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Wildfire smoke exposure and emergency department visits in Washington State. 华盛顿州的野火烟雾暴露和急诊就诊情况。
Pub Date : 2023-06-01 Epub Date: 2023-05-25 DOI: 10.1088/2752-5309/acd3a1
Annie Doubleday, Lianne Sheppard, Elena Austin, Tania Busch Isaksen

Wildfires are increasing in prevalence in western North America due to changing climate conditions. A growing number of studies examine the impact of wildfire smoke on morbidity; however, few evaluate these impacts using syndromic surveillance data that cover many emergency departments (EDs). We used syndromic surveillance data to explore the effect of wildfire smoke exposure on all-cause respiratory and cardiovascular ED visits in Washington state. Using a time-stratified case crossover design, we observed an increased odds of asthma visits immediately after and in all five days following initial exposure (lag 0 OR: 1.13; 95% CI: 1.10, 1.17; lag 1-5 ORs all 1.05 or greater with a lower CI of 1.02 or higher), and an increased odds of respiratory visits in all five days following initial exposure (lag 1 OR: 1.02; 95% CI: 1.00, 1.03; lag 2-5 ORs and lower CIs were all at least as large) comparing wildfire smoke to non-wildfire smoke days. We observed mixed results for cardiovascular visits, with evidence of increased odds emerging only several days following initial exposure. We also found increased odds across all visit categories for a 10 μg m-3 increase in smoke-impacted PM2.5. In stratified analyses, we observed elevated odds for respiratory visits among ages 19-64, for asthma visits among ages 5-64, and mixed risk estimates for cardiovascular visits by age group. This study provides evidence of an increased risk of respiratory ED visits immediately following initial wildfire smoke exposure, and increased risk of cardiovascular ED visits several days following initial exposure. These increased risks are seen particularly among children and younger to middle-aged adults.

由于气候条件的变化,野火在北美西部越来越普遍。越来越多的研究探讨了野火烟雾对发病率的影响;然而,很少有研究利用涵盖许多急诊科(ED)的综合征监测数据来评估这些影响。我们利用综合症监测数据来探讨野火烟雾暴露对华盛顿州全因呼吸道和心血管疾病急诊就诊的影响。通过采用时间分层病例交叉设计,我们观察到哮喘就诊的几率在首次暴露后的第一时间和所有五天内都有所增加(滞后 0 OR:1.13;95% CI:1.10, 1.17;滞后 1-5 OR 均为 1.05 或更高,较低的 CI 为 1.02 或更高)。02或更高),而在最初接触烟雾后的所有五天内,呼吸系统就诊的几率增加(滞后1 OR:1.02;95% CI:1.00, 1.03;滞后2-5 ORs和较低的CIs都至少一样大),将野火烟雾日与非野火烟雾日进行比较。我们观察到的心血管就诊结果好坏参半,只有在最初接触烟雾几天后才出现几率增加的证据。我们还发现,在所有就诊类别中,烟雾影响的 PM2.5 每增加 10 μg m-3 的几率都会增加。在分层分析中,我们观察到 19-64 岁人群呼吸系统就诊几率升高,5-64 岁人群哮喘就诊几率升高,各年龄组心血管就诊风险估计值不一。这项研究提供的证据表明,在初次接触野火烟雾后,呼吸系统急诊就诊的风险会立即增加,而在初次接触烟雾几天后,心血管急诊就诊的风险也会增加。这些增加的风险在儿童和中青年中尤为明显。
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引用次数: 0
Learning to live with smoke: characterizing wildland fire and prescribed fire smoke risk communication in rural Washington 学会与烟雾共存:表征华盛顿农村的荒地火灾和规定的火灾烟雾风险沟通
Pub Date : 2023-06-01 DOI: 10.1088/2752-5309/acdbe3
Savannah M D’Evelyn, L. M. Wood, Cody Desautel, Nicole A. Errett, Kris Ray, J. Spector, E. Alvarado
Extreme smoke events from wildland fires are increasing in frequency and intensity across the country. Risk communication around wildland and prescribed fires is an essential component of both smoke-readiness and resilience. To date, little research has been conducted on how smoke exposure risks can be communicated effectively, especially within the context of rural and tribal communities, who experience a disproportionate burden of smoke risks and impacts. This qualitative study analyzed how tribal and non-tribal communities in the Okanogan River Airshed Emphasis Area (ORAEA) receive and share information about smoke exposure to highlight gaps and communication opportunities for smoke risk communication. The ORAEA is a region of north-central Washington that is frequently blanketed with smoke year-round from wildland fire in the summer, prescribed fire in the fall and spring, and wood burning stoves in the winter. This study was the result of a partnership between the Okanogan River Airshed Partnership, the Natural Resource Division for the Confederated Tribes of the Colville Reservation, the Colville Environmental Trust Air Quality Program, and the University of Washington. The study team conducted seventeen key informant interviews and six focus groups to identify community perceptions of smoke exposure and describe its impact. A thematic analysis of interview and focus group data identified five themes around wildfire smoke risk communication: (1) perception of the health risks of smoke; (2) current ways of sharing information about smoke; (3) trusted sources of information; (4) gaps and communication opportunities; and (5) perceptions of prescribed fire. Based on these themes, we developed a set of six recommended actions. To create effective smoke risk communication that may be applicable to smoke-impacted regions across the country, messaging must address barriers to action, be rooted in community perceptions of risk, and be delivered through trusted channels.
