Impact of extreme weather events on the occurrence of infectious diseases in Belgium from 2011 to 2021.

The role of meteorological factors, such as rainfall or temperature, as key players in the transmission and survival of infectious agents is poorly understood. The aim of this study was to compare meteorological surveillance data with epidemiological surveillance data in Belgium and to investigate the association between intense weather events and the occurrence of infectious diseases. Meteorological data were aggregated per Belgian province to obtain weekly average temperatures and rainfall per province and categorized according to the distribution of the variables. Epidemiological data included weekly cases of reported pathogens responsible for gastroenteritis, respiratory, vector-borne and invasive infections normalized per 100 000 population. The association between extreme weather events and infectious events was determined by comparing the mean weekly incidence of the considered infectious diseases after each weather event that occurred after a given number of weeks. Very low temperatures were associated with higher incidences of influenza and parainfluenza viruses, Mycoplasma pneumoniae, rotavirus and invasive Streptococcus pneumoniae and Streptococcus pyogenes infections, whereas very high temperatures were associated with higher incidences of Escherichia coli, Salmonella spp., Shigella spp., parasitic gastroenteritis and Borrelia burgdorferi infections. Very heavy rainfall was associated with a higher incidence of respiratory syncytial virus, whereas very low rainfall was associated with a lower incidence of adenovirus gastroenteritis. This work highlights not only the relationship between temperature or rainfall and infectious diseases but also the most extreme weather events that have an individual influence on their incidence. These findings could be used to develop adaptation and mitigation strategies.

Inequities in the Impacts of Hurricanes and Other Extreme Weather Events for Cancer Survivors.

In this minireview, we examine the impacts of hurricanes and other extreme weather events on cancer survivors, focusing on structural and social determinants of health. We briefly explore influences on biological, psychosocial, and behavioral outcomes and discuss risk and resilience factors in cancer survivorship during and after hurricanes. Our goal is to inform future directions for research that can identify areas in which we can most efficiently improve cancer outcomes and inform changes in health systems, clinical practice, and public health policies. This timely minireview provides researchers and clinicians with an overview of challenges and opportunities for improving disaster preparedness and response for cancer survivors.

Presentation Rates for Acute Pharyngitis in the Emergency Room Are Influenced by Extreme Weather Events.

OBJECTIVE: Extreme weather events are becoming more prevalent with the increasing pace of climate change. These events negatively impact human health and put considerable strain on health care resources, including emergency departments. Within otolaryngology, acute pharyngitis is a common reason for emergency room visits (ERV). Therefore, we aimed to investigate the impact of extreme meteorological conditions on ERV rates related to acute pharyngitis. STUDY DESIGN: Retrospective time-series study. SETTING: ERVs related to acute pharyngitis (n = 1511) were identified at a tertiary care hospital in Vienna, Austria, between 2015 and 2018. METHODS: The effects of single-day and prolonged (3-day) extreme weather events on ERVs were analyzed using a distributed lag nonlinear model. Relative risk (RR) and cumulative relative risk (cRR) were calculated over a lag period of 14 days. RR refers to the risk for pharyngitis-related ERV at extreme conditions (1st, 5th, 95th, or 99th percentile) compared to the risk at median conditions. RESULTS: Same-day RR (lag0) was elevated more than 3-fold after prolonged extremely low mean temperatures (P = .028). Furthermore, same-day RR after single-day and prolonged extremely high relative humidity was elevated by 51% (P = .024) and 46% (P = .036), respectively. Significant delayed effects on cRR were observed for extreme mean temperatures, relative humidity, and mean wind speeds within 8 days and for extreme atmospheric pressure within 14 days. CONCLUSION: Extreme weather events impact ERV rates for acute pharyngitis. Extremely low temperatures, high relative humidity, high atmospheric pressure, and low and high wind speeds were risk-promoting factors.

Extreme weather events as an important factor for the evolution of plastisphere but not for the degradation process.

Marine plastics, with their negative effects on marine life and the human health, have been recently recognized as a new niche for the colonization and development of marine biofilms. Members of the colonizing communities could possess the potential for plastic biodegradation. Thus, there is an urgent need to characterize these complex and geographically variable communities and elucidate the functionalities. In this work, we characterize the fungal and bacterial colonizers of 5 types of plastic films (High Density Polyethylene, Low Density Polyethylene, Polypropylene, Polystyrene and Polyethylene Terepthalate) over the course of a 242-day incubation in the south-eastern Mediterranean and relate them to the chemical changes observed on the surface of the samples via ATR-FTIR. The 16s rRNA and ITS2 ribosomal regions of the plastisphere communities were sequenced on four time points (35, 152, 202 and 242 days). The selection of the time points was dictated by the occurrence of a severe storm which removed biological fouling from the surface of the samples and initiated a second colonization period. The bacterial communities, dominated by Proteobacteria and Bacteroidetes, were the most variable and diverse. Fungal communities, characterized mainly by the presence of Ascomycota, were not significantly affected by the storm. Neither bacterial nor fungal community structure were related to the polymer type acting as substrate, while the surface of the plastic samples underwent weathering of oscillating degrees with time. This work examines the long-term development of Mediterranean epiplastic biofilms and is the first to examine how primary colonization influences the microbial community re-attachment and succession as a response to extreme weather events. Finally, it is one of the few studies to examine fungal communities, despite them containing putative plastic degraders.

