| 1. |
- Azfar, Hossain Syed, et al.
(författare)
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Cardiovascular Disease and Mental Distress Among Ethnic Groups in Kyrgyzstan
- 2021
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to characterize different ethnic groups in Kyrgyzstan regarding cardiovascular disease (CVD) and mental distress, and to investigate the association between CVD and mental distress. The mental distress was measured in terms of sleep disturbance, burnout, and stress.Materials and Methods: A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used the Karolinska Sleep Questionnaire to assess sleep disturbance, the physical and emotional subscale of the Shirom Melamed Burnout Questionnaire to assess burnout, and the 10-item Perceived Stress Scale to assess perceived stress.Results: The distribution of CVD differed significantly between the six ethnic groups, with higher prevalence among East Europeans, and Western Asians and lower among Other minorities and Central Asians. In all ethnic groups in Kyrgyzstan, individuals with CVD had increased odds of sleep disturbance and burnout. There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups.Conclusion: There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. In addition to CVD prevention, mitigating sleep disturbance and preventing burnout in the general population should be aimed at in public health measures.
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| 2. |
- Dahal, Usha, et al.
(författare)
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Green dreams, local realities: Complexities of the European Union's energy transition to ensure local health and well-being in a fossil fuel-based industrial region
- 2024
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Ingår i: Environmental impact assessment review. - : Elsevier. - 0195-9255 .- 1873-6432. ; 106
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Tidskriftsartikel (refereegranskat)abstract
- European Union's Green Deal is a legal obligation to EU countries to shift towards environment-friendly energy systems from fossil-fuel-based systems. This transition will bring significant global health benefits by combating climate change, but it is crucial to understand the so far understudied impacts on local communities' lives and, thus, on their health and well-being. The study proposes a novel conceptual framework based on socio-technical systems theory and the production of space theory to identify the interacting points between energy systems and health and well-being systems in the energy transition context. This framework is tested in Estonia's transitioning fossil fuel oil-shale-based energy system based on four focus group discussions, ten expert interviews, and document analysis. We innovatively pinpoint pathways, including feedback loops, through a causal loop diagram (CLD) impacting inhabitants' health and well-being from the interplay between energy and health and well-being systems. The analysis indicates that protecting and promoting health and well-being has been a challenge not only due to disruption created by the energy transition process but also due to the accumulated problems regarding socioeconomic conditions, environmental health impacts, and well-being at the local level. The compound effects of multiple existing and emerging issues, including the divergent interpretations of health and the lack of holistic support mechanisms for inhabitants to navigate the changes in sociocultural and economic space, can harm locals' health and well-being. The developed conceptual framework provides an important theoretical background to study the impacts on the mental and physical health, including social health and well-being, of the inhabitants living in the fossil-fuel-based industrial area. The CLD developed using this framework demonstrates the interacting points to avoid unintended consequences of energy transition.
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| 3. |
- Dahal, Usha, et al.
(författare)
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Perinatal Health Inequalities in the Industrial Region of Estonia: A Birth Registry-Based Study
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:18
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Tidskriftsartikel (refereegranskat)abstract
- Despite the increasing number of studies on industrially contaminated sites (ICS) and their health effects, there are very few studies on perinatal health outcomes in ICSs. In the present study, we examined the perinatal health inequalities by comparing adverse birth outcomes (ABOs) in the oil shale industry region of Ida-Viru County in Estonia with national-level figures and investigated the effects of maternal environmental and sociodemographic factors. Based on the 208,313 birth records from 2004–2018, Ida-Viru ICS has a birth weight 124.5 g lower than the average of 3544 g in Estonia. A higher prevalence of preterm birth (4.3%) and low birth weight (4.8%) in Ida-Viru ICS is found compared to 3.3% on both indicators at the national level. Multiple logistic regression analysis shows the statistically significant association of ABOs with fine particle (PM2.5) air pollution, mother’s ethnicity, and education throughout Estonia. However, in Ida-Viru ICS, the ABOs odds are remarkably higher in these characteristics except for the mother’s ethnicity. Furthermore, the ABOs are associated with the residential proximity to ICS. Thus, the Ida-Viru ICS has unequally higher odds of adverse perinatal health across the environmental and sociodemographic factors. In addition to reducing the air pollutants, policy actions on social disparities are vital to address the country’s unjustly higher perinatal health inequalities, especially in the Ida-Viru ICS.
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| 4. |
- Demuzere, M, et al.
