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A Review of the Consequences of Global Climate Change on Human Health

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A Review of the Consequences of Global Climate Change on Human Health

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The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.
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Journal of Environmental Science
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A Review of the Consequences of Global
Climate Change on Human Health
Ki-Hyun Kima, Ehsanul Kabirb & Shamin Ara Jahanc
a Department of Civil and Environmental Engineering, Hanyang
University, Seoul, Korea
b Department of Farm, Power & Machinery, Bangladesh Agricultural
University, Mymensingh, Bangladesh
c BRAC Clinic, Mymensingh, Bangladesh
Published online: 16 Sep 2014.
To cite this article: Ki-Hyun Kim, Ehsanul Kabir & Shamin Ara Jahan (2014) A Review of the
Consequences of Global Climate Change on Human Health, Journal of Environmental Science and
Health, Part C: Environmental Carcinogenesis and Ecotoxicology Reviews, 32:3, 299-318, DOI:
10.1080/10590501.2014.941279
To link to this article: http://dx.doi.org/10.1080/10590501.2014.941279
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Journal of Environmental Science and Health, Part C, 32:299–318, 2014
Copyright C
Taylor & Francis Group, LLC
ISSN: 1059-0501 print / 1532-4095 online
DOI: 10.1080/10590501.2014.941279
A Review of the Consequences
of Global Climate Change
on Human Health
Ki-Hyun Kim,1Ehsanul Kabir,2and Shamin Ara Jahan3
1Department of Civil and Environmental Engineering, Hanyang University, Seoul,
Korea
2Department of Farm, Power & Machinery, Bangladesh Agricultural University,
Mymensingh, Bangladesh
3BRAC Clinic, Mymensingh, Bangladesh
The impact of climate change has been significant enough to endanger human health
both directly and indirectly via heat stress, degraded air quality, rising sea levels, food
and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano
eruptions, tsunamis, hurricanes,etc.), vulnerable shelter, and population migration.
The deterioration of environmental conditions may facilitate the transmission of di-
arrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses,
malnutrition, etc. Indirect effects of climate change such as mental health problems
due to stress, loss of homes, economic instability, and forced migration are also unignor-
ably important. Children, the elderly, and communities living in poverty are among the
most vulnerable of the harmful effects due to climate change. In this article, we have
reviewed the scientific evidence for the human health impact of climate change and an-
alyzed the various diseases in association with changes in the atmospheric environment
and climate conditions.
Keywords: climate change; health impacts; air quality; infectious; non-infectious
disease
1. INTRODUCTION
The Intergovernmental Panel on Climate Change (IPCC) states that “Climate
change is a change in the state of the climate that can be identified (e.g., by us-
ing statistical tests) by changes in the mean and/or the variability of its prop-
erties and that persists for an extended period typically decades or longer” [1].
Address correspondence to Ki-Hyun Kim, Department of Civil and Environmental
Engineering, Hanyang University, 222 Wangsimni-Ro, Seoul 133-791, Korea. E-mail:
kkim61@hanyang.ac.kr or kkim61@nate.com
Color versions of one or more of the figures in the article can be found online at
www.tandfonline.com/lesc.
299
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300 K.-H. Kim, E. Kabir, and S. A. Jahan
The United Nations Framework Convention on Climate Change also defines
climate change as “a change of climate which is attributed directly or indi-
rectly to human activity that alters the composition of the global atmosphere
and which is in addition to natural climate variability observed over compara-
ble time periods” [1].
Factors that cause significant changes to the earth’s incoming and outgoing
energy balance can lead to climate change [2]. Because many types of natural
phenomena (such as volcanic eruption, variations in ocean currents, or atmo-
spheric circulation) are involved in the alteration of solar radiation, they can be
represented as the major natural components controlling the climate system
[3]. However, most of those components are so episodic as to exert only rela-
tively short-term effects on climate [2]. In contrast, increases in global average
air (and ocean) temperatures, widespread melting of snow and ice, and rising
global average sea level have been observed as the apparent consequence of
climate change over the past few decades (Figure 1) [1].
The potential risks and side effects of climate change are projected to rise
substantially due to human vulnerability to changes induced by rising heat
waves and the associated extreme weather events (flash floods, droughts, heat
waves, earthquakes, volcano eruptions, tsunamis, tropical cyclones,etc.) [4, 5].
Among the many changes, deterioration of atmospheric environment is of pri-
ori significance, as such alterations can ultimately cause diverse illness and
diseases, for example, cardiovascular mortality and respiratory illnesses, vec-
tor borne diseases, nutritional diseases (due to food insufficiency), transmis-
sion of infectious diseases, and diarrhea (due to poor sanitation) [6, 7].
According to the World Health Organization (WHO), many prevalent hu-
man diseases (e.g., respiratory illnesses and cardiovascular disease) are linked
to climate fluctuations due to heat waves and altered transmissions of infec-
tious diseases [8]. Parasites that originate in tropical regions may migrate to
temperate regions with the spreading of warmer zones [9]. As a result, dis-
eases such as malaria can spread into a broader area. It is also predicted that
asthma will increase around the world as allergens of asthma become more
common [9].
The impact of climate change on human health will vary greatly depend-
ing on many variables including the behavior, age, gender, race, and economic
status of individuals. Moreover, such variables can also be expanded to in-
clude region, the sensitivity of populations, the extent and length of exposure
to climate change, and society’s ability to adapt to change [10]. People living in
small islands and coastal regions, megacities, and mountainous and polar re-
gions are particularly prone to such degrading environmental conditions [11].
Likewise, children living in poor countries, the elderly, and those with infir-
mities or pre-existing medical conditions will be affected most sensitively by
these alterations [6, 12].
According to a health report of the US National Assessment on Climate
Change, climate change may increase the risk of exposure to air pollutants
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Consequences of Global Climate Change 301
Figure 1: Observed changes in (a) global average surface temperature; (b) global average
sea level; and (c) Northern Hemisphere snow cover (smoothed curves are used to represent
decadal averaged values with yearly values in circles) (Source: [64]).
through alteration of weather, anthropogenic emissions, and biogenic emis-
sions, while inducing changes in the distribution and types of airborne aller-
gens [13]. In light of the immense latent danger of climate change, this review
was organized to collect and describe the growing evidence regarding its hu-
man health impacts with altering environmental conditions. In this context,
the aim of this review is to analyze the basic features of diverse human dis-
eases in association with climate change and air quality degradation.
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302 K.-H. Kim, E. Kabir, and S. A. Jahan
2. IMPACT OF CLIMATE CHANGE AND CONSEQUENTIAL
ALTERNATION OF POLLUTANT CYCLING
Climate change is expected to alter the concentration and distribution of pollu-
tants in the atmosphere to lead to significant public health consequences [14].
