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The aim of this study was to estimate the effects of climate on childhood diarrhoea hospitalisations across six administrative divisions in Bangladesh and to provide scientific evidence for local health authorities for disease control and prevention. Fortnightly hospital admissions (August/2013-June/2017) for diarrhoea in children under five years of age, and fortnightly average maximum temperature, relative humidity and rainfall recordings for six administrative divisions were modelled using negative binomial regression with distributed lag linear terms. Flexible spline functions were used to adjust models for seasonality and long-term trends. During the study period, 25,385 diarrhoea cases were hospitalised. Overall, each 1 °C rise in maximum temperature increased diarrhoea hospitalisations by 4.6% (IRR = 1.046; 95% CI, 1.007-1.088) after adjusting for seasonality and long-term trends in the unlagged model. Using lagged effects of maximum temperature, and adjusting for relative humidity and rainfall for each of the six administrative divisions, the relationship between maximum temperature and diarrhoea hospitalisations varied between divisions, with positive and negative effect estimates. The temperature-diarrhoea association may be confounded by seasonality and long-term trends. Our findings are a reminder that the effects of climate change may be heterogeneous across regions, and that tailored diarrhoea prevention strategies need to consider region-specific recommendations rather than relying on generic guidelines.

Background: Mental health is an important public health issue globally. A potential link between heat exposure and mental health outcomes has been recognised in the scientific literature; however, the associations between heat exposure (both high ambient temperatures and heatwaves) and mental health-related mortality and morbidity vary between studies and locations., Objective: To fill gaps in knowledge, this systematic review aims to summarize the epidemiological evidence and investigate the quantitative effects of high ambient temperatures and heatwaves on mental health-related mortality and morbidity outcomes, while exploring sources of heterogeneity., Methods: A systematic search of peer-reviewed epidemiological studies on heat exposure and mental health outcomes published between January 1990 and November 2020 was conducted using five databases (PubMed, Embase, Scopus, Web of Science and PsycINFO). We included studies that examined the association between high ambient temperatures and/or heatwaves and mental health-related mortality and morbidity (e.g. hospital admissions and emergency department visits) in the general population. A range of mental health conditions were defined using ICD-10 classifications. We performed random effects meta-analysis to summarize the relative risks (RRs) in mental health outcomes per 1 °C increase in temperature, and under different heatwaves definitions. We further evaluated whether variables such as age, sex, socioeconomic status, and climate zone may explain the observed heterogeneity., Results: The keyword search yielded 4560 citations from which we identified 53 high temperatures/heatwaves studies that comprised over 1.7 million mental health-related mortality and 1.9 million morbidity cases in total. Our findings suggest associations between heat exposures and a range of mental health-related outcomes. Regarding high temperatures, our meta-analysis of study findings showed that for each 1 °C increase in temperature, the mental health-related mortality and morbidity increased with a RR of 1.022 (95%CI: 1.015-1.029) and 1.009 (95%CI: 1.007-1.015), respectively. The greatest mortality risk was attributed to substance-related mental disorders (RR, 1.046; 95%CI: 0.991-1.101), followed by organic mental disorders (RR, 1.033; 95%CI: 1.020-1.046). A 1 °C temperature rise was also associated with a significant increase in morbidity such as mood disorders, organic mental disorders, schizophrenia, neurotic and anxiety disorders. Findings suggest evidence of vulnerability for populations living in tropical and subtropical climate zones, and for people aged more than 65 years. There were significant moderate and high heterogeneities between effect estimates in overall mortality and morbidity categories, respectively. Lower heterogeneity was noted in some subgroups. The magnitude of the effect estimates for heatwaves varied depending on definitions used. The highest effect estimates for mental health-related morbidity was observed when heatwaves were defined as "mean temperature ≥90th percentile for ≥3 days" (RR, 1.753; 95%CI: 0.567-5.421), and a significant effect was also observed when the definition was "mean temperature ≥95th percentile for ≥3 days", with a RR of 1.064 (95%CI: 1.006-1.123)., Conclusions: Our findings support the hypothesis of a positive association between elevated ambient temperatures and/or heatwaves and adverse mental health outcomes. This problem will likely increase with a warming climate, especially in the context of climate change. Further high-quality studies are needed to identify modifying factors of heat impacts., (Copyright © 2021. Published by Elsevier Ltd.)

