Climate change and water-related infectious diseases

Background: Water-related, including waterborne, diseases remain important sources of morbidity and mortality worldwide, but particularly in developing countries. The potential for changes in disease associated with predicted anthropogenic climate changes make water-related diseases a target for prevention. Methods: We provide an overview of evidence on potential future changes in water-related disease associated with climate change. Results: A number of pathogens are likely to present risks to public health, including cholera, typhoid, dysentery, leptospirosis, diarrhoeal diseases and harmful algal blooms (HABS). The risks are greatest where the climate effects drive population movements, conflict and disruption, and where drinking water supply infrastructure is poor. The quality of evidence for water-related disease has been documented. Conclusions: We highlight the need to maintain and develop timely surveillance and rapid epidemiological responses to outbreaks and emergence of new waterborne pathogens in all countries. While the main burden of waterborne diseases is in developing countries, there needs to be both technical and financial mechanisms to ensure adequate quantities of good quality water, sewage disposal and hygiene for all. This will be essential in preventing excess morbidity and mortality in areas that will suffer from substantial changes in climate in the future

FEPSAC International Congress: Sport Psychology – Theories and Applications for Performance, Health and Humanity: A doctoral student’s reflection

Recently there has been renewed interest in basing teachers’ professional learning on medically derived models. This interest has included clinical practice models and evidencebased teaching as well as the use of various forms of ‘Rounds’ which claim to derive from medical rounds. However, many arguing for these approaches may not have a detailed knowledge of the actuality of professional learning in medicine but may be basing their ideas on idealised models drawn from popular conceptions. In addition, the model used by some calling for medically derived teacher learning is biomedicine, an area in which parallels with Education are difficult. This paper argues that mental health and public health provide a better analogue for Education than biomedicine. It considers some of the lessons that can be drawn from research on evidence-based practice in these areas. The paper concludes that a way forward is neither uncritically to assume the superiority of medical models of professional learning nor to rely only on empirical evidence from Education but to enter into dialogue with colleagues in mental and public health about shared concerns and experiences in professional learning

Urban Heat Islands and their Associated Impacts on Health

Towns and cities generally exhibit higher temperatures than rural areas for a number of reasons, including the effect that urban materials have on the natural balance of incoming and outgoing energy at the surface level, the shape and geometry of buildings, and the impact of anthropogenic heating. This localized heating means that towns and cities are often described as urban heat islands (UHIs). Urbanized areas modify local temperatures, but also other meteorological variables such as wind speed and direction and rainfall patterns. The magnitude of the UHI for a given town or city tends to scale with the size of population, although smaller towns of just thousands of inhabitants can have an appreciable UHI effect. The UHI “intensity” (the difference in temperature between a city center and a rural reference point outside the city) is on the order of a few degrees Celsius on average, but can peak at as much as 10°C in larger cities, given the right conditions. UHIs tend to be enhanced during heatwaves, when there is lots of sunshine and a lack of wind to provide ventilation and disperse the warm air. The UHI is most pronounced at night, when rural areas tend to be cooler than cities and urban materials radiate the energy they have stored during the day into the local atmosphere. As well as affecting local weather patterns and interacting with local air pollution, the UHI can directly affect health through heat exposure, which can exacerbate minor illnesses, affect occupational performance, or increase the risk of hospitalization and even death. Urban populations can face serious risks to health during heatwaves whereby the heat associated with the UHI contributes additional warming. Heat-related health risks are likely to increase in future against a background of climate change and increasing urbanization throughout much of the world. However, there are ways to reduce urban temperatures and avoid some of the health impacts of the UHI through behavioral changes, modification of buildings, or by urban scale interventions. It is important to understand the physical properties of the UHI and its impact on health to evaluate the potential for interventions to reduce heat-related impacts

XXI. On the self-induction of wires .—Part VI

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Comparative assessment of the effects of climate change on heat- and cold-related mortality in the United Kingdom and Australia.