(författare)
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Mitigating and adapting to climate change : multi-functional and multi-scale assessment of green urban infrastructure
- 2014
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Ingår i: Journal of Environmental Management. - : Elsevier. - 0301-4797 .- 1095-8630. ; 146, s. 107-115
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Tidskriftsartikel (refereegranskat)abstract
- In order to develop climate resilient urban areas and reduce emissions, several opportunities exist starting from conscious planning and design of green (and blue) spaces in these landscapes. Green urban infrastructure has been regarded as beneficial, e.g. by balancing water flows, providing thermal comfort. This article explores the existing evidence on the contribution of green spaces to climate change mitigation and adaptation services. We suggest a framework of ecosystem services for systematizing the evidence on the provision of bio-physical benefits (e.g. CO2 sequestration) as well as social and psychological benefits (e.g. improved health) that enable coping with (adaptation) or reducing the adverse effects (mitigation) of climate change. The multi-functional and multi-scale nature of green urban infrastructure complicates the categorization of services and benefits, since in reality the interactions between various benefits are manifold and appear on different scales. We will show the relevance of the benefits from green urban infrastructures on three spatial scales (i.e. city, neighborhood and site specific scales). We will further report on co-benefits and trade-offs between the various services indicating that a benefit could in turn be detrimental in relation to other functions. The manuscript identifies avenues for further research on the role of green urban infrastructure, in different types of cities, climates and social contexts. Our systematic understanding of the bio-physical and social processes defining various services allows targeting stressors that may hamper the provision of green urban infrastructure services in individual behavior as well as in wider planning and environmental management in urban areas.
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| 5. |
- Orru, Hans, et al.
(författare)
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Exposures, Symptoms and Risk Perception among Office Workers in Relation to Nanoparticles in the Work Environment
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:10
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Tidskriftsartikel (refereegranskat)abstract
- Submicroscopic nanoparticles (NPs) in air have received much attention due to their possible effects on health and wellbeing. Adverse health impacts of air pollution may not only be associated with level of exposure, but also mediated by the perception of the pollution and by beliefs of the exposure being hazardous. The aim of this study was to test a model that describes interrelations between NP pollution, perceived air quality, health risk perception, stress, and sick building syndrome. In the NanoOffice study, the level of NPs was measured and a survey on health risk perception was conducted among 260 employees in twelve office buildings in northern Sweden. Path analyses were performed to test the validity of the model. The data refute the model proposing that the NP exposure level significantly influences stress, chronic diseases, or SBS symptoms. Instead, the perceived exposure influences the perceived risk of NP, and the effect of perceived exposure on SBS and chronic disease is mediated by stress. There was little concern about nanoparticles, despite relatively high levels in some facilities. Perceived pollution and health risk perception may explain a large part of the environmentally induced symptoms and diseases, particularly in relatively low levels of pollution. The research results raise important questions on the physiologically or psychologically mediated health effects of air pollution.
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| 6. |
- Orru, Hans, et al.
(författare)
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Health impacts of particulate matter in five major Estonian towns : main sources of exposure and local differences
- 2011
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Ingår i: Air quality, atmosphere and health. - : Springer. - 1873-9318 .- 1873-9326. ; 4:3-4, s. 247-258
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Tidskriftsartikel (refereegranskat)abstract
- Particulate matter (PM) is the major air pollution problem with health impacts in Estonia. The prevailing sources of particles are traffic and local heating. In this study, we quantified the health effects of PM in neighbourhoods of five main cities with a health impact assessment (HIA) approach that uses information on exposure, baseline mortality/morbidity and exposure–response relationships from previous epidemiological studies. The exposure was defined as modelled PM2.5 annual levels and daily averages of PM10 (monitoring data in Tallinn and Kohtla-Järve and modelled levels in Tartu, Narva and Pärnu). The modelled results were validated with data from monitoring stations and additional measuring programmes. The annual average concentration of PM2.5 in the neighbourhoods studied varied from 7.6 to 23.6 μg m−3. The analysis indicated that the exposure above natural background corresponds to 462 [95% confidence interval (CI) 120–815] premature deaths, resulting in 6,034 (95% CI 1,583–10,309) years of life lost per year. The average decrease in life-expectancy at birth per resident of Tallinn was estimated to be 0.63 (95% CI 0.16–1.08) years. In the polluted city centres, this average decrease may reach >1 year and in Pärnu, it may reach 0.95 year. However, in the least polluted neighbourhood, the decrease of life expectancy was only 0.17 years. In addition, 231 (95% CI 145–306) respiratory and 338 (95% CI 205–454) cardiovascular hospitalisations per year could be expected. The majority of the external costs are related to the long-term effects on mortality and amount to €270 (95% CI 190–350) million annually. In comparison, the costs of hospitalisations contribute just €1.1 (95% CI 0.6–1.6) million. The main differences in health impacts were mostly driven by differences in the pollution sources, the magnitude of such sources and distribution patterns in the atmosphere. The smallest health effects, with the exception of the green residential areas, were observed in the industrial cities Kohtla-Järve and Narva (due to the small share contributed by local residential heating and relatively little car traffic). However, it is questionable whether the mass of fine particles is the best indicator of air pollution risk in such areas.
