Early Warning System and Adaptation Advice to Reduce Human Health Consequences of Extreme Weather Conditions and Air Pollution

The authors developed a multi-site Internet service to provide the public with real time information about local weather and air quality, how they may affect health, and how general population and different sensitive population groups can protect their health during periods of extreme weather conditions or increased air pollution levels. The information service is based on data obtained from the Republic Hydrometeorological Service of Serbia and Serbian Environment Protection Agency. Health warnings and recommendations are given separately for each AIQ and heat index or wind chill index value, for each sensitive population group, as well as for the general population. The project is currently implemented on the website of the Institute of Occupational Health Niš and will be offered to other healthcare institutions in Serbia. Evaluation of the system should enable redefinition of heat and wind chill indices and air pollution threshold values if necessary. This chapter explores the service.

[1]  W R Keatinge,et al.  Heat related mortality in warm and cold regions of Europe: observational study , 2000, BMJ : British Medical Journal.

[2]  J. Xu,et al.  Heat-stress-induced damage to porcine small intestinal epithelium associated with downregulation of epithelial growth factor signaling. , 2009, Journal of animal science.

[3]  B. Coull,et al.  Composition of Inhaled Urban Air Particles Determines Acute Pulmonary Responses , 2002 .

[4]  Sabit Cakmak,et al.  Risk assessment for cardiovascular and respiratory mortality due to air pollution and synoptic meteorology in 10 Canadian cities. , 2014, Environmental pollution.

[5]  A. Peters,et al.  Activation of the Autonomic Nervous System and Blood Coagulation in Association with an Air Pollution Episode , 2000, Inhalation toxicology.

[6]  K. Smoyer.  A comparative analysis of heat waves and associated mortality in St. Louis, Missouri – 1980 and 1995 , 1998, International journal of biometeorology.

[7]  Laurence S. Kalkstein,et al.  An Evaluation of Summer Discomfort in the United State Using a Relative Climatological Index , 1986 .

[8]  Bert Brunekreef,et al.  Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study , 2002, The Lancet.

[9]  Bert Brunekreef,et al.  Particulate Air Pollution and Risk of ST-Segment Depression During Repeated Submaximal Exercise Tests Among Subjects With Coronary Heart Disease: The Exposure and Risk Assessment for Fine and Ultrafine Particles in Ambient Air (ULTRA) Study , 2002, Circulation.

[10]  P. Monks,et al.  Air quality and climate--synergies and trade-offs. , 2013, Environmental science. Processes & impacts.

[11]  P. Bi,et al.  The effect of heat waves on hospital admissions for renal disease in a temperate city of Australia. , 2008, International journal of epidemiology.

[12]  D L Davis,et al.  Reassessment of the lethal London fog of 1952: novel indicators of acute and chronic consequences of acute exposure to air pollution. , 2001, Environmental health perspectives.

[13]  M. Neuberger,et al.  Acute and Subacute Effects of Urban Air Pollution on Cardiopulmonary Emergencies and Mortality: Time Series Studies in Austrian Cities , 2013, International journal of environmental research and public health.

[14]  Rupa Basu,et al.  An exposure assessment study of ambient heat exposure in an elderly population in Baltimore, Maryland. , 2002, Environmental health perspectives.

[15]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[16]  B. Menne,et al.  Prevention and management of health hazards related to heatwaves , 2009, International journal of circumpolar health.

[17]  Günter Oberdörster,et al.  Ultrafine Particle Deposition in Humans During Rest and Exercise , 2003, Inhalation toxicology.

[18]  Frances Silverman,et al.  Inhalation of Fine Particulate Air Pollution and Ozone Causes Acute Arterial Vasoconstriction in Healthy Adults , 2002 .

[19]  A. Nel,et al.  Ultrafine particulate pollutants induce oxidative stress and mitochondrial damage. , 2002, Environmental health perspectives.

[20]  Tjeerd van Staa,et al.  Mortality associations with long-term exposure to outdoor air pollution in a national English cohort. , 2013, American journal of respiratory and critical care medicine.

[21]  H. R. Anderson,et al.  Assessment and prevention of acute health effects of weather conditions in Europe, the PHEWE project: background, objectives, design , 2007, Environmental health : a global access science source.

[22]  J. Hogg,et al.  The effect of repeated exposure to particulate air pollution (PM10) on the bone marrow. , 2001, American journal of respiratory and critical care medicine.

[23]  A. Faustini,et al.  Short-Term Effects of Air Pollution in a Cohort of Patients With Chronic Obstructive Pulmonary Disease , 2012, Epidemiology.

