Pub Date : 2023-05-05DOI: 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.
{"title":"Association between wildfire smoke exposure and Seattle, Washington Pediatric Hospital services, 2006–2020","authors":"Daaniya Iyaz, Alexandra Perkins, J. Cogen, A. Doubleday, C. Sack, T. B. Busch Isaksen","doi":"10.1088/2752-5309/acd2f6","DOIUrl":"https://doi.org/10.1088/2752-5309/acd2f6","url":null,"abstract":"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.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48454983","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}
Pub Date : 2023-05-04DOI: 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.
{"title":"Health impacts of smoke exposure in South America: increased risk for populations in the Amazonian Indigenous territories","authors":"E. Bonilla, L. Mickley, G. Raheja, S. Eastham, J. Buonocore, A. Alencar, L. Verchot, D. Westervelt, M. C. Castro","doi":"10.1088/2752-5309/acb22b","DOIUrl":"https://doi.org/10.1088/2752-5309/acb22b","url":null,"abstract":"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.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47889037","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}
Pub Date : 2023-03-29DOI: 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.
{"title":"Coding for climate: sourcing better climate-health data from medical billing","authors":"S. Wheat, E. Sbiroli, M. Dunn, B. Chekuri, Amanda Millstein, Terry O'Connor, C. Rublee, J. Lemery, Vijay S. Limaye","doi":"10.1088/2752-5309/acc887","DOIUrl":"https://doi.org/10.1088/2752-5309/acc887","url":null,"abstract":"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.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43521805","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}
Pub Date : 2023-03-22DOI: 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.
{"title":"Wildfires and the COVID-19 pandemic: a systematized literature review of converging health crises","authors":"K. Clark, M. Sheehan","doi":"10.1088/2752-5309/acc680","DOIUrl":"https://doi.org/10.1088/2752-5309/acc680","url":null,"abstract":"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.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43077652","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}
Pub Date : 2023-03-09DOI: 10.1088/2752-5309/acc2dc
Lara Schwarz, Rosana Aguilera, Javier Emmanuel Castillo Quiñones, L. C. Aguilar-Dodier, María Evarista Arellano García, T. Benmarhnia
2020 broke records for the most active fire year on the West Coast, resulting in the worst air quality observed in decades. Concurrently, the public health threat of COVID-19 caused over 1 million deaths in the United States (US) and Mexico in 2020 and 2021. Due to the effect of air pollution on respiratory diseases, wildfire-specific particulate matter is a hypothesized driver of COVID-19 severity and death. Capitalizing on wildfire smoke that hit the San Diego-Tijuana border region in September 2020, we applied synthetic control methods to explore its potential differential role in affecting COVID-19 mortality on both sides of the border. Daily data on COVID-19 cumulative deaths for US counties were obtained from the CDC COVID tracker and data for Mexican municipalities was obtained from the Mexican Secretary of Health. Counties and municipalities with wildfire smoke exposure were identified using the National Oceanic and Atmospheric Administration hazard mapping smoke product (HMS); a day where 90% of the area was covered by smoke was considered exposed for the main analyses. Unexposed counties/municipalities were considered as potential controls. The San Diego-Tijuana border region was covered by dense smoke by the 7th of September; 707 COVID-19 deaths had occurred in San Diego and 1367 in Tijuana. While a slight increase in cumulative mortality was observed in San Diego, no change was found in Tijuana; neither estimate indicated a strong precise effect of wildfire smoke on COVID-19 mortality. We hope this study will serve as an illustration of how border contexts can be used to investigate differential vulnerability to wildfire smoke for infectious diseases. Examining the interactive effect of COVID-19 and smoke can help in recognizing the implications of these dual health risks which will be increasingly important as wildfires become more frequent and severe in the context of climate change.
