Micheline Coelho - Academia.edu (original) (raw)

Papers by Micheline Coelho

Heat-related mortality has been identified as one of the key climate extremes posing a risk to hu... more Heat-related mortality has been identified as one of the key climate extremes posing a risk to human health. Current research focuses largely on how heat mortality increases with mean global temperature rise, but it is unclear how much climate change will increase the frequency and severity of extreme summer seasons with high impact on human health. In this probabilistic analysis, we combined empirical heat-mortality relationships for 748 locations from 47 countries with climate model large ensemble data to identify probable past and future highly impactful summer seasons. Across most locations, heat mortality counts of a 1-in-100 year season in the climate of 2000 would be expected once every ten to twenty years in the climate of 2020. These return periods are projected to further shorten under warming levels of 1.5°C and 2°C, where heat-mortality extremes of the past climate will eventually become commonplace if no adaptation occurs. Our findings highlight the urgent need for stro...

ANAIS DA ACADEMIA NACIONAL DE MEDICINA

O acúmulo de gases com longo tempo de permanência na atmosfera, como CO2 e metano, constrói um ma... more O acúmulo de gases com longo tempo de permanência na atmosfera, como CO2 e metano, constrói um manto de retenção de calor que vem promovendo o aquecimento progressivo da Terra. As projeções feitas indicam um cenário de aumento das áreas desertificadas, de salinificação dos aquíferos terrestres por elevação do nível dos oceanos pelo derretimento de geleiras e episódios graves de anomalias climáticas como secas, chuvas extremas e ciclones. A saúde humana será afetada por vários fatores decorrentes dos eventos acima apontados, com insegurança alimentar, deslocamentos de populações pela desertificação, aumento dos casos de doenças transmitidas por insetos vetores (malária, dengue, febre amarela, por exemplo) e por via hídrica (diarréias infecciosas). Nas cidades, dada a construção de desertos de concreto e asfalto, as mudanças climáticas são acentuadas pelas ilhas de calor urbano. O presente estuda focaliza especificamente as mudanças do clima urbano sobre a saúde humana. Este é o momen...

Science of The Total Environment

Epidemiology and Psychiatric Sciences, 2020

Aims We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geogra... more Aims We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations. Methods Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986–2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression. Results We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The...

Environment International

Journal of Environmental and Public Health, 2010

This study is aimed at creating a stochastic model, named Brazilian Climate and Health Model (BCH... more This study is aimed at creating a stochastic model, named Brazilian Climate and Health Model (BCHM), through Poisson regression, in order to predict the occurrence of hospital respiratory admissions (for children under thirteen years of age) as a function of air pollutants, meteorological variables, and thermal comfort indices (effective temperatures, ET). The data used in this study were obtained from the city of São Paulo, Brazil, between 1997 and 2000. The respiratory tract diseases were divided into three categories: URI (Upper Respiratory tract diseases), LRI (Lower Respiratory tract diseases), and IP (Influenza and Pneumonia). The overall results of URI, LRI, and IP show clear correlation withSO2and CO,PM10andO3, andPM10, respectively, and the ETw4 (Effective Temperature) for all the three disease groups. It is extremely important to warn the government of the most populated city in Brazil about the outcome of this study, providing it with valuable information in order to help...

