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18 pages, 1417 KiB

Open AccessArticle

Heat Exposure and Multiple Sclerosis—A Regional and Temporal Analysis

by Gill Chacko, Sneh Patel, Anat Galor and Naresh Kumar

Int. J. Environ. Res. Public Health 2021, 18(11), 5962; https://doi.org/10.3390/ijerph18115962 - 02 Jun 2021

Cited by 10 | Viewed by 4442

Multiple sclerosis (MS) is a neurological disorder that progressively distorts the myelination of axons within the central nervous system (CNS). Increased core body temperature or metabolism as a result of exercise are common causes of short-term exacerbations of neurological symptoms in MS. About [...] Read more.

Multiple sclerosis (MS) is a neurological disorder that progressively distorts the myelination of axons within the central nervous system (CNS). Increased core body temperature or metabolism as a result of exercise are common causes of short-term exacerbations of neurological symptoms in MS. About 60–80% of patients with MS experience a worsening of their symptoms when exposed to heat. In comparison, less data are available on the relationship between ambient meteorological conditions (e.g., temperature and relative humidity (RH)) and fluctuations in such variables in relation to MS symptoms. Thus, this study examined associations between time-lagged exposure to meteorological conditions and risk of a clinic visit due to MS among US veterans between 2010 and 2013. This study leveraged data from the Veterans Affairs (VA) and National Climactic Data Center (NCDC) for the continental US, partitioned into eight climate zones. We used a case crossover design to assess the risk of a MS clinic visit with respect to several meteorological conditions. Location-specific time-lagged daily (ambient) exposure to temperature, RH, and temperature variations (standard deviation (SD) of temperature) were computed (up to 30 days) for each case (i.e., day of MS visit) and control (a randomly assigned date ± 90–270 days prior to visit). Statistical analyses were conducted to examine independent associations between the selected meteorological conditions and risk of MS visits at the national and regional levels. A total of 533,066 patient visits received a MS diagnosis (International Classifications of Diseases (ICD)-9 code = 340). The Northeast (NE) and Upper Midwest (UMW) regions reported the highest frequency of clinic visits due to MS. Clinic visits were 9% more likely to occur in the spring, summer, and fall months (March–October) than in the winter (OR = 1.089; 95% CI = 1.076–1.103; p < 0.01). In the univariate analyses, the SD of temperature, temperature, and temperature–RH interaction were positively associated with an elevated risk of a MS clinic visit, while the RH was negatively associated with the risk for a clinic visit. In multivariate analyses, the strongest association of a MS clinic visit was observed with the SD of the temperature (OR = 1.012; 95% CI 1.008–1.017; p < 0.01). These associations between MS clinic visits and meteorological conditions varied across climate regions, with the strongest associations being observed in the LMW, UMW, DSW, and NE zones. The SD of the temperature was again the strongest associated predictor when examined regionally. Temperature variations and temperature–RH interactions (a proxy of the heat index) showed significant associations with MS clinic visits. These associations varied across climate regions when examined geographically. Our findings have implications for the management of MS in severe or recurrent cases, especially considering the impending changes in the daily temperature variations and intensity of the heatwaves expected with the intensification of global warming. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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18 pages, 1245 KiB

Open AccessArticle

Perspectives on the Health Effects of Hurricanes: A Review and Challenges

by Samantha L. Waddell, Dushyantha T. Jayaweera, Mehdi Mirsaeidi, John C. Beier and Naresh Kumar

Int. J. Environ. Res. Public Health 2021, 18(5), 2756; https://doi.org/10.3390/ijerph18052756 - 09 Mar 2021

Cited by 33 | Viewed by 7646

Abstract

Hurricanes are devastating natural disasters which dramatically modify the physical landscape and alter the socio-physical and biochemical characteristics of the environment, thus exposing the affected communities to new environmental stressors, which persist for weeks to months after the hurricane. This paper has three [...] Read more.