野外火灾产生的极端烟雾事件在全国范围内的频率和强度都在增加。围绕荒地和规定火灾的风险沟通是烟雾准备和恢复能力的重要组成部分。迄今为止,很少有人研究如何有效地传达烟雾暴露风险,特别是在农村和部落社区的背景下,他们承受着不成比例的烟雾风险和影响。这项定性研究分析了奥卡诺根河防空重点地区(OREAA)的部落和非部落社区如何接收和分享有关烟雾暴露的信息,以突出烟雾风险沟通的差距和沟通机会。OREAA是华盛顿中北部的一个地区,夏季的荒地大火、秋季和春季的规定火灾以及冬季的燃木炉全年都会产生烟雾。这项研究是奥卡诺根河流域伙伴关系、科尔维尔保留地邦联部落自然资源部、科尔维尔环境信托空气质量项目和华盛顿大学合作的结果。该研究小组进行了17次关键的线人访谈和6个焦点小组,以确定社区对烟雾暴露的看法并描述其影响。对访谈和焦点小组数据的主题分析确定了围绕野火烟雾风险沟通的五个主题:(1)对烟雾健康风险的感知;(2) 目前分享烟雾信息的方式;(3) 可信的信息来源;(4) 差距和沟通机会;以及(5)对规定火灾的感知。基于这些主题,我们制定了一套六项建议行动。为了建立有效的烟雾风险沟通,适用于全国受烟雾影响的地区,信息传递必须解决行动障碍,植根于社区对风险的认知,并通过可信的渠道传递。
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引用次数: 0
Retrospective analysis of wildfire smoke exposure and birth weight outcomes in the San Francisco Bay Area of California. 对加利福尼亚州旧金山湾区野火烟雾暴露和出生体重结果的回顾性分析。
Pub Date : 2023-06-01 Epub Date: 2023-06-13 DOI: 10.1088/2752-5309/acd5f5
Anna Claire G Fernández, Emilia Basilio, Tarik Benmarhnia, Jacquelyn Roger, Stephanie L Gaw, Joshua F Robinson, Amy M Padula

Despite the occurrence of wildfires quadrupling over the past four decades, the health effects associated with wildfire smoke exposures during pregnancy remains unknown. Particulate matter less than 2.5 μms (PM2.5) is among the major pollutants emitted in wildfire smoke. Previous studies found PM2.5 associated with lower birthweight, however, the relationship between wildfire-specific PM2.5 and birthweight is uncertain. Our study of 7923 singleton births in San Francisco between January 1, 2017 and March 12, 2020 examines associations between wildfire smoke exposure during pregnancy and birthweight. We linked daily estimates of wildfire-specific PM2.5 to maternal residence at the ZIP code level. We used linear and log-binomial regression to examine the relationship between wildfire smoke exposure by trimester and birthweight and adjusted for gestational age, maternal age, race/ethnicity, and educational attainment. We stratified by infant sex to examine potential effect modification. Exposure to wildfire-specific PM2.5 during the second trimester of pregnancy was positively associated with increased risk of large for gestational age (OR = 1.13; 95% CI: 1.03, 1.24), as was the number of days of wildfire-specific PM2.5 above 5 μg m-3 in the second trimester (OR = 1.03; 95% CI: 1.01, 1.06). We found consistent results with wildfire smoke exposure in the second trimester and increased continuous birthweight-for-gestational age z-score. Differences by infant sex were not consistent. Counter to our hypothesis, results suggest that wildfire smoke exposures are associated with increased risk for higher birthweight. We observed strongest associations during the second trimester. These investigations should be expanded to other populations exposed to wildfire smoke and aim to identify vulnerable communities. Additional research is needed to clarify the biological mechanisms in this relationship between wildfire smoke exposure and adverse birth outcomes.