How does trauma secondary to unexpected extreme weather affect orthopaedic surgery departments? An epidemiological study on the Filomena snowstorm.

INTRODUCTION: Trauma secondary to extreme weather events may heavily impact the normal activity of orthopaedic surgery departments, especially in places not prepared to deal with them. The Filomena snowstorm, which happened in January 2021, has been one of the greatest snowstorms ever in Spain. During it, the constant influx of trauma patients made the Orthopaedic Emergencies Department (OED) to collapse. The primary objective of this study was to describe the orthopaedic injuries and changes in fracture's epidemiology observed during this exceptional period. Secondary objectives were to analyse the collected variables in order to minimize the future impact of these unexpected extreme weather events. MATERIALS AND METHODS: Retrospective cohort study between patients that came to the OED during the snowstorm (Filomena group) and those who came on the same period of the previous year (Control group). The following data were collected: age, sex, injury location, injury mechanism, diagnosis, AO/OTA fracture classification, treatment type (conservative vs surgical) and delay to surgical treatment. RESULTS: A total of 1237 patients were included in total, 655 patients from the Filomena group and 582 from the Control group. One in two patients in the Filomena group sustained a fracture (50.7% vs 23.2%). The most frequent diagnosis on the Filomena group was distal radius fracture (16.2%), five times more frequent than in the Control group (3.4%). A significant increment was also observed in the incidence of ankle (21.7%) and proximal humerus (33%) fractures. In Filomena, surgically treated fractures increased by 168%, being more severe, as C-type fractures were more prevalent (23% vs 13%). Mean delay to surgery was 6.78 days during the snowstorm. CONCLUSION: Unexpected snowstorms entail an exponential rise in orthopaedic care demand and OED pressures. A significant increment in orthopaedic trauma surgery, up to 168% more, particularly distal radius, proximal humerus and ankle fractures it is to be expected, which will imply elective surgery cancellation, damaging patients and increasing costs.

Vitamin D in pregnant women from extreme areas of latitude: review from midwifery / Vitamina D en gestantes en zonas extremas: revisión desde la matronería

Insufficient vitamin D levels occur in 88.1% of the worlds population, which constitutes a global public health problem. We analyzed vitamin D deficiency and suggested vitamin D supplementation in the perinatal health of pregnant women living in geographical areas higher than 40° south-north latitude according to reviews from the last three decades and identifying midwives role. The methodology used was a qualitative systematic review of full text studies, conducted in geographical areas higher than 40°N and 40°S. Descriptors such as: "deficiency", "vitamin D", "pregnancy", "causes", "perinatal outcomes" and "supplementation", and their respective descriptors in Spanish. The matrices were tabulated according to the modified PRISMA. Eight studies were obtained in English from the Northern Hemisphere only, mostly with good quality evidence and related to the role of midwifing according to the expert round. The results showed risks such as: origin of the pregnant woman, ethnicity, low sun exposure, obesity, socioeconomic status, and perinatal risks. No studies were found in pregnant women from the Southern Hemisphere or related to the role of the midwife in this area. In conclusion, midwifery should considerer the social determinants of vitamin D deficiency in pregnant women, especially those in extreme southern areas where incorporation of supplementation are suggested as a public policy.

Los niveles insuficientes de vitamina D se dan en el 88,1% de la población mundial, lo que constituye un problema de salud pública global. Se analizó la deficiencia y la sugerencia de suplementación de vitamina D en la salud perinatal de las gestantes residentes en áreas geográficas de latitud 40° sur-norte según revisiones de las últimas tres décadas identificando el rol de la matrona. La metodología utilizada fue una revisión sistemática cualitativa de estudios a texto completo, realizados en áreas geográficas mayores al paralelo 40°N y 40°S. Descriptores como: "deficiencia", "vitamina D", "embarazo", "causas", "resultados perinatales" y "suplementación", y sus respectivos descriptores en español. Las matrices se tabularon según el PRISMA modificado. Se obtuvo ocho estudios en inglés pertenecientes sólo al hemisferio norte, la mayoría con buena calidad de evidencia. Los resultados arrojaron factores como origen de la embarazada, etnia, baja exposición al sol, obesidad, nivel socioeconómico y riesgos perinatales. No se encontraron estudios en mujeres embarazadas del hemisferio sur o relacionados con el papel de la matrona. En conclusión, desde el ejercicio de la matronería se deben considerar los determinantes sociales de las mujeres embarazadas especialmente de zonas extremas del sur donde se sugiere investigación experimental e incorporación de la suplementación como política pública.

