More than half of the world's population currently live in urban areas and are particularly at risk from the combined effects of the urban heat island phenomenon and heat increases due to climate ...change. Here, by using remotely sensed surface temperature data and social-ecological indicators, focusing on the hot dry season, and applying the risk framework of the Intergovernmental Panel on Climate Change, we assessed the current heat health risk in 139 Philippine cities, which account for about 40% of the country's total population. The cities at high or very high risk are found in Metro Manila, where levels of heat hazard and exposure are high. The most vulnerable cities are, however, found mainly outside the national capital region, where sensitivity is higher and capacity to cope and adapt is lower. Cities with high levels of heat vulnerability and exposure must be prioritized for adaptation. Our results will contribute to risk profiling in the Philippines and to the understanding of city-level heat health risks in developing regions of the Asia-Pacific.
Epidemiological studies based on mortality and crime data have indicated that short-term exposure to higher temperature increases the risk of suicide and violent crimes. However, there are few ...studies on non-fatal intentional injury, especially on non-fatal self-harm which is much more common than suicide.
We aimed to clarify how short-term exposure to temperature is associated with emergency ambulance transport caused by intentional injuries including acts of self-harm and assault.
We applied a time-stratified case-crossover design using a conditional quasi-Poisson regression model for each of the 46 prefectures. All temperatures were converted to percentile value for each prefecture, to account for the varied climate across Japan. A Distributed Lag Non-Linear Model was used to explore the temperature percentile and lag pattern. The prefecture-specific results were combined using a meta-analysis with the random effects model.
Between 2012 and 2015, the number of acts of self-harm and assault across all 46 prefectures totaled 151,801 and 95,861, respectively. We found that as the temperature increased, the relative risk (RRs) for both self-harm and assault behaviors increased in a nearly linear manner. The pooled relative risk at the 99th percentile temperature for self-harm behavior was 1.11 (95% CI: 1.07, 1.15) compared with the risk at the 1st percentile temperature, and that for assault was 1.12 (95% CI: 1.08, 1.16) at lag 0. The RRs were highest at lag0 and less than 1 at lag7–20.
The present study found that short-term exposure to higher temperature promotes the risk of emergency ambulance transport due to acts of self-harm and assault. The lag pattern indicates a possible “displacement” effect. These results suggest that exposure to high temperatures may potentially function as a trigger for intentional injuries.
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•Elevated temperature may increase intentional injuries.•The association was strongest on the same day.•There may be morbidity displacement in exposure-response lag patterns.
Several studies have noted that the existence of comorbidities lead to an increase in the risk of premature mortality and morbidity. Most of the studies examining the effects of air pollution on ...comorbidity visits were from Northern American countries, with scarce literature from Asia. This study contributes to existing, yet limited understanding of air pollution-comorbidity by examining the effects of daily air pollutants on outpatient single morbidity and comorbid cardiorespiratory visits in Japan.
A total of 1,452,505 outpatient cardiorespiratory visits were recorded among the 21 Japanese cities from 2013 to 2016. Daily outpatient cardiorespiratory visit data were obtained from a health insurance claims database managed by the Japan Medical Data Center Co., Ltd. (JMDC). A time-stratified case crossover analysis coupled with Generalized Additive Mixed Model was used to analyze the association of daily air pollutants (particulate matter 2.5 μm or less in diameter, ozone and nitrogen dioxide) on daily single (respiratory and cardiovascular) and comorbidity health outcomes. We further examined single and cumulative effects for 0–3 and 0–14 lag periods.