Hurricanes are devastating natural disasters which dramatically modify the physical landscape and alter the socio-physical and biochemical characteristics of the environment, thus exposing the affected communities to new environmental stressors, which persist for weeks to months after the hurricane. This paper has three aims. First, it conceptualizes potential direct and indirect health effects of hurricanes and provides an overview of factors that exacerbate the health effects of hurricanes. Second, it summarizes the literature on the health impact of hurricanes. Finally, it examines the time lag between the hurricane (landfall) and the occurrence of diseases. Two major findings emerge from this paper. Hurricanes are shown to cause and exacerbate multiple diseases, and most adverse health impacts peak within six months following hurricanes. However, chronic diseases, including cardiovascular disease and mental disorders, continue to occur for years following the hurricane impact. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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10 pages, 2643 KiB

Open AccessArticle

Impact of Extreme Weather on Healthcare Utilization by People with HIV in Metropolitan Miami

by Daniel Samano, Shubhayu Saha, Taylor Corbin Kot, JoNell E. Potter and Lunthita M. Duthely

Int. J. Environ. Res. Public Health 2021, 18(5), 2442; https://doi.org/10.3390/ijerph18052442 - 02 Mar 2021

Cited by 5 | Viewed by 3131

Abstract

Extreme weather events (EWE) are expected to increase as climate change intensifies, leaving coastal regions exposed to higher risks. South Florida has the highest HIV infection rate in the United States, and disruptions in clinic utilization due to extreme weather conditions could affect [...] Read more.

Extreme weather events (EWE) are expected to increase as climate change intensifies, leaving coastal regions exposed to higher risks. South Florida has the highest HIV infection rate in the United States, and disruptions in clinic utilization due to extreme weather conditions could affect adherence to treatment and increase community transmission. The objective of this study was to identify the association between EWE and HIV-clinic attendance rates at a large academic medical system serving the Miami-Dade communities. The following methods were utilized: (1) Extreme heat index (EHI) and extreme precipitation (EP) were identified using daily observations from 1990–2019 that were collected at the Miami International Airport weather station located 3.6 miles from the studied HIV clinics. Data on hurricanes, coastal storms and flooding were collected from the National Oceanic and Atmospheric Administration Storms Database (NOAA) for Miami-Dade County. (2) An all-HIV clinic registry identified scheduled daily visits during the study period (hurricane seasons from 2017–2019). (3) Daily weather data were linked to the all-HIV clinic registry, where patients’ ‘no-show’ status was the variable of interest. (4) A time-stratified, case crossover model was used to estimate the relative risk of no-show on days with a high heat index, precipitation, and/or an extreme natural event. A total of 26,444 scheduled visits were analyzed during the 383-day study period. A steady increase in the relative risk of ‘no-show’ was observed in successive categories, with a 14% increase observed on days when the heat index was extreme compared to days with a relatively low EHI, 13% on days with EP compared to days with no EP, and 10% higher on days with a reported extreme weather event compared to days without such incident. This study represents a novel approach to improving local understanding of the impacts of EWE on the HIV-population’s utilization of healthcare, particularly when the frequency and intensity of EWE is expected to increase and disproportionately affect vulnerable populations. More studies are needed to understand the impact of EWE on routine outpatient settings. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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12 pages, 1138 KiB

Open AccessArticle

The Effect of Minimum and Maximum Air Temperatures in the Summer on Heat Stroke in Japan: A Time-Stratified Case-Crossover Study

by Shinji Otani, Satomi Funaki Ishizu, Toshio Masumoto, Hiroki Amano and Youichi Kurozawa

Int. J. Environ. Res. Public Health 2021, 18(4), 1632; https://doi.org/10.3390/ijerph18041632 - 09 Feb 2021

Cited by 8 | Viewed by 2638

Abstract

An increase in the global surface temperature and changes in urban morphologies are associated with increased heat stress especially in urban areas. This can be one of the contributing factors underlying an increase in heat strokes. We examined the impact of summer minimum [...] Read more.

