Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 141
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Mol Cell ; 77(3): 669-680.e4, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32004470

RESUMO

Corticotropin-releasing factor (CRF) and the three related peptides urocortins 1-3 (UCN1-UCN3) are endocrine hormones that control the stress responses by activating CRF1R and CRF2R, two members of class B G-protein-coupled receptors (GPCRs). Here, we present two cryoelectron microscopy (cryo-EM) structures of UCN1-bound CRF1R and CRF2R with the stimulatory G protein. In both structures, UCN1 adopts a single straight helix with its N terminus dipped into the receptor transmembrane bundle. Although the peptide-binding residues in CRF1R and CRF2R are different from other members of class B GPCRs, the residues involved in receptor activation and G protein coupling are conserved. In addition, both structures reveal bound cholesterol molecules to the receptor transmembrane helices. Our structures define the basis of ligand-binding specificity in the CRF receptor-hormone system, establish a common mechanism of class B GPCR activation and G protein coupling, and provide a paradigm for studying membrane protein-lipid interactions for class B GPCRs.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32013180

RESUMO

Epidemiological evidence has shown an association between exposure to high temperatures and occupational injuries, an issue gaining importance with environmental change. The aim of this study was to better understand contributing risk factors and preventive actions based on personal experiences. Interviews were conducted with 21 workers from five Australian states using a critical phenomenological approach to capture the lived experiences of participants, whilst exploring contextual factors that surround these experiences. Two case studies are presented: a cerebrovascular injury and injuries among seasonal horticulture workers. Other accounts of heat-related injuries and heat stress are also presented. Risk factors were classified as individual, interpersonal and organizational. In terms of prevention, participants recommended greater awareness of heat risks and peer-support for co-workers. Adding value to current evidence, we have provided new insights into the etiology of the health consequences of workplace heat exposure with workers identifying a range of influencing factors, prevention measures and adaptation strategies. Underpinning the importance of these are future climate change scenarios, suggesting that extended hot seasons will lead to increasing numbers of workers at risk of heat-stress and associated occupational injuries.

4.
Environ Int ; 136: 105486, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31991239

RESUMO

BACKGROUND: Health impacts of high temperatures on hospital emergency department visits (EDVs) have been less reported, especially from developing countries. OBJECTIVES: To investigate high temperature-EDVs relationship in various regions with different climatic characteristics, to explore the regional differences, to identify vulnerable populations, and to provide scientific evidence for climate change adaptation strategies in China. METHODS: Daily data on weather, air pollution and EDVs were collected from 18 sites in China from June to August during 2014-2017. A quasi-Poisson generalized additive regression model was applied to examine the high temperature-EDVs relationship in each site. Site-specific risks of EDVs were pooled using a random effect meta-analysis model. Stratified analyses were performed by gender, age-groups, cause-specific EDVs and regions. Attributable fractions of EDVs due to high temperatures were calculated in different regions. RESULTS: 1 °C increase in daily mean temperature was associated with 1.07% (95% CI, 0.46-1.67%) increase in EDVs across all study regions. The negative health effects from high temperatures were worse for the people living in southern China, in subtropical monsoon climate zone or in counties, with percentage change of 1.96% (95% CI, 0.92-3.02%), 1.35% (95% CI, 0.95-1.76%) and 1.41% (95% CI, 0.48-2.34%), respectively. People under 18 were more vulnerable to high temperatures. Exposure to high temperatures increased EDVs risks from endocrine, respiratory, and digestive diseases and injury. The attributable fraction due to high temperatures was 8.64% for overall EDVs, 11.70% for the people living in southern China, 10.80% for people living in subtropical monsoon climate zone and 12.65% for the county population. CONCLUSIONS: Exposure to high temperatures resulted in extra burden to China's already overloaded hospital emergency departments. More resources are needed to meet increasing demands and effective preventative measurements are warranted to tackle such a challenge. Further studies should pay more attention to both heat and cold-related EDVs risks and socioeconomic cost for better climate change adaptation.