The possible impact of such consequences has been established from many
previous studies [1, 15]. Its impact can be reflected on mortality directly via
imminent threats (such as floods, droughts, earthquakes, volcano eruptions,
tsunamis, cyclones, etc.) and indirectly via slow but steady changes (e.g., wa-
ter and air pollution). In addition, the frequency and severity of heat waves is
also increasing continuously. As a result, the risk of illness and death by dehy-
dration, heart attack, stroke, and respiratory disease is increasing. The WHO
estimates that more than 150,000 deaths and 5.5 million disability-adjusted
life years can be attributed to climate change as of 2000 [16]. However, these
statistics from 2000, while still remaining as the most recent estimate, are
based on only five outcomes: direct temperature effects, diarrhea, malnutri-
tion, flood-related injury, and malaria.
There is a line of evidence that supports a close linkage between climate
change and air pollution. Moreover, many of the traditional air pollutants and
greenhouse gases share not only common sources but may also interact phys-
ically and chemically in the atmosphere. Consequently, their interactions can
cause a variety of environmental impacts on the local, regional, and global
scales. Continued global warming is expected to exacerbate air quality prob-
lems by increasing the frequency, duration, and intensity of conditions con-
ducive to the determination of air quality. For instance, elevated temperatures
can generally facilitate the formation of ozone [17]. However, the impact of
climate change on the regional ozone levels can be complicated by the inter-
actions between temperature, water vapor levels, and air circulation patterns
[18]. Although ozone concentrations are projected to increase in many regions
on the globe, the tropospheric ozone is subject to photocatalytic degradation in
the presence of increased atmospheric water vapor. It was estimated that cli-
mate change could reduce the global ozone by 0.5–1.0 ppb over the continents
and 1–2 ppb over the oceans in 2030 [19, 20]. Nevertheless, ozone smog forms
when pollution from vehicles, factories, and other sources reacts with sunlight
and heat [21]. Increasing temperatures can speed up this process with the
enhanced production of smog. Ground-level ozone is formed when certain air
pollutants (such as NOx and volatile organic compounds) are exposed to each
other under sunlight [22]. As this ozone can reduce lung function and inflame
airways, it can increase respiratory symptoms and aggravate asthma or other
lung diseases [23].
Climate change has the potential to induce shifts in precipitation patterns
and thereby affecting the fate and behavior of airborne particulate matter
(PM) [17, 24]. Hence, the formation of secondary PM can be catalyzed by the
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Consequences of Global Climate Change 303
in situ gas phase reactions [17]. Inhaling fine particles can lead to a broad
range of adverse health effects, including premature mortality, aggravation of
cardiovascular and respiratory disease, development of chronic lung disease,
exacerbation of asthma, and decreased lung function growth in children [25].
As climate change affects synoptic-scale weather patterns, it can also lead
to the alteration of the regional distribution of air pollutants [26]. Changes
in climate conditions play an important role with regards to the cycling of
persistent organic pollutants (POPs) by altering the emission rates from
primary and secondary sources, gas-particle partitioning, reaction rates
(photolysis, biodegradation, oxidation), air-surface exchanges (volatilization),
major hydroxyl radical formations, etc. [27]. The environmental fate and
behavior of POPs are thus affected, as the fundamental mechanisms of solvent
switching and solvent depletion are altered with the enhanced degradation
rate of contaminant [28, 29]. Increasing temperatures may also force plants to
participate in air quality degradation via enhanced production of pollen [30].
For instance, climate change may facilitate the spread of ragweed, an invasive
plant with very allergenic pollen [2, 6]. Furthermore, with the expansion of
dry areas, wildfire risks may go up, which would further worsen air quality
through the elevation of soot levels [31].
3. TYPES OF HUMAN DISEASES IN ASSOCIATION WITH CLIMATE
CHANGE
Changes in temperature, precipitation patterns, and extreme climatic events
could ultimately lead to the spread of diverse human diseases [32]. As ris-
ing temperatures can increase the concentrations of unhealthy air pollutants,
smog, pollen pollution, and wildfire smoke, all these can bring about diverse
symptoms such as eye irritation, headache, nasal stuffiness, wheezing, skin
irritation, coughing, and chest pain [33]. Figure 2 summarizes the global bur-
den of climate change attribute diseases. Especially, young children, the el-
derly, and those with respiratory problems (such as asthma, emphysema, and
bronchitis), are especially vulnerable to the effects of climate change [34]. In
the next section, diverse human diseases associated with climate change are
reviewed.
3.1. Climate Change and Infectious Disease
3.1.1. Vector-borne diseases
Climate change can exert an influence on transmission cycles and the oc-
currence of vector-borne diseases (VBD) (e.g., malaria, schistosomiasis, on-
chocerciasis, trypanosomiasis, filariasis, leishmaniasis, plague, Rift Valley
fever, etc.). VBD is mainly transmitted by the bite of infected arthropod species
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304 K.-H. Kim, E. Kabir, and S. A. Jahan
Droughts
Climate impacts
Extrem e weat her
(floods, cy clones, t sunamis, et c.)
Infect ious and w ater- borne
diseas es ou tbreaks
Stress disorder
Deat hs and injuries
Heat waves
Cardiovascular
diseases
Deaths
Air p ollution
Resp iratory diseas es and
allergic illnesses
Malnutrition and under-nutrition Vector-borne dise ases Stress disorder
Figure 2: Major known and probable health risks from climate change.
such as mosquitoes, ticks, triatomine bugs, sandflies, and blackflies [6]. Be-
cause arthropod vectors are cold-blooded (ectothermic), the biology and ecology
of vectors and intermediate hosts are affected by a number of factors (temporal
and spatial changes in temperature, precipitation, and humidity).
Changes in survival and the reproduction rates of vectors in turn can in-
fluence habitat suitability, distribution, abundance, intensity, and temporal
patterns of vector activity (particularly biting rates) [35]. Plasmodium falci-
parum malaria epidemics and Rift Valley fever were observed in Kenya from
1997–1998 due to a short-term increase in temperature and rainfall as an ef-
fect of El Nino [36, 37]. VBD is found to be transmitted mainly by mosquito
species. As adult female mosquitoes digest blood faster and feed more fre-
quently, they can increase transmission intensity in warmer climates [38].
In addition, mosquito larvae take a relatively short time to mature at high
temperatures. Hence, more offspring can be produced during the transmis-
sion period [39]. At the same time with rising temperature, malaria parasites
and viruses can complete extrinsic incubation within the female mosquito in a
short time [40].
