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Objectives. To determine the effect of heat waves on emergency department (ED) visits for individuals experiencing homelessness and explore vulnerability factors. Methods. We used a unique highly detailed data set on sociodemographics of ED visits in San Diego, California, 2012 to 2019. We applied a time-stratified case–crossover design to study the association between various heat wave definitions and ED visits. We compared associations with a similar population not experiencing homelessness using coarsened exact matching. Results. Of the 24 688 individuals identified as experiencing homelessness who visited an ED, most were younger than 65 years (94%) and of non-Hispanic ethnicity (84%), and 14% indicated the need for a psychiatric consultation. Results indicated a positive association, with the strongest risk of ED visits during daytime (e.g., 99th percentile, 2 days) heat waves (odds ratio = 1.29; 95% confidence interval = 1.02, 1.64). Patients experiencing homelessness who were younger or elderly and who required a psychiatric consultation were particularly vulnerable to heat waves. Odds of ED visits were higher for individuals experiencing homelessness after matching to nonhomeless individuals based on age, gender, and race/ethnicity. Conclusions. It is important to prioritize individuals experiencing homelessness in heat action plans and consider vulnerability factors to reduce their burden. (Am J Public Health. 2022;112(1):98–106. https://doi.org/10.2105/AJPH.2021.306557 )

Temperature affects the rate of all biochemical processes in ectotherms

Think globally, act locally Climate change–driven elevations in temperature over the past few decades have caused repeated coral bleaching and subsequent death. The impact is so widespread that it has been suggested that only climate change reversal can save coral reefs globally. Donovan et al. looked at the interaction between local conditions and coral reef health and found that poor conditions magnify climate impacts (see the Perspective by Knowlton). Furthermore, reefs where human stressors such as overfishing or pollution were minimized fared better. Such results suggest that caring for reefs locally may help them to persist in our warming world. Science , abd9464, this issue p. 977 ; see also abi7286, p. 908

Many studies have shown that heatwaves are associated with an increased prevalence of urinary diseases. However, few national studies have been undertaken in China, and none have considered the associated economic losses. Such information would be useful for health authorities and medical service providers to improve their policy-making and medical resource allocation decisions.To explore the association between heatwaves and hospital admissions for urinary diseases and assess the related medical costs and indirect economic losses in China from 2014 to 2019.Daily meteorological and hospital admission data from 2014 to 2019 were collected from 23 study sites with different climatic characteristics in China. We assessed the heatwave-hospitalization associations and evaluated the location-specific attributable fractions (AFs) of urinary-related hospital admissions due to heatwaves by using a time-stratified case-crossover method with a distributed lag nonlinear model. We then pooled the AFs in a meta-analysis and estimated the national excess disease burden and associated economic losses. We also performed stratified analyses by sex, age, climate zone, and urinary disease subtype.A significant association between heatwaves and urinary-related hospital admissions was found with a relative risk of 1.090 (95 % confidence interval (CI): 1.050, 1.132). The pooled AF was 8.27 % (95%CI: 4.77 %, 11.63 %), indicating that heatwaves during the warm season (May to September) caused 248,364 urinary-related hospital admissions per year, with 2.42 (95%CI: 1.35, 3.45) billion CNY in economic losses, including 2.23 (95%CI: 1.29, 3.14) billion in direct losses and 0.19 (95%CI, 0.06, 0.31) billion in indirect losses, males, people aged 15-64 years, residents of temperate continental climate zones, and patients with urolithiasis were at higher risk.Tailored community health campaigns should be developed and implemented to reduce the adverse health effects and economic losses of heatwave-related urinary diseases, especially in the context of climate change.

The relationship between diabetes mellitus and short-term exposure to extreme temperatures remains controversial. A systematic review and meta-analysis were performed to assess the association between extreme temperatures and diabetes mellitus morbidity and mortality. PubMed, Embase, the Cochrane Library, Web of Science and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched since inception to January 1, 2019, and updated on November 17, 2020. The results were combined using random effects model and reported as relative risk (RR) with 95% confidence interval (CI). 32 studies met the included criteria. (1) Both heat and cold exposures have impact on diabetes. (2) For heat exposure, the subgroup analysis revealed that the effect on diabetes mortality (RR = 1.139, 95% CI: 1.089–1.192) was higher than morbidity (RR = 1.012, 95% CI: 1.004–1.019). (3) With the increase of definition threshold, the impact of heat exposure on diabetes rised. (4) A stronger association between heat exposure and diabetes was observed in the elderly (≥ 60 years old) (RR = 1.040, 95% CI: 1.017–1.064). In conclusion, both short-term exposure to heat and cold temperatures have impact on diabetes. The elderly is the vulnerable population of diabetes exposure to heat temperature. Developing definitions of heatwaves at the regional level are suggested.