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| 7. |
- Orru, Hans, et al.
(författare)
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Residents' Self-Reported Health Effects and Annoyance in Relation to Air Pollution Exposure in an Industrial Area in Eastern-Estonia
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 15:2
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Tidskriftsartikel (refereegranskat)abstract
- Eastern Estonia has large oil shale mines and industrial facilities mainly focused on electricity generation from oil shale and shale oil extraction, which produce high air pollution emissions. The "Study of the health impact of the oil shale sector-SOHOS" was aimed at identifying the impacts on residents' health and annoyance due to the industrial processing. First, a population-wide survey about health effects and annoyance was carried out. Second, the total and oil shale sectors' emitted concentrations of benzene, phenol, and PM2.5 were modelled. Third, the differences between groups were tested and relationships between health effects and environmental pollution studied using multiple regression analysis. Compared to the control groups from non-industrial areas in Tartu or Laane-Viru, residents of Ida-Viru more frequently (p < 0.05) reported wheezing, chest tightness, shortness of breath, asthma attacks, a long-term cough, hypertension, heart diseases, myocardial infarction, stroke, and diabetes. All health effects except asthma were reported more frequently among non-Estonians. People living in regions with higher levels of PM2.5, had significantly higher odds (p < 0.05) of experiencing chest tightness (OR = 1.13, 95% CI 1.02-1.26), shortness of breath (1.16, 1.03-1.31) or an asthma attack (1.22, 1.04-1.42) during the previous year. People living in regions with higher levels of benzene had higher odds of experiencing myocardial infarction (1.98, 1.11-3.53) and with higher levels of phenol chest tightness (1.44, 1.03-2.00), long-term cough (1.48, 1.06-2.07) and myocardial infarction (2.17, 1.23-3.83). The prevalence of adverse health effects was also higher among those who had been working in the oil shale sector. Next to direct health effects, up to a quarter of the residents of Ida-Viru County were highly annoyed about air pollution. Perceived health risk from air pollution increased the odds of being annoyed. Annoyed people in Ida-Viru had significantly higher odds of experiencing respiratory symptoms during the last 12 months, e.g., wheezing (2.30, 1.31-4.04), chest tightness (2.88, 1.91-4.33 or attack of coughing (1.99, 1.34-2.95).
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| 8. |
- Orru, Kati, et al.
(författare)
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Making Administrative Systems Adaptive to Emerging Climate Change-Related Health Effects : Case of Estonia
- 2018
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Ingår i: Atmosphere. - : MDPI AG. - 2073-4433. ; 9:6
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Tidskriftsartikel (refereegranskat)abstract
- To facilitate resilience to a changing climate, it is necessary to go beyond quantitative studies and take an in-depth look at the functioning of health systems and the variety of drivers shaping its effectiveness. We clarify the factors determining the effectiveness of the Estonian health system in assessing and managing the health risks of climate change. Document analyses, expert interviews with key informants from health systems whose responsibilities are relevant to climate change, and analysis of a population-based survey conducted in 2015, indicate that the health effects of climate change have not been mainstreamed into policy. Therefore, many of the potential synergistic effects of combining information on health systems, environment, and vulnerable populations remain unexploited. The limited uptake of the issue of climate change-related health risks may be attributed to the lack of experience with managing extreme weather events; limited understanding of how to incorporate projections of longer-term health risks into policies and plans; unclear divisions of responsibility; and market liberal state approaches. Minority groups and urban dwellers are placing strong pressure on the health system to address climate change-related risks, likely due to their lower levels of perceived control over their physical wellbeing. The results have implications for national, community, and individual resilience in upper-middle income countries in Eastern Europe.
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| 9. |
- Orru, Kati, et al.