5.
Acta Trop ; 204: 105337, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31930962

RESUMO

Although Nepal has been identified as a country highly vulnerable to adverse health and socioeconomic impacts arising from climate change, extant research on climate sensitive infectious diseases has yet to develop the evidence base to adequately address these threats. In this opinion paper we identify and characterise basic requirements that are hindering the progress of climate change and infectious disease research in Nepal. Our opinion is that immediate attention should be given to strengthening Nepal's public health surveillance system, promoting inter-sectoral collaboration, improving public health capacity, and enhancing community engagement in disease surveillance. Moreover, we advocate for greater technical support of public health researchers, and data sharing among data custodians and epidemiologists/researchers, to generate salient evidence to guide relevant public health policy formulation aimed at addressing the impacts of climate change on human health in Nepal. International studies on climate variability and infectious diseases have clearly demonstrated that climate sensitive diseases, namely vector-borne and food/water-borne diseases, are sensitive to climate variation and climate change. This research has driven the development and implementation of climate-based early warning systems for preventing potential outbreaks of climate-sensitive infectious diseases across many European and African countries. Similarly, we postulate that Nepal would greatly benefit from a climate-based early warning system, which would assist in identification or prediction of conditions suitable for disease emergence and facilitate a timely response to reduce mortality and morbidity during epidemics.

6.
Int J Hyg Environ Health ; 223(1): 199-206, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31537454

RESUMO

INTRODUCTION: This study was undertaken to assess the effect of climate variability on diarrhoeal disease burden among children under 5 years of age living in Kathmandu, Nepal. The researchers sought to predict future risk of childhood diarrhoea under different climate change scenarios to advance the evidence base available to public health decision-makers, and the Nepalese infection control division, in planning for climate impacts. METHODS: A time series study was conducted using the monthly case count of diarrhoeal disease (2003-2013) among children under 5 years of age living in Kathmandu, Nepal. A quasi Poisson generalised linear equation with distributed lag linear model was fitted to estimate the lagged effect of monthly maximum temperature and rainfall on childhood diarrhoea. The environmental framework of comparative risk assessment was used to assess the environmental burden of diarrhoea within this population. RESULTS: A total of 219,774 cases of diarrhoeal disease were recorded during the study period with a median value of 1286 cases per month. The results of a regression model revealed that the monthly count of diarrhoea cases increased by 8.1% (RR: 1.081; 95% CI: 1.02-1.14) per 1 °C increase in maximum temperature above the monthly average recorded within that month. Similarly, rainfall was found to have significant effect on the monthly diarrhoea count, with a 0.9% (RR; 1.009; 95% CI: 1.004-1.015) increase in cases for every 10 mm increase in rainfall above the monthly cumulative value recorded within that month. It was estimated that 7.5% (95% CI: 2.2%-12.5%) of the current burden of diarrhoea among children under 5 years of age could be attributed to climatic factors (maximum temperature), and projected that 1357 (UI: 410-2274) additional cases of childhood diarrhoea could be climate attributable by the year 2050 under low-risk scenario (0.9 °C increase in maximum temperature). CONCLUSION: It is estimated that there exists a significant association (p < 0.05) between childhood diarrhoea and an increase in maximum temperature and rainfall in Kathmandu, Nepal. The findings of this study may inform the conceptualization and design of early warning systems for the prediction and control of childhood diarrhoea, based upon the observed pattern of climate change in Kathmandu.