The transmission rate of dengue was also found to increase as observed
from 2C rise in temperature in northern India [41]. In Mexico, Col´
on-Gonz´
alez
and colleagues [42] found significant weather influences on dengue incidences.
This was because rising temperatures shortened the extrinsic incubation pe-
riod of the virus as well as the development time and the gonotrophic cycle of
the mosquito, resulting in an increased likelihood of dengue transmission [43].
As a result of increases in heat, precipitation, and humidity, nearly 4000 cases
of imported and locally transmitted dengue fever were reported in the United
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Consequences of Global Climate Change 305
States between 1995 and 2005 [44]. However, several other factors (such as
changes in land use, population density, and human behavior) can also influ-
ence the occurrence pattern of VBD as well as the extent of its infection [35].
3.1.2. Diarrhoeal diseases
Climate change is expected to increase the global burden of diarrheal dis-
ease, which is responsible for the majority of childhood deaths globally [45].
Previous studies confirmed an array of climatic factors as the cause of diar-
rheal disease (including temperature, rainfall, and relative humidity) [46–48].
After a flood-event, rates of diarrhoeal disease (including cholera) may in-
crease, especially in areas with poor sanitation facilities [49, 50]. Indeed, even
without flooding, heavy rainfall may increase rates of diarrhoeal disease due to
the overflow of latrines or sewage systems [47, 51]. On the other hand, drought
conditions can reduce the availability of fresh water, increasing the frequency
of diarrhoeal and other diseases associated with poor hygiene [52]. High tem-
peratures are also a risk factor of increased rates of diarrhoeal diseases in-
cluding salmonella and cholera [53]. In 1997, a great number of patients with
diarrhea and dehydration were admitted to hospitals in Lima, Peru, with ab-
normal temperatures rise during an El Ni ˜
no event [54]. A time series analysis
of daily admission data from the hospital confirmed 8% increase due to diar-
rhea per 1C increase in temperature [55].
3.1.3. Cholera
Cholera is highly contagious and dose-dependent, while being ingested
via contaminated water and food (especially seafood) [56]. Vibrio cholerae,the
causative agent of cholera, was identified to be associated with plankton and
copepods for its survival, multiplication, and transmission [57]. For instance,
at a salinity of 15% and temperatures from 25to 30C, attachment of V.
cholerae to copepods was reported [58]. Fern ´
andez and colleagues [59] ana-
lyzed data from three cholera epidemics in Lusaka, Zambia from 2003 to 2006.
They concluded that the increase in cholera cases is controlled by rising tem-
peratures. They found the 5.2% increase in cholera cases during an epidemic at
1C increase in temperature (six weeks before the beginning of the outbreak).
Scientists from the International Vaccine Institute in Seoul, Korea analyzed
disease and weather data from cholera-endemic areas of Zanzibar, Tanzania
from 2002 to 2008; a cholera outbreak occurred imminently in the month if
an increase in the average minimum temperature (one degree Celsius) and an
increase in rainfall (200 mm) were recorded in a previous month [60]. Explana-
tion for cholera outbreaks in coastal areas of Bangladesh has also been sought
in terms of the rise of sea surface temperature and abundance of plankton (as
an environmental reservoir of the cholera pathogen) [61].
Magny and Colwell [56] proposed a possible linkage between cholera bac-
terium, sea surface temperature, and phytoplankton. As surface temperatures
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306 K.-H. Kim, E. Kabir, and S. A. Jahan
increased, the abundance of phytoplankton brought about a large population
of zooplankton, which served as a reservoir for cholera bacteria, a waterborne
disease [62]. Droughts can promote the growth of cholera vibrios by increasing
salinity in local waters, which in turn helps Vibrio cholerae attach to cope-
pods. Ultimately, floods help distribute the bacteria more widely [63]. Climate
change-driven storms, flooding, and heavy rainfall may also lead to the spread
of cholera in more physical ways by breaking down sanitation, sewage treat-
ment plants, water treatment systems, etc.
3.2. Climate Change and Non-infectious Disease
3.2.1. Effect of heat waves
The World Meteorological Organization [64] defines a heat wave as “when
the daily maximum temperature of more than five consecutive days exceeds
the average maximum temperature by 5C (9 F), the normal period being
1961–1990.” Rising temperature is indeed the most robust among all the phe-
nomena induced by global warming. Apart from discomfort, rising tempera-
tures can also raise the number of illnesses, emergency room visits, and even
deaths [65]. Due to the magnifying effect of paved surfaces and the lack of tree
cover, city dwellers can be frequently put under heat-related risks [9]. Hence,
illnesses are projected to increase with enhanced frequency and growing inten-
sity of heat waves.
The human body follows two natural mechanisms to cool off: (i) evaporation
of sweat from the skin and (ii) increasing skin blood flow [7]. However, these
processes may put strain on the heart and lungs. As a result, excessive heat
can cause a host of adverse health effects including heat cramps, heat edema
(swelling), heat syncope (fainting), heat exhaustion, and life-threatening heat
stroke [12]. Additionally, a number of chronic medical conditions can increase
heat stress and associated illnesses: obesity, vascular disease, multiple scle-
rosis, hyperthyroidism, diabetes, breathing problems, skin diseases, and psy-
chiatric problems [7]. A number of indirect effects of increasing temperatures
may be listed to include social isolation and the use of drugs to treat depres-
sion, high blood pressure, or insomnia [66]. Its impacts can also be extended to
add eye diseases like cataracts, dry eyes, pterygium, and vernal keratoconjunc-
tivitis, and skin diseases [67]. A deadly heat wave in Europe claimed around
70,000 lives in 2003 [68] and 56,000 in Russia in 2010 [69]. In the United
States, an average of 400 deaths per year was estimated as the direct conse-
quence of heat, while approximately 1800 died from illnesses were indirectly
worsened by rising heat, including heat exhaustion, heat stroke, and cardio-
vascular disease [9].
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Consequences of Global Climate Change 307
3.2.2. Respiratory diseases
Increases in temperature (and ozone concentration levels) can lead to an
increase in the burden of diverse diseases ranging from airway injury and
inflammation to acute decrease in lung function [70]. Inhaled ozone causes
an inflammatory response, manifested by increased airway permeability and
bronchial hyperactivity, which can lead to increasing incidences of asthma and
other cardiovascular respiratory diseases [71, 72]. In England and Wales, more
than 2000 excess deaths were reported more than 10 hot summer days (from
August 4–13, 2003) due to the devastating heatwave of that year [73]. Approx-
imately one-fourth to one-third of those deaths have been attributed to the
effects of increased particulate air pollutants and ozone, which spiked in con-
centration with the soaring temperatures [74]. Ozone has been identified as a
powerful oxidant to cause structural airway and lung tissue damage as well as
severe symptoms of asthma, which is often accompanied by such phenomena
as an increase in respiratory hospital admissions and deaths in both Europe
and the United States [75, 76].
