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1.
Artigo em Inglês | MEDLINE | ID: mdl-32882881

RESUMO

Prolonged or intense exposure to heat can lead to a range of health effects. This study investigated heat exposure and heat-related symptoms which sugarcane workers (90 sugarcane cutters and 93 factory workers) experienced during a harvesting season in Thailand. During the hottest month of harvesting season, wet bulb globe temperature was collected in the work environment, and workloads observed, to assess heat stress. Urine samples for dehydration test, blood pressure, heart rate, and body temperature were measured pre- and post-shift to measure heat strain. Fluid intake and heat-related symptoms which subjects had experienced during the harvesting season were gathered via interviews at the end of the season. From the results, sugarcane cutters showed high risk for heat stress and strain, unlike factory workers who had low risk based on the American Conference of Governmental Industrial Hygiene (ACGIH) threshold limit values (TLVs) for heat stress. Dehydration was observed among sugarcane cutters and significant physiological changes including heart rate, body temperature, and systolic blood pressure occurred across the work shift. Significantly more sugarcane cutters reported experiencing heat-related symptoms including weakness/fatigue, heavy sweating, headache, rash, muscle cramp, dry mouth, dizziness, fever, dry/cracking skin, and swelling, compared to sugarcane factory workers. We conclude that the heat stress experienced by sugarcane cutters working in extremely hot environments, with high workloads, is associated with acute health effects. Preventive and control measures for heat stress are needed to reduce the risk of heat strain.


Assuntos
Transtornos de Estresse por Calor , Exposição Ocupacional , Saccharum , Adolescente , Adulto , Transtornos de Estresse por Calor/epidemiologia , Resposta ao Choque Térmico , Temperatura Alta , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Estresse Fisiológico , Tailândia , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-32784593

RESUMO

The objective of the study was to investigate, using academic-community epidemiologic co-analysis, the odds of reported heat-related illness for people with (1) central air conditioning (AC) or window unit AC versus no AC, and (2) fair/poor vs. good/excellent reported health. From 2016 to 2017, 101 Detroit residents were surveyed once regarding extreme heat, housing and neighborhood features, and heat-related illness in the prior 5 years. Academic partners selected initial confounders and, after instruction on directed acyclic graphs, community partners proposed alternate directed acyclic graphs with additional confounders. Heat-related illness was regressed on AC type or health and co-selected confounders. The study found that heat-related illness was associated with no-AC (n = 96, odds ratio (OR) = 4.66, 95% confidence interval (CI) = 1.22, 17.72); living ≤5 years in present home (n = 57, OR = 10.39, 95% CI = 1.13, 95.88); and fair/poor vs. good/excellent health (n = 97, OR = 3.15, 95% CI = 1.33, 7.48). Co-analysis suggested multiple built-environment confounders. We conclude that Detroit residents with poorer health and no AC are at greater risk during extreme heat. Academic-community co-analysis using directed acyclic graphs enhances research on community-specific social and health vulnerabilities by identifying key confounders and future research directions for rigorous and impactful research.


Assuntos
Ar Condicionado/estatística & dados numéricos , Calor Extremo/efeitos adversos , Transtornos de Estresse por Calor/epidemiologia , Adolescente , Adulto , Idoso , Pesquisa Participativa Baseada na Comunidade , Feminino , Nível de Saúde , Temperatura Alta , Humanos , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários
3.
Artigo em Inglês | MEDLINE | ID: mdl-32784700

RESUMO

Studies on the pattern of heatwave mortality using nationwide data that include rural areas are limited. This study aimed to assess the risk of heatwave-related mortality and evaluate the health risk-based definition of heatwave. We collected data on daily temperature and mortality from 229 districts in South Korea in 2011-2017. District-specific heatwave-related mortality risks were calculated using a distributed lag model. The estimates were pooled in the total areas and for each urban and rural area using meta-regression. In the total areas, the threshold point of heatwave mortality risk was estimated at the 93rd percentile of temperature, and it was lower in urban areas than in rural areas (92nd percentile vs. 95th percentile). The maximum risk of heatwave-related mortality in the total area was 1.11 (95% CI: 1.01-1.22), and it was slightly greater in rural areas than in the urban areas (RR: 1.23, 95% CI: 0.99-1.53 vs. RR: 1.10, 95% CI: 1.01-1.20). The results differ by age- and cause-specific deaths. In conclusion, the patterns of heatwave-related mortality risk vary by area and sub-population in Korea. Thus, more target-specific heatwave definitions and action plans should be established according to different areas and populations.


