Perceptions of weather-based pain forecasts and their effect on daily activities.

As studies begin to have more success uncovering the relationships between atmospheric conditions and pain, weather-based pain forecasting becomes more of a reality. In this study, a survey was used to determine if people living with migraines and/or other pain-related conditions are receptive to weather-based pain forecasts. Moreover, we wished to identify whether these forecasts actually impact the decision-making of those who use them. Survey respondents were generally eager to use these novel forecasts. Furthermore, when provided with different scenarios involving weather-based pain forecasts, the respondents' actions were altered. When a hypothetical forecast indicated that the weather was conducive to migraines or other types of pain, many indicated that they would likely take preventative measures (e.g., medication). Additionally, respondents were less likely to continue with a planned activity, regardless of length, as forecast severity increased. The results from this survey highlight the importance of developing and improving weather-based pain forecasting.

Geographical variability in the relationship between synoptic weather type and emergency department visits for pain across North Carolina.

Bodily pain plagues populations across the globe. Past studies have discovered some links between synoptic weather types and different kinds of pain. These relationships are essential as they can aide in treatment and potentially prevention of pain. In this study, the role of geographical characteristics on the relationships between synoptic weather type and pain were looked at. North Carolina was separated into three geographic sections: Appalachian Mountains, Piedmont Plateau, and Coastal Plain. Over a 7-year period, synoptic weather types and emergency department (ED) visits for various kinds of pain (migraine, fibromyalgia, rheumatoid arthritis, osteoarthritis, and general back pain) were collected. Bootstrapped confidence intervals of the mean number of population-adjusted ED visit rates (per 100,000 persons), for the different synoptic weather types, were compared across the different geographic regions. In the plateau region, Moist Tropical and Moist Moderate weather types were often linked to the highest rates of ED visits, while Polar weather types were frequently associated with the fewest visits. The mountainous portion of the state displayed similar patterns between synoptic weather types and the different forms of pain, with migraine and fibromyalgia being the exceptions. Few statistically significant relationships were noted for the coastal region.

Heat exposure misclassification: Do current methods of classifying diurnal range in individually experienced temperatures and heat indices accurately reflect personal exposure?

Wearable sensors have been used to collect information on individual exposure to excessive heat and humidity. To date, no consistent diurnal classification method has been established, potentially resulting in missed opportunities to understand personal diurnal patterns in heat exposure. Using individually experienced temperatures (IET) and heat indices (IEHI) collected in the southeastern United States, this work aims to determine whether current methods of classifying IETs and IEHIs accurately characterize "day," which is typically the warmest conditions, and "night," which is typically the coolest conditions. IET and IEHI data from four locations were compared with the closest hourly weather station. Different day/night classifications were compared to determine efficacy. Results indicate that diurnal IET and IEHI ranges are higher than fixed-site ranges. Maximum IETs and IEHIs are warmer and occur later in the day than ambient conditions. Minimum IETs are lower and occur earlier in the day than at weather stations, which conflicts with previous assumptions that minimum temperatures occur at night. When compared to commonly used classification methods, a method of classifying day and night based on sunrise and sunset times best captured the occurrence of maximum IETs and IEHIs. Maximum IETs and IEHIs are often identified later in the evening, while minimum IETs and IEHIs occur throughout the day. These findings support future research focusing on nighttime heat exposure, which can exacerbate heat-related health issues, and diurnal patterns of personal exposure throughout the entire day as individual patterns do not necessarily follow the diurnal pattern seen in ambient conditions.

Wearable sensors for personal temperature exposure assessments: A comparative study.

The impacts of heat on human health has sparked research on different approaches to measure, map, and predict heat exposure at more accurate and precise spatiotemporal scales. Personal heat sensor studies rely on small sensors that can continuously measure ambient temperatures as individuals move through time and space. The comparison between different types of sensors and sensor placements have yet to be fully researched. The objective of this study is to assess the validity of personal ambient temperature sensors. To accomplish this objective, we evaluated the performance of multiple low-cost wearable sensors (HOBOs, iButton Thermochrons, iButton Hygrochrons, and Kestrel DROP D3FW Fire) for measuring ambient temperature in a (1) field exposure study by varying the placement on human subjects and in a (2) field calibration study by co-locating sensors with fixed site weather station monitors. A secondary aim involved investigating consensus between validation metrics that can be used in future sensor comparison studies. Bland-Altman analysis, correlation coefficients, and index of agreement statistics were used to quantify the difference between sensor and weather station ambient temperature measurements. Results demonstrated significant differences in measured temperatures for sensors based on sensor type and placement on participants. Future research should account for the differences in personal ambient temperature readings based on sensor type and placement.

