GeohealthPub Date : 2023-12-08DOI: 10.1029/2023GH000953
K. Ardon-Dryer, K. R. Clifford, J. L. Hand
{"title":"Dust Under the Radar: Rethinking How to Evaluate the Impacts of Dust Events on Air Quality in the United States","authors":"K. Ardon-Dryer, K. R. Clifford, J. L. Hand","doi":"10.1029/2023GH000953","DOIUrl":"https://doi.org/10.1029/2023GH000953","url":null,"abstract":"<p>Dust is an important and complex constituent of the atmospheric system, having significant impacts on the environment, climate, air quality, and human health. Although dust events are common across many regions of the United States, their impacts are not often prioritized in air quality mitigation strategies. We argue that there are at least three factors that result in underestimation of the social and environmental impact of dust events, making them receive less attention. These include (a) sparse monitoring stations with irregular spatial distribution in dust-influenced regions, (b) inconsistency with dust sampling methods, and (c) sampling frequency and schedules, which can lead to missed dust events or underestimation of dust particle concentrations. Without addressing these three factors, it is challenging to characterize and understand the full air quality impacts of dust events in the United States. This paper highlights the need for additional monitoring to measure these events so that we can more fully evaluate and understand their impacts, as they are predicted to increase with climate change.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 12","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agupubs.onlinelibrary.wiley.com/doi/epdf/10.1029/2023GH000953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138550458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeohealthPub Date : 2023-12-07DOI: 10.1029/2023GH000855
Matthew J. Ward, Meytar Sorek-Hamer, Jennifer A. Henke, Eliza Little, Aman Patel, Jeffery Shaman, Krishna Vemuri, Nicholas B. DeFelice
{"title":"A Spatially Resolved and Environmentally Informed Forecast Model of West Nile Virus in Coachella Valley, California","authors":"Matthew J. Ward, Meytar Sorek-Hamer, Jennifer A. Henke, Eliza Little, Aman Patel, Jeffery Shaman, Krishna Vemuri, Nicholas B. DeFelice","doi":"10.1029/2023GH000855","DOIUrl":"10.1029/2023GH000855","url":null,"abstract":"<p>West Nile virus (WNV) is the most significant arbovirus in the United States in terms of both morbidity and mortality. West Nile exists in a complex transmission cycle between avian hosts and the arthropod vector, <i>Culex</i> spp. mosquitoes. Human spillover events occur when humans are bitten by an infected mosquito and predicting these rates of infection and therefore the risk to humans may be associated with fluctuations in environmental conditions. In this study, we evaluate the hydrological and meteorological drivers associated with mosquito biology and viral development to determine if these associations can be used to forecast seasonal mosquito infection rates with WNV in the Coachella Valley of California. We developed and tested a spatially resolved ensemble forecast model of the WNV mosquito infection rate in the Coachella Valley using 17 years of mosquito surveillance data and North American Land Data Assimilation System-2 environmental data. Our multi-model inference system indicated that the combination of a cooler and dryer winter, followed by a wetter and warmer spring, and a cooler than normal summer was most predictive of the prevalence of West Nile positive mosquitoes in the Coachella Valley. The ability to make accurate early season predictions of West Nile risk has the potential to allow local abatement districts and public health entities to implement early season interventions such as targeted adulticiding and public health messaging before human transmission occurs. Such early and targeted interventions could better mitigate the risk of WNV to humans.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 12","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agupubs.onlinelibrary.wiley.com/doi/epdf/10.1029/2023GH000855","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138547136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeohealthPub Date : 2023-11-27DOI: 10.1029/2023GH000846
Wanyanhan Jiang, Han Chen, Hongwei Li, Yuelin Zhou, Mengxue Xie, Chengchao Zhou, Lian Yang