Heatwaves and greenness have been shown to affect health, but the evidence on their joint effects is limited. We aim to assess the associations of the combined exposure to greenness and heatwaves. We utilized five waves (February 2000-October 2014) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a prospective cohort of older adults aged 65. We defined heatwaves as the daily maximum temperature ≥92.5th percentile with duration ≥3 days. We calculated the number of heatwave days in one year before death to and cumulative Normalized Difference Vegetation Index (NDVI) during follow-up to assess individual long-term exposure to heatwaves and greenness. Cox proportional hazards models were used to assess the effects of greenness, heatwaves, and their interaction on mortality, adjusted for covariates. We conducted subgroup analyses by residence, gender, and age. There were 20,758 participants in our study, totaling 67,312 person-years of follow-up. The mean NDVI was 0·41 (SD 0.13), and the mean number of heatwave days was 8.92 (2.04). In the adjusted model, the mortality hazard ratio (HR) for each 3-day increase in heatwave days was 1.04 (95% CI 1.04, 1.05), each 0.1-unit decrease in cumulative NDVI was 1.06 (1.05, 1.07). In the adjusted model with an interaction term, the HR for the interaction term was 1.01 (1.01, 1.02) with a p-value less than 0.001. In our subgroup analyses, the HR for each 3-day increase in heatwave days was higher in urban areas than in rural areas (1.06 vs. 1.03), and the HR for 0.1-unit decrease in NDVI was higher in urban areas than in rural areas (1.08 vs. 1.04). Greenness can protect against the effect of heatwaves on mortality, and heatwaves affect the health effects of greenness. Urban dwellers have a higher response to the detrimental effect of heatwaves and a higher marginal benefit from greenness exposure.

Increasingly hotter temperatures threaten the environment and pose serious risks to human health. From contending with damaged crops and loss of work due to extreme weather to working in life-threateningly hot and humid temperatures, agricultural farmworkers are on the front lines of this harsh reality.

Climate warming is characterized by increase in extreme heat events (EHEs). EHEs and mild temperature periods alternate with each other and form complex climate scenarios. Among these scenarios, low-frequency and short-duration extreme heat events during long mild periods (sporadic short EHEs) and low-frequency and short-duration mild periods during long extreme heat events (sporadic short mild periods) commonly occur in nature. The biological effects of these two types of temperature events have not been thoroughly elucidated to date. To clarify the biological effects of these temperature events on organisms, we selected the English grain aphid, a globally important cereal pest, as our model system. We exposed aphids to simulated 24-h diurnal fluctuating temperatures, inserted these events during the wheat growing season and then investigated development, adult longevity, fecundity, survival, and demographic parameters. We found that sporadic short mild periods during a long EHE could improve their life history traits. Increasing the duration of mild periods from 1 day to 2 days did not significantly change their demographic performance. Sporadic short EHEs during a long mild period did not significantly affect vital rates, while increasing the duration of EHEs from 1 day to 2 days worsened the aphids’ performance. We found that short mild episodes in the hot season may benefit small insects to buffer long duration heatwaves. We discussed how sporadic short mild periods during a long EHE supplied aphids a chance to recover from heat stress. Thus, we suggest that sporadic temperature events should be considered in population prediction of small insects under climate change and should be integrated into pest management.

The 2015 heat wave resulted in an estimated over 1200 deaths during the month of June. However, there were no records on the spatial distribution of the effects of this heat wave. An analysis of Moderate Resolution Imaging Spectroradiometer (MODIS) land surface temperature (LST) daily data was conducted to identify regions that experienced above normal temperatures in 2015. An analysis of the monthly averages showed that in general April and May were the warmer months in Karachi, unlike the case in 2015. In addition, the general warm trends were common in the highly industrialised Sindh Industrial Trading Estate (SITE) and Liaquatabad towns, while Gadap, with its mostly barren land, and New Karachi also experience higher temperatures. Coastal towns were naturally cooler and more habitable in the given scenario. A count of the spatial presence of health facilities for the city was also extracted where Gadap and Korangi were poorly served while the more affluent towns of Defence Housing Authority (DHA) and Gulshan-e-Iqbal appeared to be better served.

