Future projections of temperature-related excess out-of-hospital cardiac arrest under climate change scenarios in Japan.

BACKGROUND: Recent studies have reported associations between global climate change and mortality. However, future projections of temperature-related out-of-hospital cardiac arrest (OHCA) have not been thoroughly evaluated. Thus, we aimed to project temperature-related morbidity for OHCA concomitant with climate change. METHODS: We collected national registry data on all OHCA cases reported in 2005-2015 from all 47 Japanese prefectures. We used a two-stage time series analysis to estimate temperature-OHCA relationships. Time series of current and future daily mean temperature variations were constructed according to four climate change scenarios of representative concentration pathways (RCPs) using five general circulation models. We projected excess morbidity for heat and cold and the net change in 1990-2099 for each climate change scenario using the assumption of no adaptation or population changes. RESULTS: During the study period, 739,717 OHCAs of presumed cardiac origin were reported. Net decreases in temperature-related excess morbidity were observed under higher emission scenarios. The net change in 2090-2099 compared with 2010-2019 was -0.8% (95% empirical confidence interval [eCI]: -1.9, 0.1) for a mild emission scenario (RCP2.6), -2.6% (95% eCI: -4.4, -0.8) for a stabilization scenario (RCP4.5), -3.4% (95% eCI: -5.7, -1.0) for a stabilization scenario (RCP6.0), and - 4.2% (95% eCI: -8.3, -0.1) for an extreme emission scenario (RCP8.5). CONCLUSIONS: Our study indicates that Japan is projected to experience a substantial net reduction in OHCAs in higher-emission scenarios. The decrease in risk is limited to a specific morbidity cause, and a broader assessment within climate change scenarios should consider other direct and indirect impacts

The Outcome of Eating Disorders: Relapse, Childbirth, Postnatal Depression, Family Support

This study was aimed to identify eating disorder (ED) relapse, childbirth, postnatal depression,and the family support. Of the ED patients during treatment from 1994 to 2004,55 were pregnant and had ED recovery. Of them, 25 (21 Bulimia Nervosa (BN)and 4 Anorexia Nervosa (AN)) agreed to take part in this study. We interviewed them every 2 wk. both during the pregnancy and after childbirth. We also interviewed family members each month. The Eating Attitudes Test-26 (EAT-26) and Edinburgh Postnatal Depression Scale (EPDS) were helpful for diagnosing the EDs and postnatal depression. As the statistical analysis, We conducted t-test.67%relapsed ED while pregnant and 50%relapsed postnatal. In the non-relapse group, all the subjects had vaginal delivery and their infants were male. 50% of the subjects had postnatal depression. Non-Postnatal depression group had average body- weight infants. With regard to family support, there was no relationship between ED relapse and postnatal depression. We found that the rate of ED relapse and that of suffering from postnatal depression were remarkable in this group, suggesting the necessity for long-term follow-up for the EDs

Modeling Future Projections of Temperature-Related Excess Morbidity due to Infectious Gastroenteritis under Climate Change Conditions in Japan.

BACKGROUND: Climate change has marked implications for the burden of infectious diseases. However, no studies have estimated future projections of climate change–related excess morbidity due to diarrhea according to climate change scenarios. OBJECTIVES: We aimed to examine temperature-infectious gastroenteritis associations throughout Japan and project temperature-related morbidity concomitant with climate change for the 2090s. METHODS: Weekly time series of average temperature and morbidity for infectious gastroenteritis cases in the period 2005-2015 were collated from the 47 Japanese prefectures. A two-stage time-series analysis was adopted to estimate temperature-infectious gastroenteritis relationships. Time series of present and future average daily temperature fluctuations were projected for the four climate change scenarios of representative concentration pathways (RCPs) according to five general circulation models. Excess morbidity for high and low temperatures and the net change in the period 1990–2099 were projected for each climate change scenario by assuming the absence of adaptation and population alterations. RESULTS: In the period 2005–2015, 11,529,833 infectious gastroenteritis cases were reported. There were net reductions in temperature-induced excess morbidity under higher emission scenarios. The net change in the projection period 2090-2099 in comparison with 2010–2019 was [Formula: see text] (95% empirical confidence interval [eCI]: [Formula: see text], 0.5) for RCP2.6, [Formula: see text] (95% eCI: [Formula: see text], [Formula: see text]) for RCP4.5, [Formula: see text] (95% eCI: [Formula: see text], [Formula: see text]) for RCP6.0, and [Formula: see text] (95% eCI: [Formula: see text], [Formula: see text]) for RCP8.5, and the higher the emissions scenario, the larger the estimates reductions. Spatial heterogeneity in the temperature-morbidity relationship was observed among prefectures (Cochran Q test, [Formula: see text]; [Formula: see text]). CONCLUSIONS: Japan may experience a net reduction in temperature-related excess morbidity due to infectious gastroenteritis in higher emission scenarios. These results might be because the majority of temperature-related diarrhea cases in Japan are attributable to viral infections during the winter season. Further projections of specific pathogen-induced infectious gastroenteritis due to climate change are warranted. https://doi.org/10.1289/EHP4731