According to a previous study, ozone exposure raises the risk of death from
respiratory causes because long-term, low-level exposure can exert lethal ef-
fects [77]. In another study, Bloomer and colleagues [78] examined 3-million
valid simultaneous measurements of temperature and ozone. The overall re-
sult was that for roughly every degree of warming (F) in the observed data,
there was a corresponding increase of ozone pollution by 1.2 parts per bil-
lion (ppb) [78]. Like the case of ozone, warmer air temperatures can influ-
ence the regional distribution of aeroallergens. Allergenic pollens tend to grow
more profusely in a warmer climate, spreading respiratory disorders such as
asthma, emphysema, chronic bronchitis, and allergy problems [79]. Changes
in the climate can also affect a number of pulmonary diseases like chronic ob-
structive pulmonary disease, pneumothorax, and respiratory infections in chil-
dren [79]. There are also indications of a relationship between air pollution and
tuberculosis. Further, there is a line of evidence suggesting that dust storms in
deserts (as well as high altitude areas) can cause respiratory problems for peo-
ple in distant areas [80]. Recent research presented scientific evidence that the
risk of premature death among respiratory patients is up to six times higher
than in the rest of the population with the rise of every one Celsius degree in
temperature [81].
3.2.3. Cardiovascular health
Because of climate change, the risk of cardiovascular disease rises both
directly and indirectly via air pollution and changes in dietary options [82].
The physiological reactions to increased heat exposure include a number of
symptoms (such as increased core body temperature and heart rate, shift of
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308 K.-H. Kim, E. Kabir, and S. A. Jahan
blood flow from central organs to skin, and greater sweating and associated
dehydration), if sufficient quantities of liquid are not provided [83]. Extreme
cold and extreme heat can increase hospital admissions for chest pain, stroke,
cardiac dysrhythmia (irregular heart beat), and other cardiovascular diseases
[84].
Increased ozone formation (due to temperature rise) is suspected to cause
heart attacks by damaging pulmonary gas exchange processes with enhanced
heart stress [85]. As droughts can also facilitate the rise of PM levels in the
atmosphere, it may help the development such symptoms as systematic in-
flammation, compromised heart function, deep venous thrombosis, pulmonary
embolisms, and blood vessel dysfunction [86]. As a result of extreme weather
events, growth in stress and anxiety levels can also lead to heart attacks, sud-
den cardiac death, and stress-related cardiomyopathy (heart disease) [87]. Liao
and colleagues [88] stated that the number of deaths from cardiovascular dis-
eases would increase by 0.23% with an increment of temperature by 1%. Hajat
and associates [89] reported the combined effects of cardiovascular diseases
due both to heat exposure and air pollution during hot seasons in megacities
(e.g., Delhi, S˜
ao Paulo, and London).
3.2.4. Mental health
The impact on mental health induced by extreme weather conditions (like
hurricanes, tornados, floods, fires, drought, tsunamis, etc.) is expected to be re-
flected by anxiety, post-traumatic stress, depression, etc. [90, 91]. These mental
effects can persist over extended periods because of the loss of homes, liveli-
hoods, and communities. Even in the absence of direct physical impacts, the
perception and fear of climate change may threaten mental health to a great
extent [92]. Nevertheless, such impact may differ according to the type, sud-
denness, and scale of the catastrophe, while being distinguished in the con-
text of the social, historical, and cultural factors [93]. About 63% of Hurricane
Katrina evacuees were reported to suffer from either moderate or severe symp-
toms of post-traumatic stress disorder [94]. As such, most psychosocial effects
of climate change are likely to proceed gradually and cumulatively.
Droughts are predicted to become more frequent and severe in many sub-
tropical regions of the world due to climate change, and they are subsequently
expected to cause hunger, anxiety, and depression with the reduction of agri-
cultural productivities [95]. Consequently, suicide rates, especially of farmers,
are reported to rise noticeably with droughts [96]. Heat waves that can engen-
der increased interpersonal violence, anxiety, depression, and reduced work
capacity (apart from sickening) can also lead to the deaths of those who are
unable to find the means to remain cool [97]. Social isolation is another aspect
of heat stress, as some people may not venture outdoors during hot days, which
may promote the further depression. A study conducted in Adelaide, Australia
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Consequences of Global Climate Change 309
also pointed an increased incidence of hospital admissions with mental health
diagnoses during heat waves [98].
3.2.5. Cancer
Climate change is also suspected to exert a potential impact on cancer both
directly and indirectly in the form of mitigation strategies. Most importantly,
increased exposure to suspected carcinogenic toxic chemicals is likely to in-
crease due to heavy rainfall and volatilization of chemicals due to increased
temperature [99]. Melting glaciers and ice sheets can also release cancer-
causing pollutants into the oceans and air [100]. By damaging the strato-
spheric ozone layer, climate change may dramatically raise the chance of UV
exposure, which can increase the dangers of skin cancer [101, 102]. Increased
UV radiation can also impact the human immune system and alter the body’s
ability to remove the earliest mutant cells that initiate the cancer process. It is
however yet unclear whether these changes would be beneficial or detrimental
[103]. Moreover, a decline in air quality with the rise of air pollutant level may
also increase the risk of lung cancer [104]. As weather patterns become more
erratic with climate change, liver cancer (through aflatoxin contamination) has
been suspected to become an increasing problem [105]. Nevertheless, climate
change is also expected to increase heavy precipitation and flooding events.
Such conditions, if occurring, may also affect the potential for leakage of toxic
contaminents from storage facilities or their runoff into water from land con-
taining toxic pollutants. Some of these chemicals are known carcinogens with
their ultimate impact of bringing about greater incidences of cancer [106].
4. PRE-EMPTIVE POLICIES AND PLANNED ADAPTIVE STRATEGIES
As shown in Table 1, there are diverse diseases that are tightly linked to
climate change across various regions on the globe. According to the WHO,
“Global warming that has occurred since the 1970s caused over 140 000
excess deaths annually by the year 2004” [8]. Many of the major killers
such as diarrhoeal diseases, malnutrition, malaria, and dengue are highly
climate-sensitive and are expected to worsen with time. Table 2 summarizes
some examples of death toll data as the direct or indirect consequences of
climate change. Although climate change poses many kinds of risks to human
health and ecosystems, it may also bring some limited beneficial effects like
fewer cold-related deaths, increased food supply (by enhanced agricultural
productivity and land), etc. [107]. The ideal goals of climate policy should
thus be set to reduce its risks, while taking advantage of its opportunities.