尽管野火的发生率在过去四十年里翻了两番,但怀孕期间接触野火烟雾对健康的影响仍不得而知。小于 2.5 μm 的颗粒物(PM2.5)是野火烟雾中排放的主要污染物之一。以前的研究发现,PM2.5 与较低的出生体重有关,但野火特有的 PM2.5 与出生体重之间的关系尚不确定。我们对 2017 年 1 月 1 日至 2020 年 3 月 12 日期间在旧金山出生的 7923 名单胎婴儿进行了研究,探讨了孕期野火烟雾暴露与出生体重之间的关系。我们将野火特定 PM2.5 的每日估计值与邮政编码级别的产妇居住地联系起来。我们使用线性回归和对数二项式回归来研究野火烟雾暴露与出生体重之间的关系,并对孕龄、产妇年龄、种族/民族和教育程度进行了调整。我们根据婴儿性别进行了分层,以检验潜在的效应修正。孕期后三个月暴露于野火特异性 PM2.5 与胎龄大风险增加呈正相关(OR = 1.13;95% CI:1.03,1.24),孕期后三个月野火特异性 PM2.5 超过 5 μg m-3 的天数也与胎龄大风险增加呈正相关(OR = 1.03;95% CI:1.01,1.06)。我们发现,妊娠后三个月的野火烟雾暴露与连续出生体重-胎龄 Z 值增加的结果一致。婴儿性别差异并不一致。与我们的假设相反,结果表明,暴露于野火烟雾与出生体重增加的风险有关。我们观察到,在妊娠的后三个月,这种关联性最强。这些调查应扩展到其他暴露于野火烟雾的人群,并旨在确定易受影响的社区。还需要进行更多的研究,以阐明野火烟雾暴露与不良出生结果之间关系的生物机制。
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引用次数: 0
Assessing dietary adequacy and temporal variability in the context of Covid-19 among Indigenous and rural communities in Kanungu District, Uganda: a mixed-methods study 评估乌干达卡农古地区土著和农村社区在2019冠状病毒病背景下的饮食充足性和时间变异:一项混合方法研究
Pub Date : 2023-05-18 DOI: 10.1088/2752-5309/acd6b0
G. Scarpa, L. Berrang‐Ford, S. Twesigomwe, P. Kakwangire, M. Galazoula, C. Zavaleta-Cortijo, K. Patterson, D. Namanya, S. Lwasa, E. Ninshaba, M. Kiconco, IHACC Research Team, J. Cade
Dietary adequacy is hard to achieve for many people living in low-income countries, who suffer from nutritional deficiencies. Climate change, which alters weather conditions, has combined with other cascading and compound events to disrupt Indigenous communities’ food systems, limiting the consumption of adequate diets. The aim of this work was to conduct a proof-of-concept study exploring dietary adequacy, and to investigate evidence for temporal variation in the dietary intake of Indigenous and non-Indigenous communities in Kanungu District, Uganda in the context of the Covid-19 outbreak. We randomly selected 60 participants (20 mothers, 20 fathers and 20 children aged between 6 and 23 months) from two Indigenous Batwa and two Bakiga settlements. A mixed-methods study with concurrent qualitative and quantitative data collection was conducted. Monthly dietary intake data were collected from each participant from February to July 2021 through 24 h recall surveys using a specially developed Ugandan food composition database included in the online tool myfood24. At the same time, we also collected: (i) demographic and contextual data related to Covid-19; (ii) data on weather and seasonality; (iii) data on the perception of dietary intake over the year, and during the Covid-19 period; (iv) baseline anthropometric measurements. The majority of the participants did not achieve nutrient adequacy over the 6 months period, and household dietary diversity scores were generally low. Pregnant and lactating women consumed a diet which was severely inadequate in terms of nutrient consumption. Caloric and nutrient intake varied over the 6 months period, with the highest food consumption in June and lowest in April. Temporal variation was more evident among Batwa participants. Vitamin A intake varied more over months than other nutrients in adults’ and children’s diets, and none met iodine requirements. Participants characterised the diverse mechanisms by which season and weather variability determined the type and amount of food consumed each month. Dietary intake showed indications of temporal variation that differed between nutrients. Also, they reported that the Covid-19 pandemic influenced their diet. During lockdown, 58% of adults reported changing dietary habits by consuming less—and less nutritious—foods. The findings of this work highlight that the majority of the Batwa and Bakiga participants did not meet the dietary requirements for their age and gender. Also, our research indicates that weather patterns and seasonality may cause variations in smallholder food production with consequences on households’ dietary intake. Emerging evidence suggests that nutrients and caloric intake vary monthly and under different weather conditions. Accurate and time-varying nutrition evaluations would help in identifying seasonal and monthly dietary needs, supporting preventive interventions protecting children and their parents from any form of malnutrition. Consider
