Human Beings in Antarctica

Research on Antarctica has been continuing for over a century. While living in Antarctica remains difficult owing to the extreme conditions there, expeditions have progressed greatly in improving accommodations. Expeditioners are exposed to a harsh natural environment such as coldness, dryness, dramatic change in sunshine time, ultraviolet rays, and high altitude. They also live in an extreme condition: closed small groups, absolute isolation, limited equipment and supplies, and no evacuation. As such, expedition members are placed in an extreme physical and mental state. Antarctic doctors are responsible for protecting the health of members who are wintering-over. Statistical analysis of diseases showed that the most common cases were of injuries followed by internal medicine and dental problems. Some diseases were related to environmental factors. Medical operations such as medical screening expedition, remote medical care, and telehealth care contribute to the safety, and better health management systems are themselves subjects of research. Medical researches and operations are advancing and supporting one another. As a simulation of space, the Antarctic experience and the related breakthrough are utilised in space research. Outcomes of research on Antarctica contribute to the better understanding of human society as well

Dust Storms from Degraded Drylands of Asia: Dynamics and Health Impacts

Asian dust events are massive meteorological phenomena during which dust particles from Chinese and Mongolian deserts are blown into the atmosphere and carried by westerly winds across Northeast Asia. Recently, there has been steady increase in both the frequency and the severity of Asian atmospheric dust events. Concern has been expressed regarding the potential health hazards in affected areas. The principal nature of the damage associated with Asian dust events differs between the emission (sandstorm) and downwind (air pollution) regions. In the emission region, the health impacts of dust storms are reflected in the high prevalence of respiratory diseases and severe subjective symptoms. Extreme dust storm events may cause a disaster to happen. In downwind regions such as Japan, analysis of Asian dust particles has shown the presence of ammonium ions, sulfate ions, nitrate ions, and heavy metal compounds that are considered not to originate from soil. Asian dust particles have been thought to adsorb anthropogenic atmospheric pollutants during transport. Therefore, Asian dust events coincide with increases in daily hospital admissions and clinical visits for allergic diseases such as asthma, allergic rhinitis, and conjunctivitis. Although the effect of Asian dust on human health in each region is influenced by a variety of different mechanisms, human activities are partly responsible for such negative effects in many situations. We therefore need to address these environmental problems

Lack of medical resources and public health vulnerability in Mongolia's winter disasters

Introduction: Many countries face the need to address medical resource shortages following various disasters. The dzud is a winter disaster that occurs in Mongolia following drought in dryland areas, and it leads to high livestock mortality. Affected provinces suffer increased mortality rates for children aged under 5 years. Using various factors, including medical resources, the present study aimed to evaluate the health risks for children during the dzud. Methods: Data from all of Mongolia’s 21 provinces and the capital of Ulaanbaatar were analyzed. The change in child mortality (CCM) was defined as the difference in the under-five mortality rate from 2009 to 2010. To determine the correlations, the CCM was compared with the urbanization rate (proportion of urban population), number of physicians and nurses (per 1000 residents), average temperature, total precipitation (October 2009 to February 2010), and declining rate in livestock numbers for 2009-10 (percentage livestock loss) in each province. Results: The correlation coefficients between the CCM and each factor were as follows: number of physicians (r=-0.506, p=0.016), urbanization rate (r=-0.467, p=0.029), and percentage livestock loss (r=0.469, p=0.028). In the multiple regression analysis, the number of physicians was significantly negatively related to the CCM (standardizing coefficient -0.492, p=0.020). Conclusion: These results suggest that increased medical resources and infrastructure development have positive effects on child health - even in the setting where the dzud causes considerable damage to livestock

Changes in Cytokines at Extreme Surroundings in Antarctica

We evaluated the impact of the extreme environmental conditions at high altitudes in Antarctica on health from the viewpoint of cytokines. The subjects were 7 men who joined an inland research party participating in the 40th Japanese Antarctic Research Expedition. They underwent serial hematological examinations during the expedition for over 100 days at high altitudes (the highest point was 3810 m). The serum concentration of erythropoietin (EPO) increased promptly, indicating its usefulness for altitude adaptation. The serum concentration of interleukin-6 (IL-6) increased at high altitudes, and showed 2 peaks. Changes in IL-6 levels did not correlate with arterial oxygen tension, serum C-reactive protein or EPO levels. Some psychological stress and various factors may be related to IL-6 levels. Since the subject who suffered bone fractures had a very high concentration of IL-6 and his symptoms of mountain sickness were severer than the others, elevation of IL-6 may be related with mountain sickness. All subjects remained in relatively good health for 3 months. It is thought that the human body can protect itself against extreme surroundings in Antarctica

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

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

Lung transplantation for Kartagener syndrome: technical aspects and morphological adaptation of the transplanted lungs