Perceptions and experiences of outdoor occupational workers using digital devices for geospatial biometeorological monitoring.

Wearable devices have the potential to track and monitor a wide range of biometeorological conditions (e.g., temperature, UV, air quality) and health outcomes (e.g., mental stress, physical activity, physiologic strain, and cognitive impairments). These sensors provide the potential for personalized environmental exposure information that can be harnessed for at-risk populations. Personalized environmental exposure information is of particular importance for populations that are continuously exposed to hazardous environmental conditions or with underlying health conditions. Yet, for these devices to be effective, individuals must be willing to monitor their health and, if prompted, adhere to warnings or notifications. To date, no study has examined the perceptions and use of digital devices and wearable sensors among vulnerable outdoor working populations. This study evaluated digital device use and perceptions among a population of groundworkers in three diverse geographic sites in the southeastern USA (Boone, NC, Raleigh, NC, and Starkville, MS). Our results demonstrate that biometeorological health interventions should focus on smartphone technology as a platform for monitoring environmental exposure and associated health outcomes. It was encouraging to find that those study participants were very likely to wear sensors and utilize global positioning system technology despite potential privacy issues. In addition, 3 out of 4 workers indicated that they would change their behavior if given a personalized heat preventive warning. Future development of wearable sensors and smartphone applications should integrate personalized weather warnings and ensure privacy to facilitate the use of these technologies among vulnerable populations.

Relationship between synoptic weather type and emergency department visits for different types of pain across the Triangle region of North Carolina.

Many people around the world are impacted by some form of bodily pain. Outside factors, such as weather, are thought to help trigger pain, especially in those who have pain-related conditions. When it comes to human health and comfort, understanding the potential external factors that aide in triggering pain is essential. Identifying such factors makes prevention and treatment of pain more feasible. This study focused on how those who suffer from various pain-related conditions (fibromyalgia, rheumatoid arthritis, osteoarthritis, and general back pain) are impacted by different synoptic weather types (i.e., air masses). Synoptic weather types and emergency department (ED) visits for pain in select central North Carolina counties were collected over a seven-year period to determine a potential relationship. Bootstrapped confidence intervals revealed that moist tropical weather types resulted in the highest number of ED visits for each of the conditions examined, while moist polar weather types often resulted in the fewest. The barometric pressure changes associated with transitional weather types, which are often associated with fronts, did not have any significant relationships with pain.

Temporal and spatial variation in personal ambient temperatures for outdoor working populations in the southeastern USA.

Excessive ambient temperature exposure can result in significant morbidity and mortality, especially among vulnerable occupational groups like outdoor workers. Average temperatures in the USA are projected to increase in frequency and intensity, placing future worker populations at greater risk for unhealthy levels of exposure. Unlike previous research focused on aggregate-level temperature exposures from in situ weather station data, this study will measure location-based personal ambient temperatures (PAT) at the individual-level by piloting the use of wearable sensor technology. A total of 66 outdoor workers in three geographically and climatologically diverse regions in the Southeast USA were continuously sampled during the workday for a 1-week period throughout July 11 to August 8 2016. Results indicate significant worker variation in temperature exposure within and between study locations; with PAT characterized by less pronounced variability as workers moved between indoor and outdoor environments. Developed land covers, a factor often associated with higher temperatures, were poorly correlated with PAT. Future analysis should focus on a worker's physiological response to PAT and mapping of spatial patterns of PAT for a larger worker population to produce innovative and targeted heat prevention programs.

Relationship between air mass type and emergency department visits for migraine headache across the Triangle region of North Carolina.