International Journal of Environmental Health Research, 2011

In this work we correlated dengue cases with climatic variables for the city of Singapore. This w... more In this work we correlated dengue cases with climatic variables for the city of Singapore. This was done through a Poisson Regression Model (PRM) that considers dengue cases as the dependent variable and the climatic variables (rainfall, maximum and minimum temperature and relative humidity) as independent variables. We also used Principal Components Analysis (PCA) to choose the variables that influence in the increase of the number of dengue cases in Singapore, where PC 1 (Principal component 1) is represented by temperature and rainfall and PC 2 (Principal component 2) is represented by relative humidity. We calculated the probability of occurrence of new cases of dengue and the relative risk of occurrence of dengue cases influenced by climatic variable. The months from July to September showed the highest probabilities of the occurrence of new cases of the disease throughout the year. This was based on an analysis of time series of maximum and minimum temperature. An interesting result was that for every 2-108C of variation of the maximum temperature, there was an average increase of 22.2-184.6% in the number of dengue cases. For the minimum temperature, we observed that for the same variation, there was an average increase of 26.1-230.3% in the number of the dengue cases from April to August. The precipitation and the relative humidity, after analysis of correlation, were discarded in the use of Poisson Regression Model because they did not present good correlation with the dengue cases. Additionally, the relative risk of the occurrence of the cases of the disease under the influence of the variation of temperature was from 1.2-2.8 for maximum temperature and increased from 1.3-3.3 for minimum temperature. Therefore, the variable temperature (maximum and minimum) was the best predictor for the increased number of dengue cases in Singapore.

The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry, Oct 18, 2017

Clozapine (CZ) is the most effective drug for managing treatment-resistant schizophrenic disorder... more Clozapine (CZ) is the most effective drug for managing treatment-resistant schizophrenic disorders. Its use has been limited due to adverse effects, which include weight gain and new-onset diabetes, but the incidence of these varies between patients. We investigated 187 Clozapine Clinic patients (of whom 137 consented for genotyping) for the presence of CYP2C19*17 and its association with CZ and norclozapine (NCZ) levels, and clinical outcomes. Thirty-nine percent of genotyped patients were carriers of the CYP2C 19*17 polymorphism. This group demonstrated significantly higher NCZ serum levels, and significantly lower fasting glucose (5.66 ± 1.19 vs 6.72 ± 3.01 mmol/l, P = 0.009) and Hb1Ac (35.36 ± 4.78 vs 49.40 ± 20.60 mmol/mol, P = 0.006) levels compared to non-carriers of this polymorphism. CZ-treated patients with CYP2C19*17/*17 had a significantly lower prevalence of diabetes as well as a higher likelihood of clinical improvement of their schizophrenia, compared to those without...

Introduction: The evidence is limited for the impacts of temperature variability (TV) within or b... more Introduction: The evidence is limited for the impacts of temperature variability (TV) within or between days on mortality. In this study, we applied a novel method to calculate TV, and investigated...

ISEE Conference Abstracts, 2021

Background Heat exposure, which will increase with global warming, has been linked to increased r... more Background Heat exposure, which will increase with global warming, has been linked to increased risk of a range of types of cause-specific hospitalizations. However, little is known about socioeconomic disparities in vulnerability to heat. We aimed to evaluate whether there were socioeconomic disparities in vulnerability to heat-related all-cause and cause-specific hospitalization among Brazilian cities. Methods and findings We collected daily hospitalization and weather data in the hot season (city-specific 4 adjacent hottest months each year) during 2000–2015 from 1,814 Brazilian cities covering 78.4% of the Brazilian population. A time-stratified case-crossover design modeled by quasi-Poisson regression and a distributed lag model was used to estimate city-specific heat–hospitalization association. Then meta-analysis was used to synthesize city-specific estimates according to different socioeconomic quartiles or levels. We included 49 million hospitalizations (58.5% female; media...

Many of the thermal comfort studies are carried on in areas were the seasons are marked by a decr... more Many of the thermal comfort studies are carried on in areas were the seasons are marked by a decrease of the temperature. Considering that, the necessity of a better understanding of how do the people living in regions with sub-tropical climate and high temperature variations feel and response about this kind of variation. The individual thermal comfort or upset perception is related with the metabolic heat production. With the aim of maintain the vital organic functions, this heat is transferred to the surroundings, resulting a psychologic impression and a corporal temperature. This heat transfer is influenced by environmental factors like air temperature, thermal radiation, air speed and humidity, and by individual factors like physical activity and clothing. Those variables, associated with biometeorologic indexes developed for thermal confort classification, contribute to the empiric classification of the human thermal impression. This study makes a comparative analyses of two d...

BackgroundAttributable mortality risk for heat and cold has been investigated in Europe and North... more BackgroundAttributable mortality risk for heat and cold has been investigated in Europe and North America. However, none so far has provided estimates for Latin American, with a whole temperature r...