Because adapting to the potential effects of climate change is a complex and
ongoing process, it indeed requires action taken by individuals, communities,
governments, and international agencies. In order to make proper decisions,
policymakers should be able to provide timely and useful information about
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310 K.-H. Kim, E. Kabir, and S. A. Jahan
Table 1: Global Burden of Climate Change Attribute Disease (Source: [108])
Region Malnutrition Diarrhea Malaria Floods Total
Total Disability-
Adjusted Life
Years /Million
Popul at io n
African region 616 414 860 4 1894 3072
Eastern
Mediterranean
region
313 291 112 52 768 1587
Latin American and
Caribbean region
0 17 3 72 92 188
South-East Asian
region
1918 640 0 14 2572 1703
Western Pacific
regiona0 89 43 37 169 111
Developed
countriesb
0 0 0 8 8 8.90
World 2847 1460 1018 192 5517 920
aWithout developed countries.
bAnd Cuba.
the possible consequences of climate change and available adaptation options.
Efforts should also be directed toward accurate assessments to cope with
the potential consequences of climate change to seek for the maximum
opportunities to reduce the risks.
Table 2: The Death Toll as the Direct or Indirect Consequences of Climate Change
Cause of Number of
Order Death Deaths Location Period References
1 Heat wave 600 United States 1995 [109]
2 70,000 Europe 2003 [68]
3 56,000 Russia 2010 [69]
4 760 England 2013 [110]
5 Drought 560,000 East Africa 2011–2012 [111]
6 Flood 3076 India, Bangladesh 2004 [49]
7 2828 Philippines,
Thailand,
Cambodia,
Myanmar,
Malaysia,
Vietnam,
2011 [50]
8 4723 Southeast Europe 2013 [51]
9 Cyclone 138,366 Myanmar 2008 [112]
10 Tsunamis 230,000 Indonesia 2004 [113]
11 Diarrhoeal
disease
2.2 million Global Each year [8]
12 Malnutrition and
undernutrition
3.5 million Global Each year [8]
13 Malaria 1 million Global Each year [8]
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Consequences of Global Climate Change 311
The challenge for decision-makers is complicated by the fact that climate
change is only one of the many delicate factors that can influence human
health and ecosystems, while being affected by a variety of social, political, eco-
nomic, environmental, technological, and demographic factors [66]. Because
of deep involvement in multiple sectors and resources including agriculture,
forestry, water resources, air quality, ecosystems and biodiversity, and cultural
resources, climate change may force many types of conflicts between stakehold-
ers representing the interests of different sectors [16]. To effectively allocate
scarce human and financial resources, policymakers must contend different
situations to control multiple social objectives (e.g., elimination of poverty, sup-
port for agriculture, promotion of economic growth, and protection of cultural
resources) and competing stakeholder desires. For this reason, the IPCC sug-
gested that it is helpful to view climate change as part of the large challenge
of sustainable development [1].
5. CONCLUSION
The impact of climate change on human health is largely negative despite cer-
tain potential positive effects (e.g., lower cold-related mortality and greater
crop yields in temperate zones). Its negative impacts are, however, projected
to be heavily concentrated in developing low-latitude countries already experi-
encing a large burden of disease due to flood, drought, extreme weather events,
heat wave, cyclones, etc. The consequences of climate change are thus wide
enough to alter spatial and temporal distribution of vector-borne diseases, ex-
acerbation of heat related mortality, air pollution related respiratory diseases,
and water borne diseases. It has become critical to determine the scope and
focus of both basic and applied research on climate change and the associ-
ated health impact at local, regional, national, and global levels. Significant
research is essential to integrate climate science with health sciences. Inte-
grating environmental, public health, and meteorological observations to real-
time public health issues, along with efforts to downscale long-term climate
models should be effectively and efficiently put together to accurately esti-
mate human exposure risks and burden of disease. Such systematic efforts
should also be directed to incorporate a breadth of environmental parame-
ters as well as sociodemographic parameters such as population, income, and
education.
FUNDING
This study was supported by a grant from the National Research Foundation
of Korea (NRF) funded by the Ministry of Education, Science and Technology
(MEST) (No. 2009-0093848).
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312 K.-H. Kim, E. Kabir, and S. A. Jahan
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... There is a growing body of knowledge on the impact of climate change on populations around the world (Abid et al., 2018;Field et al., 2014;Herlihy et al., 2016;KiHyun et al., 2014;Tong and Ebi, 2019). Though the literature traverses across many disciplines, there is strong consensus among scholars internationally on the adverse effects of worsening climate change on human health and lifestyle (International Panel on Climate Change, 1992;WMO, 2020). ...
... Recent reviews have been completed exploring the intersection of climate change and health (Tong and Ebi, 2019) and the intersection of climate change and child health (Helldén et al., 2021). Additional reviews have been published emphasising the adverse physical, psychosocial, and mental health outcomes related to climate change and migration, especially in instances of forced migration (KiHyun et al., 2014;Mazhin et al., 2020;McMichael et al., 2012;Palinkas and Wong, 2020;Schwerdtle et al., 2020). However, these reviews are heavily quantitative with none summarising solely qualitative studies. ...
... C l i m a t e v a r i a b i l i t y a n d c h a n g e pose significant threats to public and occupational health, especially for the urban poor. Recognized direct effects of weather and climate on physical health include heat stress; respiratory conditions linked to heat combined with air pollution and aeroallergens; injury from floods, landslides, and windstorms; plus illnesses from vector-borne and infectious disease, as well as water-and food-related pathogens (Kovats and Akhtar 2008;Kovats and Hajat 2008;Kim, Kabir, and Ara Jahan 2014). ...
Technical Report
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This report was prepared under the Asian Development Bank (ADB) regional technical assistance (TA) project Advancing Inclusive and Resilient Urban Development Targeted at the Urban Poor (TA9513-REG). The project is financed by the Urban Climate Change Resilience Trust Fund (UCCRTF), which is administered by ADB with financial support from the Rockefeller Foundation and the governments of Switzerland and the United Kingdom. The report was prepared under the overall guidance of Arghya Sinha Roy, principal climate change specialist (Climate Change Adaptation), Sustainable Development and Climate Change Department (SDCC). The development of the report was led by a team of technical experts coordinated by Robert Wilby. The consultant team included Ashna Singh Mathema (housing), Belinda Tato (urban planning and urban design including related graphics), Katherine Gough (livelihoods), Mohamed El-Sioufi (urban basic services and infrastructure), Robert Wilby (physical climate risk and health), and Tord Kjellstrom (local economy and productivity). Tom Matthews produced the heat index maps in Chapter 2, Kae Sugawara edited the manuscript, and Lowil Espada produced the layout. Production and finalization were supported by Sugar Gonzales, climate change officer (Climate Change Adaptation), SDCC. The report benefited significantly from comments received from Joris van Etten, senior urban development specialist, Southeast Asia Department; Tiffany M. Tran, human settlements expert (consultant), Southeast Asia Department; Hikaru Shoji, senior urban development specialist, South Asia Department; members of the UCCRTF team: Virinder Sharma, principal urban development specialist, SDCC, and Joy Amor Bailey (consultant); and Rowena Mantaring (TA coordinator). The report also benefited from inputs and discussions with Charles Rodgers, senior climate adaptation advisor (consultant); and Alex Fowler, climate resilience specialist (consultant).