BACKGROUND: High and low ambient temperatures are associated with increased mortality in temperate and subtropical climates. Temperature-related mortality patterns are expected to change throughout this century because of climate change. OBJECTIVES: We compared mortality associated with heat and cold in UK regions and Australian cities for current and projected climates and populations. METHODS: Time-series regression analyses were carried out on daily mortality in relation to ambient temperatures for UK regions and Australian cities to estimate relative risk functions for heat and cold and variations in risk parameters by age. Excess deaths due to heat and cold were estimated for future climates. RESULTS: In UK regions, cold-related mortality currently accounts for more than one order of magnitude more deaths than heat-related mortality (around 61 and 3 deaths per 100,000 population per year, respectively). In Australian cities, approximately 33 and 2 deaths per 100,000 population are associated every year with cold and heat, respectively. Although cold-related mortality is projected to decrease due to climate change to approximately 42 and 19 deaths per 100,000 population per year in UK regions and Australian cities, heat-related mortality is projected to increase to around 9 and 8 deaths per 100,000 population per year, respectively, by the 2080s, assuming no changes in susceptibility and structure of the population. CONCLUSIONS: Projected changes in climate are likely to lead to an increase in heat-related mortality in the United Kingdom and Australia over this century, but also to a decrease in cold-related deaths. Future temperature-related mortality will be amplified by aging populations. Health protection from hot weather will become increasingly necessary in both countries, while protection from cold weather will be still needed

Attribution of mortality to the urban heat island during heatwaves in the West Midlands, UK

BACKGROUND: The Urban Heat Island (UHI) effect describes the phenomenon whereby cities are generally warmer than surrounding rural areas. Traditionally, temperature monitoring sites are placed outside of city centres, which means that point measurements do not always reflect the true air temperature of urban centres, and estimates of health impacts based on such data may under-estimate the impact of heat on public health. Climate change is likely to exacerbate heatwaves in future, but because climate projections do not usually include the UHI, health impacts may be further underestimated. These factors motivate a two-dimensional analysis of population weighted temperature across an urban area, for heat related health impact assessments, since populations are typically densest in urban centres, where ambient temperatures are highest and the UHI is most pronounced. We investigate the sensitivity of health impact estimates to the use of population weighting and the inclusion of urban temperatures in exposure data. METHODS: We quantify the attribution of the UHI to heat related mortality in the West Midlands during the heatwave of August 2003 by comparing health impacts based on two modelled temperature simulations. The first simulation is based on detailed urban land use information and captures the extent of the UHI, whereas in the second simulation, urban land surfaces have been replaced by rural types. RESULTS AND CONCLUSIONS: The results suggest that the UHI contributed around 50 % of the total heat-related mortality during the 2003 heatwave in the West Midlands. We also find that taking a geographical, rather than population-weighted, mean of temperature across the regions under-estimates the population exposure to temperatures by around 1 °C, roughly equivalent to a 20 % underestimation in mortality. We compare the mortality contribution of the UHI to impacts expected from a range of projected temperatures based on the UKCP09 Climate Projections. For a medium emissions scenario, a typical heatwave in 2080 could be responsible for an increase in mortality of around 3 times the rate in 2003 (278 vs. 90 deaths) when including changes in population, population weighting and the UHI effect in the West Midlands, and assuming no change in population adaptation to heat in future. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12940-016-0100-9) contains supplementary material, which is available to authorized users

Potential health impacts from sulphur dioxide and sulphate exposure in the UK resulting from an Icelandic effusive volcanic eruption

Ash, gases and particles emitted from volcanic eruptions cause disruption to air transport, but also have negative impacts on respiratory and cardiovascular health. Exposure to sulphur dioxide (SO2) and sulphate (SO4) aerosols increases the risk of mortality, and respiratory and cardiovascular hospital admissions. Ash and gases can be transported over large distances and are a potential public health risk. In 2014–15, the Bárðarbunga fissure eruption at Holuhraun, Iceland was associated with high emissions of SO2 and SO4, detected at UK monitoring stations. We estimated the potential impacts on the UK population from SO2 and SO4 associated with a hypothetical large fissure eruption in Iceland for mortality and emergency hospital admissions. To simulate the effects of different weather conditions, we used an ensemble of 80 runs from an atmospheric dispersion model to simulate SO2 and SO4 concentrations on a background of varying meteorology. We weighted the simulated exposure data by population, and quantified the potential health impacts that may result in the UK over a 6-week period following the start of an eruption. We found in the majority of cases, the expected number of deaths resulting from SO2 over a 6-week period total fewer than ~100 for each model run, and for SO4, in the majority of cases, the number totals fewer than ~200. However, the 6-week simulated period with the highest SO2 was associated with 313 deaths, and the period with the highest SO4 was associated with 826 deaths. The single 6-week period relating to the highest combined SO2 and SO4 was associated with 925 deaths. Over a 5-month extended exposure period, upper estimates are for 3350 deaths, 4030 emergency cardiovascular and 6493 emergency respiratory hospitalizations. These figures represent a worst-case scenario and can inform health protection planning for effusive volcanic eruptions which may affect the UK in the future