[24]  A. Gasparrini,et al.  The effects of ambient temperature on cerebrovascular mortality: an epidemiologic study in four climatic zones in China , 2014, Environmental Health.

[25]  J M Wolfson,et al.  Mechanisms of morbidity and mortality from exposure to ambient air particles. , 2000, Research report.

[26]  K. Berhane,et al.  Air pollution and daily hospital admissions in metropolitan Los Angeles. , 2000, Environmental health perspectives.

[27]  George Havenith,et al.  Interaction of Clothing and Thermoregulation , 2003, Exogenous Dermatology.

[28]  Clinch Jp,et al.  Housing standards and excess winter mortality , 2000 .

[29]  P. Cullinan,et al.  Airway inflammation after controlled exposure to diesel exhaust particulates. , 2000, American journal of respiratory and critical care medicine.

[30]  K. Lazarević,et al.  The impact of the July 2007 heat wave on daily mortality in Belgrade, Serbia. , 2013, Central European journal of public health.

[31]  Claudia Marino,et al.  Susceptibility to heat wave-related mortality: a follow-up study of a cohort of elderly in Rome , 2009, Environmental health : a global access science source.

[32]  R. Burnett,et al.  Effects of particulate and gaseous air pollution on cardiorespiratory hospitalizations. , 1999, Archives of environmental health.

[33]  R. Burnett,et al.  Effects of air pollution on emergency room visits for respiratory illnesses in Montreal, Quebec. , 1997, American journal of respiratory and critical care medicine.

[34]  Brent Hodgkinson,et al.  Maintaining oral hydration in older adults: a systematic review. , 2003, International journal of nursing practice.

[35]  P. Ridker,et al.  High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. , 2001, Circulation.

[36]  H. R. Anderson,et al.  Heat Effects on Mortality in 15 European Cities , 2008, Epidemiology.

[37]  Annette Peters,et al.  Effects of air pollution on blood pressure: a population-based approach. , 2001, American journal of public health.

[38]  B. Coull,et al.  Inhalation of concentrated ambient air particles exacerbates myocardial ischemia in conscious dogs. , 2002, Environmental health perspectives.

[39]  P. Libby,et al.  Inflammation and Atherosclerosis , 2002, Circulation.

[40]  Payam Dadvand,et al.  Heat Waves and Cause-specific Mortality at all Ages , 2011, Epidemiology.

[41]  D. Panagiotakos,et al.  Climatological variations in daily hospital admissions for acute coronary syndromes. , 2004, International journal of cardiology.

[42]  B. Coull,et al.  Concentrated ambient air particles induce vasoconstriction of small pulmonary arteries in rats. , 2002, Environmental health perspectives.

[43]  C. Henríquez-Roldán,et al.  Pediatric Respiratory and Systemic Effects of Chronic Air Pollution Exposure: Nose, Lung, Heart, and Brain Pathology , 2007, Toxicologic pathology.

[44]  Antonella Zanobetti,et al.  The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. , 2002, Environmental health perspectives.

[45]  Errol M. Thomson,et al.  Metal composition of fine particulate air pollution and acute changes in cardiorespiratory physiology. , 2014, Environmental pollution.

[46]  Thomas J. Smith,et al.  Association of Heart Rate Variability With Occupational and Environmental Exposure to Particulate Air Pollution , 2001, Circulation.

[47]  B. Brunekreef,et al.  The Association between Air Pollution and Heart Failure, Arrhythmia, Embolism, Thrombosis, and Other Cardiovascular Causes of Death in a Time Series Study , 2001, Epidemiology.

[48]  L. Mortelmans,et al.  Passage of Inhaled Particles Into the Blood Circulation in Humans , 2002, Circulation.

[49]  W. Keatinge,et al.  Early increases in ischaemic heart disease mortality dissociated from and later changes associated with respiratory mortality after cold weather in south east England. , 1997, Journal of epidemiology and community health.

[50]  V. Smrčka,et al.  Environmental pollution and the occurrence of congenital defects in a 15-year period in a south Moravian district. , 1998, Acta chirurgiae plasticae.

[51]  J. Schwartz,et al.  The temporal pattern of respiratory and heart disease mortality in response to air pollution. , 2003, Environmental health perspectives.

[52]  Karen R. Anderson,et al.  Day-to-Day Particulate Exposures and Health Changes in Los Angeles Area Residents with Severe Lung Disease. , 1999, Journal of the Air & Waste Management Association.

