) with the mean environmental temperature (C = 0.0047), annual precipitation (C = 0.000064), and mean relative humidity (C = 0.002). Our results highlighted various effects of environmental parameters on the prevalence of CT. Therefore, different regions in the world may benefit from different types of interventions, and thus, novel preventive measures in a region should be developed according to local climate, agricultural activities and people culture.
The magnitude and distribution of physical and societal impacts from long-lived greenhouse gases are insensitive to the emission source location; the same is not true for major coemitted short-lived pollutants such as aerosols. Here, we combine novel global climate model simulations with established response functions to show that a given aerosol emission from different regions produces divergent air quality and climate changes and associated human system impacts, both locally and globally. The marginal global damages to infant mortality, crop productivity, and economic growth from aerosol emissions and their climate effects differ by more than an order of magnitude depending on source region, with certain regions creating global external climate changes and impacts much larger than those felt locally. The complex distributions of aerosol-driven societal impacts emerge from geographically distinct and region-specific aerosol-climate interactions, estimation of which is enabled by the full Earth System Modeling Framework used here.
In recent decades, human-induced climate change has caused a worldwide increase in the frequency/intensity/duration of extreme events, resulting in enormous disruptions to life and property. Hence, a comprehensive understanding of global-scale spatiotemporal trends and variability of extreme events at different intensity levels (e.g., moderate/severe/extreme) and durations (e.g., short-term/long-term) of normal, dry and wet conditions is essential in predicting/forecasting/mitigating future extreme events. This article analyses these aspects using estimates of a non-stationary standardized precipitation evapotranspiration index corresponding to different accumulation periods for 0.5° resolution CRU grids at globe-scale. Results are analyzed with respect to changes in land-use/landcover and geographic/location indicators (latitude, longitude, elevation) at different time scales (decadal/annual/seasonal/monthly) for each continent. The analysis showed an (i) increasing trend in the frequency/count of both dry and wet conditions and variability of dry conditions, and (ii) contrasting (decreasing) trend in the variability of wet conditions, possibly due to climate change-induced variations in atmospheric circulations. Globally, the highest variability in the wet and dry conditions is found during the Northern hemisphere’s winter season. The decadal-scale analysis showed that change in variability in dry and wet conditions has been predominant since the 1930s and 1950s, respectively and is found to be increasing in recent decades.
Marginalized communities lack full participation in social, economic, and political life, and they disproportionately bear the burden of environmental and health risks. This special issue of Environmental Engineering Science, the official journal of the Association of Environmental Engineering and Science Professors (AEESP), reports research on the unique environmental challenges faced by historically marginalized communities around the world. The results of community-based participatory research with an Afro-descendant community in Columbia, Native American communities in Alaska, United States, villagers in the Philippines, disadvantaged communities in California, United States, rural communities in Mexico and Costa Rica, homeless encampments in the San Diego River (United States) watershed entrepreneurs in Durban, South Africa, and remote communities in the island nation of Fiji are presented. The research reported in this special issue is transdisciplinary, bringing engineers together with anthropologists, sociologists, economists, and public health experts. In the 13 articles in this special issue, some of the topics covered include inexpensive technologies for water treatment, novel agricultural strategies for reversing biodiversity losses, and strategies for climate change adaptation. In addition, one article covered educational strategies for teaching ethics to prepare students for humanitarian engineering, including topics of poverty, sustainability, social justice, and engineering decisions under uncertainty. Finally, an article presented ways that environmental engineering professors can engage and promote the success of underrepresented minority students and enable faculty engaged in community-based participatory research.
With the rapidly changing climate, assessing the global trends of cardiovascular diseases (CVDs) attributed to high and low temperatures in different climate zones and under varying socio-demographic levels is crucial for regulations, preparation, intervention, and clinical practice for CVD. Our study included 204 countries with global CVD data ranging from 1990 to 2019. We obtained the age-standardized mortality rate (ASMR); disability-adjusted life rate of CVD attributed to high, low, and non-optimal temperatures; and socio-demographic index (SDI) data from the Global Health Data Exchange. We also downloaded the temperature data from the Climatic Research Unit. These 204 countries were divided into five climate zones and five SDI levels according to the annual average temperature data and SDI in 2019. The temporal trends of CVD burden attributed to high, low, and non-optimal temperatures were estimated by using the cubic regression spline and the generalized additive mixed model (GAMM). The total burden of temperature-related CVD has been declining in the last 30 years. However, the burden of CVD attributed to high temperature showed an increasing trend. Among different climate regions, the ASMRs of CVD attributed to high temperature were the highest in the tropical regions, followed by subtropical regions, and the lowest in the boreal regions. In the past 30 years, the burden of CVD attributed to high temperatures has shown a significant increasing trend, while declining trends are observed for non-optimal and low temperatures. The CVD burden attributed to high temperatures is particularly pronounced in warmer and low-SDI regions with an increasing trend of CVD burden due to high temperature.
BACKGROUND AND AIMS: Human and planetary health are inextricably interconnected through food systems. Food choices account for 50% of all deaths for cardiovascular diseases (CVD) – the leading cause of death in Europe – and food systems generate up to 37% of total greenhouse gas (GHG) emissions. METHODS AND RESULTS: Based on a systematic revision of meta-analyses of prospective studies exploring the association between individual foods/food groups and the incidence of CVD, we identified a dietary pattern able to optimize CVD prevention.. This dietary pattern was compared to the current diet of the European population. The nutritional adequacy of both diets was evaluated according to the European Food Safety Authority (EFSA) recommended nutrient intake for the adult population, and their environmental impact was evaluated in terms of carbon footprint (CF). As compared to the current diet, the desirable diet includes higher intakes of fruit, vegetables, wholegrains, low glycemic index (GI) cereals, nuts, legumes and fish, and lower amounts of beef, butter, high GI cereals or potatoes and sugar. The diet here identified provides appropriate intakes of all nutrients and matches better than the current Europeans’ one the EFSA requirements. Furthermore, the CF of the proposed diet is 48.6% lower than that of the current Europeans’ diet. CONCLUSION: The transition toward a dietary pattern designed to optimize CVD prevention would improve the nutritional profile of the habitual diet in Europe and, at the same time, contribute to mitigate climate change by reducing the GHG emissions linked to food consumption almost by half.
The modern slavery-environmental degradation-climate change nexus may threaten the achievement of the Sustainable Development Goals (SDGs). Globally, approximately 12.2 million workers are entrapped in modern slavery in environmentally degrading activities, and SDG target 8.7 (the elimination of all forms of modern slavery) may be instrumental in accelerating attainment of other SDG targets. However, without appropriate mitigation strategies, the attainment of some of the SDG’s environmental targets may also negatively influence progress on 8.7. Unfortunately, these feedbacks are poorly understood and data are limited and difficult to obtain. In this perspective we show how an SDG interaction framework may help overcome these data challenges by signaling how potential policy action and other interventions would influence progress on 8.7 and other environmental targets based on known processes and patterns. This understanding is crucial to move beyond data limitations, direct future research, and develop an often-lacking evidence-base to effect holistic change.
The transport vehicles have been using the internal combustion engine for many decades. The internal combustion engine is used because of its high reliability. The transport sector plays a vital role in the country’s economy. It is estimated that about 90% of the transportation sector uses fossil fuels. With the increasing industrialization, there will be a shortage of fossil fuels. Every year, there is an increase in the energy demand by 2%, stated by International Energy Agency Report. There would be 39% increase in the greenhouse gas emission by the year 2030 from fossil fuels. With the rising concern about climate change and the increasing amount of toxic emissions, manufacturers of the car are getting aware and are shifting towards less polluting vehicles or green vehicles. Biodiesel is also gaining interest and is being preferred because of its continued availability, emission characteristics showed that biodiesel has low CO emission. With addition of ethanol, the emission of CO further decreases, but NOx emission increases. NOx decreased with jatropha methyl ester and 50% turpentine oil. On the other hand, the use of electric vehicle or hybrid electric vehicle would also decrease the emission by 51% but would increase the load on power grid by 3% for every 30% penetration, which would increase the emission/air pollution from the thermal power plant. Emission in the human body can cause illness, increase the death, and be hazardous to the health of humans. This paper gives a review of the emissions from biodiesel and electric vehicles and the health effects.
The relationship between risks to health equity and climate change is well established, and various international organizations and literature has called for intersectoral action for tackling these issues. While there is a growing recognition of the importance of equity-focused responses to climate change, if and how health equity measures are incorporated into climate-change-related policy decisions has not yet been adequately explored. There are numerous approaches and frameworks for conducting policy analysis, and for understanding equity in the context of climate change and public health separately; however, a comprehensive framework for exploring the complexity of these interacting factors is hard to find. This review aims to systematically identify policy analysis frameworks and studies focusing on health equity in climate change related policies. Five electronic databases will be searched for peer-reviewed articles in English and from 2000. Articles will be subjected to systematic retrieval and quality assessment, and thematic analysis will be used for data analysis. The study findings will provide insight into different existing policy-analysis frameworks and policy-analysis approaches to understand health equity considerations in climate change policies and in health policies related to climate change.
BACKGROUND: Cardiovascular events occur more often in winter than in summer; however, the dependence of strokes on various meteorological factors remains unclear. AIMS: The purpose of this meta-analysis was to determine the dependence of the circannual dynamics of hospitalizations for hemorrhagic stroke and ischemic stroke on seasonal fluctuations in meteorological factors. SUMMARY OF REVIEW AND CONCLUSIONS: For our meta-analysis, we selected 20 and 26 publications examining the seasonal dynamics of hemorrhagic stroke and ischemic stroke, respectively . The meta-analysis showed that hemorrhagic stroke is less likely to occur in summer than in other seasons and does not depend on a region’s climate. The seasonal dynamics of ischemic stroke are not clearly expressed and are determined by the characteristics of a region’s climate. In a climate without pronounced seasonal dynamics of atmospheric pressure and in wet winters, the vector of ischemic stroke incidents will not be expressed or slightly shifted toward winter. Low atmospheric pressure in summer is associated with an increased likelihood of ischemic stroke during this season compared to winter. There was also a relation between ischemic stroke risk with high relative humidity and a significant decrease in ρO(2) in summer, but there is not enough evidence regarding this association. We did not reveal dependence of the seasonal dynamics of strokes on the amplitude of annual fluctuations in air temperature.
Climate change has a variety of effects on communities and the environment, most of which have been directly addressed, such as floods, droughts, and fires. To date, the impacts of climate change on health in in vivo conditions have not been assessed, and no protocol has been developed in this regard. Therefore, the purpose of the current study is to develop a protocol as well as design and build a pilot to deal with climate change in vivo to show the direct effects of climate change on health. For this purpose, twenty specialists, comprising ten experts active in field climate and 10 experts in field medicine and anatomy, have been consulted to design the proposed exposure protocol using the Delphi method. According to the prepared protocol, an exposure pilot was then designed and built, which provides the climatic conditions for animal exposure with a fully automatic HMI-PLC system. The results showed the average 12:12-h day/night temperature, humidity, and circadian cycle for three consecutive ten-year periods selected for exposure of 1-month-old male rats. The duration of the exposure period is four months, which is equivalent to a ten-year climatic period. This study is a framework and a starting point for examining the effects of climate change on in vivo conditions that have not yet been considered.
Objective Mobile applications, social media platforms are changing Internet user behavior; creating a new era of education in a connected world. We have previously reported training needs of health providers in the climate change. Aim is to develop and test an Android(R) Mobile app as an effective smart learning environment for climate change health impacts. Materials and methods The quasi-experimental design method was used in five phases: easy-to-reach, rich content Mobile app design and development for Android(R) operating system, scale development, finalizing scales to be used, implementation, data collection, analysis. Dependent t-test of pre-test and post-test awareness scores was analyzed. Usability and satisfaction were assessed with two scales; quantitative data with descriptive statistics. Results The developed Mobile app was effective in enhancing students’ learning experience, and well-received in terms of adopting and using such technology for educational purposes. Pre-test and post-test scores different statistically (p<0.05); increasing participants’ awareness level and were satisfied. Conclusion We conclude that our Mobile app, m-learning project, is successfully incorporated into the learning context; when tested, raised awareness about climate change and health effects for the public. To our knowledge, no currently existing tool to provide new mobile application for climate change education and promote awareness exists.
Water quality and disposability are among the main challenges that governments and societies will outside during the next years due to their close relationship to population growth and urbanization and their direct influence on the environment and socio-economic development. Potable water suitable for human consumption is a key resource that, unfortunately, is strongly limited by anthropogenic pollution and climate change. In this regard, new groups of compounds, referred to as emerging contaminants, represent a risk to human health and living species; they have already been identified in water bodies as a result of increased industrialization. Pesticides, cosmetics, personal care products, pharmaceuticals, organic dyes, and other man-made chemicals indispensable for modern society are among the emerging pollutants of difficult remediation by traditional methods of wastewater treatment. However, the majority of the currently used waste management and remediation techniques require significant amounts of energy and chemicals, which can themselves be sources of secondary pollution. Therefore, this review reported newly advanced, efficient, and sustainable techniques and approaches for water purification. In particular, new advancements in sustainable membrane-based filtration technologies are discussed, together with their modification through a rational safe-by-design to modulate their hydrophilicity, porosity, surface characteristics, and adsorption performances. Thus, their preparation by the use of biopolymer-based gels is described, as well as their blending with functional cross-linkers or nanofillers or by advanced and innovative approaches, such as electrospinning.
Existing literature on climate change as an issue of environmental justice documents the heightened vulnerability of people with disabilities to the effects of climate change. Additionally, there are numerous studies showing that access to information is a prerequisite for perceiving risk and taking action. Building on this work, our review seeks to understand how physical disability relates to perceptions of climate-related risk and adaptations to climate-related events. We introduce a critical realist model of climate justice to understand the relationships between the environmental features that disable, risk perception and information seeking, and adaptive capacity and resilience to climate change. In understanding the vulnerability and adaptive capacity of people with disabilities to climate change, this review synthesizes research on one of the U.S.’s largest minority communities with the goals of better understanding how vulnerable populations cope with climate change and integrating them into climate action and policy.
Green economy development has become a mainstream value orientation in social and global economic development to protect and improve the ecological environment. Multiple stakeholders are needed to address complex issues, such as climate change and its impact on the ecological environment and public health. This study investigates the impact of energy policy and green finance on green economic recovery via the controlling role of social capital and public health. An entropy approach was used to measure the green economic index in addition to an econometric approximation for interpreting the longitudinal dataset for the scenarios for E7 countries between 2010 and 2020. The findings show that the development of green finance significantly improves green productivity. Higher levels of economic and social conditions, a lower level of public involvement in environmental protection, and a higher level of pollution amplify this positive effect. On the other hand, energy policy can enhance the impact of green finance development. The findings suggest that the empirical findings benefit green finance planning and energy policy.
Mercury (Hg) is a toxic metal that can be released from natural and anthropogenic processes. Gaseous elemental Hg is the main form of Hg in the atmosphere with a long residence time, allowing its long-range transport and deposition at a global scale. The deposited Hg can be transformed into methylmercuy (MeHg), which bioaccumulates and biomagnifies in aquatic ecosystems and is a known developmental neurotoxin to humans. Chronic exposure in pregnant women via fish consumption, even at the modest levels, can impact intellectual development in infants, which is considered as a global environmental health issue. To protect human health and the environment, the Minamata Convention on Mercury, a legally binding international treaty, entered into force in 2017 to reduce anthropogenic emissions and releases of Hg and Hg compounds. With the enforcement of the Convention, anthropogenic Hg emissions and releases are projected to decrease in the foreseeable future, but the recovery of the ecosystem and mitigation of health impact from Hg pollution are expected to lag behind. In this paper, we provide a critical review on the processes affecting when and to which extent Hg-affected ecosystems will recover under the Minamata Convention in the context of climate change and associated human health benefit. Our review is organized around seven major scientific questions. These seven questions covered historical Hg change in the ecosystem, major factors and processes, and future assessment. The impact of implementation of Minamata Convention and climate change on Hg emission, atmospheric transportation and deposition, biota accumulation, and human exposure should be comprehensively evaluated. The Hg stable isotope tool and process-based integrated global model should be integrated together, which also should consider future global social-economic pathways and mitigation options. We hope that the knowledge gaps and potential tools identified will assist the understanding of global biogeochemical cycling of Hg, inform policy-making on mitigation and community adaptation, and support the effectiveness evaluation and future improvement of the Minamata Convention on Mercury.
INTRODUCTION: Climate change is a global problem that affects human health, especially the most vulnerable groups, including the elderly. However, no scope review includes the perspective of institutions specialised in climate change and health and whose reports are the basis for policies orientated on the environmental health. Therefore, this study aims to identify these effects on older people health. The results will allow health professionals to have valuable information enabling them to provide quality care in meeting the demand that this situation is producing. METHODS AND ANALYSIS: A scoping review of the relevant literature will be performed from 2008 to 2021. The Joanna Briggs Institute guidelines and the PRISMA-Scoping Review Extension checklist will be used. A peer-reviewed search will be conducted using the electronic databases Medline, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane, PsycINFO and Cuiden Plus between October and December 2021. Original quantitative studies and reports from official agencies on the effects of climate change on the elderly health in any health and geographical context will be included. Literature selection will be made by two reviewers. The table format used for data extraction will be reviewed by the review team and tested by two reviewers. ETHICS AND DISSEMINATION: This study does not require approval by an ethics committee to be conducted. This article will result in the mapping of the direct and indirect effects of climate change on the health of the elderly. The results will be published in scientific journals to be accessible to health professionals in the creation of care plans for the elderly at climate risk.
The occurrence and development of antibiotic resistance genes (ARGs) in pathogens poses serious threatens to global health. Agricultural soils provide reservoirs for pathogens and ARGs, closely related to public health and food safety. Especially, metals stress provides more long-standing selection pressure for ARGs, and climate change is a “threat multiplier” for the spread of ARGs. However, little is known about the impact of metals contamination on pathogens and ARGs in agricultural soils and their sensitivity to ongoing climate changes. To fill this gap, a pot experiment was conducted in open-top chambers (OTCs) to investigate the influence of mercury (Hg) contamination on the distribution of soil pathogens and ARGs under ambient and elevated CO(2) concentration. Results showed that the relative abundance of common plant and human pathogens increased significantly in Hg-contaminated soil under two CO(2) concentrations. Hg contamination was a positive effector of the activation of efflux pumps and offensive virulence factors (adhere and secretion system) under two CO(2) levels. Activation of efflux pumps caused by Hg contamination might contribute to changes of virulence or fitness of certain pathogens. Overall, our study emphasizes the critical role of efflux pumps as an intersection of antibiotic resistance and pathogen’s virulence under Hg stress.
The global population increase puts tremendous pressure on the already dwindling natural resources such as soil and freshwater. Healthy and productive soils as well as the availability of freshwater resources are critical for agricultural productivity. On the other hand, climate change and variability make the water scarcity problem even worse. Agriculture, being the biggest consumer of fresh water, is expected to be affected significantly. Yet, agriculture is expected to play a significant role in achieving greater food, and fiber needs to meet the growing global population. In addition, soil and water quality are also becoming a bigger threat to soil productivity and freshwater availability. Some portion of nutrients applied to agriculture and urban landscapes end up in runoff and leaching water that feeds streams, rivers, lakes, groundwater, etc. These excess nutrient loadings are causing soil and water quality deterioration, which could have severe impacts on human health, aquatic ecosystems, and environmental sustainability. In addition to nutrient and chemical pollutions, emerging contaminants such as heavy metals are showing an increasing trend in soil and freshwater bodies. These emerging contaminants not only impair soil quality and freshwater sources but could also get into the food chain and affect human and animal health. While growing evidence is becoming available on the increasing threats from emerging contaminants, research and understanding are still limited. This mini-review paper summarizes available research on types of emerging contaminants and their impacts on soil and water quality.
Emerging infectious diseases (EIDs) increasingly threaten global food security and public health. Despite technological breakthroughs, we are losing the battle with (re)emerging diseases as treatment costs and production losses rise. A horizon scan of diseases of crops, livestock, seafood and food-borne illness suggests these costs are unsustainable. The paradigm of coevolution between pathogens and particular hosts teaches that emerging diseases occur only when pathogens evolve specific capacities that allow them to move to new hosts. EIDs ought to be rare and unpredictable, so crisis response is the best we can do. Alternatively, the Stockholm Paradigm suggests that the world is full of susceptible but unexposed hosts that pathogens could infect, given the opportunity. Global climate change, globalized trade and travel, urbanization and land-use changes (often associated with biodiversity loss) increase those opportunities, making EID frequent. We can, however, anticipate their arrival in new locations and their behaviour once they have arrived. We can ‘find them before they find us’, mitigating their impacts. The DAMA (Document, Assess, Monitor, Act) protocol alters the current reactive stance and embodies proactive solutions to anticipate and mitigate the impacts of EID, extending human and material resources and buying time for development of new vaccinations, medications and control measures.
Gout is a chronic disease with inflammatory arthritis caused by monosodium urate (MSU) crystals deposition, an elevated serum urate level (hyperuricaemia) is the critical factor leading to MSU crystals deposition and promoting the progression of gout. The onset and development of gout is generally the result of multiple factors, such as diet, heredity and environmental factors. Although genetics and diet are thought to play as major factors, a growing body of research evidence has highlighted that environmental factors also play a significant role in the onset and exacerbation of gout. Recent studies have shown that air pollutants such as particulate matter, sulfur dioxide (SO 2 ) and carbon monoxide (CO) may increase the risk of hospitalizations for gout, and that the changes in temperature and humidity may affect uric acid (UA) levels. There is also seasonal trend in gout. It has been demonstrated that environmental factors may induce or accelerate the production and release of proinflammatory mediators, causing an unbalance oxidative stress and systemic inflammation, and then participating in the overall process or a certain link of gout. Moreover, several environmental factors have shown the ability to induce the production urate and regulate the innate immune pathways, involving in the pathogenesis of gout. Nevertheless, the role of environmental factors in the etiology of gout remains unclear. In this review, we summarized the recent literatures and aimed to discuss the relationship between environmental factors (such as microclimate, season, ambient/indoor air pollution and extreme weather) and gout. We further discussed the inflammatory mechanisms of environmental factors and gout and the comprehensive effects of environmental factors on gout. We also made a prospect of the management and treatment of gout, with special consideration to environmental factors associated with gout.
BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications globally. Environmental risk factors may lead to increased glucose levels and GDM, which in turn may affect not only the health of the mother but assuming hypotheses of “fetal programming”, also the health of the offspring. In addition to traditional GDM risk factors, the evidence is growing that environmental influences might affect the development of GDM. We conducted a systematic review analyzing the association between several environmental health risk factors in pregnancy, including climate factors, chemicals and metals, and GDM. METHODS: We performed a systematic literature search in Medline (PubMed), EMBASE, CINAHL, Cochrane Library and Web of Science Core Collection databases for research articles published until March 2021. Epidemiological human and animal model studies that examined GDM as an outcome and / or glycemic outcomes and at least one environmental risk factor for GDM were included. RESULTS: Of n = 91 studies, we classified n = 28 air pollution, n = 18 persistent organic pollutants (POP), n = 11 arsenic, n = 9 phthalate n = 8 bisphenol A (BPA), n = 8 seasonality, n = 6 cadmium and n = 5 ambient temperature studies. In total, we identified two animal model studies. Whilst we found clear evidence for an association between GDM and air pollution, ambient temperature, season, cadmium, arsenic, POPs and phthalates, the findings regarding phenols were rather inconsistent. There were clear associations between adverse glycemic outcomes and air pollution, ambient temperature, season, POPs, phenols, and phthalates. Findings regarding cadmium and arsenic were heterogeneous (n = 2 publications in each case). CONCLUSIONS: Environmental risk factors are important to consider in the management and prevention of GDM. In view of mechanisms of fetal programming, the environmental risk factors investigated may impair the health of mother and offspring in the short and long term. Further research is needed.
Climate change is a huge and present threat to human health. This article aims to deepen the knowledge about the environmental impact of inhaler devices on their carbon footprint for patients and health professionals, providing information that allows a better choice of the type of device to be prescribed for the treatment of asthma and COPD. This narrative and nonsystematic review was carried out by searching databases (PubMed, Google Scholar, SciELO, and EMBASE) for articles published between 2017 and 2022, written in Portuguese or in English, using the search words “inhalation device” OR “environmental.” The review showed that global warming cannot be addressed by focusing only on inhaler devices. However, the devices that we use to treat respiratory diseases such as asthma and COPD, which are diseases that are aggravated by climate change, are also causing that change. Therefore, health professionals, patient organizations, and industries should take a lead in health policies to offer affordable alternatives to inhalers containing hydrofluoroalkane.
PURPOSE OF REVIEW: The purpose of this review is to increase awareness among reproductive health professionals and trainees about the impact of environmental toxicants and climate change on women’s health and mitigation strategies at the individual, professional and governmental levels. RECENT FINDINGS: Global health indicators reveal a meteoric rise of noncommunicable diseases over the past 50 years, which threaten reproductive health directly and indirectly. Evolutionary genetic mutations as contributors are unlikely in this timeframe, and environmental causes have been invoked. Notably, the past 75 years have witnessed marked increases in industrial chemical production, and global warming has rendered a ‘climate crisis’ with extreme temperatures and compromised food, water, and air quality. There is now strong experimental and epidemiologic evidence for endocrine disrupting chemicals and particulate matter and chemical components of air pollution in the pathophysiology of human reproductive disorders during development and across the lifespan, especially among vulnerable populations. SUMMARY: Environmental impacts on fertility, pregnancy outcomes, childhood neurodevelopment, and reproductive tract development are significant, not widely appreciated, and may be preventable. In light of the evidence, education and advocating economical mitigations of toxic environmental chemicals and alternative energy strategies are imperatives to assure quality reproductive health for this and future generations.
Background:Global environmental change is fundamentally altering the composition and functioning of our planetary ecosystem. Effectively presenting the largest threat to the health of present and future generations, these changes and their health impacts are forcing us to think and practice healthcare in much broader terms than ever before. Objective:In this article, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy developed through a succession of carefully developed arguments. Discussion:We show how an underpinning belief in human exceptionalism has engendered an exploitative relationship with our natural planetary environment that has both shaped Western science and healthcare and led to our current environmental health crisis. Building on the dependence of human health on our planetary ecosystem, approaches like planetary health hold great promise for a corresponding, paradigmatic turn in healthcare. They fall short of this however, where they perpetuate anthropocentric interests and interventionist practices that have underpinned healthcare to date. Drawing on ethical and post-human philosophies we argue against human exceptionalism and for a solidarity that includes other-than-humans as the primary characteristic of planetary existence. Conclusion:Building on this foundation, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy, grounded in ecological awareness, multispecies justice, and a range of consonant practices of passivity and accompaniment, conceived as an alternative to the commonplace interventionism of healthcare.
Noncommunicable diseases (NCDs) are fatal for more than 38 million people each year and are thus the main contributors to the global burden of disease accounting for 70% of mortality. The majority of these deaths are caused by cardiovascular disease. The risk of NCDs is strongly associated with exposure to environmental stressors such as pollutants in the air, noise exposure, artificial light at night and climate change, including heat extremes, desert storms and wildfires. In addition to the traditional risk factors for cardiovascular disease such as diabetes, arterial hypertension, smoking, hypercholesterolemia and genetic predisposition, there is a growing body of evidence showing that physicochemical factors in the environment contribute significantly to the high NCD numbers. Furthermore, urbanization is associated with accumulation and intensification of these stressors. This comprehensive expert review will summarize the epidemiology and pathophysiology of environmental stressors with a focus on cardiovascular NCDs. We will also discuss solutions and mitigation measures to lower the impact of environmental risk factors with focus on cardiovascular disease.
INTRODUCTION: Contemporary research about environmental risk factors in an era of global climate change to inform childhood cancer prevention efforts is disjointed. Planetary pediatric providers need to establish a better understanding of how the postnatal environment influences childhood cancer. Authors conducted a scoping review of recent scientific literature with the aim of understanding the environmental risk factors for childhood cancer. METHOD: Ovid Medline, CINAHL, and Scopus databases were searched with results limited to the English language with publication years 2010-2021. Two independent reviewers screened 771 abstracts and excluded 659 abstracts and 65 full-text articles on the basis of predefinedcriteria. RESULTS: The scoping review identified 47 studies about environmental risk factors for childhood cancer with mixed results and limited consensus in four main categories, including air pollution, chemical exposures, radiation, and residential location. DISCUSSION: Research by collaborative international groups of planetary health researchers about environmental risk factors is needed to inform global health policy for childhood cancer prevention efforts.
Environmental exposure plays a major role in the development of allergic diseases. The exposome can be classified into internal (e.g., aging, hormones, and metabolic processes), specific external (e.g., chemical pollutants or lifestyle factors), and general external (e.g., broader socioeconomic and psychological contexts) domains, all of which are interrelated. All the factors we are exposed to, from the moment of conception to death, are part of the external exposome. Several hundreds of thousands of new chemicals have been introduced in modern life without our having a full understanding of their toxic health effects and ways to mitigate these effects. Climate change, air pollution, microplastics, tobacco smoke, changes and loss of biodiversity, alterations in dietary habits, and the microbiome due to modernization, urbanization, and globalization constitute our surrounding environment and external exposome. Some of these factors disrupt the epithelial barriers of the skin and mucosal surfaces, and these disruptions have been linked in the last few decades to the increasing prevalence and severity of allergic and inflammatory diseases such as atopic dermatitis, food allergy, allergic rhinitis, chronic rhinosinusitis, eosinophilic esophagitis, and asthma. The epithelial barrier hypothesis provides a mechanistic explanation of how these factors can explain the rapid increase in allergic and autoimmune diseases. In this review, we discuss factors affecting the planet’s health in the context of the ‘epithelial barrier hypothesis,’ including climate change, pollution, changes and loss of biodiversity, and emphasize the changes in the external exposome in the last few decades and their effects on allergic diseases. In addition, the roles of increased dietary fatty acid consumption and environmental substances (detergents, airborne pollen, ozone, microplastics, nanoparticles, and tobacco) affecting epithelial barriers are discussed. Considering the emerging data from recent studies, we suggest stringent governmental regulations, global policy adjustments, patient education, and the establishment of individualized control measures to mitigate environmental threats and decrease allergic disease.
Climate change is increasingly understood as a social justice issue by academics, policymakers, and the public; however, the nature of these perceptions and their implications for cooperation and decision-making have only recently begun to receive empirical attention. We review emerging empirical work that suggests that morality and justice perceptions can serve as both a bridge and a barrier to cooperation around climate change and highlight two critical areas for future development, identifying psychological processes that promote and impede climate vulnerability and that enhance equity in the design and implementation of climate solutions. We argue that conceptualizing climate justice as a multidimensional process addressing both social and structural barriers can stimulate new psychological research and help align disparate approaches within the social sciences.
Climate change is considered the greatest long-term challenge we face, and it comes with a direct impact on women’s health and pregnancy outcomes. There are many balances that physicians make in deciding elements of care, but environmental impact has not been a consideration. Health care leaders must recognize the impact of their decisions on carbon footprints and creatively look towards changes that will improve global conditions.
Water scarcity affects 1–2 billion people globally, most of whom live in drylands. Under projected climate change, millions more people will be living under conditions of severe water stress in the coming decades. This review examines observed and projected climate change impacts on water security across the world’s drylands to the year 2100. We find that efficient water management, technology, and infrastructure, and better demand and supply management, can offer more equitable access to water resources. People are already adapting but need to be supported with coherent system-oriented policies and institutions that situate water security at their core, in line with the components of integrated water resources management. Dryland water governance urgently needs to better account for synergies and trade-offs between water security and other dimensions of sustainable development, to support an equitable approach in which no one gets left behind.
Climate change in the Arctic affects both environmental, animal, and human health, as well as human wellbeing and societal development. Women and men, and girls and boys are affected differently. Sex-disaggregated data collection is increasingly carried out as a routine in human health research and in healthcare analysis. This study involved a literature review and used a case study design to analyze gender differences in the roles and responsibilities of men and women residing in the Arctic. The theoretical background for gender-analysis is here described together with examples from the Russian Arctic and a literature search. We conclude that a broader gender-analysis of sex-disaggregated data followed by actions is a question of human rights and also of economic benefits for societies at large and of the quality of services as in the health care.
Active transportation is defined as self-propelled, human-powered transportation modes, such as walking and bicycling. In this article, we review the evidence that reliance on gasoline-powered transportation is contributing to global climate change, air pollution, and physical inactivity and that this is harmful to human health. Global climate change poses a major threat to human health and in the future could offset the health gains achieved over the last 100 yr. Based on hundreds of scientific studies, there is strong evidence that human-caused greenhouse gas emissions are contributing to global climate change. Climate change is associated with increased severity of storms, flooding, rising sea levels, hotter climates, and drought, all leading to increased morbidity and mortality. Along with increases in atmospheric CO2, other pollutants such as nitrogen dioxide, ozone, and particulate matter (e.g., PM2.5) are released by combustion engines and industry, which can lead to pulmonary and cardiovascular diseases. Also, as car ownership and vehicle miles traveled have increased, the shift toward motorized transport has contributed to physical inactivity. Each of these global challenges has resulted in, or is projected to result in, millions of premature deaths each year. One of the ways that nations can mitigate the health consequences of climate change, air pollution, and chronic diseases is through the use of active transportation. Research indicates that populations that rely heavily on active transportation enjoy better health and increased longevity. In summary, active transportation has tremendous potential to simultaneously address three global public health challenges of the 21st century.
The connection between human health and climate change has had a scientific basis for many decades. However, little attention has been directed to applying the science of health informatics to this aspect of health and healthcare until recently. This paper briefly reviews examples of recent international work on two fronts: to consider how health informatics can reduce the carbon footprint of healthcare, and to consider how it can integrate new kinds of data for insights into the human health impacts of climate change. Health informatics has two principles of fundamental relevance to this work – connectedness, in other words linking and integrating health data from multiple sources; and sustainability, in other words making healthcare overall more efficient and effective. Deepening its commitment to these principles will position health informatics as a discipline and a profession to support and guide technological advances that respond to the world’s climate health challenges.
Climate change is an anthropogenic phenomenon that is alarming scientists and non-scientists alike. The emission of greenhouse gases is causing the temperature of the earth to rise and this increase is accompanied by a multitude of climate change-induced environmental exposures with potential health impacts. Tracking human exposure has been a major research interest of scientists worldwide. This has led to the development of exposome studies that examine internal and external individual exposures over their lifetime and correlate them to health. The monitoring of health has also benefited from significant technological advances in the field of “omics” technologies that analyze physiological changes on the nucleic acid, protein, and metabolism levels, among others. In this review, we discuss various climate change-induced environmental exposures and their potential health implications. We also highlight the potential integration of the technological advancements in the fields of exposome tracking, climate monitoring, and omics technologies shedding light on important questions that need to be answered.
Undernutrition is a major contributor to the global-burden of disease, and global-level health impact models suggest that climate change-mediated reductions in food quantity and quality will negatively affect it. These models, however, capture just some of the processes that will shape future nutrition. We adopt an alternative standpoint, developing an agent-based model in which producer-consumer smallholders practice different ‘styles of farming’ in the global food system. The model represents a hypothetical rural community in which ‘orphan’ (subsistence) farmers may develop by adopting an ‘entrepreneurial’ style (highly market-dependent) or by maintaining a ‘peasant’ style (agroecology). We take a first look at the question: how might patterns of farming styles-under various style preference, climate, policy, and price transmission scenarios-impact on hunger and health-supporting conditions (incomes, work, inequality, ‘real land productivity’) in rural areas? imulations without climate change or agricultural policy found that style preference patterns influence production, food price, and incomes, and there were trade-offs between them. For instance, entrepreneurial-oriented futures had the highest production and lowest prices but were simultaneously those in which farms tended towards crisis. Simulations with climate change and agricultural policy found that peasant-orientated agroecology futures had the highest production, prices equal to or lower than those under entrepreneurial-oriented futures, and better supported rural health. There were, however, contradictory effects on nutrition, with benefits and harms for different groups. Collectively the findings suggest that when attempting to understand how climate change may impact on future nutrition and health, patterns of farming styles-along with the fates of the households that practice them-matter. These issues, including the potential role of peasant farming, have been neglected in previous global-level climate-nutrition modelling but go to the heart of current debates on the future of farming: thus, they should be given more prominence in future work.
The skin plays an important role in human health by providing barrier protection against environmental stressors. In addition to human skin cells, the cutaneous barrier is also home to a network of organisms that have co-evolved with humans, referred to as the cutaneous microbiome. This network has been demonstrated to play an active role in skin health and the manifestation of cutaneous disease. Here, we review how a warming world and its attendant changes in climatic variables, including temperature, humidity, ultraviolet radiation, and air pollution, influence the cutaneous microbiome and, in turn, skin health. Studies indicate that the cutaneous microbiome is affected by these factors, and these changes may influence the epidemiology and severity of cutaneous disorders including atopic dermatitis, acne vulgaris, psoriasis, and skin cancer. Further investigation into how the cutaneous microbiome changes in response to climate change and subsequently influences skin disease is needed to better anticipate future dermatologic needs and potentially generate novel therapeutic solutions in response.
OBJECTIVE: To analyze the impacts of climate change on the development of immature respiratory and immune systems in children. SOURCE OF DATA: The authors of the present study performed a non-systematic review of English, Spanish, and Portuguese articles published in the last five years in databases such as PubMed, EMBASE, and SciELO. The terms used were air pollution OR climate changes OR smoke, AND children OR health. SYNTHESIS OF DATA: The increase in the prevalence of some diseases, such as allergic ones, is attributed to the interactions between genetic potential and the environment. However, disordered growth combined with inadequate waste management has caused problems for the planet, such as heatwaves, droughts, forest fires, increased storms and floods, interference in food crops and their nutritional values, changes in the infectious disease pattern, and air pollution resulting from the continuous use of fossil fuels. Children, beings still in the development stage with immature respiratory and immune systems, are the primary victims of the climate crisis. CONCLUSIONS: The authors documented that prenatal and postnatal exposure to ambient air pollutants will accelerate or worsen the morbidity and mortality of many health conditions, including allergic diseases. Ambient air pollutants change the microbiota, interfere with the immune response, and take direct action on the skin and respiratory epithelium, which facilitates the penetration of allergens. Understanding how the children and adolescent health and well-being are affected by climate change is an urgent matter.
Those who are under-18 are not often associated with the exercise of political rights. It is argued in this article however that youth-led climate activism is highlighting the extensive potential that children and young people have for political activism. Moreover, youth activists have come to be seen by many as uniquely competent on climate change. Youth activists have moved from the streets to the courts, utilising national and international human rights law mechanisms to further their cause. They are not the first to do so, and the extent of their impact is as yet unclear. Nevertheless, it is argued here that through applications such as Saachi (an application to the Committee on the Rights of the Child) and Duarte Agostinho (an application to the ECtHR) they are shifting the human-centric, highly procedural arena of international human rights law towards an approach which better encompasses person-environment connections.
BACKGROUND: Social science models find the ecological impacts of climate change (EICC) contribute to internal migration in developing countries and, less so, international migration. Projections expect massive climate-related migration in this century. Nascent research calls to study health, migration, population, and armed conflict potential together, accounting for EICC and other factors. System science offers a way: develop a dynamic simulation model (DSM). We aim to validate the feasibility and usefulness of a pilot DSM intended to serve as a proof-of-concept and a basis for identifying model extensions to make it less simplified and more realistic. METHODS: Studies have separately examined essential parts. Our DSM integrates their results and computes composites of health problems (HP), health care (HC), non-EICC environmental health problems (EP), and environmental health services (ES) by origin site and by immigrants and natives in a destination site, and conflict risk and intensity per area. The exogenous variables include composites of EICC, sociopolitical, economic, and other factors. We simulate the model for synthetic input values and conduct sensitivity analyses. RESULTS: The simulation results refer to generic origin and destination sites anywhere on Earth. The effects’ sizes are likely inaccurate from a real-world view, as our input values are synthetic. Their signs and dynamics are plausible, internally consistent, and, like the sizes, respond logically in sensitivity analyses. Climate migration may harm public health in a host area even with perfect HC/ES qualities and full access; and no HP spillovers across groups, conflict, EICC, and EP. Deviations from these conditions may worsen everyone’s health. We consider adaptation options. CONCLUSIONS: This work shows we can start developing DSMs to understand climate migration and public health by examining each case with its own inputs. Validation of our pilot model suggests we can use it as intended. We lay a path to making it more realistic for policy analysis.
OBJECTIVE: To confirm the factor structure of the Climate, Health, and Nursing Tool (CHANT) tool via confirmatory factor analysis. DESIGN AND SAMPLE: This is a cross-sectional analysis of voluntary, anonymous responses collected online in 2019, from a non-representative sample of 489 nurses from 12 nations with 95% of the respondents from the United States. MEASUREMENTS: A confirmatory factor analysis (CFA) was conducted to test a five-factor measurement model of the 22-item CHANT. Reliability was examined via Cronbach’s α coefficient. RESULTS: The five CHANT subscales demonstrated acceptable reliability with Cronbach’s α ranging from 0.67 to 0.91. The five-factor model of CHANT demonstrated good fit, x(2) (199) = 582.747, p < .001, CFI = 0.94, RMSEA = 0.06, and SRMR = 0.04 with statistically significant item-factor loadings. CONCLUSION: CHANT is a reliable and robust instrument to measure nurses' awareness, concern, motivation, and home and work behaviors regarding climate change and health, and is ready to be utilized in research, policy, professional settings, and among educators.
OBJECTIVES: This study measured nurses’ awareness, motivation, concern, self-reported behaviors at work, and self-reported behaviors at home regarding climate change and health. DESIGN: Descriptive study using an anonymous and voluntary web-based survey. SAMPLE: A nonrepresentative sample recruited from nurses. MEASUREMENTS: The CHANT (Climate, Health and Nursing Tool) with five psychometrically evaluated scales used to measure awareness, motivation, concern, behaviors at work, and behaviors at home. RESULTS: The 489 respondents reported moderate levels of awareness (2.97 mean score of 0-4) and high levels of concern (3.43) about health impacts of climate change. They were motivated to reduce greenhouse gas emissions (3.27), yet few did at home (2.28), and even fewer at work (1.81). They were motivated by clean air and water and concern about the future. Barriers to action included not knowing what to do and feeling overwhelmed. Respondents reported discussing climate and health with friends or family more frequently than they did with their colleagues. A majority (63%) never contacted elected officials. CONCLUSION: The respondents were aware of climate and health impacts and motivated to act. However, they reported lower frequencies of changing behaviors at work, and communicating about climate and health professionally and with elected officials.
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ”U” shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth’s climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
In cold temperatures, vehicles idle more, have high cold-start emissions including greenhouse gases, and have less effective exhaust filtration systems, which can cause up to ten-fold more harmful vehicular emissions. Only a few vehicle technologies have been tested for emissions below -7 °C (20 °F). Four-hundred-million people living in cities with sub-zero temperatures may be impacted. We conducted a scoping review to identify the existing knowledge about air-pollution-related health outcomes in a cold climate, and pinpoint any research gaps. Of 1019 papers identified, 76 were selected for review. The papers described short-term health impacts associated with air pollutants. However, most papers removed the possible direct effect of temperature on pollution and health by adjusting for temperature. Only eight papers formally explored the modifying effect of temperatures. Five studies identified how extreme cold and warm temperatures aggravated mortality/morbidity associated with ozone, particles, and carbon-monoxide. The other three found no health associations with tested pollutants and temperature. Additionally, in most papers, emissions could not be attributed solely to traffic. In conclusion, evidence on the relationship between cold temperatures, traffic-related pollution, and related health outcomes is lacking. Therefore, targeted research is required to guide vehicle regulations, assess extreme weather-related risks in the context of climate change, and inform public health interventions.
Children are crucial to the future of climate change leadership, and even as youth, they have the ability to make a difference in achieving climate equity. Explorations of children’s climate change literature is limited, despite the push from experts to involve children in climate change education and action. A thematic analysis of picturebooks books on the topic was conducted. Data were identified from online websites and accessibility was confirmed via academic and internet search engines. Findings suggest that children’s books about climate change lack informational material and overlook the human consequences of the climate crisis. Implications for environmental health communication are discussed.
The cryosphere is able to provide a variety of services for the benefit of human well-being and underpins regional sustainable development. The cryosphere deterioration induced by climate change is impacting the services and will subsequently impede the efforts to meet sustainable development goals (SDGs) in high mountain societies. Here, we detail the context of cryosphere services and establish a dataset for its linkage to SDGs. This allows us to uncover its roles in supporting SDGs, directly by a causal connection and indirectly through either cascading effects or interconnection among SDGs. We find that the SDGs in association with the basic needs of high mountain societies are mostly affected by the cryosphere services. The different types of services pitch in with distinctions to be embraced by various SDGs, whilst some play a prominent role in the contribution to a broad range of SDGs. We further investigate how the services behave in their contributions to SDGs, by taking a view via the lens of a network that deciphers the relationship between the services and SDG targets as well as the interconnections among SDG targets. With an insight into the centrality and modularity of services in the network, we then delineate the inherent criticality of services to SDG targets as a whole, and reveal the specificity of services that co-contribute to a cluster of SDG targets in each network community. We take out the services from the network and maintain their interlinks to the targets of each underlying SDG system represented in six key entry points, so that the services critical to the transformation pathways in the entry points for SDGs in high mountains can be identified. Finally, we discuss the trade-offs that can occur in high mountains, which is unique for the cryosphere services. It creates more complexity in the assessment of overall benefits that the cryosphere services may provide to SDGs, and urges the balance that has to be maintained in attaining those services for the transformation.
Mycotoxins are natural metabolites produced by fungi that contaminate food and feed worldwide. They can pose a threat to human and animal health, mainly causing chronic effects, e.g., immunotoxic and carcinogenic. Due to climate change, an increase in European population exposure to mycotoxins is expected to occur, raising public health concerns. This urges us to assess the current human exposure to mycotoxins in Europe to allow monitoring exposure and prevent future health impacts. The mycotoxins deoxynivalenol (DON) and fumonisin B(1) (FB(1)) were considered as priority substances to be studied within the European Human Biomonitoring Initiative (HBM4EU) to generate knowledge on internal exposure and their potential health impacts. Several policy questions were addressed concerning hazard characterization, exposure and risk assessment. The present article presents the current advances attained under the HBM4EU, research needs and gaps. Overall, the knowledge on the European population risk from exposure to DON was improved by using new harmonised data and a newly derived reference value. In addition, mechanistic information on FB(1) was, for the first time, organized into an adverse outcome pathway for a congenital anomaly. It is expected that this knowledge will support policy making and contribute to driving new Human Biomonitoring (HBM) studies on mycotoxin exposure in Europe.
Purpose This paper aims to analyze a decolonized peace with gender perspective. Liberal democracies had consolidated on conquest, slavery, racism, sexism, colonialism, raw material extraction and female exploitation. Additional burdens came from neoliberal globalization with the massive burning of fossil oil, changing the Earth’s history from the Holocene toward the Anthropocene. Multiple nexus between the human and environmental system requires an epistemology from the Global South. The paper explores alternative peace paradigms enabling poor and exploited people to overcome the destructive outcomes of patriarchal violence and extractivism. Regionally and locally, they are experimenting with just, safe, equal and sustainable alternatives of free societies. Design/methodology/approach The nexus approach focuses on system efficiency, internal and external feedbacks and allows decision-making processes with stronger cross-sectoral coordination and multi-level governance. It includes the understanding of the policy agenda and the political actors at different levels, explaining the discrimination of gender from local to global. The analysis establishes complex relations between theory and political actions, due that all actions are inherently mediated by gender. A key focus is a relationship and the outcomes of policies, where communication and collaboration at the local level grant efficient peaceful resource management with gender equity. Findings An engendered-sustainable peace approach is culturally decentralized and may offer alternatives to the ongoing destruction process of neoliberal corporatism and violence. Drastic systemic change requires massive changes from bottom-up and top-down before 2030-2050. Global solidarity among all excluded people, especially women and girls, promotes from childhood an engendered-sustainable peace-building process, where positive feedbacks may reduce the tipping points on Earth and among humankind. Engendered-sustainable peace can mitigate the upcoming conflicts and catastrophes, limiting the negative feedbacks from abusive, selfish and destructive corporations. A greater self-regulating sustainable system with a HUGE-security could promote a decolonized, engendered and sustainable peace for everybody. Research limitations/implications The interconnected risks are cascading across different domains, where systemic challenges have intensified conflicts and violence, due to uncertainty, instability and fragility. Cascading effects not only demand prevention for sudden disruptions (hurricanes, floods) but also for slow-ongoing processes (drought, sea-level rise, lack of water availability, etc.), which are equally or more disruptive. Women suffer differently from disasters and are prone to greater impacts on their life and livelihood. An engendered peace is limited by the deep engrained patriarchal system. Only a culture of peace with gender recognition may grant future peace and also the sustainable care of ecosystems. Practical implications The Global South is exploring alternative ways to overcome the present violent and destructive globalization by promoting deep engrained indigenous values of Aymaras’ living well, the shell model of commanding by obeying of the Zapatistas or Bhutan’s Happiness Index. Globally, critical women and men are promoting subsistence agriculture, solidarity or gift economy, where local efforts are restoring the equilibrium between humans and nature. An engendered-sustainable peace is limiting the destructive impacts of the Anthropocene, climate change and ongoing pandemics. Social implications An engendered-sustainable peace is culturally decentralized and offers alternatives to the ongoing destruction process of neoliberal corporatism, climate change and violence. The text explores how to overcome the present hybrid warfare with alternative HUGE security and peace from the bottom-up. Regional reinforcement of food security, safe water management, local jobs and a concordian economy for the most vulnerable may change the present exploitation of nature and humankind. Growing solidarity with people affected by disasters is empowering women and girls and dismantling from the bottom-up, the dominant structures of violence and exploitation. Originality/value The military-industrial-scientific corporate complex and the exploitation of women, men and natural resources, based on patriarchy, has produced climate change, poverty and global pandemics with millions of unnecessary deaths and suffering. A doughnut engendered peace looking from the outside and inside of the system of globalization and environmental destruction proposes to overcome the growth addiction by a growth agnostic society. Engendered peace explores alternative and sustainable values that go beyond the dominant technological changes. It includes a culturally, politically and institutionally ingrained model where everybody is a participant, reinforcing an engendered-sustainable peace and security for everybody.
The human population is at the centre of research on global environmental change. On the one hand, population dynamics influence the environment and the global climate system through consumption-based carbon emissions. On the other hand, the health and well-being of the population are already being affected by climate change. A knowledge of population dynamics and population heterogeneity is thus fundamental to improving our understanding of how population size, composition, and distribution influence global environmental change and how these changes affect population subgroups differentially by demographic characteristics and spatial distribution. The increasing relevance of demographic research on the topic, coupled with availability of theoretical concepts and advancement in data and computing facilities, has contributed to growing engagement of demographers in this field. In the past 25 years, demographic research has enriched climate change research-with the key contribution being in moving beyond the narrow view that population matters only in terms of population size-by putting a greater emphasis on population composition and distribution, through presenting both empirical evidence and advanced population forecasting to account for demographic and spatial heterogeneity. What remains missing in the literature is research that investigates how global environmental change affects current and future demographic processes and, consequently, population trends. If global environmental change does influence fertility, mortality, and migration, then population estimates and forecasts need to adjust for climate feedback in population projections. Indisputably, this is the area of new research that directly requires expertise in population science and contribution from demographers.
INTRODUCTION: Climate change is exacerbating a pre-existing child rights crisis. Lower- (low- and lower-middle-) income countries have borne 99% of the disease burden from the crisis, of which children under five carry 90%. In response, much of the recent global policy efforts focus on climate action. However, unsustainable levels of debt and tax abuses are draining countries of crucial revenue to handle the crisis. Like the climate crisis, these are primarily facilitated by entities domiciled within higher- (upper-middle- and high-) income countries. This paper aims to review these revenue leaks in countries where children are at the greatest risk of climate change to identify opportunities to increase climate change resilience. METHODS: We compiled data on tax abuse, debt service and climate risk for all lower-income countries with available data to highlight the need for intervention at the global level. We used the Climate Change Risk Index (CCRI), developed by UNICEF. Additionally, we used figures for tax abuse and debt service as a percentage of government revenue. RESULTS: We present data on 62 lower-income countries with data on revenue losses, of which 55 have CCRI data. Forty-two of these 62 countries (67.7%) are at high risk of lost government revenues. Forty-one (74.5%) of the 55 countries with CCRI data are at high risk of climate change. Thirty-one countries with data on both (56.4%) are at high risk of both climate change and revenue losses. Most countries at high risk of both are located in sub-Saharan Africa. This shows that countries most in need of resources lose money to arguably preventable leaks in government revenue. DISCUSSION: Higher-income countries and global actors can adopt policies and practices to ensure that they do not contribute to human rights abuses in other countries. Highlighting the impact of a failing global economic model on children’s economic and social rights and one which increases their vulnerability to the climate emergency could help drive the transition towards a model that prioritises human rights and the environment on which we all depend.
As U.S. healthcare systems plan for future physician workforce needs, the systemic impacts of climate change, a worldwide environmental and health crisis, have not been factored in. The current focus on increasing the number of trained physicians and optimizing efficiencies in healthcare delivery may be insufficient. Graduate medical education (GME) priorities and training should be considered in order to prepare a climate-educated physician workforce. Evidence: We used a holistic lens to explore the available literature regarding the intersection of future physician workforce needs, GME program priorities, and resident education within the larger context of climate change. Our interinstitutional, transdisciplinary team brought perspectives from their own fields, including climate science, climate and health research, and medical education to provide recommendations for building a climate-educated physician workforce. Implications: Acknowledging and preparing for the effects of climate change on the physician workforce will require identification of workforce gaps, changes to GME program priorities, and education of trainees on the health and societal impacts of climate change. Alignment of GME training with workforce considerations and climate action and adaptation initiatives will be critical in ensuring the U.S. has a climate-educated physician workforce capable of addressing health and healthcare system challenges. This article offers a number of recommendations for physician workforce priorities, resident education, and system-level changes to better prepare for the health and health system impacts of climate change.
Many diseases have large seasonal variations in which winter overall mortality rates are about 25% higher than in summer in mid-latitude countries, with cardiovascular diseases and respiratory infections and conditions accounting for most of the variation. Cancers, by contrast, do not usually have pronounced seasonal variations in incidence or mortality rates. This narrative review examines the epidemiological evidence for seasonal variations in blood pressure, cardiovascular disease rates and respiratory viral infections in relation to atmospheric temperature and humidity, and solar UV exposure through vitamin D production and increased blood concentrations of nitric oxide. However, additional mechanisms most likely exist by which solar radiation reduces the risk of seasonally varying diseases. Some studies have been reported with respect to temperature without considering solar UV doses, although studies regarding solar UV doses, such as for respiratory infections, often consider whether temperature can affect the findings. More research is indicated to evaluate the relative effects of temperature and sun exposure on the seasonality of mortality rates for several diseases. Since solar ultraviolet-B (UVB) doses decrease to vanishingly small values at higher latitudes in winter, the use of safe UVB lamps for indoor use in winter may warrant consideration.
Since its adoption in September 2015, the 2030 Agenda has laid the foundations for a model of shared prosperity for a sustainable world. The current global pandemic highlights profound inequalities affecting our economies, health, and quality of life. For this reason, the aim of this study was to present the current state of scientific research related to inequality, poverty, and climate change, and to propose lines of improvement that can contribute to achieving three of the 17 SDGs (end poverty, SDG 1; reduce inequality, SDG 10; and climate action, SDG 13), proposed in the 2030 Agenda. For this purpose, we undertook a systematic literature review. The results show that the subject of poverty, inequality, and climate change has been little studied or articulated by researchers, and significant differences exist between the different areas studied. The highest number of publications (51.7%) is associated with topics related to sustainability-environment and economics. The remainder are distributed among 12 other research areas. Another relevant finding is that the effects of climate change are more pressing for more vulnerable populations, including impoverished women from rural areas and children from underdeveloped countries. This gender and social inequality has been rarely addressed in studies. Food security and energy poverty is another under-researched area. According to the results obtained in this work, we consider that the circular economy may improve these indicators, constituting a line of future research. Thus, one of the main objectives of this approach is to eliminate negative externalities, specifically the existing social inequalities within the current linear economy model.
Along with the urbanization and industrialization of countries, the prevalence of chronic diseases has increased. There is ample evidence that ambient pollution can play a major role in these diseases. This study aimed to investigate the association between neurological disorders (NDs) and their subtypes with environmental factors. In this country-level study, we used the age-standardized prevalence and incidence rate (per 100,000 populations) of NDs and its subtypes that have been taken from the Global Burden of Disease (GBD) database in 2019. We used correlation and regression analysis to assess the association between variables. Also, multivariable regression analysis was performed to identify the most important variables in NDs distribution. Age-adjusted NDs incidence rate was significantly higher in developed countries compared to developing countries (11345.25 (95% CI: 11634.88-11055.62) and 9956.37 (95% CI: 10138.66-9774.08)). Association results indicated that the impact of water and sanitation could be more effective than air pollution on NDs. The increase in water and sanitation index levels was positively correlated with NDs incidence rate and prevalence (regression coefficient (b) = 38.011 (SE = 6.50) and b = 118.84 (SE = 20.64), p < 0.001, respectively) after adjusting socio-economic and demographic factors. Furthermore, the incidence of NDs was negatively correlated with the increase in air quality (b = -16.30 (SE = 7.25), p = 0.008). Water and sanitation and their related factors are plausible factors in the distribution of NDs, which may be linked to the potential role of air and water pollution, such as heavy metals and particle matters. These results can be used by politicians and municipal service planners for future planning.
Understanding how climate change will affect water quality and therefore, health, is critical for building resilient water services in low- and middle-income countries (LMICs) where the effect of climate change will be felt most acutely. Evidence of the effect of climate variables such as temperate and rainfall on water quality can generate insights into the likely impact of future climate change. While the seasonal effects on water quality are known, and there is strong qualitative evidence that climate change will impact water quality, there are no reviews that synthesise quantitative evidence from LMICs on links between climate variables and water quality. We mapped the available evidence on a range of climate exposures and water quality outcomes and identified 98 peer-reviewed studies. This included observational studies on the impact of temperature and rainfall events (which may cause short-term changes in contaminant concentrations), and modelling studies on the long-term impacts of sea level rise. Evidence on links between antecedent rainfall and microbiological contamination of water supplies is strong and relatively evenly distributed geographically, but largely focused on faecal indicator bacteria and on untreated shallow groundwater sources of drinking water. The literature on climate effects on geogenic contaminants was sparse. There is substantial research on the links between water temperature and cyanobacteria blooms in surface waters, although most studies were from two countries and did not examine potential effects on water treatment. Similarly, studies modelling the impact of sea level rise on groundwater salinity, mostly from south-Asia and the Middle East, did not discuss challenges for drinking water supplies. We identified key future research priorities based on this review. These include: more studies on specific pathogens (including opportunistic pathogens) in water supplies and their relationships with climate variables; more studies that assess likely relationships between climate variables and water treatment processes; studies into the relationships between climate variables and geogenic contaminants, including risks from heavy metals released as glacier retreat; and, research into the impacts of wildfires on water quality in LMICs given the current dearth of studies but recognised importance.
It is obvious that social, biogenic, and anthropogenic environmental factors, as well as nutrition contribute to the development and course of atopic eczema. Social deprivation and stress have a negative impact on atopic eczema symptoms, and social change in recent decades has led to a “westernized” lifestyle associated with high prevalence of atopic eczema in industrialized countries. Urbanization leads to an increase in air pollution and a decrease in biodiversity, which negatively affects atopic eczema. Climate change alters the allergenicity of pollen, which increases atopic eczema symptoms in some patients during the pollen season. Protective natural and social factors for the prevention of atopic eczema and for the promotion of “climate resilience” should be given greater consideration in future research.
This research paper is an attempt to define and analyse the concept of the blue economy (BE) and its implications for achieving Sustainable Development Goals (SDGs). This study covers aspects such as building a blue economy to achieve SDGs, the importance of a healthy ocean for current and future generations, maintaining the momentum to save the ocean, achievements of the United Nations (UN) conference on the Sustainable Blue Economy, and the highlights of the UN World Water Development Report 2020. This study specifically analyses the health effects and threats to biodiversity, adaptation and mitigation, improved wastewater management, prioritizing water, accessing climate funds, water and climate change, and the relationship between the blue economy and UN SDGs as well as identification of key stakeholders. This is achieved through a detailed literature review on the blue economy that identifies global organizations working on creating a blue economy, elements of the blue economy and current development efforts, United Nations Convention on the Law of the Sea, sustainability and equity, ocean governance, international law and frameworks, and improvement in governance frameworks among other issues. The methodology used attempted to develop a macro, comprehensive, and systematic aggregate database at the country level on macro parameters, namely blue economy, blue finance, BE-SDGs linkages, water development, marine sector, SDGs data on SDG-14 (life underwater), SDG-6 (access to safe drinking water and sanitation), SDG-3 (good health and well-being), and optimal management of water resources through scientific techniques, such as building several small reservoirs instead of mega projects, develop small catchment dams and protect wetlands, soil management, micro catchment development, recharging of underground aquifers thus reducing the need for large dams, which has encountered challenges due to data limitations. The results of this research study emphasize broader stakeholder consultations at the global level to resolve the issues relating to blue economy, blue finance, and ocean governance. The most important conclusion and policy implications of the study are that international organizations including the United Nations, the Asian Development Bank, and the World Bank are working towards achieving the SDGs in general, and the blue economy, blue finance, and ocean governance in particular.
In 2015, 196 countries boldly committed to address global antimicrobial resistance (AMR). Now, five years later, progress reports suggest the implementation of AMR activities is vastly below what was initially promised. The challenge of overcoming the ‘commitment-compliance gap’ is not unique to AMR and is common in other areas of international politics. Global health policymakers can therefore learn from theories of international relations and experience in other sectors. We reviewed international relations scholarship to generate five hypotheses for why states might comply or not comply with their global commitments. We then conducted a public policy analysis of three past international agreements on biological diversity, climate change, and nuclear weapons to test these hypotheses and identify lessons for encouraging country compliance with global health agreements, with specific application to global AMR policies. To bridge the commitment-compliance gap, international leaders should: (1) frame incentives to maximise interests for action; (2) pursue enforcement mechanisms to induce state behaviour; (3) emphasise building a culture of trust by providing mutual assurance for action; (4) include mechanisms for managing poor performers; and (5) find opportunities for continual social learning. Agreements should be designed with flexibility, data sharing, and dispute settlement mechanisms and provide financial and technical assistance to states with less capacity to deliver.
The food system and climate are closely interconnected. Although most research has focused on the need to adopt a plant-based diet to help mitigate climate change, there is also an urgent need to examine the effects of climate change on food systems to adapt to climate change. A systems approach can help identify the pathways through which climate influences food systems, thereby ensuring that programmes combating malnutrition take climate into account. Although little is known about how climate considerations are currently incorporated into nutrition programming, climate information services have the potential to help target the delivery of interventions for at-risk populations and reduce climate-related disruption during their implementation. To ensure climate services provide timely information relevant to nutrition programmes, it is important to fill gaps in our knowledge about the influence of climate variability on food supply chains. A proposed roadmap for developing climate-sensitive nutrition programmes recommends: (i) research aimed at achieving a better understanding of the pathways through which climate influences diet and nutrition, including any time lags; (ii) the identification of entry points for climate information into the decision-making process for nutrition programme delivery; and (iii) capacity-building and training programmes to better equip public health practitioners with the knowledge, confidence and motivation to incorporate climate resilience into nutrition programmes. With sustained investment in capacity-building, data collection and analysis, climate information services can be developed to provide the data, analyses and forecasts needed to ensure nutrition programmes target their interventions where and when they are most needed.
Chemicals are essential components of our daily lives, for the well-being, high living standards and comfort of modern society. They are used in many sectors, including health. However, some chemicals have hazardous properties which can harm the environment and human health. Chemical pollution is significantly contributing to the current global problem of climate change and loss of biodiversity There is an increase in health problems that can be partially explained by the use of chemicals. Some man-made chemicals are found in the most remote places in the environment, but also in our bodies. Chemicals are everywhere. Chemicals strategy for sustainability towards a toxic-free environment will ensure better protection of human health and the environment from hazardous chemicals, boost innovation for safe and sustainable chemicals and enable the transition to chemicals that are safe and sustainable by design. It is a first step towards the Zero pollution ambition for a toxic-free environment announced in the European Green Deal. The strategy proposes comprehensive chemical legislations for the transformation of industry with the aim of attracting investment into safe and sustainable products and production methods. Clinical laboratories must choose safer, more sustainable alternatives to hazardous chemicals, address sustainability issues, and implement official guidelines on how to reduce their carbon footprint.
The consequences of climate change and responses to climate change interact with multiple dimensions of human well-being in ways that are emerging or invisible to decision makers. We examine how elements of well-being-health, safety, place, self and belonging-are at risk from climate change. We propose that the material impacts of a changing climate, discourses and information on future and present climate risks, and policy responses to climate change affect all these elements of well-being. We review evidence on the scale and scope of these climate change consequences for well-being and propose policy and research priorities that are oriented towards supporting well-being though a changing climate.
INTRODUCTION: Climate change is among the most renowned concerns of the current century, endangering the lives of millions of people worldwide. To comply with the United Nations Climate Change Conference (COP21), hospitals should be on track to reduce greenhouse gas emissions. Although hospitals contribute to climate change by emitting greenhouse gases, they are also affected by the health consequences of climate change. Despite all the guidance provided, hospitals need more radical measures to confront climate change. The current study was carried out to examine the components of hospitals’ adaptation to climate change and to review measures to confront climate change in hospitals. METHOD: This systematic review was designed and carried out in 2020. The required information was collected from international electronic databases including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar. Moreover, Iranian datasets such as Scientific Database (SID), Irandoc, Magiran, and IranMedex were reviewed. No restriction was considered in the methodology of the study. For the relevant thesis, the ProQuest database was also explored. The related sources were examined and the Snowball method was applied to find additional related studies. The research team also reviewed other accessible electronic resources, such as international guidelines and academic websites. The checklist of the Joanna Briggs Institute (JBI, 2017) was employed in order to evaluate the quality of the included papers. The studies published until June1, 2020, were included in the study. RESULTS: Of 11,680 published documents in the initial search, the full-texts of 140 were read after evaluating the titles and abstracts, of which 114 were excluded due to lack of sufficient information related to countermeasures in hospitals. Finally, the full-texts of 26 studies were reviewed to extract the required components. Two strategies were found, including climate change mitigation and climate change adaptation, with 13 components including water, wastewater, energy, waste, green buildings, food, transportation, green purchasing policy, medicines, chemicals and toxins, technology, sustainable care models, and leadership in hospitals were identified as affecting these measures and strategies. CONCLUSION: Considering the significance of climate change and strategies to confront it as one of the current challenges and priorities in the world, it is necessary to develop a framework and model to reduce the effects of climate change and adapt to climate changes in hospitals and other health centers. The identification and classification of the measures and components, influencing hospital adaptability and solutions for reducing the climate change impacts could be the first stage in developing this strategy. This is because it is impossible to create this framework without identifying these factors and their mutual impacts at the first. In the present study, through a systematic review using a comprehensive approach, the related components were explored and divided into two categories, including measures to reduce the effects and measures to adapt to climate change. The results of this study can be useful in developing a comprehensive action model to reduce greenhouse gas emissions and adapt hospitals to climate change.
Climate change is the greatest existential challenge to planetary and human health and is dictated by a shift in the Earth’s weather and air conditions owing to anthropogenic activity. Climate change has resulted not only in extreme temperatures, but also in an increase in the frequency of droughts, wildfires, dust storms, coastal flooding, storm surges and hurricanes, as well as multiple compound and cascading events. The interactions between climate change and health outcomes are diverse and complex and include several exposure pathways that might promote the development of non-communicable diseases such as cardiovascular disease. A collaborative approach is needed to solve this climate crisis, whereby medical professionals, scientific researchers, public health officials and policymakers should work together to mitigate and limit the consequences of global warming. In this Review, we aim to provide an overview of the consequences of climate change on cardiovascular health, which result from direct exposure pathways, such as shifts in ambient temperature, air pollution, forest fires, desert (dust and sand) storms and extreme weather events. We also describe the populations that are most susceptible to the health effects caused by climate change and propose potential mitigation strategies, with an emphasis on collaboration at the scientific, governmental and policy levels.
There is increasing understanding, globally, that climate change and increased pollution will have a profound and mostly harmful effect on human health. This review brings together international experts to describe both the direct (such as heat waves) and indirect (such as vector-borne disease incidence) health impacts of climate change. These impacts vary depending on vulnerability (i.e., existing diseases) and the international, economic, political, and environmental context. This unique review also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and environmental justice and education. This scholarly resource explores these issues fully, linking them to global health in urban and rural settings in developed and developing countries. The review finishes with a practical discussion of action that health professionals around the world in our field can yet take.
OBJECTIVE: To increase the knowledge and communication skills of health professionals related to climate change and human health (CCHH). METHODS: From February to April 2021, Project ECHO (Extension for Community Healthcare Outcomes) created an 8-week, synchronous and virtual, CCHH ECHO telementoring series for health professionals. Didactics, simulated cases, and climate change tools were used to educate the interprofessional group of participants. RESULTS: During this CCHH ECHO pilot series, 625 unique participants represented 45 US states and 25 countries. The participants reported that they increased their knowledge, skills, and communication techniques regarding climate change and health. CONCLUSIONS: The human health effects of climate change is an emerging field, and increasing knowledge and communication skills among health practitioners is of critical importance. The CCHH ECHO is one potential platform that may reach a diverse community of health professionals globally due to the diffusion and demonopolization of knowledge.
Climate change refers to the long-term changes in temperature and weather due to human activities. Increase in average global temperature and extreme and unpredictable weather are the most common manifestations of climate change. In recent years, it has acquired the importance of global emergency and affecting not only the wellbeing of humans but also the sustainability of other lifeforms. Enormous increase in the emission of greenhouse gases (CO2, methane and nitrous oxide) in recent decades largely due to burning of coal and fossil fuels, and deforestation are the main drivers of climate change. Marked increase in the frequency and intensity of natural disasters, rise in sea level, decrease in crop productivity and loss of biodiversity are the main consequences of climate change. Obvious mitigation measures include significant reduction in the emission of greenhouse gases and increase in the forest cover of the landmass. Conference of Parties (COP 21), held in Paris in 2015 adapted, as a legally binding treaty, to limit global warming to well below 2 degrees C, preferably to 1.5 degrees C by 2100, compared to pre-industrial levels. However, under the present emission scenario, the world is heading for a 3-4 degrees C warming by the end of the century. This was discussed further in COP 26 held in Glasgow in November 2021; many countries pledged to reach net zero carbon emission by 2050 and to end deforestation, essential requirements to keep 1.5 degrees C target. However, even with implementation of these pledges, the rise is expected to be around 2.4 degrees C. Additional measures are urgently needed to realize the goal of limiting temperature rise to 1.5 degrees C and to sustain biodiversity and human welfare.
Climate change and obesity are two major concerns for policy makers globally, but can climate change be a driver of obesity? This is what our analysis tries to establish. To this purpose, we exploit inter-annual variations of the Body Mass Index (BMI) for children and adults in 134 countries over 39 years, to study to what extent changes in air temperature and precipitations affect obesity. Using panel data econometrics and exploiting both within- and cross-country variations in BMI, we uncovered a robust U-shaped associationbetween temperature and the BMI of girls, boys and women, but failed to detect any significant effect of precipitations. Our analysis also reveals that the impact of temperature on BMI, particularly for girls and women, is robust to the inclusion of other determinants of obesity stressed by the existing literature, such as GDP per capita, fertility, and agriculutral productivity, suggesting that mean air temperature is directly associated with, and may have an independent effect on, BMI.
This paper explains how a participative approach was used to collect first-hand citizens’ suggestions on how to improve science communication regarding Climate Change. A public consultation involving citizens from 5 different European countries revealed various perspectives concerning their communication preferences on scientific topics. Five main themes emerged following citizens’ proposals for better communication and involvement: producer of information, medium, message strategies, audiences and areas of action and engagement.
Climate change affects how the emerging contaminants per- and polyfluoroalkyl substances (PFAS) and microplastics impact human health and the environment. The known and implied effects from PFAS compounds and microplastics are reviewed, followed by an overview of their occurrence, transport, degradation in fresh water and ocean water, and health impacts. PFAS and microplastics releases are increasing as a result of climate change, and the breakdown of microplastics is releasing greenhouse gases, which in turn augments climate change. Strategies are presented for reductions in the release of these emerging contaminants.
The “Earthrise” photograph, taken on the 1968 Apollo 8 mission, became one of the most significant images of the 20th Century. It triggered a profound shift in environmental awareness and the potential for human unity-inspiring the first Earth Day in 1970. Taking inspiration from these events 50 years later, we initiated Project Earthrise at our 2020 annual conference of inVIVO Planetary Health. This builds on the emergent concept of planetary health, which provides a shared narrative to integrate rich and diverse approaches from all aspects of society towards shared solutions to global challenges. The acute catastrophe of the COVID-19 pandemic has drawn greater attention to many other interconnected global health, environmental, social, spiritual, and economic problems that have been underappreciated or neglected for decades. This is accelerating opportunities for greater collaborative action, as many groups now focus on the necessity of a “Great Transition”. While ambitious integrative efforts have never been more important, it is imperative to apply these with mutualistic value systems as a compass, as we seek to make wiser choices. Project Earthrise is our contribution to this important process. This underscores the imperative for creative ecological solutions to challenges in all systems, on all scales with advancing global urbanization in the digital age-for personal, environmental, economic and societal health alike. At the same time, our agenda seeks to equally consider our social and spiritual ecology as it does natural ecology. Revisiting the inspiration of “Earthrise”, we welcome diverse perspectives from across all dimensions of the arts and the sciences, to explore novel solutions and new normative values. Building on academic rigor, we seek to place greater value on imagination, kindness and mutualism as we address our greatest challenges, for the health of people, places and planet.
Water access and environmental migration are crucial global development issues to be examined from an interdisciplinary perspective. Although climate change and water-related dimensions of migration have been widely studied, a gendered lens on this topic is scarce in the current academic literature. To address this gap, I use insights from feminist political ecology and a water-migration-gender nexus to analyze the gender aspects in women’s experiences, challenges, and opportunities due to climate change and water stressors. After conducting a systematic literature review, 67 articles were appraised for quality and included in the synthesis to review existing policies. In the discussion section, based on these existing policies, I propose integrated governance strategies that could synergically mitigate water-related problems and (non) migration challenges with a neglected gender focus so that women and girls can prepare to be more resilient to the social, economic, and environmental changes in everyday life. This paper engages with vulnerability, tolerance, and adaptation of women and girls to socio-ecological changes around the water discourse, and it proposes a conceptual framework for the integrated governance strategies to understand better the connection between water-related security risks and development problems resulting from climate change, (non) migration, and gender.
The impacts of climate change, such as sea-level rise and extreme weather events, are expected to increase and alter human migration and mobility. Climate-related mobility is not inherently a crisis; it can provide a pathway for adaptation to climate change. However, a growing body of research identifies health risks and some opportunities associated with climate-related mobility. This review examines recent research (published since 2018) on the climate change-mobility-health nexus; this research focuses largely on in-country mobility in Asia, Africa, and Pacific Island countries. It considers the links between human mobility and anthropogenic climate change and documents the findings of empirical research that addresses the health consequences of displacement, planned relocation, migration, and migration into sites of climate risk. The findings highlight the need for climate-sensitive and migrant-inclusive health care in a heating world.
Global food systems are developing rapidly, and have resulted in a large burden of disease and a high proportion of environmental resource use. We combined global data sources on food supply and trade, environmental footprints, burdens of disease, and vulnerability to climate change to explore patterns from 1990 to 2017. Four distinct patterns of food supply (animal sources and sugar, vegetables and nuts, starchy roots and fruits, and seafood and oils) were matched to health and environmental risks. The animal sources and sugar pattern was found to have the greatest environmental footprint and to be associated with a greater burden of chronic disease than any other pattern, although it was also associated with lower undernutrition. This pattern is globally predominant, but has begun to decrease in higher income countries. Countries where this pattern is predominant are generally among the least susceptible to climate change, whereas more susceptible countries tend to have more sustainable patterns of food supply. More countries that are susceptible to climate change are increasingly exporting a larger proportion than before of their cereals, fruit, and vegetables globally, which will lead to increased risks in global food security. To increase resilience to future shocks, dietary change towards more sustainable patterns should accelerate in high-income countries, and the food systems of the most susceptible countries should be protected.
BACKGROUND: For hospitals, learning from disaster response efforts and adapting organizational practices can improve resilience in dealing with future disruptions. However, amidst global disruptions by climate change, the coronavirus disease 2019 (COVID-19) pandemic, and other disasters, hospitals’ ability to cope continues to be highly variable. Hence, there are increasing calls to improve hospitals’ capabilities to grow and adapt towards enhanced resilience. AIM: This study aims two-fold: (1) to characterize the current state of knowledge about how hospitals are gaining knowledge from their responses to disasters, and (2) to explore how this knowledge can be applied to inform organizational practices for hospital resilience. METHOD: This study used Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines for data collection and framework for data analysis, Covidence software, and Medical Subject Headings (MeSH) terms and keywords relevant to “hospitals,” “learn,” “disaster response,” and “resilience.” The quality appraisal used an adapted version of the Mixed Methods Assessment Tool (MMAT). RESULTS: After applying inclusion and exclusion criteria and quality appraisal, out of the 420 articles retrieved, 22 articles remained for thematic and content analysis. The thematic analysis included the hospital’s functional (operational) and physical (structural and non-structural) sections. The content analysis followed nine learning areas (Governance and Leadership, Planning and Risk Assessment, Surveillance and Monitoring, Communication and Network Engagement, Staff Practices and Safety, Equipment and Resources, Facilities and Infrastructure, Novelty and Innovation, and Learning and Evaluation).On applying the Deming cycle, only four studies described a completed learning cycle wherein hospitals adapted their organizational structures using the prior experience and evaluation gained in responding to disaster(s). CONCLUSIONS: There is a gap between hospitals’ organizational learning and institutionalized practice. The conceptualized Hybrid Resilience Learning Framework (HRLF) aims to guide the hospitals’ decision makers in evaluating organizational resilience and knowledge.In the face of disasters, both the stressful factors and the coping strategies that affect the health care workers (HCWs) should be substantially considered.
Planning policy can play a key role in effective, equitable climate change adaptation; however, its capacity remains undermined by technocratic approaches reliant on hard measures, discounting significant research on addressing sources of social vulnerability for successful adaptation policy. Not surprisingly, little research makes use of a planning lens to explore the challenge of utilizing policy measures to address social vulnerability – particularly in relation to climate change. Through a scholarly narrative review of interdisciplinary sources an indepth understanding of climate change vulnerability is gained and its importance in successful adaptation planning demonstrated. The urgency and complexity of climate change requires overcoming socio-political barriers within the existing adaptation paradigm, balancing technocratic methods with a collaborative approach focusing on the social, economic and ethical components of vulnerability to climate change.
Extreme weather events (EWEs) affected health in every world region during 2021, placing the planet in “uncharted territory.” Portraying the human impacts of EWEs is part of a health frame that suggests public knowledge of these risks will spur support for needed policy change. The health frame has gained traction since the Paris COP21 (United Nations Climate Change Conference) and arguably helped to achieve modest progress at the Glasgow COP26. However, reporting rarely covers the full picture of health impacts from EWEs, instead focusing on cost of damages, mortality, and displacement. This review summarizes data for 30 major EWEs of 2021 and, based on the epidemiological literature, discusses morbidity-related exposures for four hazards that marked the year: wildfire smoke; extreme cold and power outages; extreme, precipitation-related flooding; and drought. A very large likely burden of morbidity was found, with particularly widespread exposure to risk of respiratory outcomes (including interactions with COVID-19) and mental illnesses. There is need for a well-disseminated global annual report on EWE morbidity, including affected population estimates and evolving science. In this way, the public health frame may be harnessed to bolster evidence for the broader and promising frame of “urgency and agency” for climate change action.
Children are not responsible for diseases, natural disasters, political conflicts, and wars; yet, children generally suffer the most. Although the UN Convention on the Rights of the Child (1989) is one of the most ratified world treaties, ample evidence of violations of children’s rights exists in reports on the devastating effects of climate change, the COVID-19 pandemic, and armed conflicts (e.g., Afghanistan, Haiti, Syria, Ukraine, Yemen) including abuse, abduction, becoming child soldiers, death, early marriages, family separation, loss of schooling, malnutrition, neglect, poverty, sexual violence, and trafficking, leading to traumatic short- and long-term academic, emotional, psychological, and physical consequences. This article highlights a child-rights based approach to the global crisis: (1) sounding an alarm for immediate and greater attention of governments to address children’s rights violations and (2) calling multi-disciplinary scholars to redouble their efforts toward freely sharing their findings, partnering with policy makers and stakeholders, collecting difficult to obtain data, and putting their knowledge into action in preventive and intervention measures to empower the implementation of children’s protection and participation rights in the home, school, community, nation, and globally. The global multi-faceted children’s rights crisis requires urgent individual and collective action to make children’s rights a global reality.
The modern, global food system is unsustainable for both human and planetary health. The widespread consumption of highly processed foods and use of production systems that negatively affect the environment have led to a rise in nutrition-related diseases and exacerbated the effects of climate change. A comprehensive reform of global food systems and diets is needed to effectively respond to this problem, but the interference of food industry actors in health negotiations is diluting health policies at both domestic and international levels. This article establishes the concrete value of international legal responses grounded in human rights for tackling the global syndemic of climate change and malnutrition. The Framework Convention on Tobacco Control (FCTC) exemplifies how normative conflicts between the trade and health regimes can be overcome. Forming an effective and egalitarian response to malnutrition and climate change will require a rights-based, regime interaction approach that prioritizes human and planetary health over private interests.
Climate change poses significant threats to human health and society. Although healthcare will bear a large burden of the downstream effects of climate change, the healthcare industry is simultaneously a major contributor to climate change. Within hospitals, surgery is one of the most energy-intensive practices. There is a growing body of literature describing ways to mitigate and adapt to climate change in surgery. However, there is a need to better understand the unique implications for each surgical subspecialty. This review contextualizes plastic and reconstructive surgery within the climate change discussion. In particular, this review highlights the specific ways in which plastic surgery may affect climate change and how climate change may affect plastic surgery. In light of growing public demand for change and greater alignment between industries and nations with regard to climate change solutions, we also offer a conceptual framework to guide further work in this burgeoning field of research.
