Exploring effects of greenness and extreme heat exposure on hypertension incidence in elderly Chinese: a national cohort study

Children’s sleep is essential for healthy development, yet over a third of children in the United States experience inadequate sleep. Environmental factors can influence sleep: greenspace exposure can promote better sleep, while heat exposure can disrupt sleep. As global climate change raises nighttime and daytime temperatures, greenspace may mitigate the negative effects of heat stress on sleep. We examined the direct effects of neighborhood greenspace and extreme heat exposure on sleep and the statistical interaction between greenspace and heat exposure on sleep outcomes among a nationally representative, four-year longitudinal sample of 8580 U.S. children ages 9–10 years at baseline. Hierarchical linear models incorporated a neighborhood greenspace measure: percent open park space within individual child census tracts, a measure of extreme neighborhood heat exposure during the summer months, and extensive individual and neighborhood-level covariates to test main and interaction effects on child sleep quality. Neighborhood open park space was related to better sleep quality, after controlling for covariates. Additionally, neighborhood extreme heat exposure was associated with worse sleep quality. A two-way interaction was found between neighborhood open park space and neighborhood heat exposure on sleep quality, suggesting open park space mitigated the negative effects of heat on sleep. The results indicate the potential contribution of open greenspace to improve child sleep and enhance resilience to extreme heat, which is an adverse outcome of climate change.

Combined effects of heatwaves and air pollution, green space and blue space on the incidence of hypertension: A national cohort study

Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9-10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Additionally, we assess whether this effect is independent of socio-demographic factors such as race, family socioeconomic status (SES), and neighborhood SES. Data were drawn from the ABCD study, comprising over 10,000 children aged 9-10 years. Cognitive function was assessed through standardized cognitive tests, while extreme heat exposure was estimated using geographic and climate data. Structural equation modeling (SEM) was employed to examine the direct effects of heat exposure on cognitive outcomes and to account for potential confounding variables, including race, family SES, and neighborhood SES. Black families, low SES households, and children from low SES neighborhoods were disproportionately exposed to extreme heat. Extreme heat exposure was significantly associated with lower cognitive function in children, and this association remained robust even after adjusting for socio-demographic factors. Extreme heat exposure is linked to diminished cognitive function in children, particularly among socio-economically disadvantaged and marginalized populations. Given the increasing frequency of extreme heat events due to climate change, future research should further explore these implications for children's cognitive outcomes. Policy interventions that improve access to cooling infrastructure, expand green spaces, and prioritize at-risk populations are critical to mitigating the adverse cognitive effects of extreme heat in low SES communities.

Association between extreme ambient heat exposure and diabetes-related hospital admissions and emergency department visits: A systematic review

Associations Between Ambient Extreme Heat Exposure and Emergency Department Visits Related to Kidney Disease

Background:Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as delinquency.Objectives:This study investigates the association between extreme heat exposure and delinquency among children, utilizing data from the Adolescent Brain Cognitive Development (ABCD) study. It also explores the potential mediating roles of neighborhood socioeconomic status (SES; measured by median home value), puberty, peer deviance, and financial difficulties.Methods:Data from the national ABCD study were analyzed to assess the relationship between extreme heat exposure (exposure) and delinquency (outcome). Covariates included race/ethnicity, sex, and age. Mediators examined were neighborhood SES, puberty, peer deviance, and financial difficulties. Structural equation modeling (SEM) was employed for data analysis.Results:Overall, 11,878 children entered our analysis. The analysis revealed a significant association between extreme heat exposure and higher levels of delinquency among children. Children more exposed to extreme heat were more likely to be Black, reside in lower SES neighborhoods, experience greater financial difficulties, and have more advanced puberty status. The group facing the highest heat exposure was also economically disadvantaged.Conclusions:The findings suggest that children already disadvantaged by socio-economic factors are disproportionately affected by extreme heat, leading to increased delinquency. This highlights the need for targeted interventions to protect these vulnerable populations and address the mediators of extreme heat exposure. Future research should focus on longitudinal studies and evaluate the effectiveness of various mitigation strategies to address these disparities.

