Floods and cause-specific mortality in the UK: a nested case-control study.

BACKGROUND: Floods are the most frequent weather-related disaster, causing significant health impacts worldwide. Limited studies have examined the long-term consequences of flooding exposure. METHODS: Flood data were retrieved from the Dartmouth Flood Observatory and linked with health data from 499,487 UK Biobank participants. To calculate the annual cumulative flooding exposure, we multiplied the duration and severity of each flood event and then summed these values for each year. We conducted a nested case-control analysis to evaluate the long-term effect of flooding exposure on all-cause and cause-specific mortality. Each case was matched with eight controls. Flooding exposure was modelled using a distributed lag non-linear model to capture its nonlinear and lagged effects. RESULTS: The risk of all-cause mortality increased by 6.7% (odds ratio (OR): 1.067, 95% confidence interval (CI): 1.063-1.071) for every unit increase in flood index after confounders had been controlled for. The mortality risk from neurological and mental diseases was negligible in the current year, but strongest in the lag years 3 and 4. By contrast, the risk of mortality from suicide was the strongest in the current year (OR: 1.018, 95% CI: 1.008-1.028), and attenuated to lag year 5. Participants with higher levels of education and household income had a higher estimated risk of death from most causes whereas the risk of suicide-related mortality was higher among participants who were obese, had lower household income, engaged in less physical activity, were non-moderate alcohol consumers, and those living in more deprived areas. CONCLUSIONS: Long-term exposure to floods is associated with an increased risk of mortality. The health consequences of flooding exposure would vary across different periods after the event, with different profiles of vulnerable populations identified for different causes of death. These findings contribute to a better understanding of the long-term impacts of flooding exposure.

Community-wide Mortality Rates in Beijing, China, During the July 2012 Flood Compared with Unexposed Periods.

BACKGROUND: On 21-22 July 2012, Beijing, China, suffered its heaviest rainfall in 60 years. Two studies have estimated the fatality toll of this disaster using a traditional surveillance approach. However, traditional surveillance can miss disaster-related deaths, including a substantial number of deaths from natural causes triggered by disaster exposure. Here, we investigated community-wide mortality risk during this flood compared with rates in unexposed reference periods. METHODS: We compared community-wide mortality rates on the peak flood day and the four following days to seasonally matched nonflood days in previous years (2008-2011), controlling for potential confounders, to estimate the relative risks (RRs) of daily mortality among Beijing residents associated with this flood. RESULTS: On 21 July 2012, the flood-associated RRs were 1.34 (95% confidence interval = 1.11, 1.61) for all-cause, 1.37 (1.01, 1.85) for circulatory, and 4.40 (2.98, 6.51) for accidental mortality, compared with unexposed periods. We observed no evidence of increased risk of respiratory mortality. For the flood period of 21-22 July 2012, we estimated a total of 79 excess deaths among Beijing residents; by contrast, only 34 deaths were reported among Beijing residents in a study using a traditional surveillance approach. CONCLUSIONS: To our knowledge, this is the first study analyzing community-wide changes in mortality rates during the 2012 flood in Beijing and one of the first to do so for any major flood worldwide. This study offers critical evidence on flood-related health impacts, as urban flooding is expected to become more frequent and severe in China.

Glacier protection laws: Potential conflicts in managing glacial hazards and adapting to climate change.

The environmental, socioeconomic and cultural significance of glaciers has motivated several countries to regulate activities on glaciers and glacierized surroundings. However, laws written to specifically protect mountain glaciers have only recently been considered within national political agendas. Glacier Protection Laws (GPLs) originate in countries where mining has damaged glaciers and have been adopted with the aim of protecting the cryosphere from harmful activities. Here, we analyze GPLs in Argentina (approved) and Chile (under discussion) to identify potential environmental conflicts arising from law restrictions and omissions. We conclude that GPLs overlook the dynamics of glaciers and could prevent or delay actions needed to mitigate glacial hazards (e.g. artificial drainage of glacial lakes) thus placing populations at risk. Furthermore, GPL restrictions could hinder strategies (e.g. use of glacial lakes as reservoirs) to mitigate adverse impacts of climate change. Arguably, more flexible GPLs are needed to protect us from the changing cryosphere.

Defining Population Health Vulnerability Following an Extreme Weather Event in an Urban Pacific Island Environment: Honiara, Solomon Islands.

Extreme weather events are common and increasing in intensity in the southwestern Pacific region. Health impacts from cyclones and tropical storms cause acute injuries and infectious disease outbreaks. Defining population vulnerability to extreme weather events by examining a recent flood in Honiara, Solomon Islands, can help stakeholders and policymakers adapt development to reduce future threats. The acute and subacute health impacts following the April 2014 floods were defined using data obtained from hospitals and clinics, the Ministry of Health and in-country World Health Organization office in Honiara. Geographical information system (GIS) was used to assess morbidity and mortality, and vulnerability of the health system infrastructure and households in Honiara. The April flash floods were responsible for 21 acute deaths, 33 injuries, and a diarrhea outbreak that affected 8,584 people with 10 pediatric deaths. A GIS vulnerability assessment of the location of the health system infrastructure and households relative to rivers and the coastline identified 75% of the health infrastructure and over 29% of Honiara's population as vulnerable to future hydrological events. Honiara, Solomon Islands, is a rapidly growing, highly vulnerable urban Pacific Island environment. Evaluation of the mortality and morbidity from the April 2014 floods as well as the infectious disease outbreaks that followed allows public health specialists and policy makers to understand the health system and populations vulnerability to future shocks. Understanding the negative impacts natural disaster have on people living in urban Pacific environments will help the government as well as development partners in crafting resilient adaptation development.