(författare)
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Perception of Risks from Wood Combustion and Traffic Induced Air Pollution : Evidence from Northern Europe
- 2022
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Ingår i: Sustainability. - : MDPI. - 2071-1050. ; 14:15
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Tidskriftsartikel (refereegranskat)abstract
- The health effects of particulate matter, increasing emissions from transportation and requisites for making use of biofuels brings up the need to understand how individuals interpret air-pollution-related risks from wood burning and traffic. We aim to clarify the extent to which perceived risks from road-traffic and wood-smoke can be explained by the individual psychological, social status-related and socio-institutional factors in the case of two Northern European countries, Finland and Estonia. This approach elucidates which of the closely intertwined factors shape the perception of risks from air pollution in different socio-institutional contexts and for different air pollution sources. The study uses data from cross-sectional population surveys conducted among 1112 Finnish and 1000 Estonian residents about environmental health risk perception and coping. Binary logistic regression analysis demonstrated that in both countries’ cases, the perceived personal and general risk from traffic exhaust and wood-smoke can be explained by the perception of exposure to pollution and, also, by the level of knowledge of, the worry about and the possible symptoms from environmental health factors. The perceived vulnerability due to poor health further sensitises individuals towards risks from air pollution. Higher trust towards state institutions in guaranteeing a healthy living environment and greater perceived openness about the risks may attenuate the feelings of vulnerability to air pollution risks in Finland compared to Estonia. The ingrained appeal for wood burning may explain the higher acceptance of exhausts from wood-burning compared to traffic. This may lead to scant support for measures to reduce emissions from wood combustion.
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| 10. |
- Orru, Kati, et al.
(författare)
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The role of perceived air pollution and health risk perception in health symptoms and disease : a population-based study combined with modelled levels of PM10
- 2018
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; 91:5, s. 581-589
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Adverse health impact of air pollution on health may not only be associated with the level of exposure, but rather mediated by perception of the pollution and by top-down processing (e.g. beliefs of the exposure being hazardous), especially in areas with relatively low levels of pollutants. The aim of this study was to test a model that describes interrelations between air pollution (particles < 10 μ m, PM10), perceived pollution, health risk perception, health symptoms and diseases.Methods: A population-based questionnaire study was conducted among 1000 Estonian residents (sample was stratified by age, sex, and geographical location) about health risk perception and coping. The PM10 levels were modelled in 1 × 1 km grids using a Eulerian air quality dispersion model. Respondents were ascribed their annual mean PM10 exposure according to their home address. Path analysis was performed to test the validity of the model.Results: The data refute the model proposing that exposure level significantly influences symptoms and disease. Instead, the perceived exposure influences symptoms and the effect of perceived exposure on disease is mediated by health risk perception. This relationship is more pronounced in large cities compared to smaller towns or rural areas.Conclusions: Perceived pollution and health risk perception, in particular in large cities, play important roles in understanding and predicting environmentally induced symptoms and diseases at relatively low levels of air pollution.
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| 11. |
- Orru, Kati, et al.
(författare)
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Well-being and environmental quality : Does pollution affect life satisfaction?
- 2016
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 25:3, s. 699-705
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We aimed to explore the effect of ambient air pollution on individual persons' levels of subjective well-being. Our research question was: to what extent is an individual's life satisfaction shaped by exposure to PM10?METHODS: We used regression models to analyse data on subjective well-being indicators from the last two waves of the European social survey (ESS) and detailed information on local levels of the air pollutant PM10.RESULTS: An increase in PM10 annual concentrations by 1 μg/m(3) was associated with a significant reduction in life satisfaction of .017 points on the ESS 10-point life satisfaction scale.CONCLUSIONS: Our findings suggest that even in cases of relatively low levels of PM10 air pollution (mean annual concentration of 8.3 ± 3.9 μg/m(3)), in addition to the effects on physical health, exposure negatively affects subjective assessments of well-being.
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| 12. |
- Orru, Mall, et al.
(författare)
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Re-vegetation processes in cutaway peat production fields in Estonia in relation to peat quality and water regime
- 2016
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Ingår i: Environmental Monitoring & Assessment. - : Springer. - 0167-6369 .- 1573-2959. ; 188:12
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Tidskriftsartikel (refereegranskat)abstract
- Eighty-one cutaway peat production fields with a total area of about 9000 ha exist and were studied in Estonia in 2005-2015. Only a very small number of the fields (seven) have been restored-either afforested or used for growing berries. The re-vegetation of Estonian cutaway peat production fields is mainly the result of natural processes, which are generally very slow due to an unfavourable water regime or a too thin remaining peat layer. The fields are mostly covered by cotton grass and birches. Often sparse vegetation covers 15-20% of a peat field, but some fields have turned into heaths or grasslands with plant coverage up to 60%. However, due to changes in environmental (mainly hydrological) conditions and peat characteristics (mainly peat type), these areas can also be new niches for several species. A number of moss species new to or rare in Estonia, e.g. Pohlia elongata, Ephemerum serratum, Campylopus introflexus and Bryum oblongum, were recorded.