Assuntos
Calor Extremo/efeitos adversos , Temperatura Alta , Mortalidade , Adolescente , Adulto , Idoso , Algoritmos , Criança , Pré-Escolar , Transtornos de Estresse por Calor/epidemiologia , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Mortalidade/tendências , República da Coreia/epidemiologia , Temperatura , Adulto Jovem
4.
Public Health Rep ; 135(5): 631-639, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687733

RESUMO

OBJECTIVES: Maricopa County, Arizona (2017 population about 4.3 million), is located in the Sonoran Desert. In 2005, the Maricopa County Department of Public Health (MCDPH) established a heat-associated mortality surveillance system that captures data on circumstances of death for Maricopa County residents and visitors. We analyzed 2006-2016 surveillance system data to understand the characteristics and circumstances of heat-associated deaths. METHODS: We classified heat-associated deaths based on International Classification of Diseases, Tenth Revision codes (X30, T67.X, and P81.0) and phrases (heat exposure, environ, exhaustion, sun, heat stress, heat stroke, or hyperthermia) in part I or part II of the death certificate. We summarized data on decedents' demographic characteristics, years lived in Arizona, location of death (indoors vs outdoors), presence and functionality of air conditioning, and whether the decedent had been homeless. We examined significant associations between variables by using the Pearson χ2 tests and logistic regression. RESULTS: During 2006-2016, MCDPH recorded data on 920 heat-associated deaths, 912 of which included location of injury. Of 565 (62%) heat-associated deaths that occurred outdoors, 458 (81%) were among male decedents and 243 (43%) were among decedents aged 20-49. Of 347 (38%) heat-associated deaths that occurred indoors, 201 (58%) were among decedents aged ≥65. Non-Arizona residents were 5 times as likely as Arizona residents to have a heat-associated death outdoors (P < .001). Of 727 decedents with data on duration of Arizona residency, 438 (60%) had resided in Arizona ≥20 years. CONCLUSIONS: Ongoing evaluation of interventions that target populations at risk for both outdoor and indoor heat-associated deaths can further inform refinement of the surveillance system and identify best practices to prevent heat-associated deaths.


Assuntos
Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/mortalidade , Mortalidade/tendências , Vigilância da População/métodos , Saúde Pública/estatística & dados numéricos , Saúde Pública/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Arizona/epidemiologia , Criança , Pré-Escolar , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
J Sci Med Sport ; 23(8): 701-709, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32144023

RESUMO

OBJECTIVE: This systematic review summarises reports of the incidence of exertional heat illnesses (EHI) in organised sports, to examine any trends in the EHI incidence over time, and to describe EHI incidence based on sporting activity, geographic location, and type of EHI. METHOD: Three electronic databases (CINAHL, PubMed, SportDiscuss) were searched from inception to January 2019. Original data in all epidemiological studies (any design except case-studies and case-series) that reported EHI incidence data in organised sports, across all age categories, and published in an English language peer-reviewed journal were included. RESULTS: The primary search yielded 3556 results of which 62 studies were included in the final analysis, with 71% being from the USA. Reported EHI incidence rates ranged from 0.01 (cheerleading) to 4.19 (American football) per 1000 athletic-exposures (AEs), and 0.01 (mini-marathon) to 54.54 (desert ultra-marathon) per 100 participants. Endurance type events (running, cycling, adventure races) reported the highest EHI incidence rates per 100 participants. There was a considerable increase in EHI fatalities reported in the literature over the last three decades in American football and an increased reporting of EHI incidence in endurance type events during the last 5-years. CONCLUSION: Use of different terminology and injury definitions in most studies have resulted in an inconsistency in reporting EHI incidence data, and also likely underreporting of less-severe forms of EHI conditions. Longitudinal studies focused on different sports and conducted in more countries (outside the USA), are needed for better understanding the global impact of EHI and the impact of prevention measures.


