Baseline scenarios of heat-related ambulance transportations under climate change in Tokyo, Japan

Fujimoto, Marie; Nishiura, Hiroshi

doi:10.7717/peerj.13838

Cited by 4 publications

(5 citation statements)

References 31 publications

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“…Using daily maximum WBGT values, additional meteorological information, and accounting for probable heat acclimatization during consecutive hot days in the summer season, we estimated the number of heatstroke-related ambulance transports in the future under various climate change scenarios. The proposed model can provide better fit to observed data than our earlier model ( 30 ), yielding a long-term prediction in Tokyo until the year 2100. We showed that to reduce the future burden of heatstroke below historical levels, heatstroke adaptation measures are vital, even with a carbon-neutral scenario.…”

Section: Discussionmentioning

confidence: 82%

“…In our previous study ( 30 ), projections were made using a forecasting model that uses daily maximum WBGT. Letting T d be the daily maximum WBGT on day d , the expected number of heatstroke-related transports was modeled as:…”

Section: Methodsmentioning

confidence: 99%

“…To consider prevention strategies of heatstroke-related deaths in Japan, a super-aged society, studies have been conducted using various statistical models ( 28 , 29 ). We proposed a forecasting model using the maximum daily WBGT under several climate change scenarios ( 30 ). However, intervention studies have been limited to date.…”

Section: Introductionmentioning

confidence: 99%

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Possible adaptation measures for climate change in preventing heatstroke among older adults in Japan

Fujimoto,

Hayashi,

Nishiura

2023

Front. Public Health

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IntroductionHeatstroke mortality is highest among older adults aged 65 years and older, and the risk is even doubled among those aged 75 years and older. The incidence of heatstroke is expected to increase in the future with elevated temperatures owing to climate change. In the context of a super-aged society, we examined possible adaptation measures in Japan that could prevent heatstroke among older people using an epidemiological survey combined with mathematical modeling.MethodsTo identify possible interventions, we conducted a cross-sectional survey, collecting information on heatstroke episodes from 2018 to 2019 among people aged 75 years and older. Responses were analyzed from 576 participants, and propensity score matching was used to adjust for measurable confounders and used to estimate the effect sizes associated with variables that constitute possible interventions. Subsequently, a weather-driven statistical model was used to predict heatstroke-related ambulance transports. We projected the incidence of heatstroke-related transports until the year 2100, with and without adaptation measures.ResultsThe risk factor with the greatest odds ratio (OR) of heatstroke among older adults was living alone (OR 2.5, 95% confidence interval: 1.2–5.4). Other possible risk factors included an inability to drink water independently and the absence of air conditioning. Using three climate change scenarios, a more than 30% increase in the incidence of heatstroke-related ambulance transports was anticipated for representative concentration pathways (RCP) 4.5 and 8.5, as compared with a carbon-neutral scenario. Given 30% reduction in single living, a 15% reduction in the incidence of heatstroke is expected. Given 70% improvement in all three risk factors, a 40% reduction in the incidence can be expected.ConclusionPossible adaptation measures include providing support for older adults living alone, for those who have an inability to drink water and for those without air conditioning. To be comparable to carbon neutrality, future climate change under RCP 2.6 requires achieving a 30% relative reduction in all three identified risks at least from 2060; under RCP 4.5, a 70% reduction from 2050 at the latest is needed. In the case of RCP 8.5, the goal of heatstroke-related transports approaching RCP 1.9 cannot be achieved.

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Section: Discussionmentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

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Possible adaptation measures for climate change in preventing heatstroke among older adults in Japan

Fujimoto,

Hayashi,

Nishiura

2023

Front. Public Health

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“…[5][6][7] Specifically, the ambulance calls related to heat-related illness including heat stroke, the forecast for 2100 suggests a six-fold increase compared with 2000, with a significant rise expected among the elderly population in Japan. 8 Another investigation suggested that the incidence of heatstroke for people aged 65 years is projected to be 3.26 and 1.69 at the end of the 21st century with and without human adaptation respectively, in comparison to the period 1981-2000. 9 Air conditioning use is an effective adaptation to prevent heat-related illness and mortality.…”

Section: Introductionmentioning

confidence: 99%

Heat-related mortality and ambulance transport after a power outage in the Tokyo metropolitan area