Background With high temperature becoming an increasing health risk due to a changing climate, it is important to quantify the scale of the problem. However, estimating the burden of disease (BoD) attributable to high temperature can be challenging due to differences in risk patterns across geographical regions and data accessibility issues. Methods We present a methodological framework that uses Köppen–Geiger climate zones to refine exposure levels and quantifies the difference between the burden observed due to high temperatures and what would have been observed if the population had been exposed to the theoretical minimum risk exposure distribution (TMRED). Our proposed method aligned with the Australian Burden of Disease Study and included two parts: (i) estimation of the population attributable fractions (PAF); and then (ii) estimation of the BoD attributable to high temperature. We use suicide and self-inflicted injuries in Australia as an example, with most frequent temperatures (MFTs) as the minimum risk exposure threshold (TMRED). Results Our proposed framework to estimate the attributable BoD accounts for the importance of geographical variations of risk estimates between climate zones, and can be modified and adapted to other diseases and contexts that may be affected by high temperatures. Conclusions As the heat-related BoD may continue to increase in the future, this method is useful in estimating burdens across climate zones. This work may have important implications for preventive health measures, by enhancing the reproducibility and transparency of BoD research. [ABSTRACT FROM AUTHOR]

Highlights • Relationship between heat and work injuries is strong but varies by work location and type of work. • Research is needed to characterize specific injuries, workers at risk and injury mechanisms. • There is a need for employers and workers to be aware of the health risks during hot weather. • Targeted interventions and workplace policies focussed on preventative strategies are needed. Abstract Rationale There is increasing concern about occupational illness, injury and productivity losses due to hot weather in a changing climate. Most of the current understanding appears to relate to heat-induced illness, and relatively little regarding injuries. Objectives This paper sought to summarise the evidence on the relationship between heat exposure and injuries, to describe aetiological mechanisms and to provide policy suggestions and further research directions. Methods A literature review was conducted using a systematic search for published and grey-literature using Embase, PubMed, Scopus, CINAHL, Science Direct and Web of Science databases as well as relevant websites. Results and conclusions There was a diversity of studies in terms of occupations, industries and methods utilised. The evidence suggests an imprecise but positive relationship between hot weather and occupational injuries, and the most likely mechanism involves fatigue, reduced psychomotor performance, loss of concentration and reduced alertness. The findings reflect an increased awareness of injury risk during hot weather and the economic benefits associated with averting injury, poor health outcomes and lost productivity. Implications More work is required to characterise specific injuries and the workers at risk. Policymakers and employers should be aware that heat exposure can lead to occupational injuries with information and training resources developed to aid prevention. [ABSTRACT FROM AUTHOR]

• 5.1 % to 29 % risk of occupational injuries and illnesses is due to Heatwaves in Australian cities. • Workers located in the outer urban areas face a heightened risk of heat-related occupational injuries. • Heat-attributable fraction of OI increases up to 0.85 % in high-emission scenarios by mid-century. • Our findings inform location-specific policies for local governments to protect workers from heat impacts. Heatwaves (HWs) pose significant risks to occupational safety in Australia, particularly for workers in roles requiring prolonged heat exposure. This study, for the first time, addresses critical gaps in the existing literature by examining the impact of HWs on occupational injuries and illnesses (OI) at a fine spatial scale and projecting future OI burdens under climate change scenarios. Using time series study design and distributed lag nonlinear models we establish the association between HWs, assessed via the Excess Heat Factor (EHF), and OI in Adelaide, Brisbane, Melbourne, and Sydney at the Statistical Area Level 3 (SA3). The study reveals a substantial cumulative OI risk ranging between 5.1 and 29.0 % during heatwaves, with outer peripheries and rapidly urbanizing peri -urban areas showing heightened vulnerability. Younger workers, males, injury-related claims, and workers in areas with higher temperatures and less vegetation were identified as particularly susceptible to HWs. By utilising high-resolution geospatial data and future projections, our study provides new insights into the spatial heterogeneity of HW impacts on OI within cities, a previously underexplored area of research. Projected HW impacts indicate a potential increase in HW-related attributable fractions (AF) of OI, for example, in Greater Sydney, where the overall OI AF is projected to rise from 0.89 % to 1.64 % under high-emission climate scenarios. These findings emphasise the importance of developing localized, climate-related adaptation and intervention strategies to safeguard workers and reduce both the disease burden and associated economic costs and productivity loss. [ABSTRACT FROM AUTHOR]