Molecular responses of fishes to a heatwave are species specific and do not concur with measures of oxygen uptake in captivity., The marine heatwave of 2016 was one of the longest and hottest thermal anomalies recorded on the Great Barrier Reef, influencing multiple species of marine ectotherms, including coral reef fishes. There is a gap in our understanding of what the physiological consequences of heatwaves in wild fish populations are. Thus, in this study, we used liver transcriptomes to understand the molecular response of five species to the 2016 heatwave conditions. Gene expression was species specific, yet we detected overlap in functional responses associated with thermal stress previously reported in experimental setups. The molecular response was also influenced by the duration of exposure to elevated temperatures. This study highlights the importance of considering the effects of extreme warming events when evaluating the consequences of climate change on fish communities.

Heat stress negatively affects reproductive functions in cows. Increased temperature disturbs fetal development in utero. However, the effect of heat stress on uterine endometrial tissues has not been fully examined. Using qPCR analysis, we measured the mRNA expression of various molecular markers in uterine endometrial tissue of dairy cows from Hokkaido, Japan, in winter and summer. Markers examined were heat shock proteins (HSPs), antioxidant enzymes (catalase, copper/zinc superoxide dismutase, manganese superoxide dismutase, and glutathione peroxidase 4), inflammatory cytokines, and interferon stimulated genes. Our results showed heat stress, body and milk temperatures were higher during summer than during winter. Expression levels of HSP27, HSP60, and HSP90 mRNA, and of catalase and copper/zinc superoxide dismutase mRNA were lower in summer than in winter. Tumor necrosis factor alpha expression was higher in summer than in winter. In conclusion, summer heat stress may reduce the expression of HSPs, affecting the levels of inflammatory cytokines in bovine uterine endometrial tissue.

Daily commute substantially increases urban residents’ exposure to heat waves and slightly alleviates exposure to cold waves., Exposure to extreme temperatures is one primary cause of weather-related human mortality and morbidity. Global climate change raises the concern of public health under future extreme events, yet spatiotemporal population dynamics have been long overlooked in health risk assessments. Here, we show that the diurnal intra-urban movement alters residents’ exposure to extreme temperatures during cold and heat waves. To do so, we incorporate weather simulations with commute-adjusted population profiles over 16 major U.S. metropolitan areas. Urban residents’ exposure to heat waves is intensified by 1.9° ± 0.7°C (mean ± SD among cities), and their exposure to cold waves is attenuated by 0.6° ± 0.8°C. The higher than expected exposure to heat waves significantly correlates with the spatial temperature variability and requires serious attention. The essential role of population dynamics should be emphasized in temperature-related climate adaptation strategies for effective and successful interventions.

Tropical regions are characterized by hydrological extreme events, which are likely to be exacerbated by climate change. Therefore, quantifying the extent to which climate change may damage a hydrological system becomes crucial. This paper aims to evaluate the findings from previous research on projected impacts of climate change on hydrological systems located in regions bounded by the Tropic of Cancer and the Tropic of Capricorn. It intends to provide an in-depth understanding of the climatic conditions, applied approaches, climate change impacts on future streamflow, and measures to reduce prediction uncertainty in the tropics. The review revealed that there is a significant variation in the magnitude of climate change impacts on streamflow in the tropics. The reason for the inconsistent trend prediction is that projections are heavily dependent on the trajectory of greenhouse gas emissions, climate model structural differences, and uncertainty of downscaling methods and hydrological models. Therefore, to minimize the uncertainty and maximize confidence in streamflow projections, it is essential to apply multi-member model ensembles and to clarify the adaptation strategy (coping, adjusting, or transforming).

The MJA-Lancet Countdown on health and climate change was established in 2017 and produced its first Australian national assessment in 2018. It examined 41 indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. It found that, overall, Australia is vulnerable to the impacts of climate change on health, and that policy inaction in this regard threatens Australian lives. In this report we present the 2019 update. We track progress on health and climate change in Australia across the same five broad domains and many of the same indicators as in 2018. A number of new indicators are introduced this year, including one focused on wildfire exposure, and another on engagement in health and climate change in the corporate sector. Several of the previously reported indicators are not included this year, either due to their discontinuation by the parent project, the Lancet Countdown, or because insufficient new data were available for us to meaningfully provide an update to the indicator. In a year marked by an Australian federal election in which climate change featured prominently, we find mixed progress on health and climate change in this country. There has been progress in renewable energy generation, including substantial employment increases in this sector. There has also been some progress at state and local government level. However, there continues to be no engagement on health and climate change in the Australian federal Parliament, and Australia performs poorly across many of the indicators in comparison to other developed countries; for example, it is one of the world's largest net exporters of coal and its electricity generation from low carbon sources is low. We also find significantly increasing exposure of Australians to heatwaves and, in most states and territories, continuing elevated suicide rates at higher temperatures. We conclude that Australia remains at significant risk of declines in health due to climate change, and that substantial and sustained national action is urgently required in order to prevent this.