7.
Environ Health ; 18(1): 98, 2019 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-31771610

RESUMO

BACKGROUND: Very few studies have focused on the relationship between ambient apparent temperature (AT) and admission of mental and behaviour disorders (MDs). Therefore, a time-series study was conducted in Yancheng, China, to explore the effects of AT on the daily emergency admissions of patients with MDs over the period of 2014-17. METHODS: A quasi-Poisson generalized linear model (GLM) combined with a distributed lag non-linear model (DLNM) was adopted to explore the associations after adjusting for time trend, day of the week, humidity, sunshine duration, rainfall, holidays and air pollutants. In the subgroup analysis, the modification effects of age and sex were also examined. RESULTS: Overall, 8438 cases of MDs emergency admissions were identified. With the apparent temperature with the minimum number of admissions (- 3.4 °C) serving as a reference, a positive correlation emerged between high AT and daily emergency admissions of patients with MDs in Yancheng, China, with the lagged effect of 1 to 5 days. The subgroup analysis demonstrated a positive relationship between AT and MDs emergency admissions among males and individuals younger than 45 years old, with no lagged effect. CONCLUSIONS: The results will provide important scientific evidence for mental health policy-makers and practitioners for possible intervention, especially among the vulnerable populations.

8.
J Phys Chem Lett ; 10(22): 7100-7106, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31682127

RESUMO

The underlying hole-transfer mechanism in high-efficiency OSC bulk heterojunctions based on acceptor-donor-acceptor (A-D-A) nonfullerene acceptors (NFAs) remains unclear. Herein, we study the hole-transfer process between copolymer donor J91 and five A-D-A NFAs with different highest occupied molecular orbital energy offsets (ΔEH) (0.05-0.42 eV) via ultrafast optical spectroscopies. Transient absorption spectra reveal a rapid hole-transfer rate with small ΔEH, suggesting that a large energy offset is not required to overcome the exciton binding energy. Capacitance-frequency spectra and time-resolved photoluminescence spectra confirm the delocalization of an A-D-A-structured acceptor exciton with weak binding energy. Relative to the hole-transfer rate, hole-transfer efficiency is the key factor affecting device performance. We propose that holes primarily stem from weakly bound acceptor exciton dissociation, revealing a new insight into the hole-transfer process in A-D-A NFA-based OSCs.

9.
Artigo em Inglês | MEDLINE | ID: mdl-31706842

RESUMO

BACKGROUND: The burden of Q fever on at risk population groups in Australia is substantial, despite the availability of a vaccine. Our objectives were to: (a) describe the epidemiology of notified Q fever cases in South Australia (SA), (b) identify if Q fever infection is associated with occupational exposure, and (c) detect the possible spatial and temporal association of Q fever with livestock density. METHODS: Laboratory confirmed Q fever notifications from January 2007 to December 2017 were obtained from the SA Health Department. Q fever notification rates and incidence rate ratios were calculated for gender, notification year, age group, occupation category, and primary exposure suburb. Spatial mapping and analysis of Q fever notifications was undertaken using livestock data, and abattoirs and saleyards located in SA. RESULTS: During the study period 167 Q fever cases were notified. Males predominated (72%), with higher rates observed in the 21-40year age group (1.52/100,000), and eight cases (5%) reported prior Q fever vaccination. Most frequently listed occupation categories were livestock farmers (35%), and abattoir workers (20%), but in 15% of cases, there was no known occupational risk. Highest notifications (22%) were recorded in the suburb containing an abattoir. The number of goats, cattle and sheep was not associated with Q fever notifications. CONCLUSIONS: Q fever predominance among males in their twenties and thirties may indicate vaccination under-coverage among the young workforce possibly due to high turnover of workers. Q fever among those vaccinated raises concerns about vaccine efficacy or potential waning immunity. Our findings are consistent with previous studies highlighting abattoir workers as a high-risk occupational group because of its transient workforce, and low vaccination coverage. Q fever notifications in SA may be unrelated with spatial livestock density. Further One Health research involving veterinary, public health and environmental data is required.