... Res. Public Health 2022, 19, 9706 2 of 16 health disorders, and indirect vector-borne infectious diseases, e.g., dengue fever, malaria, Ross River virus, and hemorrhagic fever with renal syndrome [6][7][8][9][10][11][12][13][14][15]. However, it should be noted that cold temperatures can also be associated with poor health outcomes, and cold-related diseases should not be overlooked because of the recent focus on heat-related diseases in the context of climate change. ...
Article
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This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010–2016 were analyzed using distributed non-linear lag models. Future hospitalization costs were estimated based on three predicted climate change scenarios-RCP2.6, RCP4.5 and RCP8.5. The estimated respiratory disease hospitalization costs attributable to ambient temperatures increased from 493.2 million Australian dollars (AUD) in the 2010s to more than AUD 700 million in 2050s in Sydney and from AUD 98.0 million to about AUD 150 million in Perth. The current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1–20.1%) and (5.1–6.6%), respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Limitations of this study should be noted, such as lacking information on individual-level exposures, local air pollution levels, and other behavioral risks, which is common in such ecological studies. Nonetheless, this study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change may result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location.
... On top of the rising threat of non-communicable diseases like diabetes and hypertension, there is an upsurge of adverse health impacts resulting from pollution, climate change, and migration. 2 Global and national health reform efforts, such as Sustainability Development Goals, Universal Health Coverage, and One Health, engage with these global challenges, including antimicrobial resistance and novel infectious diseases. These reforms come with new informational needs, requiring, amongst others, sharing of information between different stakeholders and enhanced service delivery models based on person-based care. ...
Article
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Digital health represents a research field dedicated to realising digital technologies' potential and developing knowledge about their feasibility and impacts. Yet, drawing on a critical review of the articles in the most prominent multidisciplinary digital health journals, this paper argues that the digital health field has not profoundly engaged with its core subject, namely technology. The features of digital technologies remain in the background, and research is disconnected from the complexities of healthcare settings, including multiple technologies, established practices and people. Instead, the over-arching focus in the digital health literature is the processing capabilities of digital technologies and their posited impacts. This paper proposes a research direction in digital health where technology and the context of use take a more prominent role. It argues that realising the potential of digital health requires intensive investigation drawing on different disciplines, grounded on understanding healthcare processes, related informational needs and the concrete features of digital technologies.
... • health risks (McMichael et al., 2012;Kim et al., 2014;Mora et al., 2017;Rossiello and Szema, 2019;Lemery et al., 2021;Vicedo-Cabrera et al., 2021;Zhang et al., 2021) • the distribution of diseases Liang and Gong, 2017;Caminade et al., 2019) • freshwater availability (Firth and Fisher, 2012;Eekhout et al., 2018;Rodell et al., 2018) • food security (Dwivedi et al., 2013;Misra, 2014;Myers et al., 2017;Ray et al., 2019) • energy production (Mideksa and Kallbekken, 2010;Pryor and Barthelmie, 2010;Schaeffer et al., 2012;Khan et al., 2013;Gernaat et al., 2021) • transportation (Koetse and Rietveld, 2009;Love et al., 2010;Macarthur et al., 2012;Moretti and Loprencipe, 2018; • infrastructure (Wilbanks et al., 2012;Shiklomanov and Streletskiy, 2013;Vardon, 2015) • the overall economy (Ebele and Emodi, 2016;Batten, 2018;Kompas et al., 2018;DeFries et al., 2019;Andersson et al., 2020) • social conflicts (Swain and Öjendal, 2018;Froese and Schilling, 2019;Krieger and Panke, 2020) • human migrations (Faist and Schade, 2013;Burrows and Kinney, 2016;Berchin et al., 2017;Internal Displacement Monitoring Center, 2021;Balsari et al., 2020) Similarly to the unequal social responsibility in the causes of climate change, the social distribution of the consequences (and of resources to adapt) is also highly unequal between countries (e.g. UK and Bangladesh) and ...
Thesis
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Climate change has various impacts on society, but future changes are uncertain and a wide gap remains between the scientific knowledge and societal action (mitigation, adaptation). The gap in climate adaptation was partly addressed by the recent growth of climate services, but their local usability is associated to many barriers. France is an example of lacking climate adaptation at territorial level, and this thesis focuses on the Gulf of Morbihan as a case study. My research aims first to identify the role of climate change in the territory, second to support the local development of adaptation planning, and third to explore future climate change through the angle of clustering approaches.To identify the local role of climate change, I analyze the literature (grey and academic) and engage in field interviews with various stakeholders. Particular features of the territory emerge: the coastal-inland contrast (economy, demography), the socioeconomic life organized seasonally, and the dependence and conflict between agriculture and tourism. The local role of climate change is complex, impacting emblematic activities (oyster farming, salt production), overlapping with existing issues (socioeconomic imbalance, land-use conflict), and affecting agriculture negatively (warmer and drier summers) but tourism positively (longer summer weather). The local experiences are generally consistent with scientific knowledge (ongoing changes, link to climate change), although some elements are scarce in local perceptions (heatwaves).To assist local adaptation, I participated to the experimentation of different foresight activities (scenario workshop, art-science exhibition, conference-debate) with local stakeholders, based on an assessment of climate services and on creative art-design tools (e.g. poker design cards). The main outcomes are two long-term scenarios, multiple short-term actions and several hinge points on which the scenarios depend. The two scenarios represent divergent visions of the territory: continued occupation of the coast despite increasing risks, or withdrawal from the coast and densification of urban areas inland. The scenarios depend on the issue development of urbanization and spatial planning, food and energy autonomy, and demographic balance. The theme of food and energy autonomy concentrates conflicting views between inhabitants, highlighting fears and desires about long-term territorial choices.My investigation of the territory highlighted several climatic themes (e.g. seasonality of weather conditions) that are linked to atmospheric circulation, but future circulation changes are highly uncertain. To investigate the future seasonality of atmospheric circulation, I classify year-round patterns of geopotential height at 500 hPa (Z500) from a reanalysis and several climate models. Despite their biases, climate models reproduce similar evolution of circulation seasonality as the reanalysis. During the last decades, winter conditions have decreased while summer conditions have increased, and these changes strengthen under future climate change. Yet circulation seasonality remains similar relatively to the increase in average Z500, and the same happens for surface temperatures associated to the circulation patterns. I additionally developed the perspective of a new approach to study the local evolution of weather seasonality, based on the classification of multiple variables (temperature, precipitation, windspeed).In addition to the effects from future climate change, the Gulf of Morbihan will probably welcome new populations, and an active collective strategy of adaptation is required. Several routes have been featured in my research to address the local needs in climate adaptation, including perspectives inspired from existing climate services in other countries. The findings from this thesis highlight the physical and social dimensions of climate change.