Association between Floods and Acute Cardiovascular Diseases: A Population-Based Cohort Study Using a Geographic Information System Approach.

BACKGROUND: Floods represent a serious threat to human health beyond the immediate risk of drowning. There is few data on the potential link between floods and direct consequences on health such as on cardiovascular health. This study aimed to explore the impact of one of the worst floods in the history of Quebec, Canada on acute cardiovascular diseases (CVD). METHODS: A cohort study with a time series design with multiple control groups was built with the adult population identified in the Quebec Integrated Chronic Disease Surveillance System. A geographic information system approach was used to define the study areas. Logistic regressions were performed to compare the occurrence of CVD between groups. RESULTS: The results showed a 25%-27% increase in the odds in the flooded population in spring 2011 when compared with the population in the same area in springs 2010 and 2012. Besides, an increase up to 69% was observed in individuals with a medical history of CVD. CONCLUSION: Despite interesting results, the association was not statistically significant. A possible explanation to this result can be that the population affected by the flood was probably too small to provide the statistical power to answer the question, and leaves open a substantial possibility for a real and large effect.

Assessing climate change and health vulnerability at the local level: Travis County, Texas.

We created a measure to help comprehend population vulnerability to potential flooding and excessive heat events using health, built environment and social factors. Through principal component analysis (PCA), we created non-weighted sum index scores of literature-reviewed social and built environment characteristics. We created baseline poor health measures using 1999-2005 age-adjusted cardiovascular and combined diabetes and hypertension mortality rates to correspond with social-built environment indices. We mapped US Census block groups by linked age-adjusted mortality and a PCA-created social-built environment index. The goal was to measure flooding and excessive heat event vulnerability as proxies for population vulnerability to climate change for Travis County, Texas. This assessment identified communities where baseline poor health, social marginalisation and built environmental impediments intersected. Such assessments may assist targeted interventions and improve emergency preparedness in identified vulnerable communities, while fostering resilience through the focus of climate change adaptation policies at the local level.

Impactos de desastres socioambientais em saúde pública: estudos dos casos dos Estados de Santa Catarina em 2008 e Pernambuco em 2010 / /Impacts of socio-environmental disasters on public health: studies of scenarios in the Brazilian states of Santa Catarina in 2008 and Pernambuco in 2010 / /Impactos de los desastres socioambientales en la salud pública: estudio de los casos de los estados brasileños de Santa Catarina en 2008 y Pernambuco en 2010

Eventos como inundações e movimentos de massa podem provocar desastres, afetando amplamente a saúde pública brasileira. Além de mortes, traumas e lesões, podem ocorrer danificação de estações de tratamento de água, postos de saúde e hospitais, comprometimento de equipamentos e estoque de remédios, epidemias e proliferação de doenças, bem como danos psicossociais. Neste artigo, com o objetivo de identificar e analisar características pré e pós-impacto relacionadas à saúde pública, são estudados dois cenários: inundações ocorridas em Santa Catarina, em 2008, e em Pernambuco, em 2010. Procuramos analisar as condições socioambientais e de cobertura de serviços de saúde prévias e os danos pós-impacto em municípios que decretaram estado de calamidade pública. Para caracterizar a vulnerabilidade socioambiental, foram utilizados dados do Instituto Brasileiro de Geografia e Estatística (IBGE) do Serviço Geológico do Brasil (CPRM), da Secretaria Nacional de Proteção e Defesa Civil (Sedec) e do Sistema Único de Saúde (Datasus). Encontramos grandes diferenças entre os dois estados, principalmente nos indicadores sociais, mas os efeitos das inundações foram severos para ambos, incluindo maior número de óbitos em Santa Catarina, estado com alto índice de desenvolvimento humano e menores índices de pobreza. Estes resultados evidenciam a necessidade de inclusão do tema saúde pública em todas as etapas do gerenciamento do risco de desastres...

Events such as floods and landslides can cause disasters that affect Brazilian public health extensively. Impacts include traumas and injuries, damage to water treatment plants and hospitals, disruption of equipment and medicine supply, epidemics and the spread of diseases, as well as lasting psychosocial damage. In this article, we study disaster scenarios in municipalities from two Brazilian states that had declared a state of public calamity as a result of flooding - Santa Catarina (2008) and Pernambuco (2010). The object was to identify and analyze the impacts of these disasters on social and environmental conditions as well as on the coverage of public health. To this purpose, the before and after disaster situation in affected municipalities was analyzed. To characterize socio-environmental vulnerability, we used data from the Brazilian Institute of Geography and Statistics (IBGE), the Brazilian Geological Survey (CPRM), the National Protection and Civil Defense Secretariat (SEDEC) and the Health Ministry. Although there are expressive differences between the two investigated states, especially in regards to social indicators, both of them suffered strong impacts after floods. Despite a higher human development index and low levels of poverty, Santa Catarina suffered more deaths than Pernambuco. Altogether, results demonstrate the need to include public health issues in all steps of disaster risk management...