{"title":"The potential impact of wildfire smoke on COVID-19 cumulative deaths in the San Diego-Tijuana border region","authors":"Lara Schwarz, Rosana Aguilera, Javier Emmanuel Castillo Quiñones, L. C. Aguilar-Dodier, María Evarista Arellano García, T. Benmarhnia","doi":"10.1088/2752-5309/acc2dc","DOIUrl":"https://doi.org/10.1088/2752-5309/acc2dc","url":null,"abstract":"2020 broke records for the most active fire year on the West Coast, resulting in the worst air quality observed in decades. Concurrently, the public health threat of COVID-19 caused over 1 million deaths in the United States (US) and Mexico in 2020 and 2021. Due to the effect of air pollution on respiratory diseases, wildfire-specific particulate matter is a hypothesized driver of COVID-19 severity and death. Capitalizing on wildfire smoke that hit the San Diego-Tijuana border region in September 2020, we applied synthetic control methods to explore its potential differential role in affecting COVID-19 mortality on both sides of the border. Daily data on COVID-19 cumulative deaths for US counties were obtained from the CDC COVID tracker and data for Mexican municipalities was obtained from the Mexican Secretary of Health. Counties and municipalities with wildfire smoke exposure were identified using the National Oceanic and Atmospheric Administration hazard mapping smoke product (HMS); a day where 90% of the area was covered by smoke was considered exposed for the main analyses. Unexposed counties/municipalities were considered as potential controls. The San Diego-Tijuana border region was covered by dense smoke by the 7th of September; 707 COVID-19 deaths had occurred in San Diego and 1367 in Tijuana. While a slight increase in cumulative mortality was observed in San Diego, no change was found in Tijuana; neither estimate indicated a strong precise effect of wildfire smoke on COVID-19 mortality. We hope this study will serve as an illustration of how border contexts can be used to investigate differential vulnerability to wildfire smoke for infectious diseases. Examining the interactive effect of COVID-19 and smoke can help in recognizing the implications of these dual health risks which will be increasingly important as wildfires become more frequent and severe in the context of climate change.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42293860","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}
Pub Date : 2023-03-09DOI: 10.1088/2752-5309/acc2dd
D. Helldén, R. Ndejjo, Amanda Sturm, Ida Persson, R. Wanyenze, K. Ebi, M. Nilsson, T. Alfvén
Children are bearing and will continue to bear a high burden from climate change, through direct and indirect pathways. Climate change adaptation interventions are essential to limit the current and projected impacts of climate change on child health. However, the perspective of children and their health with regards to adaptation in research and policy is limited. Ensuring that adaptation interventions are context specific, consider interrelated barriers to implementation and leverage existing structures including multisectoral collaboration is vital. Further, a life-course perspective on child health and well-being could serve as a template for tailoring adaptation interventions to the specific vulnerabilities and needs of specific development periods of the child. A meaningful engagement of children and young persons in the design and implementation of adaptation interventions is essential to increase effectiveness and uptake. With climate change effecting millions of children worldwide, it is high time to put child health at the center of adaptation.
{"title":"Climate change adaptation across the life-course - from pregnancy to adolescence – it’s time to advance the field of climate change and child health","authors":"D. Helldén, R. Ndejjo, Amanda Sturm, Ida Persson, R. Wanyenze, K. Ebi, M. Nilsson, T. Alfvén","doi":"10.1088/2752-5309/acc2dd","DOIUrl":"https://doi.org/10.1088/2752-5309/acc2dd","url":null,"abstract":"Children are bearing and will continue to bear a high burden from climate change, through direct and indirect pathways. Climate change adaptation interventions are essential to limit the current and projected impacts of climate change on child health. However, the perspective of children and their health with regards to adaptation in research and policy is limited. Ensuring that adaptation interventions are context specific, consider interrelated barriers to implementation and leverage existing structures including multisectoral collaboration is vital. Further, a life-course perspective on child health and well-being could serve as a template for tailoring adaptation interventions to the specific vulnerabilities and needs of specific development periods of the child. A meaningful engagement of children and young persons in the design and implementation of adaptation interventions is essential to increase effectiveness and uptake. With climate change effecting millions of children worldwide, it is high time to put child health at the center of adaptation.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47318591","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}
