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Emissions of fine particulate matter (PM2.5) from human activities have been linked to substantial disease burdens, but evidence regarding how reducing PM2.5 at its sources would improve public health is sparse. We followed a population-based cohort of 2.7 million adults across Canada from 2007 through 2016. For each participant, we estimated annual mean concentrations of PM2.5 and the fractional contributions to PM2.5 from the five leading anthropogenic sources at their residential address using satellite observations in combination with a global atmospheric chemistry transport model. For each source, we estimated the causal effects of six hypothetical interventions on 10-y nonaccidental mortality risk using the parametric g-formula, a structural causal model. We conducted stratified analyses by age, sex, and income. This cohort would have experienced tangible health gains had contributions to PM2.5 from any of the five sources been reduced. Compared with no intervention, a 10% annual reduction in PM2.5 contributions from transportation and power generation, Canada's largest and fifth-largest anthropogenic sources, would have prevented approximately 175 (95%CI: 123-226) and 90 (95%CI: 63-117) deaths per million by 2016, respectively. A more intensive 50% reduction per year in PM2.5 contributions from the two sources would have averted 360 and 185 deaths per million, respectively, by 2016. The potential health benefits were greater among men, older adults, and low-income earners. In Canada, where PM2.5 levels are among the lowest worldwide, reducing PM2.5 contributions from anthropogenic sources by as little as 10% annually would yield meaningful health gains.

As the "Canadian Journal of Higher Education" celebrates its fiftieth anniversary, this article takes the measure of the research published so far on higher education administration and reflects on future work. The study examined the 38 articles on higher education administration published by the "Journal" between 1971 and 2020 to characterize how administration has been investigated and theorized since the "Journal"'s inception. The article discusses the topics that have captured the attention of scholars and the frameworks and methods they selected for their investigations. Overall, the body of work published by the "Journal" in its first 50 years of existence paints a nuanced portrait of higher education administration where administrators appear simultaneously powerless and powerful. The article suggests promising areas of inquiry based on its findings and discusses implications for editors, reviewers, and authors. [Note: Publication year printed on PDF is incorrect. This article was published in 2021.]

Background The regional disparity of heatwave-related mortality over a long period has not been sufficiently assessed across the globe, impeding the localisation of adaptation planning and risk management towards climate change. We quantified the global mortality burden associated with heatwaves at a spatial resolution of 0.5°x0.5° and the temporal change from 1990 to 2019. Methods and findings We collected data on daily deaths and temperature from 750 locations of 43 countries or regions, and 5 meta-predictors in 0.5°x0.5° resolution across the world. Heatwaves were defined as location-specific daily mean temperature [greater than or equal to]95th percentiles of year-round temperature range with duration [greater than or equal to]2 days. We first estimated the location-specific heatwave-mortality association. Secondly, a multivariate meta-regression was fitted between location-specific associations and 5 meta-predictors, which was in the third stage used with grid cell-specific meta-predictors to predict grid cell-specific association. Heatwave-related excess deaths were calculated for each grid and aggregated. During 1990 to 2019, 0.94% (95% CI: 0.68-1.19) of deaths [i.e., 153,078 cases (95% eCI: 109,950-194,227)] per warm season were estimated to be from heatwaves, accounting for 236 (95% eCI: 170-300) deaths per 10 million residents. The ratio between heatwave-related excess deaths and all premature deaths per warm season remained relatively unchanged over the 30 years, while the number of heatwave-related excess deaths per 10 million residents per warm season declined by 7.2% per decade in comparison to the 30-year average. Locations with the highest heatwave-related death ratio and rate were in Southern and Eastern Europe or areas had polar and alpine climates, and/or their residents had high incomes. The temporal change of heatwave-related mortality burden showed geographic disparities, such that locations with tropical climate or low incomes were observed with the greatest decline. The main limitation of this study was the lack of data from certain regions, e.g., Arabian Peninsula and South Asia. Conclusions Heatwaves were associated with substantial mortality burden that varied spatiotemporally over the globe in the past 30 years. The findings indicate the potential benefit of governmental actions to enhance health sector adaptation and resilience, accounting for inequalities across communities., Author(s): Qi Zhao 1,2, Shanshan Li 2,*, Tingting Ye 2, Yao Wu 2, Antonio Gasparrini 3, Shilu Tong 4,5, Ales Urban 6,7, Ana Maria Vicedo-Cabrera 8,9, Aurelio Tobias 10, Ben [...]