Honey bee colony loss linked to parasites, pesticides and extreme weather across the United States.

Honey bee (Apis mellifera) colony loss is a widespread phenomenon with important economic and biological implications, whose drivers are still an open matter of investigation. We contribute to this line of research through a large-scale, multi-variable study combining multiple publicly accessible data sources. Specifically, we analyzed quarterly data covering the contiguous United States for the years 2015-2021, and combined open data on honey bee colony status and stressors, weather data, and land use. The different spatio-temporal resolutions of these data are addressed through an up-scaling approach that generates additional statistical features which capture more complex distributional characteristics and significantly improve modeling performance. Treating this expanded feature set with state-of-the-art feature selection methods, we obtained findings that, nation-wide, are in line with the current knowledge on the aggravating roles of Varroa destructor and pesticides in colony loss. Moreover, we found that extreme temperature and precipitation events, even when controlling for other factors, significantly impact colony loss. Overall, our results reveal the complexity of biotic and abiotic factors affecting managed honey bee colonies across the United States.

Extreme Weather Disrupts Care, Widens Inequities.

Climate-related catastrophes like the recent floods in Eastern Kentucky are disrupting access to cancer care, increasing people's risk of exposure to carcinogens, and further exacerbating long-standing disparities in cancer care and survival.

Health impact assessment of Delhi's outdoor workers exposed to air pollution and extreme weather events: an integrated epidemiology approach.

This study is an assessment of the effects of outdoor air pollution and extreme weather events on the health of outdoor workers in Delhi, including auto rickshaw drivers, street vendors, and sweepers. To carry it out, a cross-sectional and perception-based epidemiological research design was used, and the primary tool used for data collection was a questionnaire. Two hundred twenty-eight people participated in the survey, and a pulmonary function test (PFT) was performed on 63 participants. Most of the respondents from different occupational groups complained about headaches/giddiness, nausea, and muscular cramps during extreme heat events due to the physically demanding nature of their jobs in the outdoor environment. Furthermore, autorickshaw drivers reported the highest prevalence of ophthalmic symptoms, such as eye redness (44%) and eye irritation (36%). In comparison, vendors reported a higher prevalence of headaches (43%) and eye redness (40%) due to increased exposure to vehicular emissions. Among sweepers, musculoskeletal problems like joint pain (40%), backache (38%), and shoulder pain (35%) were most prevalent due to occupation-related ergonomic factors. In addition, the majority of autorickshaw drivers (47%), vendors (47%), and sweepers (48%) considered that air quality had a severe impact on their health. PFT results showed that most respondents had restricted lung function. Binary logistic regression analysis showed that lung function impairment had a significant association with smoking (p = 0.023) and age (0.019). The odds ratio for smoking, which was around 4, indicated that respondents who smoked had a nearly four times greater risk of developing lung impairment. The study also highlighted the need for using personal protective equipment and developing guidelines to reduce their exposure level.

Extreme winter weather: A force to be remembered in dermatopathology.

It is important for the dermatopathologist to be adept in differentiating tissue artifacts from normal tissue variants and pathologies. Numerous tissue artifacts have been described to date; however, once we are familiar with the common artifacts that appear in our practice, we may not immediately recognize other confounders. For example, dermatopathologists in more temperate regions of the country may not be familiar with freezing artifact. In this case series, we present three common diagnoses in dermatopathology that were obscured by the extreme winter weather that severely impacted the Southern United States in February 2021 and discuss methods to prevent these artifacts.

Impact of extreme weather conditions on healthcare provision in urban Ghana.

Extreme weather events pose significant threats to urban health in low- and middle-income countries, particularly in sub-Saharan Africa where there are systemic health challenges. This paper investigates health system vulnerabilities associated with flooding and extreme heat, along with strategies for resilience building by service providers and community members, in Accra and Tamale, Ghana. We employed field observations, rainfall records, temperature measurements, and semi-structured interviews in health facilities within selected areas of both cities. Results indicate that poor building conditions, unstable power supply, poor sanitation and hygiene, and the built environment reduce access to healthcare for residents of poor urban areas. Health facilities are sited in low-lying areas with poor drainage systems and can be 6 °C warmer at night than reported by official records from nearby weather stations. This is due to a combination of greater thermal inertia of the buildings and the urban heat island effect. Flooding and extreme heat interact with socioeconomic conditions to impact physical infrastructure and disrupt community health as well as health facility operations. Community members and health facilities make infrastructural and operational adjustments to reduce extreme weather stress and improve healthcare provision to clients. These measures include: mobilisation of residents to clear rubbish and unclog drains; elevating equipment to protect it from floods; improving ventilation during extreme heat; and using alternative power sources for emergency surgery and storage during outages. Stakeholders recommend additional actions to manage flood and heat impacts on health in their cities, such as, improving the capacity of drainage systems to carry floodwaters, and routine temperature monitoring to better manage heat in health facilities. Finally, more timely and targeted information systems and emergency response plans are required to ensure preparedness for extreme weather events in urban areas.