Organ transplantation network design is a critical issue for continuing human life. This paper presents a new triobjective robust optimization model for the design of transplantation networks that are adaptable to disruption scenarios. This paper presents a new mixed-integer non-linear programming (MINLP) model to construct a scenario-based transplantation supply chain. In this regard, objective functions of the proposed scenario-based model are developed to minimize the delivery time of the organs after disruption and maximize the quality of organs and the compatibility of blood types. Afterward, the queue of people in health facilities with limiting capacity may reduce the surgeries and lead to death risk. Therefore, it is necessary to examine a queue system that reflects the situation and changes over time. The risk of climate change over the network can be created from the queue and affects the quality of organs. When the risk of climate change makes delay receiving the organs by transplant centers, the compatibility of blood types is a helpful method to handle surgery rates and decrease the mortality rate. Moreover, one of the other issues that have an impact on the decisions of the managers in the transplant process is related to making an appropriate decision by respecting uncertain conditions. For this reason, this paper has proposed a new hybrid solution approach based on the scenario-based robust optimization approach and the compromise solution method to tackle different uncertainties in an optimization model. In addition, the proposed model is NP-hard, and this paper utilizes two metaheuristic optimization algorithms to solve the problem, including genetic algorithm (GA) and black widow optimization (BWO). The empirical examples are provided to validate the performance of the proposed model, and these represent the advantage of BWO over GA. After introducing essential analyses, the comparative analysis and managerial insights are explained.
Atmospheric pollution has been considered one of the most important topics in environmental science once it can be related to the incidence of respiratory diseases, climate change, and others. Knowing the composition of this complex and variable mixture of gases and particulate matter is crucial to understand the damages it causes, help establish limit levels, reduce emissions, and mitigate risks. In this work, the current scenario of the legislation and guideline values for indoor and outdoor atmospheric parameters will be reviewed, focusing on the inorganic and organic compositions of particulate matter and on biomonitoring. Considering the concentration level of the contaminants in air and the physical aspects (meteorological conditions) involved in the dispersion of these contaminants, different approaches for air sampling and analysis have been developed in recent years. Finally, this review presents the importance of data analysis, whose main objective is to transform analytical results into reliable information about the significance of anthropic activities in air pollution and its possible sources. This information is a useful tool to help the government implement actions against atmospheric air pollution.
Background: As growing numbers of people may be forced to migrate due to climate change and variability, it is important to consider the disparate impacts on health for vulnerable populations, including sexual and reproductive health (SRH). This scoping review aims to explore the relationship between climate migration and SRH. Methods: We searched PubMed/MEDLINE, CINAHL Plus, EMBASE, Web of Science, Scopus, Global Health and Google for peer-reviewed and gray literature published before 2nd July 2021 in English that reported on SRH in the context of climate migration. Data were extracted using a piloted extraction tool and findings are reported in a narrative synthesis. Results: We screened 1,607 documents. Ten full-text publications were included for analysis: five peer-reviewed articles and five gray literature documents. Reported SRH outcomes focused on maternal health, access to family planning and antiretroviral therapy, sexual and gender-based violence, transactional sex, and early/forced marriage. Recommendations to improve SRH in the context of climate migration called for gender-transformative health systems, education and behavior change programmes, and the involvement of local women in policy planning and programme implementation. Discussion: While the disparate impacts of climate change and migration are well-established, primary data on the scope of impact due to climate migration is limited. The SRH outcomes reported in the literature focus on a relatively narrow range of SRH domains, emphasizing women and girls, over men. Achieving holistic and equitable SRH in the context of climate migration requires engaging all genders across the range of SRH outcomes and migration contexts. This review highlights the need for further empirical evidence on the effect of climate migration on SRH, with research that is context-specific and engages communities in order to reflect the heterogeneity of outcomes and impact in the climate-migration-SRH nexus.
Fibromyalgia syndrome (FMS) is a chronic widespread pain condition of unknown aetiology. The role of temperature in FMS pain has not been reviewed systematically. The goal of this study was to review the influences of temperature on pain in FMS, from meteorological and quantitative sensory testing (QST) studies. The review was registered with Prospero: ID-CRD42020167687, and followed PRISMA guidance. Databases interrogated were: MEDLINE (via OVID), EMBASE, PubMed, Web of Science, ScienceDirect, CINAHL, and ProQuest (Feb’20). Exclusion criteria were: age <18, animal studies, non-English, and noncontrolled articles. Thirteen studies pertaining to ambient temperature and FMS pain were identified; 9 of these found no uniform relationship. Thirty-five QST studies were identified, 17 of which assessed cold pain thresholds (CPTs). All studies showed numerically reduced CPTs in patients, ranging from 10.9°C to 26.3°C versus 5.9°C to 13.5°C in controls; this was statistically significant in 14/17. Other thermal thresholds were often abnormal. We conclude that the literature provides consistent evidence for an abnormal sensitization of FMS patients' temperature-sensation systems. Additional work is required to elucidate the factors that determine why a subgroup of patients perceive low ambient temperatures as painful, and to characterize that group. PERSPECTIVE: Patients often report increased pain with changes in ambient temperature; even disabling, extreme temperature sensitivity in winter. Understanding this phenomenon may help clinicians provide reassurance and advice to patients and may guide research into the everyday impact of such hypersensitivity, whilst directing future work into the pathophysiology of FMS.
BACKGROUND: Lagged associations in climate-health studies have already been ubiquitously acknowledged in recent years. Despite extensive time-series models having proposed accounting for lags, few studies have addressed the question of maximum-lag specification, which could induce considerable deviations of effect estimates. METHODS: We searched the PubMed and Scopus electronic databases for existing climate-health literature in the English language with a time-series or case-crossover study design published during 2000-2019 to summarize the statistical methodologies and reported lags of associations between climate variables and 14 common causes of morbidity and mortality. We also aggregated the results of the included studies by country and climate zone. RESULTS: The associations between infectious-disease outcomes and temperatures were found to be lagged for ∼1-2 weeks for influenza, 3-6 weeks for diarrhoea, 7-12 weeks for malaria and 6-16 weeks for dengue fever. Meanwhile, the associations between both cardiovascular and respiratory diseases and hot temperatures lasted for <5 days, whereas the associations between cardiovascular diseases and cold temperatures were observed to be 10-20 days. In addition, rainfall showed a 4- to 10-week lagged association with infectious diarrheal diseases, whereas the association could be further delayed to 8-12 weeks for vector-borne diseases. CONCLUSION: Our findings indicated some general patterns for possible lagged associations between some common health outcomes and climatic exposures, and suggested a necessity for a biologically plausible and reasonable definition of the effect lag in the modelling practices for future environmental epidemiological studies.
This theoretical paper builds on a multidisciplinary framework which is structured to acknowledge the need to combine different research disciplines to understand the problems within our current unsustainable food system and be able to develop possible solutions through new innovations. Current food production methods come at an environmental cost as they generate large amounts of greenhouse gas emissions which affect biodiversity and climate change. The article shows that the problems surrounding food systems and our culture around food, are multifaceted and intricate. The fact is that a growing number of citizens suffer from obesity with various consequential diseases as a result, while a part of the population is still malnourished and dying of hunger. This paper summarizes results from some fairly new studies and different international policy reports to try to clarify how broad the problem is, which is crucial to find new pathways forward to address the problems. Through theoretical discussion, the paper identifies some of the deep underlying root causes and fundamental reasons as to why the urgent needed change is so slow.
The burden imposed by pollution falls more on those living in low-income and middle-income countries, affecting children more than adults. Most air pollution results from incomplete combustion and contains a mixture of particulate matter and gases. Air pollution exposure has negative impacts on respiratory health. This article concentrates on air pollution in 2 settings, the child’s home and the ambient environment. There is an inextricable 2-way link between air pollution and climate change, and the effects of climate change on childhood respiratory health also are discussed.
Ambient air pollution is produced by sources including vehicular traffic, coal-fired power plants, hydraulic fracturing, agricultural production, and forest fires. It consists of primary pollutants generated by combustion and secondary pollutants formed in the atmosphere from precursor gases. Air pollution causes and exacerbates climate change, and climate change worsens health effects of air pollution. Infants and children are uniquely sensitive to air pollution, because their organs are developing and they have higher air per body weight intake. Health effects linked to air pollution include not only exacerbations of respiratory diseases but also reduced lung function development and increased asthma incidence. Additional outcomes of concern include preterm birth, low birth weight, neurodevelopmental disorders, IQ loss, pediatric cancers, and increased risks for adult chronic diseases. These effects are mediated by oxidative stress, chronic inflammation, endocrine disruption, and genetic and epigenetic mechanisms across the life span. Natural experiments demonstrate that with initiatives such as increased use of public transportation, both air quality and community health improve. Similarly, the Clean Air Act has improved air quality, although exposure inequities persist. Other effective strategies for reducing air pollution include ending reliance on coal, oil, and gas; regulating industrial emissions; reducing exposure with attention to proximity of residences, schools, and child care facilities to traffic; and a greater awareness of the Air Quality Index. This policy reviews both short- and long-term health consequences of ambient air pollution, especially in relation to developmental exposures. It examines individual, community, and legislative strategies to mitigate air pollution.
This review provides a community’s perspective on air quality research focusing mainly on developments over the past decade. The article provides perspectives on current and future challenges as well as research needs for selected key topics. While this paper is not an exhaustive review of all research areas in the field of air quality, we have selected key topics that we feel are important from air quality research and policy perspectives. After providing a short historical overview, this review focuses on improvements in characterizing sources and emissions of air pollution, new air quality observations and instrumentation, advances in air quality prediction and forecasting, understanding interactions of air quality with meteorology and climate, exposure and health assessment, and air quality management and policy. In conducting the review, specific objectives were (i) to address current developments that push the boundaries of air quality research forward, (ii) to highlight the emerging prominent gaps of knowledge in air quality research, and (iii) to make recommendations to guide the direction for future research within the wider community. This review also identifies areas of particular importance for air quality policy. The original concept of this review was borne at the International Conference on Air Quality 2020 (held online due to the COVID 19 restrictions during 18-26 May 2020), but the article incorporates a wider landscape of research literature within the field of air quality science. On air pollution emissions the review highlights, in particular, the need to reduce uncertainties in emissions from diffuse sources, particulate matter chemical components, shipping emissions, and the importance of considering both indoor and outdoor sources. There is a growing need to have integrated air pollution and related observations from both ground-based and remote sensing instruments, including in particular those on satellites. The research should also capitalize on the growing area of low-cost sensors, while ensuring a quality of the measurements which are regulated by guidelines. Connecting various physical scales in air quality modelling is still a continual issue, with cities being affected by air pollution gradients at local scales and by long-range transport. At the same time, one should allow for the impacts from climate change on a longer timescale. Earth system modelling offers considerable potential by providing a consistent framework for treating scales and processes, especially where there are significant feedbacks, such as those related to aerosols, chemistry, and meteorology. Assessment of exposure to air pollution should consider the impacts of both indoor and outdoor emissions, as well as application of more sophisticated, dynamic modelling approaches to predict concentrations of air pollutants in both environments. With particulate matter being one of the most important pollutants for health, research is indicating the urgent need to understand, in particular, the role of particle number and chemical components in terms of health impact, which in turn requires improved emission inventories and models for predicting high-resolution distributions of these metrics over cities. The review also examines how air pollution management needs to adapt to the above-mentioned new challenges and briefly considers the implications from the COVID-19 pandemic for air quality. Finally, we provide recommendations for air quality research and support for policy.
Purpose The interconnections between climate change and health are well studied. However, there is a perceived need for studies that examine how responses to health hazards (e.g. cardiovascular diseases, ozone layer effects, allergens, mental health and vector-borne diseases) may assist in reducing their impacts. The purpose of this paper is to review the evidence on health responses to climate hazards and list some measures to address them. Design/methodology/approach A mixed literature review, bibliometric analysis and an original online survey were undertaken on 140 participants from 55 countries spread across all geographical regions. Findings The bibliometric analysis identified that most climate-related health hazards are associated with extreme weather events. However, only one-third of the investigated papers specifically analysed the connections between climate change and health hazards, revealing a thematic gap. Also, although Africa is highly affected by climate change, only 5% of the assessed studies focused on this continent. Many respondents to the survey indicated “heat distress” as a significant vulnerability. The survey also identified social determinants relevant to climate-induced health vulnerabilities, such as socioeconomic and environmental factors, infrastructure and pre-existing health conditions. Most respondents agree that policies and regulations are the most effective adaptation tools to address the public health hazards triggered by climate change. This paper presents some suggestions for optimising public health responses to health hazards associated with climate change, such as the inclusion of climate-related components in public health policies, setting up monitoring systems to assess the extent to which specific climate events may pose a health threat, establishing plans to cope with the health implications of heatwaves, increased measures to protect vulnerable groups and education and awareness-raising initiatives to reduce the overall vulnerability of the population to climate-related health hazards. These measures may assist the ongoing global efforts to understand better – and cope with – the impacts of climate change on health. Originality/value The combination of a literature review, bibliometric analysis and an original world survey identified and presented a wide range of responses.
BACKGROUND: When natural disasters strike, there is a sudden decrease in access to care due to infrastructure loss and displacement. A pandemic has the similar ability to acutely limit access to care. The relationship between decreased access to care and natural disasters has been previously explored. OBJECTIVE: The purpose of this article is to present a focused review of the available and emerging literature regarding the overall impact of natural disasters and pandemics on unintended pregnancy and decreased care in this setting. METHODS: A literature search was conducted on PubMed, Cochrane, Google Scholar, and Embase databases. The search was restricted to studies that were population-based, prospective or retrospective. Only peer-reviewed articles were considered. The search was further restricted to manuscripts in English or officially translated manuscripts. All qualifying papers from which data were extracted were subjected to a quality assessment conducted by two independent investigators (SK and AA). Each investigator reviewed all nine papers relevant to data collection using the Effective Public Health Practice Project (EPHP). MeSH terms were utilized across various databases. Studies were selected that were population-based, prospective or retrospective. Case reports and case series were not used. The primary outcomes were the rates of unintended pregnancy. Secondary outcomes included the use of contraception, short interval pregnancy, and access to reproductive services. RESULTS: An initial search yielded 74 papers, of which nine papers were reviewed for qualitative data, examining the subjects affected by natural disasters or pandemics. An additional two papers regarding theoretical data and COVID-19 were analyzed. Although there seems to be a rise in unintended pregnancy and more difficulty accessing care following natural disasters and pandemics, there are variations in the rates based on region and event. CONCLUSIONS: The full effects of the COVID-19 pandemic on the rates of unplanned pregnancies will become apparent in the months and years to come. As obstetrician-gynecologists, we must communicate openly with our patients regarding the use of available contraception, sexual education, and family planning services at times of natural disasters and pandemics.
Least developed countries (LDCs) are home to over a billion people throughout Africa, Asia-Pacific, and the Caribbean. The people who live in LDCs represent just 13% of the global population but 40% of its growth rate. Characterised by low incomes and low education levels, high proportions of the population practising subsistence living, inadequate infrastructure, and lack of economic diversity and resilience, LDCs face serious health, environmental, social, and economic challenges. Many communities in LDCs have very limited access to adequate sanitation, safe water, and clean cooking fuel. LDCs are environmentally vulnerable; facing depletion of natural resources, the effects of unsustainable urbanization, and the impacts of climate change, leaving them unable to safeguard their children’s lifetime health and wellbeing. This paper reviews and describes the complexity of the causal relationships between children’s health and its environmental, social, and economic influences in LDCs using a causal loop diagram (CLD). The results identify some critical feedbacks between poverty, family size, population growth, children’s and adults’ health, inadequate water, sanitation and hygiene (WASH), air pollution, and education levels in LDCs and suggest leverage points for potential interventions. A CLD can also be a starting point for quantitative systems science approaches in the field, which can predict and compare the effects of interventions.
BACKGROUND: The escalating negative impact of climate change on our environment has the potential to result in significant morbidity of rhinologic diseases. METHODS: Evidence based review of examples of rhinologic diseases including allergic and nonallergic rhinitis, chronic rhinosinusitis, and allergic fungal rhinosinusitis was performed. RESULTS: The lower socioeconomic population, including historically oppressed groups, will be disproportionately affected. CONCLUSIONS: We need a systematic approach to improve healthcare database infrastructure and funding to promote diverse scientific collaboration to address these healthcare needs.
Catastrophic events can range from natural disasters such as Hurricane Maria which devastated Puerto Rico on September 20, 2017[1] to mass casualty terrorist attacks such as when the World Trade Center was destroyed on September 11, 2001. Hydrometeorological catastrophes such as hurricanes, tornadoes, and floods are predictable. On the other hand, geologic disasters such as earthquakes are not. Many natural disasters affect the entire infrastructure from buildings, roads, electricity, and communication. While natural disasters can affect all, they disproportionately affect the poor and vulnerable. Terrorist attacks will usually affect urban areas as they have an intentional goal to cause as many victims as possible. Complex humanitarian emergencies result in deaths from violence as well as disease. A multi-casualty incident (MCI) is an event in which the resources available (rescue personnel, healthcare providers, facilities, and equipment) are insufficient to deal with the incident. In a disaster, not only are there not enough resources, but there is a complete breakdown in communication and the ability to deliver these resources. The local rescue workers and health care personnel, may themselves become the victims or be unable to arrive at work. The local health care facilities may be damaged or destroyed.
This paper explores the relationship between climate change and reproductive injustice. It does so by highlighting several ethical concerns that warrant public policy attention at the intersection of full bodily autonomy and the transition to a carbon neutral economy. In Section one, the climate change science literature addressing the health and social harm disparities for low-income communities is summarized. This summary emphasizes the effects of this harm for poor women and girls of color. In Section two, the jurisprudential history regarding full bodily autonomy and reproductive justice is presented. This recounting draws attention to the historical legacy of inequality based on race, gender, and class. In Section three, the ethical implications of climate change are presented and discussed through the analytical lens of green criminology and reproductive justice. These implications include a feminist reclaiming of full bodily autonomy for poor women and girls of color, given the health and social inequalities they disproportionately experience.
Since 2015 there has been a surge of international agendas to address a range of global challenges: climate change (Paris Agreement), sustainable development (Agenda 2030), disaster risk reduction (Sendai Framework) and sustainable urban transformation (New Urban Agenda). Health is relevant to all of these agendas. Policymakers must now translate these global agendas into national level policies to implement the agreed goals in a coherent manner. However, approaches to synergise health activities within and across these agendas are needed, in order to achieve better coherence and maximise national level implementation. This research evaluated the framing of human health within these agendas. A content analysis of the agendas was conducted. Findings indicate (i) the importance of increased awareness of health systems strengthening as a helpful framework to guide the integration of health issues across the agendas, (ii) only two health themes had synergies across the agendas, (iii) the lack of a governance mechanism to support the integration of these four agendas to enable national (and sub-national) governments to more feasibly implement their ambitions, and (iv) the vital component of health leadership. Finally, planetary health is a relevant and timely concept that can support the urgent shift to a healthy planet and people.
Air pollution is a major issue all over the world because of its impacts on the environment and human beings. The present review discussed the sources and impacts of pollutants on environmental and human health and the current research status on environmental pollution forecasting techniques in detail; this study presents a detailed discussion of the Artificial Intelligence methodologies and Machine learning (ML) algorithms used in environmental pollution forecasting and early-warning systems; moreover, the present work emphasizes more on Artificial Intelligence techniques (particularly Hybrid models) used for forecasting various major pollutants (e.g., PM2.5, PM10, O-3, CO, SO2, NO2, CO2) in detail; moreover, focus is given to AI and ML techniques in predicting chronic airway diseases and the prediction of climate changes and heat waves. The hybrid model has better performance than single AI models and it has greater accuracy in prediction and warning systems. The performance evaluation error indexes like R-2, RMSE, MAE and MAPE were highlighted in this study based on the performance of various AI models.
People affected by conflict are particularly vulnerable to climate shocks and climate change, yet little is known about climate change adaptation in fragile contexts. While climate events are one of the many contributing drivers of conflict, feedback from conflict increases vulnerability, thereby creating conditions for a vicious cycle of conflict. In this study, we carry out a systematic review of peer-reviewed literature, taking from the Global Adaptation Mapping Initiative (GAMI) dataset to documenting climate change adaptation occurring in 15 conflict-affected countries and compare the findings with records of climate adaptation finance flows and climate-related disasters in each country. Academic literature is sparse for most conflict-affected countries, and available studies tend to have a narrow focus, particularly on agriculture-related adaptation in rural contexts and adaptation by low-income actors. In contrast, multilateral and bilateral funding for climate change adaptation addresses a greater diversity of adaptation needs, including water systems, humanitarian programming, and urban areas. Even among the conflict-affected countries selected, we find disparity, with several countries being the focus of substantial research and funding, and others seeing little to none. Results indicate that people in conflict-affected contexts are adapting to climate change, but there is a pressing need for diverse scholarship across various sectors that documents a broader range of adaptation types and their results.
Food production is affected by climate change, and, in turn, food production is responsible for 20-30% of greenhouse gases. The food system must increase output as the population increases and must meet nutrition and health needs while simultaneously assisting in achieving the Sustainable Development Goals. Good nutrition is important for combatting infection, reducing child mortality, and controlling obesity and chronic disease throughout the life course. Dietary guidelines provide advice for a healthy diet, and the main principles are now well established and compatible with sustainable development. Climate change will have a significant effect on food supply; however, with political commitment and substantial investment, projected improvements will be sufficient to provide food for the healthy diets needed to achieve the Sustainable Development Goals. Some changes will need to be made to food production, nutrient content will need monitoring, and more equitable distribution is required to meet the dietary guidelines. Increased breastfeeding rates will improve infant and adult health while helping to reduce greenhouse gases.
Compost Heat Recovery Systems (CHRS) represent an innovative technology to provide domestic decentralized thermal energy, recovering the heat naturally produced during the aerobic biodegradation of waste biomass, coming from gardening/farming/forestry activities. CHRSs represent an alternative to centralized grid-connected power systems and are usually installed (combined with most traditional systems) to power underfloor heating systems (UHS) or domestic hot water systems (DHWS), lowering impacts and costs of thermal energy production. In this study, the Global Warming Potential (GWP) of CHRSs (measured as kg(CO2)(-eq)/kWh) was investigated using life cycle assessment (LCA) approach, considering the whole life cycle of an average plant. CHRSs showed a negative Net value of GWP impact, equal to -0.268 kg(CO2)(-eq)/kWh, as full balance of positive (0.062 kg(CO2)(-eq)/kWh) and negative (-0.329 kg(CO2)(-eq)/kWh) emissions. Negative emissions are related to avoided primary materials, replacement of natural gas used as traditional thermal energy production and replacement of mineral fertilizers. Considering only the positive emissions (0.062 kg(CO2)(-eq)/kWh), CHRSs emerged to be in line with Solar Hot-Water Systems (0.061 kg(CO2)(-eq)/kWh mean value) and slightly higher than Geothermal Systems (0.019 kg(CO2)(-eq)/kWh mean value). Along with GWP impact, other midpoint and endpoint impact indicators were assessed and all showed a negative Net value: Particulate Matter PM (-2.36E-5 kg(PM2)(.5-eq)/kWh), Fresh Water eutrophication FWE (-6.78E-06 kg(P-eq)/kWh), Fresh Water ecotoxicity FWec (-2.10E-01 CTUe/kWh), Human Toxicity cancer effect HTc (-5.68E-09 CTUh/kWh), Human Toxicity non-cancer effect HTnc (-3.51E-09 CTUh/kWh) and Human Health HH (-5.22E-08 DALY/kWh). These results demonstrate that CHRS is extremely convenient considering both environmental and human health consequences.
OBJECTIVES: The addition of green spaces (GS) in cities is perceived as an efficient solution to combat climate change and biodiversity loss while also improving human health. Quantitative health impact assessment (QHIA) is a powerful tool to assess the health benefits of GS and support policy-making decisions. In France, a preliminary analysis of the literature led to the decision of developing guidance for QHIA applied to GS and mortality. This paper focuses on the choice of exposure-response functions (ERF) for those QHIA. STUDY DESIGN: Literature review and analysis of the key steps of QHIA. METHODS: Articles providing ERF for all-cause, cardiovascular and respiratory mortality in relation to GS were identified through a literature review and ranked based on a quality score. ERF from the articles with the highest scores was pooled in meta-analyses. RESULTS: In total, 13 ERF were selected for all-cause mortality, 10 for cardiovascular mortality and 5 for respiratory mortality. Meta-risk for a 0.1 increase in the normalised differential vegetation index were, 0.96 (95% confidence interval [CI] 0.94; 0.97), 0.98 (95% CI 0.96; 0.99) and 0.97 (95% CI 0.92; 1.02) for all-cause, cardiovascular and respiratory mortality, respectively. CONCLUSIONS: While current knowledge makes it possible to use QHIA on GS and mortality, interdisciplinary research is still needed to clarify the shape of the relationship and its temporality and to assess exposure in a meaningful way for decision-making.
BACKGROUND: Climate change has significant implications for health, yet healthcare provision itself contributes significant greenhouse gas emission. Medical students need to be prepared to address impacts of the changing environment and fulfil a key role in climate mitigation. Here we evaluate the effectiveness of an online module on climate-change and sustainability in clinical practice designed to achieve learning objectives adapted from previously established sustainable healthcare priority learning outcomes. METHODS: A multi-media, online module was developed, and 3(rd) and 4(th) year medical students at Brighton and Sussex Medical School were invited to enrol. Students completed pre- and post-module questionnaires consisting of Likert scale and white space answer questions. Quantitative and qualitative analysis of responses was performed. RESULTS: Forty students enrolled and 33 students completed the module (83% completion rate). There was a significant increase in reported understanding of key concepts related to climate change and sustainability in clinical practice (p < 0.001), with proportion of students indicating good or excellent understanding increasing from between 2 - 21% students to between 91 - 97% students. The majority (97%) of students completed the module within 90 min. All students reported the module was relevant to their training. Thematic analysis of white space responses found students commonly reported they wanted access to more resources related to health and healthcare sustainability, as well as further guidance on how to make practical steps towards reducing the environmental impact within a clinical setting. CONCLUSION: This is the first study to evaluate learner outcomes of an online module in the field of sustainable health and healthcare. Our results suggest that completion of the module was associated with significant improvement in self-assessed knowledge of key concepts in climate health and sustainability. We hope this approach is followed elsewhere to prepare healthcare staff for impacts of climate change and to support improving the environmental sustainability of healthcare delivery. TRIAL REGISTRATION: Study registered with Brighton and Sussex Medical School Research Governance and Ethics Committee (BSMS RGEC). Reference: ER/BSMS3576/8, Date: 4/3/2020.
Global climate change (GCC) is widely accepted as the biggest threat to human health of the 21st century. Children are particularly vulnerable to GCC due to developing organ systems, psychological immaturity, nature of daily activities, and higher level of per-body-unit exposure. There is a rising trend in the disease burden of childhood asthma and allergies in many parts of the world. The associations of CC, air pollution and other environmental exposures with childhood asthma are attracting more research attention, but relatively few studies have focused on CC adaptation measures and childhood asthma. This study aimed to bridge this knowledge gap and conducted the first systematic review on CC adaptation measures and childhood asthma. We searched electronic databases including PubMed, Embase, and Web of Science using a set of MeSH terms and related synonyms, and identified 20 eligible studies included for review. We found that there were a number of adaptation measures proposed for childhood asthma in response to GCC, including vulnerability assessment, improving ventilation and heating, enhancing community education, and developing forecast models and early warning systems. Several randomized controlled trials show that improving ventilation and installing heating in the homes appear to be an effective way to relieve childhood asthma symptoms, especially in winter. However, the effectiveness of most adaptation measures, except for improving ventilation and heating, have not been explored and quantified. Given more extreme weather events (e.g., cold spells and heatwaves) may occur as climate change progresses, this finding may have important implications. Evidently, further research is urgently warranted to evaluate the impacts of CC adaptation measures on childhood asthma. These adaptation measures, if proven to be effective, should be integrated in childhood asthma control and prevention programs as GCC continues.
Individuals in the United States and Americans abroad are exposed to inhalation hazards from a variety of sources, and these hazards can have both short- and long-term adverse effects on health. For example, exposure to wildfire smoke, which contains particulate matter and toxic chemicals, can lead to respiratory problems, increased risk for heart attacks, and other adverse health outcomes. Individuals also may be exposed to airborne infectious agents through aerosol or droplet transmission, and as demonstrated by the COVID-19 pandemic, the individual and public health consequences of these exposures can be severe. Storms, floods, and hurricanes can increase exposure to moisture-driven hazards, such as mold, and to accidental releases from production facilities or transport vehicles that may result in chemical exposures. The current regulatory system is focused primarily on ensuring access to respiratory protection in occupational settings characterized by well-defined hazards and employer-employee relationships. With this narrow regulatory focus, the respiratory protection needs of the public and many workers are not being met. As climate change increases the incidence and severity of wildfires, hurricanes, floods, infectious disease outbreaks, and other phenomena that impact air quality and human health, it is imperative that the United States ensure that the respiratory protection needs of the public and all workers are met. Recognizing the urgent need to address the gaps in the nation’s ability to meet the respiratory protection needs of the public and workers without workplace respiratory protection programs, this report makes recommendations for a framework of responsibilities and authorities that would provide a unified and authoritative source of information and effective oversight for the development, approval, and use of respiratory protection.
The deterioration of planetary health-from threats such as climate change, environmental pollution, biodiversity loss, and ocean acidification-are a growing hazard to the foundation of health and the “healthspan.” For those with chronic conditions-a large and growing subset of the global population-the health dangers are even greater. Climate change is a threat to the very pillars of lifestyle medicine that we rely on to prevent and manage chronic disease. Already, the planetary crisis is limiting our ability to prescribe healthy nutrition, safe outdoor physical activity, stress management strategies, social connection, restorative sleep, and toxic substance avoidance. In this article, we discuss the proceedings of our workshop at the American College of Lifestyle Medicine (ACLM) annual conference LM2021, “Lifestyle Medicine for Personal and Planetary Health.” We examine how lifestyle medicine (LM) interventions are a prescription for individual, community, and planetary health. Our prescriptions work to not only restore the health of individuals and families, but also to bolster health equity while allowing us to mitigate and adapt to the health impacts of the planetary crises.
Climate change is already affecting health in populations around the world, threatening to undermine the past 50 years of global gains in public health. Health is not only affected by climate change via many causal pathways, but also by the emissions that drive climate change and their co-pollutants. Yet there has been relatively limited synthesis of key insights and trends at a global scale across fragmented disciplines. Compounding this, an exponentially increasing literature means that conventional evidence synthesis methods are no longer sufficient or feasible. Here, we outline a protocol using machine learning approaches to systematically synthesize global evidence on the relationship between climate change, climate variability, and weather (CCVW) and human health. We will use supervised machine learning to screen over 300,000 scientific articles, combining terms related to CCVW and human health. Our inclusion criteria comprise articles published between 2013 and 2020 that focus on empirical assessment of: CCVW impacts on human health or health-related outcomes or health systems; relate to the health impacts of mitigation strategies; or focus on adaptation strategies to the health impacts of climate change. We will use supervised machine learning (topic modeling) to categorize included articles as relevant to impacts, mitigation, and/or adaptation, and extract geographical location of studies. Unsupervised machine learning using topic modeling will be used to identify and map key topics in the literature on climate and health, with outputs including evidence heat maps, geographic maps, and narrative synthesis of trends in climate-health publishing. To our knowledge, this will represent the first comprehensive, semi-automated, systematic evidence synthesis of the scientific literature on climate and health.
The literature on healthcare operations and supply chain management has seen unprecedented growth over the past two decades. This paper seeks to advance the body of knowledge on this topic by utilising a topic modelling-based literature review to identify the core topics, examine their dynamic changes, and identify opportunities for further research in the area. Based on an analysis of 571 articles published until 25 January 2022, we identify numerous popular topics of research in the area, including patient waiting time, COVID-19 pandemic, Industry 4.0 technologies, sustainability, risk and resilience, climate change, circular economy, humanitarian logistics, behavioural operations, service-ecosystem, and knowledge management. We reviewed current literature around each topic and offered insights into what aspects of each topic have been studied and what are the recent developments and opportunities for more impactful future research. Doing so, this review help advance the contemporary scholarship on healthcare operations and supply chain management and offers resonant insights for researchers, research students, journal editors, and policymakers in the field.
Groundwater is considered as the primary source of water for the majority of the world’s population. The preponderance of the nation’s drinking water, as well as agricultural and industrial water, comes from groundwater. Groundwater level is becoming increasingly challenging to replenish due to climate change. Fertilizer application and improper processing of industrial waste are the two major anthropogenic drivers of groundwater pollution. Arsenic and cadmium are two of the principal heavy metal pollutants that have affected groundwater quality by human activity. When people are exposed to both non-carcinogenic and carcinogenic contaminants for an extended period, toxic effects might occur. It can have detrimental health effects from long-term exposure to contaminants, even in low amounts. As a result, metal contamination concentrations and fractions can be used to determine potential health concerns. At the same time, contaminants also need to be removed or converted to harmless products by groundwater remediation. Remediation of groundwater quality can be accomplished in several ways, including natural and artificial means. The purpose of this review is to explore a wide range of factors that affect groundwater quality, including their possible health effects. This communication provides state-of-the-art information about remediation approaches for groundwater contamination including hindrances and perspectives in this area of research. The in-depth information provided in different sections of this communication would expand the scope of interdisciplinary research.
The health impacts of climate change are distributed inequitably, with marginalized communities typically facing the direst consequences. However, the concerns of the marginalized remain comparatively invisible in research, policy and practice. Participatory action research (PAR) has the potential to centre these concerns, but due to unequal power relations among research participants, the approaches often fall short of their emancipatory ideals. To unpack how power influences the dynamics of representation in PAR, this paper presents an analytical framework using the metaphor of ‘puppeteering’. Puppeteering is a metaphor for how a researcher-activist resonates and catalyses both the voices (ventriloquism) and actions (marionetting) of a marginalized community. Two questions and continuums are central to the framework. First, who and where the puppeteer is (insider and outsider agents). Second, what puppeteering is (action and research; radical and managerial). Examples from climate change and health research provide illustrations and contextualizations throughout. A key complication for applying PAR to address the health impacts of climate change is that for marginalized communities, climate change typically remains a few layers removed from the determinants of health. The community’s priorities may be at odds with a research and action agenda framed in terms of climate change and health.
Together with climate change, both the geopolitical events in Ukraine and social disruptions in supply chains from the COVID-19 pandemic could produce global food shortages or even mass starvation events. Promising new interventions include vaccines to prevent infectious causes of malnutrition or infections disproportionately causing death among the malnourished.
The spread of infectious diseases due to travel and trade can be seen throughout history, whether from early settlers or traveling businessmen. Increased globalization has allowed infectious diseases to quickly spread to different parts of the world and cause widespread infection. Posthoc analysis of more recent outbreaks-SARS, MERS, swine flu, and COVID-19-has demonstrated that the causative viruses were circulating through populations for days or weeks before they were first detected, allowing disease to spread before quarantines, contact tracing, and travel restrictions could be implemented. Earlier detection of future novel pathogens could decrease the time before countermeasures are enacted. In this Account, we examined a variety of novel technologies from the past 10 years that may allow for earlier detection of infectious diseases. We have arranged these technologies chronologically from pre-human predictive technologies to population-level screening tools. The earliest detection methods utilize artificial intelligence to analyze factors such as climate variation and zoonotic spillover as well as specific species and geographies to identify where the infection risk is high. Artificial intelligence can also be used to monitor health records, social media, and various publicly available data to identify disease outbreaks faster than traditional epidemiology. Secondary to predictive measures is monitoring infection in specific sentinel animal species, where domestic animals or wildlife are indicators of potential disease hotspots. These hotspots inform public health officials about geographic areas where infection risk in humans is high. Further along the timeline, once the disease has begun to infect humans, wastewater epidemiology can be used for unbiased sampling of large populations. This method has already been shown to precede spikes in COVID-19 diagnoses by 1 to 2 weeks. As total infections increase in humans, bioaerosol sampling in high-traffic areas can be used for disease monitoring, such as within an airport. Finally, as disease spreads more quickly between humans, rapid diagnostic technologies such as lateral flow assays and nucleic acid amplification become very important. Minimally invasive point-of-care methods can allow for quick adoption and use within a population. These individual diagnostic methods then transfer to higher-throughput methods for more intensive population screening as an infection spreads. There are many promising early warning technologies being developed. However, no single technology listed herein will prevent every future outbreak. A combination of technologies from across our infection timeline would offer the most benefit in preventing future widespread disease outbreaks and pandemics.
Climate variations cause public health problems, but the literature is still scarce on studies involving health interventions against climate-sensitive diseases. The objective of this review was to identify health interventions for the prevention of such diseases. We conducted a scoping review using the JBI Methodology. Six large research databases were searched (PubMed, Scopus, Web of Science, Lilacs, Embase, and Cochrane). The following inclusion criterion was used: studies addressing health interventions to prevent climate-sensitive diseases or consequences of climate on people’s health. The exclusion criteria consisted of thesis, dissertations, conference proceedings, studies with unclear information/methodology, and studies not addressing climate-related health interventions. No language or date restrictions were applied. Of 733 studies identified and screened by title and abstract, 55 studies underwent full-text screening, yielding 13 studies for review. The health interventions identified were classified into three levels of management. The macro level included the use of epidemiological models, renewable energy, and policies sensitive to climate change. The meso level comprised interventions such as the creation of environmental suitability maps, urban greening, chemoprophylaxis, water security plans, and sanitation projects, among other measures. Some interventions are at the intersection, such as educational campaigns and the modification of artificial larvae sites. Finally, the micro level contained interventions such as the inspection of window screens and the use of light-colored clothing and repellents. The health interventions at the macro, meso, and micro levels and the intersection may serve as a basis for public managers to implement appropriate interventions against climate-sensitive diseases.
Despite intensive research activity within the area of climate change, substantial knowledge gaps still remain regarding the potential future impacts of climate change on human health. A key shortcoming in the scientific understanding of these impacts is the lack of studies that are conducted in a coordinated and consistent fashion, producing directly comparable outputs. This Viewpoint discusses and exemplifies a bottom-up initiative generating new research evidence in a more coordinated and consistent way compared with previous efforts. It describes one of the largest model comparisons of projected health impacts due to climate change, so far. Yet, the included studies constitute only a selection of health impacts in a variety of geographical locations, and are therefore not a comprehensive assessment of all possible impact pathways and potential consequences. The new findings of these studies shed light on the complex and multidirectional impacts of climate change on health, where impacts can be both adverse or beneficial. However, the adverse impacts dominate overall, especially in the scenarios with more greenhouse gas forcing. Overall, the future population at risk of disease and incidence rates are predicted to increase substantially, but in a highly location-specific and disease-specific fashion. Greenhouse gas emission mitigation can substantially reduce risk and resultant morbidity and mortality. The potential positive impact of adaptation has not been included in the models applied, and thus remains a major source of uncertainty. This bottom-up initiative lays out a research strategy that brings more meaningful research outputs and calls for greater coordination of research initiatives across the health community.
Population growth and industrialization have led to a race for greater food and supply productivity. As a result, the occupation and population of forest areas, contact with wildlife and their respective parasites and vectors, the trafficking and consumption of wildlife, the pollution of water sources, and the accumulation of waste occur more frequently. Concurrently, the agricultural and livestock production for human consumption has accelerated, often in a disorderly way, leading to the deforestation of areas that are essential for the planet’s climatic and ecological balance. The effects of human actions on other ecosystems such as the marine ecosystem cause equally serious damage, such as the pollution of this habitat, and the reduction of the supply of fish and other animals, causing the coastal population to move to the continent. The sum of these factors leads to an increase in the demands such as housing, basic sanitation, and medical assistance, making these populations underserved and vulnerable to the effects of global warming and to the emergence of emerging and re-emerging diseases. In this article, we discuss the anthropic actions such as climate changes, urbanization, deforestation, the trafficking and eating of wild animals, as well as unsustainable agricultural intensification which are drivers for emerging and re-emerging of zoonotic pathogens such as viral (Ebola virus, hantaviruses, Hendravirus, Nipah virus, rabies, and severe acute respiratory syndrome coronavirus disease-2), bacterial (leptospirosis, Lyme borreliosis, and tuberculosis), parasitic (leishmaniasis) and fungal pathogens, which pose a substantial threat to the global community. Finally, we shed light on the urgent demand for the implementation of the One Health concept as a collaborative global approach to raise awareness and educate people about the science behind and the battle against zoonotic pathogens to mitigate the threat for both humans and animals.
Alongside modernity, the human activity has been a key factor in global environmental risks, with worldwide anthropic modification being the cause of the emergence of diseases for wild and livestock animals, and even humans. In special, the increase in the spatial distribution and in the incidence of some emerging infectious diseases (EID) are directly associated to deforestation and global climate changes. Moreover, the arise of new EID agents, such as the SARS-COV-2 have been reported for the last 30 years. On the other hand, biodiversity has been shown to be a key indicator for ecosystem health, and to pose a role to increase the promotion of human public health. In neotropical regions, and in special, in Brazil, several infectious diseases have been demonstrated to be directly affected for the biodiversity loss, such as malaria, hantavirus pulmonary syndrome, yellow fever, urban arboviruses, spotted fever, amongst other. To better understand the ecosystem capacity of regulation of infectious diseases, FAPESP BIOTA program have supported researchers and research projects to increase knowledge about Brazilian biodiversity and the ecosystems, such as diversity of bird bioagents, venomous animals biodiversity, diversity of mosquitos species in forest patches inside urban areas, propagation of the yellow fever virus over fragmented forest territories, loss of ecological corridors and occurrence of spotted fever and malaria, amongst others. It is noteworthy that FAPESP BIOTA is a successful program and must be expanded as an important tool for present and future public health promotion.
Climate change is adversely affecting the burden of infectious disease throughout the world, which is a health security threat. Climate-sensitive infectious disease includes vector-borne diseases such as malaria, whose transmission potential is expected to increase because of enhanced climatic suitability for the mosquito vector in Asia, sub-Saharan Africa, and South America. Climatic suitability for the mosquitoes that can carry dengue, Zika, and chikungunya is also likely to increase, facilitating further increases in the geographic range and longer transmission seasons, and raising concern for expansion of these diseases into temperate zones, particularly under higher greenhouse gas emission scenarios. Early spring temperatures in 2018 seem to have contributed to the early onset and extensive West Nile virus outbreak in Europe, a pathogen expected to expand further beyond its current distribution, due to a warming climate. As for tick-borne diseases, climate change is projected to continue to contribute to the spread of Lyme disease and tick-borne encephalitis, particularly in North America and Europe. Schistosomiasis is a water-borne disease and public health concern in Africa, Latin America, the Middle East, and Southeast Asia; climate change is anticipated to change its distribution, with both expansions and contractions expected. Other water-borne diseases that cause diarrheal diseases have declined significantly over the last decades owing to socioeconomic development and public health measures but changes in climate can reverse some of these positive developments. Weather and climate events, population movement, land use changes, urbanization, global trade, and other drivers can catalyze a succession of secondary events that can lead to a range of health impacts, including infectious disease outbreaks. These cascading risk pathways of causally connected events can result in large-scale outbreaks and affect society at large. We review climatic and other cascading drivers of infectious disease with projections under different climate change scenarios. Supplementary file1 (MP4 328467 KB).
Background: Climate change constitutes a complex challenge posing an urgent threat to our planet and life and creating an entirely different way of conceptualising the world and our chances to provide safe food within it. There are currently numerous studies dealing with the potential effect of increased temperature, extreme weather events and cascading events on food safety and subsequently human health. In contrast to food safety, the available data on the impact of climate change on food quality, including food spoilage, are very limited. Scope and approach: This paper presents an overview of the potential impact of climate change on both food safety and microbial spoilage at various stages of the food chain. Among the different hazards related to climate change, mycotoxin and marine biotoxin contamination, environmental residuals derived from various anthropogenic activities and zoonosis diseases are identified as climatic-driven emerging risks to human life and discussed further in this paper. Global warming is projected to affect all microorganisms, including spoilage bacteria and fungi. Hence, this paper also discusses the potential increased risk of microbial spoilage for bulk dried foods and non-refrigerated processed foods which could be high susceptible to climate change in relation to growth of spoilage organisms. Key-findings and conclusions: The paper concludes that climate change requires multidisciplinary approaches to gain in-depth knowledge and identify potential emerging risks. In addition, this paper goes beyond food safety and addresses an overlooked aspect of climate change, namely the microbiological spoilage of foods that may require a high level of preparedness by both the food industry and policy makers.
SUMMARY Outbreaks of climate-sensitive infectious diseases (CSID) in the aftermath of extreme climatic events, such as floods, droughts, tropical cyclones, and heatwaves, are of high public health concern. Recent advances in forecasting of extreme climatic events have prompted a growing interest in the development of prediction models to anticipate CSID risk, yet the evidence base linking extreme climate events to CSID outbreaks to date has not been collated and synthesized. This review identifies potential hydrometeoro-logical triggers of outbreaks and highlights gaps in knowledge on the causal chain between extreme events and outbreaks. We found higher evidence and higher agreement on the links between extreme climatic events and water-borne diseases than for vector-borne diseases. In addition, we found a substantial lack of evidence on the links between extreme climatic events and underlying vulnerability and exposure factors. This review helps inform trigger design for CSID prediction models for anticipatory public health action.
OBJECTIVE: Climate change poses a major threat to the operation of global health systems, triggering large scale health events, and disrupting normal system operation. Digital health may have a role in the management of such challenges and in greenhouse gas emission reduction. This scoping review explores recent work on digital health responses and mitigation approaches to climate change. MATERIALS AND METHODS: We searched Medline up to February 11, 2022, using terms for digital health and climate change. Included articles were categorized into 3 application domains (mitigation, infectious disease, or environmental health risk management), and 6 technical tasks (data sensing, monitoring, electronic data capture, modeling, decision support, and communication). The review was PRISMA-ScR compliant. RESULTS: The 142 included publications reported a wide variety of research designs. Publication numbers have grown substantially in recent years, but few come from low- and middle-income countries. Digital health has the potential to reduce health system greenhouse gas emissions, for example by shifting to virtual services. It can assist in managing changing patterns of infectious diseases as well as environmental health events by timely detection, reducing exposure to risk factors, and facilitating the delivery of care to under-resourced areas. DISCUSSION: While digital health has real potential to help in managing climate change, research remains preliminary with little real-world evaluation. CONCLUSION: Significant acceleration in the quality and quantity of digital health climate change research is urgently needed, given the enormity of the global challenge.
Extreme precipitation events (EPE) change the natural and built environments and alter human behavior in ways that facilitate infectious disease transmission. EPEs are expected with high confidence to increase in frequency and are thus of great public health importance. This scoping review seeks to summarize the mechanisms and severity of impacts of EPEs on infectious diseases, to provide a conceptual framework for the influence of EPEs on infectious respiratory diseases, and to define areas of future study currently lacking in this field. The effects of EPEs are well-studied with respect to enteric, vector-borne, and allergic illness where they are shown to moderately increase risk of illness, but not well-understood in relation to infectious respiratory illness. We propose a framework for a similar influence of EPEs on infectious respiratory viruses through several plausible pathways: decreased UV radiation, increased ambient relative humidity, and changes to human behavior (increased time indoors and use of heating and cooling systems). However, limited work has evaluated meteorologic risk factors for infectious respiratory diseases. Future research is needed to evaluate the effects of EPEs on infectious respiratory diseases using individual-level case surveillance, fine spatial scales, and lag periods suited to the incubation periods of the disease under study, as well as a full characterization of susceptible, vulnerable, and sensitive population characteristics.
Our world is undergoing rapid planetary changes driven by human activities, often mediated by economic incentives and resource management, affecting all life on Earth. Concurrently, many infectious diseases have recently emerged or spread into new populations. Mounting evidence suggests that global change-including climate change, land-use change, urbanization, and global movement of individuals, species, and goods-may be accelerating disease emergence by reshaping ecological systems in concert with socioeconomic factors. Here, we review insights, approaches, and mechanisms by which global change drives disease emergence from a disease ecology perspective. We aim to spur more interdisciplinary collaboration with economists and identification of more effective and sustainable interventions to prevent disease emergence. While almost all infectious diseases change in response to global change, the mechanisms and directions of these effects are system specific, requiring new, integrated approaches to disease control that recognize linkages between environmental and economic sustainability and human and planetary health.
The health impacts of climate change are substantial and represent a primary motivating factor to mitigate climate change. However, the health impacts in economic models that estimate the social cost of carbon dioxide (SC-CO(2)) have generally been made in isolation from health experts and have never been rigorously evaluated. Version 3.10 of the Framework for Uncertainty, Negotiation and Distribution (FUND) model was used to estimate the health-based portion of current SC-CO(2) estimates across low-, middle-, and high-income regions. In addition to the base model, three additional experiments assessed the sensitivity of these estimates to changes in the socio-economic assumptions in the model. Economic impacts from adverse health outcomes represent ∼8.7% of current SC-CO(2) estimates. The majority of these health impacts (74%) were attributable to diarrhea mortality (from both low- and high-income regions) followed by diarrhea morbidity (12%) and malaria mortality (11%); no other health impact makes a meaningful contribution to SC-CO(2) estimates in current economic models. The results of the socio-economic experiments show that the health-based portion of SC-CO(2) estimates are highly sensitive to assumptions regarding income elasticity of health effects, income growth, and use of equity weights. Improving the health-based portion of SC-CO(2) estimates could have substantial impacts on magnitude of the SC-CO(2). Incorporating additional health impacts not previously included in estimates of SC-CO(2) will be a critical component of model updates. This effort will be most successful through coordination between economists and health researchers and should focus on updating the form and function of concentration-response functions.
As a source of emerging infectious diseases, wildlife assemblages (and related spatial patterns) must be quantitatively assessed to help identify high-risk locations. Previous assessments have largely focussed on the distributions of individual species; however, transmission dynamics are expected to depend on assemblage composition. Moreover, disease-diversity relationships have mainly been studied in the context of species loss, but assemblage composition and disease risk (e.g. infection prevalence in wildlife assemblages) can change without extinction. Based on the predicted distributions and abundances of 4466 mammal species, we estimated global patterns of disease risk through the calculation of the community-level basic reproductive ratio R0, an index of invasion potential, persistence, and maximum prevalence of a pathogen in a wildlife assemblage. For density-dependent diseases, we found that, in addition to tropical areas which are commonly viewed as infectious disease hotspots, northern temperate latitudes included high-risk areas. We also forecasted the effects of climate change and habitat loss from 2015 to 2035. Over this period, many local assemblages showed no net loss of species richness, but the assemblage composition (i.e. the mix of species and their abundances) changed considerably. Simultaneously, most areas experienced a decreased risk of density-dependent diseases but an increased risk of frequency-dependent diseases. We further explored the factors driving these changes in disease risk. Our results suggest that biodiversity and changes therein jointly influence disease risk. Understanding these changes and their drivers and ultimately identifying emerging infectious disease hotspots can help health officials prioritize resource distribution.
Food systems are at the center of a brewing storm consisting of a rapidly changing climate, rising hunger and malnutrition and significant social inequities. At the same time, there are vast opportunities to ensure that food systems produce healthy and safe food in equitable ways that promote environmental sustainability, especially if the world can come together at the UN Food Systems Summit in late 2021 and make strong and binding commitments towards food system transformation. The NIH-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition held their 22nd Annual Harvard Nutrition Obesity Symposium entitled “Global Food Systems and Sustainable Nutrition in the 21st Century” in June 2021. This paper presents a synthesis of this symposium and highlights the importance of food systems to address the burden of malnutrition and non-communicable diseases, climate change, and the economic and social inequities. Transformation of food systems is possible, and the nutrition and health communities have a significant role to play in this transformative process.
BACKGROUND: Climate change poses a real challenge and has contributed to causing the emergence and re-emergence of many communicable diseases of public health importance. Here, we reviewed scientific studies on the relationship between meteorological factors and the occurrence of dengue, malaria, cholera, and leptospirosis, and synthesized the key findings on communicable disease projection in the event of global warming. METHOD: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow checklist. Four databases (Web of Science, Ovid MEDLINE, Scopus, EBSCOhost) were searched for articles published from 2005 to 2020. The eligible articles were evaluated using a modified scale of a checklist designed for assessing the quality of ecological studies. RESULTS: A total of 38 studies were included in the review. Precipitation and temperature were most frequently associated with the selected climate-sensitive communicable diseases. A climate change scenario simulation projected that dengue, malaria, and cholera incidence would increase based on regional climate responses. CONCLUSION: Precipitation and temperature are important meteorological factors that influence the incidence of climate-sensitive communicable diseases. Future studies need to consider more determinants affecting precipitation and temperature fluctuations for better simulation and prediction of the incidence of climate-sensitive communicable diseases.
Health problems of women experiencing homelessness are driven either from the usual background characteristics of this population, or from the homeless lifestyle. Apart from poverty and unemployment, transition to homelessness is often associated with substance abuse, history of victimization, stress, poor mental health and human immunodeficiency virus (HIV). Water insecurity can undermine bodily hygiene and dental health, posing a greater risk of dehydration and opportunistic infections. Exposure to extreme environmental conditions like heat waves and natural disasters increases morbidity, accelerates aging, and reduces life expectancy. Nutrition-wise, a high prevalence of food insecurity, obesity, and micronutrient deficiencies are apparent due to low diet quality and food waste. Poor hygiene, violence, and overcrowding increase the susceptibility of these women to communicable diseases, including sexually transmitted ones and COVID-19. Furthermore, established cardiovascular disease and diabetes mellitus are often either undertreated or neglected, and their complications are more widespread than in the general population. In addition, lack of medical screening and contraception non-use induce a variety of reproductive health issues. All these health conditions are tightly related to violations of human rights in this population, including the rights to housing, water, food, reproduction, health, work, and no discrimination. Thus, the care provided to women experiencing homelessness should be optimized at a multidimensional level, spanning beyond the provision of a warm bed, to include access to clean water and sanitation, psychological support and stress-coping strategies, disease management and acute health care, food of adequate quality, opportunities for employment and support for any minor dependants.
The universally dire threat of climate change disproportionately affects marginalized populations, including the over one billion persons with disabilities worldwide. States that disregard the Paris Agreement, or exclude disabled persons from climate change mitigation and adaptation efforts, are violating agreed-upon human rights obligations. Notably, the rights contained in the UN Convention on the Rights of Persons with Disabilities, are threatened by climate change. To date, however, disability has largely been excluded from international climate change negotiations as well as national-level discharge of climate-related measures. By contrast, a disability human rights approach views disabled persons as disproportionately experiencing environmental threats and unnatural disasters due to their exclusion from state laws, policies, and services available to their non-disabled peers. Additionally, a disability human rights approach mandates the removal of exclusionary barriers and the implementation of positive measures to ensure the equitable treatment of individuals with disabilities. Achieving disability-inclusive climate justice requires “participatory justice”-empowering persons with disabilities to ascertain climate mitigation and adaptation approaches that are efficacious for, successfully implementable by, and accountable to disabled people. Disability-inclusive climate justice solutions are in synergy with universal climate justice goals and benefit entire societies, not “only” those with disabilities.
Five billion people lack access to surgical care worldwide; climate change is the biggest threat to human health in the 21st century. This review studies how climate change could be integrated into national surgical planning in the Western Pacific region. We searched databases (PubMed, Web of Science, and Global Health) for articles on climate change and surgical care. Findings were categorised using the modified World Health Organisation Health System Building Blocks Framework. 220 out of 2577 records were included. Infrastructure: Operating theatres are highly resource-intensive. Their carbon footprint could be reduced by maximising equipment longevity, improving energy efficiency, and renewable energy use. Service delivery Tele-medicine, outreaches, and avoiding desflurane could reduce emissions. Robust surgical systems are required to adapt to the increasing burden of surgically treated diseases, such as injuries from natural disasters. Finance: Climate change adaptation funds could be mobilised for surgical system strengthening. Information systems: Sustainability should be a key performance indicator for surgical systems. Workforce: Surgical providers could change clinical, institutional, and societal practices. Governance: Planning in surgical care and climate change should be aligned. Climate change mitigation is essential in the regional surgical care scale-up; surgical system strengthening is also necessary for adaptation to climate change.
No abstract available.
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.
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.
INTRODUCTION: Food security in Small Island Developing States (SIDS) is an international policy priority. SIDS have high rates of nutrition-related non-communicable diseases, including obesity and type 2 diabetes, micronutrient deficiencies and, in many, persistent childhood stunting. This is associated with an increasing reliance on imported processed food of poor nutritional quality. Calls have been made for strengthening local food systems, resilient to climate change, to increase the consumption of nutritious locally produced food. We aimed to systematically review interventions intended to improve diet in SIDS, and specifically explore whether these interventions applied a local food approach. METHODS: The search strategy was applied to 11 databases, including in health, social science and agriculture. Screening of titles, abstracts and data extraction was undertaken in duplicate. Risk of bias was assessed using Cochrane tools. Narrative synthesis of the results was undertaken. The study protocol was registered (PROSPERO registration number: 2020CRD42020201274). RESULTS: From 26 062 records, 154 full texts were reviewed and 24 were eligible. Included studies were from the Caribbean, Pacific, Mauritius and Singapore. Five were a randomised study design, one an interrupted time series analysis, eight controlled and ten uncontrolled pre-test and post-test. Nine studies included some aspect of a local food approach. Most interventions (n=15) included nutrition education, with evidence of effectiveness largely limited to those that also included practical skills training, such as vegetable gardening or food preparation. Three studies were considered low risk of bias, with the majority (n=13) of moderate risk. CONCLUSION: There is a lack of robust evidence on interventions to improve diet in SIDS. The evidence suggests that multifaceted approaches are likely to be the most effective, and local food approaches may promote effectiveness, through mechanisms of cultural and contextual relevance. Further development and evaluation of interventions is urgently required to increase the comparability of these studies, to help guide policy on improving nutrition in SIDS.
This systematic review of reviews was conducted to examine housing precarity and homelessness in relation to climate change and weather extremes internationally. In a thematic analysis of 15 reviews (5 systematic and 10 non-systematic), the following themes emerged: risk factors for homelessness/housing precarity, temperature extremes, health concerns, structural factors, natural disasters, and housing. First, an increased risk of homelessness has been found for people who are vulnerably housed and populations in lower socio-economic positions due to energy insecurity and climate change-induced natural hazards. Second, homeless/vulnerably-housed populations are disproportionately exposed to climatic events (temperature extremes and natural disasters). Third, the physical and mental health of homeless/vulnerably-housed populations is projected to be impacted by weather extremes and climate change. Fourth, while green infrastructure may have positive effects for homeless/vulnerably-housed populations, housing remains a major concern in urban environments. Finally, structural changes must be implemented. Recommendations for addressing the impact of climate change on homelessness and housing precarity were generated, including interventions focusing on homelessness/housing precarity and reducing the effects of weather extremes, improved housing and urban planning, and further research on homelessness/housing precarity and climate change. To further enhance the impact of these initiatives, we suggest employing the Human Rights-Based Approach (HRBA).
Fungal infections are still underappreciated and their prevalence is underestimated, which renders them a serious public health problem. Realistic discussions about their distribution, symptoms, and control can improve management and diagnosis and contribute to refinement of preventive actions using currently available tools. This article represents an overview of dermatophytes and endemic fungi that cause infections in humans and animals. In addition, the impact of climate change on the fungal spread is discussed. The endemic fungal infections characterized in this article include coccidioidomycosis, histoplasmosis, blastomycosis, lobomycosis, emergomycosis and sporotrichosis. Moreover the geographic distribution of these fungi, which are known to be climate sensitive and/or limited to endemic tropical and subtropical areas, is highlighted. In turn, dermatophytes cause superficial fungal infections of skin, hairs and nails, which are the most prevalent mycoses worldwide with a high economic burden. Therefore, the possibility of causing zoonoses and reverse zoonoses by dermatophytes is highly important. In conclusion, the article illustrates the current issues of the epidemiology and distribution of fungal diseases, emphasizing the lack of public programmes for prevention and control of these types of infection.
Climate change is with us. As professionals who place value on evidence-based practice, climate change is something we cannot ignore. The current pandemic of the novel coronavirus, SARS-CoV-2, has demonstrated how global crises can arise suddenly and have a significant impact on public health. Global warming, a chronic process punctuated by acute episodes of extreme weather events, is an insidious global health crisis needing at least as much attention. Many neurological diseases are complex chronic conditions influenced at many levels by changes in the environment. This review aimed to collate and evaluate reports from clinical and basic science about the relationship between climate change and epilepsy. The keywords climate change, seasonal variation, temperature, humidity, thermoregulation, biorhythm, gene, circadian rhythm, heat, and weather were used to search the published evidence. A number of climatic variables are associated with increased seizure frequency in people with epilepsy. Climate change-induced increase in seizure precipitants such as fevers, stress, and sleep deprivation (e.g. as a result of more frequent extreme weather events) or vector-borne infections may trigger or exacerbate seizures, lead to deterioration of seizure control, and affect neurological, cerebrovascular, or cardiovascular comorbidities and risk of sudden unexpected death in epilepsy. Risks are likely to be modified by many factors, ranging from individual genetic variation and temperature-dependent channel function, to housing quality and global supply chains. According to the results of the limited number of experimental studies with animal models of seizures or epilepsy, different seizure types appear to have distinct susceptibility to seasonal influences. Increased body temperature, whether in the context of fever or not, has a critical role in seizure threshold and seizure-related brain damage. Links between climate change and epilepsy are likely to be multifactorial, complex, and often indirect, which makes predictions difficult. We need more data on possible climate-driven altered risks for seizures, epilepsy, and epileptogenesis, to identify underlying mechanisms at systems, cellular, and molecular levels for better understanding of the impact of climate change on epilepsy. Further focussed data would help us to develop evidence for mitigation methods to do more to protect people with epilepsy from the effects of climate change.
Snakebite envenoming is a set of intoxication diseases that disproportionately affect people of poor socioeconomic backgrounds in tropical countries. As it is highly dependent on the environment its burden is expected to shift spatially with global anthropogenic environmental (climate, land use) and demographic change. The mechanisms underlying the changes to snakebite epidemiology are related to factors of snakes and humans. The distribution and abundance of snakes are expected to change with global warming via their thermal tolerance, while rainfall may affect the timing of key activities like feeding and reproduction. Human population growth is the primary cause of land-use change, which may impact snakes at smaller spatial scales than climate via habitat and biodiversity loss (e.g. prey availability). Human populations, on the other hand, could experience novel patterns and morbidity of snakebite envenoming, both as a result of snake responses to environmental change and due to the development of agricultural adaptations to climate change, socioeconomic and cultural changes, development and availability of better antivenoms, personal protective equipment, and mechanization of agriculture that mediate risk of encounters with snakes and their outcomes. The likely global effects of environmental and demographic change are thus context-dependent and could encompass both increasing and or snakebite burden (incidence, number of cases or morbidity), exposing new populations to snakes in temperate areas due to “tropicalization”, or by land use change-induced snake biodiversity loss, respectively. Tackling global change requires drastic measures to ensure large-scale ecosystem functionality. However, as ecosystems represent the main source of venomous snakes their conservation should be accompanied by comprehensive public health campaigns. The challenges associated with the joint efforts of biodiversity conservation and public health professionals should be considered in the global sustainability agenda in a wider context that applies to neglected tropical and zoonotic and emerging diseases.
The recent outbreak of coronavirus disease 2019 (COVID-19) and concerns about several other pandemics in the 21st century have attracted extensive global attention. These emerging infectious diseases threaten global public health and raise urgent studies on unraveling the underlying mechanisms of their transmission from animals to humans. Although numerous works have intensively discussed the cross-species and endemic barriers to the occurrence and spread of emerging infectious diseases, both types of barriers play synergistic roles in wildlife habitats. Thus far, there is still a lack of a complete understanding of viral diffusion, migration, and transmission in ecosystems from a macro perspective. In this review, we conceptualize the ecological barrier that represents the combined effects of cross-species and endemic barriers for either the natural or intermediate hosts of viruses. We comprehensively discuss the key influential factors affecting the ecological barrier against viral transmission from virus hosts in their natural habitats into human society, including transmission routes, contact probability, contact frequency, and viral characteristics. Considering the significant impacts of human activities and global industrialization on the strength of the ecological barrier, ecological barrier deterioration driven by human activities is critically analyzed for potential mechanisms. Global climate change can trigger and expand the range of emerging infectious diseases, and human disturbances promote higher contact frequency and greater transmission possibility. In addition, globalization drives more transmission routes and produces new high-risk regions in city areas. This review aims to provide a new concept for and comprehensive evidence of the ecological barrier blocking the transmission and spread of emerging infectious diseases. It also offers new insights into potential strategies to protect the ecological barrier and reduce the wide-ranging risks of emerging infectious diseases to public health.
As society tries to tackle climate change around the globe, communities need to reduce its impact on human health. The purpose of this review is to identify key stakeholders involved in mitigating and adapting to climate change, as well as the type and characteristics of community empowerment actions implemented so far to address the problem. Published and unpublished studies from January 2005 to March 2022 in English and Portuguese were included in this review. The search, conducted on PubMed, CINAHL, Scopus, MEDLINE, Scopus, Web of Science, SciELO, and RCAAP (Repositório Científico de Acesso Aberto de Portugal), followed a three-step search strategy. Data extraction was performed by two independent reviewers, using an extraction tool specifically designed for the review questions. Twenty-seven studies were eligible for inclusion: six used interviews as a qualitative method, three were systematic reviews, three were case study analyses, three used surveys and questionnaires as quantitative methods, two used integrative baseline reviews, and three utilized a process model design. Six studies targeted local, public and private stakeholders. Community settings were the context target of fifteen studies, whereas twelve specifically referred to urban settings. Seven types of community actions were acknowledged across the globe, characterised as hybrid interventions and referring to the leading stakeholders: local governments, non-governmental organizations, civil society, universities, public health, and private sectors.
Cities must address many challenges including air quality, climate change and the health and wellbeing of communities. Public authorities and developers increasingly look to improve these through the implementation of interventions and innovations, such as low traffic neighbourhoods, deep housing retrofits and green infrastructure. Monitoring the impacts of interventions is essential to determine the success of such projects and to build evidence for broader urban transformation. In this paper we present a mixed-method cross-disciplinary approach that brings together cutting edge atmospheric and data science, measurements of activity in public spaces and novel methods to assess wellbeing-promoting behaviours. The Manchester Urban Observatory focuses on living areas that have a high density of inter-related systems, which require observation, understanding and intervention at multiple levels. This must be completed in line with urban planning goals as well as a clear and succinct data solution that allows robust scientific conclusions to be made and viewed in real time. Delivery of such a monitoring strategy is not trivial and is time, resource and expertise heavy. This paper discusses the methods employed by the Manchester Urban Observatory to monitor the effectiveness off interventions implemented within cities and effective communication strategies with local communities.
Urban climate policy offers a significant opportunity to promote improved public health. The evidence around climate and health cobenefits is growing but has yet to translate into widespread integrated policies. This article presents two systematic reviews: first, looking at quantified cobenefits of urban climate policies, where transportation, land use, and buildings emerge as the most studied sectors; and second, looking at review papers exploring the barriers and enablers for integrating these health cobenefits into urban policies. The latter reveals wide agreement concerning the need to improve the evidence base for cobenefits and consensus about the need for greater political will and leadership on this issue. Systems thinking may offer a way forward to help embrace complexity and integrate health cobenefits into decision making. Knowledge coproduction to bring stakeholders together and advance policy-relevant research for urban health will also be required. Action is needed to bring these two important policy agendas together.
Urban areas continue to be the center of action for many countries due to their contribution to economic development. Many urban areas, through the urbanization process, have become vulnerable to climate risk, thereby making risk mitigation and adaptation essential components in urban planning. The study assessed the impacts of IPCC Assessment Reports (ARs) on academic research on risk mitigation and adaptation concerns in urban areas. The study systematically reviewed literature through searches of the Web of Science and Scopus databases; 852 papers were retrieved and 370 were deemed eligible. The results showed that the East Asia and Pacific, and Europe and Central Asia regions were most interested in IPCC ARs, while Sub-Saharan Africa showed little interest. Several urban concerns, including socio-economic, air quality, extreme temperature, sea level rise/flooding, health, and water supply/drought, were identified. Additionally, studies on negative health outcomes due to extreme temperatures and air pollution did not appear in the first four IPCC ARs. However, significant studies appeared after the launch of the AR5. Here, we must state that climate-related problems of urbanization were known and discussed in scientific papers well before the formation of the IPCC. For instance, the works of Clarke on urban structure and heat mortality and Oke on climatic impacts of urbanization. Though the IPCC ARs show impact, their emphasis on combined mitigation and adaptation policies is limited. This study advocates more combined risk mitigation and adaptation policies in urban areas for increased resilience to climate risk.
Megacities are metropolitan areas with populations over 10 million, and many of them are facing significant global environmental challenges such as air pollution. Intense economic and human activities in megacities result in air pollution emissions, inducing high levels of air pollutants in the atmosphere that harm human health, cause regional haze and acid deposition, damage crops, influence regional air quality, and contribute to climate change. Since the Great London Smog and the first recognized episode of Los Angeles photochemical smog seventy years ago, substantial progress has been achieved in improving the scientific understanding of air pollution and in developing emissions reduction technologies and control measures. However, much remains to be understood about the complex processes of atmospheric transport and reaction mechanisms; the formation and evolution of secondary particles, especially those containing organic species; and the influence of emerging emissions sources and changing climate on air quality and health. Molina (DOI: ) has provided an excellent overview of the sources of emissions in megacities, atmospheric physicochemical processes, air quality trends and management, and the impacts on health and climate for the introductory lecture of this Faraday Discussion.
It has been widely recognised that the threats to human health from global environmental changes (GECs) are increasing in the Anthropocene epoch, and urgent actions are required to tackle these pressing challenges. A scoping review was conducted to provide an overview of the nine planetary boundaries and the threats to population health posed by human activities that are exceeding these boundaries in the Anthropocene. The research progress and key knowledge gaps were identified in this emerging field. Over the past three decades, there has been a great deal of research progress on health risks from climate change, land-use change and urbanisation, biodiversity loss and other GECs. However, several significant challenges remain, including the misperception of the relationship between human and nature; assessment of the compounding risks of GECs; strategies to reduce and prevent the potential health impacts of GECs; and uncertainties in fulfilling the commitments to the Paris Agreement. Confronting these challenges will require rigorous scientific research that is well-coordinated across different disciplines and various sectors. It is imperative for the international community to work together to develop informed policies to avert crises and ensure a safe and sustainable planet for the present and future generations.
Cities emit the majority of greenhouse gas emissions globally and are increasingly committing to aggressive mitigation actions. Cities are also experiencing poor-and in some cases worsening-air quality, contributing to large disease burdens for adults and children. Integrated planning frameworks can help cities leverage and prioritize measures that achieve climate, air quality, and health benefits simultaneously. We developed and applied an integrated climate action planning process that includes air quality, utilizing Pathways-AQ, a new assessment tool, in six pilot cities: Accra, Ghana; Addis Ababa, Ethiopia; Buenos Aires, Argentina; the metropolitan area of Guadalajara, Mexico; Johannesburg, South Africa; and Lima, Peru. Implementing the “ambitious” greenhouse gas reduction scenarios in these cities’ climate action plans would reduce in-city contributions to fine particulate matter (PM2.5) concentrations and would avoid 230-1,040 annual premature deaths per city, by 2050. This new integrated climate action planning process revealed the importance of (i) geographic scales of analysis, (ii) data integration across climate and air quality, (iii) local civic engagement, and (iv) nuanced health messaging. Rapidly scaling up and applying this integrated approach can broaden the group of municipal stakeholders involved in climate-related planning goals, potentially leading to greater ambition by integrating climate, air pollution, and health objectives.
Nuclear science and technology (NST) offers a multitude of applications and tools and has a high level of regulation. However, its contribution to the achievement of global development goals is still incipient. Although its application is directly related to many fields, especially sustainability, the current literature does not relate it to socio-environmental issues, hindering the adoption of public policies based on isotopic and nuclear solutions. In large and megacities, the promotion of human well-being and the conservation of ecosystems are urgent global challenges, especially as a function of the growing expansion of land use modification, water scarcity, and climate change. The relationship between society and NST is addressed in this study, which aims to show how and in what ways the emerging and innovative nuclear and isotopic solutions contribute to the urban dimension of the United Nations 2030 Agenda, expressed by SDG 11 (Sustainable Cities and Communities), and its connection to land, water, and climate change in cities. This gap in knowledge compromises the targeting of resources to improve NST as a development strategy. Demystifying NST and increasing collaboration between ecosystem services and other issues related to sustainability in cities are key to implementing global development policies, especially at the local governance level.
INTRODUCTION: This study evaluated how single or combinations of weather parameters (temperature, humidity, wind speed, and solar load) affect peak performance during endurance running events and identified which events are most vulnerable to varying weather conditions. METHODS: Results for the marathon, 50-km racewalking, 20-km racewalking, and 10,000-, 5000-, and 3000-m steeplechase were obtained from the official Web sites of large competitions. We identified meteorological data from nearby (8.9 ± 9.3 km) weather stations for 1258 races held between 1936 and 2019 across 42 countries, enabling analysis of 7867 athletes. RESULTS: The wet bulb globe temperature (WBGT) across races ranged from -7°C to 33°C, with 27% of races taking place in cold/cool, 47% in neutral, 18% in moderate heat, 7% in high heat, and 1% in extreme heat conditions, according to the World Athletics classification. Machine learning decision trees (R2 = 0.21-0.58) showed that air temperature (importance score = 40%) was the most important weather parameter. However, when used alone, air temperature had lower predictive power (R2 = 0.04-0.34) than WBGT (R2 = 0.11-0.47). Conditions of 7.5°C-15°C WBGT (or 10°C-17.5°C air temperature) increased the likelihood for peak performance. For every degree WBGT outside these optimum conditions, performance declined by 0.3%-0.4%. CONCLUSION: More than one-quarter of endurance running events were held in moderate, high, or extreme heat, and this number reached one-half when marathons were excluded. All four weather parameters should be evaluated when aiming to mitigate the health and performance implications of exercising at high intensities in a hot environment with athletes adopting heat mitigation strategies when possible.
The dynamics of host-parasite interactions are highly temperature-dependent and may be modified by increasing frequency and intensity of climate-driven heat events. Here, we show that altered patterns of temperature variance lead to an almost order-of-magnitude shift in thermal performance of host and pathogen life-history traits over and above the effects of mean temperature and, moreover, that different temperature regimes affect these traits differently. We found that diurnal fluctuations of ±3°C lowered infection rates and reduced spore burden compared to constant temperatures in our focal host Daphnia magna exposed to the microsporidium parasite Ordospora colligata. In contrast, a 3-day heatwave (+6°C) did not affect infection rates, but increased spore burden (relative to constant temperatures with the same mean) at 16°C, while reducing burden at higher temperatures. We conclude that changing patterns of climate variation, superimposed on shifts in mean temperatures due to global warming, may have profound and unanticipated effects on disease dynamics.
BACKGROUND: Increased mortality risk is associated with short-term temperature variability. However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000-19. METHODS: In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° from 2000-19. Temperature variability was calculated as the SD of the average of the same and previous days’ minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. FINDINGS: An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1 753 392 deaths (95% CI 1 159 901-2 357 718) were associated with temperature variability per year, accounting for 3·4% (2·2-4·6) of all deaths. Most of Asia, Australia, and New Zealand were observed to have a higher percentage excess in mortality than the global mean. Globally, the percentage excess in mortality increased by about 4·6% (3·7-5·3) per decade. The largest increase occurred in Australia and New Zealand (7·3%, 95% CI 4·3-10·4), followed by Europe (4·4%, 2·2-5·6) and Africa (3·3, 1·9-4·6). INTERPRETATION: Globally, a substantial mortality burden was associated with temperature variability, showing geographical heterogeneity and a slightly increasing temporal trend. Our findings could assist in raising public awareness and improving the understanding of the health impacts of temperature variability. FUNDING: Australian Research Council, Australian National Health & Medical Research Council.
This paper focuses on climate anxiety and its role in the psychology of climate change, compared with responses to the COVID-19 global pandemic. Four psychological hypotheses for why we do not act on climate change will be reviewed, and the role of anxiety for each, as well as potential solutions. Different types of climate anxiety both inside and outside the clinic will be explored, along with associated defence mechanisms and treatment.
The aim of this paper is to discuss the challenge posed to mental health by climate change. Our inquiry is based on literature review and original qualitative studies. The data are collected from both desk research and in-depth interviews with participants belonging to following groups: high school and university students, young parents, activists, and psychotherapy patients. This paper also offers the critical review of contemporary terminology used for mental health problems and emotions appearing in the context of climate change, as well as the history of scientific interest in the issue at hand. The term and phenomenon of climate depression acquires aspecial focus, based on qualitative studies participants’ self-reports and main arguments critical to medicalization of emotions experienced when facing the climate crisis. The additional analysis of socio-political and cultural aspects of climate change and mental health concludes in establishing the urgent need for further research in the area, so as to gain multidimensional understanding necessary for providing adequate mental health services. It is very likely that it will be increasingly needed in the future.
Research has pointed to startling worldwide rates of people reporting considerable anxiety vis-à-vis climate change. Yet, uncertainties remain regarding how climate anxiety’s cognitive-emotional features and daily life functional impairments interact with one another and with climate change experience, pro-environmental behaviors, and general worry. In this study, we apply network analyses to examine the associations among these variables in an international community sample (n = 874). We computed two network models, a graphical Gaussian model to explore network structure, potential communities, and influential nodes, and a directed acyclic graph to examine the probabilistic dependencies among the variables. Both network models pointed to the cognitive-emotional features of climate anxiety as a potential hub bridging general worry, the experience of climate change, pro-environmental behaviors, and the functional impairments associated with climate anxiety. Our findings offer data-driven clues for the field’s larger quest to establish the foundations of climate anxiety.
PURPOSE OF REVIEW: We review recent literature on the effects of climate change on child and adolescent mental health and discuss treatment and engagement by clinicians. RECENT FINDINGS: Climate change affects child and adolescent mental health in many intersecting ways, including as a social and ecological determinant of health, a threat amplifier, and a source of trauma and distress. Single extreme weather events contribute to significant negative mental health consequences; however, subacute and chronic climate events also have mental health sequelae. Furthermore, awareness of the climate crisis is associated with emotional distress. Young people with pre-existing mental illness and lacking social support may be at elevated risk for climate change-related mental health effects. Climate activism is associated with resilience and positive development, but may also be a source of increased stress, particularly for marginalized youths. Climate change can affect the mental health of children and adolescents in complex and diverse ways. Sources of coping and resilience also vary greatly between individuals. Mental health clinicians must respond to this existential crisis by addressing research gaps in this area, obtaining relevant clinical training, educating their communities, and joining and supporting young people in their advocacy efforts.
According to the World Health Organization (WHO), depression is a leading cause of disability worldwide and a major contributor to the overall global burden of mental disorders. An increasing number of studies have revealed that among 20 different amino acids, high proline consumption is a dietary factor with the strongest impact on depression in humans and animals, including insects. Recent studies acknowledged that gut microbiota play a key role in proline-related pathophysiology of depression. In addition, the multi-omics approach has alleged that a high level of metabolite proline is directly linked to depression severity, while variations in levels of circulating proline are dependent on microbiome composition. The gut-brain axis proline analysis is a gut microbiome model of studying depression, highlighting the critical importance of diet, but nothing is known about the role of the plant microbiome-food axis in determining proline concentration in the diet and thus about preventing excessive proline intake through food consumption. In this paper, we discuss the protocooperative potential of a holistic study approach combining the microbiota-gut-brain axis with the microbiota-plant-food-diet axis, as both are involved in proline biogenesis and metabolism and thus on in its effect on mood and cognitive function. In preharvest agriculture, the main scientific focus must be directed towards plant symbiotic endophytes, as scavengers of abiotic stresses in plants and modulators of high proline concentration in crops/legumes/vegetables under climate change. It is also implied that postharvest agriculture-including industrial food processing-may be critical in designing a proline-balanced diet, especially if corroborated with microbiome-based preharvest agriculture, within a circular agrifood system. The microbiome is suggested as a target for selecting beneficial plant endophytes in aiming for a balanced dietary proline content, as it is involved in the physiology and energy metabolism of eukaryotic plant/human/animal/insect hosts, i.e., in core aspects of this amino acid network, while opening new venues for an efficient treatment of depression that can be adapted to vast groups of consumers and patients. In that regard, the use of artificial intelligence (AI) and molecular biomarkers combined with rapid and non-destructive imaging technologies were also discussed in the scope of enhancing integrative science outcomes, agricultural efficiencies, and diagnostic medical precisions.
BACKGROUND: Climate change can negatively affect mental health, and poor mental health can negatively affect work. However, less is known about the relationship between mental health and workplace behaviours within the climate change context. AIMS: To explore existing literature relating to climate-induced mental ill-health as a potential predictor of workplace behaviours. METHODS: Scoping review, searching five databases for relevant literature using two separate search strategies. RESULTS: Only five studies with any relevant data were found. Results could not be easily synthesized because each of the five considered different work-related outcomes. However, the available data suggest that the psychological impact of extreme events could lead to increased job tension, higher turnover intentions and workplace hostility. Stress about extreme weather could also impede the ability to make essential work-related decisions and, for those who work in the environmental sector, concerns about climate could lead to overcommitment to work. There was some evidence that social support might lessen the effects of climate-induced stress on work outcomes. CONCLUSIONS: Very little literature considers the impacts of climate change on employees’ mental health and associated workplace function. The available evidence suggests there are potential negative impacts which may be mitigated by social support. It is important for future research to explore ways of supporting staff and fostering resilience.