Environment International

ISEE Conference Abstracts

The Lancet Planetary Health

Environmental Health Perspectives

BACKGROUND: Previous literature suggests that higher ambient temperature may play a role in incre... more BACKGROUND: Previous literature suggests that higher ambient temperature may play a role in increasing the risk of suicide. However, no multicountry study has explored the shape of the association and the role of moderate and extreme heat across different locations. OBJECTIVES: We examined the short-term temperature-suicide relationship using daily time-series data collected for 341 locations in 12 countries for periods ranging from 4 to 40 y. METHODS: We conducted a two-stage meta-analysis. First, we performed location-specific time-stratified case-crossover analyses to examine the temperature-suicide association for each location. Then, we used a multivariate meta-regression to combine the location-specific lag-cumulative nonlinear associations across all locations and by country. RESULTS: A total of 1,320,148 suicides were included in this study. Higher ambient temperature was associated with an increased risk of suicide in general, and we observed a nonlinear association (inverted J-shaped curve) with the highest risk at 27°C. The relative risk (RR) for the highest risk was 1.33 (95% CI: 1.30, 1.36) compared with the risk at the first percentile. Country-specific results showed that the nonlinear associations were more obvious in northeast Asia (Japan, South Korea, and Taiwan). The temperature with the highest risk of suicide ranged from the 87th to 88th percentiles in the northeast Asian countries, whereas this value was the 99th percentile in Western countries (Canada, Spain, Switzerland, the UK, and the United States) and South Africa, where nearly linear associations were estimated. The country-specific RRs ranged from 1.31 (95% CI: 1.19, 1.44) in the United States to 1.65 (95% CI: 1.40, 1.93) in Taiwan, excluding countries where the results were substantially uncertain. DISCUSSION: Our findings showed that the risk of suicide increased with increasing ambient temperature in many countries, but to varying extents and not necessarily linearly. This temperature-suicide association should be interpreted cautiously, and further evidence of the relationship and modifying factors is needed.

Heat-related mortality has been identified as one of the key climate extremes posing a risk to hu... more Heat-related mortality has been identified as one of the key climate extremes posing a risk to human health. Current research focuses largely on how heat mortality increases with mean global temperature rise, but it is unclear how much climate change will increase the frequency and severity of extreme summer seasons with high impact on human health. In this probabilistic analysis, we combined empirical heat-mortality relationships for 748 locations from 47 countries with climate model large ensemble data to identify probable past and future highly impactful summer seasons. Across most locations, heat mortality counts of a 1-in-100 year season in the climate of 2000 would be expected once every ten to twenty years in the climate of 2020. These return periods are projected to further shorten under warming levels of 1.5°C and 2°C, where heat-mortality extremes of the past climate will eventually become commonplace if no adaptation occurs. Our findings highlight the urgent need for stro...

ANAIS DA ACADEMIA NACIONAL DE MEDICINA

O acúmulo de gases com longo tempo de permanência na atmosfera, como CO2 e metano, constrói um ma... more O acúmulo de gases com longo tempo de permanência na atmosfera, como CO2 e metano, constrói um manto de retenção de calor que vem promovendo o aquecimento progressivo da Terra. As projeções feitas indicam um cenário de aumento das áreas desertificadas, de salinificação dos aquíferos terrestres por elevação do nível dos oceanos pelo derretimento de geleiras e episódios graves de anomalias climáticas como secas, chuvas extremas e ciclones. A saúde humana será afetada por vários fatores decorrentes dos eventos acima apontados, com insegurança alimentar, deslocamentos de populações pela desertificação, aumento dos casos de doenças transmitidas por insetos vetores (malária, dengue, febre amarela, por exemplo) e por via hídrica (diarréias infecciosas). Nas cidades, dada a construção de desertos de concreto e asfalto, as mudanças climáticas são acentuadas pelas ilhas de calor urbano. O presente estuda focaliza especificamente as mudanças do clima urbano sobre a saúde humana. Este é o momen...