10.
Med J Aust ; 211(11): 490-491.e21, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31722443

RESUMO

The MJA-Lancet Countdown on health and climate change was established in 2017 and produced its first Australian national assessment in 2018. It examined 41 indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. It found that, overall, Australia is vulnerable to the impacts of climate change on health, and that policy inaction in this regard threatens Australian lives. In this report we present the 2019 update. We track progress on health and climate change in Australia across the same five broad domains and many of the same indicators as in 2018. A number of new indicators are introduced this year, including one focused on wildfire exposure, and another on engagement in health and climate change in the corporate sector. Several of the previously reported indicators are not included this year, either due to their discontinuation by the parent project, the Lancet Countdown, or because insufficient new data were available for us to meaningfully provide an update to the indicator. In a year marked by an Australian federal election in which climate change featured prominently, we find mixed progress on health and climate change in this country. There has been progress in renewable energy generation, including substantial employment increases in this sector. There has also been some progress at state and local government level. However, there continues to be no engagement on health and climate change in the Australian federal Parliament, and Australia performs poorly across many of the indicators in comparison to other developed countries; for example, it is one of the world's largest net exporters of coal and its electricity generation from low carbon sources is low. We also find significantly increasing exposure of Australians to heatwaves and, in most states and territories, continuing elevated suicide rates at higher temperatures. We conclude that Australia remains at significant risk of declines in health due to climate change, and that substantial and sustained national action is urgently required in order to prevent this.

11.
ACS Comb Sci ; 21(12): 833-842, 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31663716

RESUMO

The combinatorial materials chip approach is vastly superior to the conventional one that characterizes one sample at a time in the efficiency of composition-phase map construction. However, the resolution of its high-throughput characterization and the correct rate of automated composition-phase mapping are often affected by inherent experimental limitations and imperfect automated analyses, respectively. Therefore, effective data preprocessing and refined automated analysis methods are required to automatically process huge amounts of experiment data to score a higher correct rate. In this work, the pixel-by-pixel structural and compositional characterization of the Fe-Cr-Ni combinatorial materials chip annealed at 750 °C was performed by microbeam X-ray at a synchrotron light source and by electron probe microanalysis, respectively. The severe baseline drift and system noise in the X-ray diffraction patterns were successfully eliminated by the three-step automated preprocessing (baseline drift removal, noise elimination, and baseline correction) proposed, which was beneficial to the subsequent quantitative analysis of the patterns. Through the injection of human experience, hierarchy clustering analyses, based on three dissimilarity measures (the cosine, Pearson correlation coefficient, and Jenson-Shannon divergence), were further accelerated by the simplified vectorization of the preprocessed X-ray diffraction patterns. As a result, a correct rate of 91.15% was reached for the whole map built automatically in comparison with the one constructed manually, which confirmed that the present data processing could assist humans to improve and expedite the processing of X-ray diffraction patterns and was feasible for composition-phase mapping. The constructed maps were generally consistent with the corresponding isothermal section of the Fe-Cr-Ni ternary alloy system in the ASM Alloy Phase Diagram Database except the inexistence of the σ phase under insufficient annealing.

12.
Sci Total Environ ; 687: 898-906, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31412493

RESUMO

BACKGROUND: The thermal working environment can have direct and in-direct effects on health and safety. Ambient temperatures have been associated with an increased risk of occupational injuries but it is unknown how the relationship can vary by weather, location and climate. OBJECTIVES: To examine the relationship between ambient temperatures and work-related injury and illness compensation claims in three Australian cities: Melbourne and Perth (temperate climate) and Brisbane (subtropical climate) in order to determine how hot and cold weather influences the risk of occupational injury in Australia. METHODS: Workers' compensation claims from each city for the period 2005 to 2016 were merged with local daily weather data. A time-stratified case-crossover design combined with a distributed lag non-linear model was used to quantify the impacts of daily maximum temperature (Tmax) on the risk of work-related injuries and illnesses. RESULTS: Compared to the median maximum temperature (Tmax), extremely hot temperatures (99th percentile) were associated with a 14% (95%CI: 3-25%) increase in total workers' compensation claims in Melbourne, but there were no observed effects in Brisbane or Perth, with the exception of traumatic injuries that increased by 17% (95%CI: 3-35%) during extreme heat in Perth. For extremely low temperatures (1st percentile), there was a protective effect in Brisbane (RR 0.89; 95%CI: 0.81-0.98), while no effects were observed in Melbourne or Perth. CONCLUSION: The relationship between injury and ambient temperature appears to be variable depending on location and climate. In general, work-related injuries and illnesses appear to be more common at higher temperatures than lower temperatures. Adopting adaptation and prevention measures could reduce the social and economic burden of injury, and formulating effective measures for dealing with high temperatures should be prioritised given the predicted increase in the frequency and intensity of hot weather.


