Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burden to the management of people with diabetes. According to pharmacopeia unopened insulin vials must be stored in a... refrigerator (2–8°C), while storage at ambient temperature (25–30°C) is usually permitted for the 4-week usage period during treatment. In the present work we address a critical question towards improving diabetes care in resource poor settings, namely whether insulin is stable and retains biological activity in tropical temperatures during a 4-week treatment period. To answer this question, temperature fluctuations were measured in Dagahaley refugee camp (Northern Kenya) using log tag recorders. Oscillating temperatures between 25 and 37°C were observed. Insulin heat stability was assessed under these specific temperatures which were precisely reproduced in the laboratory. Different commercialized formulations of insulin were quantified weekly by high performance liquid chromatography and the results showed perfect conformity to pharmacopeia guidelines, thus confirming stability over the assessment period (four weeks). Monitoring the 3D-structure of the tested insulin by circular dichroism confirmed that insulin monomer conformation did not undergo significant modifications. The measure of insulin efficiency on insulin receptor (IR) and Akt phosphorylation in hepatic cells indicated that insulin bioactivity of the samples stored at oscillating temperature during the usage period is identical to that of the samples maintained at 2–8°C. Taken together, these results indicate that insulin can be stored at such oscillating ambient temperatures for the usual four–week period of use. This enables the barrier of cold storage during use to be removed, thereby opening up the perspective for easier management of diabetes in humanitarian contexts and resource poor settings.
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2023 is seeing intense heatwaves. According to a July 2023 briefing by the World Meteorological Association temperatures will frequently reach above 35–40°C in many places across the Mediterranean region, with temperatures in the Middle East and southeastern Türkiye reaching up to 45°C and, in ...North Africa, 44–49°C. April–May 2023 also saw temperature records broken across many parts of Asia, including Thailand, Laos and Myanmar.
The IPCC predicts that 420 million people will be exposed to extreme heat and heatwaves in the near future. Hundreds of thousands of people die from preventable heat-related causes each year, while temperature extremes and wildfires cause devastation to lives and livelihoods. According to the WMO, ‘heatwaves are amongst the deadliest natural hazards [and] heat is a rapidly growing health risk’.
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Global temperatures and the frequency and intensity of heatwaves will rise in the 21st century as a result of climate change. Extended periods of high day and nighttime temperatures create cumulative physiological stress on the human body which exacerbates the top causes of death globally, including... respiratory and cardiovascular diseases, diabetes mellitus and renal disease. Heatwaves can acutely impact large populations for short periods of time, often trigger public health emergencies, and result in excess mortality, and cascading socioeconomic impacts
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Billions of people are at risk of preventable death and illness from extreme heat. The Global Heat Health Information Network is helping to increase awareness and capacity to better manage and adapt to the health risks of dangerously hot weather in a changing climate.
Heatwaves, or heat and hot weather that can last for several days, can have a significant impact on society, including a rise in heat-related deaths. Heatwaves are among the most dangerous of natural hazards, but rarely receive adequate attention because their death tolls and destruction are not alw...ays immediately obvious
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The global proportion of people at risk to heat stress is increasing. The Lancet Countdown is tracking our exposure and vulnerability to changes in heat caused by climate change.
Over long periods of time, individuals and communities can adapt to their local climates. When both warmer and colder temperatures go above or below those norms rapidly, scientific evidence shows that people become vulnerable to associated health effects related to those extremes. Studies suggest th...at climate change will greatly increase the severity and frequency of extreme temperature conditions, leading to increases in temperature-related illness and death
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This publication presents a comprehensive methodology to support the Member States of the Pan American Health Organization (PAHO) in preparing for and responding to heat-health risks in the Region of the Americas. It builds on World Health Organization and the World Meteorological Organization globa...l documents, as well as on the disaster preparedness methodologies employed throughout the countries of the Region. This publication is part of an effort coordinated by PAHO to support Member States in multihazard preparedness, and includes: early warning system strengthening; threat characterization; activation and deactivation procedure definition; and institutional coordination. It engages different disciplines and recognizes the importance of intersectoral collaboration to respond to heat-health risks. It aims to bring awareness of the impacts of heat on the health of people of the Americas to public health decisionmakers, and thereby strengthen health service provision.
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Lancet 2021; 398: Series: Heat and Health
Hot weather and heat extremes harm human health, with poverty, ageing, and chronic illnesses as aggravating factors. As the global community contends with even hotter weather in a changing climate, there is a pressing need to better understand the most eff...ective prevention and response measures, particularly in low-resource settings. In this two-paper series, the physiological, social, and environmental factors that contribute to individual heat vulnerability, and the megatrends affecting future heat-related morbidity and mortality at the population level, are comprehensively reviewed. Solutions to address the physiological heat strain that underlies the negative health effects of heat extremes and hot weather, which can be employed across a range of settings at individual, building, and landscape scales, are presented.
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The first update of the ECDC ventilation guidance document contains:
key new findings that emphasise four bundles of NPIs to reduce the risk of SARS-CoV-2 transmission in closed spaces;
updated references on the evidence of transmission in closed spaces;
recommendations based on the n...ew evidence and on national and international guidance; and
an overview of national guidance ventilation documents in the context of COVID-19 based on an inquiry sent to ECDC’s National Focal Points (NFPs) for Preparedness and Response and NFPs for Influenza and other respiratory diseases.
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Heat is the top killer among all types of weather hazards, including hurricanes and tornadoes. But hospitals and health care providers do not always report heat-related illnesses or heat as an underlying cause of a death, making it hard to measure the actual impact of extreme heat on health.
Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an...d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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Emerging evidence and experience to inform risk management in a warming world
DOI: 10.5772/intechopen.75559
In book: Extreme WeatherPublisher: IntechOpen
Heat-related deaths are preventable. Infographic
"Heat Wave Guidelines aim to facilitate the stakeholders in preparing a Heat Wave Action Plan by providing insights into heat-related illness and the necessary mitigative and response actions to be undertaken. It will also help in mobilization of and coordination among various ministries/departments..., individuals and communities to help and protect their neighbours, friends, relatives, and themselves against avoidable health problems during spell of very hot weather."
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Climate change is already having severe impacts across our planet, bringing new and previously unimaginable challenges to the people least responsible for greenhouse gas emissions.
This report, the first we’ve released jointly in the history of our organizations, provides a sobering review of h...ow just one of those challenges – the increase in deadly heat-waves – threatens to drive new emergency needs in the not-so-distant future.
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The HEAT is designed to enable users without expertise in impact assessment to conduct economic assessments of the health impacts of walking or cycling.