The relationship between extreme ambient temperature and small for gestational age: A cohort study of 1,436,480 singleton term births in China

Preterm birth (PTB) is associated with adverse health outcomes. The outcomes of heat exposure during pregnancy and the moderating association of greenness with PTB remain understudied. To investigate associations between heat exposure, greenness, and PTB, as well as interactions between these factors. Included in this cohort study were births occurring in Sydney, New South Wales, Australia, between 2000 and 2020, retrieved from New South Wales Midwives Data Collection. Participants with incomplete or missing data on their residential address or those who resided outside of New South Wales during their pregnancy were excluded. Data were analyzed from March to October 2023. Greenness measured using normalized difference vegetation index (NDVI) and tree cover derived from satellite images. Daily extreme heat and nighttime extreme heat were defined as above the 95th percentile of community- and trimester-specific daily mean temperatures and nighttime temperatures. Logistic regression models estimated the independent association of extreme heat with PTB, adjusting for individual- and area-level covariates, season of conception, and long-term trend. An interaction term between extreme heat exposure and greenness was included to explore potential modification. With a significant interaction observed, the number of preventable heat-associated PTBs that were associated with greenness was estimated. A total of 1 225 722 births (median [IQR] age, 39 [38-40] weeks; 631 005 male [51.5%]) were included in the analysis, including 63 144 PTBs (median [IQR] age, 35 [34-36] weeks; 34 822 male [55.1%]). Compared with those without heat exposure, exposure to daily extreme heat and nighttime extreme heat in the third trimester was associated with increased risks of PTB, with an adjusted odds ratio (OR) of 1.61 (95% CI, 1.55-1.67) and 1.51 (95% CI, 1.46-1.56]), respectively (PTB rates: exposed, 4615 of 61 338 [7.5%] vs unexposed, 56 440 of 1 162 295 [4.9%] for daily extreme heat and 4332 of 61 337 [7.1%] vs 56 723 of 1 162 296 [4.9%] for nighttime extreme heat). Disparities in associations between extreme heat exposure and PTB were observed, with lower odds of PTB among pregnant individuals residing in greener areas. The associations between extreme heat exposure and PTB could be mitigated significantly by higher greenness. Improving NDVI and tree cover could reduce daily extreme heat-associated PTB by 13.7% (95% CI, 2.3%-15.1%) and 20.9% (95% CI, 5.8%-31.5%), respectively. For nighttime extreme heat-associated PTB, reductions were 13.0% (0.2%-15.4%) and 17.2% (4.1%-27.0%), respectively. Results of this large birth cohort study suggest that extreme heat exposure was adversely associated with PTB, with greenness playing a moderating role. Increasing greenness levels in residential communities could prevent heat-associated PTBs. These findings emphasize the importance of integrating heat mitigation strategies and improving green space in urban planning and public health interventions.

Nowadays, more and more studies indicate that heat exposure negatively affects human health. As climate change and global warming increased, extreme heat exposure became more rigorous and killed mountains of people every year. Extreme heat is not only a threat to physical health but also to mental health. Epidemiological studies have shown that heat waves can increase peoples morbidity and mortality. This literature review will discuss in detail the impact of extreme heat on human health, and what measures governments and individuals can take to respond to or prevent the damage of extreme heat. We used extreme heat and human health as keywords to collect the papers in the Embase database and review all the results. After sorting out all the results, the research focuses on the effect of extreme heat exposure on human physical and mental health. It can be found that extreme heat exposure causes heat-related illnesses (HRI) and aggravates chronic diseases, especially cardiovascular and respiratory diseases. And extreme heat can also lead to Preterm birth (PTB) which threatens the lives of pregnant women and infants. Mental health and related deaths are also affected by extreme heat exposure.

Association between extreme heat exposures and survival in patients with multiple myeloma

BACKGROUND AND AIM: Extreme heat exposure during pregnancy may increase the risk of adverse birth outcomes. This study examines the association between extreme heat and preterm birth (PTB) using the novel sibling-matched design which has the potential to eliminate the effects of unknown and unmeasurable confounders. METHODS: Using a large population-based birth cohort across 16 counties in China, we collected 10,826 sibling pairs (21,652 singleton live births) from March 2013 to December 2018. Daily mean temperature was collected in each county and extreme heat was defined as temperatures above the 90th percentile of trimester- and location-specific mean temperature. Conditional logistic regression models were used to estimate the effects of extreme heat exposure during each trimester and for the entire pregnancy on PTB. Stratified analyses were performed by regional characteristics, birth order, prenatal care status, inter-pregnancy interval, and delivery mode. RESULTS:Of the 21,652 births (10,826 pairs) included in the study, 804 (3.71%) cases were PTB, and 29 sibling pairs were both PTB. Contrasting with normal temperature exposure, heat exposure during the 3rd trimester and entire pregnancy was associated with PTB risk, with Odds Ratios (ORs) of 2.34 (95% CI: 1.65, 3.33) and 3.21 (95% CI: 2.23, 4.61), respectively. Women who lived in areas with lower levels of health services had a higher risk of PTB (OR: 4.28, 95% CI: 1.72-12.72). Heat-related PTBs were also more likely to be observed for first-borns and for second-born neonates with an inter-pregnancy interval of less than 18 months; ORs (95% CIs) were 4.59 (3.39, 6.22) and 3.43 (2.16, 5.40), respectively. Insufficient prenatal care also increased the risk of PTB associated with heat exposure. CONCLUSIONS:Using a sibling-matched design, our research strengthens the evidence that extreme heat exposure during pregnancy increases the risk of PTB. Our findings for susceptible subgroups could also help to improve guidance for prenatal care in China. KEYWORDS: Climate, Temperature extremes, Birth outcomes, Environmental epidemiology

