Heat stress
Two reviews related to heat stress were found. A review of the impact of green spaces within cities found ~1°C lower temperatures in city parks than in built up city areas [72]. The GRADE score showed very low quality of evidence. Whether such green spaces had any impact on reducing morbidity and mortality during heat waves was not addressed. The second review included 14 observational studies investigating whether heat health warning systems increased awareness and reduced mortality and morbidity [73]. The authors presented a narrative synthesis and did not judge study validity. They reported high levels of awareness about the public health campaigns and heat wave events amongst the general public, but evidence of behavioural change as a result of this awareness was less forthcoming. The associated quality of evidence was considered to be of very low quality. A key problem was that some studies recruited people in the street and so did not include the group particularly vulnerable to heat stress. Most of the studies made comparisons between different heat wave periods in the same city before and after the heat health warning system was in place. Generally they found reduced mortality in the second period, which was attributed to the public health response. However, as pointed out by the authors, few studies considered other possible factors that may have had an impact. For example in Chicago, there had been a failure in the electricity supply during the first heat wave which would have exacerbated the adverse impact. In addition, harvesting or mortality displacement is an important factor that is likely to be a major contributor to the reduced mortality associated with the second heat wave, but this has not been considered. Bassil and Cole concluded that limited evidence suggests a positive impact of public health interventions for heat waves but the most vulnerable groups are not being adequately reached [73]. Further primary research is needed to address effective interventions for heat stress.
ความเครียดความร้อนTwo reviews related to heat stress were found. A review of the impact of green spaces within cities found ~1°C lower temperatures in city parks than in built up city areas [72]. The GRADE score showed very low quality of evidence. Whether such green spaces had any impact on reducing morbidity and mortality during heat waves was not addressed. The second review included 14 observational studies investigating whether heat health warning systems increased awareness and reduced mortality and morbidity [73]. The authors presented a narrative synthesis and did not judge study validity. They reported high levels of awareness about the public health campaigns and heat wave events amongst the general public, but evidence of behavioural change as a result of this awareness was less forthcoming. The associated quality of evidence was considered to be of very low quality. A key problem was that some studies recruited people in the street and so did not include the group particularly vulnerable to heat stress. Most of the studies made comparisons between different heat wave periods in the same city before and after the heat health warning system was in place. Generally they found reduced mortality in the second period, which was attributed to the public health response. However, as pointed out by the authors, few studies considered other possible factors that may have had an impact. For example in Chicago, there had been a failure in the electricity supply during the first heat wave which would have exacerbated the adverse impact. In addition, harvesting or mortality displacement is an important factor that is likely to be a major contributor to the reduced mortality associated with the second heat wave, but this has not been considered. Bassil and Cole concluded that limited evidence suggests a positive impact of public health interventions for heat waves but the most vulnerable groups are not being adequately reached [73]. Further primary research is needed to address effective interventions for heat stress.
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