An increase in the global surface temperature and changes in urban morphologies are associated with increased heat stress especially in urban areas. This can be one of the contributing factors underlying an increase in heat strokes. We examined the impact of summer minimum air temperatures, which often represent nighttime temperatures, as well as a maximum temperature on a heat stroke. We collected data from the records of daily ambulance transports for heat strokes and meteorological data for July and August of 2017–2019 in the Tottori Prefecture, Japan. A time-stratified case-crossover design was used to determine the association of maximum/minimum air temperatures and the incidence of heat strokes. We used a logistic regression to identify factors associated with the severity of heat strokes. A total of 1108 cases were identified with 373 (33.7%) calls originating in the home (of these, 59.8% were the age of ≥ 75). A total of 65.8% of cases under the age of 18 were related to exercise. Days with a minimum temperature ≥ 25 °C had an odds ratio (95% confidence interval) of 3.77 (2.19, 6.51) for the incidence of an exercise-related heat stroke (reference: days with a minimum temperature < 23 °C). The odds ratio for a heat stroke occurring at home or for calls for an ambulance to the home was 6.75 (4.47, 10.20). The severity of the heat stroke was associated with older age but not with air temperature. Minimum and maximum air temperatures may be associated with the incidence of heat strokes and in particular the former with non-exertional heat strokes. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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17 pages, 2101 KiB

Open AccessArticle

Drought, Wellbeing and Adaptive Capacity: Why Do Some People Stay Well?

by Emma K. Austin, Tonelle Handley, Anthony S. Kiem, Jane L. Rich, David Perkins and Brian Kelly

Int. J. Environ. Res. Public Health 2020, 17(19), 7214; https://doi.org/10.3390/ijerph17197214 - 02 Oct 2020

Cited by 10 | Viewed by 3231

Abstract

Drought is a threat to public health. Individual and community adaptive capacity is crucial when responding to the impacts of drought. Gaps remain in the understandings of the relationship between wellbeing and adaptive capacity, and whether increased wellbeing can lead to improved adaptive [...] Read more.

Drought is a threat to public health. Individual and community adaptive capacity is crucial when responding to the impacts of drought. Gaps remain in the understandings of the relationship between wellbeing and adaptive capacity, and whether increased wellbeing can lead to improved adaptive capacity (or vice versa). This paper explores the relationship between drought, wellbeing and adaptive capacity to provide insights that will inform actions to enhance adaptive capacity, and hence increase opportunities for effective drought adaptation. The theory of salutogenesis and the associated sense of coherence (SOC) are used to measure adaptive capacity and to explain why some individuals remain well and adapt to adversity while others do not. An online survey of rural residents (n = 163) in drought-affected New South Wales (NSW), Australia, was conducted from November 2018 to January 2019. Linear regression was used to model the relationships between SOC, sociodemographic factors, drought and wellbeing. Findings demonstrate that SOC is strongly correlated with wellbeing. Drought condition did not influence adaptive capacity, although adaptive capacity and drought-related stress were only weakly correlated. Increased wellbeing was found to be associated with stronger adaptive capacity and therefore, an individuals’ capacity to cope with adversity, such as drought. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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17 pages, 698 KiB

Open AccessArticle

Factors Associated with Food Insecurity Following Hurricane Harvey in Texas

by Lauren A. Clay and Ashley D. Ross

Int. J. Environ. Res. Public Health 2020, 17(3), 762; https://doi.org/10.3390/ijerph17030762 - 25 Jan 2020

Cited by 33 | Viewed by 6243

Abstract

Food insecurity prevalence among disaster-affected households has been found to be higher than state prevalence in non-disaster times. This study applies a socio-ecological model of post-disaster food insecurity to a nested quota sample (n = 1002) recruited for a web survey from [...] Read more.

Food insecurity prevalence among disaster-affected households has been found to be higher than state prevalence in non-disaster times. This study applies a socio-ecological model of post-disaster food insecurity to a nested quota sample (n = 1002) recruited for a web survey from 41 Texas counties affected by Hurricane Harvey 12–15 months post-event. This analysis identifies risk and protective factors for food insecurity. Chi-square analysis was used to examine independent associations between individual, household, and social factors with food insecurity. A multivariate logistic model was fitted and adjusted odds ratios are reported. Economic instability (adjusted odds ratio (OR) 2.43; 95% Confidence Interval (CI) 1.73, 3.41), relocation due to Hurricane Harvey (OR 1.89; CI 1.15, 3.09), major home damage (OR 2.11; CI 1.12, 3.98), non-white race – black (OR 1.79; CI 1.01, 3.18), Hispanic (OR 1.67; CI 1.09, 2.54), other race (OR 4.39; CI 1.96, 9.82) – and community-based organization assistance (1.99; 1.11, 3.58) were risk factors while older age (45–64 years: 0.49; 0.32, 0.73; 65+ years 0.40; 0.22, 0.75), better physical health (0.46; 0.29, 0.71), better mental health (0.46; 0.32, 0.67), and high social support (0.37; 0.25, 0.55) were protective against food insecurity. Disaster policies and programs should address the disproportionate burden on households that relocate or have health conditions. Fostering social support networks, especially among relocated populations, may improve disaster health outcomes. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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15 pages, 3245 KiB

Open AccessArticle

Regional Temperature-Sensitive Diseases and Attributable Fractions in China

by Xuemei Su, Yibin Cheng, Yu Wang, Yue Liu, Na Li, Yonghong Li and Xiaoyuan Yao

Int. J. Environ. Res. Public Health 2020, 17(1), 184; https://doi.org/10.3390/ijerph17010184 - 26 Dec 2019

Cited by 17 | Viewed by 3089

Abstract

Few studies have been carried out to systematically screen regional temperature-sensitive diseases. This study was aimed at systematically and comprehensively screening both high- and low-temperature-sensitive diseases by using mortality data from 17 study sites in China located in temperate and subtropical climate zones. [...] Read more.

Few studies have been carried out to systematically screen regional temperature-sensitive diseases. This study was aimed at systematically and comprehensively screening both high- and low-temperature-sensitive diseases by using mortality data from 17 study sites in China located in temperate and subtropical climate zones. The distributed lag nonlinear model (DLNM) was applied to quantify the association between extreme temperature and mortality to screen temperature-sensitive diseases from 18 kinds of diseases of eight disease systems. The attributable fractions (AFs) of sensitive diseases were calculated to assess the mortality burden attributable to high and low temperatures. A total of 1,380,713 records of all-cause deaths were involved. The results indicate that injuries, nervous, circulatory and respiratory diseases are sensitive to heat, with the attributable fraction accounting for 6.5%, 4.2%, 3.9% and 1.85%, respectively. Respiratory and circulatory diseases are sensitive to cold temperature, with the attributable fraction accounting for 13.3% and 11.8%, respectively. Most of the high- and low-temperature-sensitive diseases seem to have higher relative risk in study sites located in subtropical zones than in temperate zones. However, the attributable fractions for mortality of heat-related injuries were higher in temperate zones. The results of this research provide epidemiological evidence of the relative burden of mortality across two climate zones in China. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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14 pages, 798 KiB

Open AccessEssay

Heat Extremes, Public Health Impacts, and Adaptation Policy in Germany

by Hans-Guido Mücke and Jutta Maria Litvinovitch

Int. J. Environ. Res. Public Health 2020, 17(21), 7862; https://doi.org/10.3390/ijerph17217862 - 27 Oct 2020

Cited by 29 | Viewed by 13586

Abstract

Global warming with increasing weather extremes, like heat events, is enhancing impacts to public health. This essay focuses on unusual extreme summer heat extremes occurring in Germany at higher frequency, longer duration, and with new temperature records. Large areas of the country are [...] Read more.

Global warming with increasing weather extremes, like heat events, is enhancing impacts to public health. This essay focuses on unusual extreme summer heat extremes occurring in Germany at higher frequency, longer duration, and with new temperature records. Large areas of the country are affected, particularly urban settlements, where about 77% of the population lives, which are exposed to multiple inner-city threats, such as urban heat islands. Because harm to public health is directly released by high ambient air temperatures, local and national studies on heat-related morbidity and mortality indicate that vulnerable groups such as the elderly population are predominantly threatened with heat-related health problems. After the severe mortality impacts of the extreme summer heat 2003 in Europe, in 2008, Germany took up the National Adaptation Strategy on Climate Change to tackle and manage the impacts of weather extremes, for example to protect people’s health against heat. Public health systems and services need to be better prepared to improve resilience to the effects of extreme heat events, e.g., by implementing heat health action plans. Both climate protection as well as adaptation are necessary in order to be able to respond as adequate as possible to the challenges posed by climate change. Full article

(This article belongs to the Special Issue (In)Direct Health Effects of Extreme Weather)

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