Assuntos
Transtornos de Estresse por Calor/epidemiologia , Esportes/estatística & dados numéricos , Humanos , Incidência , Fatores de Risco
6.
Environ Res ; 185: 109398, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32203732

RESUMO

Heat stress has been recognized as one of the consequences of climate change in urban areas. Its adverse effects on the urban population range from economy, social, environment, and human health. With the increasing urbanization and economic development in cities, heat stress is expected to worsen. This particular study aims to achieve two objectives: (1) to understand the determinants of heat stress, especially the roles of the urban environment in exacerbating the heat stress, and (2) to explore the effects of heat stress to human health using self-reported health assessment. We employed a cross-sectional study using a survey questionnaire from 505 respondents living in the urban area of Bangkok, Thailand. We found that socioeconomic conditions of the individual and urban environment were significant determinants of urban heat stress. Low-income urban populations living in high-density areas with less green open space were more likely to experience heat stress. We also found that heat stress significantly affects human health. Those who reported a higher level of heat stress were more likely to have adverse health and well-being outcomes. The findings suggest that the increased risk of heat stress represents a major problem in the Bangkok, Thailand. It is necessary to address heat stress in adaptation policy and measures at the city levels amid the continued increase of global temperature and climate change.


Assuntos
Transtornos de Estresse por Calor , Cidades , Estudos Transversais , Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/etiologia , Resposta ao Choque Térmico , Temperatura Alta , Humanos , Tailândia , Saúde da População Urbana , População Urbana
7.
Br J Sports Med ; 54(16): 1003-1007, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31992546

RESUMO

PURPOSE: Assess the health status and heat preparation strategies of athletes competing in a World Cycling Championships held in hot ambient conditions (37°C, 25% relative humidity, wet-bulb-globe-temperature 27°C) and monitor the medical events arising during competition. METHODS: 69 cyclists (~9% of the world championships participants) completed a pre-competition questionnaire. Illnesses and injuries encountered by the Athlete Medical Centre (AMC) were extracted from the race reports. RESULTS: 22% of respondents reported illness symptoms in the 10 days preceding the Championships. 57% of respondents had previously experienced heat-related symptoms (cramping most commonly) while 17% had previously been diagnosed with exertional heat illness. 61% of the respondents had undergone some form of heat exposure prior to the Championships, with 38% acclimating for 5 to 30 days. In addition, several respondents declared to live in warm countries and all arrived in Qatar ~5 days prior to their event. 96% of the respondents used a pre-cooling strategy for the time trials and 74% did so before the road race (p<0.001), with ice vests being the most common. The AMC assessed 46 injuries and 26 illnesses in total, with three cyclists diagnosed with heat exhaustion. CONCLUSIONS: The prevalence of previous heat illness in elite cyclists calls for team and event organisation doctors to be trained on heat illness management, including early diagnosis and rapid on-site cooling. Some cyclists had been exposed to the heat prior to the Championships, but few had a dedicated plan, calling for additional education on the importance of heat acclimation. Pre-cooling was widely adopted.


Assuntos
Aclimatação , Ciclismo/fisiologia , Comportamento Competitivo/fisiologia , Nível de Saúde , Transtornos de Estresse por Calor/epidemiologia , Temperatura Alta , Aniversários e Eventos Especiais , Ciclismo/lesões , Feminino , Hidratação , Exaustão por Calor/diagnóstico , Exaustão por Calor/epidemiologia , Exaustão por Calor/terapia , Transtornos de Estresse por Calor/diagnóstico , Transtornos de Estresse por Calor/terapia , Humanos , Masculino , Catar , Adulto Jovem
8.
Arch Environ Occup Health ; 75(5): 281-288, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31258055

RESUMO

Heat exposure is a major cause of health issues in outdoor workers. The aim of this study is to show a macro analysis of the heat exposure risk (HER) countrywide through the WBGT index. The index estimates are conducted from 50 years of meteorological observations. The HER takes into account the light, moderate, and heavy workloads, and the HER maps are separately generated decade by decade and season by season. It was found that HER has stronger effect on heavy workload workers during summer. It is even more critical in the Northern, Northeastern, and in part of Midwestern Brazil. There was HER increase in the last two decades, showing the need of applying control measures. It is very important taking continuous actions such as environmental and physiological monitoring, light clothing, and flexible work shifts.