... Global changes, including both anthropogenic and environmental modifications, may contribute to modifications in the geographical distribution of species and expand their potential ecological niches [4,5]. Distinct species may thus acquire a new capacity to interact, hybridize and subsequently introgress their genomes by backcrossing with parental species or other hybrids, a phenomenon called "hybrid swarm" [6]. ...
Article
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Schistosomes cause schistosomiasis, the world’s second most important parasitic disease after malaria in terms of public health and social-economic impacts. A peculiar feature of these dioecious parasites is their ability to produce viable and fertile hybrid offspring. Originally only present in the tropics, schistosomiasis is now also endemic in southern Europe. Based on the analysis of two genetic markers the European schistosomes had previously been identified as hybrids between the livestock- and the human-infective species Schistosoma bovis and Schistosoma haematobium , respectively. Here, using PacBio long-read sequencing technology we performed genome assembly improvement and annotation of S . bovis , one of the parental species for which no satisfactory genome assembly was available. We then describe the whole genome introgression levels of the hybrid schistosomes, their morphometric parameters (eggs and adult worms) and their compatibility with two European snail strains used as vectors ( Bulinus truncatus and Planorbarius metidjensis ). Schistosome-snail compatibility is a key parameter for the parasites life cycle progression, and thus the capability of the parasite to establish in a given area. Our results show that this Schistosoma hybrid is strongly introgressed genetically, composed of 77% S . haematobium and 23% S . bovis origin. This genomic admixture suggests an ancient hybridization event and subsequent backcrosses with the human-specific species, S . haematobium , before its introduction in Corsica. We also show that egg morphology (commonly used as a species diagnostic) does not allow for accurate hybrid identification while genetic tests do.
... The impact of climate change and its impact on population health has been explored extensively over the past two decades [3]. Many epidemiological studies have demonstrated the negative impacts of climate change on population health [4], and growing evidence has shown increasing temperatures were associated with increased morbidity and mortality of a range of temperature-sensitive diseases, including direct heat associated diseases, e.g., heatstroke, cardiovascular diseases, renal diseases, mental health disorders, and indirect vector-borne infectious diseases, e.g., dengue fever, malaria, ross river virus, and hemorrhagic fever with renal syndrome [4][5][6][7][8][9][10][11][12][13]. However, it should be noted that cold temperatures can also be associated with poor health outcomes, and cold-related diseases should not be overlooked because of the recent focus on heat-related diseases in the context of climate change. ...
Preprint
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Background: The association between temperatures and respiratory diseases has been extensively reported. However, the associated healthcare costs and attributable fractions due to temperature have scarcely been explored. The aims of this study were to estimate respiratory disease hospitalization costs attributable to non-optimum ambient temperature, to quantify the attributable fraction from cold and hot temperatures, and to estimate the future hospitalization costs in two Australian cities. Methods: The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010-2016 were analyzed using distributed lag non-linear models. Future hospitalization costs for respiratory diseases were estimated based on three predicted climate change scenarios - RCP2.6, RCP4.5 and RCP8.5. Results: The estimated respiratory disease hospitalization costs attributable to non-optimum ambient temperatures increased from 493.2 million Australian dollars (AUD) in 2010s to more than 700 million AUD in 2050s in Sydney, and from 98.0 million AUD to about 150 million AUD during the same period in Perth, in large part due to population growth. In the context of climate change, the current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1-20.1%) and (5.1-6.6%) respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Conclusions: This study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases in two major Australian cities, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change will result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location.
... Such mixed infections can lead to exchange of genetic material between the coinfecting agents, generating new pathogen genotypes. In the case of helminth parasites which sexually reproduce, this can occur through heterospecific (between-species) mate pairings (8,9), which can lead to the formation of hybrid offspring (9,10). Hybridizations, as well as subsequent introgressions (the introduction of single genes or chromosomal regions from one species into another through repeated backcrossing), represent an additional source of genetic variation that may drive parasite evolution, with potential implications including increased host and geographical range, altered pathology, resistance to drug therapy, and, ultimately, persistence in the face of elimination efforts (9). ...
Article
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Significance The threat to public health that is presented by zoonotic spillover of pathogens from animal reservoirs is predicted to increase with rapid anthropogenic changes and global trends such as migration and changing land use. Schistosomiasis currently infects more than 220 million people worldwide, and the multihost Schistosoma spp. system within Africa is a key example of where spillover of animal parasites into human populations has enabled the formation of viable hybrid parasite genotypes. Our study demonstrates how zoonotic spillover and complex interactions between pathogen species, such as parasite hybridization, may have implications such as resilience to current disease control strategies and may facilitate the spread of tropical diseases such as schistosomiasis beyond their original geographical boundaries.
Article
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Climate change is likely to increase the risk of drought which impacts on health are not quite known well due to its creeping nature. This study maps the publications on the consequences of drought on human health, directly or indirectly, from January 2008 to December 2018. We searched Scopus, Web of Science, PsycINFO, google scholar and Pubmed. 378 articles were included. Poisson regression analysis was performed to evaluate the relationship between the number of articles and some variables such as the continent of the study, article type, subject, and climate event type (climate change or just drought). Data were analyzed using Microsoft Excel 2019 and SPSS version 26. Based on the results, Asia had the highest number of publications (91) compared to North America (82), while the number of articles from South America (16) was lower significantly. The majority of articles had used quantitative analysis (175), and review articles were the second most frequent (104). Most of the articles had focused on the social impacts of drought. The number of articles has increased over the years and most of them were not in the health area primarily. Also, a noticeable amount of the knowledge comes from analysis of previously collected data and review articles. To mitigate and reduce the impacts of drought on the different dimensions of health, we need to understand them through more investigations with precise data and methods, especially in less developed countries with a more vulnerable population, and mental health consequences of drought that have been less considered.
