ORCID Profile
0000-0002-6862-2696
Current Organisation
University of Adelaide
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Epidemiology | Environmental and Occupational Health and Safety | Health Economics | Public Health and Health Services |
Social Impacts of Climate Change and Variability | Environmental Health | Occupational Health
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.SCITOTENV.2018.11.479
Abstract: Exposure to extreme heat can lead to a range of heat-related illnesses, exacerbate pre-existing health conditions and cause increased demand on the healthcare system. A projected increase in temperature may lead to greater healthcare expenditure, however, at present the costs of heat-related healthcare utilization is under-researched. This study aims to review the literature on heat-related costs for the healthcare system with a focus on ED visits, hospitalization, and ambulance call-outs. PubMed, Scopus, and Embase were used to search relevant literature from database inception to December 2017 and limited to human studies and English language. After screening, a total of ten papers were identified for final inclusion. In general, the healthcare costs of heat extremes have been poorly investigated in developed countries and not reported in developing countries where the largest heat-vulnerable populations reside. Studies showed that exposure to extreme heat was causing a substantial economic burden on healthcare systems. Females, the elderly, low-income families, and ethnic minorities had the highest healthcare costs on a range of health services utilization. Although a few studies have estimated heat healthcare costs, none of them quantified the temperature-healthcare cost relationship. There is a need to systematically examine heat-attributable costs for the healthcare system in the context of climate change to better inform heat-related policy making, target interventions and resource allocation.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JIPH.2018.12.010
Abstract: Dengue is a significant climate-sensitive disease. Public health professionals play an important role in prevention and control of the disease. This study aimed to explore dengue control and prevention in the context of climate change in China. A cross-sectional survey was conducted among 630 public health professionals in 2015. Descriptive analysis and logistic regression were performed. More than 80% of participants from southwest and central China believed climate change would affect dengue. However, participants from northeast China were less likely to believe so (65%). Sixty-nine percent of participants in Yunnan perceived that dengue had emerged/re-emerged in recent years, compared with 40.6% in Henan and 23.8% in Liaoning. Less than 60% of participants thought current prevention and control programs had been effective. Participants believed mosquitoes in high abundance, imported cases and climate change were main risk factors for dengue in China. There were varying views of dengue in China. Professionals in areas susceptible to dengue were more likely to be concerned about climate change and dengue. Current prevention and control strategies need to be improved. Providing more information for staff in lower levels of Centers for Disease Control and Prevention may help in containing a possible increase of dengue.
Publisher: Elsevier BV
Date: 05-2017
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.ENVRES.2016.11.009
Abstract: This study aims to (1) investigate the associations between climatic factors and dengue and (2) identify the susceptible subgroups. De-identified daily dengue cases in Guangzhou for 2005-2014 were obtained from the Chinese Center for Disease Control and Prevention. Weather data were downloaded from the China Meteorological Data Sharing Service System. Distributed lag non-linear models (DLNM) were used to graphically demonstrate the three-dimensional temperature-dengue association. Generalised estimating equation models (GEE) with piecewise linear spline functions were used to quantify the temperature-dengue associations. Threshold values were estimated using a broken-stick model. Middle-aged and older people, people undertaking household duties, retirees, and those unemployed were at high risk of dengue. Reversed U-shaped non-linear associations were found between ambient temperature, relative humidity, extreme wind velocity, and dengue. The optimal maximum temperature (T
Publisher: Elsevier BV
Date: 2021
Publisher: Cambridge University Press (CUP)
Date: 17-12-2018
DOI: 10.1017/S0950268817002254
Abstract: This study aims to investigate the climate–malaria associations in nine cities selected from malaria high-risk areas in China. Daily reports of malaria cases in Anhui, Henan, and Yunnan Provinces for 2005–2012 were obtained from the Chinese Center for Disease Control and Prevention. Generalized estimating equation models were used to quantify the city-specific climate–malaria associations. Multivariate random-effects meta-regression analyses were used to pool the city-specific effects. An inverted-U-shaped curve relationship was observed between temperatures, average relative humidity, and malaria. A 1 °C increase of maximum temperature ( T max ) resulted in 6·7% (95% CI 4·6–8·8%) to 15·8% (95% CI 14·1–17·4%) increase of malaria, with corresponding lags ranging from 7 to 45 days. For minimum temperature ( T min ), the effect estimates peaked at lag 0 to 40 days, ranging from 5·3% (95% CI 4·4–6·2%) to 17·9% (95% CI 15·6–20·1%). Malaria is more sensitive to T min in cool climates and T max in warm climates. The duration of lag effect in a cool climate zone is longer than that in a warm climate zone. Lagged effects did not vanish after an epidemic season but waned gradually in the following 2–3 warm seasons. A warming climate may potentially increase the risk of malaria resurgence in China.
