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Assessing the Health Effects of Extreme Temperatures and Development of Adaptation Strategies to Climate Change in the Asia-Pacific Region

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Assessing the Health Effects of Extreme Temperatures and Development of Adaptation Strategies to Climate Change in the Asia-Pacific Region Final Technical Report CRRP2016-10MY-Huang Assessing the health effects of extreme temperatures and development of adaptation strategies to climate change in the Asia-Pacific region The following collaborators worked on this project: 1. Cunrui Huang, Sun Yat-sen University, China, [email protected] 2. Dung Phung, Griffith University, Australia, [email protected] 3. Zhiwei Xu, Queensland University of Technology, Australia, [email protected] 4. Wenjun Ma, Guangdong Provincial Center for Disease Control and Prevention, China, [email protected] 5. Benjawan Tawatsupa, Department of Health, Ministry of Public Health, Thailand, [email protected] 6. Mohammad Sohel Shomik, International Centre for Diarrhoeal Disease Research (ICDDR, B), Bangladesh, [email protected] 7. Do Manh Cuong, Ministry of Health of Vietnam, Vietnam, [email protected] 8. Cordia Chu, Griffith University, Australia, [email protected] 9. Adrian Barnett, Queensland University of Technology, Australia, [email protected] Copyright © 2019 Asia-Pacific Network for Global Change Research APN seeks to maximise discoverability and use of its knowledge and information. All publications are made available through its online repository “APN E-Lib” (www.apn-gcr.org/resources/). Unless otherwise indicated, APN publications may be copied, downloaded and printed for private study, research and teaching purposes, or for use in non-commercial products or services. Appropriate acknowledgement of APN as the source and copyright holder must be given, while APN’s endorsement of users’ views, products or services must not be implied in any way. For reuse requests: http://www.apn-gcr.org/?p=10807 Table of Content Project Overview ................................................................................................................ 1 Chapter 1. Introduction ....................................................................................................... 5 Chapter 2. Synthesis of climate change and health research in the Asia-Pacific Region .. 14 2.1 Does hot weather affect work-related injury? a case-crossover study in Guangzhou, China..................................................................................................... 15 2.2 Estimation of work-related injury and economic burden attributable to heat stress in Guangzhou, China ................................................................................................. 29 2.3 Overlooked heat-related morbidity indicator: consequence from increasing ambulance dispatches associated with high ambient temperatures ........................... 47 2.4 Effects of heat on first-ever strokes and the effect modification of atmospheric pressure: A time-series study in Shenzhen, China..................................................... 66 2.5 Interaction of air pollutants and meteorological factors on birth weight in Shenzhen, China ....................................................................................................... 81 2.6 Modification effects of population expansion, ageing and adaptation on heat- related mortality under climate change scenarios in Guangzhou, China .................. 101 2.7 Effects of extreme temperatures on mortality and hospitalization in Ho Chi Minh City, Vietnam ........................................................................................................... 120 2.8 Spatial variation of heat-related morbidity: A hierarchical Bayesian analysis in multiple districts of the Mekong Delta Region .......................................................... 136 2.9 Mortality burden attributable to heatwaves in Thailand: A systematic assessment incorporating evidence-based lag structure ............................................................. 153 2.10 Preparing the next generation of health professionals to tackle climate change: Are China's medical students ready? ....................................................................... 177 Chapter 3. Public health adaptation to extreme heat events in response to climate change in the Asia-Pacific Region ............................................................................................... 196 Appendix ........................................................................................................................ 