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CONTEXT: Hearing loss (HL) is a major health concern among military personnel due to noise from shooting, blasts, military vehicles, and noisy training environments. Nevertheless, one's exposure can be partially reduced by using personal protective equipment (PPE). The aim of this study is to estimate the prevalence of HL among military personnel, to analyse associations between HL and self-reported occupational and leisure noise exposure, and use of PPEs. MATERIALS AND METHODS: A cross-sectional study was conducted among 150 military personnel during their routine medical examinations. First, all participants filled in a questionnaire about their exposure to noise and later the respondents went through an audiometric test. The diagnostic criteria for slight, moderate, and severe HL was HL of 25–40, 41–60, and >60 dB at 4 and 6 kHz, respectively. The associations between noise exposure and HL were studied with multinomial logistic regression analysis. RESULTS: The prevalence of slight to severe HL in high frequencies (4 and 6 kHz) among study participants was 62.7%. Nevertheless, the majority of it was slight, as the prevalence of severe HL was 9.3%. The prevalence of any kind of HL was highest in the Navy and the prevalence of severe HL was highest in the Central Command Units. The relative risk ratios (RRRs) for HL were higher among those who had been working for a long time in a noisy environment, working with noise-producing equipment, driving in a PASI or a Bandvagn or had been shooting with blanks at least once per week. It also appeared that military personnel who had HL, reported tinnitus more often. Respondents' previous health problems, music-listening habits, and amount of exposure to loud noise in non-military environments were not independently associated with HL, but in several cases it increased the RRRs together with military exposure. We also found significantly more frequent HL among those never using PPEs. CONCLUSION: HL loss was more prevalent among personnel who are more often exposed to ...

Air temperature has been the most commonly used exposure metric in assessing relationships between thermal stress and mortality. Lack of the high-quality meteorological station data necessary to adequately characterize the thermal environment has been one of the main limitations for the use of more complex thermal indices. Global climate reanalyses may provide an ideal platform to overcome this limitation and define complex heat and cold stress conditions anywhere in the world. In this study, we explored the potential of the Universal Thermal Climate Index (UTCI) based on ERA5 – the latest global climate reanalysis from the European Centre for Medium-Range Weather Forecasts (ECMWF) – as a health-related tool. Employing a novel ERA5-based thermal comfort dataset ERA5-HEAT, we investigated the relationships between the UTCI and daily mortality data in 21 cities across 9 European countries. We used distributed lag nonlinear models to assess exposure-response relationships between mortality and thermal conditions in individual cities. We then employed meta-regression models to pool the results for each city into four groups according to climate zone. To evaluate the performance of ERA5-based UTCI, we compared its effects on mortality with those for the station-based UTCI data. In order to assess the additional effect of the UTCI, the performance of ERA5-and station-based air temperature (T) was evaluated. Whilst generally similar heat- and cold-effects were observed for the ERA5-and station-based data in most locations, the important role of wind in the UTCI appeared in the results. The largest difference between any two datasets was found in the Southern European group of cities, where the relative risk of mortality at the 1st percentile of daily mean temperature distribution (1.29 and 1.30 according to the ERA5 vs station data, respectively) considerably exceeded the one for the daily mean UTCI (1.19 vs 1.22). These differences were mainly due to the effect of wind in the cold tail of the UTCI distribution. The comparison of exposure-response relationships between ERA5-and station-based data shows that ERA5-based UTCI may be a useful tool for definition of life-threatening thermal conditions in locations where high-quality station data are not available. ; We would like to thank all the national data providers for supplying meteorological as well as health data (see more details in the Supplementary Material). The study was primarily supported by the Czech Science Foundation, project no. 18-22125S (AU and JK), the European Commission's HORIZON2020 ANYWHERE project (Enhancing Emergency Management and Response to Extreme Weather and Climate Events, Project ID 700099, CDN, HLC), and FATHUM (Forecasts for AnTicipatory HUManitarian action) part of the UKRI NERC/DFID SHEAR programme, grant number NE/P000525/1 (HLC). The following individual grants also supported this work: Medical Research Council-UK (Grant ID: MR/M022625/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655), Spanish Ministry of Economy, Industry and Competitiveness (Grant ID: PCIN-2017-046). ; Peer reviewed