对于生活在低收入国家的许多人来说,饮食充足是很难实现的,他们患有营养缺乏症。气候变化改变了天气条件,再加上其他层叠和复合事件,破坏了土著社区的粮食系统,限制了适当饮食的消费。这项工作的目的是开展一项探索饮食充足性的概念验证研究,并调查在Covid-19疫情背景下乌干达卡农古地区土著和非土著社区饮食摄入量时间变化的证据。我们从两个土著巴特瓦和两个巴加定居点随机选择了60名参与者(20名母亲、20名父亲和20名年龄在6至23个月之间的儿童)。同时进行定性和定量数据收集的混合方法研究。从2021年2月至7月,通过使用在线工具myfood24中包含的专门开发的乌干达食品成分数据库进行24小时回忆调查,从每位参与者收集每月膳食摄入量数据。与此同时,我们还收集了:(i)与Covid-19相关的人口和背景数据;(ii)有关天气和季节性的数据;(三)全年和2019冠状病毒病疫情期间对膳食摄入量的认知数据;(iv)基线人体测量值。大多数参与者在6个月的时间里没有达到营养充足,家庭饮食多样性得分普遍较低。孕妇和哺乳期妇女的饮食在营养消耗方面严重不足。在6个月的时间里,热量和营养的摄入量各不相同,6月的食物消耗量最高,4月最低。时间差异在Batwa参与者中更为明显。几个月来,维生素A的摄入量比成人和儿童饮食中的其他营养素变化更大,而且没有一种符合碘的要求。参与者描述了季节和天气变化决定每个月食物消耗类型和数量的不同机制。膳食摄入量显示出不同营养素之间的时间变化迹象。此外,他们报告说,Covid-19大流行影响了他们的饮食。在封锁期间,58%的成年人报告说,他们通过减少和减少营养食物来改变饮食习惯。这项工作的结果强调,大多数巴特瓦和巴加参与者不符合他们年龄和性别的饮食要求。此外,我们的研究表明,天气模式和季节性可能导致小农粮食生产的变化,从而影响家庭的饮食摄入量。新出现的证据表明,营养物质和热量的摄入量每个月和在不同的天气条件下都是不同的。准确和随时间变化的营养评估将有助于确定季节性和月度饮食需求,支持预防干预措施,保护儿童及其父母免受任何形式的营养不良。随着气候变化影响到小农自给作物的季节性和可得性,考虑随时间变化的营养摄入量将变得越来越重要。
{"title":"Assessing dietary adequacy and temporal variability in the context of Covid-19 among Indigenous and rural communities in Kanungu District, Uganda: a mixed-methods study","authors":"G. Scarpa, L. Berrang‐Ford, S. Twesigomwe, P. Kakwangire, M. Galazoula, C. Zavaleta-Cortijo, K. Patterson, D. Namanya, S. Lwasa, E. Ninshaba, M. Kiconco, IHACC Research Team, J. Cade","doi":"10.1088/2752-5309/acd6b0","DOIUrl":"https://doi.org/10.1088/2752-5309/acd6b0","url":null,"abstract":"Dietary adequacy is hard to achieve for many people living in low-income countries, who suffer from nutritional deficiencies. Climate change, which alters weather conditions, has combined with other cascading and compound events to disrupt Indigenous communities’ food systems, limiting the consumption of adequate diets. The aim of this work was to conduct a proof-of-concept study exploring dietary adequacy, and to investigate evidence for temporal variation in the dietary intake of Indigenous and non-Indigenous communities in Kanungu District, Uganda in the context of the Covid-19 outbreak. We randomly selected 60 participants (20 mothers, 20 fathers and 20 children aged between 6 and 23 months) from two Indigenous Batwa and two Bakiga settlements. A mixed-methods study with concurrent qualitative and quantitative data collection was conducted. Monthly dietary intake data were collected from each participant from February to July 2021 through 24 h recall surveys using a specially developed Ugandan food composition database included in the online tool myfood24. At the same time, we also collected: (i) demographic and contextual data related to Covid-19; (ii) data on weather and seasonality; (iii) data on the perception of dietary intake over the year, and during the Covid-19 period; (iv) baseline anthropometric measurements. The majority of the participants did not achieve nutrient adequacy over the 6 months period, and household dietary diversity scores were generally low. Pregnant and lactating women consumed a diet which was severely inadequate in terms of nutrient consumption. Caloric and nutrient intake varied over the 6 months period, with the highest food consumption in June and lowest in April. Temporal variation was more evident among Batwa participants. Vitamin A intake varied more over months than other nutrients in adults’ and children’s diets, and none met iodine requirements. Participants characterised the diverse mechanisms by which season and weather variability determined the type and amount of food consumed each month. Dietary intake showed indications of temporal variation that differed between nutrients. Also, they reported that the Covid-19 pandemic influenced their diet. During lockdown, 58% of adults reported changing dietary habits by consuming less—and less nutritious—foods. The findings of this work highlight that the majority of the Batwa and Bakiga participants did not meet the dietary requirements for their age and gender. Also, our research indicates that weather patterns and seasonality may cause variations in smallholder food production with consequences on households’ dietary intake. Emerging evidence suggests that nutrients and caloric intake vary monthly and under different weather conditions. Accurate and time-varying nutrition evaluations would help in identifying seasonal and monthly dietary needs, supporting preventive interventions protecting children and their parents from any form of malnutrition. Consider","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47304479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Human mortality attributable to outdoor air pollution in China during the period 2016–2020 2016-2020年中国室外空气污染导致的人类死亡率