Science of The Total Environment

Epidemiology and Psychiatric Sciences, 2020

Aims We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geogra... more Aims We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations. Methods Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986–2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression. Results We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The...

Environment International

Journal of Environmental and Public Health, 2010

This study is aimed at creating a stochastic model, named Brazilian Climate and Health Model (BCH... more This study is aimed at creating a stochastic model, named Brazilian Climate and Health Model (BCHM), through Poisson regression, in order to predict the occurrence of hospital respiratory admissions (for children under thirteen years of age) as a function of air pollutants, meteorological variables, and thermal comfort indices (effective temperatures, ET). The data used in this study were obtained from the city of São Paulo, Brazil, between 1997 and 2000. The respiratory tract diseases were divided into three categories: URI (Upper Respiratory tract diseases), LRI (Lower Respiratory tract diseases), and IP (Influenza and Pneumonia). The overall results of URI, LRI, and IP show clear correlation withSO2and CO,PM10andO3, andPM10, respectively, and the ETw4 (Effective Temperature) for all the three disease groups. It is extremely important to warn the government of the most populated city in Brazil about the outcome of this study, providing it with valuable information in order to help...

International Journal of Environmental Health Research, 2011

In this work we correlated dengue cases with climatic variables for the city of Singapore. This w... more In this work we correlated dengue cases with climatic variables for the city of Singapore. This was done through a Poisson Regression Model (PRM) that considers dengue cases as the dependent variable and the climatic variables (rainfall, maximum and minimum temperature and relative humidity) as independent variables. We also used Principal Components Analysis (PCA) to choose the variables that influence in the increase of the number of dengue cases in Singapore, where PC 1 (Principal component 1) is represented by temperature and rainfall and PC 2 (Principal component 2) is represented by relative humidity. We calculated the probability of occurrence of new cases of dengue and the relative risk of occurrence of dengue cases influenced by climatic variable. The months from July to September showed the highest probabilities of the occurrence of new cases of the disease throughout the year. This was based on an analysis of time series of maximum and minimum temperature. An interesting result was that for every 2-108C of variation of the maximum temperature, there was an average increase of 22.2-184.6% in the number of dengue cases. For the minimum temperature, we observed that for the same variation, there was an average increase of 26.1-230.3% in the number of the dengue cases from April to August. The precipitation and the relative humidity, after analysis of correlation, were discarded in the use of Poisson Regression Model because they did not present good correlation with the dengue cases. Additionally, the relative risk of the occurrence of the cases of the disease under the influence of the variation of temperature was from 1.2-2.8 for maximum temperature and increased from 1.3-3.3 for minimum temperature. Therefore, the variable temperature (maximum and minimum) was the best predictor for the increased number of dengue cases in Singapore.

The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry, Oct 18, 2017

Clozapine (CZ) is the most effective drug for managing treatment-resistant schizophrenic disorder... more Clozapine (CZ) is the most effective drug for managing treatment-resistant schizophrenic disorders. Its use has been limited due to adverse effects, which include weight gain and new-onset diabetes, but the incidence of these varies between patients. We investigated 187 Clozapine Clinic patients (of whom 137 consented for genotyping) for the presence of CYP2C19*17 and its association with CZ and norclozapine (NCZ) levels, and clinical outcomes. Thirty-nine percent of genotyped patients were carriers of the CYP2C 19*17 polymorphism. This group demonstrated significantly higher NCZ serum levels, and significantly lower fasting glucose (5.66 ± 1.19 vs 6.72 ± 3.01 mmol/l, P = 0.009) and Hb1Ac (35.36 ± 4.78 vs 49.40 ± 20.60 mmol/mol, P = 0.006) levels compared to non-carriers of this polymorphism. CZ-treated patients with CYP2C19*17/*17 had a significantly lower prevalence of diabetes as well as a higher likelihood of clinical improvement of their schizophrenia, compared to those without...

Introduction: The evidence is limited for the impacts of temperature variability (TV) within or b... more Introduction: The evidence is limited for the impacts of temperature variability (TV) within or between days on mortality. In this study, we applied a novel method to calculate TV, and investigated...