Extreme Weather Events (EWEs) impose a substantial health and socio-economic burden on exposed populations. Projected impacts on public health, based on increasing EWE frequencies since the 1950s, alongside evidence of human-mediated climatic change represents a growing concern. To date, the impacts of EWEs on mental health remain ambiguous, largely due to the inherent complexities in linking extreme weather phenomena with psychological status. This exploratory investigation provides a new empirical and global perspective on the psychological toll of EWEs by exclusively focusing on psychological morbidity among individuals exposed to such events. Morbidity data collated from a range of existing psychological and well-being measures have been integrated to develop a single (“holistic”) metric, namely, psychological impairment. Morbidity, and impairment, were subsequently pooled for key disorders-, specifically PTSD, anxiety and depression. A “composite” (any impairment) post-exposure pooled-prevalence rate of 23% was estimated, with values of 24% calculated for depression and ⁓17% for both PTSD and anxiety. Notably, calculated pooled odds ratios (pOR = 1.9) indicate a high likelihood of any negative psychological outcome (+90%) following EWE exposure. Pooled analyses of reported risk factors (p < 0.05) highlight the pronounced impacts of EWEs among individuals with higher levels of event exposure or experienced stressors (14.5%) and socio-demographic traits traditionally linked to vulnerable sub-populations, including female gender (10%), previous history (i.e., pre-event) of psychological impairment (5.5%), lower socio-economic status (5.5%), and a lower education level (5.2%). Inherent limitations associated with collating mental health data from populations exposed to EWEs, and key knowledge gaps in the field are highlighted. Study findings provide a robust evidence base for developing and implementing public health intervention strategies aimed at ameliorating the psychological impacts of extreme weather among exposed populations.
As climate change worsens and public awareness of its grave impact increases, individuals are increasingly experiencing distressing mental health symptoms which are often grouped under the umbrella term of eco-anxiety. Clear guidance is needed to enable mental health professionals to make informed choices of appropriate interventions and approaches in their eco-anxiety treatment plans. A scoping review was conducted to examine the current understanding of eco-anxiety and related intervention options and recommendations. The review included 34 records, 13 of which reflected specific psychological approaches. A thematic analysis of the content of the selected records yielded five major themes across interventions for individual and group treatment of eco-anxiety: practitioners’ inner work and education, fostering clients’ inner resilience, encouraging clients to take action, helping clients find social connection and emotional support by joining groups, and connecting clients with nature. Recommendations for treatment plans are to focus on holistic, multi-pronged, and grief-informed approaches that include eco-anxiety focused group work.
Climate change anxiety is a growing problem for individual well-being the world over. However, psychological interventions to address climate change anxiety may have unintended effects on outcomes other than individual well-being, such as group cohesion and pro-environmental behavior. In order to address these complexities, we outline a multiple needs framework of climate change anxiety interventions, which can be used to analyze interventions in terms of their effects on individual, social, and environmental outcomes. We use this framework to contextualize a systematic review of the literature detailing the effects of climate change anxiety interventions. This analysis identifies interventions centered around problem-focused action, emotion management, and enhancing social connections as those which have beneficial effects on the widest range of outcomes. It also identifies interventions that may have detrimental effects on one or more outcomes. We identify gaps where more research is required, including research that assesses the effects of climate change anxiety interventions on individual, social, and environmental outcomes in concert. An interactive website summarizes these insights and presents the results of the systematic review in a way that is, accessible to a range of stakeholders. The multiple needs framework provides a way to conceptualize the effectiveness of climate change anxiety interventions beyond their impact on individual well-being, contributing to a more holistic understanding of the effects of this global phenomenon. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
The evidence supporting the idea that natural disaster-related prenatal maternal stress (PNMS) influences the child’s development has been accumulating for several years. We conducted a meta-analytical review to quantify this effect on different spheres of child development: birth outcomes, cognitive, motor, physical, socio-emotional, and behavioral development. We systematically searched the literature for articles on this topic (2756 articles retrieved and 37 articles included in the systematic review), extracted the relevant data to calculate the effect sizes, and then performed a meta-analysis for each category of outcomes (30 articles included across the meta-analyses) and meta-regressions to determine the effect of some factors of interest on the association between PNMS and child development: type of PNMS (objective, psychological, cognitive, diet), type of natural disaster (ice storm, flood/cyclone), type of report (maternal, third-party observer, medical), timing of exposure (preconception exposure included or not) and child age at assessment (under 10 or 10 years and older). We found that PNMS significantly influences all spheres of child development. Higher PNMS levels were associated with longer gestational age, larger newborns, and higher BMI and adiposity levels, as well as worse cognitive, motor, socio-emotional, and behavioral outcomes.
Responding to climate change requires radical transformations in social, political, economic and social-ecological systems. Recent research has argued that individuals can drive transformations at scale through changes in beliefs and values that affect political activity. We draw from sociological and psychological perspectives on mental health outcomes among survivors of violence and abuse, taking a gendered approach, to show how potential for individual transformation is differentially constructed through personal life trajectories and intersectional social relations. We also argue that being resilient and transforming is stressful and involves significant personal costs. In integrating this psychological perspective, we suggest a more equitable way to define the individual’s role in, and their responsibility for, sustainable, societal-scale shifts for climate change.
BACKGROUND: Climate change is a threat to children’s physical health, but there are also implications for mental well-being. Additionally, children may experience negative emotional responses stemming from an overarching awareness of the imminent threats to the planet due to climate change. METHOD: Using a scoping review, we examined the impact of climate change awareness on children’s mental well-being and negative emotions. Our aim was to identify and describe the existing literature and highlight priorities for future research. Three specific objectives guided the review: (1) to identify and provide an overview of research regarding the impact of climate change awareness on children’s mental well-being and negative emotions; (2) to summarize and clarify the terminology related to climate change awareness and children’s mental well-being and negative emotions; and (3) to make recommendations for areas of future research. RESULTS: Thirty-three articles were included in a narrative synthesis. Many articles were reviews or editorials/commentaries. Of the empirical research, most were from Europe, North America, and Australia. The articles emphasized a large range of negative emotions that children felt about climate change, with anxiety and worry being the most researched and discussed. CONCLUSIONS: The research on the impact of awareness of climate change on children’s mental well-being and negative emotions is in its early phases. Efforts are needed to advance conceptual clarity and operationalize concepts. Additionally, there is a need for research into the impact of climate change awareness on children’s mental well-being and negative emotions among a greater diversity of people and places. Existing studies provide an encouraging basis from which to develop future research.
A debate has emerged over the potential socio-ecological drivers of wildlife-origin zoonotic disease outbreaks and emerging infectious disease (EID) events. This Review explores the extent to which the incidence of wildlife-origin infectious disease outbreaks, which are likely to include devastating pandemics like HIV/AIDS and COVID-19, may be linked to excessive and increasing rates of tropical deforestation for agricultural food production and wild meat hunting and trade, which are further related to contemporary ecological crises such as global warming and mass species extinction. Here we explore a set of precautionary responses to wildlife-origin zoonosis threat, including: (a) limiting human encroachment into tropical wildlands by promoting a global transition to diets low in livestock source foods; (b) containing tropical wild meat hunting and trade by curbing urban wild meat demand, while securing access for indigenous people and local communities in remote subsistence areas; and (c) improving biosecurity and other strategies to break zoonosis transmission pathways at the wildlife-human interface and along animal source food supply chains.
Zoonotic disease outbreaks are an important threat to human health and numerous drivers have been recognized as contributing to their increasing frequency. Identifying and quantifying relationships between drivers of zoonotic disease outbreaks and outbreak severity is critical to developing targeted zoonotic disease surveillance and outbreak prevention strategies. However, quantitative studies of outbreak drivers on a global scale are lacking. Attributes of countries such as press freedom, surveillance capabilities and latitude also bias global outbreak data. To illustrate these issues, we review the characteristics of the 100 largest outbreaks in a global dataset (n = 4463 bacterial and viral zoonotic outbreaks), and compare them with 200 randomly chosen background controls. Large outbreaks tended to have more drivers than background outbreaks and were related to large-scale environmental and demographic factors such as changes in vector abundance, human population density, unusual weather conditions and water contamination. Pathogens of large outbreaks were more likely to be viral and vector-borne than background outbreaks. Overall, our case study shows that the characteristics of large zoonotic outbreaks with thousands to millions of cases differ consistently from those of more typical outbreaks. We also discuss the limitations of our work, hoping to pave the way for more comprehensive future studies. This article is part of the theme issue ‘Infectious disease macroecology: parasite diversity and dynamics across the globe’.
At least 10,000 virus species have the ability to infect humans but, at present, the vast majority are circulating silently in wild mammals(1,2). However, changes in climate and land use will lead to opportunities for viral sharing among previously geographically isolated species of wildlife(3,4). In some cases, this will facilitate zoonotic spillover-a mechanistic link between global environmental change and disease emergence. Here we simulate potential hotspots of future viral sharing, using a phylogeographical model of the mammal-virus network, and projections of geographical range shifts for 3,139 mammal species under climate-change and land-use scenarios for the year 2070. We predict that species will aggregate in new combinations at high elevations, in biodiversity hotspots, and in areas of high human population density in Asia and Africa, causing the cross-species transmission of their associated viruses an estimated 4,000 times. Owing to their unique dispersal ability, bats account for the majority of novel viral sharing and are likely to share viruses along evolutionary pathways that will facilitate future emergence in humans. Notably, we find that this ecological transition may already be underway, and holding warming under 2 °C within the twenty-first century will not reduce future viral sharing. Our findings highlight an urgent need to pair viral surveillance and discovery efforts with biodiversity surveys tracking the range shifts of species, especially in tropical regions that contain the most zoonoses and are experiencing rapid warming.
Every year we see many changes in the world around us. One of these changes is the climate and weather, and it could be one of the reasons for changing behaviors between humans and animals, which could cause zoonotic diseases. We usually face new diseases that infect a growing population leading to a pandemic. Different reasons are leading to an increase in the emergence of new infections. Some of these diseases can be associated with zoonotic diseases and the diverse world of viral genetics and its failures. Furthermore, properties like mutations and also unknown effects of these mutations on the virulence of the agents make it challenging to trace new diseases. As we know, preventing emerging diseases is inevitable and viral diseases are dangerous, and some viruses can spread quickly and cause an endemic or pandemic. As was noticed during the recent pandemic, the need to study emerging diseases in the field of virology has become more and more apparent to us. In this review, we want to look at how we could monitor and control these diseases with new approaches and what should be done when a disease emerges. Moreover, we will investigate risk factors, ways to deal with emerging viral infections, new treatments that make the condition better when a person gets infected, and the future of these diseases. We will also study the ways to deal with pandemics with the new generations of vaccines.
OBJECTIVE: To describe and quantify the extent of wildlife and environment sector inclusion in country evaluation and prioritization tools for health security, and to provide practical recommendations for global and national action to improve pandemic prevention and preparedness. METHODS: To assess coverage of wildlife and other environmental aspects, we reviewed major health security reports (including World Organisation for Animal Health Performance of Veterinary Services reports, and World Health Organization Joint External Evaluations and follow-on National Action Plans for Health Security) published by 107 countries and territories. We extracted information on stated coverage gaps, wildlife surveillance systems and priority diseases. We also searched National Biodiversity Strategies and Action Plans published by 125 countries to assess whether disease surveillance or prevention activities were included. FINDINGS: We noted that the occurrence frequency of keywords indicative of wildlife, environment, biodiversity and climate factors varied with type of report and between countries. We found that more than half (57.9%, 62/107) of the reporting countries did not provide any evidence of a functional wildlife health surveillance programme. Most countries (83.2%, 89/107) indicated specific gaps in operations, coordination, scope or capacity. Only eight of the 125 countries (6.4%) publishing a National Biodiversity Strategy and Action Plan reported tangible activities related to wildlife health or zoonotic disease. CONCLUSION: Overall, despite their importance for pandemic prevention, wildlife and environmental considerations are neglected in health security priorities and plans. Strengthening wildlife health capacity and operations should be emphasized in One Health efforts to monitor and mitigate known and novel disease risks.
The emergence of an outbreak of Monkeypox disease (MPXD) is caused by a contagious zoonotic Monkeypox virus (MPXV) that has spread globally. Yet, there is no study investigating the effect of climatic changes on MPXV transmission. Thus, studies on the changing epidemiology, evolving nature of the virus, and ecological niche are highly paramount. Determination of the role of potential meteorological drivers including temperature, precipitation, relative humidity, dew point, wind speed, and surface pressure is beneficial to understand the MPXD outbreak. This study examines the changes in MPXV cases over time while assessing the meteorological characteristics that could impact these disparities from the onset of the global outbreak. To conduct this data-based research, several well-accepted statistical techniques including Simple Exponential Smoothing (SES), Auto-Regressive Integrated Moving Average (ARIMA), Automatic forecasting time-series model (Prophet), and Autoregressive Integrated Moving Average with Explanatory Variables (ARIMAX) were applied to delineate the correlation of the meteorological factors on global daily Monkeypox cases. Data on MPXV cases including affected countries spanning from 6 May 2022, to 9 November 2022, from global databases and meteorological data were used to evaluate the developed models. According to the ARIMAX model, the results showed that temperature, relative humidity, and surface pressure have a positive impact [(51.56, 95% confidence interval (CI): -274.55 to 377.68), (17.32, 95% CI: -83.71 to 118.35) and (23.42, 95% CI: -9.90 to 56.75), respectively] on MPXV cases. In addition, dew/frost point, precipitation, and wind speed show a significant negative impact on MPXD cases. The Prophet model showed a significant correlation with rising MPXD cases, although the trend predicts peak values while the overall trend increases. This underscores the importance of immediate and appropriate preventive measures (timely preparedness and proactive control strategies) with utmost priority against MPXD including awareness-raising programs, the discovery, and formulation of effective vaccine candidate(s), prophylaxis and therapeutic regimes, and management strategies.
Recent cases of monkeypox (MPX), a zoonotic illness caused by monkeypox virus (MPXV), outside of Africa have prompted international public health concerns. The emergence, re-emergence, and global dispersion of zoonoses are profoundly impacted by a wide variety of causes, including but not limited to climate change, urbanization, animal migration, quick means of travel and tourism, vector biology, anthropogenic influences, and natural factors. Human MPX was first identified in the Democratic Republic of the Congo (DRC) in 1970, and since then it has spread throughout Africa, particularly to West and Central Africa, with some instances even emerging outside of Africa. Since the 1970s, there has been an increasing trend in the occurrence of human MPX, with the DRC seeing the largest increase. The median age at first presentation has increased from 4 years in the 1970s to 21 years in the current time. The total fatality rate was 8.7%, although there was a significant variation between clades: Central African (10.6%) and West African (3.6%). Since 2003, sporadic outbreaks have occurred outside of Africa due to imports and travel-related dissemination. Risky practices that could lead to contracting MPX include having contact with infected animals or people. There is still much to learn about MPXV, such as the reason for the sudden increase in cases while travel links from endemic countries have not yet been established profoundly, identity the natural reservoir animal(s), make advances in diagnostics, increase surveillance and monitoring, carry out in-depth epidemiological investigations, genome sequencing and phylogenetic analysis, explore the reasons for the changing epidemiology and evolving nature of the virus, its ecological niche, and the discovery of effective treatment and management of MPX. This l mini-review aims to reveal an increase in the number of reported cases of MPX worldwide, with the highest concentration in the DRC, as well as its spread to other countries and a shift in the median age of patients from infants to teenagers and young adults highlighting from older years to current 2022 MPX outbreaks. Some cross-protection against MPX was provided by smallpox vaccination, suggesting that its discontinuation may have contributed to an increase in human-to-human transmission. The disease’s worldwide significance is underscored by the fact that it has spread beyond Africa. As the epidemiology of this resurging disease is constantly shifting, surveillance and detection programs are crucial to keeping up with it.
Hyperarid, arid, semiarid, and dry subhumid areas cover approximately 41% of the global land area. The human population in drylands, currently estimated at 2.7 billion, faces limited access to sufficient, affordable, and nutritious food. We discuss the interlinkages among water security, environmental security, energy security, economic security, health security, and food security governance, and how they affect food security in drylands. Reliable and adequate water supply, and the prevention of water contamination, increase the potential for ample food, fodder, and fiber production. Protecting woodlands and rangelands increases food security by buffering the slow onset effects of climate change, including biodiversity loss, desertification, salinization, and land degradation. The protection of natural lands is expected to decrease environmental contamination, and simultaneously, reduce the transfer of diseases from wildlife to humans. Biofuel production and hydroelectric power plants increase energy security but generate land-use conflicts, deforestation, and ecosystem degradation. Economic security generally positively correlates with food security. However, economic growth often degrades the environment, changes tenure rights over natural resources, and stimulates migration to urban areas, resulting in lower food and health security. Moreover, civil unrest, political instability, and armed conflicts disrupt local economies in drylands. Maintaining food security is crucial for health security; conversely, malnourished populations and unresponsive health systems decrease economic security, and adversely affect environmental, energy, and food security. Climate change is expected to deteriorate health security by spreading vector-borne diseases. Effective governance and timely interventions can substantially shorten periods of food insecurity, lower their intensities, and accelerate recovery from inevitable crises, and are therefore crucial in preventing humanitarian crises. Since global drylands population will nearly double by 2050, and since drylands are among the most susceptible areas to climate change, integrated multi-hazard approaches to food security are needed.
Climate change has become a global emergency, which mental health effects are increasingly being described and understood. Children and adolescents, especially those in low income countries and minority communities, are particularly vulnerable to experience the worst impacts of climate change now and in the coming decades. Our group of early career mental health clinicians and researchers in nine culturally and socioeconomic different countries across three continents initiated a global, online discussion about the effects of climate change on the mental health of children and adolescents, based on literature and our professional experience. We identified a paucity of research and psychiatric education on the topic, and a need to advance global and local efforts in this direction. We also identified three main domains of mental health impact of climate change: direct, indirect, and through physical conditions. Our work offers a preliminary, up-to-date overview of the consequences of climate change on the mental health of children and adolescents, and provides recommendations to advance policies, public health efforts, research, education, and clinical care in the emerging area of ‘Climate Psychiatry’.
The first trigger to any form of personal and collective change begins with emotions. They influence whether and how our attention is drawn to stimuli, how we reflect upon those stimuli, and how we choose courses of action. Emotions are thus at the center of social responses to climate change. We offer a selective, interdisciplinary review of emotions research to inform the development of a hypothetical emotion-cognition model of climate change response, followed by exploration of the emotional precedents supporting three prevailing behavioral responses which support inaction: apathy, denial, and withdrawal. We then review research that can inform emotion triggers to pro-climate adaptive and mitigative action. We conclude with a discussion of two key research needs: intersectionality and interdisciplinarity. Addressing these needs will enhance our ability to respond to the climate emergency. This article is categorized under: Perceptions, Behavior, and Communication of Climate Change.
Background: Although there is no standard definition for eco-anxiety, most authors define it as people’s emotional reaction of concern, worry, anxiety, and fear in view of global Climate Change (CC) threats and concurrent environmental degradation. This systematic review was carried out to critically evaluate the evidence on eco-anxiety related to CC and its health implications in general populations. Methods: We performed a search for scientific articles in PubMed, Scopus, Embase, Web of Science, and Cochrane Central. Studies were included if they complied with the study objective. Selection of articles and data extraction were carried out independently by 2 reviewers. We used the Axis tool and JBI critical appraisal checklist to assess the quality of the studies. Results: A final sample of 12 articles was included in this review. The methodological quality of the studies was limited. A wide variety of eco-anxiety definitions was used in the different studies but further research is needed to provide conceptual clarity of the term eco-anxiety. Eco-anxiety was associated with functional impairment, symptoms of depression, anxiety, PTSD, stress and insomnia, lower self-rated mental health, and reluctance to have children. Moreover, habitual worry about global warming was associated with a pro-ecological worldview, a green self-identity and pro-environmental behavior, strongly suggesting a constructive nature. Indeed, pro -environmental behavior in the form of climate activism would buffer the impact of CCA cognitive-emotional impairment on MDD symptoms. However, sometimes engaging in pro-environmental behavior might not be successful in dealing with eco-anxiety, since individuals might perceive that their efforts do not help to mitigate the CC crisis. Conclusions: Results have to be interpreted with caution since the methodological quality of the studies was limited. However, they do suggest a link between eco-anxiety and negative mental health outcomes, mainly in younger generations, women, and poorer countries in the “Global South”. Eco-anxiety may constitute a stressor to mental health, particularly if coping mechanisms are not successfully developed.
To what extent do socioeconomic conditions in early life shape individuals’ noncognitive skills? Using exogenous variation in the timing of weather shocks in 28 agricultural countries, I examine the impact of shocks in childhood on adult locus of control. The results show that experiencing rainfall shortages before age five causes individuals to believe that they cannot control their life outcomes. The impact is larger and persists longer for females, and the gender difference in the impact of weather shocks accounts for 21% of the gender difference in the adult locus of control. Rainfall shocks also decrease females’ political participation.
The working landscape approach is gaining rapid recognition for its potential to help address global environmental crises such as climate change and biodiversity loss and support social well-being. Yet, the working landscape approach still lacks a comprehensive conceptual framework to guide further research and practice. This article provides such a framework through a comprehensive review and synthesis of the governance dimension of working landscapes. The framework is built on five premises, including (1) the working landscape approach focuses on simultaneously achieving social well-being and environmental protection within the landscapes, (2) it is concerned with fostering collective action among multiple actors to deliver sustainable outcomes, (3) the social-ecological context affects and is affected by the working landscape in question, (4) five common elements-equity, facilitative leadership, local autonomy, incentives, and trust-are essential for facilitating collective action in working landscapes, and (5) collaborative and multilevel interactions enhance governance fit in working landscapes. Our framework focuses on the local scale and how the local is embedded within multilevel governance arrangements. This framework can guide empirical case studies on the working landscape approach, further its theoretical understanding, and contribute to enhancing policy aimed at increased social well-being and environmental protection.
Climate change is an existential threat facing humanity on a global scale. To handle this problem, all societal actors, including young people, need to get involved. This narrative review focuses on what implications climate change has for research in developmental psychology. It is argued that how young people relate to climate change is closely associated with key issues dealt with in this research field. The aim of this article is to present an overview of research about young people and climate change concerning four interrelated topics: (a) climate change and mental well-being, (b) coping with climate change, (c) private-sphere pro-environmental behaviour as a form of pro-social development, and d) climate change and political socialization. The emphasis is on young people from middle childhood to early adulthood. Implications for future research are discussed, for instance, the need for more longitudinal and intervention studies.
Global change, population growth, and urbanization have been exerting a severe influence on the environment, including the social system and ecosystem. To find solutions based on nature, clarifying the complicated mechanisms and feedback among land use/land cover changes, ecosystem services, and human well-being, is increasingly crucial. However, the in-depth linkages among these three elements have not been clearly and systematically illustrated, present research paths have not been summarized well, and the future research trends on this topic have not been reasonably discussed. In this sense, the purpose of this paper is to provide an insight into how land use/land cover changes, ecosystem services, and human well-being are linked, as well as their relationships, interacting ways, applications in solving ecological and socioeconomic problems, and to reveal their future research trends. Here, we use a systematic literature review of the peer-reviewed literature to conclude the state of the art and the progress, emphasize the hotspot, and reveal the future trend of the nexus among the three aspects. Results show that (1) ecosystem services are generally altered by the changes in land use type, spatial pattern, and intensity; (2) the nexus among land use change, ecosystem services, and human well-being is usually used for supporting poverty alleviation, ecosystem health, biodiversity conservation, and sustainable development; (3) future research on land use/land cover changes, ecosystem services, and human well-being should mainly focus on strengthening multiscale correlation, driving force analysis, the correlation among different group characteristics, land use types and ecosystem service preferences, and the impact of climate change on ecosystem services and human well-being. This study provides an enhanced understanding of the nexus among the three aspects and a reference for future studies to mitigate the relevant problems.
In the context of climate change and its accompanying impact on stress and mental health, we argue that positive psychology (PP) may benefit from an integration of spirituality to better support people’s wellbeing. Starting with an overview of climate change’s impact on wellbeing and health, we explore the paradoxical and complex relationship between humans and nature. Following which, we will briefly define spirituality and present an evocative metaphor of the wave to portray the evolution of the field of PP. In our conclusive remarks, we argue that the field of PP has gradually become more open to integrate spirituality (since the first wave), as it evolves towards greater complexity (in its third wave). In addition to meaning, some spiritual perspectives potentially relevant to positive psychology facilitate an ecocentric view (i.e., eco-spiritualities) which allow for a better understanding of the paradoxical human-nature relationship, as we struggle to deal with the complex issues related to climate change.
INTRODUCTION: Many young people report experiencing negative emotional responses to their awareness of climate change and the threats it poses to their future. With that, an increasing number of survey instruments have been developed to examine young people’s negative emotional responses to their awareness of climate change. This report describes a protocol for a systematic review that aims to identify, synthesise and critically appraise how negative emotional responses to climate change among young people have been measured in survey research. The research questions addressed in this review are: (1) How has negative emotional responses to climate change been defined and measured among young people? (2) How do survey instruments measuring young people’s negative emotional responses to climate change vary in terms of reliability and validity? (3) What factors are associated with negative emotional responses to climate change among young people? METHODS AND ANALYSIS: Seven academic databases (CINAHL, ERIC, MEDLINE, PsycINFO, Web of Science, Scopus, and Environment Complete) will be searched to retrieve studies published between 1 January 2006 and 31 March 2022 and published in English. Studies including survey instruments that measure negative emotional responses among young people (aged 10-24 years) will be eligible for inclusion. Targeted journals will be hand-searched. This review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for systematic reviews. The methodological quality, in terms of reliability and validity, of the included studies will be assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist for risk of bias of patient-reported outcome measures. To rate the quality of the instruments, we will use a modified Grading of Recommendations, Assessment, Development and Evaluations technique defined by the COSMIN guidelines. ETHICS AND DISSEMINATION: Ethical approval is not applicable for this study. We will disseminate the findings through publication in peer-reviewed journals and presentations. PROSPERO REGISTRATION NUMBER: CRD42022295733.
Our ambulatory assessment study explores the impact of the weather on the mental well-being of people with increased susceptibility. Participants with hay fever (n = 28) were assessed three times a day over a period of two weeks. Self-reported assessments covered different indicators of mental well-being, including momentary affect, subjective health as well as symptom burden. Based on tracked time stamps and location information, the data was matched with concurrent observation data from weather stations. We applied multilevel analysis to identify the main effects of selected environmental parameters (temperature, precipitation, wind power, sunshine duration and relative humidity) on all indicators of subjective well-being. Results confirm the main effects of sunshine duration, relative humidity and temperature on momentary affect as well as of sunshine duration, relative humidity and precipitation on subjective health and symptom burden. However, influences of environmental parameters on momentary affect were quite small and do not differ from effects documented in previous research in healthy samples with non-increased susceptibility.
Climate change is the largest threat to human health of the twenty-first century. Women are disproportionately affected by climate change. While the physical health impacts of climate change are an active area of research, works related to the mental health impacts are less developed. Furthermore, the mental health impacts of climate change on women are a particular area of interest due to women’s disproportionately negative experiences with climate change and climate change-related events. Therefore, the purpose of this scoping review is to understand what is known from the existing literature regarding the mental health impacts of climate change on women. The methods for this review follow the Arksey and O’Malley framework for a scoping review. By searching databases for publications that discuss women, mental health, and climate change, and screening for relevant work, 20 studies that met inclusion criteria were included in the review. Themes derived from the reviewed studies include negative mental health outcomes, gender-based violence, burdens of care and responsibility, attachment to land and traditions, and the importance of intersectionality. From these findings, there is a clear need for climate policies on adaptation and mitigation to reflect women’s unique needs to ensure their health and safety.
Global climate change awareness is increasing, but efforts to convey information can trigger undesirable behaviors, including denial, skepticism, and increased resource consumption. It is therefore essential to more fully investigate social-psychological responses to climate information and messaging if we are to prompt, support, and sustain pro-environmental behaviors. Yet consideration of these responses is typically absent from interdisciplinary environmental study designs. Of specific relevance is research using social psychology’s Terror Management Theory (TMT) showing that people’s efforts to repress mortality salience (MS) or awareness significantly influence their attitudes, beliefs, and behaviors. Research on MS’s influence on climate change beliefs is progressing but, to date, a systematic scoping review of the literature has been unavailable. Here, we provide such a review. We propose that TMT insights and methods should be better integrated into research designs to guide climate communications and to generate the comprehensive cultural and behavioral changes needed to address societies’ climate problems. We introduce a methodological framework for interdisciplinary researchers to incorporate TMT into their research designs and to help practitioners anticipate how their mortality-laden messaging could trigger unintentional social-psychological responses that degrade climate communication strategies. This article is categorized under: Perceptions, Behavior, and Communication of Climate Change > Behavior Change and Responses
As global mean temperatures rise and extreme climate and weather events increase in frequency and intensity, the severity of the climate situation and its potential impacts on human well-being – particularly of the world’s most vulnerable populations – strikingly evident. Research and policy responses to address climate change are required to meet U.S. targets set for the coming decades, which include a reduction of 50 to 52 percent of greenhouse gas emissions by 2030 and net-zero emissions by 2050. In coordination with other activities on climate, energy, and environmental and human health across the National Academies of Sciences, Engineering, and Medicine, the Government-University-Industry Research Roundtable convened a series of five workshops in June and July of 2021 to discuss opportunities for enhancing U.S. scientific and technological approaches to climate research and policy through cross-sector collaboration and partnerships, and to examine the impacts of climate policy on economic development, inequality, and international competitiveness. This document summarizes the presentations and discussions at the five workshops.
Counteracting the worst effects of human-induced climate change is one of the most daunting challenges of our time. There has been an increased recognition of the important role that human emotions, in particular positive affect, play in shaping people’s climate change-relevant decision-making and collective action. Here, we briefly review the rapidly expanding body of empirical research on positive emotions and climate change, focusing on two distinct yet closely intertwined ways in which positive emotions come into play: as antecedents and as consequences of climate change-relevant engagement. Our review reveals that positive emotions are positively linked to and can promote productive engagement with climate change but also that there is no ‘one size fits all’ approach to incorporating emotion into engagement and communication efforts.
Climate change has been acknowledged as one of the most significant current threats for younger generations. However, few studies have focused on climate change impacts on youth and how they can be supported. The purpose of this systematic review is to emphasize that a developmental perspective is fundamental within the interdisciplinary studies concerning climate change. Specifically, we focus our research on how the Positive Youth Development framework may inform future approaches to promote adolescents’ and young adults’ well-being and engagement in the context of climate change. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search comprised two databases, and a total of 13 articles were finally considered eligible for review. Data were analyzed using a narrative method. The results show that the Positive Youth Development theory is not yet directly embedded in existing studies concerning adolescents and young adults in the context of climate change, but some of its principles were identified. Examples are provided of how Positive Youth Development characteristics and constructs can enhance future research, practice, and policies. We highlight this framework as an innovative and promising approach in the context of climate change.
Climate change worry involves primarily verbal-linguistic thoughts about the changes that may occur in the climate system and the possible effects of these changes. Such worry is one of several possible psychological responses (e.g., fear, anxiety, depression, and trauma) to climate change. Within this article, the psychometric development of the ten-item Climate Change Worry Scale (CCWS) is detailed in three studies. The scale was developed to assess proximal worry about climate change rather than social or global impacts. Study 1 provided evidence that the CCWS items were internally consistent, constituted a single factor, and that the facture structure of the items was invariant for men and women. The results from Study 1 also indicated a good fit with a Rasch model of the items. Study 2 affirmed the internal consistency of the CCWS items and indicated that peoples’ responses to the measure were temporally stable over a two-week test-retest interval (r = 0.91). Study 3 provided support for the convergent and divergent validity of the CCWS through its pattern of correlations with several established clinical and weather-related measures. The limitations of the studies and the possible uses of the CCWS were discussed. The current work represents a starting point.
BACKGROUND: Despite the growing impact of climate change on mental health, there have been few studies to date investigating how children and teenagers manage their ecological grief and eco-anxiety and how they can leverage it into environmental action. In this scoping review, we analyze lay press narratives about how youth respond to climate change to examine the dynamics between minors and adults around the evolving climate crisis. METHODS: We included articles published between 2018 and 2021 in six of the top ten American newspapers by circulation about young people during the climate crisis. The 131 articles we selected addressed the attitudes of children, adolescents, and parents toward the climate crisis. We conducted a qualitative analysis based on discourse analysis aided by NVivo software. RESULTS: Newspaper articles commonly categorized children, adolescents, and their respective perspectives and experiences around climate change along four patterns of discourse: (a) fierce young activists; (b) adultified children; (c) innocent victims; and/or (d) ultimate saviors. In turn, articles considered parents and adults in one of four paradigmatic ways: (a) experiencing eco-anxiety through parenthood; (b) taming children’s eco-anxiety; (c) criticizing youth-led activism; and/or (d) reimagining climate action as a source of meaning in the lives of young people. CONCLUSION: Through the framework of childism, or prejudice against children, we conceptualize immature ways for adults to respond to youths’ concerns as a defensive stance against overwhelming climate change anxiety. Alternatively, principles of existential psychology can help inform healthier and more productive responses from parents, clinicians, educators, and public health officials as they seek truthful yet supportive responses to address legitimate ecological threats that will disproportionately affect generations to come.
BACKGROUND: Suicide is a leading cause of death, particularly for young adults. Suicidal behaviours are influenced by a wide-range of personal, social, and cultural factors. Emerging evidence suggests that daily changes in meteorological conditions, including temperature, increases the risk of suicide. METHODS: We conducted a systematic review and meta-analysis of studies that examined associations between either daily, or weekly, variations for eight meteorological variables and suicide outcomes (attempts, or deaths). Meta-analytic methods were applied to derive summary measures of association using random effect models. We assessed the heterogeneity in these associations by region and biological sex. RESULTS: We identified 29 studies of suicide. Of these, 26 reported associations between temperature, while fewer studies reported on rain (n = 4), solar radiation (n = 4), humidity (n = 3), sunshine (n = 3), atmospheric pressure (n = 2), wind (n = 2) and cloud cover (n = 2). The overall relative risk for suicide deaths/attempts per 1 °C increase in ambient temperature was 1.016 (95% CI: 1.013-1.019). Subgroup analysis of temperature found stronger associations with suicide when using the maximum rather than the mean daily temperature, among men, and for completed suicides relative to attempts. Regionally, the strongest associations were found in the East Asia and Pacific region. While associations were found for solar radiation and cloud coverage and suicide, we did not undertake a meta-analysis for these exposures as it was not possible to standardize measures of association across studies. Statistically significant associations were not observed for other identified meteorological variables. CONCLUSIONS: Our findings suggest that daily increases in temperature increase the risk of suicide, particularly, among men and in the East Asia and Pacific region.
Anthropogenic climate change is an existential threat whose influences continue to increase in severity. It is pivotal to understand the implications of climate change and their effects on mental health. This integrative review aims to summarize the relevant evidence examining the harm climate change may have on mental health, suggest potential mechanisms and discuss implications. Empirical evidence has begun to indicate that negative mental health outcomes are a relevant and notable consequence of climate change. Specifically, these negative outcomes range from increased rates of psychiatric diagnoses such as depression, anxiety and post-traumatic stress disorder to higher measures of suicide, aggression and crime. Potential mechanisms are thought to include neuroinflammatory responses to stress, maladaptive serotonergic receptors and detrimental effects on one’s own physical health, as well as the community wellbeing. While climate change and mental health are salient areas of research, the evidence examining an association is limited. Therefore, further work should be conducted to delineate exact pathways of action to explain the mediators and mechanisms of the interaction between climate change and mental health.
Climate change-related eco-anxiety in young people has made headlines around the world, but most study of this phenomenon has been limited to adults. Eco-anxiety is still not well defined in the literature, but generally refers to distress, worry, or concern related to the climate change crisis. Young people will be chronologically more exposed to climate change-related harms and problems, and this may be causing increased eco-anxiety in this population. This literature review aimed to summarize the relevant works on eco-anxiety in young people, provide a critique of the literature, identify gaps, and discuss the relevance to nursing practice. A literature search using multiple databases and other sources was completed, using applicable key terms and resulted in 23 sources to inform the review. Key themes of eco-anxiety definition variation, hopelessness and burden in young people, and responses to eco-anxiety are discussed, and critical analysis is undertaken. The main conclusions include a broad working definition of eco-anxiety that does not pathologize the eco-anxiety experience but recognizes that it can cause suffering. Also discussed is the role of nurses in reducing the potential or actual suffering of youth through hope promotion, challenging binary thinking patterns, building emotional resilience, encouraging action or involvement in climate change spheres, and promoting climate justice and advocacy. Recommendations for further research are offered.
No abstract available.
AIMS: Not only is nature essential for human existence, but many of its functions and contributions are irreplaceable. Studying the impact of these changes on individuals and communities, researchers and public health officials have largely focused on physical health. Our aim is to better understand how climate change also exacerbates many social and environmental risk factors for mental health and psychosocial problems, and can lead to emotional distress, the development of new mental health conditions and a worsening situation for people already living with these conditions. METHODS: We considered all possible direct and indirect pathways by which climate change can affect mental health. We built a framework which includes climate change-related hazards, climate change-related global environmental threats, social and environmental exposure pathways, and vulnerability factors and inequalities to derive possible mental health and psychosocial outcomes. RESULTS: We identified five approaches to address the mental health and psychosocial impacts of climate change which we suggest should be implemented with urgency: (1) integrate climate change considerations into policies and programmes for mental health, to better prepare for and respond to the climate crisis; (2) integrate mental health and psychosocial support within policies and programmes dealing with climate change and health; (3) build upon global commitments including the Sustainable Development Goals, the Paris Agreement and the Sendai Framework for Disaster Risk Reduction; (4) implement multisectoral and community-based approaches to reduce vulnerabilities and address the mental health and psychosocial impacts of climate change; and (5) address the large gaps that exist in funding both for mental health and for responding to the health impacts of climate change. CONCLUSIONS: There is growing evidence of the various mechanisms by which climate change is affecting mental health. Given the human impacts of climate change, mental health and psychosocial well-being need to be one of the main focuses of climate action. Therefore, countries need to dramatically accelerate their responses to climate change, including efforts to address its impacts on mental health and psychosocial well-being.
BACKGROUND: Youth and young adults, ages 15-29, have been identified as assets in mitigation and management for natural disasters around the world. This study reviews the literature on disaster mitigation, response, and recovery following natural disasters with a focus on the engagement of youth and young adults. METHODS: The Arksey and O’Malley (2005) scoping review model was used to broadly summarize existing literature. A comprehensive electronic search was conducted using several databases. Keywords and index terms were searched using four concepts: (a) age (e.g., youth, young adult), (b) participation type (e.g., engagement, participation), (c) natural disaster type (e.g., hurricane, tsunami), and (d) disaster response type (e.g., planning, mitigation). RESULTS: The search yielded 214 articles published between 1990 and 2021. Of these articles, 19 met inclusion criteria. Identified literature focused on youth and young adults’ mitigation and recovery efforts responding to natural disasters in several different countries. Themes of young people’s participation or youth-led efforts focused on community mobilization and resilience (n = 5), youth empowerment and policy advocacy (n = 2), communication technology (n = 2), education-community partnerships (n = 9), and postdisaster rescue efforts (n = 1). CONCLUSIONS: With a changing climate and increased weather-related natural disasters, as well as in the context of a global health pandemic, community-based groups would benefit from learning from international efforts to engage young people in disaster mitigation and recovery efforts especially as it relates to promoting mental health and well-being.
PURPOSE OF REVIEW: The evidence for the impact of climate change on the mental health of individuals and communities is reviewed, and the literature on the importance of digital systems in reducing carbon emissions is addressed. RECENT FINDINGS: Most of the climate change impacts on mental health are disaster related, although recent literature on “eco-anxiety,” often described as anxiety about the long-term effects of climate change, is emerging. There is strong evidence that the use of telepsychiatry and digital approaches to mental health care can reduce carbon emissions by reducing travel for patients and providers as well as provide effective distance care in disasters. Hybrid care, asynchronous consultations, and care at home are all innovations that will further reduce carbon emissions. The COVID-19 pandemic has rapidly accelerated the digitization of psychiatry, and climate change will continue to drive these changes in the future. Much more research on these overlapping issues is required.
Climate change is driving a public mental health crisis that disproportionately, and unjustly, affects the world’s young people. Despite the growing evidence for harm to the next generation, the medical community has largely been hesitant to take the next step and act on the evidence. We propose that the medical community has a responsibility to do more.Drawing from our interdisciplinary experience in paediatrics and psychiatry, we call for our profession to take the ‘leap’ beyond the walls of our clinics and laboratories, and take a courageous stance on the topic of climate change. We argue that the medical profession must adopt a broader conception of health and its determinants-or a ‘social lens’-if it is to move beyond rhetoric to action.Viewing climate change as a clear determinant of mental health opens up potential avenues of action, both as individual clinicians and as a profession as a whole. We offer the beginnings of a framework for action in the context of climate change and youth mental health, before calling for our profession to re-examine its role – and its very purpose – to better address the climate crisis.
Disasters invariably result in a surge in demand for mental health services, and this surge quickly exceeds available mental health resources. The pursuit of alternative sources of psychological support for communities adversely affected by disasters has therefore been necessitated. This paper describes the application of an awarding-winner, empirically validated, model for psychological support and its applicability for enhancing community disaster mental health resources that are consistent with United Nations’ recommendations for a “whole society” approach to disaster mental health. The model utilises the concept of peer-based psychological support. Peer psychological support is defined as the utilisation of individuals specially trained in the provision of acute psychological crisis interventions and psychological first aid, but who do not possess professional-level training or licensure in one of the mental health disciplines. These peer-based crisis intervention services may be delivered telephonically, via the internet, or face-to-face. This model, referred to as Reciprocal Peer Support (RPS), is the peer support activity provided at Rutgers University Behavioural HealthCare (UBHC) National Center for Peer Support in a variety of peer programs. More than 20 years of peer support interventions have been reviewed and assessed to clarify the lessons learned for the application of RPS as a prime exemplar for the utilization of peer support during and after a disaster. The Cop 2 Cop, NJ Vet 2 Vet, and several other UBHC peer support programs, which conform to best practices criteria, have been created, sustained, and expanded based on the RSP principles discussed in this article. RPS and derivative applications for human-made disasters such as the terrorist events of 9/11/2001 as well as natural disasters such as Hurricane Katrina or the COVID- 19 pandemic represent platforms for the implementation of peer psychological support and the establishment of a peer-based continuum of psychological connection.
Climate change is a global problem, and it is receiving increasing scientific attention due to its significant impact. To provide valuable insights for understanding and summarizing the research trends and prospects on climate change risk perception, this study takes a qualitative and quantitative analysis by using bibliometric tools. This analysis presents information related to authors, countries, institutions, journals, top cited publications, research hot spots, trends, and prospects. The analysis involved 4429 articles after rigorous screening and evaluated them on the risk perception of climate change in countries and the public. The majority of publications were published during the period of 2016-2022 (70.92%), with Climatic Change being the dominant journal and most research originating from the USA, England and Australia. The research content of this topic is primarily divided into several categories, including environmental sciences, atmospheric sciences, water resources and public health. The results showed that adaptation and vulnerability attract much attention. Finally, this paper identifies and discusses five research themes that should be further studied: determinants of perception, human behavior, human mental health risk, agriculture and adaptive strategy.
Climate change threatens human health, food security, and ecological sustainability. In marginalized and vulnerable communities around the globe, there is a crucial need to initiate actions to reduce adverse climatic impacts and support sustainable development goals (SDGs), particularly on food and health. Climate change’s multidimensional and complex impact on food and health has prompted calls for an integrated, science-based approach that could simultaneously improve the environment and nourish development-constrained communities. This paper examines a transdisciplinary practice of agroecology that bridges the gap between science, practice, and policy for climate action. We also analyze the significance of agroecology in building climate-resilient communities through sustainable food systems. We assert that the marriage of science and local knowledge that addresses access inequities through agroecology can lessen the impact of climate change on rural communities to achieve healthier, more sustainable, and equitable food systems. Furthermore, a transformative agroecological paradigm can provide farmers with a host of adaptive possibilities leading to healthier communities, improved food security, and restored lands and forests that can sequester greenhouse gases. Based on our findings, we call on the science and policy communities to integrate agroecology as part of the broader strategic approach to climate change adaptation and mitigation.
INTRODUCTION: Community resilience (CR) has gradually become a hot topic in uncertain times, especially in the last five years. The current study presents a systematic review based on content analysis to present a knowledge graph of CR research over the last 20 years. METHODS: We use an approach of Leximancer to conduct the content analysis to explore the intellectual foundations, research context, topics, and methods of CR literature based on 583 published studies. RESULTS: The results show that framework research of CR is a hot topic throughout the last 20 years. In the first stage (from 2001 to 2015), CR connected with the themes of “framework, disaster, change, and model”. Comparatively, in the second stage (from 2016 to 2020), the themes of “social capital, capacity, and framework” are more salient connecting with CR. Additionally, the study detected that the key issues varied across countries. Specifically, research in the US focused on the social support dynamic, while in Australia, recovery from the disaster was the predominant theme. Furthermore, in the UK, studies mostly explore resilience issues in the background related to flooding. DISCUSSION: Our findings provide a comprehensive picture of CR research covering the last 20 years and put forward thoughts and recommendations for future resilience studies considering 1) obstacles within daily life, 2) resilience set within organizational perspectives, and 3) cultural context.
(Im)mobility studies often focus on people on the move, neglecting those who stay, are immobile, or are trapped. The duality of the COVID-19 pandemic and the climate crisis creates a global mental health challenge, impacting the most structurally oppressed, including immobile populations. The construct of immobility is investigated in the context of socio-political variables but lacks examination of the clinical psychological factors that impact immobility. Research is beginning to identify self-reported emotions that immobile populations experience through describing metaphors like feeling trapped. This article identifies links in the literature between Cultural Concepts of Distress drawn from transcultural psychiatry and immobility studies. Feeling trapped is described in mental health research widely. Among (im)mobile people and non-mobility contexts, populations experience various mental health conditions from depression to the cultural syndrome, nervios. The connection of feeling trapped to CCD research lends itself to potential utility in immobility research. The conceptualisation can support broadening and deepening the comprehension of this global mental health challenge – how immobile populations’ experience feeling trapped. To broaden the analytical framework of immobility and incorporate CCD, evidence is needed to fill the gaps on the psychological aspects of immobility research.
Children, particularly those living in low- and middle-income countries (LMICs), are highly vulnerable to climate change and its impacts. Our main objective was to conduct a scoping literature review to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders among children in LMICs. We also aimed to identify gaps in this area of scholarship. We included studies of children in LMICs that had a climate change or climate-related disaster exposure and mental disorder outcome. Twenty-three studies were included in the final synthesis. Fourteen studies were conducted in China, three in India, two each in Pakistan and the Philippines, and one each in Namibia and Dominica. All studies assessed the association between a climate-related disaster exposure and a mental disorder outcome, while none explored broader climate change-related exposures. Post-traumatic stress disorder (n = 21 studies) and depression (n = 8 studies) were the most common mental disorder outcomes. There was considerable between-study heterogeneity in terms of sample size, follow-up length, and outcome measurement. Overall, the literature in this area was sparse. Additional high-quality research is required to better understand the impacts of climate-related disasters and climate change on mental disorders within this population to ultimately inform future policies and interventions.
Due to human activities, atmospheric greenhouse gas levels have increased dramatically, leading to an increase in the global mean surface temperature by 1.1° Celsius. Unless we can achieve a significant reduction in emissions, the global mean surface temperature will continue to rise to a dangerous level. Adverse outcomes of this warming will include extreme weather events, a deterioration of food, water and air quality, decreased food security, and an increase in vector-borne infectious disease. Political and economic instability as well as mass population migration will result in reduced access to healthcare resources. Mitigation of and adaptation to climate change will be key determinants of humanity’s survival in the face of this existential crisis. Women will be more adversely affected by climate change than men, and pregnant persons will be particularly vulnerable. Particular differential impacts on women include higher heat and particulate-related morbidity and mortality; pregnancy risks including preterm birth, fetal growth lag, hypertensive disorders; and mental health impacts. To prepare for the climate crisis, it is imperative for women’s healthcare providers to assist their patients through political advocacy, provide family planning services, and focus on nutrition and lifestyle counseling.
Climate change is one of the biggest challenges of our time and is likely to affect human beings in substantial ways. Recently, researchers started paying more attention to the changes in climate and their subsequent impact on the social, environmental and economic determinants of health, and the role they play in causing or exacerbating mental health problems. The effects of climate change-related events on mental well-being could be classified into direct and indirect effects. The direct effects of climate change mostly occur after acute weather events and include post-traumatic stress disorder, anxiety, substance abuse disorder, depression and even suicidal ideation. The indirect effects include economic losses, displacement and forced migration, competition over scarce resources and collective violence. The risk factors for developing those mental health issues include young age, female gender, low socioeconomic status, loss or injury of a loved one, being a member of immigrant groups or indigenous people, pre-existing mental illness and inadequate social support. However, in some individuals, especially those undisturbed by any directly observable effects of climate change, abstract awareness and acknowledgement of the ongoing climate crisis can induce negative emotions that can be intense enough to cause mental health illness. Coping strategies should be provided to the affected communities to protect their mental health from collapse in the face of climate disasters. Awareness of the mental health impacts of climate change should be raised, especially in the high-risk groups. Social and global attention to the climate crisis and its detrimental effects on mental health are crucial. This paper was written with the aim of trying to understand the currently, scientifically proven impact of climate change-related disasters on mental health and understanding the different methods of solving the problem at the corporate level, by trying to decrease greenhouse gas emissions to zero, and at the individual level by learning how to cope with the impacts of those disasters.
Conflict and climate change continue to displace millions of people, who experience unique trauma and stressors as they resettle in host countries. Both children and adults who are forcibly displaced, or choose to migrate, experience posttraumatic stress disorder, anxiety, depression, and other mental health conditions at higher rates than the general population. This may be attributed to severe, cumulative stress and trauma (largely interpersonal traumas); discrimination and harassment in host countries; and structural barriers to accessing and addressing mental health concerns, including clinician availability, language barriers, cultural differences, geographic accessibility, health care access, and stigma. Despite high exposure to and clinical impact of such experiences, and despite representing 1% of the world population, forcibly displaced people are underrepresented in neuroscientific research. The availability of such literature and research findings is significant in understanding the unique genetic and cultural aspects of trauma- and stress-related mental health, advocacy, reducing stigma, informing prevention, and treatment. The present work aimed to explore how the field of neuroscience can address mental health equity for individuals who have been uprooted in relation to land, with a focus on refugee populations. We offer practical suggestions on how to improve research in this area and narrow the gap in knowledge.
Research on climate change and mental health is a new but rapidly growing field. To summarise key advances and gaps in the current state of climate change and mental health studies, we conducted a scoping review that comprehensively examined research methodologies using large-scale datasets. We identified 56 eligible articles published in Embase, PubMed, PsycInfo, and Web of Science between Jan 1, 2000, and Aug 9, 2020. The primary data collection method used was surveys, which focused on self-reported mental health effects due to acute and subacute climate events. Other approaches used administrative health records to study the effect of environmental temperature on hospital admissions for mental health conditions, and national vital statistics to assess the relationship between environmental temperature and suicide rates with regression analyses. Our work highlights the need to link population-based mental health outcome databases to weather data for causal inference. Collaborations between mental health providers and data scientists can guide the formation of clinically relevant research questions on climate change.
BACKGROUND/RATIONALE: The impact of climate change on the mental health of young people is poorly understood. Emerging evidence suggests that exposure to climate change exerts a disproportionate mental health burden on young people. An understanding of the risk factors (RFs) and protective factors (PFs) that affect the likelihood of mental health impacts arising from exposure to climate change is required to support youth wellbeing. AIMS/OBJECTIVES: This review scopes the current research on what and how RFs and PFs are related to the mental health impacts of both direct and indirect exposure to climate change for young people. RFs and PFs were reviewed through the lens of ecological system theory. METHODS: We conducted systematic searches in four databases: PubMed, PsycInfo, Web of Science, and Scopus. Grey literature searches were conducted in ProQuest Dissertations, GreyLit.org, OpenGrey, and relevant organisations’ websites. We included 92 empirical studies focused on the RFs and PFs of the mental wellbeing under the impact of climate change of young people (0-24). We extracted data on study characteristics, type of climate change event, mental health outcomes, RFs and PFs, and associated ecological system level. RESULTS: The current evidence base focuses predominantly on young people’s experience of PTSD (k = 59), depression (k = 26), or anxiety (k = 17) mainly following exposure to singular climate change-related natural disaster events. Only four studies explored the impacts of climate change in general. Majority of the studies investigated RFs and PFs at the individual level and at the micro-system level. CONCLUSIONS: Several RFs and PFs were identified, such as coping strategies, family factors (e.g. parenting style), social support, community connection, and cultural identity. Positioning the mental health impacts of singular events within the broader context of ongoing and escalating climate change impacts will better inform the development of interventions that seek to build resilience among young people.
OBJECTIVE: In this discussion, we build the case for why climate change is an emerging threat to perinatal mental health. METHOD: A search of current literature on perinatal and maternal mental health and extreme weather events was conducted in PubMed/MEDLINE and Web of Science databases. Only articles focusing on maternal mental health were included in this narrative review. RESULTS: The perinatal period represents a potentially challenging timeframe for women for several reasons. Necessary role adjustments (reprioritization), changes in one’s ability to access pre-birth levels (and types) of social support, fluctuating hormones, changes in body shape, and possible complications during pregnancy, childbirth, or postpartum are just a few of the factors that can impact perinatal mental health. Trauma is also a risk factor for negative mood symptoms and can be experienced as the result of many different types of events, including exposure to extreme weather/natural disasters. CONCLUSION: While the concepts of “eco-anxiety,” “climate despair,” and “climate anxiety” have garnered attention in the mainstream media, there is little to no discussion of how the climate crisis impacts maternal mental health. This is an important omission as the mother’s mental health impacts the family unit as a whole.
Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from PubMed®, and both relevance and relatedness of terms in different time frames were computed using VOSviewer. Co-occurrence graphs were used to visualize results. The development of exemplary terms over time was plotted separately. The number of research papers on mental health and environmental challenges is growing in a linear fashion. Major topics are climate change, chemical pollution, including psychiatric medication in wastewater, and neurobiological effects. Research on specific psychiatric syndromes and diseases, particularly on their ethical and social aspects is less prominent. There is a growing body of research literature on links between mental health, climate change, pollution, and deforestation. This research provides a graphic overview to mental healthcare professionals and political stakeholders. Social and ethical aspects of the climate change-mental health link have been neglected, and more research is needed.
This article is a review of recent contributions in critical psychology and its close cousins, critical social psychology, critical community psychology and liberation psychology, to understand human response to climate change. It contrasts critical psychology with mainstream psychology in general terms, before introducing a critical psychological perspective on climate change. Central to this perspective is a critique of the framing of individual behaviour change as the problem and solution to climate change in mainstream psychology and a related emphasis on identifying ‘barriers’ to proenvironmental behaviour. This framework is argued to be reductive, obscuring or downplaying the influence of a range of factors in shaping predominant responses to climate change to date, including social context, discourse, power and affect. Currently, critical psychologies set out to study the relative contribution of these factors to (in)action on climate change. A related concern is how the psychological and emotional impacts of climate change impact unevenly on communities and individuals, depending on place-based, economic, geographic and cultural differences, and give rise to experiences of injustice, inequality and disempowerment. Critical psychology does not assume these to be overriding or inevitable psychological and social responses, however. Critical psychologies also undertake research and inform interventions that highlight the role of collective understanding, activism, empowerment and resistance as the necessary foundations of a genuine shift towards sustainable societies.
Mitigation solutions are often evaluated in terms of costs and greenhouse gas reduction potentials, missing out on the consideration of direct effects on human well-being. Here, we systematically assess the mitigation potential of demand-side options categorized into avoid, shift and improve, and their human well-being links. We show that these options, bridging socio-behavioural, infrastructural and technological domains, can reduce counterfactual sectoral emissions by 40-80% in end-use sectors. Based on expert judgement and an extensive literature database, we evaluate 306 combinations of well-being outcomes and demand-side options, finding largely beneficial effects in improvement in well-being (79% positive, 18% neutral and 3% negative), even though we find low confidence on the social dimensions of well-being. Implementing such nuanced solutions is based axiomatically on an understanding of malleable rather than fixed preferences, and procedurally on changing infrastructures and choice architectures. Results demonstrate the high mitigation potential of demand-side mitigation options that are synergistic with well-being. Evaluation of mitigation actions often focuses on cost and overlooks the direct effects on well-being. This work shows demand-side measures have large mitigation potential and beneficial effects on well-being outcomes.
BACKGROUND: Minimum mortality temperature (MMT) is an important indicator to assess the temperature-mortality association, indicating long-term adaptation to local climate. Limited evidence about the geographical variability of the MMT is available at a global scale. METHODS: We collected data from 658 communities in 43 countries under different climates. We estimated temperature-mortality associations to derive the MMT for each community using Poisson regression with distributed lag nonlinear models. We investigated the variation in MMT by climatic zone using a mixed-effects meta-analysis and explored the association with climatic and socioeconomic indicators. RESULTS: The geographical distribution of MMTs varied considerably by country between 14.2 and 31.1 °C decreasing by latitude. For climatic zones, the MMTs increased from alpine (13.0 °C) to continental (19.3 °C), temperate (21.7 °C), arid (24.5 °C), and tropical (26.5 °C). The MMT percentiles (MMTPs) corresponding to the MMTs decreased from temperate (79.5th) to continental (75.4th), arid (68.0th), tropical (58.5th), and alpine (41.4th). The MMTs indreased by 0.8 °C for a 1 °C rise in a community’s annual mean temperature, and by 1 °C for a 1 °C rise in its SD. While the MMTP decreased by 0.3 centile points for a 1 °C rise in a community’s annual mean temperature and by 1.3 for a 1 °C rise in its SD. CONCLUSIONS: The geographical distribution of the MMTs and MMTPs is driven mainly by the mean annual temperature, which seems to be a valuable indicator of overall adaptation across populations. Our results suggest that populations have adapted to the average temperature, although there is still more room for adaptation.
Food choice impacts human health and planetary sustainability. The feeding patterns that reduce risk factors for noncommunicable diseases and various mortality causes are recognized as healthy eating habits. The average world population is far from reaching these habits due to the lack of access to healthy foods and a high prevalence of malnutrition. Understanding the impact of healthy sustainable food systems is growing worldwide to reach food security for the global population and future generations. A systemic perspective of this concept includes the health and well-being of individuals and the environmental, economic, socio-cultural, public policies context, besides food, agriculture, and ecological sciences. We need to confront the menaces and challenges represented by the ongoing changes of our era, which strongly generate global food insecurity. This issue is relevant not only for human health but also for climate change and other threats, based on modifications in production, handling, and consumption of foods that consider health and welfare impact at individual and planetary levels. In this review, some key concepts related to healthy and sustainable food systems are presented.
BACKGROUND: The relationship between climate adaptation strategies and nutrition security is poorly understood and often unclear. Although several adaptation strategies have been implemented to mitigate the impact of climate change, there is still a lack of conclusive evidence or studies on the interrelationships between adopted climate change adaptation strategies and nutrition outcomes. OBJECTIVE: This study aimed to develop a conceptual framework that links climate change, adaptation strategies and nutrition and to show the indicators that can be used to assess the impact of climate adaptation strategies on nutrition. METHODOLOGY: The proposed conceptual framework was developed through a literature review. RESULTS: A generic conceptual framework that could be used to assess the impact of adopted climate change adaptation strategies on nutrition outcomes was developed. The framework consists of 5 key elements: agro-food system, context characteristics, adaptation strategies, climatic shocks and stress, and system output. The principles used in designing the conceptual framework include systems approach, contingency theory, and system output. CONCLUSION: The developed framework offers a channel to evaluate adopted climate change adaptation strategies and their impact on nutrition outcomes. Such a conceptual framework can also be used in selecting and identifying more suitable climate adaptation strategies given specific contextual environments.
Obesity is a chronic disease associated with increased metabolic and cardiovascular risk, excessive morbidity and mortality worldwide. The authors of the present consensus, clinicians representing medical specialties related to the treatment of obesity and its complications, reviewed a number of European and American guidelines, published mostly in 2019-2021, and summarized the principles of obesity management to provide a practical guidance considering the impact that increased adiposity poses to health. From a clinical perspective, the primary goal of obesity treatment is to prevent or slow down the progression of diseases associated with obesity, reduce metabolic and cardiovascular risk, and improve the quality of life by achieving adequate and stable weight reduction. However, obesity should be not only considered a disease requiring treatment in an individual patient, but also a civilization disease requiring preventive measures at the populational level. Despite the evident benefits, obesity management within the health care system-whether through pharmacotherapy or bariatric surgery-is only a symptomatic treatment, with all its limitations, and will not ultimately solve the problem of obesity. The important message is that available treatment options fail to correct the true drivers of the obesity pandemic. To this end, new solutions and efforts to prevent obesity in the populations are needed.
Climate change increases risks to natural and human systems. Green infrastructure (GI) has been increasingly recognized as a promising nature-based solution for climate change adaptation, mitigation, and other societal objectives for sustainable development. Although the climate contribution of GI has been extensively addressed in the literature, the linkages between the climate benefits and associated co-benefits and trade-offs remain unclear. We systematically reviewed the evidence from 141 papers, focusing on their climate benefits, relevant co-benefits and trade-offs, and the GI types that provide such climate (co-)benefits. This study presents a comprehensive overview of the links between climate benefits, co-benefits and types of GI, categorized along a green-grey continuum so that researchers/practitioners can find information according to their topic of interest. We further provide an analysis of trade-offs between various GI benefits. ‘Bundles’ of major co-benefits and trade-offs for each climate benefit can be identified with recommendations for strategies to maximize benefits and minimize trade-offs. To promote climate-resilient pathways through GI, it is crucial for decision-makers to identify opportunities to deliver multiple ecosystem services and benefits while recognizing disservices and trade-offs that need to be avoided or managed.
A plant-based diet, which can include small amounts of meat, is the foundation for healthy sustainable diets, which will have co-benefits for health, climate and the environment. Studies show that some of the barriers to making this dietary change and reducing meat consumption are perceptions that plant-based diets are inconvenient, it takes too much time and skills to prepare meals and ingredients are expensive. The food environment is changing and the industry is responding with the exponential increase in the market of highly processed, convenient and cheap plant-based foods. This overcomes some of the barriers, but there is concern about whether they are healthy and environmentally sustainable. Plant-based foods have a halo effect around health and the environment, but many being produced are ultra-processed foods that are high in energy, fat, sugar and salt and have a higher environmental impact than minimally processed plant-based foods. The trend towards eating more highly processed plant-based convenience foods is a concern with regard to both public health and the targets set to reduce greenhouse gas (GHG) emissions. The ‘modern day’ plant-based diet emerging is very different to a more traditional one comprising pulses, vegetables and wholegrain. Studies show that those who are younger and have been a vegetarian for a shorter duration are eating significantly more ultra-processed plant-based foods. While there is a place for convenient, desirable and affordable plant-based food to encourage dietary change, care should be taken that this does not subconsciously set a path which may ultimately be neither healthy nor sustainable.
Climate change represents a serious threat to the health and well-being of populations. Today, many countries, regions, and cities around the world are implementing policies and strategies to adapt to climate change and mitigate its effects. A scoping review was performed to identify tools and methods that help integrate health into climate change adaptation and mitigation policies and strategies. The literature search includes scientific and grey literature. The scientific literature was conducted using PubMed, Elsevier Embase, and Web of Science databases. A grey literature web search was performed to complement the results. A total of 35 studies (28 from the scientific literature and 7 from the grey literature) were finally included. A large majority of research articles (24/28) and almost all reports (6/7) from the grey literature were published after 2010. Results show that the tools that were found most frequently are the nested models (12/35), health impact assessment (6/35), vulnerability and adaptation assessment (3/35), conceptual frameworks (3/35), and mixed methods (3/35). This review shows an increasing interest in the topic of developing tools to better manage health issues in adaptation and mitigation strategies, with a recent increase in the number of publications. Additional analyses of tools’ effectiveness should be conducted in further studies.
The recent and projected upward trends in the frequency and intensity of climate-induced events in cities have enhanced the focus on adaptation. In addition to enhancing the capacity of cities to prepare for and absorb risks, adaptation measures provide multiple co-benefits. However, health co-benefits are among the least explored. These are now seen as increasingly important with the renewed focus on public health since the COVID-19 pandemic. This study reviews literature focused on the health co-benefits of urban climate change adaptation measures. Health co-benefits of seven different categories of adaptation measures are discussed. Results showed that existing evidence is mainly related to some categories such as critical infrastructure, nature-based solutions, and urban planning and design measures. Other adaptation categories like early warning systems; policy, management & governance, including local adaptation policies; and measures and strategies related to ‘knowledge, perceptions & behavior’ that mainly involve people’s understanding and individual responses to climate change, are relatively underexplored. Moreover, it was discussed that some adaptation measures may result in health trade-offs and these needs to be further studied. Overall, through identifying health co-benefits, results of this review can make a strong case for further promotion of climate change adaptation in cities.
Record climate extremes are reducing urban liveability, compounding inequality, and threatening infrastructure. Adaptation measures that integrate technological, nature-based, and social solutions can provide multiple co-benefits to address complex socioecological issues in cities while increasing resilience to potential impacts. However, there remain many challenges to developing and implementing integrated solutions. In this Viewpoint, we consider the value of integrating across the three solution sets, the challenges and potential enablers for integrating solution sets, and present examples of challenges and adopted solutions in three cities with different urban contexts and climates (Freiburg, Germany; Durban, South Africa; and Singapore). We conclude with a discussion of research directions and provide a road map to identify the actions that enable successful implementation of integrated climate solutions. We highlight the need for more systematic research that targets enabling environments for integration; achieving integrated solutions in different contexts to avoid maladaptation; simultaneously improving liveability, sustainability, and equality; and replicating via transfer and scale-up of local solutions. Cities in systematically disadvantaged countries (sometimes referred to as the Global South) are central to future urban development and must be prioritised. Helping decision makers and communities understand the potential opportunities associated with integrated solutions for climate change will encourage urgent and deliberate strides towards adapting cities to the dynamic climate reality.
Experiences of ‘climate anxiety’ are considered an adaptive response to a real threat, as well as a potential cause of impairment. To date, little attention has been paid to how children and adolescents may be uniquely predisposed to climate anxiety, despite being an age cohort particularly vulnerable to the impacts of climate change. This Review uses a social-ecological framework to identify the influences on climate anxiety for young people. We explore the directionality and interplay between individual factors, the physical environment and the influence of micro- (family, peers), meso- (school, community), exo- (government, media) and macro- (culture) systems on children’s and adolescents’ experience of climate anxiety. The Review highlights future research considerations and key issues relevant to professionals working with youth. Children and adolescents may be the age cohort most vulnerable to climate anxiety. This Review uses a social-ecological theoretical framework to outline how they are uniquely susceptible to climate anxiety and identify potential protective factors.
Nature-Based Solutions (NBS) can be defined as solutions based on natural processes that meet societal challenges and simultaneously provide human well-being and biodiversity benefits. These solutions are envisioned to contribute to operationalizing sustainable development strategies, especially in the context of adaptation to climate change (e.g. flood risk reduction). In order to quantify NBS performance, ease their uptake and advocate for them as alternatives to “business-as-usual” infrastructures, a comprehensive, holistic valuation of their multiple benefits (multiple advantages and disadvantages) is needed. This entails quantifying non-market benefits for people and nature in addition to determining the (direct) cost-benefit of the risk-reduction measure. Despite the importance given to the assessment of non-tangible benefits for people and nature in the literature, systematic data collection on these dimensions seems to be missing. This study reviews publications that used stated preference methods to assess non-market human benefits of NBS and NBS-like strategies. Its aim is to highlight any biases or knowledge gaps in this kind of evaluation. Our results show that the valuation of non-tangible benefits of NBS (e.g. increased recreation and well-being, enhanced biodiversity) still suffers from a lack of common framing. Despite some steps being taken on enabling interconnected benefit assessments, unexploited opportunities concerning the integrated assessment of non-market human and nature benefits predominate. Moreover, the research to-date appears based on a case-to-case approach, and thus a shared holistic method does not emerge from the present literature, potentially delaying the uptake of NBS. We argue that future research could minimize missed opportunities by focusing on and systematically applying holistic benefits assessments. Methods based on stated preference surveys may help to ensure holistic approaches are taken, as well as contributing to their replicability and application when upscaling NBS.
Facing complex issues such as climate change and its effects on public health require the participation of various actors. The research tool citizen science is one way for people to get involved. Through it, citizens collaborate with scientists to find solutions to problems in their territories. From a participatory work with citizens, we designed a taxonomy proposal, which can facilitate citizen and community action in suggesting research ideas. We expect stakeholders to use it to systematically classify and code initial questions and answers on public health and climate change issues. The development of this taxonomy integrates the global agenda of Sustainable Development Goals (SDG) in such a way that citizens not only help their communities but also, the direct fulfillment of SDGs such as Climate Action (SDG 13), indirectly impacting other SDGs – given their interdependent nature (SDG 3, SDG 5, SDG 6, SDG 7, SDG 11, SDG 12). The systematic classification and coding of citizens’ contributions worldwide will contribute to the large-scale organized collection of information to be analyzed in proposing better responses to reduce the impacts of climate change on health.
BACKGROUND: Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-based adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus. METHODS: We followed a structured approach to prioritise future climate change and mental health research. We consulted with experts working across mental health and climate change, both within and outside of research and working in high, middle, and low-income countries, to garner consensus about the future research priorities for mental health and climate change. Experts were identified based on whether they had published work on climate change and mental health, worked in governmental and non-governmental organisations on climate change and mental health, and from the professional networks of the authors who have been active in the mental health and climate change space. RESULTS: Twenty-two experts participated from across low- and middle-income countries (n = 4) and high-income countries (n = 18). Our process identified ten key priorities for progressing research on mental health and climate change. CONCLUSION: While climate change is considered the biggest threat to global mental health in the coming century, tackling this threat could be the most significant opportunity to shape our mental health for centuries to come because of health co-benefits of transitioning to more sustainable ways of living. Research on the impacts of climate change on mental health and mental health-related systems will assist decision-makers to develop robust evidence-based mitigation and adaptation policies and plans with the potential for broad benefits to society and the environment.
The United Nations has signalled a ‘code red’, marking climate change as an existential threat for humanity. The world is rapidly warming, and the consequences of climate change include an increase and intensification in flooding, droughts, wildfires, and other traumatic exposures. Although countries in the Global South have contributed least to global warming, they are the most vulnerable owing to historical inequities. The concept of ‘climate justice’ recognises that historical racial discrimination, class disenfranchisement, political misrecognition, and other social injustices make surviving climate change and thriving within it more challenging. This narrative review considers the psychological consequences of the climate emergency through a climate justice lens. The article discusses the unequal exposures to psychological adversities, socio-historical barriers to adaptations and, finally, institutional betrayal that complicates the experience of psychological distress. The review concludes by pragmatically discussing how psychology could support climate justice ends.
Climate change is one of the biggest challenges of our times. Its impact on human populations is not yet completely understood. Many studies have focused on single aspects with contradictory observations. However, climate change is a complex phenomenon that cannot be adequately addressed from a single discipline’s perspective. Hence, we propose a comprehensive conceptual framework on the relationships between climate change and human responses. This framework includes biological, psychological, and behavioural aspects and provides a multidisciplinary overview and critical information for focused interventions. The role of tipping points and regime shifts is explored, and a historical perspective is presented to describe the relationship between climate evolution and socio-cultural crisis. Vulnerability, resilience, and adaptation are analysed from an individual and a community point of view. Finally, emergent behaviours and mass effect phenomena are examined that account for mental maladjustment and conflicts.
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.
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.
Climate change can have detrimental effects on child health and wellbeing. Despite the imperative for a fuller understanding of how climate change affects child health and wellbeing, a systematic approach and focus solely on children (aged <18 years) has been lacking. In this Scoping Review, we did a literature search on the impacts of climate change on child health from January, 2000, to June, 2019. The included studies explicitly linked an alteration of an exposure to a risk factor for child health to climate change or climate variability. In total, 2970 original articles, reviews, and other documents were identified, of which 371 were analysed. Employing an expanded framework, our analysis showed that the effects of climate change on child health act through direct and indirect pathways, with implications for determinants of child health as well as morbidity and mortality from a range of diseases. This understanding can be further enhanced by using a broader range of research methods, studying overlooked populations and geographical regions, investigating the costs and benefits of mitigation and adaptation for child health, and considering the position of climate change and child health within the UN Sustainable Development Goals. Present and future generations of children bear and will continue to bear an unacceptably high disease burden from climate change.
This article presents an empirically driven critique of the predominant theoretical perspective concerning the relationship between disability and vulnerability that continues to underpin much of the scholarship focusing on the human geographies of environmental hazards and disasters, as well as policies and practices of Disaster Risk Reduction. Findings from a study involving semi-structured interviews from six case study sites in the United Kingdom examining responses to prolonged electricity outages during periods of extreme weather demonstrate that the simple equating of disability with vulnerability cannot be sustained. This is because people with disabilities were no less likely than those without disabilities to be able cope and adapt to challenges imposed by extreme weather. Furthermore, in instances where people with disabilities struggled to cope, this can be seen to result from social, physical, and structural constraints, rather than the presence of impairment per se. From this, we argue that the experiences of people with disabilities can be better understood from a relational perspective, which promotes consideration of local relations, interdependencies, and networks within which people with disabilities are embedded, and through which they engage with society and place. We conclude that UK Priority Service Register (PSR) emergency response systems, like other emergency response protocols utilised in other geographic locations and which uncritically equate disability with vulnerability, need to be replaced with an approach that recognises the capabilities and agency of people with disabilities and considers how social and environmental factors interrelate to produce vulnerabilities and enhance capabilities.
The past several decades have been marked by an increasing occurrence of climate events worldwide, and consequentially, there has been growing study of the health impacts in exposed populations. While a plethora of studies have investigated the impact of climate change on health or migration, there is a smaller body of literature where these three concepts overlap, and an even smaller proportion of these are qualitative studies. Thus, this review sought to assess the breadth of the available qualitative literature on climate change as a primary driver for migration and the related health contexts. Our findings highlight the nuances of climate-influenced migration decisions and the challenges experienced by populations who have left their homes because of climate change impacts. Further research should focus on the health experiences and migration decisions of those exposed to climate change hazards to identify appropriate multi-level interventions in disaster planning and response.
Background: Several studies have been conducted on the effects of floods on the health of the affected community. We aimed to determine the effects of floods as the most common disaster on hypertension (HTN) as one of the most common noncommunicable diseases (NCDs). Materials and Methods: Four databases including Medline, Scopus, Google Scholar, and ScienceDirect were searched with the search strategy protocol up to the end of June 2021 and with the keywords of flood and high blood pressure or hypertension. Grey literature database and websites of WHO, UNDRR, and PreventionWeb were also searched. After removing duplicate articles, abstracts of the relevant titles were reviewed, and eligible articles were included for full-text review. Finally, the study variables were extracted from selected articles. Results: The search strategy resulted in eight final relevant articles from 48,980 articles. All final articles noted meaningful effect of flood on high blood pressure. There was a positive correlation between anxiety level, property loss, financial loss, physical activity, use of alcoholic beverages, interruption of medication, and medical cares with HTN. Different studies have also reported long-term effects of flooding on blood pressure. Conclusions: The flood has significant effect on high blood pressure in affected population. However, cases of unknown HTN in the affected population should also be considered, so screening is recommended in the affected community.
BACKGROUND: Weather and climate-related disasters, including floods, impact undernutrition through multiple pathways, including food security, inadequate child care practices, and water and sanitation. This review aimed to provide systematic evidence of the impact of floods on undernutrition in children under five years of age in Low and Middle-income countries (LMICs). METHODS: We searched PubMed, Web of Science, Embase, MEDLINE, CINAHL and Scopus for peer-reviewed articles. Popline, WHO Library database (WHOLIS), the International Disaster database (EM-DAT), Food and Agriculture Organisation (FAO), UNICEF and Eldis were searched for grey literature articles. Database searches were first conducted in 2016 and updated in 2020. We included English language articles that reported the effect of floods on undernutrition outcomes in children under 5 years of age in LMICs, without limitation to study design and year of publication. The quality of selected studies was assessed using the National Institutes of Health (NIH) tool for Observational Cohort and Cross-Sectional Studies. RESULTS: Of the 5701 articles identified, 14 met our inclusion criteria. The review noted stunting as the most frequently reported significant form of undernutrition in flood-affected areas. Severe and recurrent floods showed the greatest impact on undernutrition. Due to weak and limited evidence, the study is inconclusive on the most significant forms within the short-term and intermediate periods following floods. On the other hand, stunting was noted as the most frequently reported significant form of undernutrition in the long-term period following floods. There was generally little evidence of the effect of floods on micronutrient deficiencies. Factors associated with child undernutrition in the flood-affected areas included age, gender, diarrhoea, maternal and paternal education, maternal age, household size, land ownership and socioeconomic status. Overall, the quality of the evidence was fairly weak, with the main challenge lying in the inability of the studies to establish causal pathways for the observed effects. CONCLUSIONS: The review suggests clear plans and strategies for preventing and reducing the long-term impact of floods on undernutrition in children under five years. Future research utilising long-term prospective data is indispensable to provide more robust evidence to guide better prevention measures, response decisions and interventions.
While it is well recognized that the frequency and intensity of flood events are increasing worldwide, the environmental, economic, and societal consequences of remobilization and distribution of pollutants during flood events are not widely recognized. Loss of life, damage to infrastructure, and monetary cleanup costs associated with floods are important direct effects. However, there is a lack of attention towards the indirect effects of pollutants that are remobilized and redistributed during such catastrophic flood events, particularly considering the known toxic effects of substances present in flood-prone areas. The global examination of floods caused by a range of extreme events (e.g., heavy rainfall, tsunamis, extra- and tropical storms) and subsequent distribution of sediment-bound pollutants are needed to improve interdisciplinary investigations. Such examinations will aid in the remediation and management action plans necessary to tackle issues of environmental pollution from flooding. River basin-wide and coastal lowland action plans need to balance the opposing goals of flood retention, catchment conservation, and economical use of water.
Flash flood risk assessment, a widely applied technology in preventing catastrophic flash flood disasters, has become the current research hotspot. However, most existing machine learning methods for assessing flash flood risk rely on a single classifier, which is suitable for processing small sets of sample data, but the resulting prediction accuracy and generalization ability are insufficient. Meanwhile, machine learning methods that integrate multiple classifiers are thus far unknown. Extreme Gradient Boosting (XGBoost) is an excellent algorithm for ensemble learning methods which has achieved remarkable results in many fields. It not only optimizes the algorithm but also automatically applies the CPU’s multi-threading to perform parallel calculations, thus greatly improving the model training speed and prediction accuracy. Therefore, this article introduces the XGBoost model for the assessment of flash flood risk, and then combines the two input strategies and the Least squares support vector machine (LSSVM) model to verify its optimal effect, thus proposing the XGBoost-based method for flash flood risk assessment. Subsequently, an attribution analysis was implemented to assess the possible errors of this approach; and finally, a county-level flash flood risk map for Yunnan Province, China, was generated based on the proposed method. The results demonstrate that: (1) XGBoost performs well, with an accuracy of 0.84 in the testing period, and its five indices (precision, recall, accuracy, kappa, and F-score) are all higher than those of LSSVM. (2) The XGBoost-based approach provided the reliable flash flood risk maps, which were validated by another flash flood inventory, although some errors may be attributed to critical environmental factors and statistical disaster location accuracy. (3) The high-risk counties (including high-risk and highest-risk) accounted for 40.3%, with the highest-risk counties mainly concentrated in southeastern Yunnan. This article further addresses the limitations of XGBoost (e.g., as a time-consuming greedy algorithm, the non-necessity of multi-threaded optimization). All of the above results indicate that the XGBoost-based method is an effective method for obtaining high-quality county-level flash flood risk maps, which contributes to the theoretical basis for ongoing county-level flash flood prevention in China.
INTRODUCTION: As a result of destruction and lack of access to vital infrastructures and mental stress, disasters intensify cardiovascular diseases (CVDs) and hence management of CVDs becomes more challenging. The aim of this study is investigating incidence and prevalence of CVDs, morbidity and mortality of CVDs, treatment and management of CVDs at the time of natural disasters. METHODS: In the present systematic review, the articles published in English language until 28. 11. 2020, which studied CVDs in natural disasters were included. The inclusion criteria were CVDs such as myocardial infarction (MI), acute coronary syndrome (ACS), hypertension (HTN), pulmonary edema, and heart failure (HF) in natural disasters such as earthquake, flood, storm, hurricane, cyclone, typhoon, and tornado. RESULT: The search led to accessing 4426 non-duplicate records. Finally, the data of 104 articles were included in quality appraisal. We managed to find 4, 21 and 79 full text articles, which considered cardiovascular diseases at the time of flood, storm, and earthquake, respectively. CONCLUSION: Prevalence of CVD increases after disasters. Lack of access to medication or lack of medication adjustment, losing home blood pressure monitor as a result of destruction and physical and mental stress after disasters are of the most significant challenges of controlling and managing CVDs. By means of quick establishment of health clinics, quick access to appropriate diagnosis and treatment, providing and access to medication, self-management, and self-care incentives along with appropriate medication and non-medication measures to control stress, we can better manage and control cardiovascular diseases, particularly hypertension.
Climate change is increasing the frequency and intensity of extreme precipitation events, the impacts of which disproportionately impact urban populations. Pluvial flooding and flooding related sewer backups are thought to result in an increase in potentially hazardous human-pathogen encounters. However, the extent and nature of associations between flooding events and non-communicable respiratory diseases such as chronic bronchitis, asthma, and chronic obstructive pulmonary disease (COPD) are not well understood. This research seeks to characterize the state of research on flooding and NCRDs through a systematic review of the scientific literature. We conducted a systematic search of PubMed, Web of Science, and Scopus for published scholarly research papers using the terms flooding, monsoon, and tropical storm with terms for common NCRDs such as asthma, COPD, and chronic bronchitis. Papers were included if they covered research studies on individuals with defined outcomes of flooding events. We excluded review papers, case studies, and opinion pieces. We retrieved 200 articles from PubMed, 268 from Web of Science and 203 from Scopus which comprised 345 unique papers. An initial review of abstracts yielded 38 candidate papers. A full text review of each left 16 papers which were included for the review. All papers except for one found a significant association between a severe weather event and increased risk for at least one of the NCRDs included in this research. Our findings further suggest that extreme weather events may worsen pre-existing respiratory conditions and increase the risk of development of asthma. Future work should focus on more precisely defining measure of health outcomes using validated tools to describe asthma and COPD exacerbations. Research efforts should also work to collect granular data on patients’ health status and family history and assess possible confounding and mediating factors such as neighborhood water mitigation infrastructure, housing conditions, pollen counts, and other environmental variables.