Pub Date : 2023-03-01DOI: 10.1088/2752-5309/ac78fa
Jennifer D Stowell, Yuantong Sun, Keith R Spangler, Chad W Milando, Aaron Bernstein, Kate R Weinberger, Shengzhi Sun, Gregory A Wellenius
High ambient temperatures have become more likely due to climate change and are linked to higher rates of heat-related illness, respiratory and cardiovascular diseases, mental health disorders, and other diseases. To date, far fewer studies have examined the effects of high temperatures on children versus adults, and studies including children have seldom been conducted on a national scale. Compared to adults, children have behavioral and physiological differences that may give them differential heat vulnerability. We acquired medical claims data from a large database of commercially insured US children aged 0-17 from May to September (warm-season) 2016-2019. Daily maximum ambient temperature and daily mean relative humidity estimates were aggregated to the county level using the Parameter-elevation Relationships on Independent Slopes dataset, and extreme heat was defined as the 95th percentile of the county-specific daily maximum temperature distribution. Using a case-crossover design and temperature lags 0-5 days, we estimated the associations between extreme heat and cause-specific emergency department visits (ED) in children aged <18 years, using the median county-specific daily maximum temperature distribution as the reference. Approximately 1.2 million ED visits in children from 2489 US counties were available during the study period. The 95th percentile of warm-season temperatures ranged from 71 °F to 112 °F (21.7 °C to 44.4 °C). Comparing 95th to the 50th percentile, extreme heat was associated with higher rates of ED visits for heat-related illness; endocrine, nutritional and metabolic diseases; and otitis media and externa, but not for all-cause admissions. Subgroup analyses suggested differences by age, with extreme heat positively associated with heat-related illness for both the 6-12 year (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.16, 1.56) and 13-17 year age groups (OR: 1.55, 95% CI: 1.37, 1.76). Among children with health insurance across the US, days of extreme heat were associated with higher rates of healthcare utilization. These results highlight the importance of individual and population-level actions to protect children and adolescents from extreme heat, particularly in the context of continued climate change.
{"title":"Warm-season temperatures and emergency department visits among children with health insurance.","authors":"Jennifer D Stowell, Yuantong Sun, Keith R Spangler, Chad W Milando, Aaron Bernstein, Kate R Weinberger, Shengzhi Sun, Gregory A Wellenius","doi":"10.1088/2752-5309/ac78fa","DOIUrl":"https://doi.org/10.1088/2752-5309/ac78fa","url":null,"abstract":"<p><p>High ambient temperatures have become more likely due to climate change and are linked to higher rates of heat-related illness, respiratory and cardiovascular diseases, mental health disorders, and other diseases. To date, far fewer studies have examined the effects of high temperatures on children versus adults, and studies including children have seldom been conducted on a national scale. Compared to adults, children have behavioral and physiological differences that may give them differential heat vulnerability. We acquired medical claims data from a large database of commercially insured US children aged 0-17 from May to September (warm-season) 2016-2019. Daily maximum ambient temperature and daily mean relative humidity estimates were aggregated to the county level using the Parameter-elevation Relationships on Independent Slopes dataset, and extreme heat was defined as the 95th percentile of the county-specific daily maximum temperature distribution. Using a case-crossover design and temperature lags 0-5 days, we estimated the associations between extreme heat and cause-specific emergency department visits (ED) in children aged <18 years, using the median county-specific daily maximum temperature distribution as the reference. Approximately 1.2 million ED visits in children from 2489 US counties were available during the study period. The 95th percentile of warm-season temperatures ranged from 71 °F to 112 °F (21.7 °C to 44.4 °C). Comparing 95th to the 50th percentile, extreme heat was associated with higher rates of ED visits for heat-related illness; endocrine, nutritional and metabolic diseases; and otitis media and externa, but not for all-cause admissions. Subgroup analyses suggested differences by age, with extreme heat positively associated with heat-related illness for both the 6-12 year (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.16, 1.56) and 13-17 year age groups (OR: 1.55, 95% CI: 1.37, 1.76). Among children with health insurance across the US, days of extreme heat were associated with higher rates of healthcare utilization. These results highlight the importance of individual and population-level actions to protect children and adolescents from extreme heat, particularly in the context of continued climate change.</p>","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":"1 1","pages":"015002"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10375213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-14DOI: 10.1088/2752-5309/acbbe6