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| 13. |
- Reckien, D., et al.
(författare)
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Dedicated versus mainstreaming approaches in local climate plans in Europe
- 2019
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Ingår i: Renewable & sustainable energy reviews. - : Elsevier. - 1364-0321 .- 1879-0690. ; 112, s. 948-959
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Tidskriftsartikel (refereegranskat)abstract
- Cities are gaining prominence committing to respond to the threat of climate change, e.g., by developing local climate plans or strategies. However, little is known regarding the approaches and processes of plan development and implementation, or the success and effectiveness of proposed measures. Mainstreaming is regarded as one approach associated with (implementation) success, but the extent of integration of local climate policies and plans in ongoing sectoral and/or development planning is unclear. This paper analyses 885 cities across the 28 European countries to create a first reference baseline on the degree of climate mainstreaming in local climate plans. This will help to compare the benefits of mainstreaming versus dedicated climate plans, looking at policy effectiveness and ultimately delivery of much needed climate change efforts at the city level. All core cities of the European Urban Audit sample were analyzed, and their local climate plans classified as dedicated or mainstreamed in other local policy initiatives. It was found that the degree of mainstreaming is low for mitigation (9% of reviewed cities; 12% of the identified plans) and somewhat higher for adaptation (10% of cities; 29% of plans). In particular horizontal mainstreaming is a major effort for local authorities; an effort that does not necessarily pay off in terms of success of action implementation. This study concludes that climate change issues in local municipalities are best tackled by either, developing a dedicated local climate plan in parallel to a mainstreamed plan or by subsequently developing first the dedicated and later a mainstreaming plan (joint or subsequent “dual track approach”). Cities that currently provide dedicated local climate plans (66% of cities for mitigation; 26% of cities for adaptation) may follow-up with a mainstreaming approach. This promises effective implementation of tangible climate actions as well as subsequent diffusion of climate issues into other local sector policies. The development of only broad sustainability or resilience strategies is seen as critical.
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| 14. |
- Reckien, Diana, et al.
(författare)
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How are cities planning to respond to climate change? : Assessment of local climate plans from 885 cities in the EU-28
- 2018
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Ingår i: Journal of Cleaner Production. - : Elsevier. - 0959-6526 .- 1879-1786. ; 191, s. 207-219
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Tidskriftsartikel (refereegranskat)abstract
- The Paris Agreement aims to limit global mean temperature rise this century well below 2 degrees Celsius above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial proportions of greenhouse gas emissions. This paper reports the state of planning for climate change by collecting and analysing local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and analysis framework was developed that classifies local climate plans in terms of their spatial (alignment with local, national and international policy) and sectoral integration (alignment into existing local policy documents). We document local climate plans that we call type A1: non-compulsory by national law and not developed as part of international climate networks; A2: compulsory by national law and not developed as part of international networks; A3: plans developed as part of international networks. This most comprehensive analysis to date reveals that there is large diversity in the availability of local climate plans with most being available in Central and Northern European cities. Approximately 66% of EU cities have an A1, A2, or A3 mitigation plan, 26% an adaptation plan, 17% joint adaptation and mitigation plans, and about 30% lack any form of local climate plan (i.e. what we classify as A1, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but mitigation does not always precede adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 70% of the cities above 1 million inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (A1 or A2). Countries with national climate legislation (A2), such as Denmark, France, Slovakia and the United Kingdom, are found to have nearly twice as many urban mitigation plans, and five times more likely to produce urban adaptation plans, than countries without such legislation. A1 and A2 mitigation plans are particularly numerous in Denmark, Poland, Germany, and Finland; while A1 and A2 adaptation plans are prevalent in Denmark, Finland, UK and France. The integration of adaptation and mitigation is country-specific and can mainly be observed in countries where local climate plans are compulsory, especially in France and the UK. Finally, local climate plans of international climate networks (A3) are mostly found in the many countries where autonomous, i.e. A1 plans are less common. The findings reported here are of international importance as they will inform and support decision-making and thinking of stakeholders with similar experiences or developments at all levels and sectors in other regions around the world.