{"title":"The Short-Term Effects and Burden of Ambient Air Pollution on Hospitalization for Type 2 Diabetes: Time-Stratified Case-Crossover Evidence From Sichuan, China","authors":"Wanyanhan Jiang, Han Chen, Hongwei Li, Yuelin Zhou, Mengxue Xie, Chengchao Zhou, Lian Yang","doi":"10.1029/2023GH000846","DOIUrl":"https://doi.org/10.1029/2023GH000846","url":null,"abstract":"<p>Type 2 diabetes mellitus (T2DM), a complicated metabolic disease, might be developed or exacerbated by air pollution, resulting in economic and health burden to patients. So far, limited studies have estimated associations between short-term exposure to air pollution and disease burden of T2DM in China. Hence, we aimed to estimate the associations and burden of ambient air pollutants (NO<sub>2</sub>, PM<sub>10</sub>, PM<sub>2.5</sub>, SO<sub>2</sub>, and CO) on hospital admissions (HAs) for T2DM using a time-stratified case-crossover design. Data on HAs for T2DM during 2017–2019 were collected from hospital electronic health records in nine cities in Sichuan Province using conditional poisson regression. Totally, 92,381 T2DM hospitalizations were recorded. There were significant short-term effects of NO<sub>2</sub>, PM<sub>10</sub>, PM<sub>2.5</sub>, SO<sub>2</sub> and CO on HAs for T2DM. A 10 μg/m<sup>3</sup> increment of NO<sub>2</sub>, PM<sub>10</sub>, PM<sub>2.5</sub>, SO<sub>2</sub> and CO as linked with a 3.39% (95% CI: 2.26%, 4.54%), 0.33% (95% CI: 0.04%, 0.62%), 0.76% (95% CI: 0.35%, 1.16%), 12.68% (95% CI: 8.14%, 17.42%) and 79.00% (95% CI: 39.81%, 129.18%) increase in HAs for T2DM at lag 6. Stratified analyses modified by age, sex, and season showed old (≥65 years) and female patients linked with higher impacts. Using WHO's air quality guidelines of NO<sub>2</sub>, PM<sub>10</sub>, PM<sub>2.5</sub>, and CO as the reference, the attributable number of T2DM HAs exceeding these pollutants exposures were 786, 323, 793, and 2,127 during 2017–2019. Besides, the total medical costs of 25.83, 10.54, 30.74, and 67.78 million China Yuan were attributed to NO<sub>2</sub>, PM<sub>10</sub>, PM<sub>2.5</sub>, and CO. In conclusion, short-term exposures to air pollutants were associated with higher risks of HAs for T2DM.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 11","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agupubs.onlinelibrary.wiley.com/doi/epdf/10.1029/2023GH000846","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138439782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prenatal Exposure to Heavy Metals and Adverse Birth Outcomes: Evidence From an E-Waste Area in China","authors":"Chen Chen, Chaochen Ma, Qiyao Li, Jin Guo Hang, Jiantong Shen, Shoji F. Nakayama, Teruhiko Kido, Yibin Lin, Hao Feng, Chau-Ren Jung, Xian Liang Sun, Jianlin Lou","doi":"10.1029/2023GH000897","DOIUrl":"https://doi.org/10.1029/2023GH000897","url":null,"abstract":"<p>Electronic waste that has not been properly treated can lead to environmental contamination including of heavy metals, which can pose risks to human health. Infants, a sensitive group, are highly susceptible to heavy metals exposure. The aim of this study was to investigate the association between prenatal heavy metal exposure and infant birth outcomes in an e-waste recycling area in China. We analyzed cadmium (Cd), chromium (Cr), manganese (Mn), lead (Pb), copper (Cu), and arsenic (As) concentrations in 102 human milk samples collected 4 weeks after delivery. The results showed that 34.3% of participants for Cr, which exceeds the World Health Organization (WHO) guidelines, as well as the mean exposure of Cr exceeded the WHO guidelines. We collected data on the birth weight (BW) and length of infants and analyzed the association between metal concentration in human milk and birth outcomes using multivariable linear regression. We observed a significant negative association between the Cd concentration in maternal milk and BW in female infants (<i>β</i> = −162.72, 95% CI = −303.16, −22.25). In contrast, heavy metals did not associate with birth outcomes in male infants. In this study, we found that 34.3% of participants in an e-waste recycling area had a Cr concentration that exceeded WHO guidelines, and there was a significant negative association between prenatal exposure to the Cd and infant BW in females. These results suggest that prenatal exposure to heavy metals in e-waste recycling areas may lead to adverse birth outcomes, especially for female infants.