From raging wildfires to melting ice in Greenland, the top of the world is screaming for help. From raging wildfires to melting ice in Greenland, the top of the world is screaming for help.

Extreme summertime heat is a significant public health threat that disproportionately impacts vulnerable urban populations. Research on health impacts of climate change (including increasing intensity, duration, and frequency of hot weather) is sometimes designed and implemented without the involvement of the communities being studied, i.e., &ldquo, community-placed&rdquo, not &ldquo, community-based.&rdquo, We describe how the Heatwaves, Housing, and Health: Increasing Climate Resiliency in Detroit (HHH) partnership engaged relevant communities by integrating a community-based participatory research (CBPR) approach into an existing, academic-designed research project through a steering committee of community and academic partners. Using a case study approach, we analyze program documentation, partnership evaluation questionnaires, and HHH steering committee meeting notes. We describe the CBPR process by which we successfully collected research data in Detroit during summer 2016, engaged in collaborative analysis of data, and shared results with Detroit residents. Evaluations of the partnership over 2 years show community involvement in research, enhanced capacities, success in securing new grant funding, and ways that CBPR strengthened the validity, relevance, and translation of research. Engaging communities as equal partners using CBPR, even after a study is underway, can strengthen research to understand and address the impacts of extreme heat on health and equity in urban communities.

In the present cross-sectional study we aimed to identify factors associated with morbidity and mortality in patients during the heat wave period (June 17th till 23rd, 2015) in the emergency department. The inclusion criteria of the study was core temperature38 degree Celsius and signs of dehydration recorded in-patient notes and CNS dysfunction without infection recorded through GCS. Of 400 patients mortality was observed in 50 patients (12.7%) of which majority were males (54%). Of the non-survivors, 27.3% had prior history of cerebrovascular accident. Difference was noted in clinical presentation among non-survivors with unconsciousness (14%) and gasping (12%). Differences were noted in median of platelets [251(190-331) versus 183.5(155-228.5)] and Creatinine [1.1(0.9-1.7) versus 2.1(1.4-2.4)] between survivors and non-survivors. Majority of non-survivors had deranged coagulation profile and hypoxaemia.

Weather conditions, especially temperature and precipitation, play a critical role in shaping patterns of diarrhoeal diseases. They determine the frequency of outbreaks, and the spatial and seasonal distribution of cases. Not surprisingly, it is anticipated that the burden of diarrhoeal diseases will escalate with climate change, in tandem with gradual increments in mean temperatures, but also during episodic heatwaves. The degree and nature of this escalation will, however, vary with the mix of pathogens in an area, the quality of sanitation services, food hygiene regulations and their enforcement, and the age structure of the population, among other factors. Understanding these patterns can inform the design of measures to prevent and control heat-related diarrhoea. In this editorial, we sum evidence on the heat sensitivity of enteric infections in South Africa (SA) and other parts of sub-Saharan Africa (19 studies), drawing on articles located in a systematic review (methods detailed in Manyuchi et al. [1]), and consider the implications of these findings for control of diarrhoea in SA in the context of climate change.

Intraspecific discrete polymorphism is associated with the use of alternative life-history strategies, reflected by distinct reproductive or copying strategies in individuals of different morphs. Yet, morph-specific costs and benefits related to different life-history strategies remain unclear. Here, we examined in the polymorphic Gouldian finch ( Erythrura gouldiae ) whether markers of somatic maintenance (body mass, oxidative status and telomere length) differed between red- and black-headed birds under energetically demanding conditions (during heatwaves of different intensity, and during moult or breeding following heatwaves). During heatwaves, red-headed birds showed a homogeneous response, as males and females initially tended to gain mass and had reduced plasma hydroperoxide levels (a marker of oxidative damage) irrespective of heatwave intensity. In contrast, black-headed birds showed a stronger and more heterogeneous response, as black-headed males gained mass at the beginning of the thermoneutral heatwave and showed stable oxidative status, whereas black-headed females lost mass and tended to show higher hydroperoxide levels at the end of the thermocritical heatwave. Following heatwaves, we found morph-specific oxidative costs owing to moult or reproduction, with oxidative markers varying only in black-headed birds. Again, oxidative markers varied differently in black-headed males and females, as plasma antioxidant capacity decreased in moulting or breeding females, whereas males showed higher hydroperoxide levels with larger broods. For the first time, our study highlights that within polymorphic species, some individuals appear more vulnerable than others when coping with energetically demanding conditions. In the context of climate change, such differential effects may ultimately alter the currently observed balance between morphs and sexes within natural populations.