COVID-19 pandemic modifies temperature and heat-related illness ambulance transport association in Japan: a nationwide observational study

Background: During the COVID-19 pandemic, several illnesses were reduced. In Japan, heat-related illnesses were reduced by 22% compared to pre-pandemic period. However, it is uncertain as to what has led to this reduction. Here, we model the association of maximum temperature and heat-related illnesses in the 47 Japanese prefectures. We specifically examined how the exposure and lag associations varied before and during the pandemic.Methods: We obtained the summer-specific, daily heat-related illness ambulance transport (HIAT), exposure variable (maximum temperature) and covariate data from relevant data sources. We utilized a stratified (pre-pandemic and pandemic), two-stage approach. In each stratified group, we estimated the 1) prefecture-level association using a quasi-Poisson regression coupled with a distributed lag non-linear model, which was 2) pooled using a random-effects meta-analysis. The difference between pooled pre-pandemic and pandemic associations was examined across the exposure and the lag dimensions.Results: A total of 321,655 HIAT cases was recorded in Japan from 2016 to 2020. We found an overall reduction of heat-related risks for HIAT during the pandemic, with a wide range of reduction (10.85 to 57.47%) in the HIAT risk, across exposure levels ranging from 21.69 °C to 36.31 °C. On the contrary, we found an increment in the delayed heat-related risks during the pandemic at Lag 2 (16.33%; 95% CI: 1.00, 33.98%).Conclusion: This study provides evidence of the impact of COVID-19, particularly on the possible roles of physical interventions and behavioral changes, in modifying the temperature-health association. These findings would have implications on subsequent policies or heat-related warning strategies in light of ongoing or future pandemics

Airborne Bacterial Communities in Three East Asian Cities of China, South Korea, and Japan

The global diversity of airborne bacteria has not yet been studied, despite its importance in human health and climate change. Here, we focused on the diversity of airborne bacteria and their correlations with meteorological/environmental conditions in China, South Korea, and Japan. Beijing (China) had more diverse airborne bacteria, followed by Seoul (South Korea) and Nagasaki (Japan), and seasonal variations were observed. Beijing and Seoul had more diverse airborne bacteria during the winter, whereas Nagasaki showed greater diversity during the summer. According to principal component analysis and Bray-Curtis similarity, higher similarity was observed between Beijing and Seoul than between Seoul and Nagasaki during all seasons except summer. Among meteorological/environmental variables, temperature and humidity were highly correlated with the diversity of airborne bacteria on the measurement day, whereas wind speeds and the frequency of northwest winds were highly correlated for 2–3-day moving averages. Thus, proximity and resuspension could enhance bacterial diversity in East Asian cities

Airborne Bacterial Communities in Three East Asian Cities of China, South Korea, and Japan

The global diversity of airborne bacteria has not yet been studied, despite its importance in human health and climate change. Here, we focused on the diversity of airborne bacteria and their correlations with meteorological/environmental conditions in China, South Korea, and Japan. Beijing (China) had more diverse airborne bacteria, followed by Seoul (South Korea) and Nagasaki (Japan), and seasonal variations were observed. Beijing and Seoul had more diverse airborne bacteria during the winter, whereas Nagasaki showed greater diversity during the summer. According to principal component analysis and Bray-Curtis similarity, higher similarity was observed between Beijing and Seoul than between Seoul and Nagasaki during all seasons except summer. Among meteorological/environmental variables, temperature and humidity were highly correlated with the diversity of airborne bacteria on the measurement day, whereas wind speeds and the frequency of northwest winds were highly correlated for 2–3-day moving averages. Thus, proximity and resuspension could enhance bacterial diversity in East Asian cities

Assessment of Climate-sensitive Infectious Diseases in the Federated States of Micronesia

Background: The health impacts of climate change are an issue of growing concern in the Pacific region. Prior to 2010, no formal, structured, evidence-based approach had been used to identify the most significant health risks posed by climate change in Pacific island countries. During 2010 and 2011, the World Health Organization supported the Federated States of Micronesia (FSM) in performing a climate change and health vulnerability and adaptation assessment. This paper summarizes the priority climate-sensitive health risks in FSM, with a focus on diarrheal disease, its link with climatic variables and the implications of climate change. Methods: The vulnerability and adaptation assessment process included a review of the literature, extensive stakeholder consultations, ranking of climate-sensitive health risks, and analysis of the available long-term data on climate and climate-sensitive infectious diseases in FSM, which involved examination of health information data from the four state hospitals in FSM between 2000 and 2010; along with each state’s rainfall, temperature and El Nino-Southern Oscillation data. Generalized linear Poisson regression models were used to demonstrate associations between monthly climate variables and cases of climate-sensitive diseases at differing temporal lags. Results: Infectious diseases were among the highest priority climate-sensitive health risks identified in FSM, particularly diarrheal diseases, vector-borne diseases and leptospirosis. Correlation with climate data demonstrated significant associations between monthly maximum temperature and monthly outpatient cases of diarrheal disease in Pohnpei and Kosrae at a lag of one month and 0 to 3 months, respectively; no such associations were observed in Chuuk or Yap. Significant correlations between disease incidence and El Nino-Southern Oscillation cycles were demonstrated in Kosrae state. Conclusions: Analysis of the available data demonstrated significant associations between climate variables and climate-sensitive infectious diseases. This information should prove useful in implementing health system and community adaptation strategies to avoid the most serious impacts of climate change on health in FSM

