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      Climate Change Impacts on Disaster and Emergency Medicine Focusing on Mitigation Disruptive Effects: an International Perspective

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          Abstract

          In recent decades, climate change has been responsible for an increase in the average temperature of the troposphere and of the oceans, with consequences on the frequency and intensity of many extreme weather phenomena. Climate change’s effects on natural disasters can be expected to induce a rise in humanitarian crises. In addition, it will surely impact the population’s long-term general health, especially among the most fragile. There are foreseeable health risks that both ambulatory care organizations and hospitals will face as global temperatures rise. These risks include the geographic redistribution of infectious (particularly zoonotic) diseases, an increase in cardiac and respiratory illnesses, as well as a host of other health hazards. Some of these risks have been detailed for most developed countries as well as for some developing countries. Using these existing risk assessments as a template, organizational innovations as well as implementation strategies should be proposed to mitigate the disruptive effects of these health risks on emergency departments and by extension, reduce the negative impact of climate change on the populations they serve.

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          Most cited references72

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          International study of temperature, heat and urban mortality: the 'ISOTHURM' project.

          This study describes heat- and cold-related mortality in 12 urban populations in low- and middle-income countries, thereby extending knowledge of how diverse populations, in non-OECD countries, respond to temperature extremes. The cities were: Delhi, Monterrey, Mexico City, Chiang Mai, Bangkok, Salvador, São Paulo, Santiago, Cape Town, Ljubljana, Bucharest and Sofia. For each city, daily mortality was examined in relation to ambient temperature using autoregressive Poisson models (2- to 5-year series) adjusted for season, relative humidity, air pollution, day of week and public holidays. Most cities showed a U-shaped temperature-mortality relationship, with clear evidence of increasing death rates at colder temperatures in all cities except Ljubljana, Salvador and Delhi and with increasing heat in all cities except Chiang Mai and Cape Town. Estimates of the temperature threshold below which cold-related mortality began to increase ranged from 15 degrees C to 29 degrees C; the threshold for heat-related deaths ranged from 16 degrees C to 31 degrees C. Heat thresholds were generally higher in cities with warmer climates, while cold thresholds were unrelated to climate. Urban populations, in diverse geographic settings, experience increases in mortality due to both high and low temperatures. The effects of heat and cold vary depending on climate and non-climate factors such as the population disease profile and age structure. Although such populations will undergo some adaptation to increasing temperatures, many are likely to have substantial vulnerability to climate change. Additional research is needed to elucidate vulnerability within populations.
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            Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence.

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              Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy

              Climate change has led to significant rise of 0.8°C-0.9°C in global mean temperature over the last century and has been linked with significant increases in the frequency and severity of heat waves (extreme heat events). Climate change has also been increasingly connected to detrimental human health. One of the consequences of climate-related extreme heat exposure is dehydration and volume loss, leading to acute mortality from exacerbations of pre-existing chronic disease, as well as from outright heat exhaustion and heat stroke. Recent studies have also shown that recurrent heat exposure with physical exertion and inadequate hydration can lead to CKD that is distinct from that caused by diabetes, hypertension, or GN. Epidemics of CKD consistent with heat stress nephropathy are now occurring across the world. Here, we describe this disease, discuss the locations where it appears to be manifesting, link it with increasing temperatures, and discuss ongoing attempts to prevent the disease. Heat stress nephropathy may represent one of the first epidemics due to global warming. Government, industry, and health policy makers in the impacted regions should place greater emphasis on occupational and community interventions.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                01 July 2018
                July 2018
                : 15
                : 7
                : 1379
                Affiliations
                [1 ]Emergency Department and EMS, University Hospital of Bichat, Paris 75018, France; maximilien.guericolas@ 123456aphp.fr (M.G.); enrique.casalino@ 123456aphp.fr (E.C.)
                [2 ]Ilumens Simulation Center, University of Paris-Diderot, Paris 75018, France
                [3 ]Acute Care Division & Emergency Department, Grand Hôpital de Charleroi, Charleroi 6040, Belgium; frederic.thys@ 123456uclouvain.be
                [4 ]Faculty of Public Health & Medicine, Catholic University of Louvain, Brussels 1348, Belgium
                [5 ]Emergency Department, University Hospital of Geneva, Geneva 44041, Switzerland; francois.sarasin@ 123456hcuge.ch
                [6 ]University of Geneva Medical School, Geneva 1205, Switzerland
                [7 ]Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo 33006, Spain; arcos@ 123456uniovi.es
                [8 ]University of Paris Diderot, Sorbonne Paris Cité, EA 7334 Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris 75018, France
                [9 ]Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris 75018, France
                Author notes
                [* ]Correspondence: aiham@ 123456hotmail.com ; Tel.: +33-(0)1-40-25-77-61
                Author information
                https://orcid.org/0000-0003-0129-4322
                https://orcid.org/0000-0002-4147-5948
                https://orcid.org/0000-0003-4882-5442
                Article
                ijerph-15-01379
                10.3390/ijerph15071379
                6069477
                29966379
                2447552d-45c5-4cb1-ac35-1e3204a3e086
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 May 2018
                : 25 June 2018
                Categories
                Review

                Public health
                climate change,emergency medicine,health,disaster preparedness,management,european perspective

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