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| 15. |
- Reckien, Diana, et al.
(författare)
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Quality of urban climate adaptation plans over time
- 2023
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Ingår i: npj Urban Sustainability. - : Springer Nature. - 2661-8001. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Defining and measuring progress in adaptation are important questions for climate adaptation science, policy, and practice. Here, we assess the progress of urban adaptation planning in 327 European cities between 2005 and 2020 using three ‘ADAptation plan Quality Assessment’ indices, called ADAQA-1/ 2/ 3, that combine six plan quality principles. Half of the cities have an adaptation plan and its quality significantly increased over time. However, generally, plan quality is still low in many cities. Participation and monitoring and evaluation are particularly weak aspects in urban adaptation policy, together with plan ‘consistency’. Consistency connects impacts and vulnerabilities with adaptation goals, planned measures, actions, monitoring and evaluation, and participation processes. Consistency is a key factor in the overall quality of plans. To help evaluate the quality of plans and policies and promote learning, we suggest incorporating our ADAptation plan Quality Assessment indices into the portfolio of adaptation progress assessments and tracking methodologies.
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| 16. |
- Salvia, Monica, et al.
(författare)
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Will climate mitigation ambitions lead to carbon neutrality? An analysis of the local-level plans of 327 cities in the EU
- 2021
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Ingår i: Renewable & sustainable energy reviews. - : Elsevier. - 1364-0321 .- 1879-0690. ; 135
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Tidskriftsartikel (refereegranskat)abstract
- Cities across the globe recognise their role in climate mitigation and are acting to reduce carbon emissions. Knowing whether cities set ambitious climate and energy targets is critical for determining their contribution towards the global 1.5 °C target, partly because it helps to identify areas where further action is necessary. This paper presents a comparative analysis of the mitigation targets of 327 European cities, as declared in their local climate plans. The sample encompasses over 25% of the EU population and includes cities of all sizes across all Member States, plus the UK. The study analyses whether the type of plan, city size, membership of climate networks, and its regional location are associated with different levels of mitigation ambition. Results reveal that 78% of the cities have a GHG emissions reduction target. However, with an average target of 47%, European cities are not on track to reach the Paris Agreement: they need to roughly double their ambitions and efforts. Some cities are ambitious, e.g. 25% of our sample (81) aim to reach carbon neutrality, with the earliest target date being 2020.90% of these cities are members of the Climate Alliance and 75% of the Covenant of Mayors. City size is the strongest predictor for carbon neutrality, whilst climate network(s) membership, combining adaptation and mitigation into a single strategy, and local motivation also play a role. The methods, data, results and analysis of this study can serve as a reference and baseline for tracking climate mitigation ambitions across European and global cities.
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| 17. |
- Veber, Triin, et al.
(författare)
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Industrial Air Pollution Leads to Adverse Birth Outcomes : A Systematized Review of Different Exposure Metrics and Health Effects in Newborns
- 2022
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Ingår i: Public Health Reviews. - : Frontiers Media S.A.. - 0301-0422 .- 2107-6952. ; 43
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To review the evidence of associations between adverse birth outcomes (ABO) and industrial air pollution.Methods: Searches were conducted in PubMed, and Scopus databases, and additional articles were found from snowball search techniques. The included studies feature a study population of mothers with live-born babies exposed to industrial air pollutants, and they examine the effects of industrial pollutants on adverse birth outcomes-namely, low birth weight, term low birth weight, preterm birth, and small for gestational age.Results: Altogether, 45 studies were included in this review. Exposure to PM2.5, PAHs, benzene, cadmium, and mixtures of industrial air pollutants and living near an industrial area affect birth outcomes.Conclusion: This study concludes that industrial air pollution is an important risk factor for ABO, especially low birth weight and preterm birth. The strongest evidence is associations between ABO and air pollution from power plants and petrochemical industries. Understanding of specific chemicals that are critical to birth outcomes is still vague. However, the evidence is strongest for more specific air pollutants from the industry, such as PAH, benzene, BTEX, and cadmium.
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| 18. |
- Armstrong, Ben, et al.
