The journal of climate change and health最新文献

Background

Climate change has been deemed the biggest global health threat of the 21st century. One consequence of climate change is the increasing frequency and severity of forest fires. Smoke from wildfires has the ability to negatively impact air quality over large distances. The aim of this study was to examine the association that air quality had on emergency department visits for cardiac, respiratory and psychiatric/behavioral health chief complaints during forest fire season in Vancouver, British Columbia.

Methods

The study period was January 1, 2009 – December 31, 2019. Forest fire season was defined as April 1- September 30. Air quality (measured by PM2.5 in ug/m³) was obtained from the Vancouver International Airport (YVR) Air Quality station. Emergency department visit data (CEDIS triage complaint) was acquired from a regional emergency department database. A generalized linear mixed model with Poisson link function was used to determine the relative risk (as a percentage) for respiratory, cardiac and psychiatric/behavioral health CEDIS triage complaints associated with a 10 unit increase in PM2.5.

Results

PM2.5 during forest fire season was significantly associated with emergency department visits for respiratory chief complaints. For every 10 ug/m³ increase in PM2.5, there was a 4.61% (95% CI: 3.07, 6.17) increase in relative risk of respiratory chief complaints presenting to emergency departments. No association was found between PM2.5 and cardiac or psychiatric/behavioral health chief complaints during forest fire season or non-forest fire season. During non-forest fire season, PM2.5 was found to be negatively associated with respiratory (-3.57, 95% CI: -5.44, -1.66) and cardiac chief complaints (-2.77, 95% CI: -4.16, -1.47).

Conclusion

Our results indicate a probable association between air quality during forest fire season and emergency department visits for respiratory chief complaints. This provides further illustration of the widespread impact of climate change, and underscores the importance of efforts to address it.

The brain health and development implications of climate change are situated within a large and rapidly increasing body of evidence that addresses the physical and mental health impacts and implications of extreme and worsening environments. The costs to individuals and societies of negatively impacted brain development are profound – be it in the form of diagnosable developmental disability, reduced cognitive capacity, or areas of behavioral functioning. We have sought to describe the key risk domains that climate change presents with respect to healthy brain development, from the prenatal through to youth stages. Scoping review methods and an a priori search strategy were used to address the question: What are the major considerations of the peer-reviewed literature that address climate change as it relates to brain development and health from early development through to youth populations? Themes from the identified papers were charted, and findings were summarized through a consensus process. A total of 40 papers were identified in the search, spanning 2008–2022. Based on the thematic analysis, results are organized into the following nine themes: 1) heat extremes, 2) weather extremes and stress, 3) air pollution, 4) vector and waterborne illnesses, 5) malnutrition, 6) equity, 7) economic implications, 8) methods issues, and 9) responses. There is a clear consensus amongst the papers in this review suggesting that changing climate patterns and weather extremes have substantial and wide-ranging effects on developing brains. A range of responses are proposed with an emphasis upon early intervention and better data.

Background

Climate change is predicted to be one of the most substantial influences on future global public health. Addressing this urgent problem requires substantive public and professional engagement in developing public health policy and ensuring its implementation and adherence. This paper explores the current perceptions of the public and officers of public health and their willingness to engage in a climate health policy.

Methods

A systematic integrative review was conducted, drawing on an established framework. This incorporated systematic literature searching, quality appraisal, data extraction and synthesis of findings from qualitative and quantitative studies.

Results

Only 13 studies were included in the review, indicating a paucity of knowledge. However, a growth in the number of studies during the recent decade was observed. Significant concerns identified were belief that public health wasn't sufficiently engaged in the climate debate or associated policies, a felt lack of expertise among public health experts regarding their ability to influence policy in this area (knowledge, resources and influence), and a small but significant proportion of professionals and the public denying the reality of climate change. The findings demonstrate public understanding and support for policy when climate change is seen within a health frame. Further, the study shows gaps in the required knowledge, attitudes, resources, and political and administrative support in effective public health engagement.

Conclusion

These findings point to the need for both strategic involvement and empowerment of public health officials at national and local levels, and development of a robust evidence base to support resultant policies.

Introduction

Academic medical faculty, who devote their lives to improving human health, are often frequent travelers. Given the significant contribution of transportation and travel activities to local and global environmental degradation, faculty must grapple with the impact of their work on patients and the public. During the COVID-19 pandemic, academicians were forced to develop innovative communication and business strategies, which also spawned new perspectives on the role of travel in academic life. We sought to learn more about these adaptations and perspectives, and to consider whether insights gained might inform a more deliberate and conscientious culture of academic travel.