Daniel J. Smith, Elizabeth Mizelle, Sharon L. Leslie, Grace X Li, Sheila Stone, P. Stauffer, Anna R. Smith, Gianna Lewis, E. L. Rodden, R. McDermott-Levy, Lisa M. Thompson
Climate change, the greatest public health threat of the 21st century, will uniquely affect rural areas that are geographically isolated and experience greater health inequities. This systematic review describes and evaluates interventions to lessen the effects of climate change on human health in the rural United States, including interventions on air pollution, vector ecology, water quality, severe weather, extreme heat, allergens, and water and food supply. Searches were constructed based on the eight domains of the Centers for Disease Control and Prevention (CDC) Framework “Impact of Climate Change on Human Health.” Searches were conducted in EBSCO Environment Complete, EBSCO GreenFILE, Embase.com, MEDLINE via PubMed, and Web of Science. Duplicate citations were removed, abstracts were screened for initial inclusion, and full texts were screened for final inclusion. Pertinent data were extracted and synthesized across the eight domains. Article quality was assessed using the Mixed Methods Appraisal Tool. Of 8471 studies screened, 297 were identified for full text review, and a total 49 studies were included in this review. Across the domains, 34 unique interventions addressed health outcomes due to air pollution (n = 8), changes in vector ecology (n = 6), water quality (n = 5), severe weather (n = 3), extreme heat (n = 2) increasing allergens (n = 1), water and food supply (n = 1), and across multiple CDC domains (n = 8). Participatory action research methodology was commonly used and strived to mobilize/empower communities to tackle climate change. Our review identified three randomized controlled trials, with two of these three published in the last five years. While original research on the impact of climate change on health has increased in the past decade, randomized control trials may not be ethical, cost effective, or feasible. There is a need for time-efficient and high-quality scholarship that investigates intervention efficacy and effectiveness for reducing health impacts of climate change upon rural populations.
{"title":"Intervention studies to reduce the impact of climate change on health in rural communities in the United States: a systematic review","authors":"Daniel J. Smith, Elizabeth Mizelle, Sharon L. Leslie, Grace X Li, Sheila Stone, P. Stauffer, Anna R. Smith, Gianna Lewis, E. L. Rodden, R. McDermott-Levy, Lisa M. Thompson","doi":"10.1088/2752-5309/acbbe6","DOIUrl":"https://doi.org/10.1088/2752-5309/acbbe6","url":null,"abstract":"Climate change, the greatest public health threat of the 21st century, will uniquely affect rural areas that are geographically isolated and experience greater health inequities. This systematic review describes and evaluates interventions to lessen the effects of climate change on human health in the rural United States, including interventions on air pollution, vector ecology, water quality, severe weather, extreme heat, allergens, and water and food supply. Searches were constructed based on the eight domains of the Centers for Disease Control and Prevention (CDC) Framework “Impact of Climate Change on Human Health.” Searches were conducted in EBSCO Environment Complete, EBSCO GreenFILE, Embase.com, MEDLINE via PubMed, and Web of Science. Duplicate citations were removed, abstracts were screened for initial inclusion, and full texts were screened for final inclusion. Pertinent data were extracted and synthesized across the eight domains. Article quality was assessed using the Mixed Methods Appraisal Tool. Of 8471 studies screened, 297 were identified for full text review, and a total 49 studies were included in this review. Across the domains, 34 unique interventions addressed health outcomes due to air pollution (n = 8), changes in vector ecology (n = 6), water quality (n = 5), severe weather (n = 3), extreme heat (n = 2) increasing allergens (n = 1), water and food supply (n = 1), and across multiple CDC domains (n = 8). Participatory action research methodology was commonly used and strived to mobilize/empower communities to tackle climate change. Our review identified three randomized controlled trials, with two of these three published in the last five years. While original research on the impact of climate change on health has increased in the past decade, randomized control trials may not be ethical, cost effective, or feasible. There is a need for time-efficient and high-quality scholarship that investigates intervention efficacy and effectiveness for reducing health impacts of climate change upon rural populations.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48652620","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}