An estimated 240 million people worldwide suffer from migraines. Because migraines are often debilitating, understanding the mechanisms that trigger them is crucial for effective prevention and treatment. Synoptic air mass types and emergency department (ED) visits for migraine headaches were examined over a 7-year period within a major metropolitan area of North Carolina to identify potential relationships between large-scale meteorological conditions and the incidence of migraine headaches. Barometric pressure changes associated with transitional air masses, or changing weather patterns, were also analyzed for potential relationships. Bootstrapping analysis revealed that tropical air masses (moist and dry) resulted in the greatest number of migraine ED visits over the study period, whereas polar air masses led to fewer. Moist polar air masses in particular were found to correspond with the fewest number of migraine ED visits. On transitional air mass days, the number of migraine ED visits fell between those of tropical air mass days and polar air mass days. Transitional days characterized by pressure increases exhibited a greater number of migraine ED visits than days characterized by pressure decreases. However, no relationship was found between migraine ED visits and the magnitude of barometric pressure changes associated with transitional air masses.

Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007-2011).

Extreme heat is the leading cause of weather-related mortality in the U.S. Extreme heat also affects human health through heat stress and can exacerbate underlying medical conditions that lead to increased morbidity and mortality. In this study, data on emergency department (ED) visits for heat-related illness (HRI) and other selected diseases were analyzed during three heat events across North Carolina from 2007 to 2011. These heat events were identified based on the issuance and verification of heat products from local National Weather Service forecast offices (i.e. Heat Advisory, Heat Watch, and Excessive Heat Warning). The observed number of ED visits during these events were compared to the expected number of ED visits during several control periods to determine excess morbidity resulting from extreme heat. All recorded diagnoses were analyzed for each ED visit, thereby providing insight into the specific pathophysiological mechanisms and underlying health conditions associated with exposure to extreme heat. The most common form of HRI was heat exhaustion, while the percentage of visits with heat stroke was relatively low (<10%). The elderly (>65 years of age) were at greatest risk for HRI during the early summer heat event (8.9 visits per 100,000), while young and middle age adults (18-44 years of age) were at greatest risk during the mid-summer event (6.3 visits per 100,000). Many of these visits were likely due to work-related exposure. The most vulnerable demographic during the late summer heat event was adolescents (15-17 years of age), which may relate to the timing of organized sports. This demographic also exhibited the highest visit rate for HRI among all three heat events (10.5 visits per 100,000). Significant increases (p < 0.05) in visits with cardiovascular and cerebrovascular diseases were noted during the three heat events (3-8%). The greatest increases were found in visits with hypotension during the late summer event (23%) and sequelae during the early summer event (30%), while decreases were noted for visits with hemorrhagic stroke during the middle and late summer events (13-24%) and for visits with aneurysm during the early summer event (15%). Significant increases were also noted in visits with respiratory diseases (5-7%). The greatest increases in this category were found in visits with pneumonia and influenza (16%), bronchitis and emphysema (12%), and COPD (14%) during the early summer event. Significant increases in visits with nervous system disorders were also found during the early summer event (16%), while increases in visits with diabetes were noted during the mid-summer event (10%).

Relationships between maximum temperature and heat-related illness across North Carolina, USA.

Heat kills more people than any other weather-related event in the USA, resulting in hundreds of fatalities each year. In North Carolina, heat-related illness accounts for over 2,000 yearly emergency department admissions. In this study, data on emergency department (ED) visits for heat-related illness (HRI) were obtained from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool to identify spatiotemporal relationships between temperature and morbidity across six warm seasons (May-September) from 2007 to 2012. Spatiotemporal relationships are explored across different regions (e.g., coastal plain, rural) and demographics (e.g., gender, age) to determine the differential impact of heat stress on populations. This research reveals that most cases of HRI occur on days with climatologically normal temperatures (e.g., 31 to 35 °C); however, HRI rates increase substantially on days with abnormally high daily maximum temperatures (e.g., 31 to 38 °C). HRI ED visits decreased on days with extreme heat (e.g., greater than 38 °C), suggesting that populations are taking preventative measures during extreme heat and therefore mitigating heat-related illness.