OBJECTIVE: Information gaps that accompany hurricanes and floods limit researchers’ ability to determine the impact of disasters on population health. Defining key use cases for sharing complex disaster data with research communities and facilitators, and barriers to doing so are key to promoting population health research for disaster recovery. MATERIALS AND METHODS: We conducted a mixed-methods needs assessment with 15 population health researchers using interviews and card sorting. Interviews examined researchers’ information needs by soliciting barriers and facilitators in the context of their expertise and research practices. Card sorting ranked priority use cases for disaster preparedness. RESULTS: Seven barriers and 6 facilitators emerged from interviews. Barriers to collaborative research included process limitations, collaboration dynamics, and perception of research importance. Barriers to data and technology adoption included data gaps, limitations in information quality, transparency issues, and difficulty to learn. Facilitators to collaborative research included collaborative engagement and human resource processes. Facilitators to data and technology adoption included situation awareness, data quality considerations, adopting community standards, and attractive to learn. Card sorting prioritized 15 use cases and identified 30 additional information needs for population health research in disaster preparedness. CONCLUSIONS: Population health researchers experience barriers to collaboration and adoption of data and technology that contribute to information gaps and limit disaster preparedness. The priority use cases we identified can help address information gaps by informing the design of supportive research tools and practices for disaster preparedness. Supportive tools should include information on data collection practices, quality assurance, and education resources usable during failures in electric or telecommunications systems.
Landslides triggered by rainfall kill people worldwide, and frequent extreme events that are expected to be an effect of climate change could exacerbate this problem. This review aims to identify recent research, highlighting both the dynamics of landslide accidents and the characteristics of victims. From SCOPUS and WOS databases, using the PRISMA (preferred reporting items for systematic reviews and meta-analysis) approach, 25 articles written in English, published in the January 2010-March 2022 period and focused on landslide fatalities, were mined. The selected articles recognized a worldwide underestimation of landslide fatalities and analyzed landslide mortality from three perspectives, indicating the importance of this topic for a multidisciplinary research community. The papers focused on (a) fatal landslides and their geographic distribution, seasonality, trends, and relationships with socioeconomic indicators; (b) landslide fatalities and their behaviors and the dynamics of accidents; and (c) clinical causes of death or injury types, aiming to improve emergency rescue procedures. The gaps that emerged include (a) the insufficient reuse of valuable fatality databases; (b) the absence of simple take-home messages for citizens, practitioners, schoolteachers, and policymakers, aiming to set educational campaigns and adaptation measures; and (c) the lack of joint research projects between researchers working on landslides and doctors treating victims to provide complete research results that would be able to actually reduce landslide mortality.
PURPOSE OF REVIEW: Tropical cyclones impact human health, sometimes catastrophically. Epidemiological research characterizes these health impacts and uncovers pathways between storm hazards and health, helping to mitigate the health impacts of future storms. These studies, however, require researchers to identify people and areas exposed to tropical cyclones, which is often challenging. Here we review approaches, tools, and data products that can be useful in this exposure assessment. RECENT FINDINGS: Epidemiological studies have used various operational measures to characterize exposure to tropical cyclones, including measures of physical hazards (e.g., wind, rain, flooding), measures related to human impacts (e.g., damage, stressors from the storm), and proxy measures of distance from the storm’s central track. The choice of metric depends on the research question asked by the study, but there are numerous resources available that can help in capturing any of these metrics of exposure. Each has strengths and weaknesses that may influence their utility for a specific study. Here we have highlighted key tools and data products that can be useful for exposure assessment for tropical cyclone epidemiology. These results can guide epidemiologists as they design studies to explore how tropical cyclones influence human health.
BACKGROUND: The frequency and destructiveness of hurricanes and related extreme weather events (e.g., cyclones, severe storms) have been increasing due to climate change. A growing body of evidence suggests that victims of hurricanes have increased incidence of cardiovascular disease (CVD), likely due to increased stressors around time of the hurricane and in their aftermath. OBJECTIVES: The objective was to systematically examine the evidence of the association between hurricanes (and related extreme weather events) and adverse CVD outcomes with the goal of understanding the gaps in the literature. METHODS: A comprehensive literature search of population-level and cohort studies focused on CVD outcomes (i.e., myocardial infarction, stroke, and heart failure) related to hurricanes, cyclones, and severe storms was performed in the following databases from inception to December 2021: Ovid MEDLINE, Ovid EMBASE, Web of Science, and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. Studies were then qualitatively synthesized based on the time frame of the CVD outcomes studied and special populations that were studied. Gaps in the literature were identified based on this synthesis. RESULTS: Of the 1,103 citations identified, 48 met our overall inclusion criteria. We identified articles describing the relationship between CVD and extreme weather, primarily hurricanes, based on data from the United States (42), Taiwan (3), Japan (2), and France (1). Outcomes included CVD and myocardial infarction-related hospitalizations (30 studies) and CVVD-related mortality (7 studies). Most studies used a retrospective study design, including one case-control study, 39 cohort studies, and 4 time-series studies. DISCUSSION: Although we identified a number of papers that reported evaluations of extreme weather events and short-term adverse CVD outcomes, there were important gaps in the literature. These gaps included a) a lack of rigorous long-term evaluation of hurricane exposure, b) lack of investigation of hurricane exposure on vulnerable populations regarding issues related to environmental justice, c) absence of research on the exposure of multiple hurricanes on populations, and d) absence of an exploration of mechanisms leading to worsened CVD outcomes. Future research should attempt to fill these gaps, thus providing an important evidence base for future disaster-related policy. https://doi.org/10.1289/EHP11252.
This research highlights the mismatch between food security and climate adaptation literature and practice in the Global North and South by focusing on nested case studies in rural India and the United States during the COVID-19 pandemic. The United States is one of the wealthiest countries in the world, but also has one of the largest wealth gaps. Comparatively, India has one of the largest populations of food insecure people. To demonstrate how adaptive food security approaches to climate change will differ, we first review the unique climate, agricultural, demographic, and socio-economic features; and then compare challenges and solutions to food security posed by the COVID-19 pandemic. While both countries rely on rural, low-income farmworkers to produce food, the COVID-19 pandemic has highlighted how agricultural and food security policies differ in their influence on both food insecurity and global hunger alike. Emphasis on agricultural production in developing regions where a majority of individuals living in rural areas are smallholder subsistence farmers will benefit the majority of the population in terms of both poverty alleviation and food production. In the Global North, an emphasis on food access and availability is necessary because rural food insecure populations are often disconnected from food production.
PurposeAs global warming intensifies, climatic conditions are changing dramatically, potentially affecting specific businesses and cities’ livability. The temperature increase in cities significantly affects urban residents whose percentage is to reach about 70% by 2050. This paper aimed at highlighting the climate change risks in cities, particularly focusing on the threats to people’s health due to a continuous temperature increase. Design/methodology/approachThis study was conducted in three main steps. First, the literature review on the effects of climate change, particularly on the continuous temperature rise in cities, was conducted based on the publications retrieved from PubMed, Science Direct, Google Scholar and Research Gate. Second, the survey was conducted for the sample cities for one month. Third, the questionnaire was used to assess possible climate change threats to the livability of cities. FindingsThe findings showed that urban areas are usually warmer than the surrounding rural areas, mainly due to the urban heat island effect, causing more hot days in metropolitan areas compared to rural areas. This paper outlines some mitigation and adaptation measures, which can be implemented to improve the livability in cities, their sustainability and the well-being of their populations. Originality/valueThis study reports on the climate change impacts on the health and livability of 15 cities, in industrialized and developing countries. It examines the average and maximum temperature and relative humidity of each city and its correlation with their livability. It was complemented by a survey focused on 109 cities from Africa, Asia, Europe, Latin America, North America and Oceania.
The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO-‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO in Preamble to the constitution of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)-and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as ‘coping with the environment’. We develop the idea of ‘coping with the environment’, by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop adaptive strategies in the current pandemic scenario: community-centred care and microbiologically healthier buildings.
Climate change is the biggest global health threat of the 21st century. In addition to short-term reproductive health impacts, climate-related events will influence the risks of long-term and intergenerational mortality and morbidity for both birthing parents and offspring. As climate conditions continue to deteriorate in future generations, less healthy parents will give birth to less healthy offspring, who themselves will experience increased risk of reproductive outcomes. This intergenerational process causes a repeating cycle of poor parental preconception health, gestational complications, and poor offspring health, which leads to suboptimal preconception health among those offspring when they reach reproductive age. Because our ongoing efforts mostly focus on helping families achieve and maintain a healthy pregnancy, a critical need to think beyond the infant in our arms and consider the long-term implications of climate change exists. Such efforts may involve policy strengthening efforts to reduce emissions, further engaging health care providers as active advocates, ensuring equitable and sustainable mitigation and adaptable strategies, and conducting more research that yields actionable data to guide policy efforts, especially in regions and populations most affected by climate change.
INTRODUCTION: Climate change (CC) has been identified as the biggest global health threat of the 21st century. Although health care facilities (HCF) play a central role in the care of populations, there has been no comprehensive assessment of the impact of CC on HCF. The objective of our study was to highlight the components of HCFs affected by CC through a mapping review of the literature. METHODS: To meet our objective, we first assessed the place of HCFs in relation to CC in the scientific literature and in the Intergovernmental Panel on Climate Change (IPCC) reports. Bibliometric data from the PubMed database were analyzed between 1979 and 2021 to assess the penetration of keywords on CC alone, and in relation to health and HCF in particular. Second, we analyzed the changes in HCF keywords in the IPCC reports. Finally, we conducted a mapping review in five databases, of the international scientific literature published between 1979 and 2019, and identified the components of HCF affected by CC using the Ishikawa diagram. RESULTS: From the 2000s, the number of publications on CC and HCF increased gradually with 137 articles in 2005, and even more sharply since 2008 with 358 articles published and 813 in 2021. Even though CC is only recently present in the biomedical literature, all climatic events (warming and heatwaves, droughts, wildfires, storms, hurricanes and cyclones, floods and sea-level rise, and other indirect effects) have had an impact on at least one component of HCF. CONCLUSION: HCFs are already impacted, in all their components, by CC. By enhancing our understanding of the impacts of CC on HCF, this work could contribute to the engagement of health professionals in the implementation of mitigation and adaptation actions, thereby limiting the consequences of CC on patient care.
This paper explores the extent to which participatory budgeting (PB) contributes to climate change adaptation and mitigation, based on an analysis of initiatives from 15 cities and regions in the global South and North. PB contributions are far from marginal, with significant investments decided by local people. The paper highlights some of the numerous innovations introduced to integrate PB into climate adaptation and mitigation efforts. Through a scrutiny of 4,400 PB projects, the research identified six categories of climate-related projects encompassing hardware as well as software approaches, such as awareness-raising activities, community-based early warning projects and research. The paper advocates for solidarity PBs for climate justice, and raises awareness of the huge (and as yet largely untapped) potential for this to help address the dramatic impacts that climate change has on millions of people’s lives. It also points to questions for future research.
The purpose of this study is to study the life cycle assessment of biocementitious materials production in comparison to traditional cement materials production. The environmental impact of production processes over the life cycle was evaluated on the basis of global warming and ozone depletion, human health, land, freshwater, marine ecotoxicity, and natural water system eutrophication. LCA uses endpoint methods (ECO indicators) and SimaPro 8 software to assess the health and environmental impact of raw materials used in the production process, including cement, Ca(NO3)(2)center dot 4H(2)O, urea, molasses, and electricity. The results showed that cement materials made 82.88% of the world’s warming in all raw materials used in production processes, 87.24% of the world’s health, 89.54% of the deforestation of freshwater, and 30.48% to marine eutrophication. Ca(NO3)(2)center dot 4H(2)O contributes by 58.88% to ozone depletion, 15.37 to human carcinogenic toxicity, 3.19% to freshwater eutrophication, and 11.76% to marine eutrophication. In contrast, urea contributes 38.15% to marine eutrophication and 5.25% to freshwater eutrophication. Molasses contribute by 13.77% to marine eutrophication. Cement contributes 74.27% to human health damage, 79.36% to ecosystem damage; Ca(NO3)(2)center dot 4H(2)O contributes 13.54% to human health damage and 9.99% to ecosystem damage; while urea contributes 6.5% to human health damage and 5.91% to ecosystem damage. Bio-cementitious wastewater should undergo a treatment process to remove urea and molasses residues, as well as nitrates, before final disposal into the environment.
It is widely accepted that climate change is the biggest threat to human health. The pandemic of diabetes is also a major threat to human health, especially in rapidly developing nations. Climate change and diabetes appear to have common global vectors, including increased urbanisation, increased use of transportation, and production and ingestion of ultra-processed foods. People with diabetes appear to be at higher risk of threats to health from climate change, including effects from extreme heat or extreme cold, and natural disasters. Solutions to climate change offer some benefits for the prevention of diabetes and diabetes-related complications. Moving towards lower carbon economies is likely to help reduce reliance on intensive agriculture, reduce physical inactivity, reduce air pollution and enhance quality of life. It may enable a reduction in the prevalence of diabetes and reduced morbidity from the condition.
BACKGROUND: Climate change presents an increasing challenge for food-nutrition security. Nutrition metrics calculated from quantitative food system projections can help focus policy actions. OBJECTIVES: To estimate future chronic and hidden hunger disability-adjusted life years (DALYs)-due to protein-energy undernutrition and micronutrient deficiencies, respectively-using food systems projections to evaluate the potential impact of climate change and agricultural sector investment for adaptation. METHODS: We use a novel combination of a chronic and hidden hunger DALY estimation procedure and food system projections from quantitative foresight modeling to assess DALYs under alternative agricultural sector scenarios to midcentury. RESULTS: Total chronic and hidden hunger DALYs are projected to increase globally out to 2050-by over 30 million compared with 2010-even without climate change. Climate change increases total DALY change between 2010 and 2050 by nearly 10% compared with no climate change. Agricultural sector investments show promise for offsetting these impacts. With investments, DALY incidence due to chronic and hidden hunger is projected to decrease globally in 2050 by 0.24 and 0.56 per 1000 capita, respectively. Total global DALYs will still rise because projected population growth will outpace the rate reduction, especially in Africa south of the Sahara. However, projections also show important regional reductions in total DALYs due to chronic (13.9 million in South Asia, 4.3 million in East Asia and the Pacific) and hidden hunger (7.5 million in East Asia and the Pacific) with investments. CONCLUSIONS: Food system projections to 2050 show a decreasing DALY incidence from both chronic and hidden hunger. Population growth is projected to outpace these improvements and lead to increasing total chronic and hidden hunger DALYs globally, concentrated in Africa south of the Sahara. Climate change increases per-capita chronic and hidden hunger DALY incidence compared with no climate change. Agricultural sector investments show the potential to offset the climate impact on DALYs.
BACKGROUND: Instituted under the Paris Agreement, nationally determined contributions (NDCs) outline countries’ plans for mitigating and adapting to climate change. They are the primary policy instrument for protecting people’s health in the face of rising global temperatures. However, evidence on engagement with health in the NDCs is scarce. In this study, we aimed to examine how public health is incorporated in the NDCs, and how different patterns of engagement might be related to broader inequalities and tensions in global climate politics. METHODS: We analysed the NDCs in the UN Framework Convention on Climate Change registry submitted by 185 countries. Using content analysis and natural language processing (NLP) methods, we developed measures of health engagement. Multivariate regression analyses examined whether country-level factors (eg, population size, gross domestic product [GDP], and climate-related exposures) were associated with greater health engagement. Using NLP methods, we compared health engagement with other climate-related challenges (ie, economy, energy, and agriculture) and examined broader differences in the keyword terms used in countries with high and low health engagement in their NDCs. FINDINGS: Countries that did not mention health in their NDCs were clustered in high-income countries, whereas greater health engagement was concentrated in low-income and middle-income countries. Having a low GDP per capita and being a small island developing state were associated with higher levels of health engagement. In addition, higher levels of population exposure to temperature change and ambient air pollution were associated with more health coverage included in a country’s NDC. Variation in health engagement was greater than for other climate-related issues and reflected wider differences in countries’ approaches to the NDCs. INTERPRETATION: A focus on health in the NDCs follows broader patterns of global inequalities. Poorer and climate-vulnerable countries that contribute least to climate change are more likely to engage with health in their NDCs, while richer countries focus on non-health sectors in their NDCs, such as energy and the economy. FUNDING: This work was in part funded through an unrestricted grant from the Wellcome Trust and supported by The Economic and Social Research Council.
Compound dry and hot events (CDHEs) have increased significantly and caused agricultural losses and adverse impacts on human health. It is thus critical to investigate changes in CDHEs and population exposure in responding to climate change. Based on the simulations of the Coupled Model Intercomparison Project Phase 6 (CMIP6), future changes in CDHEs and population exposure are estimated under four Shared Socioeconomic Pathways climate scenarios (SSPs) at first. And then the driving forces behind these changes are analyzed and discussed. The results show that the occurrence of CDHEs is expected to increase by larger magnitudes by the end of the 21st century (the 2080s) than that by the mid-21st century (2050s). Correspondingly, population exposure to CDHEs is expected to increase significantly responding to higher global warming (SSP3-7.0 and SSP5-8.5) but is limited to a relatively low level under the modest emission scenarios (SSP1-2.6). Globally, compared to 1985-2014, the exposure is expected to increase by 8.5 and 7.7 times under SSP3-7.0 and SSP5-8.5 scenarios by the 2080s, respectively. Regionally, Sahara has the largest increase in population exposure to CDHEs, followed by the Mediterranean, Northeast America, Central America, Africa, and Central Asia. The contribution of climate change to the increase of exposure is about 75% by the 2080s under the SSP5-8.5 scenarios, while that of population change is much lower. The conclusion highlights the importance and urgency of implementing mitigation strategies to alleviate the influence of CDHEs on human society.
Previous studies seldom consider humidity when examining heat-related extremes, and none have explored the effects of humidity on concurrent extremes of high heat stress and low river streamflow. Here, we present the first global picture of projected changes in compound lethal heat stress (T-h)-drought hazards (CHD) across 11,637 catchments. Our observational datasets show that atmospheric conditions (e.g., energy and vapor flux) play an important role in constraining the heat extremes, and that T-h (32% +/- 11%) yields a higher coincidence rate of global CHD than wet-bulb temperature (28% +/- 11%), driven by lower relative humidity (RH) and thus air dryness in T-h extremes. Our large model ensemble projects a 10-fold intensification of bivariate CHD risks by 2071-2100, mainly driven by increases in heat extremes. Future declines in RH, wind, snow, and precipitation in many regions are likely to exacerbate such water and weather-related hazards (e.g., drought and CHD).
Outdoor thermal comfort is significantly affected by climate, including macroclimate, local climate, and microclimate. However, the combined impacts of macroclimate and microclimate factors are less understood in previous thermal comfort studies. This paper employed 43 previ-ously published studies to comprehensively explore the impacts of macro-and micro-climatic factors on the outdoor thermal comfort. The relative importance of these influencing factors was assessed via five verified artificial neural network (ANN) models. For studies employing subjec-tive thermal indices which collected participants’ thermal perceptions, the neutral temperature expressed by physiologically equivalent temperature (PET) was found to be significantly corre-lated with macroclimate factors, especially the latitude and season. In studies employing only objective thermal indices, it was found that macroclimate factors, such as the latitude, distance from the sea, and altitude, have similar contribution to the outdoor thermal comfort as micro-climate factors, such as height to width ratio (H/W) and sky view factor. Results resonated with previous findings that outdoor comfort can be improved by changing urban geometry, vegetation, surfaces, and waterbodies. Future design and planning works should consider both macroclimate and microclimate factors and carefully design urban geometry and morphology to improve out-door thermal comfort for regions with disadvantageous macroclimates.
Exposure to extreme environmental heat or cold during military activities can impose severe thermal strain, leading to impairments in task performance and increasing the risk of exertional heat (including heat stroke) and cold injuries that can be life-threatening. Substantial individual variability in physiological tolerance to thermal stress necessitates an individualized approach to mitigate the deleterious effects of thermal stress, such as physiological monitoring of individual thermal strain. During heat exposure, measurements of deep-body (T(c)) and skin temperatures and heart rate can provide some indication of thermal strain. Combining these physiological variables with biomechanical markers of gait (in)stability may provide further insight on central nervous system dysfunction – the key criterion of exertional heat stroke (EHS). Thermal strain in cold environments can be monitored with skin temperature (peripheral and proximal), shivering thermogenesis and T(c). Non-invasive methods for real-time estimation of T(c) have been developed and some appear to be promising but require further validation. Decision-support tools provide useful information for planning activities and biomarkers can be used to improve their predictions, thus maximizing safety and performance during hot- and cold-weather operations. With better understanding on the etiology and pathophysiology of EHS, the microbiome and markers of the inflammatory responses have been identified as novel biomarkers of heat intolerance. This review aims to (i) discuss selected physiological and biomechanical markers of heat or cold strain, (ii) how biomarkers may be used to ensure operational readiness in hot and cold environments, and (iii) present novel molecular biomarkers (e.g., microbiome, inflammatory cytokines) for preventing EHS.
BACKGROUND: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. METHODS: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature-mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature-mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. FINDINGS: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967-5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58-11·07) of all deaths (8·52% [6·19-10·47] were cold-related and 0·91% [0·56-1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60-87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000-03 to 2016-19, the global cold-related excess death ratio changed by -0·51 percentage points (95% eCI -0·61 to -0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13-0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe. INTERPRETATION: Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios. FUNDING: Australian Research Council and the Australian National Health and Medical Research Council.
Construction sites continue to operate despite inclement weather, exposing workers to unpleasant working circumstances that can lead to various physical and mental health challenges. A thorough literature review yielded 21 challenges for hot weather conditions such as heat stroke, kidney disease, heat cramps, anxiety and depression, and 20 challenges for cold weather conditions like asthma, frostbite, musculoskeletal disorders and hallucination. Workers vulnerable to hot and cold weather based on demographic characteristics were identified. The study also provides 27 strategies to address the challenges experienced in hot and cold weather conditions. Some of these include ensuring that workers stay hydrated, scheduling sufficient rest periods and allowing workers to self-pace. The results of this study will help construction decision-makers and project managers understand the difficulties faced by a field workforce who labors in extreme working conditions on construction sites and will facilitate adoption of strategies that can prevent weather-related physical and mental health problems.
One of the many consequences of climate change is an increase in the frequency, severity, and, thus, impact of wildfires across the globe. The destruction and loss of one’s home, belongings, and surrounding community, and the threat to personal safety and the safety of loved ones can have significant consequences on survivors’ mental health, which persist for years after. The objective of this scoping review was to identify primary studies examining the impact of wildfires on mental health and to summarize findings for PTSD, depression, anxiety, and substance use. Literature searches on Pubmed and Embase were conducted in February and April of 2021, respectively, with no date restrictions. A total of 254 studies were found in the two database searches, with 60 studies meeting the inclusion criteria. Three other studies were identified and included based on relevant in-text citations during data abstraction. The results show an increased rate of PTSD, depression, and generalized anxiety at several times of follow-up post-wildfire, from the subacute phase, to years after. An increased rate of mental health disorders post-wildfire has been found in both the adult and pediatric population, with a number of associated risk factors, the most significant being characteristics of the wildfire trauma itself. Several new terms have arisen in the literature secondary to an increased awareness and understanding of the impact of natural disasters on mental health, including ecological grief, solastalgia, and eco-anxiety. There are a number of patient factors and systemic changes that have been identified post-wildfire that can contribute to resilience and recovery.
Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compromise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings pertaining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63-72.5%) and nightmares (ranging between 33.3-46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associations between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires.
OBJECTIVES: Due to accelerating wildland fire activity, there is mounting urgency to understand, prevent, and mitigate the occupational health impacts associated with wildland fire suppression. The objectives of this review of academic and grey literature were to: 1. Identify the impact of occupational exposure to wildland fires on physical, mental, and emotional health; and 2. Examine the characteristics and effectiveness of prevention, mitigation, or management strategies studied to reduce negative health outcomes associated with occupational exposure to wildland fire. METHODS: Following established scoping review methods, academic literature as well as government and industry reports were identified by searching seven academic databases and through a targeted grey literature search. 4679 articles were screened using pre-determined eligibility criteria. Data on study characteristics, health outcomes assessed, prevention or mitigation strategies studied, and main findings were extracted from each included document. The results of this scoping review are presented using descriptive tables and a narrative summary to organize key findings. RESULTS: The final sample was comprised of 100 articles: 76 research articles and 24 grey literature reports. Grey literature focused on acute injuries and fatalities. Health outcomes reported in academic studies focused on respiratory health (n = 14), mental health (n = 16), and inflammation and oxidative stress (n = 12). The identified studies evaluated short-term outcomes measuring changes across a single shift or wildland fire season. Most research was conducted with wildland firefighters and excluded personnel such as aviation crews, contract crews, and incident management teams. Five articles reported direct study of mitigation strategies, focusing on the potential usage of masks, advanced hygiene protocols to reduce exposure, fluid intake to manage hydration and core temperature, and glutamine supplementation to reduce fatigue. CONCLUSIONS: While broad in scope, the evidence base linking wildland fire exposure to any one health outcome is limited. The lack of long-term evidence on changes in health status or morbidity is a clear evidence gap and there is a need to prioritize research on the mental and physical health impact of occupational exposure to wildland fire.
Wildfires are becoming more frequent and increasing in intensity, which results in significant threats to human life and property. Road networks play an important role in emergency activities. It is reasonable that robust road connectivity will give evacuees and emergency services the ability to respond more effectively, which may lead to a reduction in casualties. This study ex-plores a novel graph-based connectivity index for road networks that considers different analysis scales to measure the impact on global wildfire fatality events in past decades. We find a sig-nificant and systematic relationship between fatalities and a calibrated connectivity index across different wildfire events. This parsimonious and simple graph theoretic measure can provide planners a useful metric to reduce vulnerability and increase resilience among areas that are prone to wildfires.
INTRODUCTION: The Anthropocene is used to describe the most recent period where major disruptions in Earth’s system processes have resulted from humanity’s increasing ecological footprint. Climate change affects the social and environmental determinants of good health, such as clean air, stable ecosystems, safe drinking water, and sufficient and safe food, and they seem to be closely related to air pollution. OBJECTIVES: This article aims to review the evidence of how extreme weather events and indoor and outdoor pollution are associated with insufficient lung growth in early life, changes in lung function, and the increase in respiratory infections, favoring the development of allergic respiratory diseases. MATERIAL AND METHODS: Non-systematic review of English, Spanish, and Portuguese articles published in the last ten years in databases such as PubMed, EMBASE, and SciELO. The terms used were air pollution OR climate changes OR smoke, AND health OR allergic disease. RESULTS: Climate change and air pollution are the leading contributors to health emergencies around the world. On a global scale, those most at risk of adverse health effects associated with climate change include children, the elderly, and other vulnerable groups. Climate change and air pollution have adverse impacts on respiratory allergies, and the mechanisms are complex and interactive. CONCLUSION: Health professionals must receive information and education necessary to establish effective mitigation and adaptation strategies to minimize the effects of climate changes on the respiratory health of their patients.
Evacuation of residents during wildfire is a highly time-sensitive process. Available time may be limited. Previous research on other types of incident demonstrate that individuals delay their evacuation by first undertaking actions in response to the threat. However, currently there is little evidence of what actions individuals undertake (‘behavioural itineraries’), how many, which are prioritised, and how much time is committed to them in a wildfire. Additionally, where some understanding exists concerning human behaviour in wildfire evacuations, data has mostly been acquired from Australia; European regions, which are increasingly threatened by wildfires, lack attention. This study presents the first cross-cultural investigation of its kind: survey data (N = 293) from the South of France and Australia were compared. Participants with actual experience of wildfires and those inexperienced yet residing in at-risk areas answered questions about what they did or would hypothetically do, respectively, and for how long, prior to commencing evacuation. Results revealed that, across the two regions, the discrete actions comprising behavioural itineraries were similar overall, albeit their priority sometimes differed. However, when analysed by category, the prioritisation of actions was uniform across samples. Of significance is the finding that regional differences were also observed in relation to: mean number of actions, time committed to actions and the influence of socio-demographic factors, indicating geographical and cultural determinants. Implications for future research, evacuation modelling and wildfire management, education and training are discussed.
In this paper we propose a method for sparse dynamic allocation of resources to bound the risk of spreading processes, such as epidemics and wildfires, using convex optimization and dynamic programming techniques. Here, risk is defined as the risk of an undetected outbreak, i.e. the product of the probability of an outbreak occurring and the future impact of that outbreak, and we can allocate budgeted resources each time step to bound and minimize the risk. Our method in particular provides sparsity of resources, which is important due to the large network structures involved with spreading processes and has advantages when resources can not be distributed widely.
Background: Maternal wildfire exposure (e.g., smoke, stress) has been associated with poor birth outcomes with effects potentially mediated through air pollution and psychosocial stress. Despite the recent hike in the intensity and frequency of wildfires in some regions of the world, a critical appraisal of the evidence on the association between maternal wildfire exposure and adverse birth outcomes has not yet been undertaken. We conducted a systematic review that evaluated the scientific evidence on the association between wildfire exposure during pregnancy and the risk of adverse birth outcomes. Methods: Comprehensive searches in nine bibliographic databases were conducted from database inception up to June 2020. Observational epidemiological studies that evaluated associations between exposure to wildfire during pregnancy and adverse birth outcomes were eligible for inclusion. Studies were assessed using the National Toxicology Program’s Office of Health Assessment and Translation (NTP OHAT) risk of bias tool and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Screening of retrieved articles, data extraction, and risk of bias assessment were performed by two independent reviewers. Study results were synthesized descriptively. Results: Eight epidemiological studies conducted in four countries and involving 1,702,252 births were included in the review. The exposure to wildfire during pregnancy was assessed in individual studies by measurement of PM2.5 (n = 2), PM10 (n = 1), Total Ozone Mapping Spectrometer (TOMS) aerosol index (n = 1), heat spots (n = 1), and by proximity of maternal residence to wildfire-affected areas (n = 3). There is some evidence indicating that maternal wildfire exposure associates with birth weight reduction (n = 7) and preterm birth (n = 4), particularly when exposure to wildfire smoke occurred in late pregnancy. The association between wildfire exposure and small for gestational age (n = 2) and infant mortality (n = 1) was inconclusive. Conclusion: Current evidence suggests that maternal exposure to wildfire during late pregnancy is linked to reduced birth weight and preterm birth. Well-designed comprehensive studies are needed to better understand the perinatal effects of wildfires.
Association between short-term exposure to ambient air pollution and respiratory health is well documented. At the same time, it is widely known that extreme weather events intrinsically exacerbate air pollution impact. Particularly, hot weather and extreme temperatures during heat waves (HW) significantly affect human health, increasing risks of respiratory mortality and morbidity. Concurrently, a synergistic effect of air pollution and high temperatures can be combined with weather–air pollution interaction during wildfires. The purpose of the current review is to summarize literature on interplay of hot weather, air pollution, and respiratory health consequences worldwide, with the ultimate goal of identifying the most dangerous pollution agents and vulnerable population groups. A literature search was conducted using electronic databases Web of Science, Pubmed, Science Direct, and Scopus, focusing only on peer-reviewed Researchs published in English from 2000 to 2021. The main findings demonstrate that the increased level of PM10 and O3 results in significantly higher rates of respiratory and cardiopulmonary mortality. Increments in PM2.5 and PM10, O3, CO, and NO2 concentrations during high temperature episodes are dramatically associated with higher admissions to hospital in patients with chronic obstructive pulmonary disease, daily hospital emergency transports for asthma, acute and chronic bronchitis, and premature mortality caused by respiratory disease. Excessive respiratory health risk is more pronounced in elderly cohorts and small children. Both heat waves and outdoor air pollution are synergistically linked and are expected to be more serious in the future due to greater climate instability, being a crucial threat to global public health that requires the responsible involvement of researchers at all levels. Sustainable urban planning and smart city design could significantly reduce both urban heat islands effect and air pollution.
Theories of epidemiologic transition analyze the shift in causes of mortality due to changes in risk factors over time, and through processes of urbanization and development by comparing risk factors between countries or over time. These theories do not account for health inequities such as those resulting from environmental injustice, in which minority and lower income residents are more likely to be exposed to environmental hazards or have less access to environmental goods. Neighborhoods with histories of environmental injustice are also at risk for gentrification as they undergo environmental improvements and new greening projects. We aimed to understand how environmental injustice, urban renewal and green gentrification could inform the understanding of epidemiologic risk transitions. We examined 7 case neighborhoods in cities in the United States and Western Europe which were representative in terms of city region and type, which 1) had experienced a history of environmental injustice and 2) exhibited evidence of recent processes of urban renewal and/or gentrification. In each city, we conducted semi-structured qualitative interviews (n = 172) with city representatives, activists, non-profits, developers and residents. Respondents reported health implications of traditional (heavy pollutants, poor social conditions), transitional (decontamination, new amenities), new (gentrification, access to amenities), and emerging (displacement, climate-related risks, re-emergence of traditional exposures) exposures. Respondents reported renewed, complexified and overlapping exposures leading to poor mental and physical health and to new patterns of health inequity. Our findings point to the need for theories of environmental and epidemiologic risk transitions to incorporate analysis of trends 1) on a city-scale, acknowledging that segregation and patterns of environmental injustice have created unequal conditions within cities and 2) over a shorter and more recent time period, taking into account worsening patterns of social inequity in cities.
Urban floods are becoming more and more intense and frequent allover the world. Extreme events are the main triggering factors of such floods, and merit attention for what concerns the urban planning and emergency strategies. Numerical models aimed at investigating the optimal paths for evacuees escaping a flooded urban environment may be used by local authorities to properly understand how to improve people safety and mitigate the flood risk. Implementation of empirical laws in such models to describe the people stability in flooded areas is thus crucial to understand the behavior of evacuees and rescuers during emergency conditions. Laboratory experiments have been undertaken using a physical model representing a human body at quasi-natural scale, towed by an electrical engine in the water at rest. This represents a novel laboratory approach which exploits a non-inertial reference frame in motion with the model. The experimental results, obtained using different combinations of water depth and flow speed, have led to empirical laws which outline the stability conditions occurring when either the model front or the model back faces the flow, these respectively corresponding to Backward Toppling Instability (BTI) and Forward Toppling Instability (FTI). Such laws have been found through comparison with reference literature works, using various statistical methods. The FTI condition has been seen to largely improve the human stability compared to BTI, in contrast to the results of previous literature works, which stated an overall similarity between the results of the two toppling conditions. To better understand the role of the water flow during the different tests, hydraulic forces and moments have been measured. It has been seen that dynamic and static effects are comparable during high-speed conditions, especially due to a relevant fluid-model interaction and an increase of the water-surface level, while dynamic effects are negligible during low-speed conditions. The results of the present contribution can represent an important step forward for the numerical models applied to the framework of urban and emergency planning.
Potentially toxic elements (PTEs) in urban soil environments pose a noticeable risk to both ecosystem and human health; however, only a fraction of the elemental content is available for biota. To better know the potential risk of PTEs in the urban soil environment, geochemical fractionation, bioaccessibility, and potential bioavailability of four PTEs (Cd, Cu, Pb, and Zn) were investigated by the combined use of different methods. The results showed that a high non-residual chemical fraction is related to a high bioavailability of the selected elements. The ranges of labile concentration of Cu, Zn, Cd and Pb in all sampling sites measured by diffusive gradients in thin films (DGT) were 3.5-18.0, 14.2-26.5, 0.09-1.0, and 1.8-15.7 μg/L, respectively. The high non-residual contents pointed out a serious hazard to the urban environment. The bioaccessible concentrations in gastric and lung phases were closely positively correlated with DGT-measured content (r = 0.63-0.99, p < 0.05), suggesting the potential use of DGT for the prediction of PTEs risk to human health. Moreover, the correlation of DGT results with the soluble and reducible fractions of PTEs may allow DGT use for quick screenings of the PTEs fraction potentially mobilizable during flooding events in urban soil environments. Our study suggests that combing DGT, bioaccessibility and biogeochemical fractionation could provide a more accurate assessment of the urban environmental quality and be helpful for pollution control and urban planning.
This study presents a global explanatory analysis of the interplay between the severity of flood losses and human presence in floodplain areas. In particular, we relate economic losses and fatalities caused by floods during 1990-2000, with changes in human population and built-up areas in floodplains during 2000-2015 by exploiting global archives. We found that population and built-up areas in floodplains increased in the period 2000-2015 for the majority of the analyzed countries, albeit frequent flood losses in the previous period 1990-2000. In some countries, however, population in floodplains decreased in the period 2000-2015, following more severe floods losses that occurred in the period 1975-2000. Our analysis shows that (i) in low-income countries, population in floodplains increased after a period of high flood fatalities; while (ii) in upper-middle and high-income countries, built-up areas increased after a period of frequent economic losses. In this study, we also provide a general framework to advance knowledge of human-flood interactions and support the development of sustainable policies and measures for flood risk management and disaster risk reduction.
Deaths and property damage from floods have increased drastically in the past two decades due to various reasons such as increased populations, unplanned developments, and climate change. Such losses from floods can be reduced by issuing timely early warnings and through effective response mechanisms based on situational intelligence during emerging flood situations. This paper presents the outcome of a literature review that was conducted to identify the types and sources of the intelligence required for flood warning and response processes as well as the technology solutions that can be used for offering such intelligence. Twenty-seven different types of intelligence are presented together with the technologies that can be used to extract such intelligence. Furthermore, a conceptual architecture that illustrates how relevant technology solutions can be used to extract intelligence at various stages of a flood cycle for decision-making in issuing early warnings and planning responses is presented.
Purpose. Noise and heat are the most important physical hazardous agents that can affect physiological parameters. This study investigated the independent and combined effects of noise and heat exposure on human saliva cortisol and blood pressure. Methods. In this experimental study, 72 students were exposed to noise (at sound pressure levels of 45, 75, 85 and 95 dB(A)) and heat (at wet bulb globe temperatures [WBGTs] of 22, 29 and 34 °C) for 30 min. Samples of saliva and blood pressure were taken before and after each independent and combined exposure. Results. The results revealed that the average saliva cortisol and blood pressure in male and female subjects increased significantly after independent exposure to noise at 95 dB(A) and a WBGT of 34 °C. The combined exposure to noise and heat increased saliva cortisol and blood pressure, which was statistically significant for three combinations of 95 dB(A) at 34 °C, 95 dB(A) at 29 °C and 85 dB(A) at 34 °C. Conclusions. Combined exposure to noise and heat could affect saliva cortisol and blood pressure in both male and female groups. Further studies are recommended to capture other combinations of physical hazardous agents, especially in the field.
EPIDEMIOLOGY: An increasing number of inhabitants of Central America have developed a form of chronic kidney disease of unknown cause, named Mesoamerican nephropathy (MeN). Because similar epidemics have been reported in other parts of the world, such as Sri Lanka, India, Egypt, and Tunisia, this condition is currently called chronic kidney disease of uncertain origin (CKDu). CLINICAL PRESENTATION: This disease is characterized by minimal proteinuria, leukocyturia, hyperuricemia, hypokalemia reduced glomerular filtration rate, and renal tubular dysfunctions. Pathology: The kidneys manifest tubulo-interstitial nephritis and glomerulosclerosis. Electron microscopy shows large dimorphic lysosomes with dark electron-dense aggregates. Potential causes: The cause(s) of this disease remain largely unknown. Several hypotheses have been proposed including infections, dehydration, global warming, hyperuricemia, exposure to agro-chemicals or heavy metals, and genetic susceptibility. This review addresses a mounting body of evidence suggesting that the disease may be the result of exposure to a variety of water contaminants combined with volume depletion. THERAPY: Absent a clear understanding of the causes of the disease, no specific therapeutic interventions can be recommended. Preliminary studies suggest that reduction of working hours, frequent rest in shaded area, and administration of purified water may reduce the risk of CKDu.
Environmental factors such as climate change are now underway, which have substantial impacts on health and well-being of human kind, but still imprecisely quantified, implications for human health. At present, one of the most significant discussions among scientists worldwide is interdependency of escalating environmental risk factors and the increasing rates of noncommunicable diseases (NCDs), which are the leading cause of death and disability worldwide. Climate change also triggers the occurrence of NCDs through a variety of direct and indirect pathways. Therefore, it is likely that the interdependence of climate change, environmental risk factors, and NCDs as a whole poses great threat to global health. Hence, this paper aims to review the latest evidence on impacts of environmental risk factors on NCDs and methods used in establishing the cause or correlation of environmental risk factors and NCDs. The literature review leveraged online databases such as PubMed and Google Scholar with articles that matched keywords “climate change”, “environmental risk factors,” and “noncommunicable diseases”. This review shows that the burden of NCDs is increasing globally and attribution of environmental risk factors such as climate change is significant. Understanding the nature of the relation between NCDs and the environment is complex and has relied on evidence generated from multiple study designs. This paper reviews eight types of study designs that can be used to identify and measure causal and correlational nature between environment and NCDs. Future projections suggest that increases in temperatures will continue and also increase the public health burden of NCDs.
BACKGROUND: The adverse effects of heat on workers’ health and work productivity are well documented. However, the resultant economic consequences and productivity loss are less understood. This review aims to summarize the retrospective and potential future economic burden of workplace heat exposure in the context of climate change. METHODS: Literature was searched from database inception to October 2020 using Embase, PubMed, and Scopus. Articles were limited to original human studies investigating costs from occupational heat stress in English. RESULTS: Twenty studies met criteria for inclusion. Eighteen studies estimated costs secondary to heat-induced labor productivity loss. Predicted global costs from lost worktime, in US$, were 280 billion in 1995, 311 billion in 2010 (≈0.5% of GDP), 2.4-2.5 trillion in 2030 (>1% of GDP) and up to 4.0% of GDP by 2100. Three studies estimated heat-related healthcare expenses from occupational injuries with averaged annual costs (US$) exceeding 1 million in Spain, 1 million in Guangzhou, China and 250,000 in Adelaide, Australia. Low- and middle-income countries and countries with warmer climates had greater losses as a proportion of GDP. Greater costs per worker were observed in outdoor industries, medium-sized businesses, amongst males, and workers aged 25-44 years. CONCLUSIONS: The estimated global economic burden of occupational heat stress is substantial. Climate change adaptation and mitigation strategies should be implemented to likely minimize future costs. Further research exploring the relationship between occupational heat stress and related expenses from lost productivity, decreased work efficiency and healthcare, and costs stratified by demographic factors, is warranted. Key messages. The estimated retrospective and future economic burden from occupational heat stress is large. Responding to climate change is crucial to minimize this burden. Analyzing heat-attributable occupational costs may guide the development of workplace heat management policies and practices as part of global warming strategies.
BACKGROUND: Increased rates of exclusive breastfeeding could significantly improve infant survival in low- and middle-income countries. There is a concern that increased hot weather due to climate change may increase rates of supplemental feeding due to infants requiring fluids, or the perception that infants are dehydrated. OBJECTIVE: To understand how hot weather conditions may impact infant feeding practices by identifying and appraising evidence that exclusively breastfed infants can maintain hydration levels under hot weather conditions, and by examining available literature on infant feeding practices in hot weather. METHODS: Systematic review of published studies that met inclusion criteria in MEDLINE, EMBASE, Global Health and Web of Science databases. The quality of included studies was appraised against predetermined criteria and relevant data extracted to produce a narrative synthesis of results. RESULTS: Eighteen studies were identified. There is no evidence among studies of infant hydration that infants under the age of 6months require supplementary food or fluids in hot weather conditions. In some settings, healthcare providers and relatives continue to advise water supplementation in hot weather or during the warm seasons. Cultural practices, socio-economic status, and other locally specific factors also affect infant feeding practices and may be affected by weather and seasonal changes themselves. CONCLUSION: Interventions to discourage water/other fluid supplementation in breastfeeding infants below 6 months are needed, especially in low-middle income countries. Families and healthcare providers should be advised that exclusive breastfeeding (EBF) is recommended even in hot conditions.
Climate change should be of special concern for the nephrologist as the kidney has a critical role in protecting the host from dehydration, but is also a favorite target of heat stress and dehydration. Here we discuss how rising temperatures and extreme heat events may affect the kidney. The most severe presentation of heat stress is heat stroke, which can result in severe electrolyte disturbance and both acute and chronic kidney disease. However, lesser levels of heat stress also have multiple effects, including exacerbating kidney disease and precipitating cardiovascular events in subjects with established kidney disease. Heat stress can also increase the risk for kidney stones, cause multiple electrolyte abnormalities, and induce both acute and chronic kidney disease. Recently there have been multiple epidemics of chronic kidney disease of uncertain etiology in various regions of the world, including Mesoamerica, Sri Lanka, India and Thailand. There is increasing evidence that climate change and heat stress may have a contributory role in these conditions, although other causes including toxins could also be involved. As climate change worsens, the nephrologist should prepare for an increase in diseases associated with heat stress and dehydration.
The climate change induced global warming, and in particular the increased frequency and intensity of heat waves, have been linked to health problems. Among them, scientific works have been reporting an increased incidence of neurological diseases, encompassing also neurodegenerative ones, such as Dementia of Alzheimer’s type, Parkinson’s Disease, and Motor Neuron Diseases. Although the increase in prevalence of neurodegenerative diseases is well documented by literature reports, the link between global warming and the enhanced prevalence of such diseases remains elusive. This is the main theme of our work, which aims to examine the connection between high temperature exposure and neurodegenerative diseases. Firstly, we evaluate the influence of high temperatures exposure on the pathophysiology of these disorders. Secondly, we discuss its effects on the thermoregulation, already compromised in affected patients, and its interference with processes of excitotoxicity, oxidative stress and neuroinflammation, all of them related with neurodegeneration. Finally, we investigate chronic versus acute stressors on body warming, and put forward a possible interpretation of the beneficial or detrimental effects on the brain, which is responsible for the incidence or progression of neurological disorders.
The wet-bulb temperature (WBT; T-W) comprehensively characterizes the temperature and humidity of the thermal environment and is a relevant variable to describe the energy regulation of the human body. The daily maximum TW can be effectively used in monitoring humid heat waves and their effects on health. Because meteorological stations differ in temporal resolution and are susceptible to non-climatic influences, it is difficult to provide complete and homogeneous long-term series. In this study, based on the sub-daily station-based HadISD (Met Office Hadley Centre Integrated Surface Database) dataset and integrating the NCEP-DOE reanalysis dataset, the daily maximum T-W series of 1834 stations that have passed quality control were homogenized and reconstructed using the method of Climatol. These stations form a new dataset of global station-based daily maximum T-W (GSDM-WBT) from 1981 to 2020. Compared with other station-based and reanalysis-based datasets of TW, the average bias was -0.48 and 0.34 degrees C, respectively. The GSDM-WBT dataset handles stations with many missing values and possible inhomogeneities, and also avoids the underestimation of the TW calculated from reanalysis data. The GSDM-WBT dataset can effectively support the research on global or regional extreme heat events and humid heat waves. The dataset is available at (Dong et al., 2022).
The unbearable heat waves that we are experiencing these days around the world are the result of increasing global warming, leading to heat stress and a constant health issue for the existing population. The thermoregulatory dysfunction of the human body due to climatological changes might result in fluid and electrolyte imbalance and transforms the human body from a normal physiological condition to a distorted pathological state. Subsequently, at one point in time, the human body may fail to handle its normal thermoregulatory function in the form of sudden unconsciousness and health defects. There might be associated dehydration that imposes renal damage, even to the extent to cause acute kidney injury (AKI), followed by chronic kidney disease (CKD). Thus, we cannot deny CKD as a major cause of death, mainly in patients having long-standing medical issues such as cardiac dysfunction, hypertension, diabetes, and obesity, heat stress nephropathy (HSN) might therefore become a major health problem. There is always a hopeful way in our hands, fortunately, which is of course prevention, that comes through government policies and human awareness. The present review brings out light on the alarming resultant facts of heat stress, dehydration, its pathology, molecular derangements, and recommendations for the prevention of heat stress nephropathy.
BACKGROUND: Heat stroke (HS) is an acute physical disorder that is associated with a high risk of organ dysfunction and even death. HS patients are usually treated symptomatically and conservatively; however, there remains a lack of specific and effective drugs in clinical practice. An analysis of publication contributions from institutions, journals and authors in different countries/regions was used to study research progress and trends regarding HS. METHODS: We extracted all relevant publications on HS between 1989 and 2019 from Web of Science. Using the Statistical Package for Social Science (SPSS, version 24) and the software GraphPad Prism 8, graphs were generated and statistical analyses were performed, while VOSviewer software was employed to visualize the research trends in HS from the perspectives of co-occurring keywords. RESULTS: As of April 14, 2020, we identified 1443 publications with a citation frequency of 5216. The United States accounted for the largest number of publications (36.2%) and the highest number of citations (14,410), as well as the highest H-index at 74. Although the sum of publications from China ranked second, there was a contradiction between the quantity and quality of publications. Furthermore, Medicine & Science in Sports & Exercise published the most papers related to HS, with Lin MT publishing the most papers in this field (112), while the review by Knochel JP received the highest citation frequency at 969. The keyword heat-stress appeared most recently, with an average appearing year of 2015.5. In the clinical research cluster, exertional heat-stroke was determined to be the hotspot, while ambient-temperature and heat waves were the new trends in the epidemiological research cluster. CONCLUSIONS: Corresponding to this important field, while the contributions of the publications from the United States were significant, the mismatch between the quantity and quality of publications from China must be examined. Moreover, it is hypothesized that clinical and epidemiological studies may become hotspots in the near future.
Policy and technology responses to increased temperatures in urban heat islands (UHIs) are discussed in a variety of research; however, their interaction is overlooked and understudied. This is an important oversight because policy and technology are often developed in isolation of each other and not in conjunction. Therefore, they have limited synergistic effects when aimed at solving global issues. To examine this aspect, we conducted a systematic literature review and synthesised 97 articles to create a conceptual structuring of the topic. We identified the following categories: (a) evidence base for policymaking including timescale analysis, effective policymaking instruments as well as decision support and scenario planning; (b) policy responses including landscape and urban form, green and blue area ratio, albedo enhancement policies, transport modal split as well as public health and participation; (c) passive technologies including green building envelopes and development of cool surfaces; and (d) active technologies including sustainable transport as well as energy consumption, heating, ventilation and air conditioning, and waste heat. Based on the findings, we present a framework to guide future research in analysing UHI policy and technology responses more effectively in conjunction with each other.
Rationale: Avoiding excess health damages attributable to climate change is a primary motivator for policy interventions to reduce greenhouse gas emissions. However, the health benefits of climate mitigation, as included in the policy assessment process, have been estimated without much input from health experts. Objectives: In accordance with recommendations from the National Academies in a 2017 report on approaches to update the social cost of greenhouse gases (SC-GHG), an expert panel of 26 health researchers and climate economists gathered for a virtual technical workshop in May 2021 to conduct a systematic review and meta-analysis and recommend improvements to the estimation of health impacts in economic-climate models. Methods: Regionally resolved effect estimates of unit increases in temperature on net all-cause mortality risk were generated through random-effects pooling of studies identified through a systematic review. Results: Effect estimates and associated uncertainties varied by global region, but net increases in mortality risk associated with increased average annual temperatures (ranging from 0.1% to 1.1% per 1°C) were estimated for all global regions. Key recommendations for the development and utilization of health damage modules were provided by the expert panel and included the following: not relying on individual methodologies in estimating health damages; incorporating a broader range of cause-specific mortality impacts; improving the climate parameters available in economic models; accounting for socioeconomic trajectories and adaptation factors when estimating health damages; and carefully considering how air pollution impacts should be incorporated in economic-climate models. Conclusions: This work provides an example of how subject-matter experts can work alongside climate economists in making continued improvements to SC-GHG estimates.
BACKGROUND: The link between heat exposure and adverse health outcomes in workers is well documented and a growing body of epidemiological evidence from various countries suggests that extreme heat may also contribute to increased risk of occupational injuries (OI). Previously, there have been no comparative reviews assessing the risk of OI due to extreme heat within a wide range of global climate zones. The present review therefore aims to summarise the existing epidemiological evidence on the impact of extreme heat (hot temperatures and heatwaves (HW)) on OI in different climate zones and to assess the individual risk factors associated with workers and workplace that contribute to heat-associated OI risks. METHODS: A systematic review of published peer-reviewed articles that assessed the effects of extreme heat on OI among non-military workers was undertaken using three databases (PubMed, Embase and Scopus) without temporal or geographical limits from database inception until July 2020. Extreme heat exposure was assessed in terms of hot temperatures and HW periods. For hot temperatures, the effect estimates were converted to relative risks (RR) associated with 1 °C increase in temperature above reference values, while for HW, effect estimates were RR comparing heatwave with non-heatwave periods. The patterns of heat associated OI risk were investigated in different climate zones (according to Köppen Geiger classification) based on the study locations and were estimated using random-effects meta-analysis models. Subgroup analyses according to workers’ characteristics (e.g. gender, age group, experience), nature of work (e.g. physical demands, location of work i.e. indoor/outdoor) and workplace characteristics (e.g. industries, business size) were also conducted. RESULTS: A total of 24 studies published between 2005 and 2020 were included in the review. Among these, 22 studies met the eligibility criteria, representing almost 22 million OI across six countries (Australia, Canada, China, Italy, Spain, and USA) and were included in the meta-analysis. The pooled results suggested that the overall risk of OI increased by 1% (RR 1.010, 95% CI: 1.009-1.011) for 1 °C increase in temperature above reference values and 17.4% (RR 1.174, 95% CI: 1.057-1.291) during HW. Among different climate zones, the highest risk of OI during hot temperatures was identified in Humid Subtropical Climates (RR 1.017, 95% CI: 1.014-1.020) followed by Oceanic (RR 1.010, 95% CI: 1.008-1.012) and Hot Mediterranean Climates (RR 1.009, 95% CI: 1.008-1.011). Similarly, Oceanic (RR 1.218, 95% CI: 1.093-1.343) and Humid Subtropical Climates (RR 1.213, 95% CI: 0.995-1.431) had the highest risk of OI during HW periods. No studies assessing the risk of OI in Tropical regions were found. The effects of hot temperatures on the risk of OI were acute with a lag effect of 1-2 days in all climate zones. Young workers (age < 35 years), male workers and workers in agriculture, forestry or fishing, construction and manufacturing industries were at high risk of OI during hot temperatures. Further young workers (age < 35 years), male workers and those working in electricity, gas and water and manufacturing industries were found to be at high risk of OI during HW. CONCLUSIONS: This review strengthens the evidence on the risk of heat-associated OI in different climate zones. The risk of OI associated with extreme heat is not evenly distributed and is dependent on underlying climatic conditions, workers' attributes, the nature of work and workplace characteristics. The differences in the risk of OI across different climate zones and worker subgroups warrant further investigation along with the development of climate and work-specific intervention strategies.
BACKGROUND: Respiratory diseases are a leading cause of mortality and morbidity, and are exacerbated by air pollution and temperature. AIM: To assess published literature on the effect of air pollution modified by temperature on respiratory mortality and hospital admissions. METHODS: We identified 26,656 papers in PubMed and Web of Science, up to March 2021, and selected for analysis; inclusion criteria included observational studies, short-term air pollution, and temperature exposure. Air pollutants considered were particulate matter with a diameter of 2.5 μg/m(3), and 10 μg/m(3) (PM(2.5), and PM(10)), ozone (O(3)), and nitrogen dioxide (NO(2)). A random-effects model was used for our meta-analysis. RESULTS: For respiratory mortality we found that when the effect PM(10) is modified by high temperatures there is an increased pooled Odds Ratio [OR, 95% Confidence Interval (CI)] of 1.021 (1.008 to 1.034) and for the effect of O(3) the pooled OR is 1.006 (1.001-1.012) during the warm season. For hospital admissions, the effects of PM(10) and O(3) respectively, during the warm season found an increased pooled OR of 1.011 (0.999-1.024), and 1.015 (0.995-1.036). In our analysis for low temperatures, results were inconsistent. CONCLUSIONS: Exposure to air pollution when modified by high temperature is likely to increase the odds of respiratory mortality and hospital admissions. Analysis on the interaction effect of air pollution and temperature on health outcomes is a relatively new research field and results are largely inconsistent; therefore, further research is encouraged to establish a more conclusive conclusion on the strength and direction of this effect.
With climate change increasing global temperatures, more workers are exposed to hotter ambient temperatures that exacerbate risk for heat injury and illness. Continuously monitoring core body temperature (T(C)) can help workers avoid reaching unsafe T(C). However, continuous T(C) measurements are currently cost-prohibitive or invasive for daily use. Here, we show that Kenzen’s wearable device can accurately predict T(C) compared to gold standard T(C) measurements (rectal probe or gastrointestinal pill). Data from four different studies (n = 52 trials; 27 unique subjects; >4000 min data) were used to develop and validate Kenzen’s machine learning T(C) algorithm, which uses subject’s real-time physiological data combined with baseline anthropometric data. We show Kenzen’s T(C) algorithm meets pre-established accuracy criteria compared to gold standard T(C): mean absolute error = 0.25 °C, root mean squared error = 0.30 °C, Pearson r correlation = 0.94, standard error of the measurement = 0.18 °C, and mean bias = 0.07 °C. Overall, the Kenzen T(C) algorithm is accurate for a wide range of T(C), environmental temperatures (13-43 °C), light to vigorous heart rate zones, and both biological sexes. To our knowledge, this is the first study demonstrating a wearable device can accurately predict T(C) in real-time, thus offering workers protection from heat injuries and illnesses.
Rising temperature especially in summer is currently a hot debate. Scientists around the world have raised concerns about Heat Stress Assessment (HSA). It depends on the urban geometry, building materials, greenery, environmental factor of the region, psychological and behavioral factors of the inhabitants. Effective and accurate heat stress forecasts are useful for managing thermal comfort in the area. A widely used technique is artificial intelligence (AI), especially neural networks, which can be trained on weather variables. In this study, the five most important meteorological parameters such as air temperature, global radiation, relative humidity, surface temperature and wind speed are considered for HSA. System dynamic approach and a new version of the Gated Recurrent Unit (GRU) method is used for the prediction of the mean radiant temperature, the mean predicted vote and the physiological equivalent temperature. GRU is a promising technology, the results with higher accuracy are obtained from this algorithm. The results obtained from the model are validated with the output of reference software named Rayman. Django’s graphical user interface was created which allows users to select the range of thermal comfort scales based on their perception which depends on the age factor, local weather adaptability, and habit of tolerating the heat events. It also gives a warning to the user by color code about the level of discomfort which helps them to schedule and manage their outdoor activities. Future work consists of coupling this model with urban greenery factors to analyze the impact on the estimation of heat stress. Copyright (C) 2022 The Authors.
Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days’ minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: -0.33 to 1.69), 1.34% (95% CI: -0.14 to 2.73), 1.99% (95% CI: 0.29-3.57), and 2.73% (95% CI: 0.76-4.50) of total deaths for Q1-Q4 (first quartile-fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25-9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: -0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health.
We examine the effect of short-run weather shocks and long-run climate change on a variety of national health outcomes for a sample of 170 countries between 1960 and 2016. We find that changing climate conditions – especially in the form of increasing temperatures – lead to health losses (e.g., increased infant mortality and lower life expectancy) both in the short and long run. The adverse effect of increasing temperatures is much more strongly felt in relatively poor countries, indicating that these countries are more vulnerable. Predicted health losses in poor countries due to weather shocks and climate change have already been substantial. Future health losses especially in less developed countries will likely also be considerable unless adequate adaptation and mitigation efforts are undertaken. (C) 2020 Elsevier Ltd. All rights reserved.
Health risks associated with heatwaves and ozone pollution are projected to rise significantly under the effects of climate change. Although the literature has considered the future health risks of heatwaves and ozone pollution separately, the compound effects remain unexplored, and this could potentially impair risk-prevention plans. Here, using a model from the Coupled Model Intercomparison Project Phase 6 (CMIP6) and four shared socioeconomic pathway (SSPs) scenarios, we explore the global tempo-spatial trend and country disparity of compound-event days and population-exposure person-days. We find that compared with the baseline of 1995-2014, by 2071-2090 under the high-emission scenario of SSP3-7.0, an increased annual mean of 34.6 compound-event days and mean population-exposure of 93.5 million person-days is expected. Furthermore, lower-income countries are facing dramatically higher exposure compared with higher-income countries. These projections could contribute to developing targeted mitigation and adaptation plans.
INTRODUCTION: There is an increasing interest in understanding whether air pollutants modify the quantitative relationships between temperature and health outcomes. The results of available studies were, however, inconsistent. This study aims to sum up the current evidence and provide a comprehensive understanding of this topic. METHODS: We conducted an electronic search in PubMed (MEDLINE), EMBASE, Web of Science Core Collection, and ProQuest Dissertations and Theses. The modified Navigation Guide was applied to evaluate the quality and strength of evidence. We calculated pooled temperature-related mortality at low and high pollutant levels respectively, using the random-effects model. RESULTS: We identified 22 eligible studies, eleven of which were included in the meta-analysis. Significant effect modification was observed on heat effects for all-cause and non-accidental mortality by particulate matter with an aerodynamic diameter of <10 μm (PM(10)) and ozone (O(3)) (p < 0.05). The excess risks (ERs) for all-cause and non-accidental mortality were 5.4% (4.4%, 6.4%) and 6.3% (4.8%, 7.8%) at the low PM(10) level, 8.8% (7.5%, 10.1%) and 11.4% (8.7%, 14.2%) at the high PM(10) level, respectively. As for O(3), the ERs for all-cause and non-accidental mortality were 5.1% (3.9%, 6.3%) and 3.6% (0.1%, 7.2%) at the low O(3) level, 7.6% (6.3%, 9.0%) and 12.5% (4.7%, 20.9%) at the high O(3) level, respectively. Surprisingly, the heat effects on cardiovascular mortality were found to be lower at high carbon monoxide (CO) levels [ERs = 5.4% (3.9%, 6.9%)] than that at low levels [ERs = 9.4% (7.0%, 11.9%)]. The heterogeneity varied, but the results of sensitivity analyses were generally robust. Significant effect modification by air pollutants was not observed for heatwave or cold effects. CONCLUSIONS: PM(10) and O(3) modify the heat-related all-cause and non-accidental mortality, indicating that policymakers should consider air pollutants when establishing heat-health warning systems. Future studies with comparable designs and settings are needed.
Invasive fungal diseases are rare in individuals with intact immunity. This, together with the fact that there are only a few species that account for most mycotic diseases, implies a remarkable natural resistance to pathogenic fungi. Mammalian immunity to fungi rests on two pillars, powerful immune mechanisms and elevated temperatures that create a thermal restriction zone for most fungal species. Conditions associated with increased susceptibility generally reflect major disturbances of immune function involving both the cellular and humoral innate and adaptive arms, which implies considerable redundancy in host defense mechanisms against fungi. In general, tissue fungal invasion is controlled through either neutrophil or granulomatous inflammation, depending on the fungal species. Neutrophils are critical against Candida spp. and Aspergillus spp. while macrophages are essential for controlling mycoses due to Cryptococcus spp., Histoplasma spp., and other fungi. The increasing number of immunocompromised patients together with climate change could significantly increase the prevalence of fungal diseases.
Climate change is a worsening global crisis that will continue negatively impacting population health and well-being unless adaptation and mitigation interventions are rapidly implemented. Climate change-related cardiovascular disease is mediated by air pollution, increased ambient temperatures, vector-borne disease and mental health disorders. Climate change-related cardiovascular disease can be modulated by climate change adaptation; however, this process could result in significant health inequity because persons and populations of lower socioeconomic status have fewer adaptation options. Clear scientific evidence for climate change and its impact on human health have not yet resulted in the national and international impetus and policies necessary to slow climate change. As respected members of society who regularly communicate scientific evidence to patients, clinicians are well-positioned to advocate on the importance of addressing climate change. This narrative review summarizes the links between climate change and cardiovascular health, proposes actionable items clinicians and other healthcare providers can execute both in their personal life and as an advocate of climate policies, and encourages communication of the health impacts of climate change when counseling patients. Our aim is to inspire the reader to invest more time in communicating the most crucial public health issue of the 21st century to their patients.
An investigation is made on the environmental factors that may determine the seasonal cycle of respiratory affections. The driving role of temperature is examined, for its inverse synergism with the dissolution of oxygen in human plasma. Two best-fit equations are discussed to interpolate the experimental data about the oxygen solubility and the saturation levels reached at various temperatures, referring to the value of the basic alveolar temperature. A vulnerable condition is when the airways temperature is lowered, e.g. breathing cold air, or increasing the breathing frequency. In winter, the upper airways reach lower temperatures and greater oxygen concentrations; the opposite occurs in summer. As low temperatures increase the dissolution of oxygen in plasma, and blood oxidation favours viral activity, an explanation is given to the seasonality of infections affecting the respiratory system.
BACKGROUND: A warming climate throughout the 21st century makes ambient high temperature exposure a major threat to population health worldwide. Mitigating the health impact of high temperature requires a timely, comprehensive and reliable assessment of disease burden globally, regionally and temporally. AIM: Based on Global Burden of Disease (GBD) Study 2019, this study aimed to evaluate the disease burden attributable to high temperature from various epidemiology perspectives. METHODS: A three-stage analysis was undertaken to investigate the number and age-standardized rates of death and disability-adjusted life years (DALY) attributable to high temperature from GBD Study 2019. First, we reported the high temperature-related disease burden for the whole world and for different groups by gender, age, region, country and disease. Second, we examined the temporal trend of the disease burden attributable to high temperature from 1990 to 2019. Finally, we explored if and how the high temperature-related disease burden was modified by a number of country-level indicators. RESULTS: Globally, high temperature accounted for 0.54% of death and 0.46% of DALY in 2019, equating to the age-standardized rates of death and DALY (per 100,000 population) of 3.99 (95% uncertainty interval (UI): 2.88, 5.93) and 156.81 (95% UI: 107.98, 261.98), respectively. In 2019, the high temperature-related DALY and death rates were the highest for lower respiratory infections, although they showed a downward trend. In contrast, during 1990-2019, high temperature-related non-communicable diseases burden exhibited an upward trend. Meanwhile, the disease burden attributable to high temperature varied spatially, with the heaviest burden in regions with low sociodemographic index (SDI) and the lightest burden in regions with high SDI. In addition, high temperature-related disease burden appeared to be higher in a country with a higher population density and PM(2.5) concentration background but lower in a country with a higher density of greenness. CONCLUSION: This study for the first time provided a comprehensive understanding of the global disease burden attributable to high temperature, underscoring the policy priority to protect human health worldwide in the context of global warming with particular attention to vulnerable countries or regions as well as susceptible population and diseases.
Many have claimed that climate change is an imminent threat to humanity, but there is no way to verify such claims. This is concerning, especially given the prominence of some of these claims and the fact that they are confused with other well verified and settled aspects of climate science. This paper seeks to build an analytical framework to help explore climate change’s contribution to Global Catastrophic Risk (GCR), including the role of its indirect and systemic impacts. In doing so it evaluates the current state of knowledge about catastrophic climate change and integrates this with a suite of conceptual and evaluative tools that have recently been developed by scholars of GCR and Existential Risk. These tools connect GCR to planetary boundaries, classify its key features, and place it in a global policy context. While the goal of this paper is limited to producing a framework for assessment; we argue that applying this framework can yield new insights into how climate change could cause global catastrophes and how to manage this risk. We illustrate this by using our framework to describe the novel concept of possible’ global systems death spirals,’ involving reinforcing feedback between collapsing sociotechnological and ecological systems.
Homo sapiens is currently living in serious disharmony with the rest of the natural world. For our species to survive, and for our well-being, we must gather knowledge from multiple perspectives and actively engage in studies of planetary health. The enormous diversity of species, one of the most striking aspects of life on our planet, provides a source of solutions that have been developed through evolution by natural selection by animals living in extreme environments. The food system is central to finding solutions; our current global eating patterns have a negative impact on human health, driven climate change and loss of biodiversity. We propose that the use of solutions derived from nature, an approach termed biomimetics, could mitigate the effects of a changing climate on planetary health as well as human health. For example, activation of the transcription factor Nrf2 may play a role in protecting animals living in extreme environments, or animals exposed to heat stress, pollution and pesticides. In order to meet these challenges, we call for the creation of novel interdisciplinary planetary health research teams.
(1) Background: Research on heart rate variability has increased in recent years and the temperature has not been controlled in some studies assessing repeated measurements. This study aimed to analyze how heart rate variability may change based on environmental temperature during measurement depending on parasympathetic and sympathetic activity variations. (2) Methods: A total of 22 volunteers participated in this study divided into an experimental (n = 12) and control group (n = 10). Each participant was assessed randomly under two different environmental conditions for the experimental group (19 °C and 35 °C) and two identical environmental conditions for the control group (19 °C). During the procedure, heart rate variability measurements were carried out for 10 min. (3) Results: Significantly changes were observed for time and frequency domains as well as Poincaré plot variables after heat exposure (p < 0.05). These findings were not observed in the control group, whose conditions between measurements did not change. (4) Conclusions: The reduction of heart rate variability due to exposure to hot conditions appears to be produced mostly by a parasympathetic withdrawal rather than a sympathetic activation. Therefore, if consecutive measurements have to be carried out, these should always be done under the same temperature conditions.
The steady increase in global temperatures, resulting from the combustion of fossil fuels and the accumulation of greenhouse gases (GHG), continues to destabilize all ecosystems worldwide. Although annual emissions must halve by 2030 and reach net-zero by 2050 to limit some of the most catastrophic impacts associated with a warming planet, the world’s efforts to curb GHG emissions fall short of the commitments made in the 2015 Paris Agreement (1). To this effect, July 2021 was recently declared the hottest month ever recorded in 142 years (2). The ramifications of these changes on global temperatures are complex and further promote outdoor air pollution, pollen exposure, and extreme weather events. Besides worsening respiratory health, air pollution, promotes atopy and susceptibility to infections. The GHG effects on pollen affect the frequency and severity of asthma and allergic rhinitis. Changes in temperature, air pollution, and extreme weather events exert adverse multisystemic health effects and disproportionally affect disadvantaged and vulnerable populations. This article is an update for allergists and immunologists about the health impacts of climate change, already evident in our daily practices. It is also a call to action and advocacy, including integrating climate change-related mitigation, education, and adaptation measures to protect our patients and avert further injury to our planet.
We develop a model of population dynamics accounting for the impact of climate change on mortality through five channels (heat, diarrhoeal disease, malaria, dengue, undernutrition). An age-dependent mortality, which depends on global temperature increase, is introduced and calibrated. We consider three climate scenarios (RCP 6.0, RCP 4.5 and RCP 2.6) and find that the five risks induce deaths in the range from 135,000 per annum (in the near term) to 280,000 per annum (at the end of the century) in the RCP 6.0 scenario. We examine the number of life-years lost due to the five selected risks and find figures ranging from 4 to 9 million annually. These numbers are too low to impact the aggregate dynamics but they have interesting evolution patterns. The number of life years lost is constant (RCP 6.0) or decreases over time (RCP 4.5 and RCP 2.6). For the RCP 4.5 and RCP 2.6 scenarios, we find that the number of life-years lost is higher today than in 2100, due to improvements in generic mortality conditions, the bias of those improvements towards the young, and an ageing population. From that perspective, the present generation is found to bear the brunt of the considered climate change impacts.
Exposure to global warming can be dangerous for health and can lead to an increase in the prevalence of neurological diseases worldwide. Such an effect is more evident in populations that are less prepared to cope with enhanced environmental temperatures. In this work, we extend our previous research on the link between climate change and Parkinson’s disease (PD) to also include Alzheimer’s Disease and other Dementias (AD/D) and Amyotrophic Lateral Sclerosis/Motor Neuron Diseases (ALS/MND). One hundred and eighty-four world countries were clustered into four groups according to their climate indices (warming and annual average temperature). Variations between 1990 and 2016 in the diseases’ indices (prevalence, deaths, and disability-adjusted life years) and climate indices for the four clusters were analyzed. Unlike our previous work on PD, we did not find any significant correlation between warming and epidemiological indices for AD/D and ALS/MND patients. A significantly lower increment in prevalence in countries with higher temperatures was found for ALS/MND patients. It can be argued that the discordant findings between AD/D or ALS/MND and PD might be related to the different features of the neuronal types involved and the pathophysiology of thermoregulation. The neurons of AD/D and ALS/MND patients are less vulnerable to heat-related degeneration effects than PD patients. PD patients’ substantia nigra pars compacta (SNpc), which are constitutively frailer due to their morphology and function, fall down under an overwhelming oxidative stress caused by climate warming.
BACKGROUND: Climate change, including global warming, will cause poorer global health and rising numbers of environmental refugees. As neurological disorders account for a major share of morbidity and mortality worldwide, global warming is also destined to alter neurological practice; however, to what extent and by which mechanisms is unknown. We aimed to collect information about the effects of ambient temperatures and human migration on the epidemiology and clinical manifestations of neurological disorders. METHODS: We searched PubMed and Scopus from 01/2000 to 12/2020 for human studies addressing the influence of ambient temperatures and human migration on Alzheimer’s and non-Alzheimer’s dementia, epilepsy, headache/migraine, multiple sclerosis, Parkinson’s disease, stroke, and tick-borne encephalitis (a model disease for neuroinfections). The protocol was pre-registered with PROSPERO (2020 CRD42020147543). RESULTS: Ninety-three studies met inclusion criteria, 84 of which reported on ambient temperatures and nine on migration. Overall, most temperature studies suggested a relationship between increasing temperatures and higher mortality and/or morbidity, whereas results were more ambiguous for migration studies. However, we were unable to identify a single adequately designed study addressing how global warming and human migration will change neurological practice. Still, extracted data indicated multiple ways by which these aspects might alter neurological morbidity and mortality soon. CONCLUSION: Significant heterogeneity exists across studies with respect to methodology, outcome measures, confounders and study design, including lack of data from low-income countries, but the evidence so far suggests that climate change will affect the practice of all major neurological disorders in the near future. Adequately designed studies to address this issue are urgently needed, requiring concerted efforts from the entire neurological community.
Environmental pollution, accounting for both chemical and physical factors, is a major matter of concern due to its health consequences in both humans and animals. The release of greenhouse gases with the consequent increase in environmental temperature is acknowledged to have a major impact on the health of both animals and humans, in current and future generations. A large amount of evidence reports detrimental effects of acute heat stress on testis function, particularly on the spermatogenetic and steroidogenetic process, in both animal and human models, wich is largely related to the testis placement within the scrotal sac and outside the abdomen, warranting an overall scrotal temperature of 2°C-4°C lower than the core body temperature. This review will provide a thorough evaluation of environmental temperature’s effect on testicular function. In particular, basic concepts of body thermoregulation will be discussed together with available data about the association between testis damage and heat stress exposure. In addition, the possible association between global warming and the secular decline of testis function will be critically evaluated in light of the available epidemiological studies.
High ambient temperature-induced heat stress (HS) during pregnancy may affect the placental function and fetal development. Late gestation is a critical period of the developing fetal brain and intestine. The study aimed to investigate the effects of HS during late pregnancy on the function of placenta, fetal brain and intestine in a mouse model. We found that the number of stillborn fetal mice were increased due to maternal HS. Transcriptome analysis revealed that the expression of genes enriched in nutrients transport and metabolism of HS group were up-regulated in the placenta, but down-regulated in the fetal duodenum and jejunum. Interestingly, the concentration of triglyceride (TG) in the HS group was raised in the placenta, but reduced both in the fetal duodenum and jejunum compared with the thermal-neutral (TN) group. Additionally, maternal HS also reduced total cholesterol (TC) contents in the fetal duodenum. The mRNA expression and protein levels of placental fatty acid binding protein 2 and 4 (fabp2 and fabp4) were not affected by maternal HS, but the mRNA expression and protein levels of cluster of differentiation 36 (CD36) and diacylglycerol acyltransferase-2 (Dgat2) were decreased in the fetal intestine. Furthermore, maternal HS reduced the mRNA expression and protein levels of the placental 11beta-hydroxysteroid dehydrogenase type 2 (Hsd11b2) and 5-hydroxytryptamine receptor 1D (Htr1d). The concentrations of corticosterone and the expression of heat shock protein 90 beta family member 1 (hsp90b1), hypoxia up-regulated 1 (hyou1) and corticotropin releasing hormone receptor 1 (crhr1) enriched in response to glucocorticoids in the fetal brain were increased by maternal HS. Taken together, our findings demonstrated that maternal HS disrupted the placental glucocorticoid barrier and serotonin system associated with the raised corticosterone levels in the fetal brain, which might contribute to the decreased capacity of nutrients transport and metabolism in the fetal intestine.
Background Worldwide rising trend in infertility has been observed in the past few years with male infertility arising as a major problem. One main reason for the rise in male infertility cases is declining semen quality. It was found that any factor that affects semen quality can affect male fertility. There are several modifiable factors affecting semen quality including air pollution, use of pesticides and harmful chemicals, exposure to excessive heat, and can lead to decreased male fertility. Main body The present review focuses on some of these environmental factors that affect semen quality and hence, can cause male infertility. The literature from 2000 till June 2021 was searched from various English peer-reviewed journals and WHO fact sheets using the USA National Library of Medicine (PubMed) database, the regional portal of Virtual Health Library, and Scientific Electronic Library Online. The search terms used were: “Air pollution and male fertility”, “Chemicals and male infertility”, “Heat exposure and infertility”, “heavy metals and male fertility”. Conclusion Adverse environmental factors have a significant impact on semen quality, leading to decreased sperm concentration, total sperm count, motility, viability, and increased abnormal sperm morphology, sperm DNA fragmentation, ultimately causing male infertility. However, all these factors are modifiable and reversible, and hence, by mere changing of lifestyle, many of these risk factors can be avoided.
OBJECTIVE: The deterioration in environmental quality has an economic and social cost. The aim of this study is to analyze the impact of environmental factors on health expenditures in developing countries. METHOD: To analyze the relationship between environmental quality (air pollution and temperature) and health expenditure in thirty-three developing countries, the study uses system generalized method of moments (GMM) using data from 2000 to 2017. RESULTS: The results suggest a positive effect of both air pollution and temperature on health expenditure. However, the effect is highest for government health expenditure, followed by private and total health expenditure in the studied countries. The results further suggest that the impact of environmental factors is greater in higher-income countries when we divide the studied countries into two groups, i.e., higher- and lower-income countries. CONCLUSION: Our results are interesting and informative for the policy makers to design such policies to attain better environmental quality and social well-being. The increased healthcare expenditures due to increased air pollution and climate change necessitate for an efficient, reliable, affordable and modern energy policy by emphasizing the use of clean and renewable energy in these countries that ensure better health for the masses. Furthermore, a smart and sustainable environmentally friendly economic growth policy is necessary to ensure better health for the masses.
Insects are highly successful animals. They have limited ability to regulate their temperature and therefore will expand range in response to warming temperatures. Climate change and associated rising global temperature is impacting the range and distribution of stinging insects. There is evidence that many species are expanding range toward the poles, primarily in response to warming. With expanded distribution of stinging insects, increased interaction with humans is anticipated with consequently increased rates of sting-related reactions and need for intervention. This article focuses on evidence that insects are expanding their range in response to warming temperature, increasing likelihood of human interaction.
This study investigated physiological, cognitive and neuromuscular performances in firefighters after a structural live-fire scenario. Changes in vital signs, environmental parameters and cognitive and neuromuscular performance were measured before and after a live-fire training session in a closed environment, in conditions similar to those one could encounter in a structural fire. Very high ambient temperature peaks were reached during the 30-min sessions. After the session, the forehead temperature was increased by 0.5 °C, mean water body loss was 639 ml and the mean heart rate increase was 7.5 bpm. Mental calculation speed did not vary significantly, however we observed a reduction in reaction time. These findings demonstrated that after 30 min of exposure, heat stress had little impact on firemen. Stress activation seems beneficial after firefighting operations. Normal vital parameters should allow re-engagement for a second firefighting task. This result must be compared with longer exposures.
As current action remains insufficient to meet the goals of the Paris agreement let alone to stabilize the climate, there is increasing hope that solutions related to demand, services and social aspects of climate change mitigation can close the gap. However, given these topics are not investigated by a single epistemic community, the literature base underpinning the associated research continues to be undefined. Here, we aim to delineate a plausible body of literature capturing a comprehensive spectrum of demand, services and social aspects of climate change mitigation. As method we use a novel double-stacked expert-machine learning research architecture and expert evaluation to develop a typology and map key messages relevant for climate change mitigation within this body of literature. First, relying on the official key words provided to the Intergovernmental Panel on Climate Change by governments (across 17 queries), and on specific investigations of domain experts (27 queries), we identify 121 165 non-unique and 99 065 unique academic publications covering issues relevant for demand-side mitigation. Second, we identify a literature typology with four key clusters: policy, housing, mobility, and food/consumption. Third, we systematically extract key content-based insights finding that the housing literature emphasizes social and collective action, whereas the food/consumption literatures highlight behavioral change, but insights also demonstrate the dynamic relationship between behavioral change and social norms. All clusters point to the possibility of improved public health as a result of demand-side solutions. The centrality of the policy cluster suggests that political actions are what bring the different specific approaches together. Fourth, by mapping the underlying epistemic communities we find that researchers are already highly interconnected, glued together by common interests in sustainability and energy demand. We conclude by outlining avenues for interdisciplinary collaboration, synthetic analysis, community building, and by suggesting next steps for evaluating this body of literature.
Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.
PURPOSE OF REVIEW: Climate change has manifested itself in multiple environmental hazards to human health. Older adults and those living with cardiovascular diseases are particularly susceptible to poor outcomes due to unique social, economic, and physiologic vulnerabilities. This review aims to summarize those vulnerabilities and the resultant impacts of climate-mediated disasters on the heart health of the aging population. RECENT FINDINGS: Analyses incorporating a wide variety of environmental data sources have identified increases in cardiovascular risk factors, hospitalizations, and mortality from intensified air pollution, wildfires, heat waves, extreme weather events, rising sea levels, and pandemic disease. Older adults, especially those of low socioeconomic status or belonging to ethnic minority groups, bear a disproportionate health burden from these hazards. The worldwide trends responsible for global warming continue to worsen climate change-mediated natural disasters. As such, additional investigation will be necessary to develop personal and policy-level interventions to protect the cardiovascular wellbeing of our aging population.