Pub Date : 2023-01-26DOI: 10.1088/2752-5309/acb663
L. Edwards, P. Wilkinson, G. Rutter, Leslie Iverson, A. Milojevic
Air purifiers (APs) and home sealing are interventions used to help protect U.S. diplomats against particle pollution in the home when working in polluted cities. We investigated the effect of these interventions on home indoor and personal PM2.5 exposure in Kathmandu, Nepal. Twenty-one participants underwent repeated 48 hour personal monitoring before and after intervention. We analyzed these measurements by microenvironment. Indoor-outdoor ratios (I/O) using the home indoor PM2.5 values were calculated in order to assess the air filtration capacity at home in light of increasing outdoor PM2.5 post-intervention. To quantify the effect of intervention on home indoor PM2.5, we conducted a meta-analysis of the results of dwelling-by-dwelling regression of indoor-on-outdoor (I/O) PM2.5 concentrations. On average, adding high-capacity APs and home sealing led to a 15% decrease in PM2.5 measured at home, excluding cooking periods, with a mean (standard deviation) of 7.5 (6.4) μg m−3 pre- to 6.4 (8.1) μg m−3 post-intervention despite a 57% increase in outdoor PM2.5, from 43.8 (30.8) μg m−3 pre- to 68.9 (40.7) μg m−3 post-intervention. Overall mean personal exposure fell by 36% from 15.2 (10.6) μg m−3 to 9.8 (8.7) μg m−3. I/O ratios decreased as outdoor PM2.5 strata increased; when outdoor PM2.5 < 25 μg m−3 the I/O decreased from 0.38 pre- to 0.12 post-intervention and when outdoor PM2.5 was 101–200 μg m−3 the I/O decreased from 0.12 pre- to 0.07 post-intervention. The mean regression slope of indoor-on-outdoor PM2.5 decreased from 0.13 (95% CI 0.09, 0.17) in pre-intervention dwellings to 0.07 (0.04, 0.10) post-intervention. I/O ratios showed a weak negative (not statistically significant) inverse association with air changes per hour at home. In the high pollution environment of Kathmandu, APs with home sealing provide substantial protection against ambient PM2.5 in the home environment, including during periods when outdoor PM2.5 concentration was above 100 μg m−3.
{"title":"Impact of mitigation measures to improve home indoor air quality in Kathmandu, Nepal","authors":"L. Edwards, P. Wilkinson, G. Rutter, Leslie Iverson, A. Milojevic","doi":"10.1088/2752-5309/acb663","DOIUrl":"https://doi.org/10.1088/2752-5309/acb663","url":null,"abstract":"Air purifiers (APs) and home sealing are interventions used to help protect U.S. diplomats against particle pollution in the home when working in polluted cities. We investigated the effect of these interventions on home indoor and personal PM2.5 exposure in Kathmandu, Nepal. Twenty-one participants underwent repeated 48 hour personal monitoring before and after intervention. We analyzed these measurements by microenvironment. Indoor-outdoor ratios (I/O) using the home indoor PM2.5 values were calculated in order to assess the air filtration capacity at home in light of increasing outdoor PM2.5 post-intervention. To quantify the effect of intervention on home indoor PM2.5, we conducted a meta-analysis of the results of dwelling-by-dwelling regression of indoor-on-outdoor (I/O) PM2.5 concentrations. On average, adding high-capacity APs and home sealing led to a 15% decrease in PM2.5 measured at home, excluding cooking periods, with a mean (standard deviation) of 7.5 (6.4) μg m−3 pre- to 6.4 (8.1) μg m−3 post-intervention despite a 57% increase in outdoor PM2.5, from 43.8 (30.8) μg m−3 pre- to 68.9 (40.7) μg m−3 post-intervention. Overall mean personal exposure fell by 36% from 15.2 (10.6) μg m−3 to 9.8 (8.7) μg m−3. I/O ratios decreased as outdoor PM2.5 strata increased; when outdoor PM2.5 < 25 μg m−3 the I/O decreased from 0.38 pre- to 0.12 post-intervention and when outdoor PM2.5 was 101–200 μg m−3 the I/O decreased from 0.12 pre- to 0.07 post-intervention. The mean regression slope of indoor-on-outdoor PM2.5 decreased from 0.13 (95% CI 0.09, 0.17) in pre-intervention dwellings to 0.07 (0.04, 0.10) post-intervention. I/O ratios showed a weak negative (not statistically significant) inverse association with air changes per hour at home. In the high pollution environment of Kathmandu, APs with home sealing provide substantial protection against ambient PM2.5 in the home environment, including during periods when outdoor PM2.5 concentration was above 100 μg m−3.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43309359","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}
Pub Date : 2023-01-10DOI: 10.1088/2752-5309/ac9748