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 11","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agupubs.onlinelibrary.wiley.com/doi/epdf/10.1029/2023GH000897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138439843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urban Versus Lake Impacts on Heat Stress and Its Disparities in a Shoreline City","authors":"TC. Chakraborty, Jiali Wang, Yun Qian, William Pringle, Zhao Yang, Pengfei Xue","doi":"10.1029/2023GH000869","DOIUrl":"https://doi.org/10.1029/2023GH000869","url":null,"abstract":"<p>Shoreline cities are influenced by both urban-scale processes and land-water interactions, with consequences on heat exposure and its disparities. Heat exposure studies over these cities have focused on air and skin temperature, even though moisture advection from water bodies can also modulate heat stress. Here, using an ensemble of model simulations covering Chicago, we find that Lake Michigan strongly reduces heat exposure (2.75°C reduction in maximum average air temperature in Chicago) and heat stress (maximum average wet bulb globe temperature reduced by 0.86°C) during the day, while urbanization enhances them at night (2.75 and 1.57°C increases in minimum average air and wet bulb globe temperature, respectively). We also demonstrate that urban and lake impacts on temperature (particularly skin temperature), including their extremes, and lake-to-land gradients, are stronger than the corresponding impacts on heat stress, partly due to humidity-related feedback. Likewise, environmental disparities across community areas in Chicago seen for skin temperature are much higher (1.29°C increase for maximum average values per $10,000 higher median income per capita) than disparities in air temperature (0.50°C increase) and wet bulb globe temperature (0.23°C increase). The results call for consistent use of physiologically relevant heat exposure metrics to accurately capture the public health implications of urbanization.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 11","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agupubs.onlinelibrary.wiley.com/doi/epdf/10.1029/2023GH000869","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138432084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeohealthPub Date : 2023-11-17DOI: 10.1029/2023GH000906
Karen M. Holcomb, J. Erin Staples, Randall J. Nett, Charles B. Beard, Lyle R. Petersen, Stanley G. Benjamin, Benjamin W. Green, Hunter Jones, Michael A. Johansson
{"title":"Multi-Model Prediction of West Nile Virus Neuroinvasive Disease With Machine Learning for Identification of Important Regional Climatic Drivers","authors":"Karen M. Holcomb, J. Erin Staples, Randall J. Nett, Charles B. Beard, Lyle R. Petersen, Stanley G. Benjamin, Benjamin W. Green, Hunter Jones, Michael A. Johansson","doi":"10.1029/2023GH000906","DOIUrl":"https://doi.org/10.1029/2023GH000906","url":null,"abstract":"<p>West Nile virus (WNV) is the leading cause of mosquito-borne illness in the continental United States (CONUS). Spatial heterogeneity in historical incidence, environmental factors, and complex ecology make prediction of spatiotemporal variation in WNV transmission challenging. Machine learning provides promising tools for identification of important variables in such situations. To predict annual WNV neuroinvasive disease (WNND) cases in CONUS (2015–2021), we fitted 10 probabilistic models with variation in complexity from naïve to machine learning algorithm and an ensemble. We made predictions in each of nine climate regions on a hexagonal grid and evaluated each model's predictive accuracy. Using the machine learning models (random forest and neural network), we identified the relative importance and variation in ranking of predictors (historical WNND cases, climate anomalies, human demographics, and land use) across regions. We found that historical WNND cases and population density were among the most important factors while anomalies in temperature and precipitation often had relatively low importance. While the relative performance of each model varied across climatic regions, the magnitude of difference between models was small. All models except the naïve model had non-significant differences in performance relative to the baseline model (negative binomial model fit per hexagon). No model, including the ensemble or more complex machine learning models, outperformed models based on historical case counts on the hexagon or region level; these models are good forecasting benchmarks. Further work is needed to assess if predictive capacity can be improved beyond that of these historical baselines.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 11","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agupubs.onlinelibrary.wiley.com/doi/epdf/10.1029/2023GH000906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134808153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeohealthPub Date : 2023-11-13DOI: 10.1029/2023GH000853