Ozone, NO2, and PM2.5 were positively associated with cardiorespiratory visits in either shorter or longer lags, with more apparent comorbidity associations with NO2 exposure. A 10-unit increase in NO2, after adjusting for ozone, was associated with a 2.24% (95% CI: 1.34–3.15) and 6.49% (95% CI: 5.00–8.01) increase in comorbidity visit at Lag 0 (of Lag 0–3) and cumulative lag 0–3, respectively. Our results contribute to existing evidence suggesting that short-term and extended exposure to air pollution elicit health risks on cardiovascular, respiratory and comorbid clinic visits. Exposure to NO2, in particular, was associated with increase in the risk of single and comorbidity cardiorespiratory visits. Results can be potentially utilized for both individual health (e.g. risk population health management) and health facility management (e.g. health visit influx determination).
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•NO2 exposure leads to greater risks for comorbid visit than single morbidity visit.•Ozone and NO2 exhibited immediate and delayed effects on morbidity visits.•PM2.5 showed delayed association for single- and comorbid cardiorespiratory visits.
The Philippine health system has undergone various changes which addressed the needs of the time. These changes were reflected in the benchmarks and indicators of performance of the whole health ...system. To understand how these changes affected the health system (HS), this study determined the changes in the Philippine health system in relation to different health domains (health determinants, financing, and management/development). Two HS periods were identified, namely, health system period 1 (HS 1) from 1997-2007 and health system period 2 (HS 2) from 2008-2017. Each HS period was assessed based on three domains. The first two domains were quantitatively assessed based on an interrupted time-series method, while the third one underwent a comparative analysis using two Health Systems in Transition reports (2011 and 2018). This study was able to assess the developmental changes in the Philippine health system. Specifically, the (health determinant) maternal mortality rate (MMR) significantly decreased by three maternal deaths per 100,000 live births, the (health financing) tobacco excise tax increased by 13,855 (in Million PhP) in HS 2, and there was (health management/development) an improvement in access to health facilities. However, there was an indication of retrogressive progress with some challenges in HS 1 which remained unaddressed in HS 2. While it seems promising that the health system has progressed with improvements apparent in both health outcomes (e.g., MMR) and health financing (e.g., tobacco excise tax), such improvements were overshadowed by the inefficiencies, which were not addressed by the current health system (HS 2), thus making it more retrogressive than progressive.
To quantify heat-related deaths in Ho Chi Minh City, Vietnam, caused by the urban heat island (UHI) and explore factors that may alleviate the impact of UHIs.
We estimated district-specific ...meteorological conditions from 2010 to 2013 using the dynamic downscaling model and calculated the attributable fraction and number of mortalities resulting from the total, extreme, and mild heat in each district. The difference in attributable fraction of total heat between the central and outer districts was classified as the attributable fraction resulting from the UHI. The association among attributable fraction, attributable number with a green space, population density, and budget revenue of each district was then explored.
The temperature-mortality relationship between the central and outer areas was almost identical. The attributable fraction resulting from the UHI was 0.42%, which was contributed by the difference in temperature distribution between the 2 areas. Every 1-square-kilometer increase in green space per 1000 people can prevent 7.4 deaths caused by heat.
Green space can alleviate the impacts of UHIs, although future studies conducting a heath economic evaluation of tree planting are warranted.
Background Temperature has a significant impact on dengue incidence, however, changes on the temperature-dengue relationship across axes of socio-economic vulnerability is not well described. This ...study sought to determine the association between dengue and temperature in multiple locations in the Philippines and explore the effect modification by socio-economic factors. Method Nationwide dengue cases per province from 2010 to 2019 and data on temperature were obtained from the Philippines' Department of Health-Epidemiological Bureau and ERA5-land, respectively. A generalized additive mixed model (GAMM) with a distributed lag non-linear model was utilized to examine the association between temperature and dengue incidence. We further implemented an interaction analysis in determining how socio-economic factors modify the association. All analyses were implemented using R programming. Results Nationwide temperature-dengue risk function was noted to depict an inverted U-shaped pattern. Dengue risk increased linearly alongside increasing mean temperature from 15.8 degrees Celsius and peaking at 27.5 degrees Celsius before declining. However, province-specific analyses revealed significant heterogeneity. Socio-economic factors had varying impact on the temperature-dengue association. Provinces with high population density, less people in urban areas with larger household size, high poverty incidence, higher health spending per capita, and in lower latitudes were noted to exhibit statistically higher dengue risk compared to their counterparts at the upper temperature range. Conclusions This observational study found that temperature was associated with dengue incidence, and that this association is more apparent in locations with high population density, less people in urban areas with larger household size, high poverty incidence, higher health spending per capita, and in lower latitudes. Differences with socio-economic conditions is linked with dengue risk. This highlights the need to develop interventions tailor-fit to local conditions.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Few studies have examined variation in the associations between heat waves and mortality in an international context.