(författare)
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The Role of Humidity in Associations of High Temperature with Mortality : A Multicountry, Multicity Study
- 2019
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Ingår i: Journal of Environmental Health Perspectives. - : The National Institute of Environmental Health Sciences. - 0091-6765 .- 1552-9924. ; 127:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is strong experimental evidence that physiologic stress from high temperatures is greater if humidity is higher. However, heat indices developed to allow for this have not consistently predicted mortality better than dry-bulb temperature.Objectives: We aimed to clarify the potential contribution of humidity an addition to temperature in predicting daily mortality in summer by using a large multicountry dataset.Methods: In 445 cities in 24 countries, we fit a time-series regression model for summer mortality with a distributed lag nonlinear model (DLNM) for temperature (up to lag 3) and supplemented this with a range of terms for relative humidity (RH) and its interaction with temperature. City-specific associations were summarized using meta-analytic techniques.Results: Adding a linear term for RH to the temperature term improved fit slightly, with an increase of 23% in RH (the 99th percentile anomaly) associated with a 1.1% [95% confidence interval (CI): 0.8, 1.3] decrease in mortality. Allowing curvature in the RH term or adding terms for interaction of RH with temperature did not improve the model fit. The humidity-related decreased risk was made up of a positive coefficient at lag 0 outweighed by negative coefficients at lags of 1–3 d. Key results were broadly robust to small model changes and replacing RH with absolute measures of humidity. Replacing temperature with apparent temperature, a metric combining humidity and temperature, reduced goodness of fit slightly.Discussion:The absence of a positive association of humidity with mortality in summer in this large multinational study is counter to expectations from physiologic studies, though consistent with previous epidemiologic studies finding little evidence for improved prediction by heat indices. The result that there was a small negative average association of humidity with mortality should be interpreted cautiously; the lag structure has unclear interpretation and suggests the need for future work to clarify.
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| 19. |
- Carlsen, Hanne Krage, et al.
(författare)
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Indicators of residential traffic exposure: Modelled NOX, traffic proximity, and self-reported exposure in RHINE III
- 2017
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Ingår i: Atmospheric Environment. - : Elsevier BV. - 1352-2310 .- 1873-2844. ; 167, s. 416-425
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have investigated associations between self-reported and modelled exposure to traffic pollution. The objective of this study was to examine correlations between self-reported traffic exposure and modelled (a) NOX and (b) traffic proximity in seven different northern European cities; Aarhus (Denmark), Bergen (Norway), Gothenburg, Umeå, and Uppsala (Sweden), Reykjavik (Iceland), and Tartu (Estonia). We analysed data from the RHINE III (Respiratory Health in Northern Europe, www.rhine.nu) cohorts of the seven study cities. Traffic proximity (distance to the nearest road with >10,000 vehicles per day) was calculated and vehicle exhaust (NOX) was modelled using dispersion models and land-use regression (LUR) data from 2011. Participants were asked a question about self-reported traffic intensity near bedroom window and another about traffic noise exposure at the residence. The data were analysed using rank correlation (Kendall's tau) and inter-rater agreement (Cohen's Kappa) between tertiles of modelled NOX and traffic proximity tertile and traffic proximity categories (0–150 metres (m), 150–200 m, >300 m) in each centre. Data on variables of interest were available for 50–99% of study participants per each cohort. Mean modelled NOX levels were between 6.5 and 16.0 μg/m3; median traffic intensity was between 303 and 10,750 m in each centre. In each centre, 7.7–18.7% of respondents reported exposure to high traffic intensity and 3.6–16.3% of respondents reported high exposure to traffic noise. Self-reported residential traffic exposure had low or no correlation with modelled exposure and traffic proximity in all centres, although results were statistically significant (tau = 0.057–0.305). Self-reported residential traffic noise correlated weakly (tau = 0.090–0.255), with modelled exposure in all centres except Reykjavik. Modelled NOX had the highest correlations between self-reported and modelled traffic exposure in five of seven centres, traffic noise exposure had the highest correlation with traffic proximity in tertiles in three centres. Self-reported exposure to high traffic intensity and traffic noise at each participant's residence had low or weak although statistically significant correlations with modelled vehicle exhaust pollution levels and traffic proximity. © 2017
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| 20. |
- Chen, Gongbo, et al.
(författare)
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Mortality risk attributable to wildfire-related PM2·5 pollution : a global time series study in 749 locations
- 2021
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Ingår i: The Lancet Planetary Health. - : Elsevier. - 2542-5196. ; 5:9, s. e579-e587
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2·5 and mortality across various regions of the world.METHODS: For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfire-related PM2·5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM2·5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM2·5 exposure was calculated.FINDINGS: 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m3 increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM2·5 exposure were 1·019 (95% CI 1·016-1·022) for all-cause mortality, 1·017 (1·012-1·021) for cardiovascular mortality, and 1·019 (1·013-1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48-0·75) of all-cause deaths, 0·55% (0·43-0·67) of cardiovascular deaths, and 0·64% (0·50-0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM2·5 exposure during the study period.INTERPRETATION: Short-term exposure to wildfire-related PM2·5 was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires.