N. M. Rametov, M. Steiner, N. A. Bizhanova, Z. Zh. Abdel, D. T. Yessimseit, B. Z. Abdeliyev, R. S. Mussagalieva
{"title":"Mapping Plague Risk Using Super Species Distribution Models and Forecasts for Rodents in the Zhambyl Region, Kazakhstan","authors":"N. M. Rametov, M. Steiner, N. A. Bizhanova, Z. Zh. Abdel, D. T. Yessimseit, B. Z. Abdeliyev, R. S. Mussagalieva","doi":"10.1029/2023GH000853","DOIUrl":"10.1029/2023GH000853","url":null,"abstract":"<p>One of the most extensive natural plague centers, or foci, is located in Central Asia, in particular, the Zhambyl region in Southern Kazakhstan. Here, we conducted plague surveillance from 2000 to 2020 in the Zhambyl region in Kazakhstan and confirmed 3,072 cases of infected wild animals. We used Species Distribution Modeling by employing MaxEnt, and identified that the natural plague foci are primarily located in the Moiynqum, Betpaqdala, and Tauqum Deserts. The Zhambyl region's central part, including the Moiynqum and Sarysu districts, has a high potential risk of plague outbreak for the rural towns and villages. Since the phenomenon of climate change has been identified as a determinant that affects the rodent populations, thereby elevating the likelihood of an outbreak of plague, we investigated the potential dissemination routes of the disease under the changing climate conditions, thus creating Species Distribution Forecasts for the rodent species in southern part of Kazakhstan for the year 2100. By 2100, in case of increasing temperatures, the range of host species is likely to expand, leading to a higher risk of plague outbreaks. The highest risk of disease transmission can be expected at the outer limits of the modeled total distribution range, where infection rates are high, but antibody presence is low, making many species susceptible to the pathogen. To mitigate the risk of a potential plague outbreak, it is necessary to implement appropriate sanitary-epidemiological measures and climate mitigation policies.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 11","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeohealthPub Date : 2023-11-03DOI: 10.1029/2023GH000877
Yuqing Mao, Mohamed Zeineldin, Moiz Usmani, Antarpreet Jutla, Joanna L. Shisler, Rachel J. Whitaker, Thanh H. Nguyen
{"title":"Local and Environmental Reservoirs of Salmonella enterica After Hurricane Florence Flooding","authors":"Yuqing Mao, Mohamed Zeineldin, Moiz Usmani, Antarpreet Jutla, Joanna L. Shisler, Rachel J. Whitaker, Thanh H. Nguyen","doi":"10.1029/2023GH000877","DOIUrl":"10.1029/2023GH000877","url":null,"abstract":"<p>In many regions of the world, including the United States, human and animal fecal genetic markers have been found in flood waters. In this study, we use high-resolution whole genomic sequencing to examine the origin and distribution of <i>Salmonella enterica</i> after the 2018 Hurricane Florence flooding. We specifically asked whether <i>S. enterica</i> isolated from water samples collected near swine farms in North Carolina shortly after Hurricane Florence had evidence of swine origin. To investigate this, we isolated and fully sequenced 18 independent <i>S. enterica</i> strains from 10 locations (five flooded and five unflooded). We found that all strains have extremely similar chromosomes with only five single nucleotide polymorphisms (SNPs) and possessed two plasmids assigned bioinformatically to the incompatibility groups IncFIB and IncFII. The chromosomal core genome and the IncFIB plasmid are most closely related to environmental <i>Salmonella</i> strains isolated previously from the southeastern US. In contrast, the IncFII plasmid was found in environmental <i>S. enterica</i> strains whose genomes were more divergent, suggesting the IncFII plasmid is more promiscuous than the IncFIB type. We identified 65 antibiotic resistance genes (ARGs) in each of our 18 <i>S. enterica</i> isolates. All ARGs were located on the <i>Salmonella</i> chromosome, similar to other previously characterized environmental isolates. All isolates with different SNPs were resistant to a panel of commonly used antibiotics. These results highlight the importance of environmental sources of antibiotic-resistant <i>S. enterica</i> after extreme flood events.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 11","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeohealthPub Date : 2023-10-31DOI: 10.1029/2023GH000874