Assuntos
Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Temperatura Ambiente , Austrália , Cidades , Humanos , Local de Trabalho
13.
Sci Total Environ ; 685: 1030-1041, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31390694

RESUMO

PURPOSE: The association between meteorological variables and risk of fractures has attracted increasing attentions but remain controversial. Therefore, our main aim is to clarify the association, and also to identify possible susceptible groups. METHODS: Relevant literature was obtained through standard MeSH literature searching seven electronic databases. Because some studies expressed the association as the rate of incidence (IRR) of fractures associated with each 1 °C rise in temperature and 1% increase in relative humidity (RH), some expressed as IRR of fractures for the day with specific climatic variable versus control days, and also the association was expressed as correlations coefficients (COR) in some studies, separated meta-analyses were undertaken, with one based on IRR and another based on COR. RESULTS: A total of 24 studies were included. Results showed that each 1 °C increase was significantly associated with a 3.0% decrease in fracture risk (IRR = 0.970, 95%CI: 0.952-0.988). The day with freezing rain and snow were associated with increased risk for both the lower extremity fracture (freezing rain: IRR = 1.174, 95%CI: 1.022-1.348; snow: IRR = 1.245, 95%CI: 1.050-1.477) and the upper extremity fracture (freezing rain: IRR = 1.376, 95%CI: 1.192-1.588; snow: IRR = 1.548, 95%CI: 1.361-1.761). No significant association was detected between RH, dew, frost, fog, storm and high wind, and fracture. The COR meta-analysis showed that mean temperature (moderately), maximum temperature (moderately), rainfall (weakly) and sunlight duration (weakly) were correlated with fracture occurrence. CONCLUSION: The incidence of fractures was increased in lower temperature, the day with freezing rain, and snow. Other meteorological factors may have some effects on the incidence of fracture. The association maybe stronger for males, lower extremity fracture, and people living in Asia, subtropical zone, low-latitude, and northern hemisphere. Further studies are needed.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Conceitos Meteorológicos , Humanos
14.
Artigo em Inglês | MEDLINE | ID: mdl-31251367

RESUMO

BACKGROUND: China's capacity to control and prevent emerging and re-emerging infectious diseases is critical to the nation's population health. This study aimed to explore the capacity of Centers for Disease Control and Prevention (CDCs) in China to deal with infectious diseases now and in the future. METHODS: A survey was conducted in 2015 among 973 public health professionals at CDCs in Beijing and four provinces, to assess their capacity to deal with emerging and re-emerging infectious diseases. RESULTS: Although most professionals were confident with the current capacity of CDCs to cope with outbreaks, nearly all indicated more funding was required to meet future challenges. Responses indicated that Yunnan Province faced more challenges than Anhui, Henan and Liaoning Provinces in being completely prepared and able to deal with outbreaks. Participants aged 20-39 years were more likely than those aged 40 and over to believe strategies such as interdisciplinary and international collaborations for disease surveillance and control, would assist capacity building. CONCLUSION: The capacity of China's CDCs to deal with infectious diseases was excellent. However, findings suggest it is imperative to increase the number of skilled CDC staff, financial support, and strengthen county level staff training and health education programs.