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| 21. |
- Choi, Hayon Michelle, et al.
(författare)
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Effect modification of greenness on the association between heat and mortality : A multi-city multi-country study
- 2022
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Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 84
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting.METHODS: We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations.FINDINGS: Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries.INTERPRETATION: Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change.FUNDING: This publication was developed under Assistance Agreement No. RD83587101 awarded by the U.S. Environmental Protection Agency to Yale University. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Research reported in this publication was also supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012769. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Also, this work has been supported by the National Research Foundation of Korea (2021R1A6A3A03038675), Medical Research Council-UK (MR/V034162/1 and MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), Academy of Finland (Grant ID: 310372), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655 and 874990), Czech Science Foundation (22-24920S), Emory University's NIEHS-funded HERCULES Center (Grant ID: P30ES019776), and Grant CEX2018-000794-S funded by MCIN/AEI/ 10.13039/501100011033 The funders had no role in the design, data collection, analysis, interpretation of results, manuscript writing, or decision to publication.
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| 22. |
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| 23. |
- Domingo, Nina G.G., et al.
(författare)
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Ozone-related acute excess mortality projected to increase in the absence of climate and air quality controls consistent with the Paris Agreement
- 2024
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Ingår i: One Earth. - : Elsevier. - 2590-3330 .- 2590-3322. ; 7:2, s. 325-335
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Tidskriftsartikel (refereegranskat)abstract
- Short-term exposure to ground-level ozone in cities is associated with increased mortality and is expected to worsen with climate and emission changes. However, no study has yet comprehensively assessed future ozone-related acute mortality across diverse geographic areas, various climate scenarios, and using CMIP6 multi-model ensembles, limiting our knowledge on future changes in global ozone-related acute mortality and our ability to design targeted health policies. Here, we combine CMIP6 simulations and epidemiological data from 406 cities in 20 countries or regions. We find that ozone-related deaths in 406 cities will increase by 45 to 6,200 deaths/year between 2010 and 2014 and between 2050 and 2054, with attributable fractions increasing in all climate scenarios (from 0.17% to 0.22% total deaths), except the single scenario consistent with the Paris Climate Agreement (declines from 0.17% to 0.15% total deaths). These findings stress the need for more stringent air quality regulations, as current standards in many countries are inadequate.
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| 24. |
- Ekland, Johan, et al.
(författare)
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The effect of current and future maternal exposure to near-surface ozone on preterm birth in 30 European countries : an EU-wide health impact assessment
- 2021
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Ingår i: Environmental Research Letters. - : Institute of Physics Publishing (IOPP). - 1748-9326. ; 16:5
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Tidskriftsartikel (refereegranskat)abstract
- Preterm birth is the largest contributor to neonatal mortality globally and it is also associated with several adverse health outcomes. Recent studies have found an association between maternal exposure to air pollution and an increased risk for preterm birth. As a constituent of air pollution, ozone is a highly reactive molecule with several negative health effects when present near earth's surface. This health impact assessment aims to estimate the proportion of preterm births - in current and future situations - attributable to maternal ozone exposure in 30 European countries (EU30). A literature search was performed using relevant keywords, followed by meta-analysis with STATA software in which five studies investigating exposure-response relationship of interest were included. The attributable proportion, and number of cases, was modelled with the software AirQ+ against current and future European ozone concentrations. According to our meta-analysis, the relative risk for giving birth preterm was calculated to 1.027 (95% CI 1.009-1.046) per 10 μg m-3 increase in ozone concentration. This rendered 7.1% (95% CI 2.5-11.7) of preterm births attributable to maternal ozone exposure to in EU30 during 2010, which is equal to approximately 27 900 cases. By 2050, the projected decrease in ozone precursor emissions rendered an estimated 30% decrease of ozone attributable preterm births. Not taking emission change into account, due to climate change the ozone-related preterm birth burden might slightly increase by 2050 in Central and Southern Europe, and decrease in Eastern and Northern Europe. In summation, these numbers make a substantial impact on public health.
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| 25. |
- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
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Tidskriftsartikel (refereegranskat)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
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