Yamasaki,

Kamada,

et al. 2024

Environmental Epidemiology

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Background: Air conditioners can prevent heat-related illness and mortality, but the increased use of air conditioners may enhance susceptibility to heat-related illnesses during large-scale power failures. Here, we examined the risks of heat-related illness ambulance transport (HIAT) and mortality associated with typhoon-related electricity reduction (ER) in the summer months in the Tokyo metropolitan area. Methods: We conducted event study analyses to compare temperature–HIAT and mortality associations before and after the power outage (July to September 2019). To better understand the role of temperature during the power outage, we then examined whether the temperature–HIAT and mortality associations were modified by different power outage levels (0%, 10%, and 20% ER). We computed the ratios of relative risks to compare the risks associated with various ER values to the risks associated without ER. Results: We analyzed the data of 14,912 HIAT cases and 74,064 deaths. Overall, 93,200 power outage cases were observed when the typhoon hit. Event study results showed that the incidence rate ratio was 2.01 (95% confidence interval [CI] = 1.42, 2.84) with effects enduring up to 6 days, and 1.11 (95% CI = 1.02, 1.22) for mortality on the first 3 days after the typhoon hit. Comparing 20% to 0% ER, the ratios of relative risks of heat exposure were 2.32 (95% CI = 1.41, 3.82) for HIAT and 0.95 (95% CI = 0.75, 1.22) for mortality. Conclusions: A 20% ER was associated with a two-fold greater risk of HIAT because of summer heat during the power outage, but there was little evidence for the association with all-cause mortality.

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“…it has been reported that episodes of extreme heat waves will increase in the future, meaning that the incidence of HS is likely to increase further (3). Furthermore, a previous study from Kyoto indicated that the estimated number of patients with HS transported by ambulance is predicted to be >3x greater among people aged 0-64 years and 6x greater among people aged ≥65 years (4). Therefore, it is necessary to explore the medical intervention methods against HS.…”

Section: Introductionmentioning

confidence: 99%

DNAJA1‑knockout alleviates heat stroke‑induced endothelial barrier disruption via improving thermal tolerance and suppressing the MLCK‑MLC signaling pathway

Li,

Wang,

Chang

et al. 2024

Mol Med Rep

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endothelial barrier disruption plays a key role in the pathophysiology of heat stroke (HS). Knockout of dnaJa1 (dnaJa1-Ko) is thought to be protective against HS based on a genome-wide criSPr-cas9 screen experiment. The present study aimed to illustrate the function of dnaJa1-Ko against HS in human umbilical vein endothelial cells. dnaJa1-Ko cells were infected using a lentivirus to investigate the role of dnaJa1-Ko in HS-induced endothelial barrier disruption. it was shown that dnaJa1-Ko could ameliorate decreased cell viability and increased cell injury, according to the results of cell counting Kit-8 and lactate dehydrogenase assays. Moreover, HS-induced endothelial cell apoptosis was inhibited by dnaJa1-Ko, as indicated by annexin V-FiTc/Pi staining and cleaved-caspase-3 expression using flow cytometry and western blotting, respectively. Furthermore, the endothelial barrier function, as measured by transepithelial electrical resistance and FiTc-dextran, was sustained during HS. DNAJA1-KO was not found to have a significant effect on the expression and distribution of cell junction proteins under normal conditions without HS. However, dnaJa1-Ko could effectively protect the HS-induced decrease in the expression and distribution of cell junction proteins, including zonula occludens-1, claudin-5, junctional adhesion molecule a and occludin. A total of 4,394 proteins were identified using proteomic analysis, of which 102 differentially expressed proteins (dePs) were activated in HS-induced wild-type cells and inhibited by dnaJa1-Ko. dePs were investigated by enrichment analysis, which demonstrated significant enrichment in the 'calcium signaling pathway' and associations with vascular-barrier regulation. Furthermore, the 'myosin light-chain kinase (MlcK)-Mlc signaling pathway' was proven to be activated by HS and inhibited by dnaJa1-Ko, as expected. Moreover, dnaJa1-Ko mice and a HS mouse model were established to demonstrate the protective effects on endothelial barrier in vivo. in conclusion, the results of the present study suggested that dnaJa1-Ko alleviates HS-induced endothelial barrier disruption by improving thermal tolerance and suppressing the MlcK-Mlc signaling pathway.

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Baseline scenarios of heat-related ambulance transportations under climate change in Tokyo, Japan

Cited by 4 publications

References 31 publications

Possible adaptation measures for climate change in preventing heatstroke among older adults in Japan

Possible adaptation measures for climate change in preventing heatstroke among older adults in Japan

Heat-related mortality and ambulance transport after a power outage in the Tokyo metropolitan area

DNAJA1‑knockout alleviates heat stroke‑induced endothelial barrier disruption via improving thermal tolerance and suppressing the MLCK‑MLC signaling pathway

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