BackgroundClimate models project that heat waves will increase in frequency and severity. Despite many studies of mortality from heat waves, few studies have examined morbidity.ObjectivesIn this study we investigated whether any age or race/ethnicity groups experienced increased hospitalizations and emergency department (ED) visits overall or for selected illnesses during the 2006 California heat wave.MethodsWe aggregated county-level hospitalizations and ED visits for all causes and for 10 cause groups into six geographic regions of California. We calculated excess morbidity and rate ratios (RRs) during the heat wave (15 July to 1 August 2006) and compared these data with those of a reference period (8–14 July and 12–22 August 2006).ResultsDuring the heat wave, 16,166 excess ED visits and 1,182 excess hospitalizations occurred statewide. ED visits for heat-related causes increased across the state [RR = 6.30; 95% confidence interval (CI), 5.67–7.01], especially in the Central Coast region, which includes San Francisco. Children (0–4 years of age) and the elderly (≥ 65 years of age) were at greatest risk. ED visits also showed significant increases for acute renal failure, cardiovascular diseases, diabetes, electrolyte imbalance, and nephritis. We observed significantly elevated RRs for hospitalizations for heat-related illnesses (RR = 10.15; 95% CI, 7.79–13.43), acute renal failure, electrolyte imbalance, and nephritis.ConclusionsThe 2006 California heat wave had a substantial effect on morbidity, including regions with relatively modest temperatures. This suggests that population acclimatization and adaptive capacity influenced risk. By better understanding these impacts and population vulnerabilities, local communities can improve heat wave preparedness to cope with a globally warming future.

[1] To simulate ozone (O 3 ) air quality in future decades over the eastern United States, a modeling system consisting of the NASA Goddard Institute for Space Studies Atmosphere-Ocean Global Climate Model, the Pennsylvania State University/National Center for Atmospheric Research mesoscale regional climate model (MM5), and the Community Multiscale Air Quality model has been applied. Estimates of future emissions of greenhouse gases and ozone precursors are based on the A2 scenario developed by the Intergovernmental Panel on Climate Change (IPCC), one of the scenarios with the highest growth of CO 2 among all IPCC scenarios. Simulation results for five summers in the 2020s, 2050s, and 2080s indicate that summertime average daily maximum 8-hour O 3 concentrations increase by 2.7, 4.2, and 5.0 ppb, respectively, as a result of regional climate change alone with respect to five summers in the 1990s. Through additional sensitivity simulations for the five summers in the 2050s the relative impact of changes in regional climate, anthropogenic emissions within the modeling domain, and changed boundary conditions approximating possible changes of global atmospheric composition was investigated. Changed boundary conditions are found to be the largest contributor to changes in predicted summertime average daily maximum 8-hour O 3 concentrations (5.0 ppb), followed by the effects of regional climate change (4.2 ppb) and the effects of increased anthropogenic emissions (1.3 ppb). However, when changes in the fourth highest summertime 8-hour O 3 concentration are considered, changes in regional climate are the most important contributor to simulated concentration changes (7.6 ppb), followed by the effect of increased anthropogenic emissions (3.9 ppb) and increased boundary conditions (2.8 ppb). Thus, while previous studies have pointed out the potentially important contribution of growing global emissions and intercontinental transport to O 3 air quality in the United States for future decades, the results presented here imply that it may be equally important to consider the effects of a changing climate when planning for the future attainment of regional-scale air quality standards such as the U.S. national ambient air quality standard that is based on the fourth highest annual daily maximum 8-hour O 3 concentration.

A fundamental aspect of climate change is the potential shifts in flowering phenology and pollen initiation associated with milder winters and warmer seasonal air temperature. Earlier floral anthesis has been suggested, in turn, to have a role in human disease by increasing time of exposure to pollen that causes allergic rhinitis and related asthma. However, earlier floral initiation does not necessarily alter the temporal duration of the pollen season, and, to date, no consistent continental trend in pollen season length has been demonstrated. Here we report that duration of the ragweed (Ambrosia spp.) pollen season has been increasing in recent decades as a function of latitude in North America. Latitudinal effects on increasing season length were associated primarily with a delay in first frost of the fall season and lengthening of the frost free period. Overall, these data indicate a significant increase in the length of the ragweed pollen season by as much as 13-27 d at latitudes above ∼44°N since 1995. This is consistent with recent Intergovernmental Panel on Climate Change projections regarding enhanced warming as a function of latitude. If similar warming trends accompany long-term climate change, greater exposure times to seasonal allergens may occur with subsequent effects on public health. aerobiology | allergies | global warming