Rationale: Avoiding excess health damages attributable to climate change is a primary motivator for policy interventions to reduce greenhouse gas emissions. However, the health benefits of climate mitigation, as included in the policy assessment process, have been estimated without much input from health experts. Objectives: In accordance with recommendations from the National Academies in a 2017 report on approaches to update the social cost of greenhouse gases (SC-GHG), an expert panel of 26 health researchers and climate economists gathered for a virtual technical workshop in May 2021 to conduct a systematic review and meta-analysis and recommend improvements to the estimation of health impacts in economic-climate models. Methods: Regionally resolved effect estimates of unit increases in temperature on net all-cause mortality risk were generated through random-effects pooling of studies identified through a systematic review. Results: Effect estimates and associated uncertainties varied by global region, but net increases in mortality risk associated with increased average annual temperatures (ranging from 0.1% to 1.1% per 1°C) were estimated for all global regions. Key recommendations for the development and utilization of health damage modules were provided by the expert panel and included the following: not relying on individual methodologies in estimating health damages; incorporating a broader range of cause-specific mortality impacts; improving the climate parameters available in economic models; accounting for socioeconomic trajectories and adaptation factors when estimating health damages; and carefully considering how air pollution impacts should be incorporated in economic-climate models. Conclusions: This work provides an example of how subject-matter experts can work alongside climate economists in making continued improvements to SC-GHG estimates.

BackgroundThe tremendous global health burden related to COVID-19 means that identifying determinants of COVID-19 severity is important for prevention and intervention. We aimed to explore long-term exposure to ambient air pollution as a potential contributor to COVID-19 severity, given its known impact on the respiratory system.MethodsWe used a cohort of all people with confirmed SARS-CoV-2 infection, aged 20 years and older and not residing in a long-term care facility in Ontario, Canada, during 2020. We evaluated the association between long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ground-level ozone (O3), and risk of COVID-19-related hospital admission, intensive care unit (ICU) admission and death. We ascertained individuals' long-term exposures to each air pollutant based on their residence from 2015 to 2019. We used logistic regression and adjusted for confounders and selection bias using various individual and contextual covariates obtained through data linkage.ResultsAmong the 151 105 people with confirmed SARS-CoV-2 infection in Ontario in 2020, we observed 8630 hospital admissions, 1912 ICU admissions and 2137 deaths related to COVID-19. For each interquartile range increase in exposure to PM2.5 (1.70 μg/m3), we estimated odds ratios of 1.06 (95% confidence interval [CI] 1.01-1.12), 1.09 (95% CI 0.98-1.21) and 1.00 (95% CI 0.90-1.11) for hospital admission, ICU admission and death, respectively. Estimates were smaller for NO2. We also estimated odds ratios of 1.15 (95% CI 1.06-1.23), 1.30 (95% CI 1.12-1.50) and 1.18 (95% CI 1.02-1.36) per interquartile range increase of 5.14 ppb in O3 for hospital admission, ICU admission and death, respectively.InterpretationChronic exposure to air pollution may contribute to severe outcomes after SARS-CoV-2 infection, particularly exposure to O3.