223 Project Overview Project Duration : October 2016 - March 2019 Funding Awarded : US$ 49,000 for Year 1; US$ 33,000 for Year 2 Key organisations : Sun Yat-Sen University, China (Prof. Cunrui Huang, Dr. involved Lianping Yang, Dr. Qiong Wang, Dr. Junzhe Bao) Guangdong Provincial Centre for Disease Control and Prevention, China (Prof. Wenjun Ma, Dr. Tao Liu) Ministry of Health, Vietnam (Dr. Do Manh Cuong) University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam (Dr. Tran Ngoc Dang) Ministry of Public Health, Thailand (Dr. Benjawan Tawatsupa) International Centre for Diarrhoeal Disease Research, Bangladesh (Dr. Mohammad Sohel Shomik) Griffith University, Australia (Prof. Cordia Chu, Dr. Dung Phung) Queensland University of Technology, Australia (Dr. Zhiwei Xu, Prof Wenbiao Hu, Prof. Adrian Barnett) Project Summary Climate change is expected to be one of the biggest global health threats in the 21st century. Temperature-related health effects are the most direct and well-understood impact of climate change on human health. Most previous studies have focused on assessing mortality/morbidity in relation to extreme temperatures in high-income countries, with few studies investigating low- and middle-income countries. Countries within the Asia-Pacific region is home to more than half of the world’s population, and changes in the Earth’s climate are impacting human health and survival. This project aimed to quantify the health effects of extreme temperatures, particularly heat waves, in the Asia-Pacific region and to identify individual- and community-level factors which modify the health effects of temperature, attempting to formulate local adaptation strategies for dealing with heat-related health risks and reduce vulnerability. The results suggested that extreme heat events were associated with substantial burdens of morbidity/mortality in China, Vietnam and Thailand. Spatial heterogeneity in terms of heat vulnerability was also observed. The significant individual- and community-level modifiers varied across different health outcomes. The findings of this 1 project shed new light on the development of tailored and cost-effective climate change adaptation strategies. Keywords：Extreme temperature, climate change; health impact, vulnerability assessment, adaptation strategy Project outputs and outcomes Project outputs: - Ten publications on the health effects of temperature in China, Vietnam, and Thailand. - One workshop and two international forums initiated by the proponent of this project (Cunrui Huang). Project outcomes: - Improved knowledge on the burden of diseases attributable to extreme temperatures among vulnerable populations. - Evidence provided to decision-makers on formulating adaptation strategies to heat waves and climate change. - Cultivated early career researchers and high degree students in the field of climate change and human health. - Strengthened the collaborative network on climate change and health research in the Asia-Pacific region. Key facts/figures - Health database was built up, including work-injury claim and insurance data, ambulance dispatch data, first-ever stroke data, and also data from Birth Registry Database and Maternal and Children’s Health Information System, and survey data among medical students in China, hospitalisation and death data in Vietnam, and mortality data in Thailand. - One international workshop was held in Guangzhou, China with over 20 participants from collaborating institutes. - Two international forums were held in Guangzhou, China with hundreds of delegates from Europe, USA, Australia, and Asian countries. Potential for further work - More multicity analyses and further exploration of susceptible diseases and vulnerable populations due to heat waves and climate change are needed in the Asia Pacific Region as they are densely populated. 2 - Based on the findings of this project, projecting the health effects of climate change in some big cities of selected countries are warranted. - Further studies are required to understand the relative importance and interactive effects of air pollutants and temperature on health outcomes, especially in areas with high level of air pollution. - Efforts should be taken to develop and implement adaptation strategies for alleviating public health impacts of climate change, such as heat-health warning system or real- time health surveillance system. Publications 1. Sheng R, Li C, Wang Q, Yang L, Bao J, Wang K, et al. Does hot weather affect work-related injury? A case-crossover study in Guangzhou, China. International Journal of Hygiene and Environmental Health 2018;221(3):423-428. 2. Ma R, Zhong S, Morabito M, Hajat S, Xu Z, He Y, et al. Estimation of work-related injury and economic burden attributable to heat stress in Guangzhou, China. Science of The Total Environment 2019;666:147-154. 3. Bao J, Guo Y, Wang Q, He Y, Ma R, Hua J, et al. Effects of heat on first-ever strokes and the effect modification of atmospheric pressure: A time-series study in Shenzhen, China. Science of The Total Environment 2019;654:1372-1378. 4. Qiong W, Qianhong L, Changchang L, Meng R, Shao L, Luke DK, et al. Interaction of Air Pollutants and Meteorological Factors on Birth Weight in Shenzhen,
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