In this paper, we present a narrative review of primary research on the health impacts of extreme weather events in urban informal settlements published between 1990 and June 2021. We include 54 studies and examine the health impacts of extreme weather events and how these were determined. We find that these events impact health directly by causing mortality, injury and disease and through indirect pathways by impacting livelihoods, access to healthcare, coping strategies and adaptive capacity. Drawing on the social determinants of health framework to frame our analysis, we find that health impacts are determined by multiple intersecting factors, relating to individual circumstances, material conditions, health status, and political and socio-economic context. Consequently, vulnerability varies between and within informal settlements. Overall, we show that responding to and minimising these health impacts requires an intersectional approach to understand and address these contextual root causes of vulnerability.
As climate change increases the frequency and intensity of extreme weather events, governments and civil society organizations are making large investments in early warning systems (EWS) with the aim to avoid death and destruction from hydro-meteorological events. Early warning systems have four components: (1) risk knowledge, (2) monitoring and warning, (3) warning dissemi-nation and communication, and (4) response capability. While there is room to improve all four of these components, we argue that the largest gaps in early warning systems fall in the latter two categories: warning dissemination/communication and response capability. We illustrate this by examining the four components of early warning systems for the deadliest and costliest meteo-rological disasters of this century, demonstrating that the lack of EWS protection is not a lack of forecasts or warnings, but rather a lack of adequate communication and lack of response capa-bility. Improving the accuracy of weather forecasts is unlikely to offer major benefits without resolving these gaps in communication and response capability. To protect vulnerable groups around the world, we provide recommendations for investments that would close such gaps, such as improved communication channels, impact forecasts, early action policies and infrastructure. It is our hope that further investment to close these gaps can better deliver on the goal of reducing deaths and damages with EWS.
BACKGROUND: Previous studies have shown that extreme heat likely increases the risk of road injuries. However, the global burden of road injuries due to high temperature and contributing factors remain unclear. This study aims to characterize the global, regional and national burden of road injuries due to high temperature from 1990 to 2019. METHODS: Based on the Global Burden of Disease (GBD) study 2019, we obtained the numbers and age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (DALY) rates (ASDR) of the road injury due to high temperature at global, regional, and national levels from 1990 to 2019. The world is divided into five climate zones according to the average annual temperature of each country: tropical, subtropical, warm temperate, cold temperate, and boreal. We used the generalized additive models (GAM) to model the trends of road injuries globally and by region. RESULTS: Globally, between 1990 and 2019, the deaths of road injury attributable to high temperature increased significantly from 20,270 (95% uncertainty interval [UI], 7836 to 42,716) to 28,396 (95% UI, 13,311 to 51,178), and the DALYs increased from 1,169,309 (95% UI, 450,834 to 2,491,075) to 1,414,527 (95% UI, 658,347 to 2,543,613). But the ASMR and the ASDR slightly decreased by 8.49% and 13.16%, respectively. The burden of road injury death attributable to high temperature remained high in low SDI and tropical regions. In addition, road transport infrastructure investment per inhabitant is associated with the burden of road injuries attributable to high temperature. CONCLUSIONS: Globally, the ASMR and ASDR for road injuries attributable to high temperature decreased from 1990 to 2019, but the absolute death and DALYs continued to increase. Thus, concerning global warming, implementation of prevention and interventions to reduce road injuries from heat exposure should be stressed globally.
Compound hot extremes (ChotEs) that refer to continuous heats throughout days and nights are projected to increase, causing more serious impacts on human health than daytime or nighttime heats alone. Previous studies have focused on daytime heats, but the timing of substantial increase in ChotEs relative to natural variability, which is defined as the time of emergence (ToE) for ChotEs, remains unknown. Here we examine ToE for duration of summertime ChotEs from coupled model intercomparison project phase 6 climate model projections under two shared socioeconomic pathway scenarios (i.e., SSP245 and SSP585). We further quantify the cumulative fraction of areal and population exposed to the emergence at global and continental scales. We find that, without implementation of climate mitigation policies (i.e., SSP585), global mean ToE is around 2062 (with 16%-84% uncertainty range of 2048-2072). On the basis of the ToE for each grid cell, 80.7% (with uncertainty range of 64.2%-96.7%) of global lands will expose to the emergence by 2080. Such substantial increases in ChotEs will lead to 75.2% (66.8%-93%) of global population exposed to the emergence by the end of 21st century. A moderate mitigation (i.e., SSP245) can delay the ToE by over 14 years and, more importantly, reduce the global land areal and population exposures by 50.3% and 39.7% respectively. Regionally, northern Europe, central America and western North America benefit the most. Therefore, early action towards moderate development socioeconomic pathways can remarkably cut back the possibility of large population exposure to ChotEs and relevant impacts.
It is generally believed that global warming drives an increase in heatwaves, but these changes vary regionally. Projected trends of heatwaves and comparisons between observed and projected heatwave trends are poorly understood. We selected multiple characteristics of global heatwave events, including indicators on heat-related health impacts under historical and future scenarios from the NASA Earth Exchange/Global Daily Downscaled Projections (NEX-GDDP) dataset. We quantified the trends in the frequency, intensity, duration and peak temperature of heatwave events and identified heatwave hotspots that respond dramatically to radiative forcing. Future simulations suggest a four-fold increase in the duration of heatwaves by 2050s, spatially concentrated in central Africa, northern South America and Southeast Asia, and the maximum duration of single heatwave event will be up to 44 days under a high emission scenario. Accelerated increasing trends are also detected in intensity, total duration and temperature of heatwaves with up to 2-fold, 8-fold and 9-fold larger than the trends of the baseline period under the high emission scenario. Considering socioeconomic exposure to extreme heatwaves, we identified some hotspot areas in western Europe, eastern North America and northern China that will face greater potential risks in the coming future and therefore need to urgently strengthen their adaptation capacity.
Global climate change is leading to higher ambient temperatures and more frequent heatwaves. To date, impacts of ambient extreme heat on childhood morbidity have been understudied, although-given children’s physiologic susceptibility, with smaller body surface-to-mass ratios, and many years of increasing temperatures ahead-there is an urgent need for better information to inform public health policies and clinical approaches. In this review, we aim to (1) identify pediatric morbidity outcomes previously associated with extreme heat, (2) to identify predisposing co-morbidities which may make children more susceptible to heat-related outcomes, and (3) to map the current body of available literature. A scoping review of the current full-text literature was conducted using the Arksey and O’Malley framework Int J Soc Res Methodol 8:19-32, (2015). Search terms for (1) pediatric population, (2) heat exposures, (3) ambient conditions, and (4) adverse outcomes were combined into a comprehensive PubMed and Medline literature search. Of the 1753 publications identified, a total of 20 relevant studies were ultimately selected based on selection criteria of relevance to US urban populations. Most identified studies supported positive associations between high extreme temperature exposures and heat-related illness, dehydration/electrolyte imbalance, general symptoms, diarrhea and digestion disorders, infectious diseases/infections, asthma/wheeze, and injury. Most studies found no association with renal disease, cardiovascular diseases, or diabetes mellitus. Results were mixed for other respiratory diseases and mental health/psychological disorders. Very few of the identified studies examined susceptibility to pre-existing conditions; Cystic Fibrosis was the only co-morbidity for which we found significant evidence. Further research is needed to understand the nuances of associations between extreme heat and specific outcomes-particularly how associations may vary by child age, sex, race/ ethnicity, community characteristics, and other pre-existing conditions.
Climate change is upon us, and it will have a major effect on both kidney disease and the nephrology practice. But the converse is also true: our treatment of kidney disease has an effect on the climate. Much attention has focused on how rising temperatures can lead to acute and CKD and health exacerbations in patients with established kidney disease. Climate change is also associated with rising air pollution from wildfires and industrial wastes and infectious diseases associated with flooding and changing habitats, all of which heighten the risk of acute and CKD. Less well recognized or understood are the ways nephrology practices, in turn, contribute to still more climate change. Hemodialysis, although lifesaving, can be associated with marked water usage (up to 600 L per dialysis session), energy usage (with one 4-hour session averaging as much as one fifth of the total energy consumed by a household per day), and large clinical wastes (with hemodialysis accounting for one third of total clinical medicine-associated waste). Of note, >90% of dialysis occurs in highly affluent countries, whereas dialysis is much less available in the poorer countries where climate change is having the highest effect on kidney disease. We conclude that not only do nephrologists need to prepare for the rise in climate-associated kidney disease, they must also urgently develop more climate-friendly methods of managing patients with kidney disease.
Extreme humid heat events have seen rapid increases globally in recent decades, but regional changes and higher-order temporal characteristics, such as interannual and intra-annual clustering, have not been widely explored. Using ERA5 reanalysis data from 1979 to 2019, we find increasing trends of varying magnitudes in extreme wet-bulb temperatures at the Intergovernmental Panel on Climate Change Sixth Assessment Report (IPCC AR6) regional scale. In many locations, interannual variations in extremes show a strong relationship with the El Nino-Southern Oscillation. The temporal proximity of precipitation events to humid heat days in arid regions suggests that local moisture effects may lead to clustering. Knowledge of these spatial and temporal patterns aids in understanding how potential heat stress is increasing, as well as facilitates the development of regionally specific adaptation and mitigation strategies for combating the associated societal impacts. Plain Language Summary Extreme humid heat, or the combination of high temperature and humidity, poses a more severe threat to human health than does dry heat alone. Though extremes are particularly dangerous, even moderate levels of humid heat can lead to a variety of health and socioeconomic effects. Motivated by the growing demand for regional, decision-relevant climate information, we calculate historical changes in the intensity of humid heat extremes in the regions used in the Intergovernmental Panel on Climate Change Sixth Assessment Report. Humid heat extremes have intensified in most regions, though some areas have experienced greater increases than others. The timing of extremes also affects their impacts, and thus we additionally analyze how humid heat extremes are distributed, both within the year and across all years. In many locations across the world, extreme humid heat is more common during strong El Nino episodes. In some typically dry regions, extremes tend to occur near each other within a given year and around the same time as rainfall events. Our results help advance the understanding of potential heat stress and the development of regionally specific strategies for combating its impacts.
Natural and human-made disasters can cause tremendous physical damage, societal change, and suffering. In addition to their effects on people, disasters have been shown to alter the microbial population in the area affected. Alterations for microbial populations can lead to new ecological interactions, with additional potentially adverse consequences for many species, including humans. Disaster-related stressors can be powerful forces for microbial selection. Studying microbial adaptation in disaster sites can reveal new biological processes, including mechanisms by which some microbes could become pathogenic and others could become beneficial (e.g., used for bioremediation). Here we survey examples of how disasters have affected microbiology and suggest that the topic of “disaster microbiology” is itself a new field of study. Given the accelerating pace of human-caused climate change and the increasing encroachment of the natural word by human activities, it is likely that this area of research will become increasingly relevant to the broader field of microbiology. Since disaster microbiology is a broad term open to interpretation, we propose criteria for what phenomena fall under its scope. The basic premise is that there must be a disaster that causes a change in the environment, which then causes an alteration to microbes (either a physical or biological adaptation), and that this adaptation must have additional ramifications.
Drowning and climate change are both significant global health threats, yet little research links climate change to drowning risk. Research into the epidemiology, risk factors and preventive strategies for unintentional drowning in high-income and in low-income and middle-income countries has expanded understanding, but understanding of disaster and extreme weather-related drowning needs research focus. As nation states and researchers call for action on climate change, its impact on drowning has been largely ignored. This state-of-the-art review considers existing literature on climate change as a contributor to changes in drowning risks globally. Using selected climate change-related risks identified by the World Meteorological Organization and key risks to the Sustainable Development Goals as a framework, we consider the drowning risks associated with heat waves, hydrometeorological hazards, drought and water scarcity, damaged infrastructure, marine ecosystem collapse, displacement, and rising poverty and inequality. Although the degree of atmospheric warming remains uncertain, the impact of climate change on drowning risk is already taking place and can no longer be ignored. Greater evidence characterising the links between drowning and climate change across both high-income and low-income and middle-income contexts is required, and the implementation and evaluation of drowning interventions must reflect climate change risks at a local level, accounting for both geographical variation and the consequences of inequality. Furthermore, collaboration between the injury prevention, disaster risk reduction and climate change mitigation sectors is crucial to both prevent climate change from stalling progress on preventing drowning and further advocate for climate change mitigation as a drowning risk reduction mechanism.
This scoping review provides an overview of the published literature, identifies research gaps, and summarises the current evidence of the association between elevated ambient temperature exposure during pregnancy and adverse maternal, foetal, and neonatal outcomes. Following the PRISMA extension for scoping reviews reporting guidelines, a systematic search was conducted on CINAHL, PubMed, and Embase and included original articles published in the English language from 2015 to 2020 with no geographical limitations. A total of seventy-five studies were included, conducted across twenty-four countries, with a majority in the USA (n = 23) and China (n = 13). Study designs, temperature metrics, and exposure windows varied considerably across studies. Of the eighteen heat-associated adverse maternal, foetal, and neonatal outcomes identified, pre-term birth was the most common outcome (n = 30), followed by low birth weight (n = 11), stillbirth (n = 9), and gestational diabetes mellitus (n = 8). Overall, papers reported an increased risk with elevated temperature exposures. Less attention has been paid to relationships between heat and the diverse range of other adverse outcomes such as congenital anomalies and neonatal mortality. Further research on these less-reported outcomes is needed to improve understanding and the effect size of these relationships with elevated temperatures, which we know will be exacerbated by climate change.
Many actions to reduce greenhouse gases (GHGs) in cities have benefits for environmental quality, public health, and equity. These local and immediate “co-benefits” can include cleaner air, expanded green space, improved physical activity, and reduced noise. However, progress incorporating co-benefits assessments into climate mitigation planning has been limited. Here, we capitalized on the new availability of climate action plans (CAPs) from dozens of C40 cities to explore the stated role of environmental quality, health, and equity in urban GHG mitigation planning. Specifically, we qualitatively reviewed how four topics-equity, exposure to environmental risk factors, health effects of climate change, and health co-benefits of GHG mitigation-were addressed in CAPs from 27 C40 member cities. The cities span Africa, Asia, Australia, Europe, North America, and South America. We found that more references pertained to exposures (57% of all identified references across the four topics) than to equity (21%), health co-benefits of GHG mitigation (15%), or health effects of climate change (7%). On average across all cities, five exposure categories represented the majority of exposure references: green space (23% of total coded exposure references), disasters (20%), physical activity (24%), heat (16%), and air quality (12%). Approximately two-thirds of health effects and health co-benefits references noted a link with health generally, without specificity to disease or other health outcome. Our results indicate that while environmental quality is commonly considered in CAPs, health effects of climate change and health co-benefits of GHG mitigation are mentioned less frequently. Future work should further develop methods to qualitatively and quantitatively assess health consequences of action and inaction to reduce GHG emissions, using approaches that are appropriate for and accessible to multiple levels of governments.
As global temperatures continue to rise, extreme heat events are becoming more frequent and intense. Extreme heat affects cardiovascular health as it is associated with a greater risk of adverse cardiovascular events, especially for adults with preexisting cardiovascular diseases. Nonetheless, the pathophysiology underlying the association between extreme heat and cardiovascular risk remains understudied. Furthermore, specific recommendations to mitigate the effects of extreme heat on cardiovascular health remain limited to guide clinical practice within the context of a warming climate. The overall objective of this review article is to raise awareness that extreme heat poses a risk for cardiovascular health. Specifically, the review discusses why cardiovascular healthcare professionals should care about extreme heat, how extreme heat affects cardiovascular health, and recommendations to minimise the cardiovascular consequences of extreme heat. Future research directions are also provided to further our understating of the cardiovascular health consequences of extreme heat. A better awareness and understanding of the cardiovascular consequences of extreme heat will help cardiovascular health professionals assess the risk and optimise the care of their patients exposed to an increasingly warm climate.
BACKGROUND: Extreme heat caused by climate change is a major public health concern, disproportionately affecting poor and racialized communities. Gestational heat exposure is a well-established teratogen in animal studies, with a growing body of literature suggesting human pregnancies are similarly at risk. Characterization of extreme heat as a pregnancy risk is problematic due to nonstandard definitions of heat waves, and variable study designs. To better focus future research in this area, we conducted a scoping review to assess the effects of extreme heat on pregnancy outcomes. METHODS: A scoping review of epidemiological studies investigating gestational heat-exposure and published 2010 and 2020, was conducted with an emphasis on study design, gestational windows of sensitivity, adverse pregnancy outcomes and characterization of environmental temperatures. RESULTS: A sample of 84 studies was identified, predominantly set in high-income countries. Preterm birth, birthweight, congenital anomalies and stillbirth were the most common pregnancy outcome variables. Studies reported race/ethnicity and/or socioeconomic variables, however these were not always emphasized in the analysis. CONCLUSION: Use of precise temperature data by most studies avoided pitfalls of imprecise, regional definitions of heat waves, however inconsistent study design, and exposure windows are a significant challenge to systematic evaluation of this literature. Despite the high risk of extreme heat events and limited mitigation strategies in the global south, there is a significant gap in the epidemiological literature from these regions. Greater consistency in study design and exposure windows would enhance the rigor of this field.
PURPOSE OF REVIEW: With cardiovascular disease (CVD) being the top cause of deaths worldwide, it is important to ensure healthy cardiovascular aging through enhanced understanding and prevention of adverse health effects exerted by external factors. This review aims to provide an updated understanding of environmental influences on cardiovascular aging, by summarizing epidemiological and mechanistic evidence for the cardiovascular health impact of major environmental stressors, including air pollution, endocrine-disrupting chemicals (EDCs), metals, and climate change. RECENT FINDINGS: Recent studies generally support positive associations of exposure to multiple chemical environmental stressors (air pollution, EDCs, toxic metals) and extreme temperatures with increased risks of cardiovascular mortality and morbidity in the population. Environmental stressors have also been associated with a number of cardiovascular aging-related subclinical changes including biomarkers in the population, which are supported by evidence from relevant experimental studies. The elderly and patients are the most vulnerable demographic groups to majority environmental stressors. Future studies should account for the totality of individuals’ exposome in addition to single chemical pollutants or environmental factors. Specific factors most responsible for the observed health effects related to cardiovascular aging remain to be elucidated.
BACKGROUND: Heat exposure is an important but underappreciated risk factor contributing to cardiovascular disease. Warming temperatures might therefore pose substantial challenges to population health, especially in a rapidly aging population. To address a potential increase in the burden of cardiovascular disease, a better understanding of the effects of ambient heat on different types of cardiovascular disease and factors contributing to vulnerability is required, especially in the context of climate change. This study reviews the current epidemiological evidence linking heat exposures (both high temperatures and heatwaves) with cardiovascular disease outcomes, including mortality and morbidity. METHODS: In this systematic review and meta-analysis, we searched PubMed, Embase, and Scopus for literature published between Jan 1, 1990, and March 10, 2022, and evaluated the quality of the evidence following the Navigation Guide Criteria. We included original research on independent study populations in which the exposure metric was high temperatures or heatwaves, and observational studies using ecological time series, case crossover, or case series study designs comparing risks over different exposures or time periods. Reviews, commentaries, grey literature, and studies that examined only seasonal effects without explicitly considering temperature were excluded. The risk estimates were derived from included articles and if insufficient data were available we contacted the authors to provide clarification. We did a random-effects meta-analysis to pool the relative risk (RR) of the association between high temperatures and heatwaves and cardiovascular disease outcomes. The study protocol was registered with PROSPERO (CRD42021232601). FINDINGS: In total, 7360 results were returned from our search of which we included 282 articles in the systematic review, and of which 266 were eligible for the meta-analysis. There was substantial heterogeneity for both mortality (high temperatures: I(2)=93·6%, p<0·0001; heatwaves: I(2)=98·9%, p<0·0001) and morbidity (high temperatures: I(2)=98·8%, p<0·0001; heatwaves: I(2)=83·5%, p<0·0001). Despite the heterogeneity in environmental conditions and population dynamics among the reviewed studies, results showed that a 1°C increase in temperature was positively associated with cardiovascular disease-related mortality across all considered diagnoses. The overall risk of cardiovascular disease-related mortality increased by 2·1% (RR 1·021 [95%CI 1·020-1·023]), with the highest specific disease risk being for stroke and coronary heart disease. A 1°C temperature rise was also associated with a significant increase in morbidity due to arrhythmias and cardiac arrest and coronary heart disease. Our findings suggest heat exposure leads to elevated risk of morbidity and mortality for women, people 65 years and older, individuals living in tropical climates, and those in countries of lower-middle income. Heatwaves were also significantly associated with a 17% increase in risk of mortality (RR 1·117 [95% CI 1·093-1·141]), and increasing heatwave intensity with an increasing risk (RR 1·067 [95% CI 1·056-1·078] for low intensity, 1·088 [1·058-1·119] for middle intensity, and 1·189 [1·109-1·269] for high intensity settings). INTERPRETATION: This review strengthens the evidence on the increase in cardiovascular disease risk due to ambient heat exposures in different climate zones. The widespread prevalence of exposure to hot temperatures, in conjunction with an increase in the proportion of older people in the population, might result in a rise in poor cardiovascular disease health outcomes associated with a warming climate. Evidence-based prevention measures are needed to attenuate peaks in cardiovascular events during hot spells, thereby lowering the worldwide total heat-related burden of cardiovascular disease-related morbidity and death. FUNDING: Australian Research Council Discovery Program.
Links between heat exposure and congenital anomalies have not been explored in detail despite animal data and other strands of evidence that indicate such links are likely. We reviewed articles on heat and congenital anomalies from PubMed and Web of Science, screening 14,880 titles and abstracts in duplicate for articles on environmental heat exposure during pregnancy and congenital anomalies. Thirteen studies were included. Most studies were in North America (8) or the Middle East (3). Methodological diversity was considerable, including in temperature measurement, gestational windows of exposure, and range of defects studied. Associations were detected between heat exposure and congenital cardiac anomalies in three of six studies, with point estimates highest for atrial septal defects. Two studies with null findings used self-reported temperature exposures. Hypospadias, congenital cataracts, renal agenesis/hypoplasia, spina bifida, and craniofacial defects were also linked with heat exposure. Effects generally increased with duration and intensity of heat exposure. However, some neural tube defects, gastroschisis, anopthalmia/microphthalmia and congenital hypothyroidism were less frequent at higher temperatures. While findings are heterogenous, the evidence raises important concerns about heat exposure and birth defects. Some heterogeneity may be explained by biases in reproductive epidemiology. Pooled analyses of heat impacts using registers of congenital anomalies are a high priority.
Although extreme weather events have played a constant role in human history, heatwaves (HWs) have become more frequent and intense in the past decades, causing concern especially in light of the increasing evidence on climate change. Despite the increasing number of reviews suggesting a relationship between heat and health, these reviews focus primarily on mortality, neglecting other important aspects. This systematic review of reviews gathered the available evidence from research syntheses conducted on HWs and health. Following the PRISMA guidelines, 2232 records were retrieved, and 283 reviews were ultimately included. Information was extracted from the papers and categorized by topics. Quantitative data were extracted from meta-analyses and, when not available, evidence was collected from systematic reviews. Overall, 187 reviews were non-systematic, while 96 were systematic, of which 27 performed a meta-analysis. The majority evaluated mortality, morbidity, or vulnerability, while the other topics were scarcely addressed. The following main knowledge gaps were identified: lack of a universally accepted definition of HW; scarce evidence on the HW-mental health relationship; no meta-analyses assessing the risk perception of HWs; scarcity of studies evaluating the efficacy of adaptation strategies and interventions. Future efforts should meet these priorities to provide high-quality evidence to stakeholders.
INTRODUCTION: From the perspective of public health, the climate crisis is also causing many health problems worldwide. In contrast with the cardiovascular, respiratory, and urinary system, the adverse effects of heatwaves on the endocrine system, particularly in people with diabetes mellitus (DM), are not well established to date. In this study, the author investigated the morbidity and mortality changes of DM patients during heatwave periods, using the meta-analysis method. METHODS: The author searched MEDLINE, EMBASE, and the Cochrane Library until March 12, 2020. The quality of each included study was assessed using the National Institutes of Health (NIH) Quality Assessment tools. The meta-analysis was conducted using the studies with a relative risk (RR) estimate and odds ratio (OR) estimate. The subgroup analysis and the meta-ANOVA analysis were conducted using various covariates, including lag days considered. RESULTS: Only 36 articles were included in the meta-analysis. The pooled RR of mortality and of morbidity for diabetics under the heatwave were 1.18 (95% CI 1.13-1.25) and 1.10 (95% CI 1.06-1.14). For mortality studies, whether or not the lag days considered were 10 days or more was only a significant covariate for the meta-ANOVA analysis (Q = 3.17, p = 0.075). For morbidity studies, the definition of the heatwave (Q = 65.94, p < 0.0001), whether or not the maximum temperature was 40 °C or more (Q = 4.78, p = 0.0288), and the type of morbidity (Q = 60.23, p < 0.0001) were significant covariates for the analysis. DISCUSSION: The mortality and morbidity risks of diabetes patients under the heatwave were mildly increased by about 18 percent for mortality and 10 percent for overall morbidity. The mortality risk of diabetics can increase more when lag days of 10 days or more are considered than when lag days of less than 10 days are considered. These valuable findings can be used in developing public health strategies to cope with heatwaves in the current era of aggravating global warming and climate crisis.
Background Heatstroke is associated with exposure to high ambient temperature (AT) and relative humidity (RH), and an increased risk of organ damage or death. Previously proposed animal models of heatstroke disregard the impact of RH. Therefore, we aimed to establish and validate an animal model of heatstroke considering RH. To validate our model, we also examined the effect of hydration and investigated gene expression of cotransporter proteins in the intestinal membranes after heat exposure. Methods Mildly dehydrated adult male C57/BL6J mice were subjected to three AT conditions (37 degrees C, 41 degrees C, or 43 degrees C) at RH > 99% and monitored with WetBulb globe temperature (WBGT) for 1 h. The survival rate, body weight, core body temperature, blood parameters, and histologically confirmed tissue damage were evaluated to establish a mouse heatstroke model. Then, the mice received no treatment, water, or oral rehydration solution (ORS) before and after heat exposure; subsequent organ damage was compared using our model. Thereafter, we investigated cotransporter protein gene expressions in the intestinal membranes of mice that received no treatment, water, or ORS. Results The survival rates of mice exposed to ATs of 37 degrees C, 41 degrees C, and 43 degrees C were 100%, 83.3%, and 0%, respectively. From this result, we excluded AT43. Mice in the AT 41 degrees C group appeared to be more dehydrated than those in the AT 37 degrees C group. WBGT in the AT 41 degrees C group was > 44 degrees C; core body temperature in this group reached 41.3 +/- 0.08 degrees C during heat exposure and decreased to 34.0 +/- 0.18 degrees C, returning to baseline after 8 h which showed a biphasic thermal dysregulation response. The AT 41 degrees C group presented with greater hepatic, renal, and musculoskeletal damage than did the other groups. The impact of ORS on recovery was greater than that of water or no treatment. The administration of ORS with heat exposure increased cotransporter gene expression in the intestines and reduced heatstroke-related damage. Conclusions We developed a novel mouse heatstroke model that considered AT and RH. We found that ORS administration improved inadequate circulation and reduced tissue injury by increasing cotransporter gene expression in the intestines.
Critical environmental limits are those combinations of ambient temperature and humidity above which heat balance cannot be maintained for a given metabolic heat production, limiting exposure time, and placing individuals at increased risk of heat-related illness. The aim of this study was to establish those limits in young (18-34 yr) healthy adults during low-intensity activity approximating the metabolic demand of activities of daily living. Twenty-five (12 men/13 women) subjects were exposed to progressive heat stress in an environmental chamber at two rates of metabolic heat production chosen to represent minimal activity (MinAct) or light ambulation (LightAmb). Progressive heat stress was performed with either 1) constant dry-bulb temperature (T(db)) and increasing ambient water vapor pressure (P(a)) (P(crit) trials; 36°C, 38°C, or 40°C) or 2) constant P(a) and increasing T(db) (T(crit) trials; 12, 16, or 20 mmHg). Each subject was tested during MinAct and LightAmb in two to three experimental conditions in random order, for a total of four to six trials per participant. Higher metabolic heat production (P < 0.001) during LightAmb compared with MinAct trials resulted in significantly lower critical environmental limits across all P(crit) and T(crit) conditions (all P < 0.001). These data, presented graphically herein on a psychrometric chart, are the first to define critical environmental limits for young adults during activity resembling those of light household tasks or other activities of daily living and can be used to develop guidelines, policy decisions, and evidence-based alert communications to minimize the deleterious impacts of extreme heat events.NEW & NOTEWORTHY Critical environmental limits are those combinations of temperature and humidity above which heat balance cannot be maintained, placing individuals at increased risk of heat-related illness. Those limits have been investigated in young adults during exercise at 30% V_(O2max), but not during metabolic rates that approximate those of light activities of daily living. Herein, we establish critical environmental limits for young adults at two metabolic rates that reflect activities of daily living and leisurely walking.
Thermal stress has a direct effect on various types of DNA damage, which depends on the stage of the cell cycle when the cell is exposed to different climate conditions. A literature review was conducted to systematically investigate and assess the overall effect of heat stress and DNA damage following heat exposure. In this study, electronic databases including PubMed, Scopus, and Web of Science were searched to find relevant literature on DNA damage in different ambient temperatures. Outcomes included (1) measurement of DNA damage in heat exposure, (2) three different quantification methods (comet assay, 8-hydroxy-2-deoxyguanosine (8-OHdG), and γ-H2AX), and (3) protocols used for moderate (31) and high temperatures (42). The evidence shows that long exposure and very high temperature can induce an increase in DNA damage through aggregate in natural proteins, ROS generation, cell death, and reproductive damage in hot-humid and hot-dry climate conditions. A substantial increase in DNA damage occurs following acute heat stress exposure, especially in tropical and subtropical climate conditions. The results of this systematic literature review showed a positive association between thermal stress exposure and inhibition of repair of DNA damage.
Hyperthermia is defined as a body temperature greater than 40 degrees C. Several conditions can cause hyperthermia. In sepsis, the immunologic reaction to the infection most often manifests as a fever. Some toxic ingestions and withdrawal states can cause elevated body temperature. Certain medications can cause a hyperthermic response, such as in neuroleptic malignant syndrome. The most common disease that can be treated by cooling alone is heat-related illness and heat stroke. Heat-related illness is a spectrum of disease that occurs when the body’s thermoregulatory system does not work properly. Heat exhaustion is characterized by elevated core body temperature associated with orthostatic hypotension, tachycardia, diaphoresis, and tachypnea. Heat stroke is defined as elevated core body temperature plus central nervous system involvement (delirium, decreased the level of consciousness, or ataxia). Heat-related illness most often affects athletes (exertional hyperthermia), but can also occur during the warm weather months or in locations with extreme temperatures. Patients with impaired thermoregulation (those at extremes of age, the obese or mentally ill) are at higher risk. The definitive treatment for heat-related illness is total body cooling. Conduction and evaporation are the two modes of cooling employed in the treatment of heat-related illness. Studies have shown ice water immersion to be the most effective and most rapid. However, there are obvious barriers to performing this in an emergency department. Marathons and other athletic events that have frequent heat-related illness sometimes have this capability. Evaporation (mist and fan) is the second most rapid way to cool a patient. Ice packs to the groin, axilla, neck, and areas near other great vessels have been shown to be less effective. Cooled intravenous fluids have been studied, but there is no clear consensus regarding their benefit (preservation of neurologic function) versus potential harm (induced shivering), but they may be considered. This article will discuss the procedure for performing evaporative cooling with other adjuncts in the field. The priority in heat-related illness is early recognition and intervention. Military and sports literature has identified 40 degrees C as the target, and the faster the target is achieved, the lower the patient mortality.
BACKGROUND: Although effects on labour is one of the most tangible and attributable climate impact, our quantification of these effects is insufficient and based on weak methodologies. Partly, this gap is due to the inability to resolve different impact channels, such as changes in time allocation (labour supply) and slowdown of work (labour productivity). Explicitly resolving those in a multi-model inter-comparison framework can help to improve estimates of the effects of climate change on labour effectiveness. METHODS: In this empirical, multi-model study, we used a large collection of micro-survey data aggregated to subnational regions across the world to estimate new, robust global and regional temperature and wet-bulb globe temperature exposure-response functions (ERFs) for labour supply. We then assessed the uncertainty in existing labour productivity response functions and derived an augmented mean function. Finally, we combined these two dimensions of labour into a single compound metric (effective labour effects). This combined measure allowed us to estimate the effect of future climate change on both the number of hours worked and on the productivity of workers during their working hours under 1·5°C, 2·0°C, and 3·0°C of global warming. We separately analysed low-exposure (indoors or outdoors in the shade) and high-exposure (outdoor in the sun) sectors. FINDINGS: We found differentiated empirical regional and sectoral ERF’s for labour supply. Current climate conditions already negatively affect labour effectiveness, particularly in tropical countries. Future climate change will reduce global total labour in the low-exposure sectors by 18 percentage points (range -48·8 to 5·3) under a scenario of 3·0°C warming (24·8 percentage points in the high-exposure sectors). The reductions will be 25·9 percentage points (-48·8 to 2·7) in Africa, 18·6 percentage points (-33·6 to 5·3) in Asia, and 10·4 percentage points (-35·0 to 2·6) in the Americas in the low-exposure sectors. These regional effects are projected to be substantially higher for labour outdoors in full sunlight compared with indoors (or outdoors in the shade) with the average reductions in total labour projected to be 32·8 percentage points (-66·3 to 1·6) in Africa, 25·0 percentage points (-66·3 to 7·0) in Asia, and 16·7 percentage points (-45·5 to 4·4) in the Americas. INTERPRETATION: Both labour supply and productivity are projected to decrease under future climate change in most parts of the world, and particularly in tropical regions. Parts of sub-Saharan Africa, south Asia, and southeast Asia are at highest risk under future warming scenarios. The heterogeneous regional response functions suggest that it is necessary to move away from one-size-fits-all response functions to investigate the climate effect on labour. Our findings imply income and distributional consequences in terms of increased inequality and poverty, especially in low-income countries, where the labour effects are projected to be high. FUNDING: COST (European Cooperation in Science and Technology).
Enhanced intestinal permeability is a pervasive issue in modern medicine, with implications demonstrably associated with significant health consequences such as sepsis, multiorgan failure, and death. Key issues involve the trigger mechanisms that could compromise intestinal integrity and increase local permeability allowing the passage of larger, potentially dangerous molecules. Heat stress, whether exertional or environmental, may modulate intestinal permeability and begs interesting questions in the context of global climate change, increasing population vulnerabilities, and public health. Emerging evidence indicates that intestinal leakage of digestive enzymes and associated cell dysfunctions–a process referred to as autodigestion–may play a critical role in systemic physiological damage within the body. This increased permeability is exacerbated in the presence of elevated core temperatures. We employed Latent Dirichlet Allocation (LDA) topic modeling methods to analyze the relationship between heat stress and the nascent theory of autodigestion in a systematic, quantifiable, and unbiased manner. From a corpus of 11,233 scientific articles across four relevant scientific journals (Gut, Shock, Temperature, Gastroenterology), it was found that over 1,000 documents expressed a relationship between intestine, enhanced permeability, core temperature, and heat stress. The association has grown stronger in recent years, as heat stress and potential autodigestion are investigated in tandem, yet still by a limited number of specific research studies. Such findings justify the design of future studies to critically test novel interventions against digestive enzymes permeating the intestinal tract, especially the small intestine.
Wet-bulb globe temperature (WBGT) is a widely applied heat stress index. However, most applications of WBGT within the heat stress impact literature that do not use WBGT at all, but use one of the ad hoc approximations, typically the simplified WBGT (sWBGT) or the environmental stress index (ESI). Surprisingly, little is known about how well these approximations work for the global climate and climate change settings that they are being applied to. Here, we assess the bias distribution as a function of temperature, humidity, wind speed, and radiative conditions of both sWBGT and ESI relative to a well-validated, explicit physical model for WBGT developed by Liljegren, within an idealized context and the more realistic setting of ERA5 reanalysis data. sWBGT greatly overestimates heat stress in hot-humid areas. ESI has much smaller biases in the range of standard climatological conditions. Over subtropical dry regions, both metrics can substantially underestimate extreme heat. We show systematic overestimation of labor loss by sWBGT over much of the world today. We recommend discontinuing the use of sWBGT. ESI may be acceptable for assessing average heat stress or integrated impact over a long period like a year, but less suitable for health applications, extreme heat stress analysis, or as an operational index for heat warning, heatwave forecasting, or guiding activity modification at the workplace. Nevertheless, Liljegren’s approach should be preferred over these ad hoc approximations and we provide a fast Python implementation to encourage its widespread use.
The heat index is a widely used measure of apparent temperature that accounts for the effects of humidity using Steadman’s model of human thermoregulation. Steadman’s model, however, gives unphysical results when the air is too hot and humid or too cold and dry, leading to an undefined heat index. For example, at a relative humidity of 80%, the heat index is only defined for temperatures in the range of 288-304 K (59 degrees-88 degrees F). Here, Steadman’s thermoregulation model is extended to define the heat index for all combinations of temperature and humidity, allowing for an assessment of Earth’s future habitability. The extended heat index can be mapped onto physiological responses of an idealized human, such as heat exhaustion, heat stroke, and even heat death, providing an indication of regional health outcomes for different degrees of global warming. Significance StatementThe existing heat index is well-defined for most combinations of high temperature and humidity experienced on Earth in the preindustrial climate, but global warming is increasingly generating conditions for which the heat index is undefined. Therefore, an extension of the original heat index is needed. When extending the heat index, we use the same physiological model as in the original work of Steadman to ensure backward compatibility. Following Steadman, each value of the heat index is mapped onto a measurable physiological variable, which can be useful for assessing the health impacts of various combinations of temperature and humidity, especially for outdoor workers.
Given health threat by global warming and increased energy consumption in regulating body temperature, it is an urgent need to construct smart temperature-regulating materials. Herein, a novel fiber-spinning asymmetric chemical assembly (FACA) method is proposed to construct nanofiber materials with asymmetric photothermal properties. The silver nanowires (AgNWs) and poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) with opposite thermal radiation are assembled on reduced graphene oxide (rGO) film, imparting AgNW/rGO/PVDF-HFP film with Janus structure that can realize the AgNWs side consistently keeps temperature of ca. 11 °C lower than the side of PVDF-HFP nanofiber regardless of the irradiation directions under 1 sun, suggesting the adjustable photothermal regulation. Such photothermally selective hybrid nanofiber film provides great potential as fabrics to achieve all-weather smart clothes, promoting controllable and comprehensive utilization of solar energy.
The direct impacts of climate change on crop yields and human health are individually well-studied, but the interaction between the two have received little attention. Here we analyze the consequences of global warming for agricultural workers and the crops they cultivate using a global economic model (GTAP) with explicit treatment of the physiological impacts of heat stress on humans’ ability to work. Based on two metrics of heat stress and two labor functions, combined with a meta-analysis of crop yields, we provide an analysis of climate, impacts both on agricultural labor force, as well as on staple crop yields, thereby accounting for the interacting effect of climate change on both land and labor. Here we analyze the two sets of impacts on staple crops, while also expanding the labor impacts to highlight the potential importance on non-staple crops. We find, worldwide, labor and yield impacts within staple grains are equally important at +3 C warming, relative to the 1986-2005 baseline. Furthermore, the widely overlooked labor impacts are dominant in two of the most vulnerable regions: sub-Saharan Africa and Southeast Asia. In those regions, heat stress with 3 C global warming could reduce labor capacity in agriculture by 30%-50%, increasing food prices and requiring much higher levels of employment in the farm sector. The global welfare loss at this level of warming could reach $136 billion, with crop prices rising by 5%, relative to baseline.
Climate change affects various fundamental human activities, and understanding the consequences of its impacts is essential. Among them, heat stress considerably affects economic conditions. Furthermore, when analyzing the socioeconomic impacts of climate change, both socioeconomic and climate systems must be considered simultaneously, though such studies are scarce. This study aimed to evaluate the socioeconomic impacts of changes in labor productivity due to heat stress (measured by wet bulb globe temperature) under various climate change scenarios through a new modeling framework that coupled a computable general equilibrium model and an Earth system model of intermediate complexity to realize the interactions between the two systems through the relationship between heat stress and labor productivity. Results indicated that labor productivity declined as climate change progressed (particularly in hot and humid regions), driving a gradual decline in total global gross domestic product (GDP). Although regional GDP largely decreased where labor productivity considerably declined, it slightly increased in some areas because of a comparative advantage brought about by the difference in the impact on labor productivity by region. Consequently, carbon dioxide (CO2) emissions and concentrations and the resulting temperature were slightly reduced when examining the impact of climate change on labor productivity. These tendencies were similar in both business-as-usual and climate change mitigation scenarios, but the overall impacts were smaller under the latter. There was a limited impact on CO2 emissions, CO2 concentrations, and temperature via integrated socioeconomic and climate systems. However, this study focused on only a single channel of the various interactions between the two systems. For a more complete evaluation of the impacts of climate change, further development of the integrated model is required.
The human body constantly exchanges heat with the environment. Temperature regulation is a homeostatic feedback control system that ensures deep body temperature is maintained within narrow limits despite wide variations in environmental conditions and activity-related elevations in metabolic heat production. Extensive research has been performed to study the physiological regulation of deep body temperature. This review focuses on healthy and disordered human temperature regulation during heat stress. Central to this discussion is the notion that various morphological features, intrinsic factors, diseases, and injuries independently and interactively influence deep body temperature during exercise and/or exposure to hot ambient temperatures. The first sections review fundamental aspects of the human heat stress response, including the biophysical principles governing heat balance and the autonomic control of heat loss thermoeffectors. Next, we discuss the effects of different intrinsic factors (morphology, heat adaptation, biological sex, and age), diseases (neurological, cardiovascular, metabolic, and genetic), and injuries (spinal cord injury, deep burns, and heat stroke), with emphasis on the mechanisms by which these factors enhance or disturb the regulation of deep body temperature during heat stress. We conclude with key unanswered questions in this field of research.
Due to the continuous rise of global temperatures and heatwaves worldwide as a result of climate change, concerns for the health and safety of working populations have increased. Workers in the food production chain, particularly farmworkers, are especially vulnerable to heat stress due to the strenuous nature of their work, which is performed primarily outdoors under poor working conditions. At the cross-section of climate change and farmworkers’ health, a scoping review was undertaken to summarize the existing knowledge regarding the health impacts associated with climate change and heat stress, guide future research toward better understanding current and future climate change risks, and inform policies to protect the health and safety of agricultural workers. A systematic search of 5 electronic databases and gray literature websites was conducted to identify relevant literature published up until December 2021. A total of 9045 records were retrieved from the searches, of which 92 articles were included in the final review. The majority of the reviewed articles focused on heat-related illnesses (n = 57) and kidney diseases (n = 28). The risk factors identified in the reviewed studies included gender, dehydration, heat strain, wearing inappropriate clothing, workload, piece-rate payment, job decision latitude, and hot environmental conditions. On the other hand, various protective and preventive factors were identified including drinking water, changing work hours and schedule of activities, wearing appropriate clothing, reducing soda consumption, taking breaks in shaded or air-conditioned areas, and increasing electrolyte consumption in addition to improving access to medical care. This review also identified various factors that are unique to vulnerable agricultural populations, including migrant and child farmworkers. Our findings call for an urgent need to expand future research on vulnerable agricultural communities including migrant workers so as to develop effective policies and interventions that can protect these communities from the effects of heat stress.
AIMS: Heat stroke is a life-threatening disorder triggered by thermoregulatory failure. Hyperthermia-induced splanchnic hypoperfusion has been reported to induce intestinal barrier dysfunction and systemic immune response that ultimately cause multiple-organ failure and death. Intestinal goblet cells contribute greatly to the formation of mucus barrier, which hinders translocation of gut microorganisms. Studies have reported that misoprostol can not only alleviate ischemic injury but also protect GI mucosal layer. Therefore, we evaluated the effects of misoprostol on intestinal goblet cells after heat stress and on multiple-organ dysfunction in heat stroke rats. MAIN METHODS: Heat stress was established in the heating chamber and followed by misoprostol treatment. Changes in hemodynamics, organ function indices, inflammation, oxidative stress, and survival rate were analyzed. Furthermore, ilea and LS174T cells were used to examine intestinal functions. KEY FINDINGS: Heat stress caused dysfunction of intestinal goblet cells and damage to ilea by increasing oxidative stress and apoptosis. Increased nitrosative stress and inflammation accompanied by hypotension, hypoperfusion, tachycardia, multiple-organ dysfunction, and death were observed in the heat stroke rat model. Treatment of LS174T cells with misoprostol not only decreased oxidative stress and apoptosis but also reduced cytotoxicity caused by heat stress. Moreover, misoprostol prevented disruption of the enteric barrier, multiple-organ injury, and death in rats with heat stroke. SIGNIFICANCE: This study indicates that misoprostol could alleviate intestinal damage and organ injury caused by heat stress and be a potential therapy for heat-related illnesses.
In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this first paper of the series, we conducted a systematic review (registration: INPLASY202090088) to identify all TSIs and provide reliable information regarding their use (funded by EU Horizon 2020; HEAT-SHIELD). Eight databases (PubMed, Agricultural and Environmental Science Collection, Web of Science, Scopus, Embase, Russian Science Citation Index, MEDLINE, and Google Scholar) were searched from database inception to 15 April 2020. No restrictions on language or study design were applied. Of the 879 publications identified, 232 records were considered for further analysis. This search identified 340 instruments and indicators developed between 200 BC and 2019 AD. Of these, 153 are nomograms, instruments, and/or require detailed non-meteorological information, while 187 can be mathematically calculated utilizing only meteorological data. Of these meteorology-based TSIs, 127 were developed for people who are physically active, and 61 of those are eligible for use in occupational settings. Information regarding the equation, operating range, interpretation categories, required input data, as well as a free software to calculate all 187 meteorology-based TSIs is provided. The information presented in this systematic review should be adopted by those interested in performing on-site monitoring and/or big data analytics for climate services to ensure appropriate use of the meteorology-based TSIs. Studies two and three in this series of companion papers present guidance on the application and validation of these TSIs, to guide end users of these indicators for more effective use.
Increasing air movement can alleviate or exacerbate occupational heat strain, but the impact is not well defined across a wide range of hot environments, with different clothing levels. Therefore, we combined a large empirical study with a physical model of human heat transfer to determine the climates where increased air movement (with electric fans) provides effective body cooling. The model allowed us to generate practical advice using a high-resolution matrix of temperature and humidity. The empirical study involved a total of 300 1-h work trials in a variety of environments (35, 40, 45, and 50 °C, with 20 up to 80% relative humidity) with and without simulated wind (3.5 vs 0.2 m(s^(-1)), and wearing either minimal clothing or a full body work coverall. Our data provides compelling evidence that the impact of fans is strongly determined by air temperature and humidity. When air temperature is ≥ 35 °C, fans are ineffective and potentially harmful when relative humidity is below 50%. Our simulated data also show the climates where high wind/fans are beneficial or harmful, considering heat acclimation, age, and wind speed. Using unified weather indices, the impact of air movement is well captured by the universal thermal climate index, but not by wet-bulb globe temperature and aspirated wet-bulb temperature. Overall, the data from this study can inform new guidance for major public and occupational health agencies, potentially maintaining health and productivity in a warming climate.
The PSU HEAT protocol has been used to determine critical environmental limits, i.e., those combinations of ambient temperature and humidity above which heat stress becomes uncompensable and core temperature rises continuously. However, no studies have rigorously investigated the reliability and validity of this experimental protocol. Here, we assessed the 1) between-visit reliability and 2) validity of the paradigm. Twelve subjects (5 M/7W; 25 ± 4 yr) completed a progressive heat stress protocol during which they walked on a treadmill (2.2 mph, 3% gradient) in a controllable environmental chamber. After an equilibration period, either dry-bulb temperature (T(db)) was increased every 5 min while ambient water vapor pressure (P(a)) was held constant (T(crit) experiments) or P(a) was increased every 5 min while T(db) was held constant (P(crit) experiments) until an upward inflection in gastrointestinal temperature (T(gi)) was observed. For reliability experiments, 11 subjects repeated the same protocol on a different day. For validity experiments, 10 subjects performed a T(crit) experiment at their previously determined P(crit) or vice versa. The between-visit reliability (intraclass correlation coefficient, ICC) for critical environmental limits was 0.98. Similarly, there was excellent agreement between original and validity trials for T(crit) (ICC = 0.95) and P(crit) (ICC = 0.96). Furthermore, the wet-bulb temperature at the T(gi) inflection point was not different during reliability (P = 0.78) or validity (P = 0.32) trials compared with original trials. These findings support the reliability and validity of this experimental paradigm for the determination of critical environmental limits for maintenance of human heat balance.NEW & NOTEWORTHY The PSU HEAT progressive heat stress protocol has been used to identify critical environmental limits for various populations, clothing ensembles, and metabolic intensities. However, no studies have rigorously investigated the reliability and validity of this experimental model. Here, we demonstrate excellent reliability and validity of the PSU HEAT protocol.
The objective of this study is to determine the impacts of low-intensity heat on human health in regions with hot, humid summers. Current literature has highlighted an increase in mortality and morbidity rates during significant heat events. While the impacts on high-intensity events are established, the impacts on low-intensity events, particularly in regions with hot, humid summers, are less clear. A scoping review was conducted searching three databases (PubMed, EMBASE, Web of Science) using key terms based on the inclusion criteria. We included papers that investigated the direct human health impacts of low-intensity heat events (single day or heatwaves) in regions with hot, humid summers in middle- and high-income countries. We excluded papers written in languages other than English. Of the 600 publications identified, 33 met the inclusion criteria. Findings suggest that low-intensity heatwaves can increase all-cause non-accidental, cardiovascular-, respiratory- and diabetes-related mortality, in regions experiencing hot, humid summers. Impacts of low-intensity heatwaves on morbidity are less clear, with research predominantly focusing on hospitalisation rates with a range of outcomes. Few studies investigating the impact of low-intensity heat events on emergency department presentations and ambulance dispatches were found. However, the data from a limited number of studies suggest that both of these outcome measures increase during low-intensity heat events. Low-intensity heat events may increase mortality. There is insufficient evidence of a causal effect of low-intensity heat events on increasing morbidity for a firm conclusion. Further research on the impact of low-intensity heat on morbidity and mortality using consistent parameters is warranted.
The concept of nature-based solutions (NBSs) has become increasingly popular among urban policymakers and planners to help them tackle the urban challenges arising from urban expansion and climate change. Stakeholders’ involvement is a fundamental step, and stakeholders’ perceptions and preferences can affect the development of NBS projects. This study aims to identify stakeholders’ perceptions of the most critical urban challenges, the priority interventions, the preferred NBSs and the benefits of the NBSs, and to identify the determinants of these perceptions. A survey was administered to assess stakeholders’ perceptions and views on implementing NBSs in two Portuguese cities with distinct urban, geographical, and socio-economic contexts. A binary logistic regression model was used to understand the determinants of the likelihood of the stakeholders’ answers. According to the stakeholders, climate change is one of the main concerns in the urban context. It is usually associated with the incidence of heatwaves and water scarcity. Additionally, stakeholders are concerned about the low quantity and poor management of green spaces (GSs). They believe that it will be necessary to increase the GS, to recover some degraded areas, and to increase mobility. The preferred NBSs were planting more urban trees, making green shaded areas, and rehabilitating riverbanks. The main expected benefits were benefits for leisure and relaxation, reductions in air temperature, purer air, and improvements in public health. The results showed mostly coherent connections between the main concerns/priorities of the stakeholders and the perceived NBS benefits; however, some stakeholders did not present coherent connections, indicating low awareness of the current policy for implementing NBSs to overcome existing and future urban challenges.
Climate change will have complex consequences for the environment, society, economy and people’s health. The issue of climate change has received comparatively little attention to date in the fields of sports science. Thus, sport-related health risks caused by climate change are discussed and summarized in a conceptual model presented here for the first time. Climate change is associated with the following increases of health-related risks for athletes in particular: Direct consequences caused by extreme temperature and other extreme weather events (e.g. increasing risks due to heatwaves, thunderstorms, floods, lightning, ultraviolet radiation) and indirect consequences as a result of climate-induced changes to our ecosystem (e.g. due to increased air pollution by ozone, higher exposures to allergens, increasing risks of infection by viruses and bacteria and the associated vectors and reservoir organisms). Each aspect is supplemented with advice on the prevention of health hazards. Not only individual athletes but also sports organizations and local clubs will have to respond to the changes in our climate, so that they can appropriately protect both athletes and spectators and ensure a plannable continuation of the sport in the future.
INTRODUCTION: Climate change is causing an increase in the frequency and intensity of extreme heat events, which disproportionately impact the health of vulnerable populations. Heatstroke, the most serious heat-related illness, is a medical emergency that causes multiorgan failure and death without intervention. Rapid recognition and aggressive early treatment are essential to reduce morbidity and mortality. The objective of this study was to evaluate current standards of care for the emergent management of heatstroke and propose an evidence-based algorithm to expedite care. METHODS: We systematically searched PubMed, Embase, and key journals, and reviewed bibliographies. Original research articles, including case studies, were selected if they specifically addressed the recognition and management of heatstroke in any prehospital, emergency department (ED), or intensive care unit population. Reviewers evaluated study quality and abstracted information regarding demographics, scenario, management, and outcome. RESULTS: In total, 63 articles met full inclusion criteria after full-text review and were included for analysis. Three key themes identified during the qualitative review process included recognition, rapid cooling, and supportive care. Rapid recognition and expedited external or internal cooling methods coupled with multidisciplinary management were associated with improved outcomes. Delays in care are associated with adverse outcomes. We found no current scalable ED alert process to expedite early goal-directed therapies. CONCLUSION: Given the increased risk of exposure to heat waves and the time-sensitivity of the condition, EDs and healthcare systems should adopt processes for rapid recognition and management of heatstroke. This study proposes an evidence-based prehospital and ED heat alert pathway to improve early diagnosis and resource mobilization. We also provide an evidence-based treatment pathway to facilitate efficient patient cooling. It is hoped that this protocol will improve care and help healthcare systems adapt to changing environmental conditions.
Heatwaves are one of the most dangerous natural hazards causing more than 166,000 deaths from 1998-2017. Their frequency is increasing, and they are becoming more intense. Electric fans are an efficient, and sustainable solution to cool people. They are, for most applications, the cheapest cooling technology available. However, many national and international health guidelines actively advise people not to use them when indoor air temperatures exceed the skin temperature, approximately 35 degrees C. We used a human energy balance model, to verify the validity of those recommendations and to determine under which environmental (air temperature, relative humidity, air speed and mean radiant temperature) and personal (metabolic rate, clothing) conditions the use of fans would be beneficial. We found that current guidelines are too restrictive. Electric fans can be used safely even if the indoor dry-bulb temperature exceeds 35 degrees C since they significantly increase the amount of sweat that evaporates from the skin. The use of elevated air speeds (0.8 m/s) increases the critical operative temperature at which heat strain is expected to occur by an average of 14 degrees C for relative humidity values above 22 %. We also analyzed the most extreme weather events from 1990 to 2014 recorded in the 115 most populous cities worldwide, and we determined that in 93 of them the use of fans would have been beneficial. We developed a free, open-source, and easy-to-use online tool to help researchers, building practitioners, and policymakers better understand under which conditions electric fans can be safely used to cool people.
Wet heatwaves can have more impact on human health than hot dry heatwaves. However, changes in these have received little scientific attention. Using the ECMWF Reanalysis v5 reanalysis dataset, wet-bulb temperatures (T (w)) were used to investigate the spatial-temporal variation of wet heatwaves in Eurasia for 1979-2017. Wet heatwaves were defined as three day or longer periods when T (w) was above the 90th percentile of the summer distribution and characterized by amplitude, duration and frequency. Maximum values of amplitude, close to 31 degrees C, occur in the Indus-Ganges plain, the lower Yangtze valley, and the coasts of the Persian Gulf and Red Sea. Significant positive trends in the frequency and amplitude of wet heatwaves have occurred over most of Eurasia though with regional variations. Changes in heatwave amplitude (HWA) are largely driven by changes in summer mean T (w). For Eurasia as a whole, increases in temperature contribute more than six times the impact of changes in relative humidity (RH) to changes in T (w) HWA. Changes in T (w) have a strong dependence on climatological RH with an increase in RH of 1% causing a T (w) increase of 0.2 degrees C in arid regions, and only increasing T (w) by 0.1 degrees C in humid regions. During T (w) heatwaves in Europe, parts of Tibet, India, East Asia and parts of the Arabian Peninsula both temperature and humidity contribute to the increase in T (w), with temperature the dominant driver. During wet heatwaves in part of Russia, changes in humidity are weak and the increase in T (w) is mainly caused by an increase in temperature. In the Mediterranean and Central Asia, RH has fallen reducing the increase in T (w) from general warming.
In the past two decades, record-breaking heatwaves have caused an increasing number of heat-related deaths, including heatstroke, globally. Heatstroke is a heat illness characterized by the rapid rise of core body temperature above 40 °C and central nervous system dysfunction. It is categorized as classic when it results from passive exposure to extreme environmental heat and as exertional when it develops during strenuous exercise. Classic heatstroke occurs in epidemic form and contributes to 9-37% of heat-related fatalities during heatwaves. Exertional heatstroke sporadically affects predominantly young and healthy individuals. Under intensive care, mortality reaches 26.5% and 63.2% in exertional and classic heatstroke, respectively. Pathological studies disclose endothelial cell injury, inflammation, widespread thrombosis and bleeding in most organs. Survivors of heatstroke may experience long-term neurological and cardiovascular complications with a persistent risk of death. No specific therapy other than rapid cooling is available. Physiological and morphological factors contribute to the susceptibility to heatstroke. Future research should identify genetic factors that further describe individual heat illness risk and form the basis of precision-based public health response. Prioritizing research towards fundamental mechanism and diagnostic biomarker discovery is crucial for the design of specific management approaches.
PURPOSE: We compared the accuracy and design of two thermoregulatory models, the US Army’s empirically designed Heat Strain Decision Aid (HSDA) and the rationally based Health Risk Prediction (HRP) for predicting human thermal responses during exercise in hot and humid conditions and wearing chemical protective clothing. METHODS: Accuracy of the HSDA and HRP model predictions of core body and skin temperature (Tc, Ts) were compared to each other and relative to measured outcomes from eight male volunteers (age 24 ± 6 years; height 178 ± 5 cm; body mass 76.6 ± 8.4 kg) during intermittent treadmill marching in an environmental chamber (air temperature 29.3 ± 0.1 °C; relative humidity 56 ± 1%; wind speed 0.4 ± 0.1 m∙s(-1)) wearing three separate chemical protective ensembles. Model accuracies and precisions were evaluated by the bias, mean absolute error (MAE), and root mean square error (RMSE) compared to observed data mean ± SD and the calculated limits of agreement (LoA). RESULTS: Average predictions of Tc were comparable and acceptable for each method, HSDA (Bias 0.02 °C; MAE 0.18 °C; RMSE 0.21 °C) and HRP (Bias 0.10 °C; MAE 0.25 °C; RMSE 0.34 °C). The HRP averaged predictions for Ts were within an acceptable agreement to observed values (Bias 1.01 °C; MAE 1.01 °C; RMSE 1.11 °C). CONCLUSION: Both HSDA and HRP acceptably predict Tc and HRP acceptably predicts Ts when wearing chemical protective clothing during exercise in hot and humid conditions.
The intensity and duration of hot weather and the number of extreme weather events, such as heatwaves, are increasing, leading to a growing need for space cooling energy demand. Together with the building stock’s low energy performance, this phenomenon may also increase households’ energy consumption. On the other hand, the low level of ownership of cooling equipment can cause low energy consumption, leading to a lack of indoor thermal comfort and several health-related problems, yet increasing the risk of energy poverty in summer. Understanding future temperature variations and the associated impacts on building cooling demand will allow mitigating future issues related to a warmer climate. In this respect, this paper analyses the effects of change in temperatures in the residential sector cooling demand in 2050 for a case study of nineteen cities across seven countries: Cyprus, Finland, Greece, Israel, Portugal, Slovakia, and Spain, by estimating cooling degree days and hours (CDD and CDH). CDD and CDH are calculated using both fixed and adaptive thermal comfort temperature thresholds for 2020 and 2050, understanding their strengths and weaknesses to assess the effects of warmer temperatures. Results suggest a noticeable average increase in CDD and CDH values, up to double, by using both thresholds for 2050, with a particular interest in northern countries where structural modifications in the building stock and occupants’ behavior should be anticipated. Furthermore, the use of the adaptive thermal comfort threshold shows that the projected temperature increases for 2050 might affect people’s capability to adapt their comfort band (i.e., indoor habitability) as temperatures would be higher than the maximum admissible values for people’s comfort and health.
HIGHLIGHTS: Cultural factors and acculturative stressors affect the health and safety behaviors of Hispanic/Latino farmworkers. Cultural factors and stressors also increase their risk of heat-related illnesses (HRIs). Interventions targeting HRIs in this population should account for cultural factors. ABSTRACT: Hispanic/Latino farmworkers have been widely recognized as a particularly vulnerable population in the U.S., with among the lowest levels of income and education in the country. Existing research has identified and explored factors, including cultural and demographic characteristics, that increase the vulnerability of these workers to adverse occupational health and safety outcomes. This review assesses Hispanic/Latino farmworkers’ vulnerability to increasing temperatures and intense heat events, focusing on the role of demographic and cultural factors in heat-related health outcomes. A systematic literature search was conducted using the search terms “heat” and “(Hispanic or Latino) farmworkers” and “health” over the years 2000 to 2020. A total of 348 articles were screened through a title review. The articles included in this review focused on heat-related illnesses (HRIs) and related symptoms among the population of interest. Hispanic/Latino workers were at heightened risk of HRI symptoms as a result of their work environments, working conditions, acculturative stressors, and other cultural factors.
BACKGROUND: With high temperature becoming an increasing health risk due to a changing climate, it is important to quantify the scale of the problem. However, estimating the burden of disease (BoD) attributable to high temperature can be challenging due to differences in risk patterns across geographical regions and data accessibility issues. METHODS: We present a methodological framework that uses Köppen-Geiger climate zones to refine exposure levels and quantifies the difference between the burden observed due to high temperatures and what would have been observed if the population had been exposed to the theoretical minimum risk exposure distribution (TMRED). Our proposed method aligned with the Australian Burden of Disease Study and included two parts: (i) estimation of the population attributable fractions (PAF); and then (ii) estimation of the BoD attributable to high temperature. We use suicide and self-inflicted injuries in Australia as an example, with most frequent temperatures (MFTs) as the minimum risk exposure threshold (TMRED). RESULTS: Our proposed framework to estimate the attributable BoD accounts for the importance of geographical variations of risk estimates between climate zones, and can be modified and adapted to other diseases and contexts that may be affected by high temperatures. CONCLUSIONS: As the heat-related BoD may continue to increase in the future, this method is useful in estimating burdens across climate zones. This work may have important implications for preventive health measures, by enhancing the reproducibility and transparency of BoD research.
Adaptation is key to minimizing heatwaves’ societal burden; however, our understanding of adaptation capacity across the socioeconomic spectrum is incomplete. We demonstrate that observed heatwave trends in the past four decades were most pronounced in the lowest-quartile income region of the world resulting in >40% higher exposure from 2010 to 2019 compared to the highest-quartile income region. Lower-income regions have reduced adaptative capacity to warming, which compounds the impacts of higher heatwave exposure. We also show that individual contiguous heatwaves engulfed up to 2.5-fold larger areas in the recent decade (2010-2019) as compared to the 1980s. Widespread heatwaves can overwhelm the power grid and nullify the electricity dependent adaptation efforts, with significant implications even in regions with higher adaption capacity. Furthermore, we compare projected global heatwave exposure using per-capita gross domestic product as an indicator of adaptation capacity. Hypothesized rapid adaptation in high-income regions yields limited changes in heatwave exposure through the 21st century. By contrast, lagged adaptation in the lower-income region translates to escalating heatwave exposure and increased heat-stress inequality. The lowest-quartile income region is expected to experience 1.8- to 5-fold higher heatwave exposure than each higher income region from 2060 to 2069. This inequality escalates by the end of the century, with the lowest-quartile income region experiencing almost as much heatwave exposure as the three higher income regions combined from 2090 to 2099. Our results highlight the need for global investments in adaptation capabilities of low-income countries to avoid major climate-driven human disasters in the 21st century.
Extreme heat research has largely focused on dry-heat, while humid-heat that poses a substantial threat to human-health remains relatively understudied. Using hourly high-resolution ERA5 reanalysis and HadISD station data, we provide the first spatially comprehensive, global-scale characterization of the magnitude, seasonal timing, and frequency of dry- and wet-bulb temperature extremes and their trends. While the peak dry- and humid-heat extreme occurrences often coincide, their timing differs in climatologically wet regions. Since 1979, dry- and humid-heat extremes have become more frequent over most land regions, with the greatest increases in the tropics and Arctic. Humid-heat extremes have increased disproportionately over populated regions (similar to 5.0 days per-person per-decade) relative to global land-areas (similar to 3.6 days per-unit-land-area per-decade) and population exposure to humid-heat has increased at a faster rate than to dry-heat. Our study highlights the need for a multivariate approach to understand and mitigate future harm from heat stress in a warming world.
The frequency and intensity of extreme events especially heat waves (HW) are growing all around the world which ultimately poses a serious threat to the health of individuals. To quantify the effects of extreme temperature, appropriate information, and the importance of HW and heat index (HI) are carefully discussed for different parts of the world. Varied definitions of the HW and HI formula proposed and used by different countries are carried out systematically continent-wise. Different studies highlighted the number of definitions of HW; however, mostly used Steadman’s formulae, which was developed in the late 1970s, for the calculation of HI that uses surface air temperature and relative humidity as climatic fields. Since then, dramatic changes in climatic conditions have been observed as evident from the ERA5 datasets which need to be addressed; likewise, the definition of HW, which is modified by the researchers as per the geographic conditions. It is evident from the ERA5 data that the temperature has increased by 1-2 ??C as compared to the 1980s. There is a threefold increase in the number of heatwave days over most of the continents in the last 40 years. This study will help the researcher community to understand the importance of HW and HI. Furthermore, it opens the scope to develop an equation based on the present scenario keeping in mind the basics of an index as considered by Steadman.
Prior research demonstrates a link between heat risk perception and population response to a heat warning. Communicating a precise and understandable definition of “heat” or “heatwaves” can affect how a population perceives and responds to extreme heat. Still, little is known about how heat perception affects behavior changes to heat and heat communication across diverse populations. This scoping review aims to identify and describe the main themes and findings of recent heat perception research globally and map critical research gaps and priorities for future studies. Results revealed risk perception influences a person’s exposure to and behavioral response to excessive heat. Risk perception varied geographically along the rural-urban continuum and was typically higher among vulnerable subgroups, including populations who were low-income, minority, and in poor health. A more integrated approach to refining risk communication strategies that result in a behavioral change and incorporates the individual, social, and cultural components of impactful group-based or community-wide interventions is needed. Research employing longitudinal or quasi-experimental designs and advanced statistical techniques are required to tease apart the independent and interacting factors that causally influence risk communication, heat perception, and adaptive behaviors. We advance a framework to conceptualize the structural, environmental, personal, and social drivers of population heat risk perception and how they interact to influence heat perception and adaptive behaviors. Our findings map future research priorities needed for heat perception and a framework to drive future research design.
Increases in the severity of heat stress extremes are potentially one of the most impactful consequences of climate change, affecting human comfort, productivity, health, and mortality in many places on Earth. Heat stress results from a combination of elevated temperature and humidity, but the relative contributions of each of these to heat stress changes have yet to be quantified. Here, conditions for the baseline specific humidity are derived for when specific humidity or temperature dominates heat stress changes, as measured using the equivalent potential temperature (theta(E)). Separate conditions are derived over ocean and over land, in addition to a condition for when relative humidity changes make a larger contribution than the Clausius-Clapeyron response at fixed relative humidity. These conditions are used to interpret the theta(E) responses in transient warming simulations with an ensemble of models participating in phase 6 of the Climate Model Intercomparison Project. The regional pattern of theta(E) changes is shown to be largely determined by the pattern of specific humidity changes, with the pattern of temperature changes playing a secondary role. This holds whether considering changes in seasonal-mean theta(E) or in extreme (98th-percentile) theta(E) events, and uncertainty in the response of specific humidity to warming is shown to be the leading source of uncertainty in the theta(E) response at most land locations. Finally, analysis of ERA5 data demonstrates that the pattern of observed theta(E) changes is also well explained by the pattern of specific humidity changes. These results demonstrate that understanding regional changes in specific humidity is largely sufficient for understanding regional changes in heat stress.
Purpose The purpose of this study is to analyze the question “In what order of magnitude does the comfort and performance improvement lie with the use of a cooling vest for construction workers?”. Design/methodology/approach The use of personal cooling systems, in the form of cooling vests, is not only intended to reduce the heat load, in order to prevent disruption of the thermoregulation system of the body, but also to improve work performance. A calculation study was carried out on the basis of four validated mathematical models, namely a cooling vest model, a thermophysiological human model, a dynamic thermal sensation model and a performance loss model for construction workers. Findings The use of a cooling vest has a significant beneficial effect on the thermal sensation and the loss of performance, depending on the thermal load on the body. Research limitations/implications Each cooling vest can be characterized on the basis of the maximum cooling power (Pmax; in W/m(2)), the cooling capacity (Auc; in Wh/m2) and the time (tc; in minutes) after which the cooling power is negligible. In order to objectively compare cooling vests, a (preferably International and/or European) standard/guideline must be compiled to determine the cooling power and the cooling capacity of cooling vests. Practical implications It is recommended to implement the use of cooling vests in the construction process so that employees can use them if necessary or desired. Social implications Climate change, resulting in global warming, is one of the biggest problems of present times. Rising outdoor temperatures will continue in the 21st century, with a greater frequency and duration of heat waves. Some regions of the world are more affected than others. Europe is one of the regions of the world where rising global temperatures will adversely affect public health, especially that of the labor force, resulting in a decline in labor productivity. It will be clear that in many situations air conditioning is not an option because it does not provide sufficient cooling or it is a very expensive investment; for example, in the situation of construction work. In such a situation, personal cooling systems, such as cooling vests, can be an efficient and financially attractive solution to the problem of discomfort and heat stress. Originality/value The value of the study lies in the link between four validated mathematical models, namely a cooling vest model, a thermophysiological human model, a dynamic thermal sensation model and a performance loss model for construction workers.
Heatstroke is increasingly becoming a significant concern due to global warming. Systemic inflammation and coagulopathy are the two major factors that provoke life-threatening organ dysfunction in heatstroke. Dysregulated thermo-control induces cellular injury, damage-associated molecular patterns release, hyperinflammation, and hypercoagulation with suppressed fibrinolysis to produce heatstroke-induced coagulopathy (HSIC). HSIC can progress to disseminated intravascular coagulation and multiorgan failure if severe enough. Platelet count, D-dimer, soluble thrombomodulin, and inflammation biomarkers such as interleukin-6 and histone H3 are promising markers for HSIC. In exertional heatstroke, the measurement of myoglobin is helpful to anticipate renal dysfunction. However, the optimal cutoff for each biomarker has not been determined. Except for initial cooling and hydration, effective therapy continues to be explored, and the use of antiinflammatory and anticoagulant therapies is under investigation. Despite the rapidly increasing risk, our knowledge is limited, and further study is warranted. In this review, we examine current information and what future efforts are needed to better understand and manage HSIC.
The combination of high humidity and ambient temperature of the 2021 Tokyo Summer Olympic Game will undoubtfully result in greater physiological strains and thereby downregulates the endurance performance of athletes. Although many research studies have highlighted that the thermoregulatory strain is greater when the environment is hot and humid, no review articles have addressed the thermoregulatory and performance differences between dry and humid heat and such lack of consensuses in this area will lead to increase the risk of heat-related injuries as well as suboptimal preparation. Furthermore, specific strategies to counteract this stressful environment has not been outlined in the current literature. Therefore, the purposes of this review are: 1) to provide a clear evidence that humid heat is more stressful than dry heat for both male and female athletes and therefore the preparation for the Tokyo Summer Olympic should be environmental specific instead of a one size fits all approach; 2) to highlight why female athletes may be facing a disadvantage when performing a prolonged endurance event under high humidity environment and 3) to highlight the potential interventional strategies to reduce thermal strain in hot-humid environment. The summaries of this review are: both male and female should be aware of the environmental condition in Tokyo as humid heat is more stressful than dry heat; Short-term heat acclimation may not elicit proper thermoregulatory adaptations in hot-humid environment; cold water immersion with proper hydration and some potential per-cooling modalities may be beneficial for both male and female athletes in hot-humid environment.
Clinical Background: Hydration status, which is influenced by environment and self-behavior is associated with kidney health and disease. Epidemiology: Lack of safe water, sanitation, and high temperatures are environmental issues that affect a significant part of the worldwide population. Occupational factors that discourage proper hydration, as well as low water intake in favorable environment conditions, are also highly prevalent. As a consequence, inadequate water intake can lead to several kidney problems ranging from uncomplicated urinary tract infections to kidney stones, acute kidney injury, and chronic disorders with high mortality rates. Challenges: Increasing water intake is an individual effort when self-behavior is the main reason for inadequate hydration status. When the environment is an obstacle, it might require complex changes in a concerted multidisciplinary effort from employers, health authorities, researchers, and governments. Prevention and Treatment: Strategies can be implemented at global, local, and individual levels. Global efforts include actions to decrease poverty and climate change consequences, while increasing access to safe water and sanitation. Local actions can improve working conditions and access to water and toilets to workers. At an individual level, self-monitoring through regular observation of thirst sensation, acute weight loss, urine frequency, and urine color are recommended tools to monitor hydration status.
Residential buildings instigate a vital role in creating a safe and comfortable indoor living environment. The phenomenon of overheating, an impact of climate change, can cause a negative effect on residents’ productiveness and heat-related illnesses and can even force high pressure on electricity generation by increasing the risk of power outages due to excessive peak cooling and heating requirements. Various issues on building thermal comfort are being evolved and discussed in review articles. However, there are few articles that review the current condition of adaptive thermal comfort studies and the potential for energy savings in residential buildings. Therefore, the aims for this paper are to: identify comfort temperature ranges in residential buildings, investigate the correlation of comfort temperature with indoor and outdoor temperatures with the aid of ‘comfort threads’, and clarify the effect of adaptive measures on residential energy saving potential. This study obtained a large variation of residential comfort temperatures, which mostly depend on the climate and operation modes of the building. ‘Comfort threads’ explains that people are adapting to a large variation of indoor and outdoor temperatures and the wide range of comfort temperature could provide significant energy savings in residential buildings. This review provides insight on and an overview of thermal comfort field studies in residential buildings.
High ambient temperature and humidity greatly increase the risk of hyperthermia and mortality, particularly in infants, who are especially prone to dehydration. World areas at high risk of heat stress include many of the low- and middle-income countries (LMICs) where most of their inhabitants have no access to air conditioning. This study aimed to design, evaluate, and test a novel low-cost and easy-to-assemble device aimed at preventing the risk of infant hyperthermia in LMICs. The device is based on optimizing negative heat transfer from a small amount of ice and transferring it directly to the infant by airflow of refrigerated air. As a proof of concept, a device was assembled mainly using recycled materials, and its performance was assessed under laboratory-controlled conditions in a climatic chamber mimicking realistic stress conditions of high temperature and humidity. The device, which can be assembled by any layperson using easily available materials, provided sufficient refrigerating capacity for several hours from just 1-2 kg of ice obtained from a domestic freezer. Thus, application of this novel device may serve to attenuate the adverse effects of heat stress in infants, particularly in the context of the evolving climatic change trends.
To fully address the multi-faceted challenges of urban heat, it is paramount that humans are placed at the center of the agenda. This is manifested in a recent shift in urban heat studies that aim to achieve a ‘human-centric’ approach, i.e. focusing on personalized characteristics of comfort, well-being, performance, and health, as opposed to the one-size-fits-all solutions and guidelines. The proposed article is focused on systematically reviewing personalized urban heat studies and detailing the objectives posed, methodologies utilized, and limitations yet to be addressed. We further summarize current knowledge and challenges in addressing the impact of personal heat exposure on human life by discussing the literature linked with urban heat studies at the human, building, and city scales. Lastly, this systematic review reveals the need for future evaluations focused on accuracy and standardization of human-centric data collection and analytics, and more importantly, addressing critical geographic and socio-economic knowledge gaps identified in the field.
BACKGROUND: Mental health is an important public health issue globally. A potential link between heat exposure and mental health outcomes has been recognised in the scientific literature; however, the associations between heat exposure (both high ambient temperatures and heatwaves) and mental health-related mortality and morbidity vary between studies and locations. OBJECTIVE: To fill gaps in knowledge, this systematic review aims to summarize the epidemiological evidence and investigate the quantitative effects of high ambient temperatures and heatwaves on mental health-related mortality and morbidity outcomes, while exploring sources of heterogeneity. METHODS: A systematic search of peer-reviewed epidemiological studies on heat exposure and mental health outcomes published between January 1990 and November 2020 was conducted using five databases (PubMed, Embase, Scopus, Web of Science and PsycINFO). We included studies that examined the association between high ambient temperatures and/or heatwaves and mental health-related mortality and morbidity (e.g. hospital admissions and emergency department visits) in the general population. A range of mental health conditions were defined using ICD-10 classifications. We performed random effects meta-analysis to summarize the relative risks (RRs) in mental health outcomes per 1 °C increase in temperature, and under different heatwaves definitions. We further evaluated whether variables such as age, sex, socioeconomic status, and climate zone may explain the observed heterogeneity. RESULTS: The keyword search yielded 4560 citations from which we identified 53 high temperatures/heatwaves studies that comprised over 1.7 million mental health-related mortality and 1.9 million morbidity cases in total. Our findings suggest associations between heat exposures and a range of mental health-related outcomes. Regarding high temperatures, our meta-analysis of study findings showed that for each 1 °C increase in temperature, the mental health-related mortality and morbidity increased with a RR of 1.022 (95%CI: 1.015-1.029) and 1.009 (95%CI: 1.007-1.015), respectively. The greatest mortality risk was attributed to substance-related mental disorders (RR, 1.046; 95%CI: 0.991-1.101), followed by organic mental disorders (RR, 1.033; 95%CI: 1.020-1.046). A 1 °C temperature rise was also associated with a significant increase in morbidity such as mood disorders, organic mental disorders, schizophrenia, neurotic and anxiety disorders. Findings suggest evidence of vulnerability for populations living in tropical and subtropical climate zones, and for people aged more than 65 years. There were significant moderate and high heterogeneities between effect estimates in overall mortality and morbidity categories, respectively. Lower heterogeneity was noted in some subgroups. The magnitude of the effect estimates for heatwaves varied depending on definitions used. The highest effect estimates for mental health-related morbidity was observed when heatwaves were defined as “mean temperature ≥90th percentile for ≥3 days” (RR, 1.753; 95%CI: 0.567-5.421), and a significant effect was also observed when the definition was “mean temperature ≥95th percentile for ≥3 days”, with a RR of 1.064 (95%CI: 1.006-1.123). CONCLUSIONS: Our findings support the hypothesis of a positive association between elevated ambient temperatures and/or heatwaves and adverse mental health outcomes. This problem will likely increase with a warming climate, especially in the context of climate change. Further high-quality studies are needed to identify modifying factors of heat impacts.
‘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.
The Warsaw International Mechanism for Loss and Damage has identified increasing temperatures as a key slow onset event. However, it is the resulting increases in short-term heat events – heatwaves – that have so far been the primary focus of risk assessment and policy, while gradual and sustained increases in temperature have received less attention. This is a global issue but particularly important in tropical and subtropical regions already chronically exposed to extreme heat. This paper reviews recent analyses of intensifying seasonal and year-round extreme heat exposures and how this affects daily life, including worker productivity, health and wellbeing, reduced GDP and economic viability. It frames this as a slow onset event and closes with a brief indication of tools available to assess and address these risks.
Prolonged and/or extreme heat has become a natural hazard that presents a significant risk to humans and the buildings, technologies, and infrastructure on which they have previously relied on to provide cooling. This paper presents a conceptual model of a resilient cooling system centred on people, the socio-cultural-technical contexts they inhabit, and the risks posed by the temperature hazard. An integrative literature review process was used to undertake a critical and comprehensive evaluation of published research and grey literature with the objective of adding clarity and detail to the model. Two databases were used to identify risk management and natural hazard literature in multiple disciplines that represent subcomponents of community resilience (social, economic, institutional, infrastructure and environment systems). This review enabled us to characterise in more detail the nature of the temperature hazard, the functionality characteristics of a resilient cooling system, and key elements of the four subsystems: people, buildings, cooling technologies and energy infrastructure. Six key messages can be surmised from this review, providing a guide for future work in policy and practice.
Increased exposure to extreme heat from both climate change and the urban heat island effect-total urban warming-threatens the sustainability of rapidly growing urban settlements worldwide. Extreme heat exposure is highly unequal and severely impacts the urban poor. While previous studies have quantified global exposure to extreme heat, the lack of a globally accurate, fine-resolution temporal analysis of urban exposure crucially limits our ability to deploy adaptations. Here, we estimate daily urban population exposure to extreme heat for 13,115 urban settlements from 1983 to 2016. We harmonize global, fine-resolution (0.05°), daily temperature maxima and relative humidity estimates with geolocated and longitudinal global urban population data. We measure the average annual rate of increase in exposure (person-days/year(-1)) at the global, regional, national, and municipality levels, separating the contribution to exposure trajectories from urban population growth versus total urban warming. Using a daily maximum wet bulb globe temperature threshold of 30 °C, global exposure increased nearly 200% from 1983 to 2016. Total urban warming elevated the annual increase in exposure by 52% compared to urban population growth alone. Exposure trajectories increased for 46% of urban settlements, which together in 2016 comprised 23% of the planet’s population (1.7 billion people). However, how total urban warming and population growth drove exposure trajectories is spatially heterogeneous. This study reinforces the importance of employing multiple extreme heat exposure metrics to identify local patterns and compare exposure trends across geographies. Our results suggest that previous research underestimates extreme heat exposure, highlighting the urgency for targeted adaptations and early warning systems to reduce harm from urban extreme heat exposure.