Background More intense tropical cyclones (TCs) are expected in the future under a warming climate scenario, but little is known about their mortality effect pattern across countries and over decades. We aim to evaluate the TC-specific mortality risks, periods of concern (POC) and characterize the spatiotemporal pattern and exposure-response (ER) relationships on a multicountry scale. Methods and findings Daily all-cause, cardiovascular, and respiratory mortality among the general population were collected from 494 locations in 18 countries or territories during 1980 to 2019. Daily TC exposures were defined when the maximum sustained windspeed associated with a TC was [greater than or equal to]34 knots using a parametric wind field model at a 0.5° x 0.5° resolution. We first estimated the TC-specific mortality risks and POC using an advanced flexible statistical framework of mixed Poisson model, accounting for the population changes, natural variation, seasonal and day of the week effects. Then, a mixed meta-regression model was used to pool the TC-specific mortality risks to estimate the overall and country-specific ER relationships of TC characteristics (windspeed, rainfall, and year) with mortality. Overall, 47.7 million all-cause, 15.5 million cardiovascular, and 4.9 million respiratory deaths and 382 TCs were included in our analyses. An overall average POC of around 20 days was observed for TC-related all-cause and cardiopulmonary mortality, with relatively longer POC for the United States of America, Brazil, and Taiwan (>30 days). The TC-specific relative risks (RR) varied substantially, ranging from 1.04 to 1.42, 1.07 to 1.77, and 1.12 to 1.92 among the top 100 TCs with highest RRs for all-cause, cardiovascular, and respiratory mortality, respectively. At country level, relatively higher TC-related mortality risks were observed in Guatemala, Brazil, and New Zealand for all-cause, cardiovascular, and respiratory mortality, respectively. We found an overall monotonically increasing and approximately linear ER curve of TC-related maximum sustained windspeed and cumulative rainfall with mortality, with heterogeneous patterns across countries and regions. The TC-related mortality risks were generally decreasing from 1980 to 2019, especially for the Philippines, Taiwan, and the USA, whereas potentially increasing trends in TC-related all-cause and cardiovascular mortality risks were observed for Japan. Conclusions The TC mortality risks and POC varied greatly across TC events, locations, and countries. To minimize the TC-related health burdens, targeted strategies are particularly needed for different countries and regions, integrating epidemiological evidence on region-specific POC and ER curves that consider across-TC variability., Author(s): Wenzhong Huang 1, Zhengyu Yang 1, Yiwen Zhang 1, Thomas Vogt 2, Ben Armstrong 3, Wenhua Yu 1, Rongbin Xu 1, Pei Yu 1, Yanming Liu 1, Antonio Gasparrini [...]

In the last three decades, Canadian universities have grown in size and complexity and undergone deep transformations. Meanwhile, who should be appointed as highest-ranking administrative officers and what they ought to be doing once appointed has remained hotly debated. This paper examines how Canadian universities' understanding and framing of their presidents and provosts in job advertisements has changed over this last thirty-year period. Our study analysed 153 job advertisements published between 1987 and 2017 to determine how these positions were portrayed over time. The analysis relied on a conceptualization of academic administration as a combination of scholarship, management, and leadership roles. Overall, the findings show an important shift in the symbolic language used to describe these positions, shifts which appear to be linked to Canadian universities' increasing use of recruiting firms. Presidents, first depicted as respected scholars, are now portrayed as charismatic heroes, while depictions of provosts have remained largely stable, focusing on their administrative support roles. Overall, the findings suggest that popular, if unrealistic, heroic depictions of Canadian university senior administrators are becoming prevalent in the crafting of job advertisements. Recognizing how these in turn shape how stakeholders understand these positions, greater attention should be given to the crafting of these key role signals.

This article reports on a study investigating the link between education and work. Instead of looking at the labour outcomes of graduates, the study examined the qualifications held by workers in technician- and professional-level jobs from three types of occupational fields: regulated, applied, and general. The approach shifts the focus away from the supply of qualifications to the way qualifications are used in the workplace. The findings show evidence of disparities between qualifications and work levels and of the presence of obstacles preventing workers with additional qualifications from securing access to better jobs. Overall, the findings show that the structure of the labour market shapes how workers and employers make use of qualifications. They highlight some of the limitations of human capital theory in explaining the links between education and the labour market and call for a reframing of the purpose of postsecondary qualifications.

Academic administrators are evaluated periodically. Thus, every decision comes with potential career consequences. This simple observation has important implications for understanding how higher education institutions are managed. This paper takes a step towards understanding how universities evaluate their academic administrators by investigating Canadian university decanal reappointments. The sample included 13 reappointed and one non-reappointed deans and the analysis focused on organizational politics. The paper proposes a framework based on formal, normative, and moral criteria to adjudicate political behaviour and finds reappointment politics to be simultaneously embedded, necessary, and problematic. The implications for research, practice, and policy are discussed.