Thesis
La Corse est une île méditerranéenne montagneuse présentant une grande diversité de biotopes. C'est également une région de chasse, de randonnée et d'élevage pratiqué de façon semi-extensive à extensive (bovins, ovins, caprins et porcins). Les interactions sont multiples entre l'homme, les animaux domestiques et la faune sauvage. Même si ce contexte apparait propice à l'implantation d'une grande diversité d'espèces de tiques et à la circulation des agents pathogènes qu'elles transmettent, ils n’avaient jamais fait l’objet d’une étude exhaustive. Le cheptel bovin insulaire, élevé dans un état de semi-liberté (avec une utilisation restreinte de traitements acaricides), est apparu comme un modèle approprié pour dresser un premier état des lieux des tiques présents sur le territoire insulaire. Durant une année, 1 938 tiques ont été collectées dans les trois abattoirs bovins de l'île. Huit espèces de tiques ont été identifiées : Rhipicephalus (Rh.) bursa (56% des tiques prélevées), Hyalomma (Hy.) marginatum (21%), Hy. scupense (9%), Ixodes (I.) ricinus (6%), Haemaphysalis (Ha.) punctata (5%), Rh. sanguineus sensu lato (2%), Rh. (Boophilus) annulatus (0,7%) et Dermacentor (D.) marginatus (0,3%). Le taux d'infestation des bovins est resté élevé toute l'année (63%), et plusieurs espèces de tiques ont montré des variations saisonnières de leur activité. Des collectes plus ponctuelles sur d'autres animaux domestiques (petits ruminants, chevaux, carnivores domestiques) et sauvages (sangliers, mouflons, cerfs, hérissons et oiseaux) ont permis la collecte de 3 134 tiques (dont 60% prélevées sur bovins). Une espèce supplémentaire, Ha. sulcata (collectée sur un mouflon), a été identifiée et des préférences claires d'infestation envers certains hôtes animaux ont été mises en évidence.Une puce à PCR micro-fluidiques en temps réel à haut débit (BioMarkTM dynamic arrays, Fluidigm Corporation, USA) a permis la recherche de 27 bactéries (issues des genres Borrelia, Anaplasma, Ehrlichia, Rickettsia, Bartonella, Candidatus Neoehrlichia, Coxiella et Francisella) et 12 espèces de parasites (issues des genres Babesia et Theileria) dans des pools composés d’une à cinq tiques. Près de la moitié (48%) des 569 échantillons (1 523 tiques analysées) étaient porteurs de l’ADN d’au moins un agent pathogène. Les séquences génétiques de 11 germes, dont sept sont zoonotiques, issus de six genres, ont été détectées. Tous les hôtes animaux prélevés ont présentés des tiques infectées et des agents pathogènes ont été détectés dans 80% de la zone échantillonnée. La présence de quatre agents pathogènes en Corse a ainsi été confirmée : Rickettsia aeschlimannii (23% des pools analysés), Rickettsia slovaca (5%), Anaplasma marginale (4%) et Theileria equi (0.4%), mais pour la plupart des agents pathogènes, leur ADN a été détecté pour la première fois en Corse : Anaplasma phagocytophilum (16%), Rickettsia helvetica (1%), Borrelia afzelii (0.7%), Borrelia miyamotoi (1%), Bartonella henselae (2%), Babesia bigemina (2%) et Babesia ovis (0.5%).Le virus de la fièvre hémorragique de Crimée Congo (CCHF) recherché de façon individuelle (dans ses tiques vectrices (genre Hyalomma) ou dans des tiques connues pour au moins le transporter (Rh. bursa) n'a pas été identifié mais une enquête sérologique réalisée sur 3 890 ruminants domestiques (bovins, caprins et ovins)a montré que 9,1% d'entre eux étaient porteurs d'anticorps dirigés contre le virus suggérant ainsi la circulation d'une souche virale en Corse. De prochaines études, notamment sérologiques, devront déterminer l'exposition réelle des populations humaines et animales aux agents pathogènes détectés et ainsi estimer leur potentiel impact médical et sanitaire en Corse.
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A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.
Article
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In 1980, 1700 people died during a prolonged heat wave in a region under-prepared for heat illness prevention. Dramatically underreported, heat-related pathology contributes to significant morbidity as well as occasional mortality in athletic, elderly, paediatric and disabled populations. Among US high school athletes, heat illness is the third leading cause of death. Significant risk factors for heat illness include dehydration, hot and humid climate, obesity, low physical fitness, lack of acclimatisation, previous history of heat stroke, sleep deprivation, medications (especially diuretics or antidepressants), sweat gland dysfunction, and upper respiratory or gastrointestinal illness. Many of these risk factors can be addressed with education and awareness of patients at risk. Dehydration, with fluid loss occasionally as high as 6–10% of bodyweight, appears to be one of the most common risk factors for heat illness in patients exercising in the heat. Core body temperature has been shown to rise an additional 0.15–0.2°C for every 1% of bodyweight lost to dehydration during exercise. Identifying athletes at risk, limiting environmental exposure, and monitoring closely for signs and symptoms are all important components of preventing heat illness. However, monitoring hydration status and early intervention may be the most important factors in preventing severe heat illness.
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Summer heat waves are among the deadliest environmental events, often accompanied by stories of heat-related deaths, usually involving the elderly. In the United States, an average of 400 Americans die each year from excessive heat. The elderly and those who live alone or are unable to care for themselves represent the vast majority of these heat-related deaths. This CME article reviews the pathophysiology of heat regulation; the medical, environmental, and social components of heat-related illness in the elderly population; the essential elements of early identification and proper treatment of heat-related illnesses including heat cramps, heat exhaustion, and heat stroke; and the importance of prevention. A useful patient education sheet is included.
Article
Changes in climate that lead to an increase in temperature and a decrease in precipitation are associated with an increase in diarrheal disease in children in Botswana, a sub-Saharan country with distinct wet and dry seasons (Alexander KA et al. Int J Environ Res Public Health. 2013;10[4]:1202-1230). Because previous studies have indicated that diarrheal disease rates could be altered by changes in climate, US investigators evaluated monthly reports of diarrheal disease among patients in Botswana who visited health facilities between 1974 and 2003 and compared these data with climatic variables such as rainfall, minimum temperature, and vapor pressure during this time period. The incidence of diarrhea peaked in both the wet and dry seasons but unexpectedly was highest in the dry season, with a 20% increase over the yearly mean. The authors hypothesize that the hot, dry conditions may increase the activity and density of flies that transmit diarrhea-causing microorganisms.