[53]  Brent Coull,et al.  Rapid increases in the steady-state concentration of reactive oxygen species in the lungs and heart after particulate air pollution inhalation. , 2002, Environmental health perspectives.

[54]  W. Goggins,et al.  Evidence for an Association Between Air Pollution and Daily Stroke Admissions in Kaohsiung, Taiwan , 2003, Stroke.

[55]  P. Ridker,et al.  Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. , 2000, Circulation.

[56]  F. Dominici,et al.  Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994. , 2000, The New England journal of medicine.

[57]  David M. Brown,et al.  Increased inflammation and intracellular calcium caused by ultrafine carbon black is independent of transition metals or other soluble components , 2000, Occupational and environmental medicine.

[58]  J Schwartz,et al.  Confounding and Effect Modification in the Short-Term Effects of Ambient Particles on Total Mortality: Results from 29 European Cities within the APHEA2 Project , 2001, Epidemiology.

[59]  G. Faich,et al.  Blizzard morbidity and mortality: Rhode Island, 1978. , 1979, American journal of public health.

[60]  M. Lapeyre-Mestre,et al.  A comparative study of adverse drug reactions during two heat waves that occurred in France in 2003 and 2006 , 2012, Pharmacoepidemiology and drug safety.

[61]  W. MacNee,et al.  Particulate air pollution and acute health effects , 1995, The Lancet.

[62]  W. Cascio,et al.  Exposure to Concentrated Ambient Air Particles Alters Hematologic Indices in Humans , 2003, Inhalation toxicology.

[63]  J D Spengler,et al.  Acute effects of summer air pollution on respiratory symptom reporting in children. , 1994, American journal of respiratory and critical care medicine.

[64]  S. Simon,et al.  Vanilloid (capsaicin) receptors influence inflammatory sensitivity in response to particulate matter. , 2000, Toxicology and applied pharmacology.

[65]  J. Hogg,et al.  Particulate air pollution induces progression of atherosclerosis. , 2002, Journal of the American College of Cardiology.

[66]  J. Hogg,et al.  Cytokines involved in the systemic inflammatory response induced by exposure to particulate matter air pollutants (PM(10)). , 2001, American journal of respiratory and critical care medicine.

[67]  J Schwartz,et al.  Air pollution and incidence of cardiac arrhythmia. , 2000, Epidemiology.

[68]  D. Bogdanović,et al.  [Impact of air pollution on the rate of hospital admission of children with respiratory diseases]. , 2008, Vojnosanitetski pregled.

[69]  M. Franchini,et al.  Particulate Air Pollution and Cardiovascular Risk: Short-term and Long-term Effects , 2009, Seminars in thrombosis and hemostasis.

[70]  P. S. Gilmour,et al.  Free radical activity and pro-inflammatory effects of particulate air pollution (PM10) in vivo and in vitro. , 1996, Thorax.

[71]  Sladjana Jović,et al.  Excess winter mortality of Roma population in Serbia, 1992-2007. , 2012, Central European journal of public health.

[72]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[73]  R. Elton,et al.  Particulate air pollution and the blood , 1999, Thorax.

[74]  J. Díaz,et al.  Relationship between atmospheric pressure and mortality in the Madrid Autonomous Region: a time-series study , 2001, International journal of biometeorology.

[75]  C. Monn,et al.  Cytotoxicity and induction of proinflammatory cytokines from human monocytes exposed to fine (PM2.5) and coarse particles (PM10-2.5) in outdoor and indoor air. , 1999, Toxicology and applied pharmacology.

[76]  S T Holgate,et al.  Acute exposure to diesel exhaust increases IL-8 and GRO-alpha production in healthy human airways. , 2000, American journal of respiratory and critical care medicine.

[77]  L. Ferrucci,et al.  Cardiovascular Disease, Interleukin-6, and Risk of Mortality in Older Women: The Women’s Health and Aging Study , 2001, Circulation.

[78]  S. Fichtlscherer,et al.  Elevated C-Reactive Protein Levels and Impaired Endothelial Vasoreactivity in Patients With Coronary Artery Disease , 2000, Circulation.

[79]  Amir Lerman,et al.  Endothelial Dysfunction: A Marker of Atherosclerotic Risk , 2003, Arteriosclerosis, thrombosis, and vascular biology.

[80]  I. Adamson,et al.  Acute effects of inhaled urban particles and ozone: lung morphology, macrophage activity, and plasma endothelin-1. , 1998, The American journal of pathology.