The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children's cognitive function. This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = -0.064, p < 0.001) and reading ability (B = -0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = -0.067, p < 0.001), fluid composite (B = -0.053, p < 0.001), and crystallized intelligence (B = -0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = -0.025, p = 0.006) and card sorting (B = -0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = -0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.

The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. This study examines the relationship between extreme heat exposure and the initiation of tobacco use in adolescents, using data from the Adolescent Brain Cognitive Development (ABCD) study. It also evaluates the mediating roles of major depressive disorder (MDD) and childhood behavioral problems. Data from 11,878 participants in the ABCD study were analyzed to explore the link between extreme heat exposure (independent variable) and tobacco use initiation (dependent variable). Covariates included age, sex, and race/ethnicity, while MDD and behavioral problems (measured using the Child Behavior Checklist, CBCL) were assessed as potential mediators. Structural equation modeling (SEM) was applied for analysis. The findings indicated a significant association between extreme heat exposure and an increased likelihood of tobacco use initiation in adolescents aged 9 to 15. MDD and behavioral problems partially mediated this relationship. These results underscore the importance of targeted interventions aimed at mitigating the impact of extreme heat on adolescent health, including its influence on tobacco use initiation. Addressing mental health and behavioral challenges could help reduce these risks. Future longitudinal research is needed to confirm these findings and evaluate the efficacy of strategies to protect vulnerable youth populations.

Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. This study investigates the association between extreme heat exposure and early puberty initiation (ages 9-10), using data from the Adolescent Brain Cognitive Development (ABCD) study. It further explores how early puberty correlates with behavioral problems and tobacco use initiation. Data from 11,878 participants in the ABCD study were analyzed to examine the relationship between extreme heat exposure (independent variable) and puberty initiation (outcome). Behavioral problems and tobacco use initiation were evaluated as downstream outcomes of early puberty. Covariates included age, sex, and race/ethnicity, and behavioral problems were assessed using the Child Behavior Checklist (CBCL). Structural equation modeling (SEM) was employed for analysis. Extreme heat exposure was significantly associated with earlier puberty initiation at ages 9-10. Early puberty, in turn, correlated with higher levels of behavioral problems and an increased likelihood of tobacco use initiation. These findings underscore the importance of addressing environmental factors such as extreme heat to reduce risks associated with early maturation, including behavioral and substance use challenges. Targeted interventions and policies are needed to mitigate the impact of extreme heat on child development, and longitudinal studies are essential to confirm these results and inform effective prevention strategies.

With the advent of climate change, older adults are increasingly exposed to hot ambient temperatures that can lead to a state of heat-induced cytotoxicity contributing to heat-vulnerability. We assessed changes in serum proteins associated with indices of cellular stress in young and older adults exposed to extreme passive heat exposure. Responses were assessed in 19 young (23 ± 2.9years; 5 female) and 27 older (62 ± 7.0years; 2 female) adults exposed to a 3-h seated passive extreme heat exposure (44°C, 30% relative humidity). Serum samples were assessed before and after heat exposure for proteins indicative of systemic inflammation (CRP, sCD14, TNF-α, and IL-6), intestinal permeability (IFABP), acute kidney injury (NGAL), and cytoprotection (irisin, klotho, and HSP70) via enzyme-linked immunosorbent assays. The older group displayed significant elevations in CRP (18.06 ± 20.3 vs 24.3 ± 25.0mg/mL, p < 0.002) in response to heat exposure that was not observed in the young group (both p > 0.999) although no changes in sCD14, TNF-α, or IL-6 occurred in either group. However, significant elevations in NGAL concentrations from baseline were observed in the older group (17.74 ± 23.65 vs 40.75 ± 58.18ng/mL, p = 0.001), with no changes from baseline in the young group (p = 0.999). Conversely, klotho was significantly elevated after heat exposure in the young group (1346.37 ± 2242.49 vs 1129 ± 202pg/mL, p = 0.017) but not in older adults (p > 0.999). Taken together, older adults experienced some evidence of elevated inflammatory signaling and acute kidney injury that is accompanied by a blunted klotho response to extreme heat.