Pub Date : 2023-05-09 DOI: 10.1088/2752-5309/acd3a0
Gang Liu, Lingling Jiang, Zhuoying Xu, Yifan Liu, Haikun Wang, Zhen Peng
In this study, a latest reanalysis dataset of atmospheric composition, the Global Exposure Mortality Model and a log-linear exposure-response function were employed to estimate the national deaths attributable to fine particulate matter (PM2.5) and ozone (O3) pollution in China for the period 2016–2020, including the lockdown due to COVID-19 pandemic in 2020. The national mortality attributable to long-term PM2.5 exposure decreased year by year from 2.18 million (95% confidence interval (1.83, 2.51), the same hereinafter) in 2016 to 1.99 million (1.66, 2.30) in 2020. In particular, the number in 2020 was 133.16 thousand less than 2019 owing to the reduced emissions during the pandemic, and the mortality attributable to short-term PM2.5 exposure dropped from 46.86 thousand in 2019 to 36.56 thousand in 2020. However, because O3 concentrations have kept increasing during the period, the national mortality attributable to long-term O3 exposure increased from 132.79 thousand (128.58, 137.00) in 2016 to 197.00 thousand (190.98, 203.03) in 2020. In addition, compared to before the pandemic, the national mortality attributable to short-term O3 exposure showed an increase in February, April and May of 2020, and the sharpest year-on-year increase of 162% occurred in April. The different trends of mortality after anthropogenic emissions were reduced pose a challenge for policy-makers and researchers.
在这项研究中,采用最新的大气成分再分析数据集、全球暴露死亡率模型和对数线性暴露响应函数来估计2016-2020年期间中国细颗粒物(PM2.5)和臭氧(O3)污染造成的全国死亡人数,包括2020年新冠肺炎大流行导致的封锁。全国长期暴露于PM2.5的死亡率逐年下降,从2016年的218万(95%置信区间(1.83,2.51),下同)降至2020年的199万(1.66,2.30)。特别是,由于疫情期间排放量减少,2020年的数字比2019年减少了133.16万,短期PM2.5暴露导致的死亡率从2019年的468.6万下降到2020年的365.6万。然而,由于臭氧浓度在此期间一直在增加,长期暴露于臭氧的全国死亡率从2016年的132.79万(128.58,137.00)增加到2020年的19.7万(190.98,203.03)。此外,与疫情前相比,2020年2月、4月和5月,短期O3暴露导致的全国死亡率有所上升,4月出现了162%的最大同比增幅。人为排放减少后死亡率的不同趋势对决策者和研究人员构成了挑战。
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引用次数: 0
Air pollution and health impacts of oil & gas production in the United States 美国石油和天然气生产对空气污染和健康的影响
Pub Date : 2023-05-08 DOI: 10.1088/2752-5309/acc886
J. Buonocore, S. Reka, Do-Jin Yang, Charles Chang, Ananya Roy, T. Thompson, D. Lyon, Renee McVay, D. Michanowicz, S. Arunachalam
Oil and gas production is one of the largest emitters of methane, a potent greenhouse gas and a significant contributor of air pollution emissions. While research on methane emissions from oil and gas production has grown rapidly, there is comparatively limited information on the distribution of impacts of this sector on air quality and associated health impacts. Understanding the contribution of air quality and health impacts of oil and gas can be useful for designing mitigation strategies. Here we assess air quality and human health impacts associated with ozone, fine particulate matter, and nitrogen dioxide from the oil and gas sector in the US in 2016, and compare this impact with that of the associated methane emissions. We find that air pollution in 2016 from the oil and gas sector in the US resulted in 410 000 asthma exacerbations, 2200 new cases of childhood asthma and 7500 excess deaths, with $77 billion in total health impacts. NO2 was the highest contributor to health impacts (37%) followed by ozone (35%), and then PM2.5 (28%). When monetized, these air quality health impacts of oil and gas production exceeded estimated climate impact costs from methane leakage by a factor of 3. These impacts add to the total life cycle impacts of oil and gas, and represent potential additional health benefits of strategies that reduce consumption of oil and gas. Policies to reduce oil and gas production emissions will lead to additional and significant health benefits from co-pollutant reductions that are not currently quantified or monetized.