This article presents a customized system dynamics model to facilitate the informed development of policy for urban heat island mitigation within the context of future climate change, and with special emphasis on the reduction of heat-related mortality. The model incorporates a variety of components (incl.: the urban heat island effect; population dynamics; climate change impacts on temperature; and heat-related mortality) and is intended to provide urban planning and related professionals with: a facilitated means of understanding the risk of heat-related mortality within the urban heat island; and location-specific information to support the development of reasoned and targeted urban heat island mitigation policy.
BACKGROUND: The earth’s climate is warming and the frequency, duration, and severity of heat waves are increasing. Meanwhile, the world’s population is rapidly aging. Epidemiological data demonstrate exponentially greater increases in morbidity and mortality during heat waves in adults ≥65 years. Laboratory data substantiate the mechanistic underpinnings of age-associated differences in thermoregulatory function. However, the specific combinations of environmental conditions (i.e., ambient temperature and absolute/relative humidity) above which older adults are at increased risk of heat-related morbidity and mortality are less clear. METHODS: This review was conducted to (1) examine the recent (past 3 years) literature regarding heat-related morbidity and mortality in the elderly and discuss projections of future heat-related morbidity and mortality based on climate model data, and (2) detail the background and unique methodology of our ongoing laboratory-based projects aimed toward identifying the specific environmental conditions that result in elevated risk of heat illness in older adults, and the implications of using the data toward the development of evidence-based safety interventions in a continually-warming climate (PSU HEAT; Human Environmental Age Thresholds). RESULTS: The recent literature demonstrates that extreme heat continues to be increasingly detrimental to the health of the elderly and that this is apparent across the world, although the specific environmental conditions above which older adults are at increased risk of heat-related morbidity and mortality remain unclear. CONCLUSION: Characterizing the environmental conditions above which risk of heat-related illnesses increase remains critical to enact policy decisions and mitigation efforts to protect vulnerable people during extreme heat events.
Globally, extreme temperatures have severe impacts on the economy, human health, food and water security, and ecosystems. Mortality rates have been increased due to heatwaves in several regions. Specifically, megacities have high impacts with the increasing temperature and everexpanding urban areas; it is important to understand extreme temperature changes in terms of duration, magnitude, and frequency for future risk management and disaster mitigation. Here we framed a novel Semi-Parametric quantile mapping method to bias-correct the CMIP6 minimum and maximum temperature projections for 199 megacities worldwide. The changes in maximum and minimum temperature are quantified in terms of climate indices (ETCCDI and HDWI) for the four Shared Socioeconomic Pathways (SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). Cities in northern Asia and northern North America (Kazan, Samara, Heihe, Montre ‘ al, Edmonton, and Moscow) are warming at a higher rate compared to the other regions. There is an increasing and decreasing trend for the warm and cold extremes respectively. Heatwaves increase exponentially in the future with the increase in warming, that is, from SSP1-2.6 to SSP5-8.5. Among the CMIP6 models, a huge variability is observed, and this further increases as the warming increases. All climate indices have steep slopes for the far future (2066-2100) compared to the near future (2031-2065). Yet the variability among CMIP6 models in near future is high compared to the far future for cold indices.
Surface temperatures are generally higher in cities than in rural surroundings. This phenomenon, known as Surface Urban Heat Island (SUHI), increases the risk of heat-related human illnesses and mortality. Past global studies analysed this phenomenon aggregated at city scale or over seasonal and annual time periods, while human impacts strongly depend on shorter term heat stress experienced locally. Here we develop a global longterm high-resolution dataset of daytime SUHI, offering an insight into the space-time variability of the urban-rural temperature differences which is unprecedented at global scale. Our results show that across urban areas worldwide over the period 2003-2020, 3-day SUHI extremes are on average more than twice as high as the warm-season median SUHI, with local exceedances up to 10 K. Over this period, SUHI extremes have increased more rapidly than warm-season medians, and averaged worldwide are now 1.04 K or 31% higher compared to 2003. This can be linked with increasing urbanisation, more frequent heatwaves, and greening of the earth, processes that are all expected to continue in the coming decades. Within many cities there are hotspots where extreme SUHI intensity is 10-15 K higher compared to relatively cooler city parts. Given the limited human adaptability to heat stress, our results advocate for mitigation strategies targeted at reducing SUHI extremes in the most vulnerable and exposed city neighbourhoods.
Over the past decades, the world has experienced increasing heatwave intensity, frequency, and duration. This trend is projected to increase into the future with climate change. At the same time, the global population is also projected to increase, largely in the world’s cities. This urban growth is associated with increased heat in the urban core, compared to surrounding areas, exposing residents to both higher temperatures and more intense heatwaves than their rural counterparts. Regional studies suggest that Asia and Africa will be significantly affected. How many people may be exposed to levels of extreme heat events in the future remains unclear. Identifying the range in number of potentially exposed populations and where the vulnerable are located can help planners prioritize adaption efforts. We project the ranges of population exposed to heatwaves at varying levels to 2,100 for three future periods of time (2010-2039, 2040-2069, 2070-2099) using the Shared Socio-Economic Pathways (SSPs) and the Representative Concentration Pathways (RCPs). We hypothesize that the largest populations that will be exposed to very warm heatwaves are located in Asia and Africa. Our projections represent the warmest heatwaves for 15 days during these three periods. By the 2070-2099 period, the exposure levels to extreme heatwaves (>42 degrees) exceed 3.5 billion, under the sustainability scenario (RCP2.6-SSP1). The number of those exposed in cities climbs with greater projected climate change. The largest shares of the exposed populations are located in Southern Asia and tropical countries Western and Central Africa. While this research demonstrates the importance of this type of climate change event, urban decision-makers are only recently developing policies to address heat. There is an urgent need for further research in this area.
Climate change lead to more intense, higher frequent and prolonged heat extremes. Under-standing the spatial pattern of heatwave is vital for providing the corresponding weather services, making climate change adaptation strategies and heat-health actions. In this study, we present an approach to estimate the heatwave spatial patterns by utilizing the WUDAPT Level 0 data and machine learning. The analysis is based on two years (2009 and 2016) of air temperature data from 86 meteorological monitoring stations in Guangdong province of China, a subtropical region with frequent hot and sultry weather in summer. First, heatwave conditions were quantified by calculating the number of hot days and frequency of heatwave events in each year and used as the response variables. Then, random forest models were built by using a geospatial dataset con-sisting of WUDAPT and urban canopy parameters (UCP) as predictor variables. Based on the resultant models, spatial patterns of heatwave were estimated and mapped at 100 m spatial -resolution. The results show that this approach is able to estimate heatwave spatial patterns using open data and inform urban policy and decision-making. The study is also a new perspective and a feasible pathway of utilizing WUDPAT Level 0 product to facilitate urban environment applications.
Urban overheating, driven by global climate change and urban development, is a major contemporary challenge that substantially impacts urban livability and sustainability. Overheating represents a multifaceted threat to the well-being, performance, and health of individuals as well as the energy efficiency and economy of cities, and it is influenced by complex interactions between building, city, and global scale climates. In recent decades, extensive discipline-specific research has characterized urban heat and assessed its implications on human life, including ongoing efforts to bridge neighboring disciplines. The research horizon now encompasses complex problems involving a wide range of disciplines, and therefore comprehensive and integrated assessments are needed that address such interdisciplinarity. Here, our objective is to go beyond a review of existing literature and instead provide a broad overview and integrated assessments of urban overheating, defining holistic pathways for addressing the impacts on human life. We (a) detail the characterization of heat hazards and exposure across different scales and in various disciplines, (b) identify individual sensitivities to urban overheating that increase vulnerability and cause adverse impacts in different populations, (c) elaborate on adaptive capacities that individuals and cities can adopt, (d) document the impacts of urban overheating on health and energy, and (e) discuss frontiers of theoretical and applied urban climatology, built environment design, and governance toward reduction of heat exposure and vulnerability at various scales. The most critical challenges in future research and application are identified, targeting both the gaps and the need for greater integration in overheating assessments.
Extreme heat, the deadliest summer weather-related hazard in the USA, is projected to increase in intensity, duration, frequency, and magnitude, especially in urban areas that account for 80% of the population. Spatial visualization and representation are crucial in establishing the hotspots of vulnerability to the heat hazard. However, despite the progress in the science of vulnerability, there lacks a systematic and consistent conceptual framework. The quantification of variables is unchecked, resulting in subjective decisions regarding the weighting of variables, selection of indicators, and the suitability of the proxies. Moreover, contradicting approaches generate disparate outputs such as; inductive versus deductive, area-based versus population-based, and raster versus vector designs. The qualitative approach, meant to provide supplementary data, is often ignored. This review provides a perspective of the lacunae in the existing literature and builds on these gaps to derive a conceptual framework towards harmonizing theoretical and statistical relationships. The framework is anchored on the longitudinal study approach as the socioeconomic, biophysical, and geodemographic dimensions have an inherent temporal variance. The review calls for a precise and accurate depiction of heat vulnerability in urban areas to inform targeted adaptation and mitigation measures and the long term projection of coupled systems behavior.
When inferring on the magnitude of future heat-related mortality due to climate change, human adaptation to heat should be accounted for. We model long-term changes in minimum mortality temperatures (MMT), a well-established metric denoting the lowest risk of heat-related mortality, as a function of climate change and socio-economic progress across 3820 cities. Depending on the combination of climate trajectories and socio-economic pathways evaluated, by 2100 the risk to human health is expected to decline in 60% to 80% of the cities against contemporary conditions. This is caused by an average global increase in MMTs driven by long-term human acclimatisation to future climatic conditions and economic development of countries. While our adaptation model suggests that negative effects on health from global warming can broadly be kept in check, the trade-offs are highly contingent to the scenario path and location-specific. For high-forcing climate scenarios (e.g. RCP8.5) the maintenance of uninterrupted high economic growth by 2100 is a hard requirement to increase MMTs and level-off the negative health effects from additional scenario-driven heat exposure. Choosing a 2 °C-compatible climate trajectory alleviates the dependence on fast growth, leaving room for a sustainable economy, and leads to higher reductions of mortality risk.
The absence of vegetation in urban areas contributes to the establishment of the urban heat island, markedly increasing thermal stress for residents, driving morbidity and mortality. Mitigation strategies are, therefore, needed to reduce urban heat, particularly against a background of urbanization, anthropogenic warming and increasing frequency and intensity of heatwaves. In this Review, we evaluate the potential of green infrastructure as a mitigation strategy, focusing on greenery on the ground (parks) and greenery on buildings (green roofs and green walls). Green infrastructure acts to cool the urban environment through shade provision and evapotranspiration. Typically, greenery on the ground reduces peak surface temperature by 2-9 degrees C, while green roofs and green walls reduce surface temperature by similar to 17 degrees C, also providing added thermal insulation for the building envelope. However, the cooling potential varies markedly, depending on the scale of interest (city or building level), greenery extent (park shape and size), plant selection and plant placement. Urban planners must, therefore, optimize design to maximize mitigation benefits, for example, by interspersing parks throughout a city, allocating more trees than lawn space and using multiple strategies in areas where most cooling is required. To do so, improved translation of scientific understanding to practical design guidelines is needed.
NEW FINDINGS: What is the topic of this review? The potential role of nutrition in exertional heat stroke. What advances does it highlight? Certain nutritional and dietary strategies used by athletes and workers may exert a protective effect the pathophysiological processes of exertional heat stroke, whereas others may be detrimental. While current evidence suggests that some of these practices may be leveraged as a potential countermeasure to exertional heat stroke, further research on injury-related outcomes in humans is required. ABSTRACT: Exertional heat stroke (EHS) is a life-threatening illness and an enduring problem among athletes, military servicemen and -women, and occupational labourers who regularly perform strenuous activity, often under hot and humid conditions or when wearing personal protective equipment. Risk factors for EHS and mitigation strategies have generally focused on the environment, health status, clothing, heat acclimatization and aerobic conditioning, but the potential role of nutrition is largely underexplored. Various nutritional and dietary strategies have shown beneficial effects on exercise performance and health and are widely used by athletes and other physically active populations. There is also evidence that some of these practices may dampen the pathophysiological features of EHS, suggesting possible protection or abatement of injury severity. Promising candidates include carbohydrate ingestion, appropriate fluid intake and glutamine supplementation. Conversely, some nutritional factors and low energy availability may facilitate the development of EHS, and individuals should be cognizant of these. Therefore, the aims of this review are to present an overview of EHS along with its mechanisms and pathophysiology, discuss how selected nutritional considerations may influence EHS risk focusing on their impact on the key pathophysiological processes of EHS, and provide recommendations for future research. With climate change expected to increase EHS risk and incidence in the coming years, further investigation on how diet and nutrition may be optimized to protect against EHS would be highly beneficial.
OBJECTIVES: To analyse 11 years of FIVB heat stress-monitoring data to determine the relative influence of the different environmental parameters in increasing the likelihood of a heat-related medical time-out (MTOheat). METHODS: A total of 8530 matches were recorded. The referee measured air temperature, black globe temperature, relative humidity and wet-bulb globe temperature (WBGT) before the matches, and registered the MTOheat. The absolute humidity was computed at posteriori. RESULTS: There were 20 MTOheat cases, but only 3 resulted in forfeiting the match. MTOheat incidence was not statistically impacted by sex (p=0.59). MTOheat cases were more prevalent during the games played in Asia during the 4th quarter of the year (p<0.001). Two cases of MTOheat experienced diarrhoea or gastroenteritis during the 5 preceding days; both of them forfeited the match. A principal component analysis showed a specific environmental profile for the matches with MTOheat. They occurred at higher WBGT, temperatures and absolute humidity (p<0.001), but with a lower relative humidity (p=0.027). CONCLUSIONS: The current data showed that an increase in ambient or black globe temperature, but not relative humidity, increased the risk of a MTOheat; but that the absolute risk remained low in elite beach volleyball players. However, suffering or recovering from a recent illness may represent a risk factor for a MTOheat to lead to player forfeit.
People exercising under high ambient temperature will cause changes in physiological indicators. In order to study the thermal physiological state of the human body, we randomly selected 18 volunteers into the thermal environment exercise group and the room temperature exercise group. Two groups of volunteers performed aerobic exercises in different thermal environments. In the case of exercise performed every 15 min, the volunteers’ hemorheology, physical performance rating (RPE) value and rectal temperature (Tre) were tested. At the same time, we recorded the physiological indicators of the volunteers and simulated the thermal physiology. The results showed that there was a difference in the thermal physiology of the two groups of volunteers, and the hemorheology and the self-strain rating scale were highly correlated in the thermal environment (r=0.839, P<0.01). For this reason, we can conclude that exercising in a hot environment will make people have a heavier heat stress response, and thus render them more likely to undergo muscle fatigue. It is advised that exercising at high temperatures may be avoided as much as possible.
The recent report of the Intergovernmental Panel on Climate Change is stark in its warnings about the changing climate, including future increases in the frequency and intensity of extremely hot weather. The well-established impacts of extreme heat on human health have led to widespread implementation of national and city-wide heat plans for mitigating such impacts. Evaluations of the effectiveness of some heat plans have been published, with previous reviews highlighting key methodological challenges. This article reviews methods used since and that address those challenges, so helping to set an agenda for improving evaluations of heat plans in terms of their effectiveness in reducing heat-health impacts. We examined the reviews that identified the methodological challenges and systematically searched the literature to find evaluations that had since been conducted. We found 11 evaluations. Their methods help address the key challenge of identifying study control groups and address other challenges to a limited extent. For future evaluations, we recommend: utilising recent evaluation methodologies, such as difference-in-differences quasi-experimental designs where appropriate; cross-agency working to utilise data on morbidity and confounders; adoption of a proposed universal heat index; and greater publication of evaluations. More evaluations should assess morbidity outcomes and be conducted in low- and middle-income countries. Evaluations of heat plans globally should employ robust methodologies, as demonstrated in existing studies and potentially transferrable from other fields. Publication of such evaluations will advance the field and thus help address some of the health challenges resulting from our changing climate.
Climate change causes global effects on multiple levels. The anthropogenic input of greenhouse gases increases the atmospheric mean temperature. It furthermore leads to a higher probability of extreme weather events (e.g., heat waves, floods) and thus strongly impacts the habitats of humans, animals, and plants. Against this background, research and innovation activities are increasingly focusing on potential health-related aspects and feasible adaptation and mitigation strategies. Progressing urbanization and demographic change paired with the climate change-induced heat island effect exposes humans living in urban habitats to increasing health risks. By employing scientometric methods, this scoping study provides a systematic bird’s eye view on the epistemic landscapes of climate change, its health-related effects, and possible technological and nature-based interventions and strategies in order to make urban areas climate proof. Based on a literature corpus consisting of 2614 research articles collected in SCOPUS, we applied network-based analysis and visualization techniques to map the different scientific communities, discourses and their interrelations. From a public health perspective, the results demonstrate the range of either direct or indirect health effects of climate change. Furthermore, the results indicate that a public health-related scientific discourse is converging with an urban planning and building science driven discourse oriented towards urban blue and green infrastructure. We conclude that this development might mirror the socio-political demand to tackle emerging climate change-induced challenges by transgressing disciplinary boundaries.
BACKGROUND: In hot weather, electric fans can potentially provide effective cooling for people, with lower greenhouse gas emissions and cost than air conditioning. However, international public health organisations regularly discourage fan use in temperatures higher than 35°C, despite little evidence. We aimed to determine humidity-dependent temperature thresholds at which electric fans would become detrimental in different age groups. METHODS: We used biophysical modelling to determine the upper humidity-dependent temperature thresholds at which fan use would become detrimental (ie, worsen heat stress) for healthy young adults (aged 18-40 years), healthy older adults (aged ≥65 years), and older adults taking anticholinergic medication. We also obtained hourly environmental data for the period Jan 1, 2007, to Dec 31, 2019, for 108 populous cities to determine the number of days fan use would be effective for cooling, standardised to a 31-day hot weather month. We established simplified temperature thresholds for future fan use recommendations on the basis of temperatures below which fan use would never have been detrimental between Jan 1, 2007, and Dec 31, 2019, across all prevailing levels of ambient humidity. FINDINGS: According to our model, fan use would have been beneficial on 30·0 (96·6%) of 31 hot weather days for healthy young adults and 29·4 (94·9%) of 31 hot weather days for both older adults and older adults taking anticholinergic medication between Jan 1, 2007, and Dec 31, 2019. Adherence to the current WHO recommendation of fan use below temperatures of 35°C only, fan use would have been recommended on 27·2 days (87·7%) of 31 hot weather days. According to our simplified thresholds for fan use (at temperatures <39·0°C for healthy young adults, <38·0°C for healthy older adults, and <37·0°C for older adults taking anticholinergic medication), fan use would have been recommended on 29·6 (95·5%) of 31 hot weather days in healthy young adults, 29·4 (94·8%) days in healthy older adults, and 28·8 (93·0%) days in older adults taking anticholinergic medication between Jan 1, 2007, and Dec 31, 2019. INTERPRETATION: Electric fan use, particularly for healthy young adults, would not have worsened heat stress on the majority of study days between 2007 and 2019. Our newly proposed thresholds for fan use provide simple guidelines that improve future heatwave fan use recommendations. FUNDING: None.
The ambition to develop sustainable and healthy cities requires city-specific policy and practice founded on a multidisciplinary evidence base, including projections of human-induced climate change. A cascade of climate models of increasing complexity and resolution is reviewed, which provides the basis for constructing climate projections-from global climate models with a typical horizontal resolution of a few hundred kilometres, through regional climate models at 12-50 km to convection-permitting models at 1 km resolution that permit the representation of urban induced climates. Different approaches to modelling the urban heat island (UHI) are also reviewed-focusing on how climate model outputs can be adjusted and coupled with urban canopy models to better represent UHI intensity, its impacts and variability. The latter can be due to changes induced by urbanisation or to climate change itself. City interventions such as greater use of green infrastructure also have an effect on the UHI and can help to reduce adverse health impacts such as heat stress and the mortality associated with increasing heat. Examples for the Complex Urban Systems for Sustainability and Health (CUSSH) partner cities of London, Rennes, Kisumu, Nairobi, Beijing and Ningbo illustrate how cities could potentially make use of more detailed models and projections to develop and evaluate policies and practices targeted at their specific environmental and health priorities. PRACTICE RELEVANCE: Large-scale climate projections for the coming decades show robust trends in rising air temperatures, including more warm days and nights, and longer/more intense warm spells and heatwaves. This paper describes how more complex and higher resolution regional climate and urban canopy models can be combined with the aim of better understanding and quantifying how these larger scale patterns of change may be modified at the city or finer scale. These modifications may arise due to urbanisation and effects such as the UHI, as well as city interventions such as the greater use of grey and green infrastructures.There is potential danger in generalising from one city to another-under certain conditions some cities may experience an urban cool island, or little future intensification of the UHI, for example. City-specific, tailored climate projections combined with tailored health impact models contribute to an evidence base that supports built environment professionals, urban planners and policymakers to ensure designs for buildings and urban areas are fit for future climates.
Urban heat island and regional climate change raise the ambient temperature in cities and increase the levels of heat related mortality. Higher albedo values lower the ambient temperature and reduce the impact of excess urban heat on health. The present work reviews and analyses fourteen detailed studies investigating the impact of increased urban albedo on the ambient temperature and heat related mortality. It is found that the real magnitude of the afternoon temperature drop caused by the albedo increase is close to 0.09C per 0.1 rise of the albedo, and it is highly determined by the specific climatic, landscape and layout characteristic of cities. A statistically significant association of the temperature drop with the albedo increase, the greenery and street ratio in cities is found. It is observed that the levels of heat related mortality increase significantly as a function of the population size of the cities and the local poverty levels, Increased urban albedo is found to reduce heat related mortality between 0.1 and 4 deaths per day, corresponding to an average decrease of deaths close to 19.8% per degree of temperature drop, or 1.8% per 0.1 increase of the albedo. Mortality drop is found to be in statistically significant association with the initial heat related mortality levels, albedo increase and socioeconomic parameters like the local poverty levels. Accurate parametric functions to predict the magnitude of the temperature drop and heat mortality reduction are developed.
The relationship between sport and the environment has been primarily examined to understand how sport impacts the natural environment. However, as the influence of climate change has become more apparent, there is a need to establish a systematic understanding of the impacts of climate change on the operations of sport. The aim of this review is to take stock of existing literature on climate change’s impacts on organized competitive sport entities, with further attention paid to their adaptation efforts. A scoping review was conducted to identify relevant studies published between 1995 and 2021. After evaluating more than 2100 publications, we retained 57 articles and analyzed them to answer the research questions: (1) What evidence is available regarding the impacts of climate change on the operation of organized competitive sport entities? (2) What is known from the literature about the measures taken by organized competitive sport entities to adapt to the impacts of climate change? Our analysis yielded five major themes: (1) Heat impacts on athlete and spectator health; (2) heat impacts on athlete performance; (3) adaptive measures taken in sport; (4) suitability of various cities for event hosting; and (5) benchmarking and boundary conditions. This review reveals that there is evidence of some climate change impacts on sport, but the literature reflects only a small share of the global sport sector. Equally, much remains to be understood about the nature of adaptation. This article is categorized under: Assessing Impacts of Climate Change > Evaluating Future Impacts of Climate Change
Projections show that Earth’s climate will continue to warm concurrent with increases in the percentage of the world’s elderly population. With an understanding that the body’s resilience to the heat degrades as it ages, these coupled phenomena point to serious concerns of heat-related mortality in growing elderly populations. As many of the people in this age cohort choose to live in managed long-term care facilities, it’s imperative that outdoor spaces of these communities be made thermally comfortable so that connections with nature and the promotion of non-sedentary activities are maintained. Studies have shown that simply being outside has a positive impact on a broad range of the psychosocial well-being of older adults. However, these spaces must be designed to afford accessibility, safety, and aesthetically pleasing experiences so that they are taken full advantage of. Here, we employ an integrative review to link ideas from the disciplines of climate science, health and physiology, and landscape architecture to explain the connections between heat, increased morbidity and mortality in aging adults, existing gaps in thermal comfort models, and key strategies in the development of useable, comfortable outdoor spaces for older adults. Integrative reviews allow for new frameworks or perspectives on a subject to be introduced. Uncovering the synergy of these three knowledge bases can contribute to guiding microclimatic research, design practitioners, and care providers as they seek safe, comfortable and inviting outdoor spaces for aging adults.
The Urban Heat Islands (UHI) effect is a microclimatic phenomenon that especially affects urban areas. It is associated with significant temperature increases in the local microclimate, and may amplify heat waves. Due to their intensity, UHI causes not only thermal discomfort, but also reductions in the levels of life quality. This paper reviews the important role of green infrastructure as a means through which the intensity of UHI may be reduced, along with their negative impact on human comfort and wellbeing. Apart from a comprehensive review of the available literature, the paper reports on an analysis of case studies in a set of 14 cities in 13 countries representing various geographical regions and climate zones. The results obtained suggest that whereas UHI is a common phenomenon, green infrastructure in urban areas may under some conditions ameliorate their impacts. In addition, the study revealed that the scope and impacts of UHI are not uniform: depending on peculiarities of urban morphologies, they pose different challenges linked to the microclimate peculiar to each city. The implications of this paper are threefold. Firstly, it reiterates the complex interrelations of UHIs, heat waves and climate change. Secondly, it outlines the fact that keeping and increasing urban green resources leads to additional various benefits that may directly or indirectly reduce the impacts of UHI. Finally, the paper reiterates the need for city planners to pay more attention to possible UHI effects when initiating new building projects or when adjusting current ones.
In buildings, energy is primarily consumed by mechanical air conditioning systems. Low energy alternatives, such as natural ventilation, are needed. However, they need to be able to cope with increasing heatwaves and pollution, particularly in warm climates. This review paper looked at the ability of natural ventilation to provide adequate thermal comfort, resilience against heatwaves, and good Indoor Air Quality in warm climates. Single sided ventilation demonstrates the poorest ability to provide thermal comfort, while cross ventilation highlights better performance in terms of reducing indoor air temperatures compared to outdoor. However, windcatchers and solar chimneys displayed even better performance by producing relatively high ventilation rates. During heatwaves and future climatic scenarios, natural ventilation, by cross-ventilation, was not able to meet internal thermal comfort standards. A potential low energy solution could be combining solar chimneys or windcatchers with water evaporation cooling. A critical synthesis of the literature suggests that these systems can generate high ventilation rates and keep indoor temperatures around 8 degrees C cooler than outdoor temperatures in warm weather (>35 degrees C). However, no studies were found testing these systems against future climate scenarios, and further studies are recommended. The literature supported natural ventilation being effective in removing pollution generated indoors due to adequate ventilation rates. However, using unfiltered natural ventilation for areas with high outdoor pollution can increase the indoor deposition of harmful particulate matter. With increasing air pollution, further studies are urgently required to investigate filter enabled natural ventilation, particularly with solar chimney/windcatcher incorporated.
Hot and humid working environments exist in civil engineering, exploration, shipping, and so on. Especially in mines and textile workplaces, the air humidity is usually close to saturation. Frontline workers perform physically demanding work, which will make the body sweat greatly and increase the occurrence of heat-related illnesses. The microenvironment under clothing can be improved by a ventilation cooling vest with pressurized air (denoted VCV), and the trunk skin temperature will be decreased. However, the amount of heat that a VCV removes from a working human body in hot and humid environments is unclear. In this study, human experiments were carried out, the ambient temperature was controlled at 30 degrees C, 32 degrees C or 34 degrees C, and the air humidity was 90%. The subjects wore a labor suit (denoted LS) or a VCV, running on a treadmill at 5 km/h or 7.5 km/h. The results showed that the total trunk heat loss was increased by 169-237%, and the cooling power of the VCV was between 79.5 and 97.6 W when wearing the VCV. However, the actual skin wettedness is often less than the calculated value, and the calculated cooling power should be considered the upper limit. The study indicated that the cooling capacity of the VCV increased as the ambient temperature and labor intensity increased, and the heat dissipation of the body also increased.
Working in hot and potentially humid conditions creates health and well-being risks that will increase as the planet warms. It has been proposed that workers could adapt to increasing temperatures by moving labor from midday to cooler hours. Here, we use reanalysis data to show that in the current climate approximately 30% of global heavy labor losses in the workday could be recovered by moving labor from the hottest hours of the day. However, we show that this particular workshift adaptation potential is lost at a rate of about 2% per degree of global warming as early morning heat exposure rises to unsafe levels for continuous work, with worker productivity losses accelerating under higher warming levels. These findings emphasize the importance of finding alternative adaptation mechanisms to keep workers safe, as well as the importance of limiting global warming.
BACKGROUND: Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting. METHODS: We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations. FINDINGS: Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99(th) temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries. INTERPRETATION: Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change. FUNDING: This publication was developed under Assistance Agreement No. RD83587101 awarded by the U.S. Environmental Protection Agency to Yale University. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Research reported in this publication was also supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012769. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Also, this work has been supported by the National Research Foundation of Korea (2021R1A6A3A03038675), Medical Research Council-UK (MR/V034162/1 and MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), Academy of Finland (Grant ID: 310372), European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655 and 874990), Czech Science Foundation (22-24920S), Emory University’s NIEHS-funded HERCULES Center (Grant ID: P30ES019776), and Grant CEX2018-000794-S funded by MCIN/AEI/ 10.13039/501100011033 The funders had no role in the design, data collection, analysis, interpretation of results, manuscript writing, or decision to publication.
The kidneys’ integrative responses to heat stress aid thermoregulation, cardiovascular control, and water and electrolyte regulation. Recent evidence suggests the kidneys are at increased risk of pathological events during heat stress, namely acute kidney injury (AKI), and that this risk is compounded by dehydration and exercise. This heat stress related AKI is believed to contribute to the epidemic of chronic kidney disease (CKD) occurring in occupational settings. It is estimated that AKI and CKD affect upwards of 45 million individuals in the global workforce. Water and electrolyte disturbances and AKI, both of which are representative of kidney-related pathology, are the two leading causes of hospitalizations during heat waves in older adults. Structural and physiological alterations in aging kidneys likely contribute to this increased risk. With this background, this comprehensive narrative review will provide the first aggregation of research into the integrative physiological response of the kidneys to heat stress. While the focus of this review is on the human kidneys, we will utilize both human and animal data to describe these responses to passive and exercise heat stress, and how they are altered with heat acclimation. Additionally, we will discuss recent studies that indicate an increased risk of AKI due to exercise in the heat. Lastly, we will introduce the emerging public health crisis of older adults during extreme heat events and how the aging kidneys may be more susceptible to injury during heat stress.
Climate change and rapid urbanization increase/amplify urban heat islands (UHIs). Green infrastructure (GI) is an effective and popularly strategy used to moderate UHIs. This paper aims to better understand the progress of different GI types (urban parks, urban forests, street trees, green roofs, green walls) in mitigating UHIs, and what benefits they provide. Firstly, this paper used CiteSpace to analyze 1243 publications on the Web of Science from 1990 to 2021, then analyzed the function/regulation of ecosystem services/benefits and values of GI types in reducing UHIs. The historical review results show that research on all GI types showed rapid growth since 2013, and their GR increased rapidly. The highest-ranking keywords were urban heat island/heat island, climate/climate change/microclimate, and temperature/land surface temperature/air temperature. “Design,” “vegetation,” “quality,” and “reduction” are the top four strongest keyword bursts. The most published countries are the People’s Republic of China, USA, Australia, Germany, and Italy, and the top three institutions are the Chinese Academy of Sciences, Arizona State University, and the National University of Singapore. Landscape and Urban Planning, Building and Environment, Energy and Building, and Urban Forestry and Urban Greening are the most published journals. In urban areas, different GI types as a form of ecosystem hardware provide multiple functions (reduced land surface temperatures, lower building energy usage, improved thermal comfort and enhanced human health, reduced morbidity and mortality, etc.). GI thus provides a regulated ecosystem service to ameliorate UHIs primarily through temperature regulation and shade. At the same time, GI provides benefits and values (ecological, economic, social, and cultural) to humans and urban sustainable development. GI types determine the functions they provide, afford corresponding regulated ecosystem services, and provide benefits and values in a logical/recycle system. Overall, this review highlights the development and importance of GI, as well as the relationship of GI types and functions of regulating the ecosystem service benefits and values to mitigate UHI, and advances the study of climate change adaptation in cities.
Urban areas are expanding due to rural-urban migration and due to population increases. Their resilience is being challenged due to socio-political consequences of increasingly frequent and severe storms, due to climate changes, influx of human and animal refugees and as a consequence of the COVID-19 pandemic. The authors prepared a systematic literature of ways cities can be transformed into more resilient, and sustainable regions by creatively enhancing the quality and quantity of blue and green areas in and around them. The literature review was conducted to provide holistic insights into selection, implementation monitoring, assessment, and valuation of Nature-based Solutions in diverse urban regions. The authors reviewed no fewer than 298 articles from 109 academic journals and related sources, published within 1997-2020. The focus of the articles was upon ‘nature-based’ changes that are being implemented in urban areas, globally to enhance their resilience and the ‘quality-of-life’ of humans and other species. By implementing nature-based solutions, and complimentary ‘urban wilding’ approaches, urban areas and their hinterlands are expanding their ‘blue’ and ‘green’ areas and are thereby decreasing the ‘heat-island’ effects, while improving human health by surrounding them with rich bio-diversities of locally adapted, aquatic and terrestrial plants and animals. Although, many NBS options have been documented to be beneficial, their environmental, economic and social/psychological dimensions have not been adequately quantified, especially in the context of climate changes, and with regard to COVID-19. It is essential that the benefits of NBS are quantified with easily measurable outcomes, that are readily understood by practitioners, city policy-makers and members of community organizations, based upon specific geographical and climatological contexts. This will help them accelerate implementation of NBS and wilding into their urban systems. The reviewers found that more research is needed on anticipatory learning, backcasting and community participation to help to effectively implement the appropriate NBS for improving the sustainability of urban systems. The reviewers provide guidance for urban leaders to incorporate NBS into their policies and strategies to improve urban resilience and equity and to more effectively reduce impacts of climate change, population growth and pandemics. (C) 2020 Elsevier Ltd. All rights reserved.
The present study aims to investigate the effects of co-exposure to heat and psychological stress on sperm DNA and semen parameters among male rats. The study was conducted on 40 healthy adult male Wistar rats. The rats were randomly categorized into four groups of same size consisting of a control group, a heat stress, psychological and co-exposure groups. The heat stress group was exposed to a temperature of 36 °C at 20% relative humidity. The psychological stress exposure group was subjected to three stressors including exposure to strobe light, noise and tilting cage. According the results,the co-exposure group had lower mean sperm parameters including sperm count (17.22 ± 4.22 10^6/ml), motility (42.63 ± 12.95 %), viability (48.50 ± 23.25 %), normal morphology (56 ± 7.5%), progressive motility (11.61 ± 7.81%), non-progressive motility (31.18 ± 7.77%), curvilinear velocity (24.11 ± 3.81 μm/s) and straight-line velocity (3.2 ± 1.4 μm/s) when compared with those of the other groups (P=0.001). Mean sperm immobility (57.36 ± 12.95%) and non-progressive motility (37.93 ± 11.15%) in the co-exposure group was higher compared to the other groups (P = 0.001 and P = 0.333, respectively). Assessment of damage to sperm DNA revealed that the heat exposure group had a higher percentage of sperm DNA damage (9.44 ± 6.80 %) compared to others (P=0.185). In case of all of exposure scenario, the chance that the semen quality decreased compared to the control group has been increased. In general the combined stress had a greater significant effect on sperm parameters compared to other exposure groups, except for DNA damage.
The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme events and their effect on gender-based violence (GBV) experienced by women, girls, and sexual and gender minorities. We searched ten databases until February, 2022. Grey literature was searched using the websites of key organisations working on GBV and Google. Quantitative studies were described narratively, whereas qualitative studies underwent thematic analysis. We identified 26 381 manuscripts. 41 studies were included exploring several types of extreme events (ie, storms, floods, droughts, heatwaves, and wildfires) and GBV (eg, sexual violence and harassment, physical violence, witch killing, early or forced marriage, and emotional violence). Studies were predominantly cross-sectional. Although most qualitative studies were of reasonable quality, most quantitative studies were of poor quality. Only one study included sexual and gender minorities. Most studies showed an increase in one or several GBV forms during or after extreme events, often related to economic instability, food insecurity, mental stress, disrupted infrastructure, increased exposure to men, tradition, and exacerbated gender inequality. These findings could have important implications for sexual-transformative and gender-transformative interventions, policies, and implementation. High-quality evidence from large, ethnographically diverse cohorts is essential to explore the effects and driving factors of GBV during and after extreme events.
Climate change is a major global public-health challenge that will have wide-ranging impacts on human psychological health and well-being. Children and adolescents are at particular risk because of their rapidly developing brain, vulnerability to disease, and limited capacity to avoid or adapt to threats and impacts. They are also more likely to worry about climate change than any other age group. Drawing on a developmental life-course perspective, we show that climate-change-related threats can additively, interactively, and cumulatively increase psychopathology risk from conception onward; that these effects are already occurring; and that they constitute an important threat to healthy human development worldwide. We then argue that monitoring, measuring, and mitigating these risks is a matter of social justice and a crucial long-term investment in developmental and mental health sciences. We conclude with a discussion of conceptual and measurement challenges and outline research priorities going forward.
Empirical evidence suggests that the effects of anthropogenic climate change, and heat in particular, could have a significant impact on mental health. This article investigates the correlation between heatwaves and/or relative humidity and suicide (fatal intentional self-harm) on a global scale. The covariance between heat/humidity and suicide was modelled using a negative binomial Poisson regression with data from 60 countries between 1979-2016. Statistically significant increases and decreases in suicide were found, as well as many cases with no significant correlation. We found that relative humidity showed a more significant correlation with suicide compared to heatwaves and that both younger age groups and women seemed to be more significantly affected by changes in humidity and heatwave counts in comparison with the rest of the population. Further research is needed to provide a larger and more consistent basis for epidemiological studies; to understand better the connections among heat, humidity and mental health; and to explore in more detail which population groups are particularly impacted and why.
Extreme weather events (EWEs) are increasing in frequency and severity as the planet continues to become warmer. Resulting disasters have the potential to wreak havoc on the economy, infrastructure, family unit, and human health. Global estimates project that children will be disproportionately impacted by the changing climate – shouldering 88% of the related burdens. Exposure to EWEs in childhood is traumatic, with ramifications for mental health specifically. Symptoms of posttraumatic stress, depression, and anxiety have all been associated with childhood EWE exposure and have the potential to persist under certain circumstances. Conversely, many childhood survivors of EWE also demonstrate resilience and experience only transient symptoms. While the majority of studies are focused on the effects resulting from one specific type of disaster (hurricanes), we have synthesized the literature across the various types of EWEs. We describe psychological symptoms and behavior, the potential for long-term effects, and potential protective factors and risk factors. What this paper adds Climate change-related phenomena such as extreme weather events (EWEs) have the potential to impact mood and behavior in children. Posttraumatic stress (PTS) is the most common mental health consequence in child survivors of EWEs. PTS is often comorbid with depression and/or anxiety in this group.
AIMS: Explore the effects of heat stress and psychological stress combined exposure on the uterus and its underlying mechanisms. MAIN METHODS: Sixty female Sprague-Dawley rats were randomly assigned to four groups: control group, psychological stress group, high ambient temperature group, and high ambient temperature combined with psychological stress group. All treatments were administered for two weeks. During this period, the estrous cycle, body weights and rectal temperature were measured regularly. Then, ovarian weight coefficient, serum estradiol (E(2)) and progesterone (P) concentration, uterine histomorphological alterations, levels of tumor necrosis factor alpha (TNF-α), malondialdehyde (MDA) and superoxide dismutase (SOD), and the expressions of ovarian hormone receptors, leukemia inhibitory factor (LIF) and its receptor, homeobox gene A10 (HoxA10), Wnt5a, Wnt7a, β-catenin, and P-β-catenin(Y142) in the uterus and endometrium were detected. KEY FINDINGS: High temperature combined with psychological stress lead to body weight, body temperature, ovarian hormones and estrus cycle disorder, uterine gland ducts expansion and endometrial thickness reduction, and the decreased expression of endometrial receptivity markers (LIF and HoxA10). Further, disturbed expression of E(2) and P receptors in endometrium, elevated MDA and TNF-α levels, and decreased Wnt5a, Wnt7a and P-β-catenin(Y142) content were found. Our data suggested that co-exposure to high temperature and psychological stress could aggravate uterine damage probably by inducing ovarian hormonal disorder and the subsequent oxidative stress and inflammation, and reduce the endometrial function through suppressing Wnt signaling. SIGNIFICANCE: This will provide the scientific basis for improving female reproductive health, and preventing and treating reproductive disorders.
BACKGROUND: Mortality due to enteric infections is projected to increase because of global warming; however, the different temperature sensitivities of major enteric pathogens have not yet been considered in projections on a global scale. We aimed to project global temperature-attributable enteric infection mortality under various future scenarios of sociodemographic development and climate change. METHODS: In this modelling study, we generated global projections in two stages. First, we forecasted baseline mortality from ten enteropathogens (non-typhoidal salmonella, Shigella, Campylobacter, cholera, enteropathogenic Escherichia coli, enterotoxigenic E coli, typhoid, rotavirus, norovirus, and Cryptosporidium) under several future sociodemographic development and health investment scenarios (ie, pessimistic, intermediate, and optimistic). We then estimated the mortality change from baseline attributable to global warming using the product of projected annual temperature anomalies and pathogen-specific temperature sensitivities. FINDINGS: We estimated that in the period 2080-95, the global mean number of temperature-attributable deaths due to enteric infections could be as low as 6599 (95% empirical CI 5441-7757) under the optimistic sociodemographic development and climate change scenario, or as high as 83 888 (67 760-100 015) under the pessimistic scenario. Most of the projected temperature-attributable deaths were from shigellosis, cryptosporidiosis, and typhoid fever in sub-Saharan Africa and South Asia. Considerable reductions in the number of attributable deaths were from viral infections, such as rotaviral and noroviral enteritis, which resulted in net reductions in attributable enteric infection mortality under optimistic scenarios for Latin America and the Caribbean and East Asia and the Pacific. INTERPRETATION: Temperature-attributable mortality could increase under warmer climate and unfavourable sociodemographic conditions. Mitigation policies for limiting global warming and sociodemographic development policies for low-income and middle-income countries might help reduce mortality from enteric infections in the future. FUNDING: Japan Society for the Promotion of Science, Japan Science and Technology Agency, and Spanish Ministry of Economy, Industry, and Competitiveness.
INTRODUCTION: This study quantitatively described the disease burden of diabetes and kidney disease attributable to non-optimal temperatures and explored the influencing factors. METHODS: We quantitatively described the mortality burden of diabetes and kidney disease attributable to non-optimal temperatures in six countries (China, USA, South Africa, Australia, Iraq, Portugal), and compare trends in mortality in six countries from 1990 to 2019. We used the APC model to analyse age, period, and cohort effects on mortality in six countries. We used restricted cubic splines and quantile regression to analyse the association of SDI with mortality and YLL using data from 21 regions in the world. RESULTS: The mortality rates of diabetes and kidney disease in the six countries in 2019 were 1.72% (Australia), 1.83% (China), 2.99% (USA), 3% (Portugal), 7.45% (South Africa) and 8.71% (Iraq) attributable to non-optimal temperatures. Cold was more harmful than heat. The mortality, YLLs of diabetes and kidney disease of male were higher than females. The mortality rate showed an upwards trend with age. The period effect had little changes or showed a slight upwards trend. The cohort effect showed a downwards trend. The regions with higher mortality or YLLs rates were mainly had SDI values of 0.45-0.80. CONCLUSIONS: Among the death burdens of diabetes and kidney disease attributed to non-optimal temperatures, cold had a greater burden than heat. The burden of death was affected by sex, age, period, cohort, and SDI.
Many studies project that climate change is expected to cause a significant number of excess deaths. Yet, in integrated assessment models that determine the social cost of carbon (SCC), human mortality impacts do not reflect the latest scientific understanding. We address this issue by estimating country-level mortality damage functions for temperature-related mortality with global spatial coverage. We rely on projections from the most comprehensive published study in the epidemiology literature of future temperature impacts on mortality (Gasparrini et al. in Lancet Planet Health 1:e360-e367, 2017), which estimated changes in heat- and cold-related mortality for 23 countries over the twenty-first century. We model variation in these mortality projections as a function of baseline climate, future temperature change, and income variables and then project future changes in mortality for every country. We find significant spatial heterogeneity in projected mortality impacts, with hotter and poorer places more adversely affected than colder and richer places. In the absence of income-based adaptation, the global mortality rate in 2080-2099 is expected to increase by 1.8% [95% CI 0.8-2.8%] under a lower-emissions RCP 4.5 scenario and by 6.2% [95% CI 2.5-10.0%] in the very high-emissions RCP 8.5 scenario relative to 2001-2020. When the reduced sensitivity to heat associated with rising incomes, such as greater ability to invest in air conditioning, is accounted for, the expected end-of-century increase in the global mortality rate is 1.1% [95% CI 0.4-1.9%] in RCP 4.5 and 4.2% [95% CI 1.8-6.7%] in RCP 8.5. In addition, we compare recent estimates of climate-change induced excess mortality from diarrheal disease, malaria and dengue fever in 2030 and 2050 with current estimates used in SCC calculations and show these are likely underestimated in current SCC estimates, but are also small compared to more direct temperature effects.
INTRODUCTION: Hot and cold weather events are increasingly becoming a global burden resulting in premature and preventable morbidity and mortality, particularly in vulnerable groups such as older people and people with chronic health conditions. However, risk perception regarding weather is generally poor among vulnerable groups which often acts as a barrier to the uptake of critical health-protective behaviours. A more cohesive understanding of determinants of risk perception is needed to inform public health risk communication and behaviour change interventions that promote protective health behaviours. This scoping literature review aimed to understand factors influencing perception of personal health risks in vulnerable groups as a result of exposure to hot and cold weather events. METHODS: A five-stage scoping review framework was followed. Searches were run across Medline, PsychInfo, Web of Science and EMBASE. Papers were included if they provided rationale for risk perceptions in vulnerable groups in indoor/domestic environments and focussed on samples from OECD countries. RESULTS: In total, 13 out of 15,554 papers met the full inclusion criteria. The majority of papers focused on hot weather events: one study exclusively examined cold weather events and one study addressed both cold and hot weather events. Included papers focused on older adults aged 65+ years. The papers identified eight factors that were associated with older adults’ personal health risk perception of hot and cold weather events: (1) Knowledge of the relationship between hot/cold weather and health risks, (2) presence of comorbidities, (3) age and self-identity, (4) perceived weather severity, (5) Beliefs associated with regional climate, (6) past experience with weather, (7) misconceptions of effectiveness of protective behaviours, and (8) external locus of control. CONCLUSIONS: Future research should explore risk communication methods by implementing the identified risk perception determinants from this review into health protection interventions targeting older adults. Further understanding is needed regarding risk perceptions in non-elderly vulnerable groups, for examples individuals with chronic diseases or disabilities.
BACKGROUND: Associations between ambient temperature exposure during pregnancy and stillbirth have been reviewed and described in the literature. However, there is no existing review of environmental and epidemiologic methods applied to measure stillbirths resulting from exposure to ambient temperatures during pregnancy. The objective of this study is to systematically review published methods, data sources, and data linkage practices to characterize associations between ambient temperature and stillbirth to inform stillbirth prevention and risk management strategies. METHODS: A systematic review of published studies that assess the association between ambient temperature exposure during pregnancy using any measures or approach and stillbirth was undertaken in Cochrane Library, PubMed, Medline, Scopus, Embase, and Web of Science of studies (2000-2020, inclusive). Selection of studies were assessed by pre-specified eligibility criteria and documented using PRISMA. Citations were managed using EndNote X8 whilst selection, reviewing, and data extraction were performed using Covidence. The screening, selection, and data extraction process consisted of two blind, independent reviews followed by a tertiary independent review. An adapted Critical Appraisal Skills Program (CASP) checklist was used to assess quality and bias. The main findings and characteristics of all studies was extracted and summarized. Where appropriate, a meta-analysis will be performed for measures of association. RESULTS: Among 538 original records, 12 eligible articles were identified that analysed associations between ambient temperature exposure and stillbirth for 42,848 stillbirths among 3.4 million births across seven countries. Varied definitions of stillbirth were reported based on gestational age, birthweight, both, or neither. The overall rate of stillbirth ranged from 1.9 to 38.4 per 1000 among six high-income countries and one low-middle-income country. All study designs were retrospective and included ten cohort studies, three case-crossover studies, and two additional case-control subgroup analysis. Exposure data for ambient temperature was mostly derived from standard municipal or country-level monitors based on weather stations (66.6%) or a forecasting model (16.7%); otherwise, not reported (16.7%). Results were not statistically pooled for a meta-analysis due to heterogeneity of methods and models among included studies. All studies reported associations of increased risk of stillbirth with ambient temperature exposures throughout pregnancy, particularly in late pregnancy. One study estimates 17-19% (PAR) of stillbirths are potentially attributable to chronic exposure to hot and cold ambient temperatures during pregnancy. Overall, risk of stillbirth was observed to increase below 15 °C and above 23.4 °C, where highest risk is above 29.4 °C. CONCLUSION: Exposure to hot and cold temperatures during pregnancy may increase the risk of stillbirth, although a clear causative mechanism remains unknown. Despite lack of causal evidence, existing evidence across diverse settings observed similar effects of increased risk of stillbirth using a variety of statistical and methodological approaches for exposure assessments, exposure windows, and data linkage. Managing exposure to ambient temperatures during pregnancy could potentially decrease risk of stillbirth, particularly among women in low-resource settings where access to safe antenatal and obstetric care is challenging. To fully understand the effects or dose-response relationship of maternal exposure to ambient temperatures and stillbirth, future studies should focus on biological mechanisms and contributing factors in addition to improving measurement of ambient temperature exposure.
To date, no review has focused specifically on the potential modulating role of environmental temperature on the effects of exercise on cognitive function. Despite this, a range of occupations and performance contexts exist (e.g., military personnel, emergency services, sport) where the maintenance of cognitive function in environmentally challenging environments is crucial. Therefore, this systematic review aimed to evaluate the experimental research investigating how manipulating environmental temperature influenced the effects of acute bouts exercise on cognitive functioning from pre-to-post exercise, or during exercise. Studies to be included were assessed by two authors reviewing title, abstract, and then full-text. From the searches conducted, twenty articles were identified which met the inclusion criteria. For the purpose of this review, exercise involved in each study was categorised into low, moderate, and vigorous dosages (dependent on intensity and duration). The results indicate that moderate dosages of exercise help stimulate improved cognitive performance from pre-to-post exercise in temperate conditions, where cold exposure appears to blunt these effects. In addition, hot environments led to cognitive decrements during and post exercise which were often identified in studies that implemented prolonged moderate or vigorous exercise protocols. Therefore, suggesting a combination of heightened physiological strain from increased dose of exercise, alongside heat exposure, can be detrimental to optimal cognitive functioning, whereby executive functioning tasks appeared to be most affected. The findings from this systematic review highlight the potential modulating role of environmental temperature on the effects of exercise on cognitive function. Thus, highlighting the importance of considering the role of environmental temperature for individuals either exercising to elicit desired cognitive benefits or for those involved in physically demanding occupations or performance domains.
BACKGROUND: We investigated adolescents’ feelings of thermal comfort during the educational process in various geographical locations far apart and present recommendations for the adjustment of the thermal environment in schools. METHODS: The prospective international multicenter study took place in 8 locations on different continents. The survey in the form of a questionnaire was carried out among 2800 healthy high school students. The study was divided into “cold season survey,” “warm-season survey,” and heat wave survey. RESULTS: The statistically significant difference between the “cold season survey” score of 4.04 (discomfort) and “warm-season survey” score of 3.47 (slight discomfort) (p = .04) indicates that students feel more thermal discomfort during winter months in all 8 locations. The heat wave survey score was 4.53 (discomfort). During the cold season, 29.24% of high school students felt themselves in full thermal comfort and 76.48% of the students felt themselves relatively comfortable (slightly cool-comfortable-slightly warm). CONCLUSIONS: Even during the ongoing process of climate change, the cold season discomfort remains the main problem for students in classes. This tendency is present in different continents as a universal problem. We recommend keeping an entrance hall and classroom temperatures at different levels and to advise students about proper clothing.
BACKGROUND: There is growing evidence in support of a short-term association between ambient temperature and cardiac arrest attacks that is a serious manifestation of cardiovascular disease and has a high incidence and low survival rate. However, it remains unrecognized about the hazardous temperature exposure types, exposure risk magnitude, and vulnerable populations. OBJECTIVES: We comprehensively summarize prior epidemiological studies looking at the short-term associations of out-of-hospital cardiac arrest (OHCA) with various temperature exposures among different populations. METHODS: We searched PubMed and Web of Science databases from inception to October 2021 for eligible English language. Temperature exposure was categorized into three types: heat (included high temperature, extreme heat, and heatwave), cold (included low temperature and extreme cold), and temperature variation (included diurnal temperature range and temperature change between two adjacent days). Meta-analysis weighted by inverse variance was used to pool effect estimates. RESULTS: This study included 15 studies from 8 countries, totaling around 1 million OHCA events. Extreme heat and extreme cold were significantly associated with an increased risk of OHCA, and the pooled relative risks (RRs) were 1.071 [95 % confidence interval (CI): 1.019-1.126] and 1.662 (95%CI: 1.138-2.427), respectively. The risk of OHCA was also elevated by heatwaves (RR = 1.248, 95%CI: 1.091-1.427) and more intensive heatwaves had a greater effect. Notably, the elderly and males seemed to be more vulnerable to the effects of heat and cold. However, we did not observe a significant association between temperature variation and the risk of OHCA (1.005, 95%CI: 0.999-1.012). CONCLUSION: Short-term exposure to heat and cold may be novel risk factors for OHCA. Considering available studies in limited regions, the temperature effect on OHCA should be urgently confirmed in different regions.
OBJECTIVES: Incidence and prognosis of ST-segment elevation myocardial infarction (STEMI) vary according to ambient temperature and season. We sought to assess whether season and temperature on the day of STEMI are associated with infarct size, microvascular obstruction (MVO), left ventricular ejection fraction (LVEF) and clinical outcomes after primary percutaneous coronary intervention (PCI). METHODS: Individual patient data from 1598 patients undergoing primary PCI in six randomized clinical trials were pooled. Infarct size was evaluated by cardiac magnetic resonance within 30 days in all trials. Patients were categorized either by whether they presented on a day of temperature extremes (minimum temperature <0 °C or maximum temperature >25 °C) or according to season. RESULTS: A total of 558/1598 (34.9%) patients presented with STEMI on a day of temperature extremes, and 395 (24.7%), 374 (23.4%), 481 (30.1%) and 348 (21.8%) presented in the spring, summer, fall and winter. After multivariable adjustment, temperature extremes were independently associated with larger infarct size (adjusted difference 2.8%; 95% CI, 1.3-4.3; P < 0.001) and smaller LVEF (adjusted difference -2.3%; 95% CI, -3.5 to -1.1; P = 0.0002) but not with MVO (adjusted P = 0.12). In contrast, infarct size, MVO and LVEF were unrelated to season (adjusted P = 0.67; P = 0.36 and P = 0.95, respectively). Neither temperature extremes nor season were independently associated with 1-year risk of death or heart failure hospitalization (adjusted P = 0.79 and P = 0.90, respectively). CONCLUSION: STEMI presentation during temperature extremes was independently associated with larger infarct size and lower LVEF but not with MVO after primary PCI, whereas season was unrelated to infarct severity.
BACKGROUND: Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. METHODS: We used unified data collection protocols within the Multi-Country Multi-City Collaborative Network to assemble a database of daily counts of specific cardiovascular causes of death from 567 cities in 27 countries across 5 continents in overlapping periods ranging from 1979 to 2019. City-specific daily ambient temperatures were obtained from weather stations and climate reanalysis models. To investigate cardiovascular mortality associations with extreme hot and cold temperatures, we fit case-crossover models in each city and then used a mixed-effects meta-analytic framework to pool individual city estimates. Extreme temperature percentiles were compared with the minimum mortality temperature in each location. Excess deaths were calculated for a range of extreme temperature days. RESULTS: The analyses included deaths from any cardiovascular cause (32 154 935), ischemic heart disease (11 745 880), stroke (9 351 312), heart failure (3 673 723), and arrhythmia (670 859). At extreme temperature percentiles, heat (99th percentile) and cold (1st percentile) were associated with higher risk of dying from any cardiovascular cause, ischemic heart disease, stroke, and heart failure as compared to the minimum mortality temperature, which is the temperature associated with least mortality. Across a range of extreme temperatures, hot days (above 97.5th percentile) and cold days (below 2.5th percentile) accounted for 2.2 (95% empirical CI [eCI], 2.1-2.3) and 9.1 (95% eCI, 8.9-9.2) excess deaths for every 1000 cardiovascular deaths, respectively. Heart failure was associated with the highest excess deaths proportion from extreme hot and cold days with 2.6 (95% eCI, 2.4-2.8) and 12.8 (95% eCI, 12.2-13.1) for every 1000 heart failure deaths, respectively. CONCLUSIONS: Across a large, multinational sample, exposure to extreme hot and cold temperatures was associated with a greater risk of mortality from multiple common cardiovascular conditions. The intersections between extreme temperatures and cardiovascular health need to be thoroughly characterized in the present day-and especially under a changing climate.
BACKGROUND: There is rapidly growing evidence indicating that extreme temperature is a crucial trigger and potential activator of asthma; however, the effects of extreme temperature on asthma are inconsistently reported and the its potential mechanisms remain undefined. OBJECTIVES: This review aims to estimate the impacts of extreme heat, extreme cold, and temperature variations on asthma by systematically summarizing the existing studies from epidemiological evidence to biological plausibility. METHODS: We conducted a systematic search in PubMed, Embase, and Web of Science from inception to June 30, 2022, and we retrieved articles of epidemiology and biological studies which assessed associations between extreme temperatures and asthma. This protocol was registered with PROSPERO (CRD42021273613). RESULTS: From 12,435 identified records, 111 eligible studies were included in the qualitative synthesis, and 37 articles were included in the meta-analysis (20 for extreme heat, 16 for extreme cold, and 15 for temperature variations). For epidemiological evidence, we found that the synergistic effects of extreme temperatures, indoor/outdoor environments, and individual vulnerabilities are important triggers for asthma attacks, especially when there is extreme heat or cold. Meta-analysis further confirmed the associations, and the pooled relative risks for asthma attacks in extreme heat and extreme cold were 1.07 (95%CI: 1.03-1.12) and 1.20 (95%CI: 1.12-1.29), respectively. Additionally, this review discussed the potential inflammatory mechanisms behind the associations between extreme temperatures and asthma exacerbation, and highlighted the regulatory role of immunological pathways and transient receptor potential ion channels in asthma triggered by extreme temperatures. CONCLUSIONS: We concluded that both extreme heat and cold could significantly increase the risk of asthma. Additionally, we proposed a potential mechanistic framework, which is important for understanding the disease pathogenesis that uncovers the complex mechanisms of asthma triggered by extreme temperatures and protects the sensitive individuals from impacts of extreme weather events and climate change.
INTRODUCTION: Defining extreme temperatures as the cause of death remains challenging. It is mostly based on circumstantial, macroscopic and microscopic features. METHODS: We retrospectively compared groups of cases of fatal hypothermia, fatal hyperthermia and non-extreme temperature-related deaths. We analysed specific histological findings, focusing on samples from the liver, pancreas and kidney. RESULTS: Between 1 January 2013 and 31 December 2016, 15 autopsies were performed for deaths related to extreme temperatures. They included 11 cases of fatal hypothermia (group A), four cases of fatal hyperthermia (group B) and eight controls (group C). Perinuclear hepatocyte vacuolisation was observed in seven cases of hypothermia, one case of hyperthermia and four controls. Pancreatic cytoarchitecture was well preserved in two cases of hypothermia, one case of hyperthermia and two controls. No particular microscopic feature was found in pancreatic samples. Renal epithelial tubular cell vacuolisation was observed in seven cases of hypothermia and one case of hyperthermia, while it was absent in all controls. Chromogranin A (CgA) was markedly positive in the pancreatic tissue of five cases of fatal hypothermia and one control, and mildly positive in one case of fatal hyperthermia. No significant p-values were observed for any comparisons (p > 0.05), except when hypothermia cases group were compared to the control group for the Armanni-Ebstein phenomenon test (p = 0.0078). CONCLUSIONS: Although our study did not find a specific microscopic marker, hepatocyte vacuolisation, the Armanni-Ebstein phenomenon and pancreatic CgA positivity, taken together, may be useful tools to confirm hypo- and hyperthermia-related deaths, in addition to circumstantial and macroscopic findings.
BACKGROUND: Associations between high and low temperatures and increases in mortality and morbidity have been previously reported, yet no comprehensive assessment of disease burden has been done. Therefore, we aimed to estimate the global and regional burden due to non-optimal temperature exposure. METHODS: In part 1 of this study, we linked deaths to daily temperature estimates from the ERA5 reanalysis dataset. We modelled the cause-specific relative risks for 176 individual causes of death along daily temperature and 23 mean temperature zones using a two-dimensional spline within a Bayesian meta-regression framework. We then calculated the cause-specific and total temperature-attributable burden for the countries for which daily mortality data were available. In part 2, we applied cause-specific relative risks from part 1 to all locations globally. We combined exposure-response curves with daily gridded temperature and calculated the cause-specific burden based on the underlying burden of disease from the Global Burden of Diseases, Injuries, and Risk Factors Study, for the years 1990-2019. Uncertainty from all components of the modelling chain, including risks, temperature exposure, and theoretical minimum risk exposure levels, defined as the temperature of minimum mortality across all included causes, was propagated using posterior simulation of 1000 draws. FINDINGS: We included 64·9 million individual International Classification of Diseases-coded deaths from nine different countries, occurring between Jan 1, 1980, and Dec 31, 2016. 17 causes of death met the inclusion criteria. Ischaemic heart disease, stroke, cardiomyopathy and myocarditis, hypertensive heart disease, diabetes, chronic kidney disease, lower respiratory infection, and chronic obstructive pulmonary disease showed J-shaped relationships with daily temperature, whereas the risk of external causes (eg, homicide, suicide, drowning, and related to disasters, mechanical, transport, and other unintentional injuries) increased monotonically with temperature. The theoretical minimum risk exposure levels varied by location and year as a function of the underlying cause of death composition. Estimates for non-optimal temperature ranged from 7·98 deaths (95% uncertainty interval 7·10-8·85) per 100 000 and a population attributable fraction (PAF) of 1·2% (1·1-1·4) in Brazil to 35·1 deaths (29·9-40·3) per 100 000 and a PAF of 4·7% (4·3-5·1) in China. In 2019, the average cold-attributable mortality exceeded heat-attributable mortality in all countries for which data were available. Cold effects were most pronounced in China with PAFs of 4·3% (3·9-4·7) and attributable rates of 32·0 deaths (27·2-36·8) per 100 000 and in New Zealand with 3·4% (2·9-3·9) and 26·4 deaths (22·1-30·2). Heat effects were most pronounced in China with PAFs of 0·4% (0·3-0·6) and attributable rates of 3·25 deaths (2·39-4·24) per 100 000 and in Brazil with 0·4% (0·3-0·5) and 2·71 deaths (2·15-3·37). When applying our framework to all countries globally, we estimated that 1·69 million (1·52-1·83) deaths were attributable to non-optimal temperature globally in 2019. The highest heat-attributable burdens were observed in south and southeast Asia, sub-Saharan Africa, and North Africa and the Middle East, and the highest cold-attributable burdens in eastern and central Europe, and central Asia. INTERPRETATION: Acute heat and cold exposure can increase or decrease the risk of mortality for a diverse set of causes of death. Although in most regions cold effects dominate, locations with high prevailing temperatures can exhibit substantial heat effects far exceeding cold-attributable burden. Particularly, a high burden of external causes of death contributed to strong heat impacts, but cardiorespiratory diseases and metabolic diseases could also be substantial contributors. Changes in both exposures and the composition of causes of death drove changes in risk over time. Steady increases in exposure to the r
Due to rising temperatures and CO(2) emissions, climate change has become one of the most important global issues. We described the relationship between extreme weather-related events and death, globally, from 1999 through 2018. We used data from the emergency events database of the Université Catholique de Louvain. We also categorized the countries’ income according to the World Bank GDP and we used the CO(2) emission levels data from the Carbon Dioxide Information Analysis Center to link the GDP and CO(2) emissions to years of extreme weather conditions in each country. We conducted descriptive and Poisson Regression analysis to analyze the data. A total of 77 countries reported 425 extreme weather-related events from1999 through 2018. Mortality related events were highest in middle-income countries due to severe winter conditions (N = 2,020) and cold-waves (N = 70,972). The total number of recorded deaths due to heat waves was highest in high-income countries (N = 84,344). Furthermore, the number of deaths in high-income countries, compared to low-income countries, was five-fold higher (IRR 5.18; 95%CI 4.58; 5.85, p < 0.001). The mortality rate in heat season was almost seven-fold higher than that in cold/severe winter (IRR 33.43; 95%CI 32.85; 34.02, p < 0.001). The number of deaths increased significantly with the repetition of extreme events (IRR 6.82; 95%CI 6.68; 6.96, p < 0.001). We found the number of deaths increased in high-income countries, and this was associated with an increase in the number of times extreme events occurred per year and with heat wave.
The frequency and duration of extreme temperature events continues to increase worldwide. However, the scale of population exposure and its quantitative relationship with health risks remains unknown on a global scale, limiting our ability to identify policy priorities in response to climate change. Based on data from 171 countries between 2010 and 2019, this study estimated the exposure of vulnerable populations to extreme temperatures, and their contemporary and lag associations with disease burden attributed to non-optimal temperatures. Fixed-effects models and dynamic panel models were applied. Increased vulnerable population exposure to extreme temperatures had adverse contemporary effects on the burden of disease attributed to non-optimal temperature. Health risks stemming from extreme cold could accumulate to a greater extent, exhibiting a larger lag effect. Population exposure to extreme cold was mainly distributed in high-income countries, while extreme heat occurred more in low-income and middle-income countries. However, the association between population exposure to extreme cold and burden of disease was much stronger in low-income and middle-income countries than in high-income countries, whereas the effect size of population exposure to extreme heat was similar. Our study highlighted that differential strategies should be determined and implemented according to the characteristics in different countries.
Workplace hazards and accidents occur more frequently in the construction industry than in any other industries. Occupational hazards cannot be completely eliminated but can be reduced to an extent where workers can perform activities in a safe environment. Health and safety of workers in construction site is of at most importance to employers, which when ignored can lead to fatal injuries and even death affecting the progress of work and project completion time. The goal of this study is to identify critical factors affecting workers health in extreme weather conditions and to identify the vulnerable workers based on age, gender, and ethnicity. Therefore, a questionnaire survey was developed and distributed to identify critical health challenges faced by construction workers while working in unfavorable weather conditions. The results revealed that workers with pre-existing medical condition like hyper-tension face higher unfavorable impacts on their health while working in extreme hot weather. Based on gender, female workers suffer from more heat related disorders compared to male workers. Based on age, workers above 50 years are more affected when working in extreme weather conditions compared to workers of other age groups. In addition, some workers reported increased irritation and distraction from work due to physical discomfort of working in unfavorable environment leading to more accidents at workplace. Moreover, some workers reported increased onset of muscle fatigue due to tight thermal clothing during cold weather conditions. Prolonged exposure to cold winds tends to distract the workers, leading to workers becoming more hallucinatory and disoriented. The results of this study will help employers and project managers to take proper actions against the unforeseen factors affecting the workers’ health and safety in the construction sites with extreme weather conditions.
BACKGROUND: Although a few studies have reported the relationship between high and low temperatures and chronic kidney disease (CKD), the global burden of CKD attributable to extreme heat and cold in recent decades remains unknown. METHODS: Based on the Global Burden of Disease Study (GBD) 2019, we obtained data on age-standardized mortality rates (ASMR) and age-standardized rates of disability-adjusted life years (ASDR) per 100 000 population of the CKD attributable to non-optimum temperatures from 1990 to 2019. The annual mean temperature of each country was used to divide each country into five climate zones (tropical, subtropical, warm-temperate, cool-temperate, and boreal). The locally weighted regression model was used to estimate the burden for different climate zones and Socio-demographic index (SDI) regions. RESULTS: In 1990, the ASMR and ASDR due to high temperature estimated -0.01 (95% UI, -0.74 to 0.44) and -0.32 (-21.66 to 12.66) per 100 000 population, respectively. In 2019, the ASMR and ASDR reached 0.10 (-0.28 to 0.38) and 2.71 (-8.07 to 10.46), respectively. The high-temperature burden increased most rapidly in tropical and low SDI regions. There were 0.99 (0.59 to 1.39) ASMR attributable to low-temperature in 1990, which increased to 1.05 (0.61-1.49) in 2019. While the ASDR due to low temperature declined from 22.03 (12.66 to 30.64) in 1990 to 20.43 (11.30 to 29.26) in 2019. Overall, the burden of CKD attributable to non-optimal temperatures has increased from 1990 to 2019. CKD due to hypertension and diabetes mellitus were the primary causes of CKD death attributable to non-optimum temperatures in 2019 with males and older adults being more susceptible to these temperatures. CONCLUSIONS: The CKD burden due to high, low, and non-optimum temperatures varies considerably by regions and countries. The burden of CKD attributable to high temperature has been increasing since 1990.
BACKGROUND AND OBJECTIVES: Although the international community collectively seeks to reduce global temperature rise to less than 1.5°C before 2100, irreversible environmental changes have already occurred, and as the planet warms, these changes will continue to occur. As we witness the effects of a warming planet on human health, it is imperative that neurologists anticipate how the epidemiology and incidence of neurologic disease may change. In this review, we organized our analysis around 3 key themes related to climate change and neurologic health: extreme weather events and temperature fluctuations, emerging neuroinfectious diseases, and pollutant impacts. Across each of these themes, we appraised and reviewed recent literature relevant to neurologic disease and practice. METHODS: Studies were identified using search terms relating to climate change, pollutants, and neurologic disease in PubMed, OVID MEDLINE, EMBASE, PsycInfo, and gray literature. Studies published between 1990 and 2022 were included if they pertained to human incidence or prevalence of disease, were in English, and were relevant to neurologic disease. RESULTS: We identified a total of 364 articles, grouped into the 3 key themes of our study: extreme weather events and temperature fluctuations (38 studies), emerging neuroinfectious diseases (37 studies), and pollutant impacts (289 studies). The included studies highlighted the relationships between neurologic symptom exacerbation and temperature variability, tick-borne infections and warming climates, and airborne pollutants and cerebrovascular disease incidence and severity. DISCUSSION: Temperature extremes and variability both associated with stroke incidence and severity, migraine headaches, hospitalization in patients with dementia, and multiple sclerosis exacerbations. Exposure to airborne pollutants, especially PM2.5 and nitrates, associated with stroke incidence and severity, headaches, dementia risk, Parkinson disease, and MS exacerbation. Climate change has demonstrably expanded favorable conditions for zoonotic diseases beyond traditional borders and poses the risk of disease in new, susceptible populations. Articles were biased toward resource-rich regions, suggesting a discordance between where research occurs and where changes are most acute. As such, 3 key priorities emerged for further study: neuroinfectious disease risk mitigation, understanding the pathophysiology of airborne pollutants on the nervous system, and methods to improve delivery of neurologic care in the face of climate-related disruptions.
Chronic obstructive pulmonary disease (COPD) is one of the greatest global public health challenges. Acute exacerbations of COPD lead to the accelerated deterioration of lung function, reduced quality of life, a higher number of hospitalizations, and increased mortality. The factor causing the exacerbation is usually an infectious agent, but the impact of environmental factors is being studied more thoroughly. Among them, meteorological factors are the least examined. Multiple studies have shown that lower temperatures during the cold season, as well as sudden temperature changes regardless of the season, have the most significant negative effect on patients with COPD. However, higher temperatures, especially during summer heatwaves, can also cause COPD exacerbation and it is expected that this will be an even more important health problem in the future considering climate changes. The effects of other meteorological factors on acute exacerbation of COPD, such as atmospheric pressure, solar radiation, rainfall, wind speed, and humidity are far less investigated and opposing results have been obtained in different studies. Thus, there is a need for further research in this area that would result in clinical recommendations and public health interventions that could decrease the global burden of COPD.
The present systematic review was conducted by gathering the impacts of climate change on occupational heat strain, gathering risk factors that may increase susceptibility to climate-related occupational hazards, and gathering measures for controlling the impacts of climate change on occupational heat strain in outdoor workers. Materials and methods: In this study, three main databases PubMed, Scopus, and Web of Science were searched to find relevant literature on climate change and its effects using subject headings, appropriate Mesh terms and experts’ opinion. Results: The evidence suggests an imprecise but positive relationship between climate change and occupational heat strain in outdoor workers, and the most likely mechanism involves dehydration, fatigue, dizziness, confusion, reduced brain function, loss of concentration and discomfort. Conclusion: With predictions of increasing temperatures, the baseline heat strain incidence data from this systematic review study in tropical and subtropical countries with low and middle income may be used to help stakeholders in policy-making, promotion campaigns, occupational health interventions, and choosing appropriate control methods. Strong evidence indicates that, to manage adverse effects of heat stress on outdoor workers, key factors include anticipating, recognizing, evaluating, controlling, researching, risk management, and applying suitable policy development may be useful tools.
No abstract available.
Climate change is projected to intensify drought conditions, which may increase the risk of diarrheal diseases in children. We constructed log-binomial generalized linear mixed models to examine the association between diarrhea risk, ascertained from global-scale nationally representative Demographic and Health Surveys, and drought, represented by the standardized precipitation evapotranspiration index, among children under five in 51 low- and middle-income countries (LMICs). Exposure to 6-month mild or severe drought was associated with an increased diarrhea risk of 5% (95% confidence interval 3-7%) or 8% (5-11%), respectively. The association was stronger among children living in a household that needed longer time to collect water or had no access to water or soap/detergent for handwashing. The association for 24-month drought was strong in dry zones but weak or null in tropical or temperate zones, whereas that for 6-month drought was only observed in tropical or temperate zones. In this work we quantify the associations between exposure to long-term drought and elevated diarrhea risk among children under five in LMICs and suggest that the risk could be reduced through improved water, sanitation, and hygiene practices, made more urgent by the likely increase in drought due to climate change.
Naegleria fowleri (N. fowleri) is a free-living, unicellular, opportunistic protist responsible for the fatal central nervous system infection, primary amoebic meningoencephalitis (PAM). Given the increase in temperatures due to global warming and climate change, it is estimated that the cases of PAM are on the rise. However, there is a current lack of awareness and effective drugs, meaning there is an urgent need to develop new therapeutic drugs. In this study, the target compounds were synthesized and tested for their anti-amoebic properties against N. fowleri. Most compounds exhibited significant amoebicidal effects against N. fowleri; for example, 1h, 1j, and 1q reduced N. fowleri’s viability to 15.14%, 17.45% and 28.78%, respectively. Furthermore, the majority of the compounds showed reductions in amoeba-mediated host death. Of interest are the compounds 1f, 1k, and 1v, as they were capable of reducing the amoeba-mediated host cell death to 52.3%, 51%, and 56.9% from 100%, respectively. Additionally, these compounds exhibit amoebicidal properties as well; they were found to decrease N. fowleri’s viability to 26.41%, 27.39%, and 24.13% from 100%, respectively. Moreover, the MIC(50) values for 1e, 1f, and 1h were determined to be 48.45 µM, 60.87 µM, and 50.96 µM, respectively. Additionally, the majority of compounds were found to exhibit limited cytotoxicity, except for 1l, 1o, 1p, 1m, 1c, 1b, 1zb, 1z, 1y, and 1x, which exhibited negligible toxicity. It is anticipated that these compounds may be developed further as effective treatments against these devastating infections due to brain-eating amoebae.
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.
Water supply and wastewater systems are essential infrastructure affected by floods. Additional risk is posed in developing countries, where access to sanitation is not universal. Few studies assess the flood risk to the sanitation-health nexus. Therefore, this study aims to present a theoretical and general framework for assessing the resilience of flood-sanitation-public health nexus in urban environments, composed by risk estimation and risk management assessment. The framework was developed from a system analysis approach focusing on central supply systems. Regarding risk assessment, the main vulnerability and exposure factors identified were land use, social vulnerability, coverage of sanitation systems, occurrence of waterborne diseases, number of people affected by floods and intersection with the flood map. From the risk management assessment stage three main typologies of trade-offs and synergies were identified: urban territorial planning versus runoff control, water quality versus sanitation infrastructure and flood management policy versus social behavior.
Modelling urban inundation and its associated health implications is numerous in its many applications. Flood modelling research contains a broad wealth of material, and microbial risk assessment has gained more popularity over the last decade. However, there is still a relative lack of understanding of how the microbial risk can be quantified from urban sewer flooding. This article intends to review the literature encompassing contemporary urban flood modelling approaches. Hydrodynamic and microbial models that can be applied for quantitative microbial risk assessment will be discussed. Consequently, urban sewer flooding will be the focus. This review found that the literature contains a variety of different hazards posed by urban flooding. Yet, far fewer examples encompass microbial risk from sewer system exceedance. To date, there is no evidence of a perfect model or technique, to carry out a quantitative microbial risk assessment from hydrodynamic simulations. The literature details many different methods. We intend to detail the advantages and limitations of each method. Along similar lines, hydraulic data constitutes a large part of the uncertainty which is inherent to this research field. Many studies in the literature detail data paucity and uncertainty in input data. As such, any advancement in this discipline will very likely aid future research.
Leptospirosis is a quintessential one health disease of humans and animals caused by pathogenic spirochetes of the genus Leptospira. Intra- and interspecies transmission is dependent on 1) reservoir host animals in which organisms replicate and are shed in urine over long periods of time, 2) the persistence of spirochetes in the environment, and 3) subsequent human-animal-environmental interactions. The combination of increased flooding events due to climate change, changes in human-animal-environmental interactions as a result of the pandemic that favor a rise in the incidence of leptospirosis, and under-recognition of leptospirosis because of nonspecific clinical signs and severe signs that resemble COVID-19 represents a “perfect storm” for resurgence of leptospirosis in people and domestic animals. Although often considered a disease that occurs in warm, humid climates with high annual rainfall, pathogenic Leptospira spp have recently been associated with disease in animals and humans that reside in semiarid regions like the southwestern US and have impacted humans that have a wide spectrum of socioeconomic backgrounds. Therefore, it is critical that physicians, veterinarians, and public health experts maintain a high index of suspicion for the disease regardless of geographic and socioeconomic circumstances and work together to understand outbreaks and implement appropriate control measures. Over the last decade, major strides have been made in our understanding of the disease because of improvements in diagnostic tests, molecular epidemiologic tools, educational efforts on preventive measures, and vaccines. These novel approaches are highlighted in the companion Currents in One Health by Sykes et al, AJVR, September 2022.
BACKGROUND: Climate change is expected to increase the frequency of flooding events. Although rainfall is highly correlated with mosquito-borne diseases (MBD) in humans, less research focuses on understanding the impact of flooding events on disease incidence. This lack of research presents a significant gap in climate change-driven disease forecasting. OBJECTIVES: We conducted a scoping review to assess the strength of evidence regarding the potential relationship between flooding and MBD and to determine knowledge gaps. METHODS: PubMed, Embase, and Web of Science were searched through 31 December 2020 and supplemented with review of citations in relevant publications. Studies on rainfall were included only if the operationalization allowed for distinction of unusually heavy rainfall events. Data were abstracted by disease (dengue, malaria, or other) and stratified by post-event timing of disease assessment. Studies that conducted statistical testing were summarized in detail. RESULTS: From 3,008 initial results, we included 131 relevant studies (dengue n = 45, malaria n = 61, other MBD n = 49). Dengue studies indicated short-term ( < 1 month) decreases and subsequent (1-4 month) increases in incidence. Malaria studies indicated post-event incidence increases, but the results were mixed, and the temporal pattern was less clear. Statistical evidence was limited for other MBD, though findings suggest that human outbreaks of Murray Valley encephalitis, Ross River virus, Barmah Forest virus, Rift Valley fever, and Japanese encephalitis may follow flooding. DISCUSSION: Flooding is generally associated with increased incidence of MBD, potentially following a brief decrease in incidence for some diseases. Methodological inconsistencies significantly limit direct comparison and generalizability of study results. Regions with established MBD and weather surveillance should be leveraged to conduct multisite research to a) standardize the quantification of relevant flooding, b) study nonlinear relationships between rainfall and disease, c) report outcomes at multiple lag periods, and d) investigate interacting factors that modify the likelihood and severity of outbreaks across different settings. https://doi.org/10.1289/EHP8887.
In recent years, natural disasters such as hurricanes and floods have become more frequent, which usually leads to the pollution of drinking water. Drinking contaminated water may cause public health emergencies. The demand for healthy drinking water in disaster-affected areas is huge and urgent. Therefore, it is necessary to develop a simple water treatment technology suitable for emergencies. Inspired by nature, a fractional spray method was used to prepare graded purification material under mild conditions. The material consists of a calcium alginate isolation layer and a functional layer composed of calcium alginate, polyethylenimine, and water-based polyurethane, which can purify complex pollutants in water such as heavy metals, oils, pathogens, and micro/nano plastics through percolation. It does not require additional energy and can purify polluted water only under gravity. A disposable paper cup model was also designed, which can be used to obtain purified water by immersing in polluted water directly without other filtering devices. The test report shows that the water obtained from the paper cup was deeply purified. This design makes the material user-friendly and has the potential as a strategic material. This discovery can effectively improve the safety of drinking water after disasters and improve people’s quality of life.