While technical considerations in lung transplantation for Kartagener syndrome have been discussed, little information is available about the postoperative morphological changes of the grafted lungs. Herein, we discuss both the technical aspects and postoperative morphological adaptation of the grafted lungs in a case of Kartagener syndrome. A 46-year-old male patient with Kartagener syndrome underwent bilateral cadaveric lung transplantation. The right arterial anastomosis for transplantation of the size-matched grafts required technical elaboration. After the transplantation, we found a free space in the cardiac notch of the left lung and partial collapse of the lower lobe of the right lung due to dextrocardia. Follow-up computed tomography performed on day 42 after the transplantation demonstrated resolution of the atelectasis and morphological adaptation of the grafts into the recipient’s chest cavity with dextrocardia. Considering such early morphological adaptation of size-matched grafts, lobar reduction could be avoided in lung transplantation for Kartagener syndrome

Plasma Oxytocin Concentrations During and After Gestation in Japanese Pregnant Women Affected by Anxiety Disorder and Endometriosis

[Background] Oxytocin has a key role in mother-infant bonding, maternal care, social interaction, and stress-related psychiatric disorders. However, the factors determining oxytocin concentrations during and after pregnancy such as medical history related to nursing or parental behavior are unknown. To elucidate these, we analyzed the relationships between oxytocin concentrations during and after pregnancy, and medical history assessed in the Japan Environment and Children’s Study (JECS). [Methods] We then selected the pregnant women with a medical history of anxiety disorder and endometriosis as cases and pregnant women without medical history as controls adjusting the cohort for age and parity for a nested case-control study, after which 162 women remained for analysis. We evaluated 162 pregnant women from JECS using answers provided in a questionnaire and by measuring plasma oxytocin concentration by ELISA during the first (T1) and second (T2) trimesters of pregnancy, and after childbirth (T3). [Results] Oxytocin concentration increased in a time dependent manner, consistent with previous reports. There were weak negative correlations between oxytocin concentration at T1 and the mother’s age and height, but no correlation with other factors. The mean oxytocin concentrations of pregnant women with a history of an anxiety disorder (n = 7) and endometriosis (n = 13) were significantly lower than those of pregnant women with no such history at T2 and T3. [Conclusion] These results suggest that oxytocin concentrations during and after pregnancy were affected by a past history of anxiety disorder and endometriosis. This is the first study of the relationship between oxytocin concentration and endometriosis. To elucidate the molecular mechanisms, further study is needed

Evaluating Health Impact at High Altitude in Antarctica and Effectiveness of Monitoring Oxygen Saturation

[Background] The Japanese Antarctic Research Expedition (JARE) has been conducting research activities in inland Antarctica, which is extremely cold dryland covered with a thick ice sheet. This environment may cause a health disorder called acute mountain sickness (AMS). To improve the safety of expedition members, we evaluated the impact of extreme environmental conditions on human health and the effectiveness of monitoring of hypoxia for the early detection of AMS. [Methods] In total, 9 members from JARE 59 were studied. Dome Fuji Station (Dome F), located 3,810 m above sea level (ASL), was the destination of the research party. We analyzed daily AMS scores (higher values correspond to more severe AMS-related symptoms), physiological findings, and percutaneous arterial blood oxygen saturation (SpO2) during the inland activity. We also determined the factors related to AMS scores. [Results] The average AMS score on arrival at Dome F was significantly higher than that at the departure point (560 m ASL). The average SpO2 level was significantly lower than that at other points. The SpO2 level correlated negatively with the AMS score in Spearman’s rank correlation. Generalized estimating equations analysis showed that the AMS score was negatively associated with SpO2 level and positively associated with age. [Conclusion] Hypoxia is a contributory factor to AMS which we can easily assess by measuring the SpO2 level with a pulse oximeter. SpO2 monitoring is a potentially useful health management tool for members in inland Antarctic expeditions. In addition, our results are helpful for understanding physiological responses and health issues in extreme environments

Assessment of the Effects of Severe Winter Disasters (Dzud) on Public Health in Mongolia on the Basis of Loss of Livestock

Objective: Mongolia experienced one of its most severe natural winter disasters (dzud) in 2009-2010. It is difficult to accurately assess the risk of the effects of dzud on human lives and public health. This study aimed to evaluate the Mongolian public health risks of dzud by assessing livestock loss. Methods: We analyzed data from all 21 provinces and Ulaanbaatar in Mongolia and compared the changes in infant mortality (2009-2010) and the decline in the numbers of livestock (percentage change from the previous year), which included horses, cattle, camels, sheep, and goats (2009-2010) and/or meteorological data. We also evaluated the association among the trends in the infant mortality rate, the number of livestock, and foodstuff consumption throughout Mongolia (2001-2012). Results: The change in the infant mortality rate was positively correlated with the rate of decreasing numbers of each type of livestock in 2010. Average temperature and total precipitation were not related to the change in the infant mortality rate. In the trend from 2001 to 2012, there was a significant positive correlation between the infant mortality rate and the number of livestock and the consumption of milk products. Conclusions: Loss of livestock and shortage of milk products leading to malnutrition might have affected public health as typified by infant mortality in Mongolia. (Disaster Med Public Health Preparedness. 2016;10:549-552