Changes in population susceptibility to heat and cold over time: assessing adaptation to climate change.

BACKGROUND: In the context of a warming climate and increasing urbanisation (with the associated urban heat island effect), interest in understanding temperature related health effects is growing. Previous reviews have examined how the temperature-mortality relationship varies by geographical location. There have been no reviews examining the empirical evidence for changes in population susceptibility to the effects of heat and/or cold over time. The objective of this paper is to review studies which have specifically examined variations in temperature related mortality risks over the 20(th) and 21(st) centuries and determine whether population adaptation to heat and/or cold has occurred. METHODS: We searched five electronic databases combining search terms for three main concepts: temperature, health outcomes and changes in vulnerability or adaptation. Studies included were those which quantified the risk of heat related mortality with changing ambient temperature in a specific location over time, or those which compared mortality outcomes between two different extreme temperature events (heatwaves) in one location. RESULTS: The electronic searches returned 9183 titles and abstracts, of which eleven studies examining the effects of ambient temperature over time were included and six studies comparing the effect of different heatwaves at discrete time points were included. Of the eleven papers that quantified the risk of, or absolute heat related mortality over time, ten found a decrease in susceptibility over time of which five found the decrease to be significant. The magnitude of the decrease varied by location. Only two studies attempted to quantitatively attribute changes in susceptibility to specific adaptive measures and found no significant association between the risk of heat related mortality and air conditioning prevalence within or between cities over time. Four of the six papers examining effects of heatwaves found a decrease in expected mortality in later years. Five studies examined the risk of cold. In contrast to the changes in heat related mortality observed, only one found a significant decrease in cold related mortality in later time periods. CONCLUSIONS: There is evidence that across a number of different settings, population susceptibility to heat and heatwaves has been decreasing. These changes in heat related susceptibility have important implications for health impact assessments of future heat related risk. A similar decrease in cold related mortality was not shown. Adaptation to heat has implications for future planning, particularly in urban areas, with anticipated increases in temperature due to climate change

Climate change effects on human health: projections of temperature-related mortality for the UK during the 2020s, 2050s and 2080s

Background The most direct way in which climate change is expected to affect public health relates to changes in mortality rates associated with exposure to ambient temperature. Many countries worldwide experience annual heat-related and cold-related deaths associated with current weather patterns. Future changes in climate may alter such risks. Estimates of the likely future health impacts of such changes are needed to inform public health policy on climate change in the UK and elsewhere. Methods Time-series regression analysis was used to characterise current temperature-mortality relationships by region and age group. These were then applied to the local climate and population projections to estimate temperature-related deaths for the UK by the 2020s, 2050s and 2080s. Greater variability in future temperatures as well as changes in mean levels was modelled. Results A significantly raised risk of heat-related and cold-related mortality was observed in all regions. The elderly were most at risk. In the absence of any adaptation of the population, heat-related deaths would be expected to rise by around 257% by the 2050s from a current annual baseline of around 2000 deaths, and cold-related mortality would decline by 2% from a baseline of around 41 000 deaths. The cold burden remained higher than the heat burden in all periods. The increased number of future temperature-related deaths was partly driven by projected population growth and ageing. Conclusions Health protection from hot weather will become increasingly necessary, and measures to reduce cold impacts will also remain important in the UK. The demographic changes expected this century mean that the health protection of the elderly will be vital