Curtis D. Davis, Clara Frazier, Nihal Guennouni, Rachael King, Hannah Mast, Emily M. Plunkett, Zack J. Quirk
{"title":"Community Health Impacts From Natural Gas Pipeline Compressor Stations","authors":"Curtis D. Davis, Clara Frazier, Nihal Guennouni, Rachael King, Hannah Mast, Emily M. Plunkett, Zack J. Quirk","doi":"10.1029/2023GH000874","DOIUrl":"10.1029/2023GH000874","url":null,"abstract":"<p>Compressor stations maintain pressure along natural gas pipelines to sustain gas flow. Unfortunately, they present human health concerns as they release chemical pollutants into the air, sometimes at levels higher than national air quality standards. Further, compressor stations are often placed in rural areas with higher levels of poverty and/or minority populations, contributing to environmental justice concerns. In this paper we investigate what chemical pollutants are emitted by compressor stations, the impacts of emitted pollutants on human health, and local community impacts. Based on the information gained from these examinations, we provide the following policy recommendations with the goal of minimizing harm to those affected by natural gas compressor stations: the Environmental Protection Agency (EPA) and relevant state agencies must increase air quality monitoring and data transparency; the EPA should direct more resources to monitoring programs specifically at compressor stations; the EPA should provide free indoor air quality monitoring to homes near compressor stations; the EPA needs to adjust its National Ambient Air Quality Standards to better protect communities and assess cumulative impacts; and decision-makers at all levels must pursue meaningful involvement from potentially affected communities. We find there is substantial evidence of negative impacts to strongly support these recommendations.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 11","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeohealthPub Date : 2023-10-25DOI: 10.1029/2023GH000887
Farhan Saleem, Wenxia Zhang, Saadia Hina, Xiaodong Zeng, Irfan Ullah, Tehmina Bibi, Dike Victor Nnamdi
{"title":"Population Exposure Changes to Mean and Extreme Climate Events Over Pakistan and Associated Mechanisms","authors":"Farhan Saleem, Wenxia Zhang, Saadia Hina, Xiaodong Zeng, Irfan Ullah, Tehmina Bibi, Dike Victor Nnamdi","doi":"10.1029/2023GH000887","DOIUrl":"10.1029/2023GH000887","url":null,"abstract":"<p>The increasing prevalence of warmer trends and climate extremes exacerbate the population's exposure to urban settlements. This work investigated population exposure changes to mean and extreme climate events in different Agro-Ecological Zones (AEZs) of Pakistan and associated mechanisms (1979−2020). Spatiotemporal trends in mean and extreme temperatures revealed significant warming mainly over northern, northeastern, and southern AEZs. In contrast, mean-to-extreme precipitation changes showed non-uniform patterns with a significant increase in the northeast AEZs. Population exposure to mean (extreme) temperature and precipitation events increased two-fold during 2000–2020. The AEZs in urban settlements (i.e., Indus Delta, Northern Irrigated Plain, and Barani/Rainfall) show a maximum exposure to extreme temperatures of about 70–100 × 10<sup>6</sup> (person-days) in the reference period (1979−1999), which increases to 140–200 × 10<sup>6</sup> person-days in the recent period (2000−2020). In addition, the highest exposure to extreme precipitation days also increases to 40–200 × 10<sup>6</sup> person-days during 2000–2020 than 1979−1999 (20–100 × 10<sup>6</sup>) person-days. Relative changes in exposure are large (60%–90%) for the AEZs across northeast Pakistan, justifying the spatial population patterns over these zones. Overall, the observed changes in exposure are primarily attributed to the climate effect (50%) over most AEZs except Northern Irrigated Plain for R10 and R20 events, where the interaction effect takes the lead. The population exposure rapidly increased over major AEZs of Pakistan, which could be more vulnerable to extreme events due to rapid urbanization and population growth in the near future.</p>","PeriodicalId":48618,"journal":{"name":"Geohealth","volume":"7 10","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10599709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}