石油和天然气生产是甲烷的最大排放国之一,甲烷是一种强效温室气体,也是空气污染排放的重要来源。尽管对石油和天然气生产甲烷排放的研究迅速增长,但关于该部门对空气质量影响的分布和相关健康影响的信息相对有限。了解空气质量的贡献以及石油和天然气对健康的影响有助于制定缓解策略。在这里,我们评估了2016年美国石油和天然气行业的臭氧、细颗粒物和二氧化氮对空气质量和人类健康的影响,并将其与相关甲烷排放的影响进行了比较。我们发现,2016年美国石油和天然气行业的空气污染导致410 000例哮喘恶化,2200例儿童哮喘新增病例和7500例超额死亡,对健康的总影响为770亿美元。NO2对健康影响的贡献最大(37%),其次是臭氧(35%),然后是PM2.5(28%)。如果货币化,石油和天然气生产对空气质量和健康的影响超过了甲烷泄漏对气候影响的估计成本3倍。这些影响增加了石油和天然气的整个生命周期影响,并代表了减少石油和天然气管耗战略的潜在额外健康益处。减少石油和天然气生产排放的政策将从目前尚未量化或货币化的共污染物减少中带来额外的重大健康益处。
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引用次数: 0
Association between wildfire smoke exposure and Seattle, Washington Pediatric Hospital services, 2006–2020 野火烟雾暴露与西雅图、华盛顿儿科医院服务之间的关系,2006-2020
Pub Date : 2023-05-05 DOI: 10.1088/2752-5309/acd2f6
Daaniya Iyaz, Alexandra Perkins, J. Cogen, A. Doubleday, C. Sack, T. B. Busch Isaksen
Pacific Northwest wildfire smoke events have been increasing in prevalence and severity over the past three decades, resulting in documented negative health outcomes in adults. However, there is less evidence demonstrating the effect of wildfire smoke in pediatric populations. To evaluate the association between wildfire smoke exposure and healthcare utilization in a pediatric tertiary medical center in Seattle, WA. We utilized a case–crossover study to determine the odds of pediatric emergency department (ED) visit/ hospital admission at Seattle Children’s Hospital on wildfire smoke days versus non-wildfire smoke days during wildfire season (June to September), 2006–2020. The health outcomes dataset reports hospital encounters in two categories: ED visits or admissions that are for inpatient or observational purposes. The health outcomes dataset reports hospital encounters in two categories: ED visits or admissions that are for inpatient or observational purposes. The reported encounter types are mutually exclusive. We stratified analyses by individual-level characteristics and examined associations for lagged exposures 0–7 d prior to admission. In adjusted analyses, smoke exposure was associated with a 7.0% (95% CI: 3.0%–12.0%) increase in odds of all-cause hospital admissions and a 0.0% (95% CI: −3.0%, 3.0%) change in odds of all-cause ED visits. We also observed increases in the odds of all-cause hospital admissions ranging from 4.0% to 8.0%, for lagged exposure on days 1–7. When stratified by health outcomes, we found a 9.0% (95% CI: 1.0%–17.0%) and an 11.0% (95% CI:1.0%–21.0%) increase in the odds of ED visits for respiratory and respiratory infection-related concerns, respectively. Our results demonstrate associations between wildfire smoke and negative health effects in children. Similar to other studies, we found that wildfire smoke exposure was associated with an increase in respiratory-related ED visits and all-cause hospital admissions in a pediatric population. These results will help inform patient education and motivate interventions to reduce pediatric morbidity during wildfire season.