Objectives In this multicity study, we aimed to elucidate the city-specific factors affecting the association of high ambient temperature with ambulance dispatches due to acute illnesses. Methods We used the data of ambulance dispatches in 27 cities in Japan with more than 500,000 population excluding Tokyo, from May to September from 2012 to 2015. We included patients 20 years and older (≥20 years) and stratified them into three age groups (20-59, 60-79, and ≥80 years). We explored the city-specific pattern of the daily relative temperature (in temperature percentiles) and the risk of ambulance dispatches for each age group using a distributed lag nonlinear model and estimated the city-specific relative risks of ambulance dispatches at the 95/99 percentile temperature compared with the 77.6 percentile temperature defined as the reference temperature (Tref). Then, the estimates were combined by performing meta-analyses for each age group. We also applied meta-regression models to explore whether the city-specific characteristics modified the association of temperature with ambulance dispatches. Results The relative risks of the 95th percentile with respect to Tref were 1.14 (95% confidence interval (CI): 1.12, 1.16), 1.16 (95% CI: 1.13, 1.20), 1.13 (95% CI: 1.10, 1.16), and 1.13 (95% CI: 1.00, 1.16), for all-age (≥20) and age-stratified groups (20-59, 60-79, and ≥80 years), respectively. We observed a higher relative risk for the ≥20 years age group in the cities with higher proportions of single-elderly, single-mother, and single-father households. We also found that the relative risk for the 20-59 years age group was higher in the cities with a higher proportion of blue-collar workers. Conclusions The present study provides insights into city-specific characteristics modifying heat-related health effects.

Here we assess the quality and in-season development of European wheat (Triticum spp.) yield forecasts during low, medium, and high-yielding years. 440 forecasts were evaluated for 75 wheat forecast years from 1993–2013 for 25 European Union (EU) Member States. By July, years with median yields were accurately forecast with errors below ~2%. Yield forecasts in years with low yields were overestimated by ~10%, while yield forecasts in high-yielding years were underestimated by ~8%. Four-fifths of the lowest yields had a drought or hot driver, a third a wet driver, while a quarter had both. Forecast accuracy of high-yielding years improved gradually during the season, and drought-driven yield reductions were anticipated with lead times of ~2 months. Single, contrasting successive in-season, as well as spatially distant dry and wet extreme synoptic weather systems affected multiple-countries in 2003, ’06, ’07, ’11 and 12’, leading to wheat losses up to 8.1 Mt (>40% of total EU loss). In these years, June forecasts (~ 1-month lead-time) underestimated these impacts by 10.4 to 78.4%. To cope with increasingly unprecedented impacts, near-real-time information fusion needs to underpin operational crop yield forecasting to benefit from improved crop modelling, more detailed and frequent earth observations, and faster computation.

Background: Most excess deaths that occur during extreme hot weather events do not have natural heat recorded as an underlying or contributing cause. This study aims to identify the specific individuals who died because of hot weather using only secondary data. A novel approach was developed in which the expected number of deaths was repeatedly sampled from all deaths that occurred during a hot weather event, and compared with deaths during a control period. The deaths were compared with respect to five factors known to be associated with hot weather mortality. Individuals were ranked by their presence in significant models over 100 trials of 10,000 repetitions. Those with the highest rankings were identified as probable excess deaths. Sensitivity analyses were performed on a range of model combinations. These methods were applied to a 2009 hot weather event in greater Vancouver, Canada. Results The excess deaths identified were sensitive to differences in model combinations, particularly between univariate and multivariate approaches. One multivariate and one univariate combination were chosen as the best models for further analyses. The individuals identified by multiple combinations suggest that marginalized populations in greater Vancouver are at higher risk of death during hot weather. Conclusions This study proposes novel methods for classifying specific deaths as expected or excess during a hot weather event. Further work is needed to evaluate performance of the methods in simulation studies and against clinically identified cases. If confirmed, these methods could be applied to a wide range of populations and events of interest.