Assuntos
Transtornos de Estresse por Calor/epidemiologia , Temperatura Alta/efeitos adversos , Doenças Profissionais/epidemiologia , Exposição Ocupacional , Metabolismo Basal , Brasil/epidemiologia , Humanos , Saúde do Trabalhador , Medição de Risco , Fatores de Risco , Estações do Ano , Fatores de Tempo , Carga de Trabalho
9.
Int J Sports Physiol Perform ; 15(2): 231-237, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31172833

RESUMO

PURPOSE: Paratriathletes may display impairments in autonomic (sudomotor and/or vasomotor function) or behavioral (drinking and/or pacing of effort) thermoregulation. As such, this study aimed to describe the thermoregulatory profile of athletes competing in the heat. METHODS: Core temperature (Tc) was recorded at 30-second intervals in 28 mixed-impairment paratriathletes during competition in a hot environment (air temperature = 33°C, relative humidity = 35%-41%, and water temperature = 25°C-27°C), via an ingestible temperature sensor (BodyCap e-Celsius). Furthermore, in a subset of 9 athletes, skin temperature was measured. Athletes' wetsuit use was noted while heat illness symptoms were self-reported postrace. RESULTS: In total, 22 athletes displayed a Tc ≥ 39.5°C with 8 athletes ≥40.0°C. There were increases across the average Tc for swim, bike, and run sections (P ≤ .016). There was no change in skin temperature during the race (P ≥ .086). Visually impaired athletes displayed a significantly greater Tc during the run section than athletes in a wheelchair (P ≤ .021). Athletes wearing a wetsuit (57% athletes) had a greater Tc when swimming (P ≤ .032), whereas those reporting heat illness symptoms (57% athletes) displayed a greater Tc at various time points (P ≤ .046). CONCLUSIONS: Paratriathletes face significant thermal strain during competition in the heat, as evidenced by high Tc, relative to previous research in able-bodied athletes and a high incidence of self-reported heat illness symptomatology. Differences in the Tc profile exist depending on athletes' race category and wetsuit use.


Assuntos
Ciclismo/fisiologia , Regulação da Temperatura Corporal , Comportamento Competitivo/fisiologia , Temperatura Alta , Corrida/fisiologia , Esportes para Pessoas com Deficiência/fisiologia , Natação/fisiologia , Adulto , Feminino , Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/fisiopatologia , Humanos , Incidência , Masculino , Fatores de Risco , Temperatura Cutânea , Equipamentos Esportivos
10.
J Sport Rehabil ; 29(3): 332-338, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30747580

RESUMO

Context: Recent data on exertional heat illness (EHI) in high school sports are limited yet warranted to identify specific settings with the highest risk of EHI. Objective: To describe the epidemiology of EHI in high school sports during the 2012/2013-2016/2017 academic years. Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data collected from athletic trainers working in high school sports in the United States. Patients or Other Participants: High school athletes during the 2012/2013-2016/2017 academic years. Intervention: High School Reporting Information Online surveillance system data from the 2012/2013-2016/2017 academic years were analyzed. Main Outcome Measures: EHI counts, rates per 10,000 athlete exposures (AEs), and distributions were examined by sport, event type, and US census region. EHI management strategies provided by athletic trainers were analyzed. Injury rate ratios with 95% confidence intervals (CIs) compared EHI rates. Results: Overall, 300 EHIs were reported for an overall rate of 0.13/10,000 AE (95% CI, 0.11 to 0.14). Of these, 44.3% occurred in American football preseason practices; 20.7% occurred in American football preseason practices with a registered air temperature ≥90°F and ≥1 hour into practice. The EHI rate was higher in American football than all other sports (0.52 vs 0.04/10,000 AE; injury rate ratio = 11.87; 95% CI, 9.22 to 15.27). However, girls' cross-country had the highest competition EHI rate (1.18/10,000 AE). The EHI rate was higher in the South US census region than all other US census regions (0.23 vs 0.08/10,000 AE; injury rate ratio = 2.96; 95% CI, 2.35 to 3.74). Common EHI management strategies included having medical staff on-site at the onset of EHI (92.7%), removing athlete from play (85.0%), and giving athlete fluids via the mouth (77.7%). Conclusions: American football continues to have the highest overall EHI rate although the high competition EHI rate in girls' cross-country merits additional examination. Regional differences in EHI incidence, coupled with sport-specific variations in management, may highlight the need for region- and sport-specific EHI prevention guidelines.