Recycling of electric and electronic waste products (e-waste) which amounted to more than 50 million metric tonnes per year worldwide is a massive and global operation. Unfortunately, an estimated 70-80% of this waste has not been properly managed because the waste went from developed to low-income countries to be dumped into landfills or informally recycled. Such recycling has been carried out either directly on landfill sites or in small, often family-run recycling shops without much regulations or oversights. The process traditionally involved manual dismantling, cleaning with hazardous solvents, burning and melting on open fires, etc., which would generate a variety of toxic substances and exposure/hazards to applicators, family members, proximate residents and the environment. The situation clearly calls for global responsibility to reduce the impact on human health and the environment, especially in developing countries where poor residents have been shouldering the hazardous burden. On the other hand, formal e-waste recycling has been mainly conducted in small scales in industrialised countries. Whether the latter process would impose less risk to populations and environment has not been determined yet. Therefore, the main objectives of this review are: 1. to address current trends and emerging threats of not only informal but also formal e-waste management practices, and 2. to propose adequate measures and interventions. A major recommendation is to conduct independent surveillance of compliance with e-waste trading and processing according to the Basel Ban Amendment. The recycling industry needs to be carefully evaluated by joint effort from international agencies, producing industries and other stakeholders to develop better processes. Subsequent transition to more sustainable and equitable e-waste management solutions should result in more effective use of natural resources, and in prevention of adverse effects on health and the environment. ; Highlights: Most e-waste is informally and inequitably recycled in developing countries; Informal recycling is reported to damage human health and the environment; The currently practised e-waste management system is inequitable and unsustainable; Developing formal and safe e-waste management should be a global priority. ; This work was supported by the Diagnosis, Monitoring and Prevention of Exposure-Related Noncommunicable Diseases (DiMoPEx) COST Action project (CA15129) and its Final Action Dissemination Grant from the European Union ; info:eu-repo/semantics/publishedVersion

Epidemiological analyses of health risks associated with non-optimal temperature are traditionally based on ground observations from weather stations that offer limited spatial and temporal coverage. Climate reanalysis represents an alternative option that provide complete spatio-temporal exposure coverage, and yet are to be systematically explored for their suitability in assessing temperature-related health risks at a global scale. Here we provide the first comprehensive analysis over multiple regions to assess the suitability of the most recent generation of reanalysis datasets for health impact assessments and evaluate their comparative performance against traditional station-based data. Our findings show that reanalysis temperature from the last ERA5 products generally compare well to station observations, with similar non-optimal temperature-related risk estimates. However, the analysis offers some indication of lower performance in tropical regions, with a likely underestimation of heat-related excess mortality. Reanalysis data represent a valid alternative source of exposure variables in epidemiological analyses of temperature-related risk. ; The study was primarily supported by Grants from the European Commission's Joint Research Centre Seville (Research Contract ID: JRC/SVQ/2020/MVP/1654), Medical Research Council-UK (Grant ID: MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655). The following individual Grants also supported this work: J.K and A.U were supported by the Czech Science Foundation, project 20-28560S. A.T was supported by MCIN/AEI/10.13039/501100011033, Grant CEX2018-000794-S. V.H was supported by the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie Grant agreement No 101032087. This work was generated using Copernicus Climate Change Service (C3S) information [1985–2019]. ; Peer reviewed