ISEE Conference Abstracts, 2021

Background Heat exposure, which will increase with global warming, has been linked to increased r... more Background Heat exposure, which will increase with global warming, has been linked to increased risk of a range of types of cause-specific hospitalizations. However, little is known about socioeconomic disparities in vulnerability to heat. We aimed to evaluate whether there were socioeconomic disparities in vulnerability to heat-related all-cause and cause-specific hospitalization among Brazilian cities. Methods and findings We collected daily hospitalization and weather data in the hot season (city-specific 4 adjacent hottest months each year) during 2000–2015 from 1,814 Brazilian cities covering 78.4% of the Brazilian population. A time-stratified case-crossover design modeled by quasi-Poisson regression and a distributed lag model was used to estimate city-specific heat–hospitalization association. Then meta-analysis was used to synthesize city-specific estimates according to different socioeconomic quartiles or levels. We included 49 million hospitalizations (58.5% female; media...

Many of the thermal comfort studies are carried on in areas were the seasons are marked by a decr... more Many of the thermal comfort studies are carried on in areas were the seasons are marked by a decrease of the temperature. Considering that, the necessity of a better understanding of how do the people living in regions with sub-tropical climate and high temperature variations feel and response about this kind of variation. The individual thermal comfort or upset perception is related with the metabolic heat production. With the aim of maintain the vital organic functions, this heat is transferred to the surroundings, resulting a psychologic impression and a corporal temperature. This heat transfer is influenced by environmental factors like air temperature, thermal radiation, air speed and humidity, and by individual factors like physical activity and clothing. Those variables, associated with biometeorologic indexes developed for thermal confort classification, contribute to the empiric classification of the human thermal impression. This study makes a comparative analyses of two d...

BackgroundAttributable mortality risk for heat and cold has been investigated in Europe and North... more BackgroundAttributable mortality risk for heat and cold has been investigated in Europe and North America. However, none so far has provided estimates for Latin American, with a whole temperature r...

Environment International

ISEE Conference Abstracts

The Lancet Planetary Health

Environmental Health Perspectives

BACKGROUND: Previous literature suggests that higher ambient temperature may play a role in incre... more BACKGROUND: Previous literature suggests that higher ambient temperature may play a role in increasing the risk of suicide. However, no multicountry study has explored the shape of the association and the role of moderate and extreme heat across different locations. OBJECTIVES: We examined the short-term temperature-suicide relationship using daily time-series data collected for 341 locations in 12 countries for periods ranging from 4 to 40 y. METHODS: We conducted a two-stage meta-analysis. First, we performed location-specific time-stratified case-crossover analyses to examine the temperature-suicide association for each location. Then, we used a multivariate meta-regression to combine the location-specific lag-cumulative nonlinear associations across all locations and by country. RESULTS: A total of 1,320,148 suicides were included in this study. Higher ambient temperature was associated with an increased risk of suicide in general, and we observed a nonlinear association (inverted J-shaped curve) with the highest risk at 27°C. The relative risk (RR) for the highest risk was 1.33 (95% CI: 1.30, 1.36) compared with the risk at the first percentile. Country-specific results showed that the nonlinear associations were more obvious in northeast Asia (Japan, South Korea, and Taiwan). The temperature with the highest risk of suicide ranged from the 87th to 88th percentiles in the northeast Asian countries, whereas this value was the 99th percentile in Western countries (Canada, Spain, Switzerland, the UK, and the United States) and South Africa, where nearly linear associations were estimated. The country-specific RRs ranged from 1.31 (95% CI: 1.19, 1.44) in the United States to 1.65 (95% CI: 1.40, 1.93) in Taiwan, excluding countries where the results were substantially uncertain. DISCUSSION: Our findings showed that the risk of suicide increased with increasing ambient temperature in many countries, but to varying extents and not necessarily linearly. This temperature-suicide association should be interpreted cautiously, and further evidence of the relationship and modifying factors is needed.