Materials and Methods

We conducted faculty focus groups with participants from different academic levels and four different health graduate programs at an academic medical center, and inquired about motivations for and perspectives on past, present and future travel practices.

Results

Faculty provided extensive observations about their travel histories and how, in the middle of the COVID-19 pandemic, they were responding to abrupt challenges to their personal and professional responsibilities. They addressed the cognitive dissonance generated by flying frequently during a time of global warming, and they offered multiple recommendations for changes to the status quo.

Conclusion

Building on the rich qualitative data gathered during our focus groups, we propose a unique framework for academicians to advance the culture of travel in the 21st century. This framework proposes specific steps to mitigate planetary degradation and its associated inequities, and it suggests creative mechanisms for simultaneously enhancing the personal and professional quality of faculty life.

Introduction

Climate change impacts human health by exacerbating existing vulnerabilities to communicable and non-communicable diseases and creating new ones. Consequently, there has been increasing recognition of the need for a dedicated focus on ‘climate health’ in medical education and the healthcare profession globally. In this study, we explored the perspectives of doctors on the impact of heat on human health in Hyderabad, India and how a climate health approach can be adopted across Indian healthcare.

Methods

A global literature review on climate health broadly, and heat health specifically was carried out. Based on our analysis of the literature, we developed an interview questionnaire and conducted semi-structured interviews with 16 specialist physicians in order to understand their perspectives on the impacts of heat on human health in the region of Hyderabad and institutional transformations necessary to better address questions of heat health. Interview findings were interpreted against extant research on climate health.

Results

Climate health and heat-health challenges are aggravating globally, and the doctors perceive that the Hyderabad region is no exception. While efforts are underway to operationalize a climate health approach in healthcare systems in countries of the Global North, such an orientation is almost absent from the context of Indian medical education and healthcare.

Conclusion

Impacts of climate change and heat on human health are becoming more apparent in the Hyderabad region. This suggests a strong need to incorporate greater attention to climate health and heat health as part of medical education and the healthcare system in India.

Funding

This research has been conducted as part of the “Cool Infrastructures: Life with Heat in the Offgrid City” project funded by the Economic and Social Research Council (ESRC), UK (Award No: ES/T008091/1).

Limiting global temperatures in line with the Paris Agreement requires deep and urgent cuts to emissions this decade from across all sectors, including healthcare. Yet, it can often take many years, even decades, for evidence from health research to be translated into practice. This article explores how researchers in the climate change and health field can and perhaps should operate in such an environment. Should they shift towards ‘action-orientated’ research? Should they pursue alternative pathways, such as advocacy? Should they take to the streets? First, I describe how value judgements can shape scientific research and discourse, and, in turn, policy and practice; I then discuss the recent history of advocacy amongst climate scientists and draw parallels with the experience of health researchers; finally, I consider some possible ways to navigate the tensions between research and advocacy inherent to climate change and health research. I conclude that greater reflexivity upon the values underpinning our work on can help researchers navigate the challenges we face.

Background

There are indications that heatwaves will be intensified in duration, frequency and magnitude and will pose threats to the livelihoods and health of the global working population. The purpose of this scoping review was to map evidence regarding occupational heat stress risk factors, their impact on workers’ health and productivity, and potential adaptation measures.

Methods

Keywords reflecting climate change, heat stress, health, productivity and adaptation strategies were used for searches in PubMed, PubMed Central, Scopus and Web of Science. Manuscripts that focused on heat adaptation, health and productivity outcomes of heat exposure among working populations were considered eligible for this review, while reviews, preprints and papers focused on the general population were excluded.

Results

The evidence suggests that gender, age, pre-shift dehydration, piece-rate payment, poor access to sanitation facilities, use of inappropriate personal protective equipment, physically demanding work, high workload, low job control, and high temperatures are risk factors for heat-related illness, dehydration, kidney diseases and mental distress. Specific working populations including migrants, pregnant women, and children were found to be extremely vulnerable to heat stress. The review identified that frequent intake of fluids, resting under shade or in cooling facilities, changing work hours, and increased electrolyte intake were used as adaptation measures.

Conclusion

Measures targeting adequate hydration, self-pacing, work-rest regimes, provision of shade and appropriate sanitation facilities need to be matched with improved psychosocial work conditions such as optimal work hours, job autonomy and control, and social supports to ensure safe working conditions in changing climates.