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.ENVRES.2016.03.043
Abstract: Dengue fever is an important climate-sensitive mosquito-borne viral disease that poses a risk to half the world's population. The disease is a major public health issue in China where in 2014 a major outbreak occurred in Guangdong Province. This study aims to gauge health professionals' perceptions about the capacity of infectious disease control and prevention to meet the challenge of dengue fever in the face of climate change in Guangdong Province, China. A cross-sectional questionnaire survey was administered among staff in the Centers for Disease Control and Prevention (CDCs) in Guangdong Province. Data analysis was undertaken using descriptive methods and logistic regression. In total, 260 questionnaires were completed. Most participants (80.7%) thought climate change would have a negative effect on population health, and 98.4% of participants reported dengue fever had emerged or re-emerged in China in recent years. Additionally, 74.9% of them indicated that the capability of the CDCs to detect infectious disease outbreak/epidemic at an early stage was excellent 86.3% indicated laboratories could provide diagnostic support rapidly and 83.1% believed levels of current staff would be adequate in the event of a major outbreak. Logistic regression analysis showed higher levels of CDCs were perceived to have better capacity for infectious disease control and prevention. Only 26.8% of participants thought they had a good understanding of climate change, and most (85.4%) thought they needed more information about the health impacts of climate change. Most surveyed staff suggested the following strategies to curb the public health impact of infectious diseases in relation to climate change: primary prevention measures, strengthening the monitoring of infectious diseases, the ability to actively forecast disease outbreaks by early warning systems, and more funding for public health education programs. Vigilant disease and vector surveillance, preventive practice and health promotion programs will likely be significant in addressing the threat of dengue fever in the future. Further efforts are needed to strengthen the awareness of climate change among health professionals, and to promote relevant actions to minimize the health burden of infectious diseases in a changing climate. Results will be critical for policy makers facing the current and future challenges associated with infectious disease prevention and control in China.
Publisher: BMJ
Date: 16-06-2015
DOI: 10.1136/OEMED-2014-102706
Abstract: This study aims to examine the epidemiological characteristics of occupational heat illnesses in South Australia, to quantify the association between ambient temperature and occupational heat illnesses, and to investigate the impact of heatwaves on occupational heat illnesses. Workers' compensation claims data and weather data were obtained from SafeWork South Australia and the Bureau of Meteorology, respectively, for 2001-2010. Time series analysis with generalised estimation equation models and linear spline functions was used to quantify the temperature-heat illness claims association. A case-crossover design was applied to investigate the impact of heatwaves on occupational heat illnesses. There were 306 heat illness claims during the study period, with an incidence rate of 4.5 per 100,000 employees. The overall risk of occupational heat illness was positively associated with maximum temperature (Tmax), especially when Tmax was over the threshold of 35.5 °C. One degree increase of Tmax was associated with a 12.7% (incidence rate ratio 1.127, 95% CI 1.067 to 1.190) increase of occupational heat illness claims. During heatwave periods, the risk of occupational heat illness was about 4-7 times higher than that of non-heatwave periods. There is a need to develop or refine current heat-related regulations and guidelines to minimise the risk of occupational heat illnesses in vulnerable workers in a warming climate.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2016
Publisher: MDPI AG
Date: 07-09-2015
Publisher: BMJ
Date: 13-12-2014
DOI: 10.1136/OEMED-2013-101584
Abstract: (1) To investigate the association between temperature and work-related injuries and (2) to identify groups of workers at high risk of work-related injuries in hot environments in Adelaide, South Australia. Workers' compensation claims in Adelaide, South Australia for 2001-2010 were used. The relationship between temperature and daily injury claims was estimated using a generalised estimating equation model. A piecewise linear spline function was used to quantify the effect of temperature on injury claims below and above thresholds. Overall, a 1°C increase in maximum temperature between 14.2°C and 37.7°C was associated with a 0.2% increase in daily injury claims. Specifically, the incidence rate ratios (IRRs) for male workers and young workers aged ≤24 were (1.004, 95% CI 1.002 to 1.006) and (1.005, 95% CI 1.002 to 1.008), respectively. Significant associations were also found for labourers (IRR 1.005, 95% CI 1.001 to 1.010), intermediate production and transport workers (IRR 1.003, 95% CI 1.001 to 1.005) and tradespersons (IRR 1.002, 95% CI 1.001 to 1.005). Industries at risk were agriculture, forestry and fishing (IRR 1.007, 95% CI 1.001 to 1.013), construction (IRR 1.006, 95% CI 1.002 to 1.011), and electricity, gas and water (IRR 1.029, 95% CI 1.002 to 1.058). There is a significant association between injury claims and temperature in Adelaide, South Australia, for certain industries and groups. Relevant adaptation and prevention measures are required at both policy and practice levels to address occupational exposure to high temperatures.