BackgroundLiving in greener areas of cities was linked to increased physical activity levels, improved mental well-being, and lowered harmful environmental exposures, all of which may affect human health. However, whether living in greener areas may be associated with lower risk of cardiovascular disease incidence, progression, and premature mortality is unclear.ObjectivesWe conducted a cohort study to examine the associations between residential green spaces and the incidence of acute myocardial infarction (AMI) and heart failure (HF), post-AMI and HF hospital readmissions, and mortality.MethodsWe simultaneously followed four large population-based cohorts in Ontario, Canada, including the entire adult population, adults free of AMI and HF, and survivors of AMI or HF from 2000 to 2014. We estimated residential exposure to green spaces using satellite-derived observations and ascertained health outcomes using validated disease registries. We estimated the associations using spatial random-effects Cox proportional hazards models. We conducted various sensitivity analyses, including further adjusting for property values and performing exploratory mediation analysis.ResultsEach interquartile range increase in residential greenness was associated with a 7% [95% confidence interval (CI): 4%, 9%] decrease in incident AMI and a 6% (95% CI: 4%, 7%) decrease in incident HF. Residential greenness was linked to a ∼10% decrease in cardiovascular mortality in both adults free of AMI and HF and the entire adult population. These associations remained consistent in sensitivity analyses and were accentuated among younger adults. Additionally, we estimated that the decreases in AMI and HF incidence associated with residential greenness explained ∼53% of the protective association between residential greenness and cardiovascular mortality. Conversely, residential greenness was not associated with any delay in readmission or mortality among AMI and HF patients.ConclusionsLiving in urban areas with more green spaces was associated with improved cardiovascular health in people free of AMI and HF but not among individuals who have already developed these conditions. https://doi.org/10.1289/EHP6161.

This paper examines how the stated roles and qualifications of Canadian university presidents and provosts have evolved over the past thirty years and the growing presence of recruiting firms. The study analysed 153 job advertisements published by 22 universities between 1987 and 2017. Roles were categorized according to aspects of organizational life: human resource, political, structural, and symbolic, while we distinguished qualifications as involving traits as well as cultural, human, and social "capitals." Overall, the expected qualifications for presidential and provostial candidates have increased consistently and their roles have expanded in scope. Trait qualifications and symbolic roles, while mostly absent in 1987, became prevalent by 2017, suggesting a slow but clear shift towards managerialist and charismatic depictions of leadership. This increase took place concurrently with universities' increasing reliance on recruiting firms.

OBJECTIVE: To evaluate associations of wildfire fine particulate matter ≤2.5 mm in diameter (PM2.5) with diabetes across multiple countries and territories. RESEARCH DESIGN AND METHODS: We collected data on 3,612,135 diabetes hospitalizations from 1,008 locations in Australia, Brazil, Canada, Chile, New Zealand, Thailand, and Taiwan during 2000–2019. Daily wildfire-specific PM2.5 levels were estimated through chemical transport models and machine-learning calibration. Quasi-Poisson regression with distributed lag nonlinear models and random-effects meta-analysis were applied to estimate associations between wildfire-specific PM2.5 and diabetes hospitalization. Subgroup analyses were by age, sex, location income level, and country or territory. Diabetes hospitalizations attributable to wildfire-specific PM2.5 and nonwildfire PM2.5 were compared. RESULTS: Each 10 µg/m3 increase in wildfire-specific PM2.5 levels over the current day and previous 3 days was associated with relative risks (95% CI) of 1.017 (1.011–1.022), 1.023 (1.011–1.035), 1.023 (1.015–1.032), 0.962 (0.823–1.032), 1.033 (1.001–1.066), and 1.013 (1.004–1.022) for all-cause, type 1, type 2, malnutrition-related, other specified, and unspecified diabetes hospitalization, respectively. Stronger associations were observed for all-cause, type 1, and type 2 diabetes in Thailand, Australia, and Brazil; unspecified diabetes in New Zealand; and type 2 diabetes in high-income locations. An estimate of 0.67% (0.16–1.18%) and 1.02% (0.20–1.81%) for all-cause and type 2 diabetes hospitalizations were attributable to wildfire-specific PM2.5. Compared with nonwildfire PM2.5, wildfire-specific PM2.5 posed greater risks of all-cause, type 1, and type 2 diabetes and were responsible for 38.7% of PM2.5-related diabetes hospitalizations. CONCLUSIONS: We show the relatively underappreciated links between diabetes and wildfire air pollution, which can lead to a nonnegligible proportion of PM2.5-related diabetes hospitalizations. Precision prevention and mitigation should be developed for those in advantaged communities and in Thailand, Australia, and Brazil. [ABSTRACT FROM AUTHOR]