[81]  J. Balmes,et al.  Ozone-induced airway inflammation in human subjects as determined by airway lavage and biopsy. , 1993, The American review of respiratory disease.

[82]  S T Holgate,et al.  Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers. , 1999, American journal of respiratory and critical care medicine.

[83]  R. D. Morris,et al.  Airborne particulates and hospital admissions for cardiovascular disease: a quantitative review of the evidence. , 2001, Environmental health perspectives.

[84]  Yun-Chul Hong,et al.  Air Pollution: A New Risk Factor in Ischemic Stroke Mortality , 2002, Stroke.

[85]  Daniel J. Wilson,et al.  Public perception and behavior change in relationship to hot weather and air pollution. , 2008, Environmental research.

[86]  Joel Schwartz,et al.  Who is Sensitive to Extremes of Temperature?: A Case-Only Analysis , 2005, Epidemiology.

[87]  Deepak L. Bhatt,et al.  Need to test the arterial inflammation hypothesis. , 2002, Circulation.

[88]  J. Schwartz,et al.  Hospital Admissions for Heart Disease: The Effects of Temperature and Humidity , 2004, Epidemiology.

[89]  D. Dockery,et al.  Particulate air pollution as a predictor of mortality in a prospective study of U.S. adults. , 1995, American journal of respiratory and critical care medicine.

[90]  J. Healy,et al.  Excess winter mortality in Europe: a cross country analysis identifying key risk factors , 2003, Journal of epidemiology and community health.

[91]  R. Devlin,et al.  Inflammatory lung injury after bronchial instillation of air pollution particles. , 2001, American journal of respiratory and critical care medicine.

[92]  P. Vacek,et al.  Inhaled particulate matter causes expression of nuclear factor (NF)-kappaB-related genes and oxidant-dependent NF-kappaB activation in vitro. , 2000, American journal of respiratory cell and molecular biology.

[93]  K. Ebi,et al.  An empirical mechanistic framework for heat-related illness , 2001 .

[94]  W. Rea,et al.  Adverse health effects of outdoor air pollutants. , 2006, Environment international.

[95]  F. Kelly,et al.  Monitoring air pollution: Use of early warning systems for public health , 2012, Respirology.

[96]  P. Amouyel,et al.  Unhealthy effects of atmospheric temperature and pressure on the occurrence of myocardial infarction and coronary deaths. A 10-year survey: the Lille-World Health Organization MONICA project (Monitoring trends and determinants in cardiovascular disease). , 1999, Circulation.

[97]  A. Peters,et al.  Increased plasma viscosity during an air pollution episode: a link to mortality? , 1997, The Lancet.

[98]  R K Griffiths,et al.  Temporal association between hospital admissions for asthma in Birmingham and ambient levels of sulphur dioxide and smoke. , 1994, Thorax.

[99]  D. Bogdanović,et al.  Black smoke air pollution and daily non-accidental mortality in Nis, Serbia , 2006 .

[100]  Paul Wilkinson,et al.  Vulnerability to winter mortality in elderly people in Britain: population based study , 2004, BMJ : British Medical Journal.

[101]  L. Arab,et al.  Effect of antioxidant supplementation on ozone-induced lung injury in human subjects. , 2001, American journal of respiratory and critical care medicine.

[102]  J. Schwartz,et al.  Heart rate variability associated with particulate air pollution. , 1999, American heart journal.

[103]  Benoit Nemery,et al.  Ultrafine particles affect experimental thrombosis in an in vivo hamster model. , 2002, American journal of respiratory and critical care medicine.

[104]  R. Cull.  Barometric Pressure and Other Factors in Migraine , 1981, Headache.

[105]  C. rd,et al.  Epidemiology of fine particulate air pollution and human health: biologic mechanisms and who's at risk? , 2000 .

[106]  J. Schaanning,et al.  Effects of cold air inhalation combined with prolonged submaximal exercise on airway function in healthy young males. , 1986, European journal of respiratory diseases. Supplement.

[107]  R. Burnett,et al.  Cardiovascular Mortality and Long-Term Exposure to Particulate Air Pollution: Epidemiological Evidence of General Pathophysiological Pathways of Disease , 2003, Circulation.

[108]  J. Hogg,et al.  The human bone marrow response to acute air pollution caused by forest fires. , 2000, American journal of respiratory and critical care medicine.

[109]  G. Havenith.  Individualized model of human thermoregulation for the simulation of heat stress response. , 2001, Journal of applied physiology.

