Allergic diseases are a major public health problem globally and are increasing. The impacts of climate change on aeroallergens such as pollen and fungal spores and allergic respiratory diseases such ...as allergic asthma and allergic rhinitis have been considered since the early years of climate change and human health research, and exploration of this topic has accelerated over the past decade or so. This review examines the impacts of climate change on aeroallergens, including interactions with air pollutants, and the resulting impacts on allergic respiratory diseases. It discusses mitigation and adaptation in this context. It does this with a focus on advances over the last 2 years (2019 and 2020) to highlight research at the frontier of this field. It also explores the growing recognition of the need for a more holistic and integrated approach to environmental monitoring and exposure and presents the concept of the aeroexposome as a frame through which these impacts of climate change and responses to them could be viewed moving forward. As the evidence of impacts of climate change on aeroallergen production and atmospheric concentration, seasonality, distribution, and allergenicity mounts, crucial research demonstrating the resulting impacts on health outcomes such as aeroallergen sensitisation prevalence, asthma emergency department visits, and asthma hospitalisations is now emerging. It is vital that the momentum of the last decade continue with research to fill the many gaps that remain in our knowledge of this complex topic-refining analytical techniques, broadening the geographical coverage (to include, for example, the Southern Hemisphere), and more explicitly exploring the impacts of climate change on indoor aeroallergens.
Understanding of the factors driving global antimicrobial resistance is limited. We analysed antimicrobial resistance and antibiotic consumption worldwide versus many potential contributing factors.
...Using three sources of data (ResistanceMap, the WHO 2014 report on antimicrobial resistance, and contemporary publications), we created two global indices of antimicrobial resistance for 103 countries using data from 2008 to 2014: Escherichia coli resistance—the global average prevalence of E coli bacteria that were resistant to third-generation cephalosporins and fluoroquinolones, and aggregate resistance—the combined average prevalence of E coli and Klebsiella spp resistant to third-generation cephalosporins, fluoroquinolones, and carbapenems, and meticillin-resistant Staphylococcus aureus. Antibiotic consumption data were obtained from the IQVIA MIDAS database. The World Bank DataBank was used to obtain data for governance, education, gross domestic product (GDP) per capita, health-care spending, and community infrastructure (eg, sanitation). A corruption index was derived using data from Transparency International. We examined associations between antimicrobial resistance and potential contributing factors using simple correlation for a univariate analysis and a logistic regression model for a multivariable analysis.
In the univariate analysis, GDP per capita, education, infrastructure, public health-care spending, and antibiotic consumption were all inversely correlated with the two antimicrobial resistance indices, whereas higher temperatures, poorer governance, and the ratio of private to public health expenditure were positively correlated. In the multivariable regression analysis (confined to the 73 countries for which antibiotic consumption data were available) considering the effect of changes in indices on E coli resistance (R2 0·54) and aggregate resistance (R2 0·75), better infrastructure (p=0·014 and p=0·0052) and better governance (p=0·025 and p<0·0001) were associated with lower antimicrobial resistance indices. Antibiotic consumption was not significantly associated with either antimicrobial resistance index in the multivariable analysis (p=0·64 and p=0·070).
Reduction of antibiotic consumption will not be sufficient to control antimicrobial resistance because contagion—the spread of resistant strains and resistance genes—seems to be the dominant contributing factor. Improving sanitation, increasing access to clean water, and ensuring good governance, as well as increasing public health-care expenditure and better regulating the private health sector are all necessary to reduce global antimicrobial resistance.
None.
Reports of ChAdOx1 vaccine-associated thrombocytopenia and vascular adverse events have led to some countries restricting its use. Using a national prospective cohort, we estimated associations ...between exposure to first-dose ChAdOx1 or BNT162b2 vaccination and hematological and vascular adverse events using a nested incident-matched case-control study and a confirmatory self-controlled case series (SCCS) analysis. An association was found between ChAdOx1 vaccination and idiopathic thrombocytopenic purpura (ITP) (0-27 d after vaccination; adjusted rate ratio (aRR) = 5.77, 95% confidence interval (CI), 2.41-13.83), with an estimated incidence of 1.13 (0.62-1.63) cases per 100,000 doses. An SCCS analysis confirmed that this was unlikely due to bias (RR = 1.98 (1.29-3.02)). There was also an increased risk for arterial thromboembolic events (aRR = 1.22, 1.12-1.34) 0-27 d after vaccination, with an SCCS RR of 0.97 (0.93-1.02). For hemorrhagic events 0-27 d after vaccination, the aRR was 1.48 (1.12-1.96), with an SCCS RR of 0.95 (0.82-1.11). A first dose of ChAdOx1 was found to be associated with small increased risks of ITP, with suggestive evidence of an increased risk of arterial thromboembolic and hemorrhagic events. The attenuation of effect found in the SCCS analysis means that there is the potential for overestimation of the reported results, which might indicate the presence of some residual confounding or confounding by indication. Public health authorities should inform their jurisdictions of these relatively small increased risks associated with ChAdOx1. No positive associations were seen between BNT162b2 and thrombocytopenic, thromboembolic and hemorrhagic events.
Display omitted
•Four of the planetary boundaries have been exceeded and other are under pressure.•Planetary changes pose increasing threats to human health.•Imperative to identify the research ...progress and knowledge gaps in this field.
