Temperature Extremes and Health: Impacts of Climate Variability and Change in the United States

Department of Epidemiology and Environmental Health (Dr Neill), University of Michigan School of Public Health, Ann Arbor, Mich, USA.
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine (Impact Factor: 1.63). 02/2009; 51(1):13-25. DOI: 10.1097/JOM.0b013e318173e122
Source: PubMed

ABSTRACT We evaluated temperature-related morbidity and mortality for the 2007 U.S. national assessment on impacts of climate change and variability on human health.
We assessed literature published since the 2000 national assessment, evaluating epidemiologic studies, surveys, and studies projecting future impacts.
Under current climate change projections, heat waves and hot weather are likely to increase in frequency, with the overall temperature distribution shifting away from the colder extremes. Vulnerable subgroups include communities in the northeastern and Midwestern U.S.; urban populations, the poor, the elderly, children, and those with impaired health or limited mobility.
Temperature extremes and variability will remain important determinants of health in the United States under climate change. Research needs include estimating exposure to temperature extremes; studying nonfatal temperature-related illness; uniform criteria for reporting heat-related health outcomes; and improving effectiveness of urban heat island reduction and extreme weather response plans.

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    • "Multiple studies demonstrate that prevailing climate patterns in the patient's geographic region may account for substantial differences in health outcomes from similar weather conditions (Kalkstein and Davis, 1989; Montero et al., 2012; Ebi and Mills, 2013). Climate differences play a major role in assessing population vulnerability scores and in developing efficient early warning systems and public health interventions (O'Neill and Ebi, 2009; Johnson et al., 2012; Aubrecht et al., 2013; Chebana et al., 2013; A. Liss et al. -Geospatial Health 8(3), 2014, pp. S647-S659 "
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    ABSTRACT: Existing climate classification has not been designed for an efficient handling of public health scenarios. This work aims to design an objective spatial climate regionalization method for assessing health risks in response to extreme weather. Specific climate regions for the conterminous United States of America (USA) were defined using satellite remote sensing (RS) data and compared with the conventional Köppen-Geiger (KG) divisions. Using the nationwide database of hospitalisations among the elderly (≥65 year olds), we examined the utility of a RS-based climate regionalization to assess public health risk due to extreme weather, by comparing the rate of hospitalisations in response to thermal extremes across climatic regions. Satellite image composites from 2002-2012 were aggregated, masked and compiled into a multi-dimensional dataset. The conterminous USA was classified into 8 distinct regions using a stepwise regionalization approach to limit noise and collinearity (LKN), which exhibited a high degree of consistency with the KG regions and a well-defined regional delineation by annual and seasonal temperature and precipitation values. The most populous was a temperate wet region (10.9 million), while the highest rate of hospitalisations due to exposure to heat and cold (9.6 and 17.7 cases per 100,000 persons at risk, respectively) was observed in the relatively warm and humid south-eastern region. RS-based regionalization demonstrates strong potential for assessing the adverse effects of severe weather on human health and for decision support. Its utility in forecasting and mitigating these effects has to be further explored.
    Geospatial health 12/2014; 8(3):294. DOI:10.4081/gh.2014.294 · 1.19 Impact Factor
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    • "4 1F ( Curriero et al . , 2002 ; O ' Neill and Ebi , 2009 ) . "
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    ABSTRACT: The health impacts of exposure to summertime heat are a significant problem in New York City (NYC) and for many cities and are expected to increase with a warming climate. Most studies on heat-related mortality have examined risk factors at the municipal or regional scale and may have missed the intra-urban variation of vulnerability that might inform prevention strategies. We evaluated whether place-based characteristics (socioeconomic/demographic and health factors, as well as the built and biophysical environment) may be associated with greater risk of heat-related mortality for seniors during heat events in NYC. As a measure of relative vulnerability to heat, we used the natural cause mortality rate ratio among those aged 65 and over (MRR65+), comparing extremely hot days (maximum heat index 100°F+) to all warm season days, across 1997-2006 for NYC's 59 Community Districts and 42 United Hospital Fund neighborhoods. Significant positive associations were found between the MRR65+ and neighborhood-level characteristics: poverty, poor housing conditions, lower rates of access to air-conditioning, impervious land cover, surface temperatures aggregated to the area-level, and seniors' hypertension. Percent Black/African American and household poverty were strong negative predictors of seniors' air conditioning access in multivariate regression analysis.
    Health & Place 09/2014; 30C:45-60. DOI:10.1016/j.healthplace.2014.07.014 · 2.81 Impact Factor
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    • "The impact of temperature extremes on the health of vulnerable patient collectives such as the poor, children or especially the elderly is discussed in the medical literature [6], [7]. Even a relationship between heat periods and mortality in the overall population has been shown previously and the high number of deaths during the heat period in Europe in 2003 especially among the elderly found attention by the popular media [8], [9]. "
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    ABSTRACT: Heat periods during recent years were associated with excess hospitalization and mortality rates, especially in the elderly. We intended to study whether prolonged warmth/heat periods are associated with an increased prevalence of disorders of serum sodium and potassium and an increased hospital mortality. In this cross-sectional analysis all patients admitted to the Department of Emergency Medicine of a large tertiary care facility between January 2009 and December 2010 with measurements of serum sodium were included. Demographic data along with detailed data on diuretic medication, length of hospital stay and hospital mortality were obtained for all patients. Data on daily temperatures (maximum, mean, minimum) and humidity were retrieved by Meteo Swiss. A total of 22.239 patients were included in the study. 5 periods with a temperature exceeding 25°C for 3 to 5 days were noticed and 2 periods with temperatures exceeding 25°C for more than 5 days were noted. Additionally, 2 periods with 3 to 5 days with daily temperatures exceeding 30°C were noted during the study period. We found a significantly increased prevalence of hyponatremia during heat periods. However, in the Cox regression analysis, prolonged heat was not associated with the prevalence of disorders of serum sodium or potassium. Admission during a heat period was an independent predictor for hospital mortality. Although we found an increased prevalence of hyponatremia during heat periods, no convincing connection could be found for hypernatremia or disorders of serum potassium.
    PLoS ONE 03/2014; 9(3):e92150. DOI:10.1371/journal.pone.0092150 · 3.23 Impact Factor
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