Air quality co-benefits from climate mitigation for human health in South Korea

Climate change mitigation efforts to reduce greenhouse gas (GHG) emissions have associated costs, but there are also potential benefits from improved air quality, such as public health improvements and the associated cost savings. A multidisciplinary modeling approach can better assess the co-benefits from climate mitigation for human health and provide a justifiable basis for establishment of adequate climate change mitigation policies and public health actions. An integrated research framework was adopted by combining a computable general equilibrium model, an air quality model, and a health impact assessment model, to explore the long-term economic impacts of climate change mitigation in South Korea through 2050. Mitigation costs were further compared with health-related economic benefits under different socioeconomic and climate change mitigation scenarios. Achieving ambitious targets (i.e., stabilization of the radiative forcing level at 3.4 W/m2) would cost 1.3-8.5 billion USD in 2050, depending on varying carbon prices from different integrated assessment models. By contrast, achieving these same targets would reduce costs by 23 billion USD from the valuation of avoided premature mortality, 0.14 billion USD from health expenditures, and 0.38 billion USD from reduced lost work hours, demonstrating that health benefits alone noticeably offset the costs of cutting GHG emissions in South Korea

Community Trial on Heat Related-Illness Prevention Behaviors and Knowledge for the Elderly

This study aims to explore whether broadcasting heat health warnings (HHWs), to every household and whether the additional home delivery of bottled water labeled with messages will be effective in improving the behaviors and knowledge of elderly people to prevent heat-related illness. A community trial on heat-related-illness-prevention behaviors and knowledge for people aged between 65 and 84 years was conducted in Nagasaki, Japan. Five hundred eight subjects were selected randomly from three groups: heat health warning (HHW), HHW and water delivery (HHW+W), and control groups. Baseline and follow-up questionnaires were conducted in June and September 2012, respectively. Of the 1524 selected subjects, the 1072 that completed both questionnaires were analyzed. The HHW+W group showed improvements in nighttime AC use (p = 0.047), water intake (p = 0.003), cooling body (p = 0.002) and reduced activities in heat (p = 0.047) compared with the control, while the HHW group improved hat or parasol use (p = 0.008). An additional effect of household water delivery was observed in water intake (p = 0.067) and cooling body (p = 0.095) behaviors. HHW and household bottled water delivery improved heat-related-illness-prevention behaviors. The results indicate that home water delivery in addition to a HHW may be needed to raise awareness of the elderly

Associations of chemical composition and sources of PM2.5 with lung function of severe asthmatic adults in a low air pollution environment of urban Nagasaki, Japan

Previous studies have linked ambient PM2.5 to decreased pulmonary function, but the influence of specific chemical elements and emission sources on the severe asthmatic is not well understood. We examined the mass, chemical constituents, and sources of PM2.5 for short-term associations with the pulmonary function of adults with severe asthma in a low air pollution environment in urban Nagasaki, Japan. We recruited 35 asthmatic adults and obtained the daily record of morning peak expiratory flow (PEF) in spring 2014–2016. PM2.5 filters were extracted from an air quality monitoring station (178 days) and measured for 27 chemical elements. Source apportionment was performed using Positive Matrix Factorization (PMF). We fitted generalized linear model with generalized estimating equation (GEE) method to estimate changes in PEF (from personal monthly maximum) and odds of severe respiratory deterioration (first ≥ 15% PEF reduction within a 1-week interval) associated with mass, constituents, and sources of PM2.5, with adjustment for temperature and relative humidity. Constituent sulfate (SO42−) and PM2.5 from oil combustion and traffic were associated with reduced PEF. An interquartile range (IQR) increase in SO42− (3.7 μg/m3, average lags 0–1) was associated with a decrease of 0.38% (95% confidence interval = −0.75% to −0.001%). An IQR increase in oil combustion and traffic-sourced PM2.5 (2.64 μg/m3, lag 1) was associated with a decrease of 0.33% (−0.62% to −0.002%). We found a larger PEF decrease associated with PM2.5 from dust/soil on Asian Dust days. There was no evidence linking total mass and metals to reduced pulmonary function. The ventilatory capacity of adults with severe asthma is susceptible to specific constituents/sources of PM2.5 such as sulfate and oil combustion and traffic despite active self-management of asthma and low air pollution levels in the study location