[110]  C. Wolf.  SOCIAL IMPACT ASSESSMENT , 1982 .

[111]  D. Dockery,et al.  Increased Particulate Air Pollution and the Triggering of Myocardial Infarction , 2001, Circulation.

[112]  W. Keatinge,et al.  Cardiovascular mortality in winter. , 1995, Arctic medical research.

[113]  Fateh Chebana,et al.  A general and flexible methodology to define thresholds for heat health watch and warning systems, applied to the province of Québec (Canada) , 2013, International Journal of Biometeorology.

[114]  A. Peters,et al.  Particulate air pollution is associated with an acute phase response in men; results from the MONICA-Augsburg Study. , 2001, European heart journal.

[115]  Amy P Abernethy,et al.  Minimization of heatwave morbidity and mortality. , 2013, American journal of preventive medicine.

[116]  G. Shaw,et al.  Ambient air pollution and risk of birth defects in Southern California. , 2002, American journal of epidemiology.

[117]  Majid Ezzati,et al.  For Personal Use. Only Reproduce with Permission from the Lancet Publishing Group , 2022 .

[118]  G. Anderson,et al.  Human morphology and temperature regulation , 1999, International journal of biometeorology.

[119]  B. Brunekreef,et al.  Components of ambient air pollution affect thrombin generation in healthy humans: the RAPTES project , 2013, Occupational and Environmental Medicine.

[120]  S. Tong,et al.  Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence , 2013, International Journal of Public Health.

[121]  B. Brunekreef,et al.  Air pollution and health , 2002, The Lancet.

[122]  A Delyukov,et al.  The effects of extra-low-frequency atmospheric pressure oscillations on human mental activity , 1999, International journal of biometeorology.

[123]  M. Pascal,et al.  Summary of the mortality impact assessment of the 2003 heat wave in France. , 2005, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[124]  J. Mentes,et al.  Reducing Hydration-Linked Events in Nursing Home Residents , 2003, Clinical nursing research.

[125]  F. Kelly,et al.  Oxidative stress: its role in air pollution and adverse health effects , 2003, Occupational and environmental medicine.

[126]  N. Živković,et al.  Air quality monitoring in NIS (SERBIA) and health impact assessment , 2009, Environmental monitoring and assessment.

[127]  Steffen Loft,et al.  Personal PM2.5 exposure and markers of oxidative stress in blood. , 2002, Environmental health perspectives.

[128]  G. Donaldson.  Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe , 1997, The Lancet.

[129]  E. Donoghue,et al.  Criteria for the diagnosis of heat-related deaths: National Association of Medical Examiners. Position paper. National Association of Medical Examiners Ad Hoc Committee on the Definition of Heat-Related Fatalities. , 1997, American Journal of Forensic Medicine and Pathology.

[130]  P. Nafstad,et al.  Mortality and temperature in Oslo, Norway, 1990–1995 , 2004, European Journal of Epidemiology.

[131]  W. Cascio,et al.  Elderly humans exposed to concentrated air pollution particles have decreased heart rate variability , 2003, European Respiratory Journal.

[132]  B. Nemery,et al.  The Meuse Valley fog of 1930: an air pollution disaster , 2001, The Lancet.

[133]  J. Schwartz,et al.  Daily changes in oxygen saturation and pulse rate associated with particulate air pollution and barometric pressure. , 1999, Research report.

[134]  D. Dockery,et al.  An association between air pollution and mortality in six U.S. cities. , 1993, The New England journal of medicine.

[135]  Sladjana Jović,et al.  [Influence of air pollution on hospital admissions for cardiovascular and respiratory diseases in Nis, Serbia]. , 2010, Vojnosanitetski pregled.

[136]  G. Assmann,et al.  Relationship between plasma viscosity and the severity of coronary heart disease. , 1998, Arteriosclerosis, thrombosis, and vascular biology.

[137]  B. Coull,et al.  Electrocardiographic changes during exposure to residual oil fly ash (ROFA) particles in a rat model of myocardial infarction. , 2002, Toxicological sciences : an official journal of the Society of Toxicology.

[138]  C. Stefanadis,et al.  CLimate Impacts on Myocardial infarction deaths in the Athens TErritory: the CLIMATE study , 2006, Heart.

[139]  Alana Hansen,et al.  The Effect of Heat Waves on Mental Health in a Temperate Australian City , 2008, Environmental health perspectives.

[140]  D. Corella,et al.  Mortality as a function of temperature. A study in Valencia, Spain, 1991-1993. , 1997, International journal of epidemiology.