15.
Int J Biometeorol ; 63(10): 1319-1329, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31240387

RESUMO

Few studies have examined the attributable fraction (AF) of temperature to mortality and Years of Life Lost (YLL), especially in developing countries. This study aims to explore the short-term effect of the cold and hot temperatures on the cause-specific YLL and mortality, discover the attributable contributions from the temperature variations, and identify the vulnerable populations in Weifang, China. Daily registered death information and meteorological data over the period 2010-2016 were obtained in Weifang, a northern Chinese city. Generalized additive Poisson and Gaussian regression models were used to assess the impacts of temperatures on both mortality and YLL, explore the AF of the temperature variations on mortality, after adjusting for other covariates. Both hot and cold temperatures have had significant negative impacts on cause-specific mortality counts and YLL, with heat presented an acute and short effect and the cold temperatures had delayed effects and lasted for several days. In terms of the attributable fraction calculations, the contributions from cold effects was higher than that of hot effects on non-accidental, cardiovascular, and respiratory deaths (YLL 10.88 vs. 1.23%, 19.58 vs. 1.71%, and 14.47 vs. 3.05%; mortality 13.97 vs. 1.65%, 19.20 vs. 1.59%, and 14.89 vs. 3.09%), respectively. The elderly and women and people with low education level were the most vulnerable. The findings will provide important scientific evidences and policy implications for developing adaptation strategies to reduce the adverse effect of cold and hot exposure in Weifang, in terms of resource allocation, healthcare workforce capacity building, and community health education, especially for the vulnerable groups.


Assuntos
Temperatura Baixa , Temperatura Alta , Idoso , China , Cidades , Feminino , Humanos , Mortalidade , Temperatura Ambiente
16.
Environ Res ; 173: 255-261, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30928856

RESUMO

BACKGROUND: Climate change may lead to emerging and re-emerging infectious diseases and pose public health challenges to human health and the already overloaded healthcare system. It is therefore important to review current knowledge and identify further directions in China, the largest developing country in the world. METHODS: A comprehensive literature review was conducted to examine the relationship between climate variability and infectious disease transmission in China in the new millennium. Literature was identified using the following MeSH terms and keywords: climatic variables [temperature, precipitation, rainfall, humidity, etc.] and infectious disease [viral, bacterial and parasitic diseases]. RESULTS: Fifty-eight articles published from January 1, 2000 to May 30, 2018 were included in the final analysis, including bacterial diarrhea, dengue, malaria, Japanese encephalitis, HFRS, HFMD, Schistosomiasis. Each 1 °C rise may lead to 3.6%-14.8% increase in the incidence of bacillary dysentery disease in south China. A 1 °C rise was corresponded to an increase of 1.8%-5.9% in the weekly notified HFMD cases in west China. Each 1 °C rise of temperature, 1% rise in relative humidity and one hour rise in sunshine led to an increase of 0.90%, 3.99% and 0.68% in the monthly malaria cases, respectively. Climate change with the increased temperature and irregular patterns of rainfall may affect the pathogen reproduction rate, their spread and geographical distribution, change human behavior and influence the ecology of vectors, and increase the rate of disease transmission in different regions of China. CONCLUSION: Exploring relevant adaptation strategies and the health burden of climate change will assist public health authorities to develop an early warning system and protect China's population health, especially in the new 1.5 °C scenario of the newly released IPCC special report.


Assuntos
Mudança Climática , Doenças Transmissíveis , Dengue , Exposição Ambiental , China , Humanos , Umidade , Incidência , Temperatura Ambiente
17.
J Expo Sci Environ Epidemiol ; 29(6): 821-830, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30988389

RESUMO

BACKGROUND AND AIMS: Heatwaves have potential health and safety implications for many workers, and heatwaves are predicted to increase in frequency and intensity with climate change. There is currently a lack of comparative evidence for the effects of heatwaves on workers' health and safety in different climates (sub-tropical and temperate). This study examined the relationship between heatwave severity (as defined by the Excess Heat Factor) and workers' compensation claims, to define impacts and identify workers at higher risk. METHODS: Workers' compensation claims data from Australian cities with temperate (Melbourne and Perth) and subtropical (Brisbane) climates for the years 2006-2016 were analysed in relation to heatwave severity categories (low and moderate/high severity) using time-stratified case-crossover models. RESULTS: Consistent impacts of heatwaves were observed in each city with either a protective or null effect during heatwaves of low-intensity while claims increased during moderate/high-severity heatwaves compared with non-heatwave days. The highest effect during moderate/high-severity heatwaves was in Brisbane (RR 1.45, 95% CI: 1.42-1.48). Vulnerable worker subgroups identified across the three cities included: males, workers aged under 34 years, apprentice/trainee workers, labour hire workers, those employed in medium and heavy strength occupations, and workers from outdoor and indoor industrial sectors. CONCLUSION: These findings show that work-related injuries and illnesses increase during moderate/high-severity heatwaves in both sub-tropical and temperate climates. Heatwave forecasts should signal the need for heightened heat awareness and preventive measures to minimise the risks to workers.

