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1.
Paediatr Perinat Epidemiol ; 36(1): 13-22, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34951022

RESUMO

BACKGROUND: Climate change is increasing the frequency and intensity of heatwaves. Prior studies associate high temperature with preterm birth. OBJECTIVES: We tested the hypotheses that acute exposure to extreme heat was associated with higher risk of live spontaneous preterm birth (≥20 and <37 completed weeks), and that risks were higher among people of colour and neighbourhoods with heat-trapping landcover or concentrated racialised economic disadvantage. METHODS: We conducted a retrospective cohort study of people giving birth between 2007 and 2011 in Harris County, Texas (Houston metropolitan area) (n = 198,013). Exposures were daily ambient apparent temperature (ATmax in 5°C increments) and dry-bulb temperatures (Tmax and Tmin >historical [1971-2000] summertime 99th percentile) up to a week prior for each day of pregnancy. Survival analysis controlled for individual-level risk factors, secular and seasonal trends. We considered race/ethnicity, heat-trapping neighbourhood landcover and Index of Concentration at the Extremes as effect modifiers. RESULTS: The frequency of preterm birth was 10.3%. A quarter (26.8%) of people were exposed to ATmax ≥40°C, and 22.8% were exposed to Tmax and Tmin >99th percentile while at risk. The preterm birth rate among the exposed was 8.9%. In multivariable models, the risk of preterm birth was 15% higher following extremely hot days (hazard ratio [HR] 1.15 (95% confidence interval [CI] 1.01, 1.30) for ATmax ≥40°C vs. <20°C; HR 1.15 (95% CI 1.02, 1.28) for Tmax and Tmin >99th percentile). Censoring at earlier gestational ages suggested stronger associations earlier in pregnancy. The risk difference associated with extreme heat was higher in neighbourhoods of concentrated racialised economic disadvantage. CONCLUSIONS: Ambient heat was associated with spontaneous preterm birth, with stronger associations earlier in pregnancy and in racially and economically disadvantaged neighbourhoods, suggesting climate change may worsen existing social inequities in preterm birth rates.


Assuntos
Calor Extremo , Nascimento Prematuro , Calor Extremo/efeitos adversos , Feminino , Idade Gestacional , Temperatura Alta , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Estudos Retrospectivos
2.
Prehosp Disaster Med ; 36(6): 782-787, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34726143

RESUMO

INTRODUCTION: It is well-established that heatwaves increase demand for emergency transport in metropolitan areas; however, little is known about the impact of heat events on demand for prehospital retrieval services in rural and remote areas, or how heatwaves are defined in this context. INCLUSION CRITERIA: Papers were eligible for inclusion if they reported on the impact of a heat event on the activity of a prehospital and retrieval service in a rural or remote area. METHODS: A search of PubMed, Cochrane, Science Direct, CINAHL, and Google Scholar databases was undertaken on August 18, 2020 using search terms related to emergency medical transport, extreme heat, and rural or remote. Data relevant to the impact of heat on retrieval service activity were extracted, as well as definitions of extreme heat. RESULTS: Two papers were identified, both from Australia. Both found that heat events increased the number of road ambulance call-outs. Both studies used the Excess Heat Factor (EHF) to define heatwave periods of interest. CONCLUSIONS: This review found almost no primary literature on demand for prehospital retrieval services in rural and remote areas, and no data specifically related to aeromedical transport. The research did recognize the disproportionate impact of heat-related increase in service demand on Australian rural and regional health services. With the effects of climate change already being felt, there is an urgent need for more research and action in this area.


Assuntos
Calor Extremo , Temperatura Alta , Ambulâncias , Austrália , Humanos , População Rural
5.
WMJ ; 120(3): 222-225, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34710305

RESUMO

BACKGROUND: This article describes the first Community Assessment for Public Health Emergency Response (CASPER) rapid needs assessment project to be conducted in Wisconsin. The project focused on extreme heat preparedness. METHODS: Fifteen teams conducted household surveys in 30 census blocks in the city of Milwaukee, Wisconsin. RESULTS: Survey results indicated that the majority of households were unaware of the location of a nearby cooling center. Although the vast majority of households reported some form of air conditioning in their house, over half felt too hot inside their home sometimes, most of the time, or always. DISCUSSION: The community partnerships ensured that this project was conducted with local partner input and that the data could be used to inform extreme heat response.


Assuntos
Calor Extremo , Características da Família , Humanos , Saúde Pública , Inquéritos e Questionários , Wisconsin
6.
J Spec Oper Med ; 21(3): 41-44, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34529803

RESUMO

Tasks performed by search and rescue (SAR) teams can be physically demanding. SAR organizations are faced with mounting challenges due to increased participation in recreation in remote locations and more frequent extreme weather. We sought to describe the physiological response and the methods for data collection during helicopter emergency medical service (HEMS) winch rescue from remote wilderness in extreme heat. A flight paramedic sustained 81% of maximum heart rate (VO2 ~44.8 mL/kg/min) for ~10 minutes at a rate of perceived exertion of 19/20, and a relative heart rate of 77.5% in 37.1°C. Maximal acceptable work time for this task was calculated at 37.7 minutes. Our data collection methods were feasible, and the data captured demonstrated the level of physiological strain that may be encountered during HEMS SAR operations in austere environments and hot climate. It is essential that SAR teams that perform physically demanding tasks use a scientific approach to adapt and evolve. This is necessary to ensure personnel are appropriately selected, trained, and equipped to respond in an era of increasing demand and extreme environments.


Assuntos
Resgate Aéreo , Serviços Médicos de Emergência , Calor Extremo , Aeronaves , Pessoal Técnico de Saúde , Humanos , Trabalho de Resgate
8.
Environ Int ; 157: 106834, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34461376

RESUMO

BACKGROUND: Heat warnings are issued in advance of forecast extreme heat events, yet little evidence is available regarding their effectiveness in reducing heat-related illness and death. We estimated the association of heat warnings and advisories (collectively, "alerts") issued by the United States National Weather Service with all-cause mortality and cause-specific hospitalizations among Medicare beneficiaries aged 65 years and older in 2,817 counties, 2006-2016. METHODS: In each county, we compared days with heat alerts to days without heat alerts, matched on daily maximum heat index and month. We used conditional Poisson regression models stratified on county, adjusting for year, day of week, federal holidays, and lagged daily maximum heat index. RESULTS: We identified a matched non-heat alert day for 92,029 heat alert days in 2,817 counties, or 54.6% of all heat alert days during the study period. Contrary to expectations, heat alerts were not associated with lower risk of mortality (RR: 1.005 [95% CI: 0.997, 1.013]). However, heat alerts were associated with higher risk of hospitalization for fluid and electrolyte disorders (RR: 1.040 [95% CI: 1.015, 1.065]) and heat stroke (RR: 1.094 [95% CI: 1.038, 1.152]). Results were similar in sensitivity analyses additionally adjusting for same-day heat index, ozone, and PM2.5. CONCLUSIONS: Our results suggest that heat alerts are not associated with lower risk of mortality but may be associated with higher rates of hospitalization for fluid and electrolyte disorders and heat stroke, potentially suggesting that heat alerts lead more individuals to seek or access care.


Assuntos
Calor Extremo , Temperatura Alta , Idoso , Calor Extremo/efeitos adversos , Hospitalização , Hospitais , Humanos , Medicare , Mortalidade , Estados Unidos/epidemiologia
9.
Lancet ; 398(10301): 641, 2021 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419190
10.
Lancet ; 398(10301): 709-724, 2021 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419206

RESUMO

Heat extremes (ie, heatwaves) already have a serious impact on human health, with ageing, poverty, and chronic illnesses as aggravating factors. As the global community seeks to contend with even hotter weather in the future as a consequence of global climate change, there is a pressing need to better understand the most effective prevention and response measures that can be implemented, particularly in low-resource settings. In this Series paper, we describe how a future reliance on air conditioning is unsustainable and further marginalises the communities most vulnerable to the heat. We then show that a more holistic understanding of the thermal environment at the landscape and urban, building, and individual scales supports the identification of numerous sustainable opportunities to keep people cooler. We summarise the benefits (eg, effectiveness) and limitations of each identified cooling strategy, and recommend optimal interventions for settings such as aged care homes, slums, workplaces, mass gatherings, refugee camps, and playing sport. The integration of this information into well communicated heat action plans with robust surveillance and monitoring is essential for reducing the adverse health consequences of current and future extreme heat.


Assuntos
Ar Condicionado/tendências , Ambiente Construído , Mudança Climática , Calor Extremo/efeitos adversos , Temperatura Alta/efeitos adversos , Idoso , Envelhecimento , Água Potável , Eletricidade , Humanos
11.
Glob Chang Biol ; 27(22): 5762-5772, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34410027

RESUMO

Anthropogenic climate change is expected to have major impacts on domesticated livestock, including increased heat stress in animals in both intensive and extensive livestock systems. We estimate the changes in the number of extreme heat stress days per year for animals raised outdoors that can be expected in the major domesticated animal species (cattle, sheep, goats, poultry, and pigs) across the globe during this century. We used the temperature humidity index as a proxy for heat stress, calculated using temperature and relative humidity data collated from an ensemble of CMIP6 climate model output for mid and end century. We estimate changes in the proportions of different livestock species that may be at increased risk of extreme heat stress under two contrasting greenhouse gas emission scenarios. Results are discussed in relation to changes in the suitability of different climate conditions for domesticated livestock during the current century. We find that by end century, extreme heat stress risk is projected to increase for all livestock species in many parts of the tropics and some of the temperate zones, and to become climatically more widespread, compared to 2000. Although adaptation options exist for both intensive and extensive livestock production systems, the increasing pervasiveness of extreme heat stress risk in the future will seriously challenge the viability of outdoor livestock keeping, particularly in the lower latitudes in lower and middle-income countries where the costs of adaptation may be challenging to address.


Assuntos
Calor Extremo , Transtornos de Estresse por Calor , Animais , Bovinos , Mudança Climática , Transtornos de Estresse por Calor/veterinária , Resposta ao Choque Térmico , Temperatura Alta , Gado , Ovinos , Suínos
12.
Sci Total Environ ; 799: 149417, 2021 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-34426358

RESUMO

Heat related morbidity and mortality, especially during extreme heat events, are increasing due to climate change. More Americans die from heat than from all other natural disasters combined. Identifying the populations and locations that are under high risk of heat vulnerability is important for urban planning and design policy making as well as health interventions. An increasing number of heat vulnerability/risk models and indices (HV/R) have been developed based on indicators related to population heat susceptibility such as sociodemographic and environmental factors. The objectives of this study are to summarize and analyze current HV/R's construction, calculation, and validation, evaluate the limitation of these methods, and provide directions for future HV/R and related studies. This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and used 5 datasets for the literature search. Journal articles that developed indices or models to assess population level heat-related vulnerability or risks in the past 50 years were included. A total of 52 papers were included for analysis on model construction, data sources, weighting schemes and model validation. By synthesizing the findings, we suggested: (1) include relevant and accurately measured indicators; (2) select rational weighting methods and; (3) conduct model validation. We also concluded that it is important for future heat vulnerability models and indices studies to: (1) be conducted in more tropical areas; (2) include a comprehensive understanding of energy exchanges between landscape elements and humans; and (3) be applied in urban planning and policy making practice.


Assuntos
Calor Extremo , Temperatura Alta , Mudança Climática , Humanos , Morbidade , Populações Vulneráveis
13.
BMC Public Health ; 21(1): 1479, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34325687

RESUMO

BACKGROUND: Many countries have developed heat-health watch and warning systems (HHWWS) or early-warning systems to mitigate the health consequences of extreme heat events. HHWWS usually focuses on the four hottest months of the year and imposes the same threshold over these months. However, according to climate projections, the warm season is expected to extend and/or shift. Some studies demonstrated that health impacts of heat waves are more severe when the human body is not acclimatized to the heat. In order to adapt those systems to potential heat waves occurring outside the hottest months of the season, this study proposes specific health-based monthly heat indicators and thresholds over an extended season from April to October in the northern hemisphere. METHODS: The proposed approach, an adoption and extension of the HHWWS methodology currently implemented in Quebec (Canada). The latter is developed and applied to the Greater Montreal area (current population 4.3 million) based on historical health and meteorological data over the years. This approach consists of determining excess mortality episodes and then choosing monthly indicators and thresholds that may involve excess mortality. RESULTS: We obtain thresholds for the maximum and minimum temperature couple (in °C) that range from (respectively, 23 and 12) in April, to (32 and 21) in July and back to (25 and 13) in October. The resulting HHWWS is flexible, with health-related thresholds taking into account the seasonality and the monthly variability of temperatures over an extended summer season. CONCLUSIONS: This adaptive and more realistic system has the potential to prevent, by data-driven health alerts, heat-related mortality outside the typical July-August months of heat waves. The proposed methodology is general and can be applied to other regions and situations based on their characteristics.


Assuntos
Calor Extremo , Temperatura Alta , Canadá , Calor Extremo/efeitos adversos , Humanos , Mortalidade , Quebeque/epidemiologia , Estações do Ano
14.
Environ Res ; 202: 111738, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34331925

RESUMO

BACKGROUND: Some socioeconomically vulnerable groups may experience disproportionately higher risk of extreme heat illness than other groups, but no study has utilized the presence/absence of a social security number (SSN) as a proxy for vulnerable sub-populations. METHODS: This study focused on the warm season from 2008 to 2012 in Florida, U.S. With a total number of 8,256,171 individual level health outcomes, we devised separate case-crossover models for five heat-sensitive health outcomes (cardiovascular disease, dehydration, heat-related illness, renal disease, and respiratory disease), type of health care visit (emergency department (ED) and hospitalization), and patients reporting/not reporting an SSN. Each stratified model also considered potential effect modification by sex, age, or race/ethnicity. RESULTS: Mean temperature raised the odds of five heat-sensitive health outcomes with the highest odds ratios (ORs) for heat-related illness. Sex significantly modified heat exposure effects for dehydration ED visits (Males: 1.145, 95 % CI: 1.137-1.153; Females: 1.110, 95 % CI: 1.103-1.117) and hospitalization (Males: 1.116, 95 % CI: 1.110-1.121; Females: 1.100, 95 % CI: 1.095-1.105). Patients not reporting an SSN between 25 and 44 years (1.264, 95 % CI: 1.192-1.340) exhibited significantly higher dehydration ED ORs than those reporting an SSN (1.146, 95 % CI: 1.136-1.157). We also observed significantly higher ORs for cardiovascular disease hospitalization from the no SSN group (SSN: 1.089, 95 % CI: 1.088-1.090; no SSN: 1.100, 95 % CI: 1.091-1.110). CONCLUSIONS: This paper partially supports the idea that individuals without an SSN could experience higher risks of dehydration (for those 25-45 years), renal disease, and cardiovascular disease than those with an SSN.


Assuntos
Calor Extremo , Transtornos de Estresse por Calor , Serviço Hospitalar de Emergência , Calor Extremo/efeitos adversos , Feminino , Florida/epidemiologia , Transtornos de Estresse por Calor/epidemiologia , Humanos , Masculino , Previdência Social
15.
Sci Total Environ ; 794: 148260, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34328123

RESUMO

Extreme heat is an increasing climate threat, most pronounced in urban areas where poor populations are at particular risk. We analyzed heat impacts and vulnerabilities of 1027 outdoor workers who participated in a KAP survey in Hanoi, Vietnam in 2018, and the influence of their mitigation actions, their knowledge of heat-risks, and access to early warnings. We grouped respondents by their main income (vendors, builders, shippers, others, multiple jobs, and non-working) and analyzed their reported heat-health impacts, taking into consideration socioeconomics, knowledge of heat impacts and preventive measures, actions taken, access to air-conditioning, drinking amounts and use of weather forecasts. We applied linear and logistic regression analyses using R. Construction workers were younger and had less knowledge of heat-health impacts, but also reported fewer symptoms. Older females were more likely to report symptoms and visit a doctor. Access to air-conditioning in the bedroom depended on age and house ownership, but did not influence heat impacts as cooling was too expensive. Respondents who knew more heat exhaustion symptoms were more likely to report impacts (p < 0.01) or consult a doctor (p < 0.05). Similarly, those who checked weather updates were more likely to report heat impacts (p < 0.01) and experienced about 0.6 more symptoms (p < 0.01). Even though occupation type did not explain heat illness, builders knew considerably less (40%; p < 0.05) about heat than other groups but were twice as likely to consult a doctor than street vendors (p < 0.01). Knowledge of preventive actions and taking these actions both correlated positively with reporting of heat-health symptoms, while drinking water did not reduce these symptoms (p < 0.01). Child carers and homeowners experienced income losses in heatwaves (p < 0.01). The differences support directed actions, such as dissemination of educational materials and weather forecasts for construction workers. The Red Cross assisted all groups with cooling tents, provision of drinks and health advice.


Assuntos
Calor Extremo , Transtornos de Estresse por Calor , Calor Extremo/efeitos adversos , Feminino , Temperatura Alta , Humanos , Masculino , Percepção , Vietnã
16.
Nature ; 595(7867): 331-332, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34262218
19.
Environ Pollut ; 285: 117474, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34087635

RESUMO

Non-optimum ambient temperature has been associated with a variety of health outcomes in the elderly population. However, few studies have examined its adverse effects on neurocognitive function. In this study, we explored the temperature-cognition association in elderly women. We investigated 777 elderly women from the German SALIA cohort during the 2007-2010 follow-up. Cognitive function was evaluated using the CERAD-Plus test battery. Modelled data on daily weather conditions were assigned to the residential addresses. The temperature-cognition association over lag 0-10 days was estimated using multivariable regression with distributed lag non-linear model. The daily mean temperature ranged between -6.7 and 26.0 °C during the study period for the 777 participants. We observed an inverse U-shaped association in elderly women, with the optimum temperature (15.3 °C) located at the 68th percentile of the temperature range. The average z-score of global cognitive function declined by -0.31 (95%CI: 0.73, 0.11) for extreme cold (the 2.5th percentile of temperature range) and -0.92 (95%CI: 1.50, -0.33) for extreme heat (the 97.5th percentile of temperature range), in comparison to the optimum temperature. Episodic memory was more sensitive to heat exposure, while semantic memory and executive function were the two cognitive domains sensitive to cold exposure. Individuals living in an urban area and those with a low educational level were particularly sensitive to extreme heat. In summary, non-optimum temperature was inversely associated with cognitive function in elderly women, with the effect size for heat exposure particularly substantial. The strength of association varied by cognitive domains and individual characteristics.


Assuntos
Calor Extremo , Temperatura Alta , Idoso , Cognição , Temperatura Baixa , Feminino , Humanos , Temperatura , Tempo (Meteorologia)
20.
Artigo em Inglês | MEDLINE | ID: mdl-34069110

RESUMO

The aim of this study was to evaluate the acute and adaptive effects of passive extreme heat (100 ± 3 °C) exposition in combination with a strength training protocol on maximal isometric handgrip strength. Fifty-four untrained male university students participated in this investigation. Twenty-nine formed the control group (NG) and 25 the heat-exposed group (HG). All the participants performed a 3-week isotonic handgrip strength training program twice a week with a training volume of 10 series of 10 repetitions with 45-s rest between series, per session. All the subjects only trained their right hand, leaving their left hand untrained. HG performed the same training protocol in hot (100 ± 3 °C) conditions in a dry sauna. Maximal isometric handgrip strength was evaluated each training day before and after the session. NG participants did not experience any modifications in either hand by the end of the study while HG increased maximal strength values in both hands (p < 0.05), decreased the difference between hands (p < 0.05), and recorded higher values than the controls in the trained (p < 0.05) and untrained (p < 0.01) hands after the intervention period. These changes were not accompanied by any modification in body composition in either group. The performance of a unilateral isotonic handgrip strength program in hot conditions during the three weeks induced an increase in maximal isometric handgrip strength in both hands without modifications to bodyweight or absolute body composition.


Assuntos
Calor Extremo , Treinamento de Força , Mãos , Força da Mão , Humanos , Masculino , Músculo Esquelético , Descanso
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