在过去三十年中,太平洋西北部野火烟雾事件的发生率和严重程度都在增加,导致有记录的成年人健康不良后果。然而,很少有证据表明野火烟雾对儿科人群的影响。评估华盛顿州西雅图儿科三级医疗中心野火烟雾暴露与医疗保健利用之间的关系。我们利用一项病例交叉研究来确定2006-2020年野火季节(6月至9月)野火烟雾日与非野火烟雾日在西雅图儿童医院儿科急诊科(ED)就诊/住院的几率。健康结果数据集报告了两类医院就诊情况:急诊科就诊或住院或观察目的的入院。健康结果数据集报告了两类医院就诊情况:急诊科就诊或住院或观察目的的入院。报告的遭遇类型是互斥的。我们按个体水平特征进行分层分析,并检查入院前0-7天的滞后暴露的相关性。在校正分析中,烟雾暴露与全因住院的几率增加7.0% (95% CI: 3.0% - 12.0%)和全因急诊科就诊的几率增加0.0% (95% CI: - 3.0%, 3.0%)相关。我们还观察到,在1-7天的滞后暴露中,全因住院率增加了4.0%至8.0%。当按健康结果分层时,我们发现因呼吸道和呼吸道感染相关问题就诊的几率分别增加了9.0% (95% CI: 1.0%-17.0%)和11.0% (95% CI: 1.0%-21.0%)。我们的研究结果表明,野火烟雾与儿童的负面健康影响之间存在关联。与其他研究类似,我们发现野火烟雾暴露与儿科呼吸相关急诊科就诊和全因住院的增加有关。这些结果将有助于告知患者教育和激励干预措施,以减少儿童发病率在野火季节。
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引用次数: 0
Health impacts of smoke exposure in South America: increased risk for populations in the Amazonian Indigenous territories 南美洲接触烟雾对健康的影响:亚马逊土著领土人口的风险增加
Pub Date : 2023-05-04 DOI: 10.1088/2752-5309/acb22b
E. Bonilla, L. Mickley, G. Raheja, S. Eastham, J. Buonocore, A. Alencar, L. Verchot, D. Westervelt, M. C. Castro
Smoke particulate matter emitted by fires in the Amazon Basin poses a threat to human health. Past research on this threat has mainly focused on the health impacts on countries as a whole or has relied on hospital admission data to quantify the health response. Such analyses do not capture the impact on people living in Indigenous territories close to the fires and who often lack access to medical care and may not show up at hospitals. Here we quantify the premature mortality due to smoke exposure of people living in Indigenous territories across the Amazon Basin. We use the atmospheric chemistry transport model GEOS-Chem to simulate PM2.5 from fires and other sources, and we apply a recently updated concentration dose-response function. We estimate that smoke from fires in South America accounted for ∼12 000 premature deaths each year from 2014–2019 across the continent, with about ∼230 of these deaths occurring in Indigenous lands. Put another way, smoke exposure accounts for 2 premature deaths per 100 000 people per year across South America, but 4 premature deaths per 100 000 people in the Indigenous territories. Bolivia and Brazil represent hotspots of smoke exposure and deaths in Indigenous territories in these countries are 9 and 12 per 100 000 people, respectively. Our analysis shows that smoke PM2.5 from fires has a detrimental effect on human health across South America, with a disproportionate impact on people living in Indigenous territories.
亚马逊盆地火灾排放的烟雾颗粒物对人类健康构成威胁。过去对这一威胁的研究主要集中在对整个国家的健康影响上,或者依靠入院数据来量化健康反应。这些分析没有捕捉到对生活在靠近火灾的土著地区的人们的影响,这些人往往无法获得医疗服务,也可能不会出现在医院。在这里,我们量化了生活在亚马逊流域土著地区的人们因吸烟而过早死亡的情况。我们使用大气化学传输模型GEOS Chem来模拟火灾和其他来源的PM2.5,并应用最近更新的浓度-剂量反应函数。我们估计,南美洲火灾产生的烟雾约占12 从2014年到2019年,非洲大陆每年有1000人过早死亡,其中约230人发生在土著土地上。换句话说,每100人中有2人死于吸烟 南美洲每年有1000人死亡,但每100人中有4人过早死亡 000人。玻利维亚和巴西是烟雾暴露的热点,在这些国家的土著领土上,死亡人数分别为9/100和12/100 000人。我们的分析表明,火灾产生的烟雾PM2.5对整个南美洲的人类健康产生了不利影响,对居住在土著地区的人们产生了不成比例的影响。
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引用次数: 0
Coding for climate: sourcing better climate-health data from medical billing 为气候编码:从医疗账单中获取更好的气候健康数据
Pub Date : 2023-03-29 DOI: 10.1088/2752-5309/acc887
S. Wheat, E. Sbiroli, M. Dunn, B. Chekuri, Amanda Millstein, Terry O'Connor, C. Rublee, J. Lemery, Vijay S. Limaye
While evidence points to climate change adversely impacting health and wellbeing, there remains a great need for more authoritative and actionable data that better describes the full magnitude and scope of this growing crisis. Given the uncertainty inherent to current detection and attribution studies, the improved specificity offered by the 10th revision of the International Classification of Diseases (ICD-10) coding of climate-sensitive health outcomes at the point of care may help to better quantify the connection between more intense and frequent extreme weather events and specific health sequela. With improved application of the available ICD-10 codes designed to capture climate-sensitive health outcomes, the ICD-10 system can function as a leading indicator. In this collaboration, publicly available ICD-10 code data was downloaded from Centers for Medicare and Medicaid Services archives and cross-referenced with 29 keywords (e.g. heat, hurricane, smoke, etc) determined by relevance to climate impacts on human health from consensus literature. We identified 46 unique ICD-10 codes for climate-sensitive health conditions. By highlighting the need for broader application of these codes and advocating for the development of new codes that better document the growing burden of climate-sensitive health outcomes, we hope to drive the development of more evidence-based, health-protective interdisciplinary climate action strategies across health systems.