Summary: Background: Whilst single chemical exposures are suspected to be obesogenic, the combined role of chemical mixtures in paediatric obesity is not well understood. Objectives: We aimed to evaluate the potential associations between chemical mixtures and obesity in a population‐based sample of Canadian children. Methods: We ascertained biomonitoring and health data for children aged 3–11 from the cross‐sectional Canadian Health Measures Survey from 2007 to 2019. Several chemicals of interest were measured in blood or urine and paediatric obesity was defined based on measured anthropometrics. Using quantile‐based G computational analysis, we quantified the effects of three chemical mixtures selected a priori. Models were adjusted for sociodemographic and environmental factors identified through a directed acyclic graph. Results are presented through adjusted relative risks (RR) with 95% confidence intervals (95% CI). Results: We included 9147 children. Of these, 24.1% were overweight or obese. Exposure to the mixture of bisphenol A, acrylamide, glycidamide, metals, parabens and arsenic increased the risk of childhood overweight or obesity by 45% (95% CI 1.09, 1.93), obesity by 109% (95% CI 1.27, 3.42) and central obesity by 82% (95% CI 1.30, 2.56). Conclusions: Our findings support the role of early childhood chemical exposures in paediatric obesity and the potential combined effects of chemicals. [ABSTRACT FROM AUTHOR]

This article reports on a study of 384 decanal appointments and reappointments and examines Canadian university deans' demographics and career paths. The study focused on four variables: gender, race, experience, and provenance; and analyzed variations across faculty and university types. The findings show that the great majority of Canadian university deans possess a Canadian background, with half of them being recruited internally, and that proportions of non-White and female deans mostly align with those of the professoriate. However, the study reveals a pattern of upward cumulative attrition suggesting that structural barriers to success, perseverance, and promotion are shaping non-White and female deans' career paths. Finally, data suggest that about 40% of Canadian university deans are reappointed for a second term.

BACKGROUND: Epidemiological evidence on the health risks of sulfur dioxide (S[O.sub.2]) is more limited compared with other pollutants, and doubts remain on several aspects, such as the form of the exposure-response relationship, the potential role of co-pollutants, as well as the actual risk at low concentrations and possible temporal variation in risks. OBJECTIVES: Our aim was to assess the short-term association between exposure to S[O.sub.2] and daily mortality in a large multilocation data set, using advanced study designs and statistical techniques. METHODS: The analysis included 43,729,018 deaths that occurred in 399 cities within 23 countries between 1980 and 2018. A two-stage design was applied to assess the association between the daily concentration of S[O.sub.2] and mortality counts, including first-stage time-series regressions and second-stage multilevel random-effect meta-analyses. Secondary analyses assessed the exposure-response shape and the lag structure using spline terms and distributed lag models, respectively, and temporal variations in risk using a longitudinal meta- regression. Bi-pollutant models were applied to examine confounding effects of particulate matter with an aerodynamic diameter of RESULTS: The average daily concentration of S[O.sub.2] across the 399 cities was 11.7 [micro]g/[m.sup.3], with 4.7% of days above the World Health Organization (WHO) guideline limit (40 [micro]g/[m.sup.3], 24-h average), although the exceedances occurred predominantly in specific locations. Exposure levels decreased considerably during the study period, from an average concentration of 19.0 [micro]g/[m.sup.3] in 1980-1989 to 6.3 [micro]g/[m.sup.3] in 2010-2018. For all locations combined, a 10-[micro]g/[m.sup.3] increase in daily S[O.sub.2] was associated with an RR of mortality of 1.0045 [95% confidence interval (CI): 1.0019, 1.0070], with the risk being stable over time but with substantial between-country heterogeneity. Short-term exposure to S[O.sub.2] was associated with an excess mortality fraction of 0.50% [95% empirical CI (eCI): 0.42%, 0.57%] in the 399 cities, although decreasing from 0.74% (0.61%, 0.85%) in 1980-1989 to 0.37% (0.27%, 0.47%) in 2010-2018. There was some evidence of nonlinearity, with a steep exposure-response relationship at low concentrations and the risk attenuating at higher levels. The relevant lag window was 0-3 d. Significant positive associations remained after controlling for other pollutants. DISCUSSION: The analysis revealed independent mortality risks associated with short-term exposure to S[O.sub.2], with no evidence of a threshold. Levels below the current WHO guidelines for 24-h averages were still associated with substantial excess mortality, indicating the potential benefits of stricter air quality standards. https://doi.org/10.1289/EHP11112, Introduction Sulfur dioxide (S[O.sub.2]) is an important air pollutant linked with increased health risks. (1,2) It originates largely from the combustion of fossil fuels to generate electricity and transportation. (1,3,4) [...]