International audience ; The Paris Agreement aims to limit global mean temperature rise this century well below 2 degrees Celsius above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial proportions of greenhouse gas emissions. This paper reports the state of planning for climate change by collecting and analysing local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and analysis framework was developed that classifies local climate plans in terms of their spatial (alignment with local, national and international policy) and sectoral integration (alignment into existing local policy documents). We document local climate plans that we call type A1: non-compulsory by national law and not developed as part of international climate networks; A2: compulsory by national law and not developed as part of international networks; A3: plans developed as part of international networks. This most comprehensive analysis to date reveals that there is large diversity in the availability of local climate plans with most being available in Central and Northern European cities. Approximately 66% of EU cities have an A1, A2, or A3 mitigation plan, 26% an adaptation plan, 17% joint adaptation and mitigation plans, and about 30% lack any form of local climate plan (i.e. what we classify as A1, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but mitigation does not always precede adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 70% of the cities above 1 million inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (A1 or A2). Countries with national climate legislation (A2), such as Denmark, France, Slovakia and the United Kingdom, are found to have nearly twice as many urban mitigation plans, and five times more likely to produce urban adaptation plans, than countries without such legislation. A1 and A2 mitigation plans are particularly numerous in Denmark, Poland, Germany, and Finland; while A1 and A2 adaptation plans are prevalent in Denmark, Finland, UK and France. The integration of adaptation and mitigation is country-specific and can mainly be observed in countries where local climate plans are compulsory, especially in France and the UK. Finally, local climate plans of international climate networks (A3) are mostly found in the many countries where autonomous, i.e. A1 plans are less common. The findings reported here are of international importance as they will inform and support decision-making and thinking of stakeholders with similar experiences or developments at all levels and sectors in other regions around the world.

International audience ; The Paris Agreement aims to limit global mean temperature rise this century well below 2 degrees Celsius above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial proportions of greenhouse gas emissions. This paper reports the state of planning for climate change by collecting and analysing local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and analysis framework was developed that classifies local climate plans in terms of their spatial (alignment with local, national and international policy) and sectoral integration (alignment into existing local policy documents). We document local climate plans that we call type A1: non-compulsory by national law and not developed as part of international climate networks; A2: compulsory by national law and not developed as part of international networks; A3: plans developed as part of international networks. This most comprehensive analysis to date reveals that there is large diversity in the availability of local climate plans with most being available in Central and Northern European cities. Approximately 66% of EU cities have an A1, A2, or A3 mitigation plan, 26% an adaptation plan, 17% joint adaptation and mitigation plans, and about 30% lack any form of local climate plan (i.e. what we classify as A1, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but mitigation does not always precede adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 70% of the cities above 1 million inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (A1 or A2). Countries with national climate legislation (A2), such as Denmark, France, Slovakia and the United Kingdom, are found to have nearly twice as many urban mitigation plans, and five times more likely to ...

The Paris Agreement aims to limit global mean temperature rise this century to well below 2 degrees C above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial greenhouse gas emissions. This paper reports the state of local planning for climate change by collecting and analysing information about local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and framework for analysis was developed that classifies local climate plans in terms of their alignment with spatial (local, national and international) and other climate related policies. Out of eight types of local climate plans identified in total we document three types of stand-alone local climate plans classified as type Al (autonomously produced plans), A2 (plans produced to comply with national regulations) or A3 (plans developed for international climate networks). There is wide variation among countries in the prevalence of local climate plans, with generally more plans developed by central and northern European cities. Approximately 66% of EU cities have a type Al, A2, or A3 mitigation plan, 26% an adaptation plan, and 17% a joint adaptation and mitigation plan, while about 33% lack any form of stand-alone local climate plan (i.e. what we classify as Al, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but planning for mitigation does not always precede planning for adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 80% of the cities with above 500,000 inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (Al). Cities in four countries with national climate legislation (A2), i.e. Denmark, France, Slovakia and the United Kingdom, are nearly twice as likely to produce local mitigation plans, and five times more likely to produce local adaptation plans, compared to cities in countries without such legislation. Al and A2 mitigation plans are particularly numerous in Denmark, Poland, Germany, and Finland: while Al and A2 adaptation plans are prevalent in Denmark, Finland, UK and France. The integration of adaptation and mitigation is country-specific and can mainly be observed in two countries where local climate plans are compulsory, i.e. France and the UK. Finally, local climate plans produced for international climate networks (A3) are mostly found in the many countries where autonomous (type Al) plans are less common. This is the most comprehensive analysis of local climate planning to date. The findings are of international importance as they will inform and support decision making towards climate planning and policy development at national, EU and global level being based on the most comprehensive and up-to-date knowledge of local climate planning available to date.

