Search Results
Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study
2021, Zhao, Qi, Guo, Yuming, Ye, Tingting, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobias, Aurelio, Nunes, Baltazar, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Pan, Shih-Chun, Íñiguez, Carmen, Ameling, Caroline, De la Cruz Valencia, César, Åström, Christofer, Houthuijs, Danny, Dung, Do Van, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Di Ruscio, Francesco, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian-Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Jaakkola, Jouni J. K., Katsouyanni, Klea, Hurtado Diaz, Magali, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, de Sousa Zanotti Stagliorio Coélho, Micheline, Valdés Ortega, Nicolás, Ryti, Niilo, Scovronick, Noah, Michelozzi, Paola, Matus Correa, Patricia, Goodman, Patrick, Nascimento Saldiva, Paulo Hilario, Abrutzky, Rosana, Osorio, Samuel, Rao, Shilpa, Fratianni, Simona, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Guo, Yue Leon, Bell, Michelle L., Li, Shanshan
Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe. Interpretation: Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios. Funding: Australian Research Council and the Australian National Health and Medical Research Council. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Medical ethics in the Anthropocene: how are €100 billion of German physicians' pension funds invested?
2019, Schulz, Christian M., Ahrend, Klaus-Michael, Schneider, Gerhard, Hohendorf, Gerrit, Schellnhuber, Hans Joachim, Busse, Reinhard
[No abstract available]
Ambient carbon monoxide and daily mortality: a global time-series study in 337 cities
2021, Chen, Kai, Breitner, Susanne, Wolf, Kathrin, Stafoggia, Massimo, Sera, Francesco, Vicedo-Cabrera, Ana M., Guo, Yuming, Tong, Shilu, Lavigne, Eric, Matus, Patricia, Valdés, Nicolás, Kan, Haidong, Jaakkola, Jouni J. K., Ryti, Niilo R. I., Huber, Veronika, Scortichini, Matteo, Hashizume, Masahiro, Honda, Yasushi, Nunes, Baltazar, Madureira, Joana, Holobâcă, Iulian Horia, Fratianni, Simona, Kim, Ho, Lee, Whanhee, Tobias, Aurelio, Íñiguez, Carmen, Forsberg, Bertil, Åström, Christofer, Ragettli, Martina S., Guo, Yue-Liang Leon, Chen, Bing-Yu, Li, Shanshan, Milojevic, Ai, Zanobetti, Antonella, Schwartz, Joel, Bell, Michelle L., Gasparrini, Antonio, Schneider, Alexandra
Background Epidemiological evidence on short-term association between ambient carbon monoxide (CO) and mortality is inconclusive and limited to single cities, regions, or countries. Generalisation of results from previous studies is hindered by potential publication bias and different modelling approaches. We therefore assessed the association between short-term exposure to ambient CO and daily mortality in a multicity, multicountry setting. Methods We collected daily data on air pollution, meteorology, and total mortality from 337 cities in 18 countries or regions, covering various periods from 1979 to 2016. All included cities had at least 2 years of both CO and mortality data. We estimated city-specific associations using confounder-adjusted generalised additive models with a quasi-Poisson distribution, and then pooled the estimates, accounting for their statistical uncertainty, using a random-effects multilevel meta-analytical model. We also assessed the overall shape of the exposure–response curve and evaluated the possibility of a threshold below which health is not affected. Findings Overall, a 1 mg/m3 increase in the average CO concentration of the previous day was associated with a 0·91% (95% CI 0·32–1·50) increase in daily total mortality. The pooled exposure–response curve showed a continuously elevated mortality risk with increasing CO concentrations, suggesting no threshold. The exposure–response curve was steeper at daily CO levels lower than 1 mg/m3, indicating greater risk of mortality per increment in CO exposure, and persisted at daily concentrations as low as 0·6 mg/m3 or less. The association remained similar after adjustment for ozone but was attenuated after adjustment for particulate matter or sulphur dioxide, or even reduced to null after adjustment for nitrogen dioxide. Interpretation This international study is by far the largest epidemiological investigation on short-term CO-related mortality. We found significant associations between ambient CO and daily mortality, even at levels well below current air quality guidelines. Further studies are warranted to disentangle its independent effect from other traffic-related pollutants.