Climate change is likely to increase the risk of drought which impacts on health are not quite known well due to its creeping nature. This study maps the publications on the consequences of drought on human health, directly or indirectly, from January 2008 to December 2018. We searched Scopus, Web of Science, PsycINFO, google scholar and Pubmed. 378 articles were included. Poisson regression analysis was performed to evaluate the relationship between the number of articles and some variables such as the continent of the study, article type, subject, and climate event type (climate change or just drought). Data were analyzed using Microsoft Excel 2019 and SPSS version 26. Based on the results, Asia had the highest number of publications (91) compared to North America (82), while the number of articles from South America (16) was lower significantly. The majority of articles had used quantitative analysis (175), and review articles were the second most frequent (104). Most of the articles had focused on the social impacts of drought. The number of articles has increased over the years and most of them were not in the health area primarily. Also, a noticeable amount of the knowledge comes from analysis of previously collected data and review articles. To mitigate and reduce the impacts of drought on the different dimensions of health, we need to understand them through more investigations with precise data and methods, especially in less developed countries with a more vulnerable population, and mental health consequences of drought that have been less considered.
Drought may be efficiently managed using the following strategies: prevention, mitigation, readiness, recovery, and transformation. Biotechnological interventions may become highly important in reducing plants’ drought stress in order to address key plant challenges such as population growth and climate change. Drought is a multidimensional construct with several triggering mechanisms or contributing factors working at various spatiotemporal scales, making it one of the known natural catastrophes. Drought is among the causes of hunger and malnutrition, decreasing agricultural output, and poor nutrition. Many deaths caused in children are due to hunger situations, and one in four children face stunted growth. All this hunger and malnutrition may be responsible for the reduction in agricultural productivity caused due to the drought situations affecting food security. Global Hunger Index has been accelerating due to under-nutrition and under-5 deaths. Drought has been covering more than 20% of the world’s agricultural areas, leading to significantly less food production than what is required for consumption. Drought reduces soil fertility and adversely affects soil biological activity reducing the inherent capacity of the soil to support vegetation. Recent droughts have had a much greater effect on people’s lives, even beyond causing poverty and hunger. Drought may have substantial financial consequences across the globe it may cause a severe impact on the world economy. It is a natural feature of the environment that will appear and disappear as it has in history. Due to increasing temperatures and growing vulnerabilities, it will undoubtedly occur more often and seriously in the coming years. To ensure sustainable socio-economic and social development, it is critical to reducing the effects of potential droughts worldwide using different biotechnological interventions. It’s part of a long-term growth plan, and forecasting is essential for early warnings and global hunger management.
INTRODUCTION: Exposure to natural hazards such as fire, drought, floods, and earthquakes can have negative impacts on physical and mental health and wellbeing. The social and structural factors contributing to individual and community vulnerability also influence responses to disaster and the resulting consequences on health and wellbeing. Experiencing disasters like bushfires amplifies the impacts of inequality, magnifying existing disparities and contributing to additional psychological burdens of grief, trauma and adaptive challenge. There is a need to understand how vulnerability can influence responses to disaster, and to identify factors that develop and foster resilience in the context of increasing disasters and vulnerability. MATERIALS AND METHODS: This protocol will describe the methodology of two scoping reviews: the first will describe the mental health outcomes of vulnerable populations after droughts and bushfires; the second will identify and describe strategies that promote community resilience in vulnerable populations in the context of a disaster. A thorough search will be conducted in relevant databases. Studies will be limited to English language. The reviews will be reported using the 22-item checklist for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methodological quality of the included papers will be assessed using the Joanna Briggs Institute’s critical appraisal tools. RESULTS & CONCLUSIONS: The two scoping reviews described in this protocol will have broad relevance in the context of increasing and intensifying disasters, and will especially consider the compounded impact of disaster on vulnerable communities. Findings will contribute directly to the design and implementation of solutions to improve post-disaster health and wellbeing and community resilience.
Some extreme cold events have occurred in the past few years. Human perceptual responses and cogni-tive performances when exposed to extremely cold environments could be significantly influenced. Impaired cognition can result in human errors and other cascading impacts. This paper aims to investi-gate human thermal perception and cognitive performance in an extremely cold environment in a cli-matic chamber. The study involved and exposed twelve male participants who wore protective clothing (2.16 clo) to a-20 degrees C climate chamber. Critical parameters for evaluating human perceptual response and cognitive performance, including thermal sensation vote (TSV), thermal comfort vote (TCV), mood, health symptoms, and selective attention performance, were recorded and analyzed. The results showed that the TSV did not recover to the value before the cold exposure despite the subjects being rewarmed in a neutral environment for 40 min. The participants’ TSV reached the coldest after 20-25 min. Cold exposure increased discomfort, which required more than 40 min to recover. The extre-mely cold exposure resulted in increased tension, anger, confusion, decreased depression and fatigue. Anger and confusion had a strong correlation with tension-anxiety, and the correlation was stronger after recovery. The extremely cold exposure had a sustained impact on selective attention and heart rate. The reaction speed decreased by 36%. The results could be used to form recommendations to protect workers’ health and performance when exposed to extremely cold environments. (c) 2021 Elsevier B.V. All rights reserved.
This study investigates the effect of local floor heating mats on the thermal comfort of workers in cold environments. Experiments were performed with two sizes of floor heating mats under two power input levels. Twenty subjects participated in the experiments at three air temperature conditions of 11, 13, and 15 degrees C. The participants performed three activities in the experiments: sitting, sitting + packing, and standing + packing. Subjective questionnaires were collected, including the overall thermal sensation vote (TSV), local thermal sensation of feet (TSVfeet), and thermal comfort vote (TCV). The subjects’ mean skin temperature (MST) and cochlear temperature were measured. The results show that subjects’ TSV, TSVfeet, and TCV significantly improved when using heating mats of larger size and higher power input. TSV feet increased faster than TSV. When the air temperature decreases, TSV feet should be higher to keep TSV close to neutral. Moreover, subjects’ MST and cochlear temperature also increased slightly when heating mats were adopted. Both MST and cochlear temperature were positively correlated with TSV. Heating mats also increased the subjects’ working efficiency, related to the TSV and TCV. Analysis of the vertical temperature distribution in the vicinity of the subjects showed that with heating mats, the thermal plume was enhanced, and the ambient air temperature increased slightly. Hence, local floor heating mats can effectively improve the thermal comfort and working efficiency of workers in cold environments.
Climate change and health are inextricably linked, especially the role of ambient temperature. This study aimed to analyze the non-communicable disease (NCD) burden attributable to low temperature globally, regionally, and temporally using data from the Global Burden of Disease (GBD) study 2019. Globally, in 2019, low temperature was responsible for 5.42% DALY and 7.18% death of NCDs, representing the age-standardized disability-adjusted life years (DALY) and death rates (per 100,000 population) of 359.6 (95% uncertainty intervals (UI): 306.09, 416.88) and 21.36 (95% UI:18.26, 24.74). Ischemic heart disease was the first leading cause of DALY and death resulting from low temperature, followed by stroke. However, age-standardized DALY and death rates attributable to low temperature have exhibited wide variability across regions, with the highest in Central Asia and Eastern Europe and the lowest in Caribbean and Western sub-Saharan Africa. During the study period (1990-2019), there has been a significant decrease in the burden of NCDs attributable to low temperature, but progress has been uneven across countries, whereas nations exhibiting high sociodemographic index (SDI) declined more significantly compared with low SDI nations. Notably, three nations, including Uzbekistan, Tajikistan, and Lesotho, had the maximum NCDs burden attributed to low temperature and displayed an upward trend. In conclusion, ambient low temperature contributes to substantial NCD burden with notable geographical variations.
Pronounced changes in the Arctic environment add a new potential driver of anomalous weather patterns in midlatitudes that affect billions of people. Recent studies of these Arctic/midlatitude weather linkages, however, state inconsistent conclusions. A source of uncertainty arises from the chaotic nature of the atmosphere. Thermodynamic forcing by a rapidly warming Arctic contributes to weather events through changing surface heat fluxes and large-scale temperature and pressure gradients. But internal shifts in atmospheric dynamics-the variability of the location, strength, and character of the jet stream, blocking, and stratospheric polar vortex (SPV)-obscure the direct causes and effects. It is important to understand these associated processes to differentiate Arctic-forced variability from natural variability. For example in early winter, reduced Barents/Kara Seas sea-ice coverage may reinforce existing atmospheric teleconnections between the North Atlantic/Arctic and central Asia, and affect downstream weather in East Asia. Reduced sea ice in the Chukchi Sea can amplify atmospheric ridging of high pressure near Alaska, influencing downstream weather across North America. In late winter southward displacement of the SPV, coupled to the troposphere, leads to weather extremes in Eurasia and North America. Combined tropical and sea ice conditions can modulate the variability of the SPV. Observational evidence for Arctic/midlatitude weather linkages continues to accumulate, along with understanding of connections with pre-existing climate states. Relative to natural atmospheric variability, sea-ice loss alone has played a secondary role in Arctic/midlatitude weather linkages; the full influence of Arctic amplification remains uncertain.
Heat exposure is a well-known health hazard, which causes several problems ranging from thermal discomfort or productivity reduction to the aggravation of existing illnesses and death. Climate projections foresee an increase in the frequency and intensity of heat-related impacts on human health. To reduce these climate risks, governments need a better understanding of not only the scale and the factors affecting those risks, but also how to prepare and protect the city and citizens against these risks and prevent them through effective policy making. Therefore, climate adaptation decisions need to be made in complex systems with manifold uncertainties. In response to these deep uncertainties, different planning approaches have been developed to assist policymakers in decision making. This paper is focused on one of the dynamic adaptive policy planning approaches: the adaptation pathway. This approach allows designing alternative feasible plans that are flexible and can respond when new information appears or when conditions in the environment change. This paper presents a structured methodology for designing adaptation pathways. The work describes a high-level adaptation pathway covering heatwave impacts on productivity and health at city level in Antwerp to ensure the city adapts to future conditions. Lastly, a summary is provided of the lessons learned and the challenges of this approach are discussed.
The negative cardiorespiratory health outcomes due to extreme temperatures and air pollution are widely studied, but knowledge about the effectiveness of the implementation of adaptive mechanisms remains unclear. The objective of this paper is to explore the evidence of adaptive mechanisms for cardiorespiratory diseases regarding extreme temperatures and air pollution by comparing the results of two systematic literature review (SLR) processes sharing the same initial research question but led by two research groups with different academic backgrounds working in the same multidisciplinary team. We start by presenting the methodological procedures and the results of the SLR triggered by the research group mainly composed by researchers with a background in geography (named geographical strategy). We then compare these results with those achieved in the SLR led by the research group with a background in epidemiology (named epidemiological strategy). Both SLR were developed under the EU Horizon 2020 Project “EXHAUSTION “. The results showed: 1) the lack of evidence regarding the effectiveness of adaptation measures, namely due to the limited number of studies about the topic, the preponderance of studies dedicated to heat extremes or the unbalance between different adaptation measures; 2) that the choice of search terms in the geographical strategy, despite being more comprehensive at first sight, ended up retrieving less results, but it brought new studies that can complement the results of the epidemiological strategy. Therefore, it is suggested that to strengthen the empirical evidence of the effectiveness of adaptation measures, powerful multidisciplinary teams should work together in the preparation of SLR in topics of great complexity, such as the one presented in this paper.
OBJECTIVE: We conducted a systematic review of the published literature to test the hypothesis that maternal exposure to extremes of ambient temperatures during pregnancy is associated with the risk for psychiatric disorders or congenital malformations in offspring, both of which are indicative of perturbations of fetal neurodevelopment. METHOD: This study was conducted in accordance with the recommendations outlined in the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting proposal. Electronic databases (Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, Ovid Global Health, Web of Science, and Cochrane Library) were searched. Four independent reviewers selected studies with the following criteria: (1) prenatal maternal ambient temperature exposure; (2) outcome of offspring psychiatric disorder or congenital defects; (3) empirical study; (4) full-length article, no conference presentations or abstracts. RESULTS: Twenty-two studies met criteria and one was added from a reference list (n = 23). Of these, schizophrenia (n = 5), anorexia nervosa (n = 3) and congenital cardiovascular malformations (n = 6) studies were the most common. Each of these categories showed some evidence of association with an early pregnancy maternal ambient heat exposure effect, with other evidence for a late pregnancy cold effect. CONCLUSION: Some evidence supports a role for early pregnancy maternal exposure to extreme ambient heat in the development of psychiatric disorders, but large-scale, prospective cohort data on individual births is essential. Optimal studies will be conducted in seasonally variable climates, accounting for actual maternal residence over the pregnancy and at parturition, local environmental temperature records, and appropriate covariates, similar to studies identified by this systematic review for congenital malformations.
West Nile virus (WNV, Flaviviridae, Flavivirus) is a mosquito-borne flavivirus introduced to North America in 1999. Since 1999, the Earth’s average temperature has increased by 0.6 °C. Mosquitoes are ectothermic organisms, reliant on environmental heat sources. Temperature impacts vector-virus interactions which directly influence arbovirus transmission. RNA viral replication is highly error-prone and increasing temperature could further increase replication rates, mutation frequencies, and evolutionary rates. The impact of temperature on arbovirus evolutionary trajectories and fitness landscapes has yet to be sufficiently studied. To investigate how temperature impacts the rate and extent of WNV evolution in mosquito cells, WNV was experimentally passaged 12 times in Culex tarsalis cells, at 25 °C and 30 °C. Full-genome deep sequencing was used to compare genetic signatures during passage, and replicative fitness was evaluated before and after passage at each temperature. Our results suggest adaptive potential at both temperatures, with unique temperature-dependent and lineage-specific genetic signatures. Further, higher temperature passage was associated with significantly increased replicative fitness at both temperatures and increases in nonsynonymous mutations. Together, these data indicate that if similar selective pressures exist in natural systems, increases in temperature could accelerate emergence of high-fitness strains with greater phenotypic plasticity.
The threats, both real and perceived, surrounding the development of new and emerging infectious diseases of humans are of critical concern to public health and well-being. Among these risks is the potential for zoonotic transmission to humans of species of the malaria parasite, Plasmodium, that have been considered historically to infect exclusively non-human hosts. Recently observed shifts in the mode, transmission, and presentation of malaria among several species studied are evidenced by shared vectors, atypical symptoms, and novel host-seeking behavior. Collectively, these changes indicate the presence of environmental and ecological pressures that are likely to influence the dynamics of these parasite life cycles and physiological make-up. These may be further affected and amplified by such factors as increased urban development and accelerated rate of climate change. In particular, the extended host-seeking behavior of what were once considered non-human malaria species indicates the specialist niche of human malaria parasites is not a limiting factor that drives the success of blood-borne parasites. While zoonotic transmission of non-human malaria parasites is generally considered to not be possible for the vast majority of Plasmodium species, failure to consider the feasibility of its occurrence may lead to the emergence of a potentially life-threatening blood-borne disease of humans. Here, we argue that recent trends in behavior among what were hitherto considered to be non-human malaria parasites to infect humans call for a cross-disciplinary, ecologically-focused approach to understanding the complexities of the vertebrate host/mosquito vector/malaria parasite triangular relationship. This highlights a pressing need to conduct a multi-species investigation for which we recommend the construction of a database to determine ecological differences among all known Plasmodium species, vectors, and hosts. Closing this knowledge gap may help to inform alternative means of malaria prevention and control.
Two recent initiatives, the World Health Organization (WHO) Strategic Advisory Group on Malaria Eradication and the Lancet Commission on Malaria Eradication, have assessed the feasibility of achieving global malaria eradication and proposed strategies to achieve it. Both reports rely on a climate-driven model of malaria transmission to conclude that long-term trends in climate will assist eradication efforts overall and, consequently, neither prioritize strategies to manage the effects of climate variability and change on malaria programming. This review discusses the pathways via which climate affects malaria and reviews the suitability of climate-driven models of malaria transmission to inform long-term strategies such as an eradication programme. Climate can influence malaria directly, through transmission dynamics, or indirectly, through myriad pathways including the many socioeconomic factors that underpin malaria risk. These indirect effects are largely unpredictable and so are not included in climate-driven disease models. Such models have been effective at predicting transmission from weeks to months ahead. However, due to several well-documented limitations, climate projections cannot accurately predict the medium- or long-term effects of climate change on malaria, especially on local scales. Long-term climate trends are shifting disease patterns, but climate shocks (extreme weather and climate events) and variability from sub-seasonal to decadal timeframes have a much greater influence than trends and are also more easily integrated into control programmes. In light of these conclusions, a pragmatic approach is proposed to assessing and managing the effects of climate variability and change on long-term malaria risk and on programmes to control, eliminate and ultimately eradicate the disease. A range of practical measures are proposed to climate-proof a malaria eradication strategy, which can be implemented today and will ensure that climate variability and change do not derail progress towards eradication.
The rearing temperature of the immature stages can have a significant impact on the life-history traits and the ability of adult mosquitoes to transmit diseases. This review assessed published evidence of the effects of temperature on the immature stages, life-history traits, insecticide susceptibility, and expression of enzymes in the adult Anopheles mosquito. Original articles published through 31 March 2021 were systematically retrieved from Scopus, Google Scholar, Science Direct, PubMed, ProQuest, and Web of Science databases. After applying eligibility criteria, 29 studies were included. The review revealed that immature stages of An. arabiensis were more tolerant (in terms of survival) to a higher temperature than An. funestus and An. quadriannulatus. Higher temperatures resulted in smaller larval sizes and decreased hatching and pupation time. The development rate and survival of An. stephensi was significantly reduced at a higher temperature than a lower temperature. Increasing temperatures decreased the longevity, body size, length of the gonotrophic cycle, and fecundity of Anopheles mosquitoes. Higher rearing temperatures increased pyrethroid resistance in adults of the An. arabiensis SENN DDT strain, and increased pyrethroid tolerance in the An. arabiensis SENN strain. Increasing temperature also significantly increased Nitric Oxide Synthase (NOS) expression and decreased insecticide toxicity. Both extreme low and high temperatures affect Anopheles mosquito development and survival. Climate change could have diverse effects on Anopheles mosquitoes. The sensitivities of Anopeheles mosquitoes to temperature differ from species to species, even among the same complex. Notwithstanding, there seem to be limited studies on the effects of temperature on adult life-history traits of Anopheles mosquitoes, and more studies are needed to clarify this relationship.
One of the most important vector-borne disease in humans is malaria, caused by Plasmodium parasite. Seasonal temperature elements have a major effect on the life development of mosquitoes and the development of parasites. In this paper, we establish and analyze a reaction-diffusion model, which includes seasonality, vector-bias, temperature-dependent extrinsic incubation period (EIP) and maturation delay in mosquitoes. In order to get the model threshold dynamics, a threshold parameter, the basic reproduction number R-0 is introduced, which is the spectral radius of the next generation operator. Quantitative analysis indicates that when R-0 < 1, there is a globally attractive disease-free omega-periodic solution; disease is uniformly persistent in humans and mosquitoes if R-0 > 1. Numerical simulations verify the results of the theoretical analysis and discuss the effects of diffusion and seasonality. We study the relationship between the parameters in the model and R-0. More importantly, how to allocate medical resources to reduce the spread of disease is explored through numerical simulations. Last but not least, we discover that when studying malaria transmission, ignoring vector-bias or assuming that the maturity period is not affected by temperature, the risk of disease transmission will be underestimate.
This paper mainly explores the complex impacts of spatial heterogeneity, vector-bias effect, multiple strains, temperature-dependent extrinsic incubation period (EIP) and seasonality on malaria transmission. We propose a multi-strain malaria transmission model with diffusion and periodic delays and define the reproduction numbers Ri and R^i (i = 1, 2). Quantitative analysis indicates that the disease-free ω-periodic solution is globally attractive when Ri < 1, while if Ri > 1 > Rj (i ≠ j, i, j = 1, 2), then strain i persists and strain j dies out. More interestingly, when R1 and R2 are greater than 1, the competitive exclusion of the two strains also occurs. Additionally, in a heterogeneous environment, the coexistence conditions of the two strains are R^1 > 1 and R^2 > 1. Numerical simulations verify the analytical results and reveal that ignoring vector-bias effect or seasonality when studying malaria transmission will underestimate the risk of disease transmission.
As a long-standing public health issue, malaria still severely affects many parts of the world, especially Africa. With greenhouse gas emissions, temperatures continue to rise. Based on diverse shared socioeconomic pathways (SSPs), future temperatures can be estimated. However, the impacts of climate change on malaria infection rates in all epidemic regions are unknown. Here, we estimate the differences in global malaria infection rates predicted under different SSPs during several periods as well as malaria infection case changes (MICCs) resulting from those differences. Our results indicate that the global MICCs resulting from the conversion from SSP1-2.6 to SSP2-4.5, to SSP3-7.0, and to SSP5-8.5 are 6.506 (with a 95% uncertainty interval [UI] of 6.150-6.861) million, 3.655 (3.416-3.894) million, and 2.823 (2.635-3.012) million, respectively, from 2021 to 2040; these values represent increases of 2.699%, 1.517%, and 1.171%, respectively, compared to the 241 million infection cases reported in 2020. Temperatures increases will adversely affect malaria the most in Africa during the 2021-2040 period. From 2081 to 2100, the MICCs obtained for the three scenario shifts listed above are -79.109 (-83.626 to -74.591) million, -238.337 (-251.920 to -0.141) million, and -162.692 (-174.628 to -150.757) million, corresponding to increases of -32.825%, -98.895%, and -67.507%, respectively. Climate change will increase the danger and risks associated with malaria in the most vulnerable regions in the near term, thus aggravating the difficulty of eliminating malaria. Reducing GHG emissions is a potential pathway to protecting people from malaria.
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.
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.
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.
PURPOSE OF REVIEW: Melioidosis, caused by the soil-dwelling bacterium Burkholderia pseudomallei, is a tropical infection associated with high morbidity and mortality. This review summarizes current insights into melioidosis’ endemicity, focusing on epidemiological transitions, zoonosis, and climate change. RECENT FINDINGS: Estimates of the global burden of melioidosis affirm the significance of hot-spots in Australia and Thailand. However, it also highlights the paucity of systematic data from South Asia, The Americas, and Africa. Globally, the growing incidence of diabetes, chronic renal and (alcoholic) liver diseases further increase the susceptibility of individuals to B. pseudomallei infection. Recent outbreaks in nonendemic regions have further exposed the hazard from the trade of animals and products as potential reservoirs for B. pseudomallei. Lastly, global warming will increase precipitation, severe weather events, soil salinity and anthrosol, all associated with the occurrence of B. pseudomallei. SUMMARY: Epidemiological transitions, zoonotic hazards, and climate change are all contributing to the emergence of novel melioidosis-endemic areas. The adoption of the One Health approach involving multidisciplinary collaboration is important in unraveling the real incidence of B. pseudomallei, as well as reducing the spread and associated mortality.
Intermittent water supply systems (IWSSs) are prevalent in most developing countries and some developed ones. Their usage is driven by necessity rather than as a principal objective, mostly due to technical and economic deficiencies. Major health risks and socio-economic inequities are associated with such systems. Their impacts are aggravated by climate changes and the COVID-19 crisis. These are likely to have profound implications on progress toward advancing sustainable development goals (SDGs). Motivated by providing a comprehensive overview of global knowledge on IWSSs, the present work proposed to track and analyze research works on IWSSs utilizing bibliometric techniques and visual mapping tools. This includes investigating the trends and growth trajectories of research works on IWSSs and analyzing the various approaches proposed to expand our understanding with respect to the management, modeling, optimization, and impacts of IWSSs. The national and international contributions and collaboration figures are further analyzed at country, institution, author, and source levels. This analysis indicates that research works conducted on IWSSs have certain expectations in terms of productivity (total global productivity; 197 documents). The United States was the best country in terms of productivity (58 documents; 29.4%), while the Water Switzerland journal was the most productive journal (19 documents; 9.6%). The impacts of IWSSs on health and well-being have attracted considerable attention. The outcomes showed deep and justified worries in relation to the transition from intermittent to continuous supply, equity, and mitigating the health risks associated with IWSSs in the foreseen future. The utilization of artificial intelligence techniques and expert systems will drive and shape future IWSS-related research activities. Therefore, investments in this regard are crucial.
The quality of global water resources is increasingly strained by socio-economic developments and climate change, threatening both human livelihoods and ecosystem health. With inadequately managed wastewater being a key driver of deterioration, Sustainable Development Goal (SDG) 6.3 was established to halve the proportion of untreated wastewater discharged to the environment by 2030. Yet, the impact of achieving SDG6.3 on global ambient water quality is unknown. Addressing this knowledge gap, we develop a high-resolution surface water quality model for salinity as indicated by total dissolved solids, organic pollution as indicated by biological oxygen demand and pathogen pollution as indicated by fecal coliform. Our model includes a novel spatially-explicit approach to incorporate wastewater treatment practices, a key determinant of in-stream pollution. We show that achieving SDG6.3 reduces water pollution, but is still insufficient to improve ambient water quality to below key concentration thresholds in several world regions. Particularly in the developing world, reductions in pollutant loadings are locally effective but transmission of pollution from upstream areas still leads to water quality issues downstream. Our results highlight the need to go beyond the SDG-target for wastewater treatment in order to achieve the overarching goal of clean water for all. SGD 6.3 targets to half the proportion of untreated wastewater discharged to the environment by 2030 will substantially improve water quality globally, but a high-resolution surface water quality model suggests key thresholds will still not be met in regions with limited existing wastewater treatment.
Climate change is altering the habits of the population. Extensive drought periods and overuse of potable water led to significant water shortages in many different places. Therefore, new water sources are necessary for usage in applications where the microbiological and chemical water quality demands are less stringent, as for agriculture. In this study, we planted, germinated, and grew vegetables/fruits (cherry tomato, lettuce, and carrot) using three types of potential waters for irrigation: secondary-treated wastewater, chlorine-treated wastewater, and green wall-treated greywater, to observe potential health risks of foodstuff consumption. In this study the waters and crops were analyzed for three taxonomic groups: bacteria, enteric viruses, and protozoa. Enteric viruses, human Norovirus I (hNoVGI) and Enterovirus (EntV), were detected in tomato and carrots irrigated with secondary-treated and chlorine-treated wastewater, in concentrations as high as 2.63 log genome units (GU)/g. On the other hand, Aichi viruses were detected in lettuce. Bacteria and protozoa remained undetected in all fresh produce although being detected in both types of wastewaters. Fresh produce irrigated with green wall-treated greywater were free from the chosen pathogens. This suggests that green wall-treated greywater may be a valuable option for crop irrigation, directly impacting the cities of the future vision, and the circular and green economy concepts. On the other hand, this work demonstrates that further advancement is still necessary to improve reclaimed water to the point where it no longer constitutes risk of foodborne diseases and to human health.
Due to the growing and diverse demands on water supply, exploitation of non-conventional sources of water has received much attention. Since water consumption for irrigation is the major contributor to total water withdrawal, the utilization of non-conventional sources of water for the purpose of irrigation is critical to assuring the sustainability of water resources. Although numerous studies have been conducted to evaluate and manage non-conventional water sources, little research has reviewed the suitability of available water technologies for improving water quality, so that water reclaimed from non-conventional supplies could be an alternative water resource for irrigation. This article provides a systematic overview of all aspects of regulation, technology and management to enable the innovative technology, thereby promoting and facilitating the reuse of non-conventional water. The study first reviews the requirements for water quantity and quality (i.e., physical, chemical, and biological parameters) for agricultural irrigation. Five candidate sources of non-conventional water were evaluated in terms of quantity and quality, namely rainfall/stormwater runoff, industrial cooling water, hydraulic fracturing wastewater, process wastewater, and domestic sewage. Water quality issues, such as suspended solids, biochemical/chemical oxygen demand, total dissolved solids, total nitrogen, bacteria, and emerging contaminates, were assessed. Available technologies for improving the quality of non-conventional water were comprehensively investigated. The potential risks to plants, human health, and the environment posed by non-conventional water reuse for irrigation are also discussed. Lastly, three priority research directions, including efficient collection of non-conventional water, design of fit-for-purpose treatment, and deployment of energy-efficient processes, were proposed to provide guidance on the potential for future research.
Monitoring of fecal indicator bacteria at recreational waters is an important public health measure to minimize water-borne disease, however traditional culture methods for quantifying bacteria can take 18-24 hours to obtain a result. To support real-time notifications of water quality, models using environmental variables have been created to predict indicator bacteria levels on the day of sampling. We conducted a systematic review of predictive models of fecal indicator bacteria at freshwater recreational sites in temperate climates to identify and describe the existing approaches, trends, and their performance to inform beach water management policies. We conducted a comprehensive search strategy, including five databases and grey literature, screened abstracts for relevance, and extracted data using structured forms. Data were descriptively summarized. A total of 53 relevant studies were identified. Most studies (n = 44, 83%) were conducted in the United States and evaluated water quality using E. coli as fecal indicator bacteria (n = 46, 87%). Studies were primarily conducted in lakes (n = 40, 75%) compared to rivers (n = 13, 25%). The most commonly reported predictive model-building method was multiple linear regression (n = 37, 70%). Frequently used predictors in best-fitting models included rainfall (n = 39, 74%), turbidity (n = 31, 58%), wave height (n = 24, 45%), and wind speed and direction (n = 25, 47%, and n = 23, 43%, respectively). Of the 19 (36%) studies that measured accuracy, predictive models averaged an 81.0% accuracy, and all but one were more accurate than traditional methods. Limitations identifed by risk-of-bias assessment included not validating models (n = 21, 40%), limited reporting of whether modelling assumptions were met (n = 40, 75%), and lack of reporting on handling of missing data (n = 37, 70%). Additional research is warranted on the utility and accuracy of more advanced predictive modelling methods, such as Bayesian networks and artificial neural networks, which were investigated in comparatively fewer studies and creating risk of bias tools for non-medical predictive modelling.
Globally, waterborne gastroenteritis attributable to rotaviruses is on the increase due to the rapid increase in population growth, poor socioeconomic conditions, and drastic changes in climatic conditions. The burden of diarrhea is quite alarming in developing nations where the majority of the populations still rely on untreated surface water that is usually polluted for their immediate water needs. Humans and animals of all ages are affected by rotaviruses. In humans, the preponderance of cases occurs in children under 5 years. Global efforts in advancing water/wastewater treatment technologies have not yet realized the objective of complete viral removal from wastewater. Most times, surface waters are impacted heavily by inadequately treated wastewater run-offs thereby exposing people or animals to preventable health risks. The relative stability of rotaviruses in aquatic matrices during wastewater treatment, poor correlation of bacteriological indicators with the presence of rotaviruses, and their infectiousness at a low dose informed the proposal for inclusion in the routine microbiological water screening panel. Environmental monitoring data have been shown to provide early warnings that can complement clinical data used to monitor the impact of current rotavirus vaccination in a community. This review was therefore undertaken to critically appraise rotavirus excretion and emission pathways, and the existence, viability and persistence in the receiving aquatic milieu. The efficiency of the current wastewater treatment modality for rotavirus removal, correlation of the current bacteriological water quality assessment strategy, public health risks and current laboratory methods for an epidemiological study were also discussed.
Climate change driven seawater temperature (SWT) increases results in greater abundance and geographical expansion of marine pathogens, among which Vibrio parahaemolyticus (Vp) causes serious economic and health issues. In addition, plastic pollution in the ocean constitutes a vector for harmful pathogens dissemination. We investigate the effect of elevated SWT on the expression of genes implicated in adhesion and biofilm formation on abiotic surfaces in the clinical Vp strain RIMD2210633, which expresses hemolysins. Among the genes studied, the multivalent adhesion molecule-7 and the GlcNAc-binding protein A were involved in the adhesion of Vp to abiotic and biotic surfaces, whereas the type IV pili, the mannose-sensitive hemagglutinin, and the chitin-regulated pilins facilitate attachment and biofilm formation. Data presented here show that at 21°C, Vp is still viable but does not either proliferate or express the virulence factors studied. Interestingly, at 27°C and as early as 1 h of incubation, all factors are transiently expressed in free-living bacteria only and even more upregulated at 31°C. These results clearly show that increased SWT has an important impact on the adhesion properties of free-living Vp to plastic support and thus emphasize the role of climate change in the spread of this pathogenic bacteria.
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.
Responding to infrastructural damage in the aftermath of natural disasters at a national, regional, and local level poses a significant challenge. Damage to road networks, clean water supply, and sanitation infrastructures, as well as social amenities like schools and hospitals, exacerbates the circumstances. As safe water sources are destroyed or mixed with contaminated water during a disaster, the risk of a waterborne disease outbreak is elevated in those disaster-affected locations. A country such as Haiti, where a large quantity of the population is deprived of safe water and basic sanitation facilities, would suffer more in post-disaster scenarios. Early warning of waterborne diseases like cholera would be of great help for humanitarian aid, and the management of disease outbreak perspectives. The challenging task in disease forecasting is to identify the suitable variables that would better predict a potential outbreak. In this study, we developed five (5) models including a machine learning approach, to identify and determine the impact of the environmental and social variables that play a significant role in post-disaster cholera outbreaks. We implemented the model setup with cholera outbreak data in Haiti after the landfall of Hurricane Matthew in October 2016. Our results demonstrate that adding high-resolution data in combination with appropriate social and environmental variables is helpful for better cholera forecasting in a post-disaster scenario. In addition, using a machine learning approach in combination with existing statistical or mechanistic models provides important insights into the selection of variables and identification of cholera risk hotspots, which can address the shortcomings of existing approaches.
BACKGROUND: Climate change is expected to alter the global footprint of many infectious diseases, particularly vector-borne diseases such as malaria and dengue. Knowledge of the range and geographical context of expected climate change impacts on disease transmission and spread, combined with knowledge of effective adaptation strategies and responses, can help to identify gaps and best practices to mitigate future health impacts. To investigate the types of evidence for impacts of climate change on two major mosquito-borne diseases of global health importance, malaria and dengue, and to identify the range of relevant policy responses and adaptation strategies that have been devised, we performed a scoping review of published review literature. Three electronic databases (PubMed, Scopus and Epistemonikos) were systematically searched for relevant published reviews. Inclusion criteria were: reviews with a systematic search, from 2007 to 2020, in English or French, that addressed climate change impacts and/or adaptation strategies related to malaria and/or dengue. Data extracted included: characteristics of the article, type of review, disease(s) of focus, geographic focus, and nature of the evidence. The evidence was summarized to identify and compare regional evidence for climate change impacts and adaptation measures. RESULTS: A total of 32 reviews met the inclusion criteria. Evidence for the impacts of climate change (including climate variability) on dengue was greatest in the Southeast Asian region, while evidence for the impacts of climate change on malaria was greatest in the African region, particularly in highland areas. Few reviews explicitly addressed the implementation of adaptation strategies to address climate change-driven disease transmission, however suggested strategies included enhanced surveillance, early warning systems, predictive models and enhanced vector control. CONCLUSIONS: There is strong evidence for the impacts of climate change, including climate variability, on the transmission and future spread of malaria and dengue, two of the most globally important vector-borne diseases. Further efforts are needed to develop multi-sectoral climate change adaptation strategies to enhance the capacity and resilience of health systems and communities, especially in regions with predicted climatic suitability for future emergence and re-emergence of malaria and dengue. This scoping review may serve as a useful precursor to inform future systematic reviews of the primary literature.
BACKGROUND: Early warning systems (EWSs) are of increasing importance in the context of outbreak-prone diseases such as chikungunya, dengue, malaria, yellow fever, and Zika. A scoping review has been undertaken for all 5 diseases to summarize existing evidence of EWS tools in terms of their structural and statistical designs, feasibility of integration and implementation into national surveillance programs, and the users’ perspective of their applications. METHODS: Data were extracted from Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Latin American and Caribbean Health Sciences Literature (LILACS), PubMed, Web of Science, and WHO Library Database (WHOLIS) databases until August 2019. Included were studies reporting on (a) experiences with existing EWS, including implemented tools; and (b) the development or implementation of EWS in a particular setting. No restrictions were applied regarding year of publication, language or geographical area. FINDINGS: Through the first screening, 11,710 documents for dengue, 2,757 for Zika, 2,706 for chikungunya, 24,611 for malaria, and 4,963 for yellow fever were identified. After applying the selection criteria, a total of 37 studies were included in this review. Key findings were the following: (1) a large number of studies showed the quality performance of their prediction models but except for dengue outbreaks, only few presented statistical prediction validity of EWS; (2) while entomological, epidemiological, and social media alarm indicators are potentially useful for outbreak warning, almost all studies focus primarily or exclusively on meteorological indicators, which tends to limit the prediction capacity; (3) no assessment of the integration of the EWS into a routine surveillance system could be found, and only few studies addressed the users’ perspective of the tool; (4) almost all EWS tools require highly skilled users with advanced statistics; and (5) spatial prediction remains a limitation with no tool currently able to map high transmission areas at small spatial level. CONCLUSIONS: In view of the escalating infectious diseases as global threats, gaps and challenges are significantly present within the EWS applications. While some advanced EWS showed high prediction abilities, the scarcity of tool assessments in terms of integration into existing national surveillance systems as well as of the feasibility of transforming model outputs into local vector control or action plans tends to limit in most cases the support of countries in controlling disease outbreaks.
Water-related diseases such as diarrhoeal diseases from viral, bacterial and parasitic organisms and Aedes-borne arboviral diseases are major global health problems. We believe that these two disease groups share common risk factors, namely inadequate household water management, poor sanitation and solid waste management. Where water provision is inadequate, water storage is essential. Aedes mosquitoes commonly breed in household water storage containers, which can hold water contaminated with enteric disease-causing organisms. Microbiological contamination of water between source and point-of-use is a major cause of reduced drinking-water quality. Inadequate sanitation and solid waste management increase not only risk of water contamination, but also the availability of mosquito larval habitats. In this article we discuss integrated interventions that interrupt mosquito breeding while also providing sanitary environments and clean water. Specific interventions include improving storage container design, placement and maintenance and scaling up access to piped water. Vector control can be integrated into sanitation projects that target sewers and drains to avoid accumulation of stagnant water. Better management of garbage and solid waste can reduce the availability of mosquito habitats while improving human living conditions. Our proposed integration of disease interventions is consistent with strategies promoted in several global health frameworks, such as the sustainable development goals, the global vector control response, behavioural change, and water, sanitation and hygiene initiatives. Future research should address how interventions targeting water, sanitation, hygiene and community waste disposal also benefit Aedes-borne disease control. The projected effects of climate change mean that integrated management and control strategies will become increasingly important.
Human health is threatened by antibiotic-resistant bacteria and their related infections, which cause thousands of human deaths every year worldwide. Surface waters are vulnerable to human activities and natural processes that facilitate the emergence and spread of antibiotic-resistant bacteria in the environment. This study evaluated the pathways and drivers of antimicrobial resistance (AR) in surface waters. We analyzed antibiotic resistance healthcare-associated infection (HAI) data reported to the CDC’s National Healthcare Safety Network to determine the number of antimicrobial-resistant pathogens and their isolates detected in healthcare facilities. Ten pathogens and their isolates associated with HAIs tested resistant to the selected antibiotics, indicating the role of healthcare facilities in antimicrobial resistance in the environment. The analyzed data and literature research revealed that healthcare facilities, wastewater, agricultural settings, food, and wildlife populations serve as the major vehicles for AR in surface waters. Antibiotic residues, heavy metals, natural processes, and climate change were identified as the drivers of antimicrobial resistance in the aquatic environment. Food and animal handlers have a higher risk of exposure to resistant pathogens through ingestion and direct contact compared with the general population. The AR threat to public health may grow as pathogens in aquatic systems adjust to antibiotic residues, contaminants, and climate change effects. The unnecessary use of antibiotics increases the risk of AR, and the public should be encouraged to practice antibiotic stewardship to decrease the risk.
The reality of climate change and biodiversity collapse is irrefutable in the 21st century, with urgent action required not only to conserve threatened species but also to protect human life and wellbeing. This existential threat forces us to recognise that our existence is completely dependent upon well-functioning ecosystems that sustain the diversity of life on our planet, including that required for human health. By synthesising data on the ecology, epidemiology and evolutionary biology of various pathogens, we are gaining a better understanding of factors that underlie disease emergence and spread. However, our knowledge remains rudimentary with limited insight into the complex feedback loops that underlie ecological stability, which are at risk of rapidly unravelling once certain tipping points are breached. In this paper, we consider the impact of climate change and biodiversity collapse on the ever-present risk of infectious disease emergence and spread. We review historical and contemporaneous infectious diseases that have been influenced by human environmental manipulation, including zoonoses and vector- and water-borne diseases, alongside an evaluation of the impact of migration, urbanisation and human density on transmissible diseases. The current lack of urgency in political commitment to address climate change warrants enhanced understanding and action from paediatricians – to ensure that we safeguard the health and wellbeing of children in our care today, as well as those of future generations.
Aedes aegypti and Aedes albopictus transmit diseases such as dengue, and are of major public health concern. Driven by climate change and global trade/travel both species have recently spread to new tropic/subtropic regions and Ae. albopictus also to temperate ecoregions. The capacity of both species to adapt to new environments depends on their ecophysiological plasticity, which is the width of functional niches where a species can survive. Mechanistic distribution models often neglect to incorporate ecophysiological plasticity especially in regards to overwintering capacity in cooler habitats. To portray the ecophysiological plasticity concerning overwintering capability, we conducted temperature experiments with multiple populations of both species originating from an altitudinal gradient in South Asia and tested as follows: the cold tolerance of eggs (-2 °C- 8 days and – 6 °C- 2 days) without and with an experimental winter onset (acclimation: 10 °C- 60 days), differences between a South Asian and a European Ae. albopictus population and the temperature response in life cycles (13 °C, 18 °C, 23 °C, 28 °C). Ecophysiological plasticity in overwintering capacity in Ae. aegypti is high in populations originating from low altitude and in Ae. albopictus populations from high altitude. Overall, ecophysiological plasticity is higher in Ae. albopictus compared to Ae. aegypti. In both species acclimation and in Ae. albopictus temperate continental origin had a huge positive effect on survival. Our results indicate that future mechanistic prediction models can include data on winter survivorship of both, tropic and subtropic Ae. aegypti, whereas for Ae. albopictus this depends on the respective temperate, tropical region the model is focusing on. Future research should address cold tolerance in multiple populations worldwide to evaluate the full potential of the ecophysiological plasticity in the two species. Furthermore, we found that Ae. aegypti can survive winter cold especially when acclimated and will probably further spread to colder ecoregions driven by climate change.
This review highlights two intersecting environmental phenomena that have significantly impacted the Tokyo Summer Olympic and Paralympic Games: infectious disease outbreaks and anthropogenic climate change. Following systematic searches of five databases and the gray literature, 15 studies were identified that addressed infectious disease and climate-related health risks associated with the Summer Games and similar sports mega-events. Over two decades, infectious disease surveillance at the Summer Games has identified low-level threats from vaccine-preventable illnesses and respiratory conditions. However, the COVID-19 pandemic and expansion of vector-borne diseases represent emerging and existential challenges for cities that host mass gathering sports competitions due to the absence of effective vaccines. Ongoing threats from heat injury among athletes and spectators have also been identified at international sports events from Asia to North America due to a confluence of rising Summer temperatures, urban heat island effects and venue crowding. Projections for the Tokyo Games and beyond suggest that heat injury risks are reaching a dangerous tipping point, which will necessitate relocation or mitigation with long-format and endurance events. Without systematic change to its format or staging location, the Summer Games have the potential to drive deleterious health outcomes for athletes, spectators and host communities.
Global climate change exposes workers to increased air temperature, polluted air, and ultraviolet radiation due to ozone depletion, increased extreme weather events, and evolving patterns of vector-borne diseases. These climate change hazards are causing acute and chronic health problems to workers. The occupational distribution of the population is the most vulnerable to the negative impacts of climate change worldwide. Climate change-related adverse health hazards to the general population is getting evident around the globe. A limited focus has been made on developing a relationship between climate change and related occupational health hazards. This policy paper aims to guide health officials and policymakers to develop a climate change mitigation policy for the occupational distribution of the population. Absolute magnitude determination of climate changerelated health risks is essential to developing projecting models and predicting future hazards and risks. These models will help us to estimate climate change and environmental exposure, susceptibility of the exposed population, and capacity of public health practice and services to reduce climate change impact. Adaptation policies in international, national, and local occupational settings are required to acclimatize the workers and mitigate climate change-related adverse effects.
BACKGROUND: Mosquito-borne diseases are expanding their range, and re-emerging in areas where they had subsided for decades. The extent to which climate change influences the transmission suitability and population at risk of mosquito-borne diseases across different altitudes and population densities has not been investigated. The aim of this study was to quantify the extent to which climate change will influence the length of the transmission season and estimate the population at risk of mosquito-borne diseases in the future, given different population densities across an altitudinal gradient. METHODS: Using a multi-model multi-scenario framework, we estimated changes in the length of the transmission season and global population at risk of malaria and dengue for different altitudes and population densities for the period 1951-99. We generated projections from six mosquito-borne disease models, driven by four global circulation models, using four representative concentration pathways, and three shared socioeconomic pathways. FINDINGS: We show that malaria suitability will increase by 1·6 additional months (mean 0·5, SE 0·03) in tropical highlands in the African region, the Eastern Mediterranean region, and the region of the Americas. Dengue suitability will increase in lowlands in the Western Pacific region and the Eastern Mediterranean region by 4·0 additional months (mean 1·7, SE 0·2). Increases in the climatic suitability of both diseases will be greater in rural areas than in urban areas. The epidemic belt for both diseases will expand towards temperate areas. The population at risk of both diseases might increase by up to 4·7 additional billion people by 2070 relative to 1970-99, particularly in lowlands and urban areas. INTERPRETATION: Rising global mean temperature will increase the climatic suitability of both diseases particularly in already endemic areas. The predicted expansion towards higher altitudes and temperate regions suggests that outbreaks can occur in areas where people might be immunologically naive and public health systems unprepared. The population at risk of malaria and dengue will be higher in densely populated urban areas in the WHO African region, South-East Asia region, and the region of the Americas, although we did not account for urban-heat island effects, which can further alter the risk of disease transmission. FUNDING: UK Space Agency, Royal Society, UK National Institute for Health Research, and Swedish Research Council.
The American Society for Reproductive Medicine compels centers providing reproductive medicine care to develop and implement an emergency preparedness plan in the event of a disaster. Reproductive care is vulnerable to disruptions in energy, transportation, and supply chains as well as may have potential destructive impacts on infrastructure. With the relentless progression of events related to climate change, centers can expect a growing number of such disruptive events and must prepare to deal with them. This article provides a case study of the impact of Hurricane Sandy on one center in New York City and proposes recommendations for future preparedness and mitigation.
Climate warming is occurring most rapidly in the Arctic, which is both a sentinel and a driver of further global change. Ecosystems and human societies are already affected by warming. Permafrost thaws and species are on the move, bringing pathogens and vectors to virgin areas. During a five-year project, the CLINF – a Nordic Center of Excellence, funded by the Nordic Council of Ministers, has worked with the One Health concept, integrating environmental data with human and animal disease data in predictive models and creating maps of dynamic processes affecting the spread of infectious diseases. It is shown that tularemia outbreaks can be predicted even at a regional level with a manageable level of uncertainty. To decrease uncertainty, rapid development of new and harmonised technologies and databases is needed from currently highly heterogeneous data sources. A major source of uncertainty for the future of contaminants and infectious diseases in the Arctic, however, is associated with which paths the majority of the globe chooses to follow in the future. Diplomacy is one of the most powerful tools Arctic nations have to influence these choices of other nations, supported by Arctic science and One Health approaches that recognise the interconnection between people, animals, plants and their shared environment at the local, regional, national and global levels as essential for achieving a sustainable development for both the Arctic and the globe.
Climate change affects ecological processes and interactions, including parasitism. Because parasites are natural components of ecological systems, as well as agents of outbreak and disease-induced mortality, it is important to summarize current knowledge of the sensitivity of parasites to climate and identify how to better predict their responses to it. This need is particularly great in marine systems, where the responses of parasites to climate variables are less well studied than those in other biomes. As examples of climate’s influence on parasitism increase, they enable generalizations of expected responses as well as insight into useful study approaches, such as thermal performance curves that compare the vital rates of hosts and parasites when exposed to several temperatures across a gradient. For parasites not killed by rising temperatures, some simple physiological rules, including the tendency of temperature to increase the metabolism of ectotherms and increase oxygen stress on hosts, suggest that parasites’ intensity and pathologies might increase. In addition to temperature, climate-induced changes in dissolved oxygen, ocean acidity, salinity, and host and parasite distributions also affect parasitism and disease, but these factors are much less studied. Finally, because parasites are constituents of ecological communities, we must consider indirect and secondary effects stemming from climate-induced changes in host-parasite interactions, which may not be evident if these interactions are studied in isolation.
Arthropod-borne viruses (Arboviruses) continue to generate significant health and economic burdens for people living in endemic regions. Of these viruses, some of the most important (e.g., dengue, Zika, chikungunya, and yellow fever virus), are transmitted mainly by Aedes mosquitoes. Over the years, viral infection control has targeted vector population reduction and inhibition of arboviral replication and transmission. This control includes the vector control methods which are classified into chemical, environmental, and biological methods. Some of these control methods may be largely experimental (both field and laboratory investigations) or widely practised. Perceptively, one of the biological methods of vector control, in particular, Wolbachia-based control, shows a promising control strategy for eradicating Aedes-borne arboviruses. This can either be through the artificial introduction of Wolbachia, a naturally present bacterium that impedes viral growth in mosquitoes into heterologous Aedes aegypti mosquito vectors (vectors that are not natural hosts of Wolbachia) thereby limiting arboviral transmission or via Aedes albopictus mosquitoes, which naturally harbour Wolbachia infection. These strategies are potentially undermined by the tendency of mosquitoes to lose Wolbachia infection in unfavourable weather conditions (e.g., high temperature) and the inhibitory competitive dynamics among co-circulating Wolbachia strains. The main objective of this review was to critically appraise published articles on vector control strategies and specifically highlight the use of Wolbachia-based control to suppress vector population growth or disrupt viral transmission. We retrieved studies on the control strategies for arboviral transmissions via arthropod vectors and discussed the use of Wolbachia control strategies for eradicating arboviral diseases to identify literature gaps that will be instrumental in developing models to estimate the impact of these control strategies and, in essence, the use of different Wolbachia strains and features.
Environmental factors play a crucial role in the population dynamics of arthropod endosymbionts, and therefore in the deployment of Wolbachia symbionts for the control of dengue arboviruses. The potential of Wolbachia to invade, persist, and block virus transmission depends in part on its intracellular density. Several recent studies have highlighted the importance of larval rearing temperature in modulating Wolbachia densities in adults, suggesting that elevated temperatures can severely impact some strains, while having little effect on others. The effect of a replicated tropical heat cycle on Wolbachia density and levels of virus blocking was assessed using Aedes aegypti lines carrying strains wMel and wAlbB, two Wolbachia strains currently used for dengue control. Impacts on intracellular density, maternal transmission fidelity, and dengue inhibition capacity were observed for wMel. In contrast, wAlbB-carrying Ae. aegypti maintained a relatively constant intracellular density at high temperatures and conserved its capacity to inhibit dengue. Following larval heat treatment, wMel showed a degree of density recovery in aging adults, although this was compromised by elevated air temperatures. IMPORTANCE In the past decades, dengue incidence has dramatically increased all over the world. An emerging dengue control strategy utilizes Aedes aegypti mosquitoes artificially transinfected with the bacterial symbiont Wolbachia, with the ultimate aim of replacing wild mosquito populations. However, the rearing temperature of mosquito larvae is known to impact on some Wolbachia strains. In this study, we compared the effects of a temperature cycle mimicking natural breeding sites in tropical climates on two Wolbachia strains, currently used for open field trials. When choosing the Wolbachia strain to be used in a dengue control program it is important to consider the effects of environmental temperatures on invasiveness and virus inhibition. These results underline the significance of understanding the impact of environmental factors on released mosquitoes, in order to ensure the most efficient strategy for dengue control.
The potential for adaptive evolution to enable species persistence under a changing climate is one of the most important questions for understanding impacts of future climate change. Climate adaptation may be particularly likely for short-lived ectotherms, including many pest, pathogen, and vector species. For these taxa, estimating climate adaptive potential is critical for accurate predictive modeling and public health preparedness. Here, we demonstrate how a simple theoretical framework used in conservation biology-evolutionary rescue models-can be used to investigate the potential for climate adaptation in these taxa, using mosquito thermal adaptation as a focal case. Synthesizing current evidence, we find that short mosquito generation times, high population growth rates, and strong temperature-imposed selection favor thermal adaptation. However, knowledge gaps about the extent of phenotypic and genotypic variation in thermal tolerance within mosquito populations, the environmental sensitivity of selection, and the role of phenotypic plasticity constrain our ability to make more precise estimates. We describe how common garden and selection experiments can be used to fill these data gaps. Lastly, we investigate the consequences of mosquito climate adaptation on disease transmission using Aedes aegypti-transmitted dengue virus in Northern Brazil as a case study. The approach outlined here can be applied to any disease vector or pest species and type of environmental change.
Wolbachia intracellular bacteria successfully reduce the transmissibility of arthropod-borne viruses (arboviruses) when introduced into virus-carrying vectors such as mosquitoes. Despite the progress made by introducing Wolbachia bacteria into the Aedes aegypti wild-type population to control arboviral infections, reports suggest that heat-induced loss-of-Wolbachia-infection as a result of climate change may reverse these gains. Novel, supplemental Wolbachia strains that are more resilient to increased temperatures may circumvent these concerns, and could potentially act synergistically with existing variants. In this article, we model the ecological dynamics among three distinct mosquito (sub)populations: a wild-type population free of any Wolbachia infection; an invading population infected with a particular Wolbachia strain; and a second invading population infected with a distinct Wolbachia strain from that of the first invader. We explore how the range of possible characteristics of each Wolbachia strain impacts mosquito prevalence. Further, we analyse the differential system governing the mosquito populations and the Wolbachia infection dynamics by computing the full set of basic and invasive reproduction numbers and use these to establish stability of identified equilibria. Our results show that releasing mosquitoes with two different strains of Wolbachia did not increase their prevalence, compared with a single-strain Wolbachia-infected mosquito introduction and only delayed Wolbachia dominance.
Evidence climate change is impacting ticks and tick-borne infections is generally lacking. This is primarily because, in most parts of the world, there are no long-term and replicated data on the distribution and abundance of tick populations, and the prevalence and incidence of tick-borne infections. Notable exceptions exist, as in Canada where the northeastern advance of Ixodes scapularis and Lyme borreliosis in the USA prompted the establishment of tick and associated disease surveillance. As a result, the past 30 years recorded the encroachment and spread of I. scapularis and Lyme borreliosis across much of Canada concomitant with a 2-3 degrees C increase in land surface temperature. A similar northerly advance of I. ricinus [and associated Lyme borreliosis and tick-borne encephalitis (TBE)] has been recorded in northern Europe together with expansion of this species’ range to higher altitudes in Central Europe and the Greater Alpine Region, again concomitant with rising temperatures. Changes in tick species composition are being recorded, with increases in more heat tolerant phenotypes (such as Rhipicephalus microplus in Africa), while exotic species, such as Haemaphysalis longicornis and Hyalomma marginatum, are becoming established in the USA and Southern Europe, respectively. In the next 50 years these trends are likely to continue, whereas, at the southern extremities of temperate species’ ranges, diseases such as Lyme borreliosis and TBE may become less prevalent. Where socioeconomic conditions link livestock with livelihoods, as in Pakistan and much of Africa, a One Health approach is needed to tackling ticks and tick-borne infections under the increasing challenges presented by climate change.
The effects of current and future global warming on the distribution and activity of the primary ixodid vectors of human babesiosis (caused by Babesia divergens, B. venatorum and B. microti) are discussed. There is clear evidence that the distributions of both Ixodes ricinus, the vector in Europe, and I. scapularis in North America have been impacted by the changing climate, with increasing temperatures resulting in the northwards expansion of tick populations and the occurrence of I. ricinus at higher altitudes. Ixodes persulcatus, which replaces I. ricinus in Eurasia and temperate Asia, is presumed to be the babesiosis vector in China and Japan, but this tick species has not yet been confirmed as the vector of either human or animal babesiosis. There is no definite evidence, as yet, of global warming having an effect on the occurrence of human babesiosis, but models suggest that it is only a matter of time before cases occur further north than they do at present.
The COVID-19 pandemic has shed light on the challenges we face as a global society in preventing and containing emerging and re-emerging pathogens. Multiple intersecting factors, including environmental changes, host immunological factors, and pathogen dynamics, are intimately connected to the emergence and re-emergence of communicable diseases. There is a large and expanding list of communicable diseases that can cause neurological damage, either through direct or indirect routes. Novel pathogens of neurotropic potential have been identified through advanced diagnostic techniques, including metagenomic next-generation sequencing, but there are also known pathogens which have expanded their geographic distribution to infect non-immune individuals. Factors including population growth, climate change, the increase in animal and human interface, and an increase in international travel and trade are contributing to the expansion of emerging and re-emerging pathogens. Challenges exist around antimicrobial misuse giving rise to antimicrobial-resistant infectious neurotropic organisms and increased susceptibility to infection related to the expanded use of immunomodulatory treatments. In this article, we will review key concepts around emerging and re-emerging pathogens and discuss factors associated with neurotropism and neuroinvasion. We highlight several neurotropic pathogens of interest, including West Nile virus (WNV), Zika Virus, Japanese Encephalitis Virus (JEV), and Tick-Borne Encephalitis Virus (TBEV). We emphasize neuroinfectious diseases which impact the central nervous system (CNS) and focus on flaviviruses, a group of vector-borne pathogens that have expanded globally in recent years and have proven capable of widespread outbreak.
Dengue virus (DENV) is the causative agent of dengue fever and severe dengue. Every year, millions of people are infected with this virus. There is no vaccine available for this disease. Dengue virus is present in four serologically varying strains, DENV 1, 2, 3, and 4, and each of these serotypes is further classified into various genotypes based on the geographic distribution and genetic variance. Mosquitoes play the role of vectors for this disease. Tropical countries and some temperate parts of the world witness outbreaks of dengue mainly during the monsoon (rainy) seasons. Several algorithms have been developed to predict the occurrence and prognosis of dengue disease. These algorithms are mainly based on epidemiological data, climate factors, and online search patterns in the infected area. Most of these algorithms are based on either machine learning or deep learning techniques. We summarize the different software tools available for predicting the outbreaks of dengue based on the aforementioned factors, briefly outline the methodology used in these algorithms, and provide a comprehensive list of programs available for the same in this article.
The leishmaniases are a group of four vector-borne neglected tropical diseases (NTDs) with 1.6 billion people in some 100 countries at risk. They occur in certain eco-epidemiological foci that reflect manipulation by human activities, such as migration, urbanization and deforestation, of which poverty, conflict and climate change are key drivers. Given their synergistic impacts, risk factors and the vulnerabilities of poor populations and the launch of a new 2030 roadmap for NTDs in the context of the global sustainability agenda, it is warranted to update the state of knowledge of the leishmaniases and their effects. Using existing literature, we review socioeconomic and psychosocial impacts of leishmaniasis within a framework of risk factors and vulnerabilities to help inform policy interventions. Studies show that poverty is an overarching primary risk factor. Low-income status fosters inadequate housing, malnutrition and lack of sanitation, which create and exacerbate complexities in access to care and treatment outcomes as well as education and awareness. The co-occurrence of the leishmaniases with malnutrition and HIV infection further complicate diagnosis and treatment, leading to poor diagnostic outcomes and therapeutic response. Even with free treatment, households may suffer catastrophic health expenditure from direct and indirect medical costs, which compounds existing financial strain in low-income communities for households and healthcare systems. The dermatological presentations of the leishmaniases may result in long-term severe disfigurement, leading to stigmatization, reduced quality of life, discrimination and mental health issues. A substantial amount of recent literature points to the vulnerability pathways and burden of leishmaniasis on women, in particular, who disproportionately suffer from these impacts. These emerging foci demonstrate a need for continued international efforts to address key risk factors and population vulnerabilities if leishmaniasis control, and ultimately elimination, is to be achieved by 2030.
The rapid spread of arboviral infections in recent years has continually established arthropod-borne encephalitis to be a pressing global health concern. Causing a wide range of clinical presentations ranging from asymptomatic infection to fulminant neurological disease, the hallmark features of arboviral infection are important to clinically recognise. Arboviral infections may cause severe neurological presentations such as meningoencephalitis, epilepsy, acute flaccid paralysis and stroke. While the pathogenesis of arboviral infections is still being investigated, shared neuroanatomical pathways among these viruses may give insight into future therapeutic targets. The shifting infection transmission patterns and evolving distribution of arboviral vectors are heavily influenced by global climate change and human environmental disruption, therefore it is of utmost importance to consider this potential aetiology when assessing patients with encephalitic presentations.
The steady and ongoing change in climatic patterns across the globe is triggering a cascade of climate-adaptive phenomena, both genetic and behavioral in parasites, and influencing the host-pathogen-transmission triangle. Parasite and vector traits are now heavily influenced due to increasing temperature that almost dissolved geospatial boundaries and impacted the basic reproductive number of parasites. As consequence, continents unknown to some parasites are experiencing altered distribution and abundance of new and emerging parasites that are developing into a newer epidemiological model. These are posing a burden to healthcare and higher disease prevalence. This calls for multidisciplinary actions focusing on One Health to improve and innovate in areas of detection, reporting, and medical countermeasures to combat the growing threat of parasite emergence owing to climate adaptations for better public health outcomes.
PURPOSE OF REVIEW: The COVID-19 pandemic has cast increased attention on emerging infections. Clinicians and public health experts should be aware of emerging infectious causes of encephalitis, mechanisms by which they are transmitted, and clinical manifestations of disease. RECENT FINDINGS: A number of arthropod-borne viral infections — transmitted chiefly by mosquitoes and ticks — have emerged in recent years to cause outbreaks of encephalitis. Examples include Powassan virus in North America, Chikungunya virus in Central and South America, and tick-borne encephalitis virus in Europe. Many of these viruses exhibit complex life cycles and can infect multiple host animals in addition to humans. Factors thought to influence emergence of these diseases, including changes in climate and land use, are also believed to underlie the emergence of the rickettsial bacterium Orientia tsutsugamushi, now recognized as a major causative agent of acute encephalitis syndrome in South Asia. In addition, the COVID-19 pandemic has highlighted the role of bats as carriers of viruses. Recent studies have begun to uncover mechanisms by which the immune systems of bats are poised to allow for viral tolerance. Several bat-borne infections, including Nipah virus and Ebola virus, have resulted in recent outbreaks of encephalitis. SUMMARY: Infectious causes of encephalitis continue to emerge worldwide, in part because of climate change and human impacts on the environment. Expansion of surveillance measures will be critical in rapid diagnosis and limiting of outbreaks in the future.
PURPOSE OF REVIEW: Following their use for medicinal purposes, volatile inhalational anaesthetic agents are expelled into the atmosphere where they contribute to anthropogenic climate change. We describe recent evidence examining the benefits and harms associated with their use. RECENT FINDINGS: The environmental harms associated with desflurane and nitrous oxide likely outweigh any purported clinical benefits. Life cycle analyses are beginning to address the many gaps in our understanding, and informing choices made on all aspects of anaesthetic care. There is, however, an urgent need to move beyond the debate about anaesthetic technique A vs. B and focus also on areas such as sustainable procurement, waste management, pharmacological stewardship and joined-up solutions. SUMMARY: There is now compelling evidence that anaesthetists, departments and hospitals should avoid desflurane completely, and limit nitrous oxide use to settings where there is no viable alternative, as their environmental harms outweigh any perceived clinical benefit. Life cycle analyses seem supportive of total intravenous and/or regional anaesthesia. There are many other areas where choices can be made by individual anaesthetists that contribute towards reducing the environmental burden of healthcare, such as prioritising the reduction of inappropriate resource use and over-treatment. However, this all requires joined up solutions where all parts of an organisation engage.
The complex nature of climate change-mediated multitrophic interaction is an underexplored area, but has the potential to dramatically shift transmission and distribution of many insects and their pathogens, placing some populations closer to the brink of extinction. However, for individual insect-pathogen interactions climate change will have complicated hard-to-anticipate impacts. Thus, both pathogen virulence and insect host immunity are intrinsically linked with generalized stress responses, and in both pathogen and host have extensive trade-offs with nutrition (e.g., host plant quality), growth and reproduction. Potentially alleviating or exasperating these impacts, some pathogens and hosts respond genetically and rapidly to environmental shifts. This review identifies many areas for future research including a particular need to identify how altered global warming interacts with other environmental changes and stressors, and how consistent these impacts are across pathogens and hosts. With that achieved we would be closer to producing an overarching framework to integrate knowledge on all environmental interplay and infectious disease events.
Species distribution models (SDMs) that use climate variables to make binary predictions are effective tools for niche prediction in current and future climate scenarios. In this study, a Hutchinson hypervolume is defined with temperature, humidity, air pressure, precipitation, and cloud cover climate vectors collected from the National Oceanic and Atmospheric Administration (NOAA) that were matched to mosquito presence and absence points extracted from NASA’s citizen science platform called GLOBE Observer and the National Ecological Observatory Network. An 86% accurate Random Forest model that operates on binary classification was created to predict mosquito threat. Given a location and date input, the model produces a threat level based on the number of decision trees that vote for a presence label. The feature importance chart and regression show a positive, linear correlation between humidity and mosquito threat and between temperature and mosquito threat below a threshold of 28 °C. In accordance with the statistical analysis and ecological wisdom, high threat clusters in warm, humid regions and low threat clusters in cold, dry regions were found. With the model running on the cloud and within ArcGIS Dashboard, accurate and granular real-time threat level predictions can be made at any latitude and longitude. A device leveraging Global Positioning System (GPS) smartphone technology and the Internet of Things (IoT) to collect and analyze data on the edge was developed. The data from the edge device along with its respective date and location collected are automatically inputted into the aforementioned Random Forest model to provide users with a real-time threat level prediction. This inexpensive hardware can be used in developing countries that are threatened by vector-borne diseases or in remote areas without cloud connectivity. Such devices can be linked with citizen science mosquito data platforms to build training datasets for machine learning based SDMs.
With advancements in big geospatial data and artificial intelligence, multi-source data and diverse data-driven methods have become common in dengue risk prediction. Understanding the current state of data and models in dengue risk prediction enables the implementation of efficient and accurate prediction in the future. Focusing on predictors, data sources, spatial and temporal scales, data-driven methods, and model evaluation, we performed a literature review based on 53 journal and conference papers published from 2018 to the present and concluded the following. (1) The predominant predictors include local climate conditions, historical dengue cases, vegetation indices, human mobility, population, internet search indices, social media indices, landscape, time index, and extreme weather events. (2) They are mainly derived from the official meteorological agency satellite-based datasets, public websites, department of health services and national electronic diseases surveillance systems, official statistics, and public transport datasets. (3) Country-level, province/state-level, city-level, district-level, and neighborhood-level are used as spatial scales, and the city-level scale received the most attention. The temporal scales include yearly, monthly, weekly, and daily, and both monthly and weekly are the most popular options. (4) Most studies define dengue risk forecasting as a regression task, and a few studies define it as a classification task. Data-driven methods can be categorized into single models, ensemble learning, and hybrid learning, with single models being further subdivided into time series, machine learning, and deep learning models. (5) Model evaluation concentrates primarily on the quantification of the difference/correlation between time-series observations and predicted values, the ability of models to determine whether a dengue outbreak occurs or not, and model uncertainty. Finally, we highlighted the importance of big geospatial data, data cloud computing, and other deep learning models in future dengue risk forecasting.
When a rare pathogen emerges to cause a pandemic, it is critical to understand its dynamics and the impact of mitigation measures. We use experimental data to parametrize a temperature-dependent model of Zika virus (ZIKV) transmission dynamics and analyse the effects of temperature variability and control-related parameters on the basic reproduction number (R(0)) and the final epidemic size of ZIKV. Sensitivity analyses show that these two metrics are largely driven by different parameters, with the exception of temperature, which is the dominant driver of epidemic dynamics in the models. Our R(0) estimate has a single optimum temperature (≈30°C), comparable to other published results (≈29°C). However, the final epidemic size is maximized across a wider temperature range, from 24 to 36°C. The models indicate that ZIKV is highly sensitive to seasonal temperature variation. For example, although the model predicts that ZIKV transmission cannot occur at a constant temperature below 23°C (≈ average annual temperature of Rio de Janeiro, Brazil), the model predicts substantial epidemics for areas with a mean temperature of 20°C if there is seasonal variation of 10°C (≈ average annual temperature of Tampa, Florida). This suggests that the geographical range of ZIKV is wider than indicated from static R(0) models, underscoring the importance of climate dynamics and variation in the context of broader climate change on emerging infectious diseases.
Arboviruses (arthropod-borne viruses) are expanding their geographic range, posing significant health threats to millions of people worldwide. This expansion is associated with efficient and suitable vector availability. Apart from the well-known Aedes aegypti and Ae. albopictus, other Aedes species may potentially promote the geographic spread of arboviruses because these viruses have similar vector requirements. Aedes japonicus, Ae. vexans and Ae. vittatus are a growing concern, given their potential and known vector competence for several arboviruses including dengue, chikungunya, and Zika viruses. In the present study, we developed detailed maps of their global potential distributions under both current and future (2050) climate conditions, using an ecological niche modeling approach (Maxent). Under present-day conditions, Ae. japonicus and Ae. vexans have suitable areas in the northeastern United States, across Europe and in southeastern China, whereas the tropical regions of South America, Africa and Asia are more suitable for Ae. vittatus. Future scenarios anticipated range changes for the three species, with each expected to expand into new areas that are currently not suitable. By 2050, Ae. japonicus will have a broader potential distribution across much of Europe, the United States, western Russia and central Asia. Aedes vexans may be able to expand its range, especially in Libya, Egypt and southern Australia. For Ae. vittatus, future projections indicated areas at risk in sub-Saharan Africa and the Middle East. As such, these species deserve as much attention as Ae. aegypti and Ae. albopictus when processing arboviruses risk assessments and our findings may help to better understand the potential distribution of each species.
BACKGROUND: Mosquito-borne diseases (e.g., transmitted by Aedes aegypti) affect almost 700 million people each year and result in the deaths of more than 1 million people annually. METHODS: We examined research undertaken during the period 1951-2020 on the effects of temperature and climate change on Ae. aegypti, and also considered research location and between-country collaborations. RESULTS: The frequency of publications on the effects of climate change on Ae. aegypti increased over the period examined, and this topic received more attention than the effects of temperature alone on this species. The USA, UK, Australia, Brazil, and Argentina were the dominant research hubs, while other countries fell behind with respect to number of scientific publications and/or collaborations. The occurrence of Ae. aegypti and number of related dengue cases in the latter are very high, and climate change scenarios predict changes in the range expansion and/or occurrence of this species in these countries. CONCLUSIONS: We conclude that some of the countries at risk of expanding Ae. aegypti populations have poor research networks that need to be strengthened. A number of mechanisms can be considered for the improvement of international collaboration, representativity and diversity, such as research networks, internationalization programs, and programs that enhance representativity. These types of collaboration are considered important to expand the relevant knowledge of these countries and for the development of management strategies in response to climate change scenarios.
BACKGROUND AND AIM: Vector-borne diseases (VBDs) constitute a global problem for humans and animals. Knowledge related to the spatial distribution of various species of vectors and their relationship with the environment where they develop is essential to understand the current risk of VBDs and for planning surveillance and control strategies in the face of future threats. This study aimed to identify models, variables, and factors that may influence the emergence and resurgence of VBDs and how these factors can affect spatial local and global distribution patterns. MATERIALS AND METHODS: A systematic review was designed based on identification, screening, selection, and inclusion described in the research protocols according to the preferred reporting items for systematic reviews and meta-analyses guide. A literature search was performed in PubMed, ScienceDirect, Scopus, and SciELO using the following search strategy: Article type Original research, Language: English, Publishing period: 2010-2020, Search terms: Spatial analysis, spatial models, VBDs, climate, ecologic, life cycle, climate variability, vector-borne, vector, zoonoses, species distribution model, and niche model used in different combinations with “AND” and “OR.” RESULTS: The complexity of the interactions between climate, biotic/abiotic variables, and non-climate factors vary considerably depending on the type of disease and the particular location. VBDs are among the most studied types of illnesses related to climate and environmental aspects due to their high disease burden, extended presence in tropical and subtropical areas, and high susceptibility to climate and environment variations. CONCLUSION: It is difficult to generalize our knowledge of VBDs from a geospatial point of view, mainly because every case is inherently independent in variable selection, geographic coverage, and temporal extension. It can be inferred from predictions that as global temperatures increase, so will the potential trend toward extreme events. Consequently, it will become a public health priority to determine the role of climate and environmental variations in the incidence of infectious diseases. Our analysis of the information, as conducted in this work, extends the review beyond individual cases to generate a series of relevant observations applicable to different models.
Ticks exist on all continents and carry more zoonotic pathogens than any other type of vector. Ticks spend most of their lives in the external environment away from the host and are thus expected to be affected by changes in climate. Most empirical and theoretical studies demonstrate or predict range shifts or increases in ticks and tick-borne diseases, but there can be a lot of heterogeneity in such predictions. Tick-borne disease systems are complex, and determining whether changes are due to climate change or other drivers can be difficult. Modeling studies can help tease apart and understand the roles of different drivers of change. Predictive models can also be invaluable in projecting changes according to different climate change scenarios. However, validating these models remains challenging, and estimating uncertainty in predictions is essential. Another focus for future research should be assessing the resilience of ticks and tick-borne pathogens to climate change.
Dengue, a mosquito-borne disease, poses a tremendous burden to human health with about 390 million annual dengue infections worldwide. The environmental temperature plays a major role in the mosquito life-cycle as well as the mosquito-human-mosquito dengue transmission cycle. While previous studies have provided useful insights into the understanding of dengue diseases, there is little emphasis put on the role of environmental temperature variation, especially diurnal variation, in the mosquito vector and dengue dynamics. In this study, we develop a mathematical model to investigate the impact of seasonal and diurnal temperature variations on the persistence of mosquito vector and dengue. Importantly, using a threshold dynamical system approach to our model, we formulate the mosquito reproduction number and the infection invasion threshold, which completely determine the global threshold dynamics of mosquito population and dengue transmission, respectively. Our model predicts that both seasonal and diurnal variations of the environmental temperature can be determinant factors for the persistence of mosquito vector and dengue. In general, our numerical estimates of the mosquito reproduction number and the infection invasion threshold show that places with higher diurnal or seasonal temperature variations have a tendency to suffer less from the burden of mosquito population and dengue epidemics. Our results provide novel insights into the theoretical understanding of the role of diurnal temperature, which can be beneficial for the control of mosquito vector and dengue spread.
Early warning system (EWS) for vector-borne diseases is incredibly complex due to numerous factors originating from human, environmental, vector and the disease itself. Dengue EWS aims to collect data that leads to prompt decision-making processes that trigger disease intervention strategies to minimize the impact on a specific population. Dengue EWS may have a similar structural design, functions, and analytical approaches but different performance and ability to predict outbreaks. Hence, this review aims to summarise and discuss the evidence of different EWSs, their performance, and their ability to predict dengue outbreaks. A systematic literature search was performed of four primary databases: Scopus, Web of Science, Ovid MEDLINE, and EBSCOhost. Eligible articles were evaluated using a checklist for assessing the quality of the studies. A total of 17 studies were included in this systematic review. All EWS models demonstrated reasonably good predictive abilities to predict dengue outbreaks. However, the accuracy of their predictions varied greatly depending on the model used and the data quality. The reported sensitivity ranged from 50 to 100%, while specificity was 74 to 94.7%. A range between 70 to 96.3% was reported for prediction model accuracy and 43 to 86% for PPV. Overall, meteorological alarm indicators (temperatures and rainfall) were the most frequently used and displayed the best performing indicator. Other potential alarm indicators are entomology (female mosquito infection rate), epidemiology, population and socioeconomic factors. EWS is an essential tool to support district health managers and national health planners to mitigate or prevent disease outbreaks. This systematic review highlights the benefits of integrating several epidemiological tools focusing on incorporating climatic, environmental, epidemiological and socioeconomic factors to create an early warning system. The early warning system relies heavily on the country surveillance system. The lack of timely and high-quality data is critical for developing an effective EWS.
Climate change is unexpected weather patterns that can create an alarming situation. Due to climate change, various sectors are affected, and one of the sectors is healthcare. As a result of climate change, the geographic range of several vector-borne human infectious diseases will expand. Currently, dengue is taking its toll, and climate change is one of the key reasons contributing to the intensification of dengue disease transmission. The most important climatic factors linked to dengue transmission are temperature, rainfall, and relative humidity. The present study carries out a systematic literature review on the surveillance system to predict dengue outbreaks based on Machine Learning modeling techniques. The systematic literature review discusses the methodology and objectives, the number of studies carried out in different regions and periods, the association between climatic factors and the increase in positive dengue cases. This study also includes a detailed investigation of meteorological data, the dengue positive patient data, and the pre-processing techniques used for data cleaning. Furthermore, correlation techniques in several studies to determine the relationship between dengue incidence and meteorological parameters and machine learning models for predictive analysis are discussed. In the future direction for creating a dengue surveillance system, several research challenges and limitations of current work are discussed.
BACKGROUND: Traditionally, dengue surveillance is based on case reporting to a central health agency. However, the delay between a case and its notification can limit the system responsiveness. Machine learning methods have been developed to reduce the reporting delays and to predict outbreaks, based on non-traditional and non-clinical data sources. The aim of this systematic review was to identify studies that used real-world data, Big Data and/or machine learning methods to monitor and predict dengue-related outcomes. METHODOLOGY/PRINCIPAL FINDINGS: We performed a search in PubMed, Scopus, Web of Science and grey literature between January 1, 2000 and August 31, 2020. The review (ID: CRD42020172472) focused on data-driven studies. Reviews, randomized control trials and descriptive studies were not included. Among the 119 studies included, 67% were published between 2016 and 2020, and 39% used at least one novel data stream. The aim of the included studies was to predict a dengue-related outcome (55%), assess the validity of data sources for dengue surveillance (23%), or both (22%). Most studies (60%) used a machine learning approach. Studies on dengue prediction compared different prediction models, or identified significant predictors among several covariates in a model. The most significant predictors were rainfall (43%), temperature (41%), and humidity (25%). The two models with the highest performances were Neural Networks and Decision Trees (52%), followed by Support Vector Machine (17%). We cannot rule out a selection bias in our study because of our two main limitations: we did not include preprints and could not obtain the opinion of other international experts. CONCLUSIONS/SIGNIFICANCE: Combining real-world data and Big Data with machine learning methods is a promising approach to improve dengue prediction and monitoring. Future studies should focus on how to better integrate all available data sources and methods to improve the response and dengue management by stakeholders.
In this paper, we propose a new dynamical system model pertaining to Dengue transmission, and investigate its consequent morphology. We present and study various ramifications of our mathematical model for Dengue spread, encapsulated in a spatio-temporal differential system made of reaction-diffusion equations. Diffusion terms are incorporated into the said model by using specific derivations for infected mosquitoes, and infected humans, as well. Moreover, mechanisms for the nearest neighbor(s) infections are integrated into the model. Furthermore, using adaptive multigrid finite difference with decoupling and quasi-linearization techniques, we investigate two main factors for Dengue spatial propagation. We determine the effects of temperature variations, and the mobility of infectious agents, be they mosquitoes or humans. Finally, the proposed model-based analytico-numerical results are obtained, and rendered in graphical profiles, which show the major role the climate temperature and the mobility of infected humans have on the spread and speed of the disease. The consequent proposed model outcomes and health-based ramifications are then raised, discussed, and then validated.
Climate change impacts represent one of the most important ecological and medical issues during this century. Several fungal species will change their distribution through space and time as a response to climate changes. This will rearrange many fungal diseases throughout the world. One of the most important and very common fungi is the black mold Aspergillus niger. The COVID-19 pandemic reforms the way in which mycologists think about this fungus as an emerging healthy issue. Through this work, about one thousand records of Aspergillus niger were used to model its current and future global distribution using 19 bioclimatic variables under several climate change scenarios. Maximum entropy implemented in Maxent was chosen as the modeling tool, especially with its accuracy and reliability over the other modeling techniques. The annual mean temperature (bio 1) forms the most contributed climatological parameter to black mold distribution. The produced current distribution model came compatible with the real distribution of the species with a cosmopolitan range. The rise of temperature due to global warming will form a limitation to Aspergillus niger through several parts of its range. The generated maps of the future status of this fungus under two different RCPs for 2050 and 2070, indicate several parts that become free from black mold due to temperature limitations. The present results need more intensive future evaluation using data science and GIS, especially on a local scale including more ecological parameters other than climatological data.
BACKGROUND: Meningitis can cause devastating epidemics and is susceptible to climate change. It is unclear how temperature variability, an indicator of climate change, is associated with meningitis incidence. METHODS: We used global meningitis incidence data along with meteorological and demographic data over 1990-2019 to identify the association between temperature variability and meningitis. We also employed future (2020-2100) climate data to predict meningitis incidence under different emission levels (SSPs: Shared Socioeconomic Pathways). RESULTS: We found that the mean temperature variability increased by almost 3 folds in the past 30 years. The largest changes occurred in Australasia, Tropical Latin America, and Central Sub-Saharan Africa. With a logarithmic unit increase in temperature variability, the overall global meningitis risk increases by 4.8 %. Australasia, Central Sub-Saharan Africa, and High-income North America are the most at-risk regions. Higher statistical differences were identified in males, children, and the elderly population. Compared to high-emission (SSP585) scenario, we predicted a median reduction of 85.8 % in meningitis incidence globally under the low-emission (SSP126) climate change scenario by 2100. CONCLUSION: Our study provides evidence for temperature variability being in association with meningitis incidence, which suggests that global actions are urgently needed to address climate change and to prevent meningitis occurrence.