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.ENVRES.2014.04.042
Abstract: This study aims to investigate the impact of heatwaves on worker's health and safety to identify workers at higher risk of prevalent illnesses and injuries due to heatwaves and to provide evidence for policy-makers and service providers. South Australian workers' compensation claims data for 2001-2010 were transformed into time series format, merged with meteorological data and analysed using generalized estimating equation (GEE) models. For total injury claims there was no significant difference detected between heatwave and non-heatwave periods. However, for outdoor industries, daily claims increased significantly by 6.2% during heatwaves. Over-represented in hot weather were male labourers and tradespersons aged ≥ 55 years, and those employed in 'agriculture, forestry and fishing' and 'electricity, gas and water'. Occupational burns, wounds, lacerations, and utations as well as heat illnesses were significantly associated with heatwaves. Similarly, moving objects, contact with chemicals, and injuries related to environmental factors increased significantly during heatwaves, especially among middle-aged and older male workers. With the predicted increase of extremely hot weather, there is a need for relevant adaptation and prevention measures at both practice and policy levels for vulnerable work groups.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.SCITOTENV.2018.04.407
Abstract: This study aims to investigate the associations between meteorological factors and hemorrhagic fever with renal syndrome (HFRS) in 19 cities selected from HFRS high risk areas across different climate zones in three Provinces of China. De-identified daily reports of HFRS in Anhui, Heilongjiang, and Liaoning Provinces for 2005-2014 were obtained from the Chinese Center for Disease Control and Prevention. Daily weather data from each study location were obtained from the China meteorological Data Sharing Service System. Generalised estimating equation models (GEE) were used to quantify the city-specific HFRS-weather associations. Multivariate random-effects meta-regression models were used to pool the city-specific HFRS-weather effect estimates. HFRS showed an overall downward trend during the study period with a slight rebound after 2010. Meteorological factors were significantly associated with HFRS incidence. HFRS was relatively more sensitive to weather variability in subtropical regions (Anhui Province) than in temperate regions (Heilongjiang and Liaoning Provinces). The size of effect estimates and the duration of lagged effects varied by locations. Pooled results of the 19 cities showed that a 1 °C increase in maximum temperature (T
Publisher: Wiley
Date: 23-12-2017
DOI: 10.1111/ZPH.12335
Abstract: Zoonotic diseases transmitted by arthropods and rodents are a major public health concern in China. However, interventions in recent decades have helped lower the incidence of several diseases despite the country's large, frequently mobile population and socio-economic challenges. Increasing globalization, rapid urbanization and a warming climate now add to the complexity of disease control and prevention and could challenge China's capacity to respond to threats of emerging and re-emerging zoonoses. To investigate this notion, face-to-face interviews were conducted with 30 infectious disease experts in four cities in China. The case study diseases under discussion were malaria, dengue fever and haemorrhagic fever with renal syndrome, all of which may be influenced by changing meteorological conditions. Data were analysed using standard qualitative techniques. The study participants viewed the current disease prevention and control system favourably and were optimistic about China's capacity to manage climate-sensitive diseases in the future. Several recommendations emerged from the data including the need to improve health literacy in the population regarding the transmission of infectious diseases and raising awareness of the health impacts of climate change amongst policymakers and health professionals. Participants thought that research capacity could be strengthened and human resources issues for front-line staff should be addressed. It was considered important that authorities are well prepared in advance for outbreaks such as dengue fever in populous subtropical areas, and a prompt and coordinated response is required when outbreaks occur. Furthermore, health professionals need to remain skilled in the identification of diseases for which incidence is declining, so that re-emerging or emerging trends can be rapidly identified. Recommendations such as these may be useful in formulating adaptation plans and capacity building for the future control and prevention of climate-sensitive zoonotic diseases in China and neighbouring countries.
Publisher: National Institute of Industrial Health
Date: 2014
Publisher: Springer Science and Business Media LLC
Date: 31-03-2017
Publisher: Elsevier BV
Date: 06-2018
Publisher: Public Library of Science (PLoS)
Date: 19-08-2015
Publisher: Elsevier BV
Date: 06-2020
Location: Australia
Start Date: 2019
End Date: 2021
Funder: University of Adelaide
View Funded ActivityStart Date: 08-2019
End Date: 12-2022
Amount: $385,688.00
Funder: Australian Research Council
View Funded Activity