We aimed to systematically examine the impacts of heat waves on mortality with ...lag effects internationally.
We collected daily data of temperature and mortality from 400 communities in 18 countries/regions and defined 12 types of heat waves by combining community-specific daily mean temperature ≥90th, 92.5th, 95th, and 97.5th percentiles of temperature with duration ≥2, 3, and 4 d. We used time-series analyses to estimate the community-specific heat wave-mortality relation over lags of 0-10 d. Then, we applied meta-analysis to pool heat wave effects at the country level for cumulative and lag effects for each type of heat wave definition.
Heat waves of all definitions had significant cumulative associations with mortality in all countries, but varied by community. The higher the temperature threshold used to define heat waves, the higher heat wave associations on mortality. However, heat wave duration did not modify the impacts. The association between heat waves and mortality appeared acutely and lasted for 3 and 4 d. Heat waves had higher associations with mortality in moderate cold and moderate hot areas than cold and hot areas. There were no added effects of heat waves on mortality in all countries/regions, except for Brazil, Moldova, and Taiwan. Heat waves defined by daily mean and maximum temperatures produced similar heat wave-mortality associations, but not daily minimum temperature.
Results indicate that high temperatures create a substantial health burden, and effects of high temperatures over consecutive days are similar to what would be experienced if high temperature days occurred independently. People living in moderate cold and moderate hot areas are more sensitive to heat waves than those living in cold and hot areas. Daily mean and maximum temperatures had similar ability to define heat waves rather than minimum temperature. https://doi.org/10.1289/EHP1026.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
This cross-sectional study compares rates of help-seeking consultations for incident domestic violence before vs during the COVID-19 pandemic in Japan.
In 2020, Coronavirus disease 2019 (COVID-19) pandemic has brought a huge impact in daily life and has prompted people to take preventive measures. In the summertime, however, the Japanese government ...has cautioned that some COVID-19 pandemic conditions may affect the risk to heatstroke. This study investigated how the COVID-19 pandemic setting affected heatstroke-related ambulance dispatches (HSAD). Daily HSAD data and relevant weather parameters from June to September from 2016 to 2020 of 47 prefectures in Japan were obtained from the Fire and Disaster Management Agency (FDMA) database. A binary variable representing COVID-19 impact was created, whereby years 2016 to 2019 were coded as 0, while 2020 as 1. We employed a two-stage analysis in elucidating the impact of COVID-19 pandemic on HSAD. Firstly, we regressed HSAD with the COVID-19 binary variable after adjusting for relevant covariates to obtain prefecture-specific effect estimates. Prefecture-specific estimates were subsequently pooled via random effects meta-analysis in generating the pooled estimate. Pooled Relative Risk (RR) of HSAD during the COVID-19 pandemic was 0.78 (95% Confidential Interval CI, 0.75–0.82). We found an overall statistically significant decrease in HSAD risk during the COVID-19 pandemic in Japan. Specifically, the decrease in the risk of HSAD may be linked to the COVID-19 precautionary measures such as stay-home request and availability of alternative consultation services, which may have decreased the direct exposure of the population to extreme heat.
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•Impact of COVID-19 pandemic setting on heatstroke in Japan•Risk of HSAD under COVID-19 lower than pre-COVID-19•Precautionary measures may be linked to the decreased risk.
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