We investigated how climate change could affect ambient ozone concentrations and the subsequent human health impacts. Hourly concentrations were estimated for 50 eastern US cities for five representative summers each in the 1990s and 2050s, reflecting current and projected future climates, respectively. Estimates of future concentrations were based on the IPCC A2 scenario using global climate, regional climate, and regional air quality models. This work does not explore the effects of future changes in anthropogenic emissions, but isolates the impact of altered climate on ozone and health. The cities' ozone levels are estimated to increase under predicted future climatic conditions, with the largest increases in cities with present-day high pollution. On average across the 50 cities, the summertime daily 1-h maximum increased 4.8 ppb, with the largest increase at 9.6 ppb. The average number of days/summer exceeding the 8-h regulatory standard increased 68%. Elevated ozone levels correspond to approximately a 0.11% to 0.27% increase in daily total mortality. While actual future ozone concentrations depend on climate and other influences such as changes in emissions of anthropogenic precursors, the results presented here Climatic Change (2007) 82: [61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76]

Although considerable uncertainty exists in climate forecasts and future health vulnerability, the range of projections we developed suggests that by midcentury, acclimatization may not completely mitigate the effects of climate change in the New York City metropolitan region, which would result in an overall net increase in heat-related premature mortality.

Climate change may increase the frequency and intensity of ozone episodes in future summers in the United States. However, only recently have models become available that can assess the impact of climate change on O3 concentrations and health effects at regional and local scales that are relevant to adaptive planning. We developed and applied an integrated modeling framework to assess potential O3-related health impacts in future decades under a changing climate. The National Aeronautics and Space Administration–Goddard Institute for Space Studies global climate model at 4° × 5° resolution was linked to the Penn State/National Center for Atmospheric Research Mesoscale Model 5 and the Community Multiscale Air Quality atmospheric chemistry model at 36 km horizontal grid resolution to simulate hourly regional meteorology and O3 in five summers of the 2050s decade across the 31-county New York metropolitan region. We assessed changes in O3-related impacts on summer mortality resulting from climate change alone and with climate change superimposed on changes in O3 precursor emissions and population growth. Considering climate change alone, there was a median 4.5% increase in O3-related acute mortality across the 31 counties. Incorporating O3 precursor emission increases along with climate change yielded similar results. When population growth was factored into the projections, absolute impacts increased substantially. Counties with the highest percent increases in projected O3 mortality spread beyond the urban core into less densely populated suburban counties. This modeling framework provides a potentially useful new tool for assessing the health risks of climate change.

Background Ongoing climate change might, through rising temperatures, alter allergenic pollen biology across the northern hemisphere. We aimed to analyse trends in pollen seasonality and pollen load and to establish whether there are specific climate-related links to any observed changes.Methods For this retrospective data analysis, we did an extensive search for global datasets with 20 years or more of airborne pollen data that consistently recorded pollen season indices (eg, duration and intensity). 17 locations across three continents with long-term (approximately 26 years on average) quantitative records of seasonal concentrations of multiple pollen (aeroallergen) taxa met the selection criteria. These datasets were analysed in the context of recent annual changes in maximum temperature (T max ) and minimum temperature (T min ) associated with anthropogenic climate change. Seasonal regressions (slopes) of variation in pollen load and pollen season duration over time were compared to T max , cumulative degree day T max , T min , cumulative degree day T min , and frost-free days among all 17 locations to ascertain significant correlations.Findings 12 (71%) of the 17 locations showed significant increases in seasonal cumulative pollen or annual pollen load. Similarly, 11 (65%) of the 17 locations showed a significant increase in pollen season duration over time, increasing, on average, 0•9 days per year. Across the northern hemisphere locations analysed, annual cumulative increases in T max over time were significantly associated with percentage increases in seasonal pollen load (r=0•52, p=0•034) as were annual cumulative increases in T min (r=0•61, p=0•010). Similar results were observed for pollen season duration, but only for cumulative degree days (higher than the freezing point [0°C or 32°F]) for T max (r=0•53, p=0•030) and T min (r=0•48, p=0•05). Additionally, temporal increases in frost-free days per year were significantly correlated with increases in both pollen load (r=0•62, p=0•008) and pollen season duration (r=0•68, p=0•003) when averaged for all 17 locations.Interpretation Our findings reveal that the ongoing increase in temperature extremes (T min and T max ) might already be contributing to extended seasonal duration and increased pollen load for multiple aeroallergenic pollen taxa in diverse locations across the northern hemisphere. This study, done across multiple continents, highlights an important link between ongoing global warming and public health-one that could be exacerbated as temperatures continue to increase.

IntroductionIn the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8°C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality.MethodsWe conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1–31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations.ResultsThe May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths). In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest “summer” months of April (r = 0.69, p<0.001), May (r = 0.77, p<0.001), and June (r = 0.39, p<0.05). During a period of more intense heat (May 19–25, 2010), mortality rate ratios were 1.76 [95% CI 1.67–1.83, p<0.001] and 2.12 [95% CI 2.03–2.21] applying reference periods (May 12–18, 2010) from various years.ConclusionThe May 2010 heat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures prevail through much of April-June.