Impact of unseasonable flooding on women's food security and mental health in rural Sylhet, Bangladesh: a longitudinal observational study
2022, Gepp, Sophie, Waid, Jillian L, Brombierstäudl, Dagmar, Kader, Abdul, Müller-Hauser, Anna A, Wendt, Amanda S, Dame, Juliane, Gabrysch, Sabine
Background Climate change will lead to more frequent and intensive flooding. In April, 2017, unseasonably early flooding led to the inundation of low-lying cropland before the rice harvest in northeastern Bangladesh. We describe coping strategies and quantify short-term and medium-term effects of flooding events on food security and depressive symptoms of women. Methods This observational study is part of the cluster-randomised Food and Agricultural Approaches to Reducing Malnutrition trial (FAARM; NCT02505711). Women self-reported flooding exposure on behalf of their households when surveyed (approximately 6 months after the event). Remote sensing analysis was used to detect the extent of the flooding. We collected data on household food security at baseline, depressive symptoms 4–5 months before the flooding, and coping strategies immediately after the event. We followed up on these outcome measurements for depressive symptoms and food security for up to 2·5 years after the flooding event. We used multilevel regression adjusting for intervention allocation and pre-flooding measures to quantify the flood's effect on household food security and women's mental health. Findings The FAARM trial included 2700 young women in 96 settlements in rural Sylhet, Bangladesh. 1335 (56%) of 2405 women reported that their household being greatly affected, with many losing a large part of their rice harvest. Borrowing money with interest was the most common coping strategy, with households paying back on average 1·5 times the borrowed amount. Greatly affected households had higher odds of food insecurity, with a decreasing effect with increasing time after the flood (odds ratio: 2·4 [p<0·0001] 0·5 years after; 1·6 [p<0·0001] 2·0 years after]; and 1·3 [p=0·012] 2·5 years after). Women in such households also had 1·45 times higher odds of depression (p=0·0001) 2·5 years after the flooding event. Interpretation The 2017 flooding event negatively affected food security and the mental health of women in rural Sylhet, Bangladesh, and few affected women received formal government support. To reduce the impact of future floods, livelihood adaptations and expansion of financial protection programmes are essential measures to pursue. Funding German Federal Ministry for Education and Research (Berlin, Germany) and UK Department for International Development (London, UK).
Articulating the effect of food systems innovation on the Sustainable Development Goals
2021, Herrero, Mario, Thornton, Philip K., Mason-D'Croz, Daniel, Palmer, Jeda, Bodirsky, Benjamin L., Pradhan, Prajal, Barrett, Christopher B., Benton, Tim G., Hall, Andrew, Pikaar, Ilje, Bogard, Jessica R., Bonnett, Graham D., Bryan, Brett A., Campbell, Bruce M., Christensen, Svend, Clark, Michael, Fanzo, Jessica, Godde, Cecile M., Jarvis, Andy, Loboguerrero, Ana Maria, Mathys, Alexander, McIntyre, C. Lynne, Naylor, Rosamond L., Nelson, Rebecca, Obersteiner, Michael, Parodi, Alejandro, Popp, Alexander, Ricketts, Katie, Smith, Pete, Valin, Hugo, Vermeulen, Sonja J., Vervoort, Joost, van Wijk, Mark, van Zanten, Hannah HE, West, Paul C., Wood, Stephen A., Rockström, Johan
Food system innovations will be instrumental to achieving multiple Sustainable Development Goals (SDGs). However, major innovation breakthroughs can trigger profound and disruptive changes, leading to simultaneous and interlinked reconfigurations of multiple parts of the global food system. The emergence of new technologies or social solutions, therefore, have very different impact profiles, with favourable consequences for some SDGs and unintended adverse side-effects for others. Stand-alone innovations seldom achieve positive outcomes over multiple sustainability dimensions. Instead, they should be embedded as part of systemic changes that facilitate the implementation of the SDGs. Emerging trade-offs need to be intentionally addressed to achieve true sustainability, particularly those involving social aspects like inequality in its many forms, social justice, and strong institutions, which remain challenging. Trade-offs with undesirable consequences are manageable through the development of well planned transition pathways, careful monitoring of key indicators, and through the implementation of transparent science targets at the local level.