Assuntos
Atletas , Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/prevenção & controle , Instituições Acadêmicas , Feminino , Futebol Americano , Temperatura Alta , Humanos , Masculino , Estados Unidos/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-31842287

RESUMO

BACKGROUND: Extreme heat and heat illness are becoming very frequent in India. We aimed to identify the factors associated with heat illness and the coping practices among city dwellers of Odisha, India during the summer. METHODS: A cross-sectional study included 766 households (HHs) in twin cities of Odisha covering a population of 1099 (slum: 404 and non-slum: 695) in the year 2017. We collected information on sociodemographic, household characteristics, coping practices to heat and the heat illness history reported during the summer. Multivariate logistic regression accounting for clustering effects at the household and slum levels was used to identify the associated factors of heat illness after adjustment of other variables. RESULT: Nearly, 49% of the study participants were female and the mean age was 38.36 years (95% confidence interval (CI): 37.33-39.39 years). A significant difference of living environment was seen across the groups. More than two-thirds of the study participants at least once had heat illness. In the non-slum population, males (adjusted odds ratio (aOR): 3.56; 95% CI: 2.39-5.29), persons under medication (aOR: 3.09; 95% CI: 1.15-8.29), and chronic conditions had higher association with heat illness. Whereas, in the slum population, having a kitchen outside the home (aOR: 1.63; 95% CI: 1.02-3.96) and persons with chronic conditions were positively associated with heat illness. Use of cooling practices in slum areas reduced the risk of heat illness by 60%. CONCLUSION: Heat illness is associated with the living environment and physical health of the individuals. Identifying the vulnerable population and scaling up adaptive practices can strengthen the public health preparedness.


Assuntos
Adaptação Fisiológica , Calor Extremo/efeitos adversos , Transtornos de Estresse por Calor/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Doença Crônica , Cidades/epidemiologia , Estudos Transversais , Características da Família , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Áreas de Pobreza , Adulto Jovem
12.
Environ Monit Assess ; 191(11): 693, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31667634

RESUMO

Exposure to air pollutants and heat stress from traditional cooking fires is the leading cause of mortality and morbidity in low- and middle-income countries globally and have an adverse effect on the environment. According to the World Health Organization, 3.8 million people die annually prematurely from illness related to household air pollution. Families living in poverty are at the highest risk, especially women and children. In this study, exposure to particulate matter (PM2.5 and PM10), carbon monoxide (CO) and nitrogen dioxide (NO2) was measured among resource-poor women cassava processors. The test locations were chosen in the peri-urban settlements of Abeokuta in the Ogun State of Nigeria, where household women entrepreneurs roast garri (granulated cassava) for sale in the local market. The measurements were taken for two types of stoves which are generally existing in the study location. First, a rectangular stove (RS) with two operators and, second, a circular stove (CS) with one operator; both stoves used wood as fuel. The emissions were compared with a modern mechanical liquefied petroleum gas burner-based garri roaster (GS). Hours spent per day in front of garri stoves ranged from 6 to 12 h for both stoves, with a frequency of 1 to 3 days of operation per week. It was found that CS operators were spending significantly more time in producing garri, which is due to the low capacity of the CS. The average PM2.5 concentrations for RS and CS were 381 and 273 µg/m3, respectively, estimated to be 21 and 41 µg/m3 on an annual mean level basis. Similarly, for PM10, the mean concentration levels were 1580 and 594 µg/m3 for RS and CS, respectively. The annual mean levels for PM10 were about 89 µg/m3 for both types of stoves. CO exposure during garri processing was up to five times higher than the recommended concentrations with a 4-h mean of 48 and 50 mg/m3 for RS and CS, respectively. NO2 levels were very low, ~ 0 ppm. This investigative research concluded that wood-fired small-scale garri producers in Nigeria are exposed to very unhealthy levels of PM, CO and thermal stress. The concentration levels of both PM and CO were exceeding the global as well as Nigerian ambient air quality standard regulations. Along with air pollution, thermal stress was a significant issue, which is known to exacerbate the negative effect of air pollution on the human body.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Transtornos de Estresse por Calor/epidemiologia , Resposta ao Choque Térmico , Manihot , Adulto , Poluição do Ar/análise , Poluição do Ar em Ambientes Fechados/análise , Monóxido de Carbono/análise , Criança , Culinária , Monitoramento Ambiental , Características da Família , Feminino , Fogo , Indústria Alimentícia , Humanos , Nigéria , Dióxido de Nitrogênio , Material Particulado/análise , Madeira/química
13.
Artigo em Inglês | MEDLINE | ID: mdl-31752444

RESUMO

More and more people will experience thermal stress in the future as the global temperature is increasing at an alarming rate and the risk for extreme weather events is growing. The increased exposure to extreme weather events poses a challenge for societies around the world. This literature review investigates the feasibility of making advanced human thermal models in connection with meteorological data publicly available for more versatile practices and a wider population. By providing society and individuals with personalized heat and cold stress warnings, coping advice and educational purposes, the risks of thermal stress can effectively be reduced. One interesting approach is to use weather station data as input for the wet bulb globe temperature heat stress index, human heat balance models, and wind chill index to assess heat and cold stress. This review explores the advantages and challenges of this approach for the ongoing EU project ClimApp where more advanced models may provide society with warnings on an individual basis for different thermal environments such as tropical heat or polar cold. The biggest challenges identified are properly assessing mean radiant temperature, microclimate weather data availability, integration and continuity of different thermal models, and further model validation for vulnerable groups.


Assuntos
Temperatura Baixa , Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/fisiopatologia , Resposta ao Choque Térmico/fisiologia , Temperatura Alta , Modelos Biológicos , Tempo (Meteorologia) , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
14.
Health Place ; 60: 102228, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31654921

RESUMO

Heat stress causes morbidity and mortality and is increasing with climate change. Heat stress can pose particular challenges in northern regions not well adapted to heat. To assist decision makers, we identified the relative vulnerability of census tracts within Michigan to factors that increase exposure to heat stress or reflect susceptibilities in the population based on a California heat vulnerability index. In the MI-Environment assessment, we used a Geographic Information System (GIS) to combine future ensemble climate model projections to create a total of 9 geospatial and demographic variables. As part of a broader planned cumulative environmental exposure assessment, the statewide heat vulnerability index (HVI) maps display the location and relative magnitude of exposure on three metrics: built environment (Place), future expected long-term temperature averages (Temperature), and population susceptibility (People). We observed varied and distinct patterns for each of the three component indices. We assessed how equitably those exposures are distributed by racial and socioeconomic factors. This analysis showed that each of the component indices and the aggregate HVI are disproportionately distributed along racial and socioeconomic lines in Michigan. Census tracts with higher percentages of people of color had larger exposure to HVI factors with a deviation from equity of -0.115 [95% CI -0.108, -0.122]. Similarly, for census tracts with higher percentage of people experiencing poverty, the deviation from equity was -0.101 [95% CI -0.094, -0.107]. The MI-Environment visualization tool can help communities prepare for climate change and resolve inequities by identifying census tracts with the most vulnerable residents and highest potential exposures.


Assuntos
Ambiente Construído , Disparidades nos Níveis de Saúde , Transtornos de Estresse por Calor/etiologia , Idoso , Ambiente Construído/estatística & dados numéricos , Sistemas de Informação Geográfica , Transtornos de Estresse por Calor/epidemiologia , Humanos , Michigan/epidemiologia , Fatores de Risco , Pessoa Solteira/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos
15.
Int J Occup Environ Med ; 10(4): 194-202, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31586384

RESUMO

BACKGROUND: Heat stress is common among workers in hot-dry areas. To take preventive strategies for the protection of workers against heat stress, it is important to choose a suitable index that can accurately explain environmental parameters relative to physiological responses. OBJECTIVE: To evaluate heat stress and maximum acceptable work time (MAWT) based on physiological and environmental response in hot-dry climate among traditional bakers. METHODS: The current study was carried out on 30 traditional bakers of 3 different bread baking systems in Ahvaz, Iran. Environmental and physiological parameters were measured simultaneously for a work shift. The work-rest time was also determined based on the relative heart rate (RHR) and the wet-bulb globe temperature (WBGT) index. RESULTS: The average WBGT index was estimated to be higher than the standard limit for all baking stations. Despite the higher-than-the-recommended-limit WBGT index, there was no significant relationship between the WBGT index and physiological parameters. The results indicated a significant (p<0.05) difference between the percentages of work-rest time estimated using the WBGT and RHR index. CONCLUSION: Based on the results of environmental and physiological monitoring of this study as well as the limitations of the use of the WBGT index, it seems that using WBGT as a standard index would not suit heat stress management in hot-dry climates. A revision of this standard to adapt to hot climatic conditions should be in order.


Assuntos
Culinária , Indústria Alimentícia , Transtornos de Estresse por Calor , Temperatura Alta , Satisfação no Emprego , Exposição Ocupacional , Adulto , Pão , Doces , Clima , Culinária/métodos , Culinária/estatística & dados numéricos , Indústria Alimentícia/estatística & dados numéricos , Frequência Cardíaca/fisiologia , Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/fisiopatologia , Transtornos de Estresse por Calor/prevenção & controle , Resposta ao Choque Térmico/fisiologia , Humanos , Umidade , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Temperatura , Fatores de Tempo , Local de Trabalho/estatística & dados numéricos , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-31581630

RESUMO

Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events on hospital emergency department (ED) presentations in the two most populous regions of Tasmania, Australia, from 2008-2016. Using conditional logistic regression, we analyzed the relationship between ED presentations and severe/extreme heatwaves for the whole population, specific demographics including age, gender and socio-economic advantage, and diagnostic conditions that are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05, 95% CI 1.01-1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03-1.24) for children 15 years and under, and by 19% (OR 1.19, 95% CI 1.04-1.36) for children 5 years and under. A less precise association in the same direction was found for those over 65 years. For diagnostic subgroups, non-significant increases in ED presentations were observed for asthma, diabetes, hypertension, and atrial fibrillation. These findings may assist ED surge capacity planning and public health preparedness and response activities for heatwave events in Tasmania, highlighting the importance of using local research to inform local practice.


Assuntos
Clima , Serviço Hospitalar de Emergência/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/etiologia , Temperatura Alta/efeitos adversos , Saúde Pública/estatística & dados numéricos , Adolescente , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Fatores Socioeconômicos , Tasmânia/epidemiologia
17.
Dtsch Arztebl Int ; 116(31-32): 537-544, 2019 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-31554541

RESUMO

BACKGROUND: With climate change, heat waves are expected to become more frequent in the near future. Already, on average more than 25 000 "heat deaths" are estimated to occur in Europe every year. However, heat stress and heat illnesses arise not just when ambient temperatures are high. Physical exertion increases heat production within the organism many times over; if not enough heat is lost, there is a risk of exertional heat stress. This review article discusses contributing factors, at-risk groups, and the diagnosis and treatment of heat illnesses. METHODS: A selective literature search was carried out on PubMed. Current guidelines and expert recommendations were also included. RESULTS: Apart from muscular heat production (>70% of converted energy), there are other factors that singly or in combination can give rise to heat stress: clothing, climate/acclimatization, and individual factors. Through its insulating properties, clothing reduces the evaporation of sweat (the most effective physiological cooling mechanism). A sudden heat wave, or changing the climate zone (as with air travel), increases the risk of a heat-related health event. Overweight, low fitness level, acute infections, illness, dehydration, and other factors also reduce heat tolerance. In addition to children, older people are particularly at risk because of their reduced physiological adaptability, (multi-)morbidity, and intake of prescription drugs. A heat illness can progress suddenly to life-threatening heat stroke. Successful treatment depends on rapid diagnosis and cooling the body down as quickly as possible. The aim is to reduce core body temperature to <40 °C within 30 minutes. CONCLUSION: Immediately effective cooling interventions are the only causal treatment for heat stroke. Time once lost cannot be made up. Prevention (acclimatization, reduced exposure, etc.) and terminating the heat stress in good time (e.g., stopping work) are better than any cure.


Assuntos
Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/terapia , Mudança Climática , Europa (Continente)/epidemiologia , Humanos , Esforço Físico/fisiologia , Fatores de Risco
18.
Artigo em Inglês | MEDLINE | ID: mdl-31561463

RESUMO

The infrequency of deaths from work-related heat stress may be due to self-pacing, whereby workers adjust their work rate in response to thermal discomfort. Thirteen cases attributed after coronial investigation to work-related heat stress were studied to evaluate the causal contribution of environmental and personal risk factors. Meteorological records and coronial records were examined to estimate environmental and metabolic heat loads and to identify any personal risk factors likely to have contributed to death. Seven deaths occurred in workers within one week of hiring, demonstrating not only the importance of acclimatisation but also the likelihood of compromised self-pacing in recently-hired workers. Personal risk factors identified included intercurrent illness, cardiovascular disease and obesity. Four deaths occurred following indoor work, where the probable critical risk parameter was low air velocity. Cerebral and pulmonary oedema were reported in some autopsy reports, and uncal herniation was found in one case. Modified work rates and close supervision are essential in recently-hired workers. The risk of death from raised intracranial pressure suggests the need for specific remediation of cerebral oedema in hyperthermic individuals.


Assuntos
Adaptação Fisiológica , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/mortalidade , Transtornos de Estresse por Calor/epidemiologia , Transtornos de Estresse por Calor/mortalidade , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/mortalidade , Adulto , Idoso , Austrália/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Adulto Jovem
20.
Nutrients ; 11(9)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31454933

RESUMO

Predicted global climate change, including rising average temperatures, increasing airborne pollution, and ultraviolet radiation exposure, presents multiple environmental stressors contributing to increased morbidity and mortality. Extreme temperatures and more frequent and severe heat events will increase the risk of heat-related illness and associated complications in vulnerable populations, including infants and children. Historically, children have been viewed to possess inferior thermoregulatory capabilities, owing to lower sweat rates and higher core temperature responses compared to adults. Accumulating evidence counters this notion, with limited child-adult differences in thermoregulation evident during mild and moderate heat exposure, with increased risk of heat illness only at environmental extremes. In the context of predicted global climate change, extreme environmental temperatures will be encountered more frequently, placing children at increased risk. Thermoregulatory and overall physiological strain in high temperatures may be further exacerbated by exposure to/presence of physiological and environmental stressors including pollution, ultraviolet radiation, obesity, diabetes, associated comorbidities, and polypharmacy that are more commonly occurring at younger ages. The aim of this review is to revisit fundamental differences in child-adult thermoregulation in the face of these multifaceted climate challenges, address emerging concerns, and emphasize risk reduction strategies for the health and performance of children in the heat.


Assuntos
Desenvolvimento do Adolescente , Regulação da Temperatura Corporal , Desenvolvimento Infantil , Saúde Global , Aquecimento Global , Transtornos de Estresse por Calor/fisiopatologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Exposição Ambiental/efeitos adversos , Nível de Saúde , Transtornos de Estresse por Calor/diagnóstico , Transtornos de Estresse por Calor/epidemiologia , Humanos , Lactente , Recém-Nascido , Medição de Risco , Fatores de Risco
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