ABSTRACT: Throughout the past decades, climate change has been one of the most complex global issues. Characterized by worldwide alterations in weather patterns, along with a concomitant increase in the temperature of the Earth, climate change will undoubtedly have significant effects on food security and food safety. Climate change engenders climate variability: significant variations in weather variables and their frequency. Both climate variability and climate change are thought to threaten the safety of the food supply chain through different pathways. One such pathway is the ability to exacerbate foodborne diseases by influencing the occurrence, persistence, virulence and, in some cases, toxicity of certain groups of disease-causing microorganisms. Food safety can also be compromised by various chemical hazards, such as pesticides, mycotoxins, and heavy metals. With changes in weather patterns, such as lower rainfall, higher air temperature, and higher frequency of extreme weather events among others, this translates to emerging food safety concerns. These include the shortage of safe water for irrigation of agricultural produce, greater use of pesticides due to pest resistance, increased difficulty in achieving a well-controlled cold chain resulting in temperature abuse, or the occurrence of flash floods, which cause runoff of chemical contaminants in natural water courses. Together, these can result in foodborne infection, intoxication, antimicrobial resistance, and long-term bioaccumulation of chemicals and heavy metals in the human body. Furthermore, severe climate variability can result in extreme weather events and natural calamities, which directly or indirectly impair food safety. This review discusses the causes and impacts of climate change and variability on existing and emerging food safety risks and also considers mitigation and adaptation strategies to address the global warming and climate change problem.
Gambierdiscus is a dinoflagellate genus widely distributed throughout tropical and subtropical regions. Some members of this genus can produce a group of potent polycyclic polyether neurotoxins responsible for ciguatera fish poisoning (CFP), one of the most significant food-borne illnesses associated with fish consumption. Ciguatoxins and maitotoxins, the two major toxins produced by Gambierdiscus, act on voltage-gated channels and TRPA1 receptors, consequently leading to poisoning and even death in both humans and animals. Over the past few decades, the occurrence and geographic distribution of CFP have undergone a significant expansion due to intensive anthropogenic activities and global climate change, which results in more human illness, a greater public health impact, and larger economic losses. The global spread of CFP has led to Gambierdiscus and its toxins being considered an environmental and human health concern worldwide. In this review, we seek to provide an overview of recent advances in the field of Gambierdiscus and its associated toxins based on the existing literature combined with re-analyses of current data. The taxonomy, phylogenetics, geographic distribution, environmental regulation, toxin detection method, toxin biosynthesis, and pharmacology and toxicology of Gambierdiscus are summarized and discussed. We also highlight future perspectives on Gambierdiscus and its associated toxins.
The One Health concept that human, animal, plant, environmental, and ecosystem health are linked provides a framework for examining and addressing complex health challenges. This framework can be represented as a multi-dimensional matrix that can be used as a tool to identify upstream drivers of disease potential in a concise, systematic, and comprehensive way. The matrix can involve up to four dimensions depending on users’ needs. This paper describes and illustrates how the matrix tool might be used to facilitate systems thinking, enabling the development of effective and equitable public policies. The multidimensional One Health matrix tool will be used to examine, as an example, global human and animal fecal wastes. The fecal wastes are analyzed at the microbial and population levels over a timeframe of years. Political, social, and economic factors are part of the matrix and will be examined as well. The One Health matrix tool illustrates how foodborne illnesses, food insecurity, antimicrobial resistance, and climate change are inter-related. Understanding these inter-relationships is essential to develop the public policies needed to achieve many of the United Nations’ Sustainable Development Goals.
Bivalve shellfish consumption (ark shells, clams, cockles, and oysters) has increased over the last decades. Following this trend, infectious disease outbreaks associated with their consumption have been reported more frequently. Molluscs are a diverse group of organisms found wild and farmed. They are common on our tables, but unfortunately, despite their great taste, they can also pose a threat as a potential vector for numerous species of pathogenic microorganisms. Clams, in particular, might be filled with pathogens because of their filter-feeding diet. This specific way of feeding favors the accumulation of excessive amounts of pathogenic microorganisms like Vibrio spp., including Vibrio cholerae and V. parahaemolyticus, Pseudomonas aeruginosa, Escherichia coli, Arcobacter spp., and fecal coliforms, and intestinal enterococci. The problems of pathogen dissemination and disease outbreaks caused by exogenous bacteria in many geographical regions quickly became an unwanted effect of globalized food supply chains, global climate change, and natural pathogen transmission dynamics. Moreover, some pathogens like Shewanella spp., with high zoonotic potential, are spreading worldwide along with food transport. These bacteria, contained in food, are also responsible for the potential transmission of antibiotic-resistance genes to species belonging to the human microbiota. Finally, they end up in wastewater, thus colonizing new areas, which enables them to introduce new antibiotic-resistance genes (ARG) into the environment and extend the existing spectrum of ARGs already present in local biomes. Foodborne pathogens require modern methods of detection. Similarly, detecting ARGs is necessary to prevent resistance dissemination in new environments, thus preventing future outbreaks, which could threaten associated consumers and workers in the food processing industry.
Harmful algal blooms (HABs) are considered one of the main risks for marine ecosystems and human health worldwide. Climate change is projected to induce significant changes in species geographic distribution, and, in this sense, it is paramount to accurately predict how it will affect toxin-producing microalgae. In this context, the present study was intended to project the potential biogeographical changes in habitat suitability and occurrence distribution of three key amnesic shellfish toxin (AST)-producing diatom species (i.e., Pseudo-nitzschia australis, P. seriata, and P. fraudulenta) under four different climate change scenarios (i.e., RCP-2.6, 4.5, 6.0, and 8.5) up to 2050 and 2100. For this purpose, we applied species distribution models (SDMs) using four abiotic predictors (i.e., sea surface temperature, salinity, current velocity, and bathymetry) in a MaxEnt framework. Overall, considerable contraction and potential extirpation were projected for all species at lower latitudes together with projected poleward expansions into higher latitudes, mainly in the northern hemisphere. The present study aims to contribute to the knowledge on the impacts of climate change on the biogeography of toxin-producing microalgae species while at the same time advising the correct environmental management of coastal habitats and ecosystems.
Vibrio vulnificus is a zoonotic pathogen linked to aquaculture that is spreading due to climate change. The pathogen can be transmitted to humans and animals by ingestion of raw shellfish or seafood feed, respectively. The aim of this work was to design and test a new procedure to detect V. vulnificus hazardous to human and/or animal health in food/feed samples. For this purpose, we combined a pre-enrichment step with multiplex PCR using primers for the species and for human and animal virulence markers. In vitro assays with mixed DNA from different Vibrio species and Vibrio cultures showed that the new protocol was 100 % specific with a detection limit of 10 cfu/mL. The protocol was successfully validated in seafood using artificially contaminated live shrimp and proved useful also in pathogen isolation from animals and their ecosystem. In conclusion, this novel protocol could be applied in health risk studies associated with food/feed consumption, as well as in the routine identification and subtyping of V. vulnificus from environmental or clinical samples.
Protozoan parasites are single-celled eukaryotic organisms that cause significant human disease and pose a substantial health and socioeconomic burden worldwide. They are responsible for at least 1 million deaths annually. The treatment of such diseases is hindered by the ability of parasites to form latent cysts, develop drug resistance, or be transmitted by insect vectors. Additionally, these pathogens have developed complex mechanisms to alter host gene expression. The prevalence of these diseases is predicted to increase as climate change leads to the augmentation of ambient temperatures, insect ranges, and warm water reservoirs. Therefore, the discovery of novel treatments is necessary. Transcription factors lie at the junction of multiple signalling pathways in eukaryotes and aberrant transcription factor function contributes to the progression of numerous human diseases including cancer, diabetes, inflammatory disorders and cardiovascular disease. Transcription factors were previously thought to be undruggable. However, due to recent advances, transcription factors now represent appealing drug targets. It is conceivable that transcription factors, and the pathways they regulate, may also serve as targets for anti-parasitic drug design. Here, we review transcription factors and transcriptional modulators of protozoan parasites, and discuss how they may be useful in drug discovery. We also provide information on transcription factors that play a role in stage conversion of parasites, TATA box-binding proteins, and transcription factors and cofactors that participate with RNA polymerases I, II and III. We also highlight a significant gap in knowledge in that the transcription factors of some of parasites have been under-investigated. Understanding parasite transcriptional pathways and how parasites alter host gene expression will be essential in discovering innovative drug targets.
Climate change is a long-lasting change in the weather arrays across tropics to polls. It is a global threat that has embarked on to put stress on various sectors. This study is aimed to conceptually engineer how climate variability is deteriorating the sustainability of diverse sectors worldwide. Specifically, the agricultural sector’s vulnerability is a globally concerning scenario, as sufficient production and food supplies are threatened due to irreversible weather fluctuations. In turn, it is challenging the global feeding patterns, particularly in countries with agriculture as an integral part of their economy and total productivity. Climate change has also put the integrity and survival of many species at stake due to shifts in optimum temperature ranges, thereby accelerating biodiversity loss by progressively changing the ecosystem structures. Climate variations increase the likelihood of particular food and waterborne and vector-borne diseases, and a recent example is a coronavirus pandemic. Climate change also accelerates the enigma of antimicrobial resistance, another threat to human health due to the increasing incidence of resistant pathogenic infections. Besides, the global tourism industry is devastated as climate change impacts unfavorable tourism spots. The methodology investigates hypothetical scenarios of climate variability and attempts to describe the quality of evidence to facilitate readers’ careful, critical engagement. Secondary data is used to identify sustainability issues such as environmental, social, and economic viability. To better understand the problem, gathered the information in this report from various media outlets, research agencies, policy papers, newspapers, and other sources. This review is a sectorial assessment of climate change mitigation and adaptation approaches worldwide in the aforementioned sectors and the associated economic costs. According to the findings, government involvement is necessary for the country’s long-term development through strict accountability of resources and regulations implemented in the past to generate cutting-edge climate policy. Therefore, mitigating the impacts of climate change must be of the utmost importance, and hence, this global threat requires global commitment to address its dreadful implications to ensure global sustenance.
BACKGROUND: Numerous studies have quantified the associations between ambient temperature and enteric infections, particularly all-cause enteric infections. However, the temperature sensitivity of enteric infections might be pathogen dependent. Here, we sought to identify pathogen-specific associations between ambient temperature and enteric infections. METHODS: We did a systematic review and meta-analysis by searching PubMed, Web of Science, and Scopus for peer-reviewed research articles published from Jan 1, 2000, to Dec 31, 2019, and also hand searched reference lists of included articles and excluded reviews. We included studies that quantified the effects of ambient temperature increases on common pathogen-specific enteric infections in humans. We excluded studies that expressed ambient temperature as a categorical or diurnal range, or in a standardised format. Two authors screened the search results, one author extracted data from eligible studies, and four authors verified the data. We obtained the overall risks by pooling the relative risks of enteric infection by pathogen for each 1°C temperature rise using random-effects modelling and robust variance estimation for the correlated effect estimates. Between-study heterogeneity was measured using I(2), τ(2), and Q-statistic. Publication bias was determined using funnel plot asymmetry and the trim-and-fill method. Differences among pathogen-specific pooled estimates were determined using subgroup analysis of taxa-specific meta-analysis. The study protocol was not registered but followed the PRISMA guidelines. FINDINGS: We identified 2981 articles via database searches and 57 articles from scanning reference lists of excluded reviews and included articles, of which 40 were eligible for pathogen-specific meta-analyses. The overall increased risks of incidence per 1°C temperature rise, expressed as relative risks, were 1·05 (95% CI 1·04-1·07; I(2) 97%) for salmonellosis, 1·07 (1·04-1·10; I(2) 99%) for shigellosis, 1·02 (1·01-1·04; I(2) 98%) for campylobacteriosis, 1·05 (1·04-1·07; I(2) 36%) for cholera, 1·04 (1·01-1·07; I(2) 98%) for Escherichia coli enteritis, and 1·15 (1·07-1·24; I(2) 0%) for typhoid. Reduced risks per 1°C temperature increase were 0·96 (95% CI 0·90-1·02; I(2) 97%) for rotaviral enteritis and 0·89 (0·81-0·99; I(2) 96%) for noroviral enteritis. There was evidence of between-pathogen differences in risk for bacterial infections but not for viral infections. INTERPRETATION: Temperature sensitivity of enteric infections can vary according to the enteropathogen causing the infection, particularly for bacteria. Thus, we encourage a pathogen-specific health adaptation approach, such as vaccination, given the possibility of increasingly warm temperatures in the future. FUNDING: Japan Society for the Promotion of Science (Kakenhi) Grant-in-Aid for Scientific Research.
The Covid-19 pandemic is of zoonotic origin, and many other emerging infections of humans have their origin in an animal host population. We review the challenges involved in modelling the dynamics of wildlife-human interfaces governing infectious disease emergence and spread. We argue that we need a better understanding of the dynamic nature of such interfaces, the underpinning diversity of pathogens and host-pathogen association networks, and the scales and frequencies at which environmental conditions enable spillover and host shifting from animals to humans to occur. The major drivers of the emergence of zoonoses are anthropogenic, including the global change in climate and land use. These, and other ecological processes pose challenges that must be overcome to counterbalance pandemic risk. The development of more detailed and nuanced models will provide better tools for analysing and understanding infectious disease emergence and spread.
Climate change can have a complex impact that also influences human and animal health. For example, climate change alters the conditions for pathogens and vectors of zoonotic diseases. Signs of this are the increasing spread of the West Nile and Usutu viruses and the establishment of new vector species, such as specific mosquito and tick species, in Europe and other parts of the world. With these changes come new challenges for maintaining human and animal health. This paper reports on an analysis of the literature focused on a bibliometric analysis of the Scopus database and VOSviewer software for creating visualization maps which identifies the zoonotic health risks for humans and animals caused by climate change. The sources retained for the analysis totaled 428 and different thresholds (N) were established for each item varying from N 5 to 10. The main findings are as follows: First, published documents increased in 2009-2015 peaking in 2020. Second, the primary sources have changed since 2018, partly attributable to the increase in human health concerns due to human-to-human transmission. Third, the USA, the UK, Canada, Australia, Italy, and Germany perform most zoonosis research. For instance, sixty documents and only 17 countries analyzed for co-authorship analysis met the threshold led by the USA; the top four author keywords were “climate change”, “zoonosis”, “epidemiology”, and “one health;” the USA, the UK, Germany, and Spain led the link strength (inter-collaboration); the author keywords showed that 37 out of the 1023 keywords met the threshold, and the authors’ keyword’s largest node of the bibliometric map contains the following: infectious diseases, emerging diseases, disease ecology, one health, surveillance, transmission, and wildlife. Finally, zoonotic diseases, which were documented in the literature in the past, have evolved, especially during the years 2010-2015, as evidenced by the sharp augmentation of publications addressing ad-hoc events and peaking in 2020 with the COVID-19 outbreak.
Emerging infectious diseases (EIDs), especially those with zoonotic potential, are a growing threat to global health, economy, and safety. The influence of global warming and geoclimatic variations on zoonotic disease epidemiology is evident by alterations in the host, vector, and pathogen dynamics and their interactions. The objective of this article is to review the current literature on the observed impacts of climate change on zoonoses and discuss future trends. We evaluated several climate models to assess the projections of various zoonoses driven by the predicted climate variations. Many climate projections revealed potential geographical expansion and the severity of vector-borne, waterborne, foodborne, rodent-borne, and airborne zoonoses. However, there are still some knowledge gaps, and further research needs to be conducted to fully understand the magnitude and consequences of some of these changes. Certainly, by understanding the impact of climate change on zoonosis emergence and distribution, we could better plan for climate mitigation and climate adaptation strategies.
Species are shifting their distributions in response to climate change. This geographic reshuffling may result in novel co-occurrences among species, which could lead to unseen biotic interactions, including the exchange of parasites between previously isolated hosts. Identifying potential new host-parasite interactions would improve forecasting of disease emergence and inform proactive disease surveillance. However, accurate predictions of future cross-species disease transmission have been hampered by the lack of a generalized approach and data availability. Here, we propose a framework to predict novel host-parasite interactions based on a combination of niche modelling of future host distributions and parasite sharing models. Using the North American ungulates as a proof of concept, we show this approach has high cross-validation accuracy in over 85% of modelled parasites and find that more than 34% of the host-parasite associations forecasted by our models have already been recorded in the literature. We discuss potential sources of uncertainty and bias that may affect our results and similar forecasting approaches, and propose pathways to generate increasingly accurate predictions. Our results indicate that forecasting parasite sharing in response to shifts in host geographic distributions allow for the identification of regions and taxa most susceptible to emergent pathogens under climate change. This article is part of the theme issue ‘Infectious disease macroecology: parasite diversity and dynamics across the globe’.
Tropical diseases (TDs) are among the leading cause of mortality and fatality globally. The emergence and reemergence of TDs continue to challenge healthcare system. Several tropical diseases such as yellow fever, tuberculosis, cholera, Ebola, HIV, rotavirus, dengue, and malaria outbreaks have led to endemics and epidemics around the world, resulting in millions of deaths. The increase in climate change, migration and urbanization, overcrowding, and other factors continue to increase the spread of TDs. More cases of TDs are recorded as a result of substandard health care systems and lack of access to clean water and food. Early diagnosis of these diseases is crucial for treatment and control. Despite the advancement and development of numerous diagnosis assays, the healthcare system is still hindered by many challenges which include low sensitivity, specificity, the need of trained pathologists, the use of chemicals and a lack of point of care (POC) diagnostic. In order to address these issues, scientists have adopted the use of CRISPR/Cas systems which are gene editing technologies that mimic bacterial immune pathways. Recent advances in CRISPR-based biotechnology have significantly expanded the development of biomolecular sensors for diagnosing diseases and understanding cellular signaling pathways. The CRISPR/Cas strategy plays an excellent role in the field of biosensors. The latest developments are evolving with the specific use of CRISPR, which aims for a fast and accurate sensor system. Thus, the aim of this review is to provide concise knowledge on TDs associated with mosquitoes in terms of pathology and epidemiology as well as background knowledge on CRISPR in prokaryotes and eukaryotes. Moreover, the study overviews the application of the CRISPR/Cas system for detection of TDs associated with mosquitoes.
There are more than 3,000 mosquito species. Aedes aegypti, Ae. communis, and C. quinquefasciatus are, among others, three of the most important mosquito allergen sources in the tropics, western, and industrialized countries. Several individuals are sensitized to mosquito allergens, but the epidemiological data indicates that the frequency of sensitization markedly differs depending on the geographical region. Additionally, the geographical localization of mosquito species has been affected by global warming and some mosquito species have invaded areas where they were not previously found, at the same time as other species have been displaced. This phenomenon has repercussions in the pathogenesis and the accuracy of the diagnosis of mosquito allergy. Allergic individuals are sensitized to mosquito allergens from two origins: saliva and body allergens. Exposure to saliva allergens occurs during mosquito bite and induces cutaneous allergic reactions. Experimental and clinical data suggest that body allergens mediate different manifestations of allergic reactions such as asthma and rhinitis. The most studied mosquito species is Ae. aegypti, from which four and five allergens of the saliva and body, respectively, have been reported. Many characterized allergens are homologs to arthropod-derived allergens, which cause strong cross-reactivity at the humoral and cellular level. The generalized use of whole body Ae. communis or C. quinquefasciatus extracts complicates the diagnosis of mosquito allergy because they have low concentration of saliva allergens and may result in poor diagnosis of the affected population when other species are the primary sensitizer. This review article discusses the current knowledge about mosquito allergy, allergens, cross-reactivity, and proposals of component resolved approaches based on mixtures of purified recombinant allergens to replace saliva-based or whole-body extracts, in order to perform an accurate diagnosis of allergy induced by mosquito allergen exposure.
Purpose of Review To asses recent advances in our understanding of the epidemiology, clinical presentation, diagnosis, and treatment of infections caused by free-living amoebas Recent Findings The burden of disease by free-living amoebas is underestimated; global warming could increase incidence in future years. Early recognition of clinical syndromes may allow for prompt initiation of therapy and better disease outcome. Molecular tests allow for rapid identification of the amoeba. Treatment is based on successful clinical outcomes reported using repurposed drugs. The optimal regimen for each of the clinical syndromes is unknown. As global warming increases, clinicians will be challenged to diagnose and treat infections by free-living amoebas. Therefore, awareness of clinical syndromes, diagnostic tools, and therapeutic interventions is crucial.
The acceleration of climate change has been associated with an alarming increase in the prevalence and geographic range of tick-borne diseases (TBD), many of which have severe and long-lasting effects-particularly when treatment is delayed principally due to inadequate diagnostics and lack of physician suspicion. Moreover, there is a paucity of treatment options for many TBDs that are complicated by diagnostic limitations for correctly identifying the offending pathogens. This review will focus on the biology, disease pathology, and detection methodologies used for the Borreliaceae family which includes the Lyme disease agent Borreliella burgdorferi. Previous work revealed that Borreliaceae genomes differ from most bacteria in that they are composed of large numbers of replicons, both linear and circular, with the main chromosome being the linear with telomeric-like termini. While these findings are novel, additional gene-specific analyses of each class of these multiple replicons are needed to better understand their respective roles in metabolism and pathogenesis of these enigmatic spirochetes. Historically, such studies were challenging due to a dearth of both analytic tools and a sufficient number of high-fidelity genomes among the various taxa within this family as a whole to provide for discriminative and functional genomic studies. Recent advances in long-read whole-genome sequencing, comparative genomics, and machine-learning have provided the tools to better understand the fundamental biology and phylogeny of these genomically-complex pathogens while also providing the data for the development of improved diagnostics and therapeutics.
Background: The rapid circulation of arboviruses in the human population has been linked with changes in climatic, environmental, and socio-economic conditions. These changes are known to alter the transmission cycles of arboviruses involving the anthropophilic vectors and thus facilitate an extensive geographical distribution of medically important arboviral diseases, thereby posing a significant health threat. Using our current understanding and assessment of relevant literature, this review aimed to understand the underlying factors promoting the spread of arboviruses and how the three most renowned interdisciplinary and holistic approaches to health such as One Health, Eco-Health, and Planetary Health can be a panacea for control of arboviruses. Methods: A comprehensive structured search of relevant databases such as Medline, PubMed, WHO, Scopus, Science Direct, DOAJ, AJOL, and Google Scholar was conducted to identify recent articles on arboviruses and holistic approaches to health using the keywords including arboviral diseases, arbovirus vectors, arboviral infections, epidemiology of arboviruses, holistic approaches, One Health, Eco-Health, and Planetary Health. Results: Changes in climatic factors like temperature, humidity, and precipitation support the growth, breeding, and fecundity of arthropod vectors transmitting the arboviral diseases. Increased human migration and urbanization due to socio-economic factors play an important role in population increase leading to the rapid geographical distribution of arthropod vectors and transmission of arboviral diseases. Medical factors like misdiagnosis and misclassification also contribute to the spread of arboviruses. Conclusion: This review highlights two important findings: First, climatic, environmental, socio-economic, and medical factors influence the constant distributions of arthropod vectors. Second, either of the three holistic approaches or a combination of any two can be adopted on arboviral disease control. Our findings underline the need for holistic approaches as the best strategy to mitigating and controlling the emerging and reemerging arboviruses.
Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.
The twenty-first century has witnessed a wave of severe infectious disease outbreaks, not least the COVID-19 pandemic, which has had a devastating impact on lives and livelihoods around the globe. The 2003 severe acute respiratory syndrome coronavirus outbreak, the 2009 swine flu pandemic, the 2012 Middle East respiratory syndrome coronavirus outbreak, the 2013-2016 Ebola virus disease epidemic in West Africa and the 2015 Zika virus disease epidemic all resulted in substantial morbidity and mortality while spreading across borders to infect people in multiple countries. At the same time, the past few decades have ushered in an unprecedented era of technological, demographic and climatic change: airline flights have doubled since 2000, since 2007 more people live in urban areas than rural areas, population numbers continue to climb and climate change presents an escalating threat to society. In this Review, we consider the extent to which these recent global changes have increased the risk of infectious disease outbreaks, even as improved sanitation and access to health care have resulted in considerable progress worldwide.
Coccidioidomycosis, colloquially known as Valley Fever, is an invasive dimorphic fungal infection caused by Coccidioides immitis and C. posadasii. The fungi are found in the arid desert soils of the southwestern US, as well as in parts of Mexico and Central and South America. Acquisition is typically via inhalation of arthroconidia which become airborne after both natural (e.g., earthquakes, dust storms, and fires) and human-related events (e.g., military maneuvers, recreational activities, agriculture, and construction). The incidence of infection in increasing likely a result of both climatic and populational changes. Further, the recognized geographic distribution of Coccidioides spp. is expanding, as cases are being diagnosed in new areas (e.g., eastern Washington, Oregon, and Utah). Most coccidioidal infections are asymptomatic (60%); however, approximately one-third develop a pulmonary illness which is a leading cause of community-acquired pneumonia in highly endemic areas. Uncommonly (0.5-2% of cases), the infection disseminates to extrapulmonary locations (e.g., skin, bones/joints, and the central nervous system), and is most commonly seen among persons with cellular immunodeficiencies (e.g., transplant recipients, HIV, and pregnancy) and non-Caucasian races (especially African Americans and Filipinos). The diagnosis of coccidioidomycosis requires astute clinical suspicion and laboratory findings, including positive serology, cultures, and/or histopathology results. Treatment is warranted among persons with pneumonia who have risk factors for complicated disease and among those with extrapulmonary disease. Novel antifungals with improved fungicidal activity and rapidity of action with fewer side effects and drug interactions are needed. Preventive strategies (e.g., education regarding the disease, dust avoidance, mask wearing, including among select groups, antifungal prophylaxis, and surveillance laboratory testing) are advised for residents and travelers to endemic areas. Currently, no preventive vaccine is available. Coccidioidomycosis has been recognized for over a century, and an expanding wealth of knowledge has been gained regarding this emerging infectious disease which will be reviewed here.
Human activities have significantly impacted the environment and are changing our climate in ways that will have major consequences for ourselves, and endanger animal, plant and microbial life on Earth. Rising global temperatures and pollution have been highlighted as potential drivers for increases in infectious diseases. Although infrequently highlighted, fungi are amongst the leading causes of infectious disease mortality, resulting in more than 1.5 million deaths every year. In this review we evaluate the evidence linking anthropomorphic impacts with changing epidemiology of fungal disease. We highlight how the geographic footprint of endemic mycosis has expanded, how populations susceptible to fungal infection and fungal allergy may increase and how climate change may select for pathogenic traits and indirectly contribute to the emergence of drug resistance.
A number of studies suggest that meteorological conditions are related to the risk of Legionnaires’ disease (LD) but the findings are not consistent. A systematic review was conducted to investigate the association of weather with sporadic LD and highlight the key meteorological conditions related to this outcome. PubMed, EMBASE, The Cochrane Library and OpenGrey were searched on 26-27 March 2020 without date, language or location restrictions. Key words included “legionellosis”, “legionnaires’ disease”, combined with “meteorological conditions”, “weather”, “temperature”, “humidity”, “rain”, “ultraviolet rays”, “wind speed”, etc. Studies were excluded if they did not examine the exposure of interest, the outcome of interest and their association or if they only reported LD outbreak cases. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and it was registered in PROSPERO (#CRD42020168869). There were 811 articles, of which 17 were included in the review. The studies investigated different meteorological variables and most of them examined the combined effect of several variables. The most commonly examined factors were precipitation and temperature, followed by relative humidity. The studies suggested that increased precipitation, temperature and relative humidity were positively associated with the incidence of LD. There was limited evidence that higher wind speed, pressure, visibility, UV radiation and longer sunshine duration were inversely linked with the occurrence of LD. A period of increased but not very high temperatures, followed by a period of increased precipitation, favour the occurrence of LD. Increased awareness of the association of temperature and precipitation and LD occurrence among clinicians and public health professionals can improve differential diagnosis for cases of sporadic community-acquired pneumonia and at the same time contribute to improving LD surveillance.
The World Health Organization has identified vaccine hesitancy as one of its top ten global health threats for 2019. Efforts are underway to define the factors responsible for reductions in vaccine confidence. However, as global measles cases accelerated beginning in 2018, it became evident that additional factors were promoting measles re-emergence, including war, political and socio-economic collapse, shifting poverty, and vulnerability to weather events and climate change. Accordingly, we propose a Global Vaccine Risk Index (VRI) to consider these variables as a more comprehensive means to identify vulnerable nations where we might expect measles and other vaccine-preventable diseases to emerge or re-emerge. In Sub-Saharan African and Middle Eastern nations, conflict and political instability predominated as the basis for high vaccine risk scores, whereas in Southeast Asian countries, the major reasons included climate variability, current levels of measles vaccination coverage, and economic and educational disparities. In Europe, low vaccine confidence and refugee movements predominated, while in the Americas, economic disparities and vaccine confidence were important. The VRI may serve as a useful indicator and predictor for international agencies committed to childhood immunizations and might find relevance for accelerating future COVID19 vaccination programs.
Non-technical summaryHumans have the tendency to damage the natural environment in many ways. Deforestation and conversion of forests for residential, industrial development, and expansion of agricultural crops, as well as the burning of fossil fuels, are some activities that disrupt natural ecosystems and wildlife and contribute to climate change. As a result, the life cycles of pathogens and intermediate hosts (insects, rodents, mammals) as well as biodiversity are affected. Through these activities, humans meet wild animals that transmit pathogens, resulting in their infection by zoonoses and causing epidemics-pandemics, the effects of which have as their final recipient himself and his activities. Technical summaryThis article aims to highlight the two-way relationship between those human activities and the occurrence of epidemics-pandemics. We will try to elaborate this two-way relationship, through the overview of the current pandemic (origin of SARS-CoV-2, modes of transmission, clinical picture of the disease of COVID-19, influence of weather and air pollution on prevalence and mortality, pandemic effects, and treatments). They are used as primary sources, scientific articles, literature, websites, and databases (Supplementary appendix) to analyze factors involved in the occurrence and transmission of zoonotic diseases in humans (Ebola, influenza, Lyme disease, dengue fever, cholera, AIDS/HIV, SARS-CoV, MERS-CoV). The present paper concluded that humanity today faces two major challenges: controlling the COVID-19 pandemic and minimizing the risk of a new global health crisis occurring in the future. The first can be achieved through equitable access to vaccines and treatments for all people. The second needs the global community to make a great change and start protecting the natural environment and its ecosystems through the adoption of prevention policies. Summary of social mediaTwo-way relationship between human activities and epidemics highlighted, through review of the COVID-19 pandemic.
BACKGROUND: Zoonotic diseases account for more than 70% of emerging infectious diseases (EIDs). Due to their increasing incidence and impact on global health and the economy, the emergence of zoonoses is a major public health challenge. Here, we use a biogeographic approach to predict future hotspots and determine the factors influencing disease emergence. We have focused on the following three viral disease groups of concern: Filoviridae, Coronaviridae, and Henipaviruses. METHODS: We modelled presence-absence data in spatially explicit binomial and zero-inflation binomial logistic regressions with and without autoregression. Presence data were extracted from published studies for the three EID groups. Various environmental and demographical rasters were used to explain the distribution of the EIDs. True Skill Statistic and deviance parameters were used to compare the accuracy of the different models. RESULTS: For each group of viruses, we were able to identify and map areas at high risk of disease emergence based on the spatial distribution of the disease reservoirs and hosts of the three viral groups. Common influencing factors of disease emergence were climatic covariates (minimum temperature and rainfall) and human-induced land modifications. CONCLUSIONS: Using topographical, climatic, and previous disease outbreak reports, we can identify and predict future high-risk areas for disease emergence and their specific underlying human and environmental drivers. We suggest that such a predictive approach to EIDs should be carefully considered in the development of active surveillance systems for pathogen emergence and epidemics at local and global scales.
COVID-19 has revealed how challenging it is to manage global, systemic and compounding crises. Like COVID-19, climate change impacts, and maladaptive responses to them, have potential to disrupt societies at multiple scales via networks of trade, finance, mobility and communication, and to impact hardest on the most vulnerable. However, these complex systems can also facilitate resilience if managed effectively. This review aims to distil lessons related to the transboundary management of systemic risks from the COVID-19 experience, to inform climate change policy and resilience building. Evidence from diverse fields is synthesised to illustrate the nature of systemic risks and our evolving understanding of resilience. We describe research methods that aim to capture systemic complexity to inform better management practices and increase resilience to crises. Finally, we recommend specific, practical actions for improving transboundary climate risk management and resilience building. These include mapping the direct, cross-border and cross-sectoral impacts of potential climate extremes, adopting adaptive risk management strategies that embrace heterogenous decision-making and uncertainty, and taking a broader approach to resilience which elevates human wellbeing, including societal and ecological resilience.
The Lancet Countdown is an international collaboration that independently monitors the health consequences of a changing climate. Publishing updated, new, and improved indicators each year, the Lancet Countdown represents the consensus of leading researchers from 43 academic institutions and UN agencies. The 44 indicators of this report expose an unabated rise in the health impacts of climate change and the current health consequences of the delayed and inconsistent response of countries around the globe—providing a clear imperative for accelerated action that puts the health of people and planet above all else.
Background: Recent studies indicated the possible relationship between climate change, environmental pollution, and Coronavirus Disease 2019 (COVID-19) pandemic. This study reviewed the effects of air pollution, climate parameters, and lockdown on the number of cases and deaths related to COVID-19. Methods: The present review was performed to determine the effects of weather and air pollution on the number of cases and deaths related to COVID-19 during the lockdown. Articles were collected by searching the existing online databases, such as PubMed, Science Direct, and Google Scholar, with no limitations on publication dates. Afterwards, this review focused on outdoor air pollution, including PM2.5, PM10, NO2, SO2, and O-3, and weather conditions affecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/COVID-19. Results: Most reviewed investigations in the present study showed that exposure to air pollutants, particularly PM2.5 and NO2, is positively related to COVID-19 patients and mortality. Moreover, these studies showed that air pollution could be essential in transmitting COVID-19. Local meteorology plays a vital role in coronavirus spread and mortality. Temperature and humidity variables are negatively correlated with virus transmission. The evidence demonstrated that air pollution could lead to COVID-19 transmission. These results support decision-makers in curbing potential new outbreaks. Conclusions: Overall, in environmental perspective-based COVID-19 studies, efforts should be accelerated regarding effective policies for reducing human emissions, bringing about air pollution and weather change. Therefore, using clean and renewable energy sources will increase public health and environmental quality by improving global air quality.
Internists are experts in complexity, and the COVID-19 pandemic is disclosing complex and unexpected interactions between communicable and non-communicable diseases, environmental factors, and socio-economic disparities. The medicine of complexity cannot be limited to facing comorbidities and to the clinical management of multifaceted diseases. Evidence indicates how climate change, pollution, demographic unbalance, and inequalities can affect the spreading and outcomes of COVID-19 in vulnerable communities. These elements cannot be neglected, and a wide view of public health aspects by a “one-health” approach is strongly and urgently recommended. According to World Health Organization, 35% of infectious diseases involving the lower respiratory tract depend on environmental factors, and infections from SARS-Cov-2 is not an exception. Furthermore, environmental pollution generates a large burden of non-communicable diseases and disabilities, increasing the individual vulnerability to COVID-19 and the chance for the resilience of large communities worldwide. In this field, the awareness of internists must increase, as privileged healthcare providers. They need to gain a comprehensive knowledge of elements characterizing COVID-19 as part of a syndemic. This is the case when pandemic events hit vulnerable populations suffering from the increasing burden of chronic diseases, disabilities, and social and economic inequalities. Mastering the interplay of such events requires a change in overall strategy, to adequately manage not only the SARS-CoV-2 infection but also the growing burden of non-communicable diseases by a “one health” approach. In this context, experts in internal medicine have the knowledge and skills to drive this change.
COVID-19 has caused 100s of millions of infections and millions of deaths worldwide, overwhelming health and economic capacities in many countries and at multiple scales. The immediacy and magnitude of this crisis has resulted in government officials, practitioners and applied scholars turning to reflexive learning exercises to generate insights for managing the reverberating effects of this disease as well as the next inevitable pandemic. We contribute to both tasks by assessing COVID-19 as a super wicked problem denoted by four features we originally formulated to describe the climate crisis: time is running out, no central authority, those causing the problem also want to solve it, and policies irrationally discount the future (Levin et al. in Playing it forward: path dependency, progressive incrementalism, and the super wicked problem of global climate change, 2007; Levin et al. in Playing it forward: Path dependency, progressive incrementalism, and the super wicked problem of global climate change, 2009; Levin et al. in Policy Sci 45(2):123-152, 2012). Doing so leads us to identify three overarching imperatives critical for pandemic management. First, similar to requirements to address the climate crisis, policy makers must establish and maintain durable policy objectives. Second, in contrast to climate, management responses must always allow for swift changes in policy settings and calibrations given rapid and evolving knowledge about a particular disease’s epidemiology. Third, analogous to, but with swifter effects than climate, wide-ranging global efforts, if well designed, will dramatically reduce domestic costs and resource requirements by curbing the spread of the disease and/or fostering relevant knowledge for managing containment and eradication. Accomplishing these tasks requires building the analytic capacity for engaging in reflexive anticipatory policy design exercises aimed at maintaining, or building, life-saving thermostatic institutions at the global and domestic levels.
This study investigated the spatio-temporal variations in the occurrence of COVID-19 (confirmed cases and deaths) in relation to climate fluctuations in 61 countries, scattered around the world, from December 31, 2019 to May 28, 2020. Logarithm transformation of the count variable (COVID-19 cases) was used in a multiple linear regression model to predict the potential effects of weather variables on the prevalence of the disease. The study revealed strong associations (-0.510 ≤ r ≤ -0.967; 0.519 ≤ r ≤ 0.999) between climatic variables and confirmed cases of COVID-19 in majority (68.85%) of the selected countries. It showed evidences of 1 to 7-day delays in the response of the infection to changes in weather pattern. Model simulations suggested that a unit fall in temperature and humidity could increase (0.04-18.70%) the infection in 19.67% and 16.39% of the countries, respectively, while a general reduction (-0.05 to 9.40%) in infection cases was projected in 14.75% countries with a unit drop in precipitation. In conclusion, the study suggests that effective public health interventions are crucial to containing the projected upsurge in COVID-19 cases during both cold and warm seasons in the southern and northern hemispheres.
Structural and genetic differences among various viruses play a significant factor in host infectivity and vulnerability to environmental stressors. Zoonoses of viruses require several recombinations and mutations in their genetic material and among several viruses allowing them to switch hosts and infect new species. Additionally, the host genetics play a significant role in successful viral transmission among various hosts. For example, human immunodeficiency virus (HIV), Ebola virus and influenza viruses. In efficient zoonotic events, selective stresses in the host milieu-interieur are critical during viral infection of the first human host. The genetic rearrangement of the virus and the selective environmental pressure of the host immune system dominate the emergence of new viral disease outbreaks.
Evidences of an association between air pollution and Covid-19 infections are mixed and inconclusive. We conducted an ecological analysis at regional scale of long-term exposure to air-borne particle matter and spread of Covid-19 cases during the first wave of epidemics. Global air pollution and climate data were calculated from satellite earth observation data assimilated into numerical models at 10 km resolution. Main outcome was defined as the cumulative number of cases of Covid-19 in the 14 days following the date when > 10 cumulative cases were reported. Negative binomial mixed effect models were applied to estimate the associations between the outcome and long-term exposure to air pollution at the regional level (PM(10), PM(2.5)), after adjusting for relevant regional and country level covariates and spatial correlation. In total we collected 237,749 Covid-19 cases from 730 regions, 63 countries and 5 continents at May 30, 2020. A 10 μg/m(3) increase of pollution level was associated with 8.1% (95% CI 5.4%, 10.5%) and 11.5% (95% CI 7.8%, 14.9%) increases in the number of cases in a 14 days window, for PM(2.5) and PM(10) respectively. We found an association between Covid-19 cases and air pollution suggestive of a possible causal link among particulate matter levels and incidence of COVID-19.
Why have some countries done significantly better than others in fighting the Covid-19 pandemic? Had some countries been better prepared than others? This paper attempts to shed light on these questions by examining the role of climate risk and culture in explaining the cross-country variation in the Covid-19 mortality, while controlling for other potential drivers. In our analysis, we consider climate risk, readiness to climate change and individualism as main indicators reflecting the climate and culture status of individual countries. Using data from 110 countries, we find that the greater the climate risk; the lower the readiness to climate change and the more individualistic the society, the higher the pandemic mortality rate. We also present a series of sensitivity checks and show that our findings are robust to different specifications, alternative definitions of the mortality rate; and different estimation methods. One policy implication arising from our results is that countries that were better prepared for the climate emergency were also better placed to fight the pandemic. Overall, countries in which individuals look after each other and the environment, creating sustainable societies, are better able to cope with climate and public health emergencies.
BACKGROUND: Climate change based on temperature, humidity and wind can improve many characteristics of the arthropod carrier life cycle, including survival, arthropod population, pathogen communication, and the spread of infectious agents from vectors. This study aimed to find association between content of disease followed climate change we demonstrate in humans. METHODS: All the articles from 2016 to 2021 associated with global climate change and the effect of vector-borne disease were selected form databases including PubMed and the Global Biodiversity information facility database. All the articles selected for this short review were English. RESULTS: Due to the high burden of infectious diseases and the growing evidence of the possible effects of climate change on the incidence of these diseases, these climate changes can potentially be involved with the COVID-19 epidemic. We highlighted the evidence of vector-borne diseases and the possible effects of climate change on these communicable diseases. CONCLUSION: Climate change, specifically in rising temperature system is one of the world’s greatest concerns already affected pathogen-vector and host relation. Lice parasitic, fleas, mites, ticks, and mosquitos are the prime public health importance in the transmission of virus to human hosts.
RNA viruses include respiratory viruses, such as coronaviruses and influenza viruses, as well as vector-borne viruses, like dengue and West Nile virus. RNA viruses like these encounter various environments when they copy themselves and spread from cell to cell or host to host. Ex vivo differences, such as geographical location and humidity, affect their stability and transmission, while in vivo differences, such as pH and host gene expression, impact viral receptor binding, viral replication, and the host immune response against the viral infection. A critical factor affecting RNA viruses both ex vivo and in vivo, and defining the outcome of viral infections and the direction of viral evolution, is temperature. In this minireview, we discuss the impact of temperature on viral replication, stability, transmission, and adaptation, as well as the host innate immune response. Improving our understanding of how RNA viruses function, survive, and spread at different temperatures will improve our models of viral replication and transmission risk analyses.
Climate change is causing weather conditions to abruptly change and is directly impacting the health of humans. Due to climate change, there is an upsurge in conditions suitable for infectious pathogens and their carriers to survive and multiply. Infections that were eliminated decades ago are regaining their grounds among humans. Climate change is increasing the possibility of new outbreaks for these vector-borne, airborne, or waterborne infections. While adverse impacts of these outbreaks are only subject to the predictions, nevertheless, it is certain that these outbreaks will affect health status, mortality status and economy at local and international levels. However, these threats may be minimized if national and international public health departments would be willing to implement research- and evidence-based advanced preparedness strategies. This scientific review aims to explore how climate change is facilitating the spread of vector-borne (tick-borne encephalitis, dengue, West Nile virus, leishmaniasis), airborne (by weather conditions like storms), and waterborne infectious diseases (due to floods and droughts) and is triggering new outbreaks among humans.
There is global evidence of a general increase in the incidence and prevalence of respiratory diseases including allergic rhinitis and associated asthma. This increase in turn, has been related, in part, to concurrent increases in carbon dioxide (CO(2)) and temperature on pollen production and allergic disease generated from plant-based sources of pollen. Such links to anthropogenic climate change has suggested three significant and interrelated consequences associated with respiratory allergies or disease. First, warmer temperatures and a longer frost-free growing season can influence pollen season length and temporal exposure to airborne aeroallergens. Second, both warmer temperatures and additional CO(2) can increase the amount of pollen, the seasonal intensity, from spring through fall. Thirdly, there is evidence from oak and ragweed that rising levels of CO(2) could increase the allergen concentration of the pollen and symptom severity. However, while these outcomes are of obvious consequence, they do not fully encompass all of the plant derived changes that could, directly or indirectly, influence aeroallergen production, exposure, and consequences for public health. In this overview, I will delve deeper into other plant-based links to climate/CO(2) that are consequential either directly or indirectly to allergic rhinitis and associated disease. Such interactions range from pollen morphology to fire occurrence, from volatile organic compounds to potential changes in pesticide usage. The goal in doing so is to provide a broader context and appreciation for the interactions between plant biology and climate that can also affect allergen production and human impact but which, to date, have received little recognition or research.
Air pollution is widely viewed as a serious threat to human health and a contributor to deaths. Air pollution appears to be linked to the progression of emphysema, according to epidemiological data. The objective of this study was to examine associations between air pollution and the progression of emphysema using a meta-analysis. A meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol. A systematic literature search was conducted using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase, PubMed, and Web of Science bibliographic databases. A random-effects model for the meta-analysis was implemented to summarize effect estimates of sufficiently comparable outcomes and pollutants (e.g.: particulate matter, nitrogen oxides and ozone), and the results were visualized in forest plots. We observed that a 1-ppb rise in O3 was associated with a 0.30 increase in the percent emphysema progression (95% CI: 0.02, 0.57, p < 0.05). In contrast, no significant association was found between PM2.5 or NO2 exposure and the percent change in emphysema. Increasing O-3 concentrations may have an impact on and exacerbate human health conditions such as emphysema and respiratory diseases. Air quality and climate change should be concerns for future environmental policies and protection measures.
Surface ozone (O(3)) is an oxidizing gaseous pollutant; long-term exposure to high O(3) concentrations adversely affects human health. Based on daily surface O(3) concentration data, the spatiotemporal characteristics of O(3) concentration, exposure risks, and driving meteorological factors in 347 cities and 10 major countries (China, Japan, India, South Korea, the United States, Poland, Spain, Germany, France, and the United Kingdom) worldwide were analyzed using the MAKESENS model, Moran’ I analysis, and Generalized additive model (GAM). The results indicated that: in the boreal spring season from 2015 to 2020, the global O(3) concentration exhibited an increasing trend at a rate of 0.6 μg/m(3)/year because of the volatile organic compounds (VOCs) and NOx changes caused by human activities. Due to the lockdown policies after the outbreak of COVID-19, the average O(3) concentration worldwide showed an inverted U-shaped growth during the study period, increasing from 21.9 μg/m(3) in 2015 to 27.3 μg/m(3) in 2019, and finally decreasing to 25.9 μg/m(3) in 2020. According to exposure analytical methods, approximately 6.32% of the population (31.73 million people) in the major countries analyzed reside in rapidly increasing O(3) concentrations. 6.53% of the population (32.75 million people) in the major countries were exposed to a low O(3) concentration growth environment. Thus, the continuous increase of O(3) concentration worldwide is an important factor leading to increasing threats to human health. Further we found that mean wind speed, maximum temperature, and relative humidity are the main factors that determine the change of O(3) concentration. Our research results are of great significance to the continued implementation of strict air quality policies and prevention of population hazards. However, due to data limitations, this research can only provide general trends in O(3) and human health, and more detailed research will be carried out in the follow-up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12403-022-00463-7.
In this article we review the physical and chemical properties of methane (CH4) relevant to impacts on climate, ecosystems, and air pollution, and examine the extent to which this is reflected in climate and air pollution governance. Although CH4 is governed under the UNFCCC climate regime, its treatment there is limited to the ways in which it acts as a “CO2 equivalent” climate forcer on a 100-year time frame. The UNFCCC framework neglects the impacts that CH4 has on near-term climate, as well its impacts on human health and ecosystems, which are primarily mediated by methane’s role as a precursor to tropospheric ozone. Frameworks for air quality governance generally address tropospheric ozone as a pollutant, but do not regulate CH4 itself. Methane’s climate and air quality impacts, together with its alarming rise in atmospheric concentrations in recent years, make it clear that mitigation of CH4 emissions needs to be accelerated globally. We examine challenges and opportunities for further progress on CH4 mitigation within the international governance landscapes for climate change and air pollution.
PURPOSE OF REVIEW: Fine particulate matter (PM(2.5)) and ground-level ozone (O(3)) pose a significant risk to human health. The World Health Organization (WHO) has recently revised healthy thresholds for both pollutants. The formation and evolution of PM(2.5) and O(3) are however governed by complex physical and multiphase chemical processes, and therefore, it is extremely challenging to mitigate both pollutants simultaneously. Here, we review mechanisms and discuss the science-informed pathways for effective and simultaneous mitigation of PM(2.5) and O(3). RECENT FINDINGS: Global warming has led to a general increase in biogenic emissions, which can enhance the formation of O(3) and secondary organic aerosols. Reductions in anthropogenic emissions during the COVID-19 lockdown reduced PM(2.5); however, O(3) was enhanced in several polluted regions. This was attributed to more intense sunlight due to low aerosol loading and non-linear response of O(3) to NO (x) . Such contrasting physical and chemical interactions hinder the formulation of a clear roadmap for clean air over such regions. SUMMARY: Atmospheric chemistry including the role of biogenic emissions, aerosol-radiation interactions, boundary layer, and regional-scale transport are the key aspects that need to be carefully considered in the formulation of mitigation pathways. Therefore, a thorough understanding of the chemical effects of the emission reductions, changes in photolytic rates and boundary layer due to perturbation of solar radiation, and the effect of meteorological/seasonal changes are needed on a regional basis. Statistical emulators and machine learning approaches can aid the cumbersome process of multi-sector multi-species source attribution.
Global air pollution and climate change are major threats to planetary health. These threats are strongly linked through the short-lived climate forcers (SLCFs); ozone (O(3)), aerosols, and methane (CH(4)). Understanding the impacts of ambitious SLCF mitigation in different source emission sectors on planetary health indicators can help prioritize international air pollution control strategies. A global Earth system model is applied to quantify the impacts of idealized 50% sustained reductions in year 2005 emissions in the eight largest global anthropogenic source sectors on the SLCFs and three indicators of planetary health: global mean surface air temperature change (∆GSAT), avoided PM(2.5)-related premature mortalities and gross primary productivity (GPP). The model represents fully coupled atmospheric chemistry, aerosols, land ecosystems and climate, and includes dynamic CH(4). Avoided global warming is modest, with largest impacts from 50% cuts in domestic (-0.085 K), agriculture (-0.034 K), and waste/landfill (-0.033 K). The 50% cuts in energy, domestic, and agriculture sector emissions offer the largest opportunities to mitigate global PM(2.5)-related health risk at around 5%-7% each. Such small global impacts underline the challenges ahead in achieving the World Health Organization aspirational goal of a 2/3 reduction in the number of deaths from air pollution by 2030. Uncertainty due to natural climate variability in PM(2.5) is an important underplayed dimension in global health risk assessment that can vastly exceed uncertainty due to the concentration-response functions at the large regional scale. Globally, cuts to agriculture and domestic sector emissions are the most attractive targets to achieve climate and health co-benefits through SLCF mitigation.
The global food system is essential for the health and wellbeing of society, but is also a major cause of environmental damage. Some impacts, such as on climate change, have been the subject of intense recent inquiry, but others, such as on air quality, are not as well understood. Here, we systematically synthesize the literature to identify the impacts on ambient PM2.5 (particulate matter with diameter <= 2.5 mu m), which is the strongest contributor to premature mortality from exposure to air pollution. Our analysis indicates that the life-cycle of the global food system (pre-production, production, post-production, consumption and waste management) accounts for 58% of anthropogenic, global emissions of primary PM2.5, 72% of ammonia (NH3), 13% of nitrogen oxides (NO (x) ), 9% of sulfur dioxide (SO2), and 19% of non-methane volatile organic compounds (NMVOC). These emissions result in at least 890 000 ambient PM2.5-related deaths, which is equivalent to 23% of ambient PM2.5-related deaths reported in the Global Burden of Disease Study 2015. Predominant contributors include livestock and crop production, which contribute >50% of food-related NH3 emissions, and land-use change and waste burning, which contribute up to 95% of food-related primary PM2.5 emissions. These findings are largely underestimated given the paucity of data from the post-production and consumption stages, total underestimates in NH3 emissions, lack of sector-scale analysis of PM2.5-related deaths in South America and Africa, and uncertainties in integrated exposure-response functions. In addition, we identify mitigation opportunities-including shifts in food demand, changes in agricultural practices, the adoption of clean and low-energy technologies, and policy actions-that can facilitate meeting food demand with minimal PM2.5 impacts. Further research is required to resolve sectoral-scale, region-specific contributions to PM2.5-related deaths, and assess the efficiency of mitigation strategies. Our review is positioned to inform stakeholders, including scientists, engineers, policymakers, farmers and the public, of the health impacts of reduced air quality resulting from the global food system.
Particulate matter with aerodynamic diameter ≤2.5 μm (PM(2.5)) concentrations vary between countries with similar carbon dioxide (CO(2)) emissions, which can be partially explained by differences in air pollution control efficacy. However, no indicator of air pollution control efficacy has yet been developed. We aimed to develop such an indicator, and to evaluate its global and temporal distribution and its association with country-level health metrics. A novel indicator, ambient population-weighted average PM(2.5) concentration per unit per capita CO(2) emission (PM(2.5)/CO(2)), was developed to assess country-specific air pollution control efficacy (abbreviated as APCI). We estimated and mapped the global average distribution of APCI and its changes during 2000-2016 across 196 countries. Pearson correlation coefficients and Generalized Additive Mixed Model (GAMM) were used to evaluate the relationship between APCI and health metrics. APCI varied by country with an inverse association with economic development. APCI showed an almost stable trend globally from 2000 to 2016, with the low-income groups increased and several countries (China, India, Bangladesh) decreased. The Pearson correlation coefficients between APCI and life expectancy at birth (LE), infant-mortality rate (IMR), under-five year of age mortality rate (U5MR) and logarithm of per capita GDP (LPGDP) were -0.57, 0.65, 0.66, -0.59 respectively (all P values < 0.001). APCI could explain international variation of LE, IMR and U5MR. The associations between APCI and LE, IMR, U5MR were independent of per capita GDP and climatic factors. We consider APCI to be a good indicator for air pollution control efficacy given its relation to important population health indicators. Our findings provide a new metric to interpret health inequity across the globe from the point of climate change and air pollution control efficacy.
Accumulating evidence underscores the large role played by the environment in the health of communities and individuals. We review the currently known contribution of environmental exposures and pollutants on kidney disease and its associated morbidity. We review air pollutants, such as particulate matter; water pollutants, such as trace elements, per- and polyfluoroalkyl substances, and pesticides; and extreme weather events and natural disasters. We also discuss gaps in the evidence that presently relies heavily on observational studies and animal models, and propose using recently developed analytic methods to help bridge the gaps. With the expected increase in the intensity and frequency of many environmental exposures in the decades to come, an improved understanding of their potential effect on kidney disease is crucial to mitigate potential morbidity and mortality.
Previous research demonstrates that low-income countries face higher risks than high-income countries from toxic pollution and climate change. However, the relationship between these two risks is little explored or tested, and efforts to address the risks are often independent and uncoordinated. We argue that the global risks from toxic pollution and climate change are highly correlated and should be jointly analyzed in order to inform and better target efforts to reduce or mitigate both risks. We provide such analysis for 176 countries and found a strong (rs = -0.798;95%CI -0.852, -0.727) and significant (p<0.0001) relationship between the distribution of climate risk and toxic pollution. We also found that inequities in pollution production, economic status, and institutional readiness are interconnected and exacerbate risk for countries already in the highest risk categories for both toxic and non-toxic (greenhouse gas) pollution. The findings have policy implications, including the use of the proposed Target assessment to decide where best to address toxic and non-toxic pollution simultaneously, based on the need to minimize human suffering and maximize return on effort.
The coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted global metal mining and associated supply chains. Here we analyse the cascading effects of the metal mining disruption associated with the COVID-19 pandemic on the economy, climate change, and human health. We find that the pandemic reduced global metal mining by 10-20% in 2020. This reduction subsequently led to losses in global economic output of approximately 117 billion US dollars, reduced CO(2) emissions by approximately 33 million tonnes (exceeding Hungary’s emissions in 2015), and reduced human health damage by 78,192 disability-adjusted life years. In particular, copper and iron mining made the most significant contribution to these effects. China and rest-of-the-world America were the most affected. The cascading effects of the metal mining disruption associated with the pandemic on the economy, climate change, and human health should be simultaneously considered in designing green economic stimulus policies.
During wildfire smoke events public health agencies release advisories to stay indoors, close doors and windows, and operate a portable air cleaner (PAC). The do-it-yourself (DIY) air cleaner consisting of a box fan and a furnace filter is a widely used low-cost alternative to commercial PACs because of its increased accessibility. In this study, we evaluate the clean air delivery rate (CADR) of different DIY air cleaner designs for reducing simulated wildfire smoke and identify operating parameters that may impact their performance and use. The simplest formulation of a DIY air cleaner (box fan with taped on minimum effectiveness reporting value – [MERV] 13 furnace filter) had a CADR of 111.2 ± 1.3 ft(3) /min (CFM). Increasing the fan flow by changing the fan type, increasing the fan setting, or reducing the pressure drop across the filtering surface increased the CADR. Large increases in CADR could be obtained by using a shroud (40%), using a 4″ thick filter (123%) using two filters in a wedge shape (137%), or using four filters in a Corsi-Rosenthal (CR) box design (261%). The CADR was greatly reduced with filters heavily loaded with smoke, pointing to the need for frequent filter changes during smoke events.
In recent years, wildland fires have occurred more frequently and with increased intensity in many fire-prone areas. In addition to the direct life and economic losses attributable to wildfires, the emitted smoke is a major contributor to ambient air pollution, leading to significant public health impacts. Wildfire smoke is a complex mixture of particulate matter (PM), gases such as carbon monoxide, nitrogen oxide, and volatile and semi-volatile organic compounds. PM from wildfire smoke has a high content of elemental carbon and organic carbon, with lesser amounts of metal compounds. Epidemiological studies have consistently found an association between exposure to wildfire smoke (typically monitored as the PM concentration) and increased respiratory morbidity and mortality. However, previous reviews of the health effects of wildfire smoke exposure have not established a conclusive link between wildfire smoke exposure and adverse cardiovascular effects. In this review, we systematically evaluate published epidemiological observations, controlled clinical exposure studies, and toxicological studies focusing on evidence of wildfire smoke exposure and cardiovascular effects, and identify knowledge gaps. Improving exposure assessment and identifying sensitive cardiovascular endpoints will serve to better understand the association between exposure to wildfire smoke and cardiovascular effects and the mechanisms involved. Similarly, filling the knowledge gaps identified in this review will better define adverse cardiovascular health effects of exposure to wildfire smoke, thus informing risk assessments and potentially leading to the development of targeted interventional strategies to mitigate the health impacts of wildfire smoke.
Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.
BACKGROUND: Fine particulate matter (PM(2.5)) produced by landscape fires is thought to be more toxic than that from non-fire sources. However, the effects of “fire-sourced” PM(2.5) on acute respiratory infection (ARI) are unknown. METHODS: We combined Demographic and Health Survey (DHS) data from 48 countries with gridded global estimates of PM(2.5) concentrations from 2003 to 2014. The proportions of fire-sourced PM(2.5) were assessed by a chemical transport model using a variety of PM(2.5) source data. We tested for associations between ARI and short-term exposure to fire- and “non-fire-sourced” PM(2.5) using a bidirectional case-crossover analysis. The robustness and homogeneity of the associations were examined by sensitivity analyses. We also established a nonlinear exposure-response relationship between fire- and non-fire-sourced PM(2.5) and ARI using a two-dimensional spline function. RESULTS: The study included 36,432 children under 5 years who reported ARI symptoms. Each 1 µg/m(3) increment of fire-sourced PM(2.5) was associated with a 3.2 % (95 % confidence interval [CI] 0.2, 6.2) increment in the risk of ARI. This effect was comparable to that of each ∼5 µg/m(3) increment in PM(2.5) from non-fire sources (3.1 %; 95 % CI 2.4, 3.7). The association between ARI and total PM(2.5) concentration was significantly mediated by the proportion of fire-sourced particles. Nonlinear analysis showed that the risk of ARI was increased by both fire- and non-fire-sourced PM(2.5), but especially by the former. CONCLUSIONS: PM(2.5) produced by landscape fire was more strongly associated to ARI among children under 5 years than that from non-fire sources.
Exposures to ambient fine particulate matter (PM(2.5)) and cold ambient temperatures have been identified as important risk factors in contributing towards the global mortality from chronic obstructive pulmonary disease (COPD). Despite China currently being the country with the largest population in the world, previous relative risk (RR) models have considered little or no information from the ambient air pollution related cohort studies in the country. This likely provides a less accurate picture of the trend in air pollution attributable mortality in the country over time. A novel relative risk model called pollutant-temperature exposure (PTE) model is proposed to estimate the RR attributable to the combined effect of air pollution and ambient temperature in a population. In this paper, the pollutant concentration-response curve was extrapolated from the cohort studies in China, whereas the temperature response curve was extracted from a study in Yangtze River Delta (YRD) region. The performance of the PTE model was compared with the integrated exposure-response (IER) model using the data of YRD region, which revealed that the estimated relative risks of the PTE model were noticeably higher than the IER model during the winter season. Furthermore, the predictive ability of the PTE model was validated using actual data of Ningbo city, which showed that the estimated RR using the PTE model with 1-month moving average data showed a good result with the trend of actual COPD mortality, indicated by a lower root mean square error (RMSE = 0.956). By considering the combined effect of ambient air pollutant and ambient temperature, the PTE model is expected to provide more accurate relative risk estimates for the regions with high levels of ambient PM(2.5) and seasonal variation of ambient temperature.
Climate change and air pollution can interact to amplify risks to human health and crop production. This has significant implications for our ability to reach the Sustainable Development Goals (e.g. SDGs 2, 3, 13, 15) and for the design of effective mitigation and adaptation policies and risk management. To be able to achieve the SDG targets, closer integration of climate change and air pollution both in terms of impact assessment for human health and agricultural productivity and respective policy development is needed. Currently, studies estimating the impacts of climate and air pollutants on human health and crops mostly treat these stressors separately, and the methods used by the health and agricultural science communities differ. Better insights into the methods applied in the different communities can help to improve existing and develop new methods to advance our knowledge about the combined impacts of climate change and air pollution on human health and crops. This topical review provides an overview of current methodologies applied in the two fields of human health and agricultural crop impact studies, ranging from empirical regression-based and experimental methods to more complex process-based models. The latter are reasonably well developed for estimating impacts on agricultural crops, but not for health impacts. We review available literature addressing the combined effects of climate and air pollution on human health or agricultural productivity to provide insights regarding state-of-the-art knowledge and currently available methods in the two fields. Challenges to assess the combined effect of climate and air pollution on human health and crops, and opportunities for both fields to learn from each other, are discussed.
Desertification and climate change indicate a future expansion of the global area of dry land and an increase in the risk of drought. Humans may therefore be at an ever-increasing risk of frequent exposure to, and resultant adverse health effects of desert sand dust. This review appraises a total of 52 experimental studies that have sought to identify mechanisms and intermediate endpoints underlying epidemiological evidence of an impact of desert dust on cardiovascular and respiratory health. Toxicological studies, in main using doses that reflect or at least approach real world exposures during a dust event, have demonstrated that virgin sand dust particles and dust storm particles sampled at remote locations away from the source induce inflammatory lung injury and aggravate allergen-induced nasal and pulmonary eosinophilia. Effects are orchestrated by cytokines, chemokines and antigen-specific immunoglobulin potentially via toll-like receptor/myeloid differentiation factor signaling pathways. Findings suggest that in addition to involvement of adhered chemical and biological pollutants, mineralogical components may also be implicated in the pathogenesis of human respiratory disorders during a dust event. Whilst comparisons with urban particulate matter less than 2.5 μm in diameter (PM(2.5)) suggest that allergic inflammatory responses are greater for microbial element-rich dust- PM(2.5), aerosols generated during dust events appear to have a lower oxidative potential compared to combustion-generated PM(2.5) sampled during non-dust periods. In vitro findings suggest that the significant amounts of suspended desert dust during storm periods may provide a platform to intermix with chemicals on its surfaces, thereby increasing the bioreactivity of PM(2.5) during dust storm episodes, and that mineral dust surface reactions are an unrecognized source of toxic organic chemicals in the atmosphere, enhancing toxicity of aerosols in urban environments. In summary, the experimental research on desert dust on respiratory endpoints go some way in clarifying the mechanistic effects of atmospheric desert dust on the upper and lower human respiratory system. In doing so, they provide support for biological plausibility of epidemiological associations between this particulate air pollutant and events including exacerbation of asthma, hospitalization for respiratory infections and seasonal allergic rhinitis.
New epidemiological studies acknowledge the detrimental effects of dust storms on health. The aim of this study was to systematically review the effects of dust storms on the morbidity and mortality rates of cardiovascular and respiratory diseases. The results of this study were obtained based on articles published in English-language journals. For the purpose of this study, all articles published until the end of 2020 based on the search in the “Scopus,” “Web of Science,” and “PubMed” databases were selected. Articles were searched independently by two trained researchers. Dust storms are the cause of many diseases and health-related complications, of which cardiovascular and respiratory diseases are common. It is necessary to recognize and investigate the harmful effects of dust storms to prevent serious harms to human societies. In the reviewed articles, the impact of dust storms on several diseases, including cardiovascular and respiratory diseases, has been analyzed. Most of these articles acknowledge the effect of dust storms on increasing the incidence and mortality rate of these diseases, although in some articles this effect is not statistically significant. Many studies conducted around the world confirm the harmful effects of dust storms on cardiovascular and respiratory diseases, including increase in the number and duration of hospitalizations, as well as increase in mortality and exacerbation of these diseases. However, some studies do not consider the harmful effects of dust storms on the above diseases to be statistically significant.
Climate change and obesity were considered threats to our planet long before the onset of COVID-19. The recent pandemic has enhanced the global burden of both pre-existing crises. The aim of this narrative review is to explore the interaction between the three concurrent crises and the future of our planet should they not be dealt with accordingly. A PubMed and Google Scholar literature search was performed using different combinations of search strategies and using the keywords obesity , climate/temperature change , cold/hot temperatures , and COVID-19 . High global greenhouse gas (GHG) emissions link obesity and climate change as a result of the interplay between biological and behavioural factors. COVID-19 mitigation measures have indirectly impacted obesity and GHG emissions through the shift in dietary habits, restricted mobility, the impact on healthcare services, and enhanced psychological stress. Furthermore, COVID-19 has a more detrimental effect if acquired by an obese individual, with a higher chance of hospitalization and mechanical ventilation. This leads to higher GHG emissions and negative repercussions on the climate. A tri-directional relationship exists between obesity, climate change, and COVID-19. Various factors contribute to this relationship, but unless urgent global integrated action plans are implemented that target all three calamities, and not just COVID-19, a devastating and unsustainable future may ensue.
This review paper discusses the Stockholm Paradigm (SP) as a theoretical framework and practical computational instrument for studying and assessing the risk of emerging infectious diseases (EIDs) as a result of climate change. The SP resolves the long-standing parasite paradox and explains how carbon emissions in the atmosphere increase parasites’ generalization and intensify host switches from animals to humans. The SP argues that the growing rate of novel EID occurrence caused by mutated zoonotic pathogens is related to the following factors brought together as a unified issue of humanity: (a) carbon emissions and consequent climate change; (b) resettlement/migration of people with hyper-urbanization; (c) overpopulation; and (d) human-induced distortion of the biosphere. The SP demonstrates that, in an evolutionary way, humans now play a role migratory birds once played in spreading parasite pathogens between the three Earth megabiotopes (northern coniferous forest belt; tropical/equatorial rainforest areas; and hot/cold deserts), i.e., the role of “super-spreaders” of parasitic viruses, bacteria, fungi and protozoa. This makes humans extremely vulnerable to the EID threat. The SP sees the +1.0-+1.2 °C limit as the optimal target for the slow, yet feasible curbing of the EID hazard to public health (150-200 years). Reaching merely the +2.0 °C level will obviously be an EID catastrophe, as it may cause two or three pandemics each year. We think it useful and advisable to include the SP-based research in the scientific repository of the Intergovernmental Panel on Climate Change, since EID appearance and spread are indirect but extremely dangerous consequences of climate change.
Background: It is crucial to understand the benefits to human health from decarbonisation to galvanise action among decision makers. Most of our existing evidence comes from modelling studies and little is known about the extent to which the health co-benefits of climate change mitigation actions are realised upon implementation. We aim to analyse evidence from mitigation actions that have been implemented across a range of sectors and scales, to identify those that can improve and sustain health, while accelerating progress towards a zero-carbon economy. Objectives: To understand the implementation process of actions and the role of key actors; explain the contextual elements influencing these actions; summarise what effects, both positive and negative, planned and unplanned they may have on emissions of greenhouse gases and health; and to summarise environmental, social, or economic co-benefits. Data: We will review evidence collected through partnership with existing data holders and an open call for evidence. We will also conduct a hand search of reference lists from systematic reviews and websites of organisations relevant to climate change mitigation. Screening: Screening will be done by two reviewers according to a pre-defined inclusion and exclusion criteria. Analysis: We will identify gaps where implementation or evaluation of implementation of mitigation actions is lacking. We will synthesise the findings to describe how actions were implemented and how they achieved results in different contexts, identifying potential barriers and facilitators to their design, implementation, and uptake. We will also synthesise their effect on health outcomes and other co-benefits. Quantitative synthesis will depend on the heterogeneity of outcomes and metrics. Conclusions: Findings will be used to identify lessons that can be learned from successful and unsuccessful mitigation actions, to make inferences on replicability, scalability, and transferability and will contribute to the development of frameworks that can be used by policy makers.
Polycyclic aromatic hydrocarbons (PAHs) are a large group of organic compounds that have 2-7 benzene rings. PAHs causes many complications in humans, including respirations and increased risk of cancer. The most important fixed and mobile sources (PAHs) include food, industrial pollution, and car exhaust. The most common ways of entering the body (PAHs) are through direct contact, seafood, grilled meat, inhalation of PAHs, and contaminated water. From various studies and many publications in the field, the major issue with PAHs is increased risk of cancer, such as cancer of lungs if inhaled or skin if in contact with skin, cancer of stomach or gastrointestinal in smoked or barbecued fish and meat products. The purpose of this review study was to the epidemiological literature on the side effect of Polycyclic aromatic hydrocarbons (PAHs) on respiratory diseases and the risk factors related to Cancer. Six hundred and fifty-five articles according to different databases: Google Scholar, PubMed, Web of Science, BMJ, Springer, and Science Direct were retrieved. Forty-two studies were screened after review and, 27 full-text articles were entered into the analysis process. Finally, 15 articles were selected for this study. Studies have shown the effects of PAHs in increasing the risk of infection in the respiratory system, including asthma, lung dysfunction, and various cancers, such as skin, digestive tract, lung, and blood. The results showed that polycyclic aromatic hydrocarbons could increase the probability and risk incidence of cancers of the lung, skin, bladder, and respiratory diseases, such as asthma and lung dysfunction. Reducing the emission of polycyclic aromatic hydrocarbons (PAHs) due to activities, such as cooking, car exhaust, wildfire, and power plant can be a very influential factor in reducing the health endpoint of this pollutant, especially respiratory diseases, and Cancer.
Climate change can have economic consequences, affecting the nutritional intake of populations and increasing food insecurity, as it negatively affects diet quality parameters. One way to mitigate these consequences is to change the way we produce and consume our food. A healthy and sustainable diet aims to promote and achieve the physical, mental, and social well-being of the populations at all life stages, while protecting and safeguarding the resources of the planet and preserving biodiversity. Over the past few years, several indexes have been developed to evaluate dietary sustainability, most of them based on the EAT-Lancet reference diet. The present review explains the problems that arise in human nutrition as a result of climate change and presents currently available diet sustainability indexes and their applications and limitations, in an effort to aid researchers and policy actors in identifying aspects that need improvement in the development of relevant indexes. Overall, great heterogeneity exists among the indicators included in the available indexes and their methodology. Furthermore, many indexes do not adequately account for the diets’ environmental impact, whereas others fall short in the economic impact domain, or the ethical aspects of sustainability. The present review reveals that the design of one environmentally friendly diet that is appropriate for all cultures, populations, patients, and geographic locations is a difficult task. For this, the development of sustainable and healthy diet recommendations that are region-specific and culturally specific, and simultaneously encompass all aspects of sustainability, is required.
Respiratory diseases such as asthma, allergic rhinitis (AR) and chronic obstructive pulmonary disease (COPD) affect millions worldwide and pose a significant global public health burden. Over the years, changes in land use and climate have increased pollen quantity, allergenicity and duration of the pollen season, thus increasing its impact on respiratory disease. Many studies have investigated the associations between short-term ambient pollen (i.e., within days or weeks of exposure) and respiratory outcomes. Here, we reviewed the current evidence on the association between short-term outdoor pollen exposure and thunderstorm asthma (TA), asthma and COPD hospital presentations, general practice (GP) consultations, self-reported respiratory symptoms, lung function changes and their potential effect modifiers. The literature suggests strong evidence of an association between ambient pollen concentrations and almost all respiratory outcomes mentioned above, especially in people with pre-existing respiratory diseases. However, the evidence on sub-clinical lung function changes, COPD, and effect modifiers other than asthma, hay fever and pollen sensitisation are still scarce and requires further exploration. Better understanding of the implications of pollen on respiratory health can aid healthcare professionals to implement appropriate management strategies.
Allergic diseases affect millions of children and adolescents worldwide. In this Review, we focus on allergies to food and airborne allergens and provide examples of prevalence trends during a time when climate change is of increasing concern. Profound environmental changes have affected natural systems in terms of biodiversity loss, air pollution, and climate. We discuss the potential links between these changes and allergic diseases in children, and the clinical implications. Several exposures of relevance for allergic disease also correlate with epigenetic changes such as DNA methylation. We propose that epigenetics could be a promising tool by which exposures and hazards related to a changing environment can be captured. Epigenetics might also provide promising biomarkers and help to elucidate the mechanisms related to allergic disease initiation and progress.
Climate change has been regarded as a threat to the human species on the earth. Greenhouse gasses are leading to increased temperatures on Earth besides impacting the humanity. These atmospheric conditions have shown to alter the release pattern of pollens and can change the timing and magnitude of pollen release with flowering plants. As pollen is responsible for respiratory allergies in humans, so climate change can adversely affect human health in susceptible individuals. In this review, we highlight the association between climate change, increased prevalence and severity of asthma, and related allergic diseases. Increased air pollution can alter the production of local and regional pollen. This altered pattern depends on bioclimatic parameters. As simulated with a pollen-release model and future bioclimatic data, warmer temperatures lead to an increased pollen count in some specific locations and for longer periods. Thus, anticipation of a future allergic disease burden can help public health agencies in planning to develop strategies in mitigating the unprecedented health challenges expected in future years.
The climate crisis poses a major challenge to human health as well as the healthcare system and threatens to jeopardize the medical progress made in recent decades. However, addressing climate change may also be the greatest opportunity for global health in the 21st century. The climate crisis and its consequences, such as rising temperatures, forest fires, floods, droughts, and changes in the quality and quantity of food and water, directly and indirectly affect human physical and mental health. More intense and frequent heat waves and declining air quality have been shown to increase all-cause mortality, especially among the most vulnerable. Climate warming alters existing ecosystems and favors biological invasions by species that better tolerate heat and drought. Pathogen profiles are changing, and the transmission and spread of vector-borne diseases are increasing. The spread of neophytes in Europe, such as ragweed, is creating new pollen sources that increase allergen exposure for allergy sufferers. In addition, the overall milder weather, especially in combination with air pollution and increased CO(2) levels, is changing the production and allergenicity of pollen. The phenomenon of thunderstorm asthma is also occurring more frequently. In view of the increasing prevalence of allergic diseases due to climate change, early causal immunomodulatory therapy is therefore all the more important. During a climate consultation, patients can receive individual advice on climate adaptation and resilience and the benefits of CO(2) reduction-for their own and the planet’s health. Almost 5% of all greenhouse gas emissions in Europe come from the healthcare sector. It thus has a central responsibility for a climate-neutral and sustainable transformation.
Invasive alien plants (IAPs) substantially affect the native biodiversity, agriculture, industry, and human health worldwide. Ambrosia (ragweed) species, which are major IAPs globally, produce a significant impact on human health and the natural environment. In particular, invasion of A. artemisiifolia, A. psilostachya, and A. trifida in non-native continents is more extensive and severe than that of other species. Here, we used biomod2 ensemble model based on environmental and species occurrence data to predict the potential geographical distribution, overlapping geographical distribution areas, and the ecological niche dynamics of these three ragweeds and further explored the environmental variables shaping the observed patterns to assess the impact of these IAPs on the natural environment and public health. The ecological niche has shifted in the invasive area compared with that in the native area, which increased the invasion risk of three Ambrosia species during the invasion process in the world. The potential geographical distribution and overlapping geographical distribution areas of the three Ambrosia species are primarily distributed in Asia, North America, and Europe, and are expected to increase under four representative concentration pathways in the 2050s. The centers of potential geographical distributions of the three Ambrosia species showed a tendency to shift poleward from the current time to the 2050s. Bioclimatic variables and the human influence index were more significant in shaping these patterns than other factors. In brief, climate change has facilitated the expansion of the geographical distribution and overlapping geographical distribution areas of the three Ambrosia species. Ecomanagement and cross-country management strategies are warranted to mitigate the future effects of the expansion of these ragweed species worldwide in the Anthropocene on the natural environment and public health.
Allergic diseases are a major public health problem globally and are increasing. The impacts of climate change on aeroallergens such as pollen and fungal spores and allergic respiratory diseases such as allergic asthma and allergic rhinitis have been considered since the early years of climate change and human health research, and exploration of this topic has accelerated over the past decade or so. This review examines the impacts of climate change on aeroallergens, including interactions with air pollutants, and the resulting impacts on allergic respiratory diseases. It discusses mitigation and adaptation in this context. It does this with a focus on advances over the last 2 years (2019 and 2020) to highlight research at the frontier of this field. It also explores the growing recognition of the need for a more holistic and integrated approach to environmental monitoring and exposure and presents the concept of the aeroexposome as a frame through which these impacts of climate change and responses to them could be viewed moving forward. As the evidence of impacts of climate change on aeroallergen production and atmospheric concentration, seasonality, distribution, and allergenicity mounts, crucial research demonstrating the resulting impacts on health outcomes such as aeroallergen sensitisation prevalence, asthma emergency department visits, and asthma hospitalisations is now emerging. It is vital that the momentum of the last decade continue with research to fill the many gaps that remain in our knowledge of this complex topic-refining analytical techniques, broadening the geographical coverage (to include, for example, the Southern Hemisphere), and more explicitly exploring the impacts of climate change on indoor aeroallergens.
Seasonal allergic rhinitis (SAR) is one of the most frequent chronic conditions of the modern world. Pollen carried by the wind from pollinated trees is a major source of SAR. Betulaceae, Oleaceae and Platanus are the most important sources of airway sensitization with regard to tree pollen and, therefore, they are included in the official recommendations of skin prick testing by different official societies. Salicaceae pollen is a moderate source of pollen sensitization. Conversely, large areas are covered with poplars and willows around the world. A number of studies from many countries showed that in some particular situations (large and compacted areas covered by Salicaceae, weather conditions, air pollution, urban ornamental vegetation), poplar and willow pollens may become of local importance in producing SAR. The aim of this review was to present a synthesis of information regarding Salicaceae pollen allergy showing that, if various unfavorable aspects are brought together, a minor problem (Salicaceae sensitization) can became a public health problem.
Thunderstorm-triggered asthma (TA) can be defined as the occurrence of acute asthma attacks immediately following a thunderstorm during pollen seasons. Outbreaks have occurred across the world during pollen season with the capacity to rapidly inundate a health care service, resulting in potentially catastrophic outcomes for allergic patients. TA occurs when specific meteorological and aerobiological factors combine to affect predisposed atopic patients with IgE-mediated sentitization to pollen allergens. Thunderstorm outflows can concentrate aeroallergens, most commonly grass pollen but also other pollens such as Parietaria and moulds in TA, at ground level to release respirable allergenic particles after rupture by osmotic shock related to humidity and rainfall. Inhalation of high concentrations of these aeroallergens by sensitized individuals can induce early asthmatic responses which can be followed by a late inflammatory phase. There is evidence that, during pollen season, thunderstorms can induce allergic asthma outbreaks, sometimes also severe asthma crisis and sometimes deaths in patients suffering from pollen allergy. It has been observed that changes in the weather such as rain or humidity may induce hydratation of pollen grains during pollen seasons and sometimes also their fragmentation which generates atmospheric biological aerosols carrying allergens. Asthma attacks are induced for the high concentration at ground level of pollen grains which may release allergenic particles of respirable size after rupture by osmotic shock. In other words, it is a global health problem observed in several cities and areas of the world that can strike without sufficient warning, inducing sometimes severe clinical consequences also with deaths of asthma patients. Due to constant climate change, future TA events are likely to become more common, more disastrous and more unpredictable, as a consequence it is important to have deep knowledge on this topic to prevent asthma attacks. Other environmental factors, such as rapid changes in temperature and agricultural practices, also contribute to causing TA.
BACKGROUND: Itch is a cardinal feature of paediatric disorders and can impair quality of life. However, few studies have addressed symptoms and impacts of itch in paediatric patients. OBJECTIVES: We focused on understanding the child’s experience of itch and the impact of itch specifically on affected children, including comparison with the adult experience. METHODS: Semistructured interviews (nine parents, 15 children with itch) explored concerns related to paediatric itch experiences and effects. Themes were compared with those of previous adult interviews. Literature was reviewed to identify the need for a more comprehensive measure of paediatric itch. RESULTS: Itch quality, intensity, duration and environmental triggers (sweating, climate change, stress and certain fabrics) are important aspects of the child’s itch experience. Skin disruption, physical function, concentration, emotional reactions, stigma and relationships/social effects are itch impact themes that emerged. No paediatric-specific scale comprehensively captures the paediatric patient itch experience. However, differences between child and adult reports of itch-related pain, functional limitations, fatigue and restlessness, emotional reactions to itch, and treatment effects emphasize the need for a paediatric-specific measurement tool. CONCLUSIONS: Children and parents endorse the importance of capturing the paediatric-focused characteristics and impacts of itch in measuring disease severity and response to intervention.
The aim of the Compendium is to provide information and guidance on how to assess and address the risks posed by sand and dust storms and plan actions to combat sand and dust storms. The Compendium brings together information and guidance from a wide range of sources. It includes approaches and methodology frameworks on data collection, assessment, monitoring and early warning, impact mitigation and preparedness, and source mapping and anthropogenic source mitigation that are required in the development and implementation of policies related to sand and dust storms at sub-national, national, regional and global levels, taking into account the principles set out in the Policy Advocacy Framework for Sand and Dust Storms, and the cross-sectoral and multidisciplinary nature of the impact that sand and dust storms can cause to societies, economies, and the environment.