18.
Artigo em Inglês | MEDLINE | ID: mdl-30823481

RESUMO

Q fever, a zoonotic disease transmitted from animals to humans, is a significant public health problem with a potential for outbreaks to occur. Q fever prevention strategies should incorporate human, animal, and environmental domains. A One Health approach, which engages cross-sectoral collaboration among multiple stakeholders, may be an appropriate framework and has the underlying principles to control Q fever holistically. To assess whether components of One Health for Q fever prevention and control have been applied, a comprehensive literature review was undertaken. We found 16 studies that had practiced or recommended a One Health approach. Seven emerging themes were identified: Human risk assessment, human and animal serology, integrated human⁻animal surveillance, vaccination for at-risk groups, environmental management, multi-sectoral collaboration, and education and training. Within the multi-sectoral theme, we identified five subthemes: Policy and practice guidelines, information sharing and intelligence exchange, risk communication, joint intervention, and evaluation. One Health practices varied between studies possibly due to differences in intercountry policy, practice, and feasibility. However, the key issue of the need for multi-sectoral collaboration was highlighted across most of the studies. Further research is warranted to explore the barriers and opportunities of adopting a One Health approach in Q fever prevention and control.


Assuntos
Saúde Única , Febre Q/prevenção & controle , Zoonoses/prevenção & controle , Animais , Humanos , Colaboração Intersetorial , Febre Q/epidemiologia , Zoonoses/epidemiologia
19.
Int J Biometeorol ; 63(4): 435-447, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30687904

RESUMO

The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016-1.076), urolithiasis (IRR 1.106, 95% 1.046-1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258-1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048-1.133) and AKI (IRR 1.335, 95% CI 1.204-1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.


Assuntos
Temperatura Alta/efeitos adversos , Raios Infravermelhos , Doenças Urológicas/epidemiologia , Idoso , Mudança Climática , Serviço Hospitalar de Emergência , Feminino , Hospitalização , Humanos , Incidência , Masculino , Austrália do Sul/epidemiologia
20.
Sci Total Environ ; 657: 608-618, 2019 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-30677927

RESUMO

Exposure to extreme heat can lead to a range of heat-related illnesses, exacerbate pre-existing health conditions and cause increased demand on the healthcare system. A projected increase in temperature may lead to greater healthcare expenditure, however, at present the costs of heat-related healthcare utilization is under-researched. This study aims to review the literature on heat-related costs for the healthcare system with a focus on ED visits, hospitalization, and ambulance call-outs. PubMed, Scopus, and Embase were used to search relevant literature from database inception to December 2017 and limited to human studies and English language. After screening, a total of ten papers were identified for final inclusion. In general, the healthcare costs of heat extremes have been poorly investigated in developed countries and not reported in developing countries where the largest heat-vulnerable populations reside. Studies showed that exposure to extreme heat was causing a substantial economic burden on healthcare systems. Females, the elderly, low-income families, and ethnic minorities had the highest healthcare costs on a range of health services utilization. Although a few studies have estimated heat healthcare costs, none of them quantified the temperature-healthcare cost relationship. There is a need to systematically examine heat-attributable costs for the healthcare system in the context of climate change to better inform heat-related policy making, target interventions and resource allocation.


Assuntos
Serviço Hospitalar de Emergência/economia , Calor Extremo , Custos de Cuidados de Saúde , Transtornos de Estresse por Calor/economia , Hospitalização/economia , Idoso , Ambulâncias/economia , Países Desenvolvidos , Feminino , Humanos , Pobreza , Populações Vulneráveis
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA