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Fonseca Rodriguez, O., Sheridan, S., Häggström Lundevaller, E. & Schumann, B. (2020). Hot and cold weather based on the spatial synoptic classification and cause-specific mortality in Sweden: a time-stratified case-crossover study. International journal of biometeorology
Open this publication in new window or tab >>Hot and cold weather based on the spatial synoptic classification and cause-specific mortality in Sweden: a time-stratified case-crossover study
2020 (English)In: International journal of biometeorology, ISSN 0020-7128, E-ISSN 1432-1254Article in journal (Refereed) Epub ahead of print
Abstract [en]

The spatial synoptic classification (SSC) is a holistic categorical assessment of the daily weather conditions at specific locations; it is a useful tool for assessing weather effects on health. In this study, we assessed (a) the effect of hot weather types and the duration of heat events on cardiovascular and respiratory mortality in summer and (b) the effect of cold weather types and the duration of cold events on cardiovascular and respiratory mortality in winter. A time-stratified case-crossover design combined with a distributed lag nonlinear model was carried out to investigate the association of weather types with cause-specific mortality in two southern (Skåne and Stockholm) and two northern (Jämtland and Västerbotten) locations in Sweden. During summer, in the southern locations, the Moist Tropical (MT) and Dry Tropical (DT) weather types increased cardiovascular and respiratory mortality at shorter lags; both hot weather types substantially increased respiratory mortality mainly in Skåne. The impact of heat events on mortality by cardiovascular and respiratory diseases was more important in the southern than in the northern locations at lag 0. The cumulative effect of MT, DT and heat events lagged over 14 days was particularly high for respiratory mortality in all locations except in Jämtland, though these did not show a clear effect on cardiovascular mortality. During winter, the dry polar and moist polar weather types and cold events showed a negligible effect on cardiovascular and respiratory mortality. This study provides valuable information about the relationship between hot oppressive weather types with cause-specific mortality; however, the cold weather types may not capture sufficiently effects on cause-specific mortality in this sub-Arctic region.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Cardiovascular mortality, Respiratory mortality, Spatial synoptic classification, Sweden, Hot weather, Cold weather
National Category
Public Health, Global Health, Social Medicine and Epidemiology Environmental Sciences Meteorology and Atmospheric Sciences
Research subject
Epidemiology; environmental science
Identifiers
urn:nbn:se:umu:diva-170076 (URN)10.1007/s00484-020-01921-0 (DOI)000528322900001 ()
Funder
Swedish Research Council Formas, FR-2017/0009
Available from: 2020-04-24 Created: 2020-04-24 Last updated: 2020-05-11
Lena, K., Häggström Lundevaller, E. & Schumann, B. (2020). Neonatal Mortality and Temperature in Two Northern Swedish Rural Parishes, 1860–1899—The Significance of Ethnicity and Gender. International Journal of Environmental Research and Public Health, 17(4), Article ID 1216.
Open this publication in new window or tab >>Neonatal Mortality and Temperature in Two Northern Swedish Rural Parishes, 1860–1899—The Significance of Ethnicity and Gender
2020 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 4, article id 1216Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to analyze the association between season of birth and daily temperature for neonatal mortality in two Swedish rural parishes between 1860 and 1899. Further, we aimed to study whether the association varied according to ethnicity (indigenous Sami reindeer herders and non-Sami settlers) and gender. The source material for this study comprised digitized parish records from the Demographic Data Base, Umeå University, combined with local weather data provided by the Swedish Meteorological and Hydrological Institute. Using a time event-history approach, we investigated the association between daily temperature (at birth and up to 28 days after birth) and the risk of neonatal death during the coldest months (November through March). The results showed that Sami neonatal mortality was highest during winter and that the Sami neonatal mortality risk decreased with higher temperatures on the day of birth. Male neonatal risk decreased with higher temperatures during the days following birth, while no effect of temperature was observed among female neonates. We conclude that weather vulnerability differed between genders and between the indigenous and non-indigenous populations.

Place, publisher, year, edition, pages
Basel: MDPI, 2020
Keywords
neonatal mortality, temperature, seasonality, indigenous population, gender, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Historical Demography
Identifiers
urn:nbn:se:umu:diva-168105 (URN)10.3390/ijerph17041216 (DOI)000522388500092 ()32070044 (PubMedID)
Funder
Riksbankens Jubileumsfond, P17-0033:1
Available from: 2020-02-17 Created: 2020-02-17 Last updated: 2020-04-27Bibliographically approved
Fonseca Rodriguez, O., Häggström Lundevaller, E., Sheridan, S. C. & Schumann, B. (2019). Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014. International Journal of Environmental Research and Public Health, 16(10), Article ID 1696.
Open this publication in new window or tab >>Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 10, article id 1696Article in journal (Refereed) Published
Abstract [en]

Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
Spatial Synoptic Classification, Sweden, all-cause mortality, distributed lag non-linear models, oppressive weather types
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-159094 (URN)10.3390/ijerph16101696 (DOI)31091805 (PubMedID)
Funder
Swedish Research Council Formas, FR-2017/0009
Available from: 2019-05-17 Created: 2019-05-17 Last updated: 2019-07-09Bibliographically approved
Furberg, M., Anticona Huaynate, C. & Schumann, B. (2019). Post-infectious fatigue following Puumala virus infection. Infectious Diseases, 51(7), 519-526
Open this publication in new window or tab >>Post-infectious fatigue following Puumala virus infection
2019 (English)In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 51, no 7, p. 519-526Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Puumala virus infection or nephropathia epidemica (NE) is common in northern Sweden. NE causes haemorrhagic fever with renal syndrome. Most patients make a full recovery, but a convalescent phase with fatigue has been reported. Although post-infectious fatigue has been demonstrated for other viral infections, it is not well studied in relation to NE. This study assessed recovery time and levels of fatigue in former NE patients, as compared to the general population.

METHODS: NE patients diagnosed in northern Sweden between 2007 and 2011, together with a comparison sample from the general population, answered a questionnaire on demographic and health-related factors, including the Fatigue Severity Scale (FSS), and characteristics of NE infection. Self-reported recovery time was assessed, and fatigue levels were compared across the two groups by multiple linear regression, stratified by gender.

RESULTS: In total, 1132 NE patients and 915 comparison group subjects participated. Time to complete recovery was reported to exceed 3 months for 47% and 6 months for 32% of the NE patients. Recovery time differed by gender and age. NE patients had significantly higher FSS scores than the comparison group. Differences were greater among women than men, and adjustments for current illness, body mass index, smoking and current residence only slightly modified the estimates.

CONCLUSIONS: Individuals with previous NE infection show higher fatigue scores than non-infected individuals, even 5 years following the infection. Full recovery takes half a year or longer for a substantial proportion of former NE patients.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Puumala virus, nephropathia epidemica, post-infectious fatigue, recovery time, Northern Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology Infectious Medicine
Identifiers
urn:nbn:se:umu:diva-159095 (URN)10.1080/23744235.2019.1605191 (DOI)000469658200001 ()31081420 (PubMedID)
Available from: 2019-05-17 Created: 2019-05-17 Last updated: 2019-10-14Bibliographically approved
Lena, K., Häggström Lundevaller, E. & Schumann, B. (2019). Season of birth, stillbirths, and neonatal mortality in Sweden: the Sami and non-Sami population, 1800–1899. International Journal of Circumpolar Health, 78(1), Article ID 1629784.
Open this publication in new window or tab >>Season of birth, stillbirths, and neonatal mortality in Sweden: the Sami and non-Sami population, 1800–1899
2019 (English)In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 78, no 1, article id 1629784Article in journal (Refereed) Published
Abstract [en]

Seasonal patterns of neonatal mortality and stillbirths have been found around the world. However, little is known about the association between season of birth and infant mortality of pre-industrial societies in a subarctic environment. In this study, we compared how season of birth affected the neonatal and stillbirth risk among the Sami and non-Sami in Swedish Sápmi during the nineteenth century. Using digitised parish records from the Demographic Data Base at Umeå University, we applied logistic regression models for estimating the association of season of birth with stillbirths and neonatal mortality, respectively. Higher neonatal mortality was found among the winter- and autumn-born Sami, compared to summer-born infants. Stillbirth risk was higher during autumn compared to summer among the Sami, whereas we found no seasonal differences in mortality among the non-Sami population. We relate the higher neonatal mortality risk among winter-born Sami to differences in seasonality of living conditions associated with reindeer herding.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
neonatal mortality; season of birth; indigenous population, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-160496 (URN)10.1080/22423982.2019.1629784 (DOI)
Funder
Riksbankens Jubileumsfond, P0033:1
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-06-24Bibliographically approved
Lena, K., Häggström Lundevaller, E. & Schumann, B. (2019). The association between cold extremes and neonatal mortality in Swedish Sápmi from 1800–1895. Global Health Action, 12(1), Article ID 1623609.
Open this publication in new window or tab >>The association between cold extremes and neonatal mortality in Swedish Sápmi from 1800–1895
2019 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, no 1, article id 1623609Article in journal (Refereed) Published
Abstract [en]

Background: Studies in which the association between temperature and neonatal mortality (deaths during the first 28 days of life) is tracked over extended periods that cover demographic, economic and epidemiological transitions are quite limited. From previous research about the demographic transition in Swedish Sápmi, we know that infant and child mortality was generally higher among the indigenous (Sami) population compared to non-indigenous populations.

Objective: The aim of this study was to analyse the association between extreme temperatures and neonatal mortality among the Sami and non-Sami population in Swedish Sápmi (Lapland) during the nineteenth century.

Methods: Data from the Demographic Data Base, Umeå University, were used to identify neonatal deaths. We used monthly mean temperature in Tornedalen and identified cold and warm month (5th and 95th) percentiles. Monthly death counts from extreme temperatures were modelled using negative binomial regression. We computed relative risks (RR) with 95% confidence intervals (CI), adjusting for time trends and seasonality.

Results: Overall, the neonatal mortality rate was higher among Sami compared to non-Sami infants (62/1,000 vs 35/1,000 live births), although the differences between the two populations decreased after 1860. For the Sami population prior 1860, the results revealed a higher neonatal incidence rate during cold winter months (< -15.4 °C, RR=1.60, CI 1.14–2.23) compared to infants born during months of medium temperature). No association was found between extreme cold months and neonatal mortality for non-Sami populations. Warm months (+15.1 °C) had no impact on Sami or non-Sami populations.

Conclusions: This study revealed the role of environmental factors (temperature extremes) on infant health during the demographic transition where cold extremes mainly affected the Sami population. Ethnicity and living conditions contributed to differential weather vulnerability.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
neonatal mortality, temperature, seasonality, preindustrial societies, indigenous populations, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Historical Demography
Identifiers
urn:nbn:se:umu:diva-159307 (URN)10.1080/16549716.2019.1623609 (DOI)000472604700001 ()
Funder
Riksbankens Jubileumsfond, P17-0033:1
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-07-12Bibliographically approved
Bashir, F., Ba Wazir, M., Schumann, B. & Lindvall, K. (2019). The realities of HIV prevention. A closer look at facilitators and challenges faced by HIV prevention programmes in Sudan and Yemen. Global Health Action, 12(1), Article ID 1659098.
Open this publication in new window or tab >>The realities of HIV prevention. A closer look at facilitators and challenges faced by HIV prevention programmes in Sudan and Yemen
2019 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, no 1, article id 1659098Article in journal (Refereed) Published
Abstract [en]

Background: HIV/AIDS prevention has historically encountered many obstacles. Understanding the factors affecting HIV/AIDS prevention is central to designing and implementing suitable context-specific interventions. Research relating to HIV prevention in the Middle East and North African region is required to address the gradually increasing HIV epidemic.

Objective: This study aimed to explore the perspectives of employees/health care professionals who are working or have worked within HIV prevention in Sudan and Yemen on the challenges and facilitating factors facing HIV prevention.

Methods: A qualitative approach was employed using an open-ended questionnaire. Sixteen stakeholders from governmental and non-governmental agencies participated in the study. The questionnaire focused on the various challenges and facilitating factors facing HIV prevention as well as proposed possible solutions from the perspectives of the participants. The data were analysed using thematic analysis.

Results: The study illustrated the similarities in context and HIV prevention systems between Sudan and Yemen. Thematic analysis resulted in three main themes: I) much is achieved despite difficulties; II) a programme left to be paralysed; this theme addressed the main obstacles facing HIV prevention in Sudan and Yemen generating a total of six sub-themes; III) comprehensive change is needed. The participants drew focus and attention to vital changes required to improve the delivery of HIV prevention services. Conclusion: Increased financial support for HIV prevention in Sudan and Yemen is urgently needed. De-stigmatisation and increased political support, advocacy and improved legislation for people living with HIV (PLHIV) are required for the sustainability and effectiveness of HIV prevention programmes in Sudan and Yemen. Civil society organisations must be aided and supported in their role in engaging key populations.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
HIV, Sudan, Yemen, prevention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-167390 (URN)10.1080/16549716.2019.1659098 (DOI)000508196600001 ()31496422 (PubMedID)2-s2.0-85071964694 (Scopus ID)
Available from: 2020-01-17 Created: 2020-01-17 Last updated: 2020-03-02Bibliographically approved
Schumann, B., Häggström Lundevaller, E. & Lena, K. (2019). Weather extremes and perinatal mortality - Seasonal and ethnic differences in northern Sweden, 1800-1895. PLoS ONE, 14(10), Article ID e0223538.
Open this publication in new window or tab >>Weather extremes and perinatal mortality - Seasonal and ethnic differences in northern Sweden, 1800-1895
2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 10, article id e0223538Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Many studies have shown the impact of heat and cold on total and age-specific mortality, but knowledge gaps remain regarding weather vulnerability of very young infants. This study assessed the association of temperature extremes with perinatal mortality (stillbirths and deaths in the first week of life), among two ethnic groups in pre-industrial northern Sweden.

METHODS: We used population data of indigenous Sami and non-Sami in selected parishes of northern Sweden, 1800-1895, and monthly temperature data. Multiple logistic regression models were conducted to estimate the association of cold (<10th percentile of temperature) and warmth (>90th percentile) in the month of birth with perinatal mortality, adjusted for cold and warmth in the month prior birth and period, stratified by season and ethnicity.

RESULTS: Perinatal mortality was slightly higher in Sami than in non-Sami (46 vs. 42 / 1000 live and stillbirths), but showed large variations across the region and over time. Both groups saw the highest perinatal mortality in autumn. For Sami, winter was a high-risk time as well, while for non-Sami, seasonality was less distinct. We found an association between exposure to cold and perinatal mortality among winter-born Sami [Odds ratio (OR) 1.91, 95% confidence interval (CI) 1.26-2.92, compared to moderate temperature], while there was little effect of cold or warmth during other seasons. Non-Sami, meanwhile, were affected in summer by warmth (OR 0.20, CI 0.05-0.81), and in autumn by cold (OR 0.39, CI 0.19-0.82).

CONCLUSIONS: In this pre-industrial, subarctic setting, the indigenous Sami's perinatal mortality was influenced by extreme cold in winter, while non-Sami seemed to benefit from high temperature in summer and low temperature in autumn. Climate vulnerability of these two ethnic groups sharing the same environment was shaped by their specific lifestyles and living conditions.

Place, publisher, year, edition, pages
PLOS, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-165076 (URN)10.1371/journal.pone.0223538 (DOI)31639133 (PubMedID)2-s2.0-85073743418 (Scopus ID)
Available from: 2019-11-08 Created: 2019-11-08 Last updated: 2019-11-26Bibliographically approved
Schumann, B., Kinsman, J. & Lindvall, K. (2018). ClimRef project – Resilient public health in the context of large-scale, drought-related migration in East Africa: Knowledge status and knowledge needs: Ethiopia country report.
Open this publication in new window or tab >>ClimRef project – Resilient public health in the context of large-scale, drought-related migration in East Africa: Knowledge status and knowledge needs: Ethiopia country report
2018 (English)Report (Other academic)
Publisher
p. 24
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162172 (URN)
Available from: 2019-08-15 Created: 2019-08-15 Last updated: 2019-08-16Bibliographically approved
Schumann, B., Kinsman, J. & Lindvall, K. (2018). ClimRef project – Resilient public health in the context of large-scale, drought-related migration in East Africa: Knowledge status and knowledge needs: Kenya country report.
Open this publication in new window or tab >>ClimRef project – Resilient public health in the context of large-scale, drought-related migration in East Africa: Knowledge status and knowledge needs: Kenya country report
2018 (English)Report (Other academic)
Publisher
p. 25
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162171 (URN)
Available from: 2019-08-15 Created: 2019-08-15 Last updated: 2019-08-16Bibliographically approved
Projects
Climate, social and demographic change and disease in Sweden during three hundred years [P12-1312:1_RJ]; Umeå UniversityWhat´s the weather got to do with it? - Infant mortality in Northern Sweden during the demographic transition [P17-0033:1_RJ]; Umeå University; Publications
Lena, K., Häggström Lundevaller, E. & Schumann, B. (2019). The association between cold extremes and neonatal mortality in Swedish Sápmi from 1800–1895. Global Health Action, 12(1), Article ID 1623609.
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9722-0370

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