虽然有证据表明气候变化对健康和福祉产生不利影响,但仍然非常需要更权威和可操作的数据,以更好地描述这一日益严重的危机的全部程度和范围。鉴于目前的检测和归因研究固有的不确定性,《国际疾病分类》(ICD-10)第10次修订提供的护理点气候敏感健康结果编码的改进特异性可能有助于更好地量化更强烈和频繁的极端天气事件与特定健康后遗症之间的联系。通过改进现有的旨在捕捉气候敏感健康结果的《国际疾病分类-10》代码的应用,《国际疾病分类-10》系统可以作为领先指标发挥作用。在这项合作中,从医疗保险和医疗补助服务中心的档案中下载了可公开获得的ICD-10代码数据,并与共识文献中根据与气候对人类健康影响的相关性确定的29个关键词(如热、飓风、烟雾等)进行了交叉对照。我们为气候敏感型健康状况确定了46个独特的ICD-10代码。我们强调需要更广泛地应用这些准则,并倡导制定新的准则,以便更好地记录气候敏感型卫生结果带来的日益沉重的负担。我们希望通过这些准则,推动整个卫生系统制定更多以证据为基础、保护健康的跨学科气候行动战略。
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引用次数: 0
Wildfires and the COVID-19 pandemic: a systematized literature review of converging health crises 野火与新冠肺炎大流行:对趋同健康危机的系统化文献综述
Pub Date : 2023-03-22 DOI: 10.1088/2752-5309/acc680
K. Clark, M. Sheehan
The emergence and global spread of the COVID-19 pandemic in 2020 converged with wildfire seasons of unprecedented extent. These co-occurring crises brought the potential for amplified health impacts. A systematized literature review was conducted to identify the health impacts from co-exposure to wildfires and the COVID-19 pandemic. A search of PubMed and Scopus identified 373 distinct references which were screened according to predetermined criteria. A total of 22 peer-reviewed publications were included in the final analysis. Studies were located in Australia and the western United States, with a single study in the Amazonian region of Brazil. The studies identified focused primarily on the impact of wildfire smoke exposure on COVID-19 infection and mortality, and the impact of exposure to both crises on mental health. The collective evidence shows that wildfire exposure within the context of the pandemic exacerbated COVID-19 infection and mortality as well as various adverse mental health effects. Additional research is needed in more diverse contexts and with individual-level data. Findings highlight the need for public health preparedness to anticipate overlapping, related crises and to advance climate change mitigation to protect public health.
2020年COVID-19大流行的出现和全球传播与前所未有的野火季节相吻合。这些同时发生的危机有可能扩大对健康的影响。进行了系统的文献综述,以确定共同暴露于野火和COVID-19大流行对健康的影响。对PubMed和Scopus的搜索确定了373个不同的参考文献,这些参考文献是根据预先确定的标准筛选的。共有22份同行评议的出版物被纳入最终分析。研究在澳大利亚和美国西部进行,其中一项研究在巴西的亚马逊地区进行。这些研究主要集中在野火烟雾暴露对COVID-19感染和死亡率的影响,以及暴露于这两种危机对心理健康的影响。集体证据表明,大流行背景下的野火暴露加剧了COVID-19的感染和死亡率,以及各种不良的心理健康影响。需要在更多样化的背景下和在个人层面上进行更多的研究。调查结果强调需要做好公共卫生准备,以预测重叠的相关危机,并推进减缓气候变化以保护公众健康。
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引用次数: 0
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