The Paris Agreement aims to limit global mean temperature rise this century to well below 2 °C above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial greenhouse gas emissions. This paper reports the state of local planning for climate change by collecting and analysing information about local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and framework for analysis was developed that classifies local climate plans in terms of their alignment with spatial (local, national and international) and other climate related policies. Out of eight types of local climate plans identified in total we document three types of stand-alone local climate plans classified as type A1 (autonomously produced plans), A2 (plans produced to comply with national regulations) or A3 (plans developed for international climate networks). There is wide variation among countries in the prevalence of local climate plans, with generally more plans developed by central and northern European cities. Approximately 66% of EU cities have a type A1, A2, or A3 mitigation plan, 26% an adaptation plan, and 17% a joint adaptation and mitigation plan, while about 33% lack any form of stand-alone local climate plan (i.e. what we classify as A1, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but planning for mitigation does not always precede planning for adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 80% of the cities with above 500,000 inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (A1). Cities in four countries with national climate legislation (A2), i.e. Denmark, France, Slovakia and the United Kingdom, are nearly twice as likely to produce local mitigation plans, and five times more likely to produce local adaptation plans, compared to cities in countries without such legislation. A1 and A2 mitigation plans are particularly numerous in Denmark, Poland, Germany, and Finland; while A1 and A2 adaptation plans are prevalent in Denmark, Finland, UK and France. The integration of adaptation and mitigation is country-specific and can mainly be observed in two countries where local climate plans are compulsory, i.e. France and the UK. Finally, local climate plans produced for international climate networks (A3) are mostly found in the many countries where autonomous (type A1) plans are less common. This is the most comprehensive analysis of local climate planning to date. The findings are of international importance as they will inform and support decision-making towards climate planning and policy development at national, EU and global level being based on the most comprehensive and up-to-date knowledge of local climate planning available to date. ; EU COST Action TU0902 that made the initial work possible and the positive engagement and interaction of the members of this group which led to this work. MO acknowledges funding from the Spanish Government (Grant no. FPDI-2013-16631). EKL was supported by the Ministry of Education, Youth and Sports of CR within the National Sustainability Program I (NPU I), grant number LO1415. OH and RD were funded by the EC project RAMSES Reconciling Adaptation, Mitigation and Sustainable Development for Cities (contract Ref 308497) and the EPSRC project LC Transforms: Low Carbon Transitions of Fleet Operations in Metropolitan Sites Project (EP/N010612/1).

The Paris Agreement aims to limit global mean temperature rise this century well below 2 degrees Celsius above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial proportions of greenhouse gas emissions. This paper reports the state of planning for climate change by collecting and analysing local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and analysis framework was developed that classifies local climate plans in terms of their spatial (alignment with local, national and international policy) and sectoral integration (alignment into existing local policy documents). We document local climate plans that we call type A1: non-compulsory by national law and not developed as part of international climate networks; A2: compulsory by national law and not developed as part of international networks; A3: plans developed as part of international networks. This most comprehensive analysis to date reveals that there is large diversity in the availability of local climate plans with most being available in Central and Northern European cities. Approximately 66% of EU cities have an A1, A2, or A3 mitigation plan, 26% an adaptation plan, 17% joint adaptation and mitigation plans, and about 30% lack any form of local climate plan (i.e. what we classify as A1, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but mitigation does not always precede adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 70% of the cities above 1 million inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (A1 or A2). Countries with national climate legislation (A2), such as Denmark, France, Slovakia and the United Kingdom, are found to have nearly twice as many urban mitigation plans, and five times more likely to produce urban adaptation plans, than countries without such legislation. A1 and A2 mitigation plans are particularly numerous in Denmark, Poland, Germany, and Finland; while A1 and A2 adaptation plans are prevalent in Denmark, Finland, UK and France. The integration of adaptation and mitigation is country-specific and can mainly be observed in countries where local climate plans are compulsory, especially in France and the UK. Finally, local climate plans of international climate networks (A3) are mostly found in the many countries where autonomous, i.e. A1 plans are less common. The findings reported here are of international importance as they will inform and support decision-making and thinking of stakeholders with similar experiences or developments at all levels and sectors in other regions around the world.