It has been widely recognised that the threats to human health from global environmental changes (GECs) are increasing in the Anthropocene epoch, and urgent actions are required to tackle these pressing challenges. A scoping review was conducted to provide an overview of the nine planetary boundaries and the threats to population health posed by human activities that are exceeding these boundaries in the Anthropocene. The research progress and key knowledge gaps were identified in this emerging field. Over the past three decades, there has been a great deal of research progress on health risks from climate change, land-use change and urbanisation, biodiversity loss and other GECs. However, several significant challenges remain, including the misperception of the relationship between human and nature; assessment of the compounding risks of GECs; strategies to reduce and prevent the potential health impacts of GECs; and uncertainties in fulfilling the commitments to the Paris Agreement. Confronting these challenges will require rigorous scientific research that is well-coordinated across different disciplines and various sectors. It is imperative for the international community to work together to develop informed policies to avert crises and ensure a safe and sustainable planet for the present and future generations.
Climate change has been identified as the biggest global health threat of the twenty-first century. Hundreds of millions of people around the world currently suffer from allergic diseases such as ...asthma and allergic rhinitis (hay fever), and the prevalence of these diseases is increasing. This book is the first authoritative and comprehensive assessment of the many impacts of climate change on allergens, such as pollen and mould spores, and allergic diseases. The international authorship team of leaders in this field explore the topic to a breadth and depth far beyond any previous work. This book will be of value to anyone with an interest in climate change, environmental allergens, and related allergic diseases. It is written at a level that is accessible for those working in related physical, biological, and health and medical sciences, including researchers, academics, clinicians, and advanced students.
Accumulation of anthropogenic gases, particularly CO2 , is likely to have 2 fundamental effects on plant biology. The first is an indirect effect through Earth’s increasing average surface ...temperatures, with subsequent effects on other aspects of climate, such as rainfall and extreme weather events. The second is a direct effect caused by CO2 -induced stimulation of photosynthesis and plant growth. Both effects are likely to alter a number of fundamental aspects of plant biology and human health, including aerobiology and allergic diseases, respectively. This review highlights the current and projected effect of increasing CO2 and climate change in the context of plants and allergen exposure, emphasizing direct effects on plant physiologic parameters (eg, pollen production) and indirect effects (eg, fungal sporulation) related to diverse biotic and abiotic interactions. Overall, the review assumes that future global mitigation efforts will be limited and suggests a number of key research areas that will assist in adapting to the ongoing challenges to public health associated with increased allergen exposure.
Summary Human activities are resulting in increases in atmospheric greenhouse gases, such as carbon dioxide, and changes in global climate. These, in turn, are likely to have had, and will continue ...to have, impacts on human health. While such impacts have received increasing attention in recent years, the impacts of climate change on aeroallergens and related allergic diseases have been somewhat neglected. Despite this, a number of studies have revealed potential impacts of climate change on aeroallergens that may have enormous clinical and public health significance. The purpose of this review is to synthesize this work and to outline a number of research challenges in this area. There is now considerable evidence to suggest that climate change will have, and has already had, impacts on aeroallergens. These include impacts on pollen amount, pollen allergenicity, pollen season, plant and pollen distribution, and other plant attributes. There is also some evidence of impacts on other aeroallergens, such as mould spores. There are many research challenges along the road to a more complete understanding of the impacts of climate change on aeroallergens and allergic diseases such as asthma and hayfever. It is important that public health authorities and allergy practitioners be aware of these changes in the environment, and that research scientists embrace the challenges that face further work in this area.
Introduced
Vespula wasps have successfully invaded beech (
Nothofagus) forests in New Zealand. By collecting honeydew, an abundant carbohydrate resource, wasps can reach high numbers. Honeydew is ...produced by an endemic scale insect which infests about 1 million hectares of land, 15% of New Zealand's remaining native forest. At the peak of the wasp season, honeydew beech forests had an average biomass of about 3.8 kg of introduced wasps ha
−1 (10,000 workers ha
−1). These abundant invaders reduce the standing crop of honeydew by more than 90% for 5 months of the year and so compete with native species (such as birds and invertebrates) that also consume honeydew. The behaviour of three species of native bird is affected by this reduction in honeydew, but it is unknown if this affects the survival or reproductive success of these birds. Nevertheless, to avoid altering the birds' behaviour, wasp density should not increase above a level where wasps revisit honeydew threads more than once every 180–400 min. Additionally, the predation rate of wasps on some invertebrate prey species is so high that the probability of an individual surviving through the wasp season is virtually nil. Hence wasps probably reduce or eradicate populations of some invertebrates. Wasp abundance needs to be reduced by 80–90% to conserve some native invertebrate species. Wasps could also affect nutrient cycling in the honeydew beech forest community by reducing the flow of carbon to micro-organisms in the phyllosphere and the soil, which ultimately could affect soil solution chemistry. Current control tools are unable to reduce wasp populations over large tracts of forest. The challenge is to identify and develop new control techniques to achieve widespread control for conservation gains. The impact of introduced social wasps provides a warning of the damage exotic ants could cause if they were to invade honeydew beech forest. New Zealand needs to be vigilant to reduce the risk of an invasion by ants or other social wasps.
Antimicrobial resistance is a growing global problem that causes increased deaths as well as increased suffering for people. Overall, there are two main factors that drive antimicrobial resistance: ...the volumes of antimicrobials used and the spread of resistant micro-organisms along with the genes encoding for resistance. Importantly, a growing body of evidence points to contagion (i.e., spread) being the major, but frequently under-appreciated and neglected, factor driving the increased prevalence of antimicrobial resistance. When we aggregate countries into regional groupings, it shows a pattern where there is an inverse aggregate relationship between AMR and usage. Poor infrastructure and corruption levels, however, are highly and positively correlated with antimicrobial resistance levels. Contagion, antibiotic volumes, governance, and the way antibiotics are used are profoundly affected by a host of social and economic factors. Only after we identify and adequately address these factors can antimicrobial resistance be better controlled.
PDF