K. Maciaszek, S. Gillies, S. Kawichai, T. Prapamontol, Teetawat Santijitpakdee, Wissanupong Kliengchuay, Narut Sahanavin, W. Mueller, S. Vardoulakis, Pawitrabhorn Samutrtai, J. Cherrie, David M. Brown, Kraichat Tantrakarnapa, H. Johnston
Chiang Mai (Thailand) experiences severe haze pollution in the dry season (December–April) each year mainly due to local and regional biomass burning (e.g. of agricultural land). A major component of the haze is airborne particulate matter (PM). During haze events, biomass burning is likely to be the dominant source of PM emissions, and at other times emissions from traffic dominate. The hazard of traffic derived PM has been extensively investigated previously but there are uncertainties regarding the toxicity of PM emitted from biomass burning. The toxicity of PM10 samples collected during and after haze events in Chiang Mai in 2020 was compared in vitro in J774.1 macrophages as they are responsible for the clearance of inhaled particles. Diesel exhaust particles and ultrafine carbon black were included as benchmark particles as they have been commonly used as a surrogate for PM. Cytotoxicity was evaluated 24 h post exposure at concentrations of 3.9–125 µg ml−1. Cytokine production (tumour necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-1β, macrophage inflammatory protein (MIP-2)) was assessed and cell morphology visualised using light and scanning electron microscopy. The hydrodynamic diameter, zeta potential and endotoxin content of all particles was assessed as well as the metal content of PM samples. All particles induced a concentration dependent decrease in cell viability and increased TNF-α and MIP-2 production. Only PM samples stimulated IL-6 production and only non-haze PM caused IL-1β production. No change in IL-10 production was detected for any particle. PM samples and DEP caused vacuole formation in cells. The concentrations of endotoxin and metals were highest in non-haze PM, which may explain why it induced the greatest inflammatory response. As non-haze PM was more toxic than haze PM, our results indicate that the source of PM emissions can influence its toxic potency and more specifically, that PM emitted from biomass burning may be less toxic than PM emitted from traffic.
{"title":"In vitro assessment of the pulmonary toxicity of particulate matter emitted during haze events in Chiang Mai, Thailand via investigation of macrophage responses","authors":"K. Maciaszek, S. Gillies, S. Kawichai, T. Prapamontol, Teetawat Santijitpakdee, Wissanupong Kliengchuay, Narut Sahanavin, W. Mueller, S. Vardoulakis, Pawitrabhorn Samutrtai, J. Cherrie, David M. Brown, Kraichat Tantrakarnapa, H. Johnston","doi":"10.1088/2752-5309/ac9748","DOIUrl":"https://doi.org/10.1088/2752-5309/ac9748","url":null,"abstract":"Chiang Mai (Thailand) experiences severe haze pollution in the dry season (December–April) each year mainly due to local and regional biomass burning (e.g. of agricultural land). A major component of the haze is airborne particulate matter (PM). During haze events, biomass burning is likely to be the dominant source of PM emissions, and at other times emissions from traffic dominate. The hazard of traffic derived PM has been extensively investigated previously but there are uncertainties regarding the toxicity of PM emitted from biomass burning. The toxicity of PM10 samples collected during and after haze events in Chiang Mai in 2020 was compared in vitro in J774.1 macrophages as they are responsible for the clearance of inhaled particles. Diesel exhaust particles and ultrafine carbon black were included as benchmark particles as they have been commonly used as a surrogate for PM. Cytotoxicity was evaluated 24 h post exposure at concentrations of 3.9–125 µg ml−1. Cytokine production (tumour necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-1β, macrophage inflammatory protein (MIP-2)) was assessed and cell morphology visualised using light and scanning electron microscopy. The hydrodynamic diameter, zeta potential and endotoxin content of all particles was assessed as well as the metal content of PM samples. All particles induced a concentration dependent decrease in cell viability and increased TNF-α and MIP-2 production. Only PM samples stimulated IL-6 production and only non-haze PM caused IL-1β production. No change in IL-10 production was detected for any particle. PM samples and DEP caused vacuole formation in cells. The concentrations of endotoxin and metals were highest in non-haze PM, which may explain why it induced the greatest inflammatory response. As non-haze PM was more toxic than haze PM, our results indicate that the source of PM emissions can influence its toxic potency and more specifically, that PM emitted from biomass burning may be less toxic than PM emitted from traffic.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45418016","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}
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