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Climate Change and Human Health: Where Are The
Research Gaps?
A scoping review protocol
Journal: BMJ Open
Manuscript ID bmjopen-2016-012022
Article Type: Protocol
Date Submitted by the Author: 23-Mar-2016
Complete List of Authors: Herlihy, Niamh; Centre Vircho-Villermé de Santé Publique, Paris-Berlin Bar-Hen, Avner; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Laboratoire MAP5, Univeristé Paris Descartes, France Verner, Glenn; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; French School of Public Health, Paris-Rennes, France Fischer, Helen; Institute of Psychology, University of Heidelberg Sauerborn, Rainer; Institute of Public Health, University of Heidelberg, Tropical Medecine and Public Health Depoux, Anneliese; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Université Paris Sorbonne-Celsa, Groupe de recherches interdisciplinaires sur les processus d\'information et de communication (EA 1498) Flahault, Antoine; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Institute of Global Health, University of Geneva Schutte, Stefanie; Centre Vircho-Villermé de Santé Publique, Paris-Berlin
<b>Primary Subject Heading</b>:
Global health
Secondary Subject Heading: Public health, Research methods
Keywords: Research Methods, Climate Change, Global Health
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Climate Change and Human Health: Where Are The Research Gaps? A scoping review protocol
Niamh Herlihly1, Avner Bar-Hen1,2, Glenn Verner1,3, Helen Fischer4, Rainer Sauerborn5,
Anneliese Depoux1,6, Antoine Flahault1,7, Stefanie Schütte1
1 Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, France
2 Laboratoire MAP5, Université Paris Descartes, France
3 French School of Public Health, Paris-Rennes, France
4 Institute of Psychology, University of Heidelberg, Germany
5 Institute of Public Health, University of Heidelberg, Germany
6 Groupe de recherches interdisciplinaires sur les processus d'information et de communication (EA 1498), Université Paris Sorbonne-Celsa, France 7 Institute of Global Health, University of Geneva, Switzerland
Corresponding author: Dr. Stefanie Schütte Centre Virchow-Villermé for Public Health Hôtel-Dieu AP-HP 1, parvis de Notre-Dame 75004 Paris – France stefanie.schutte@parisdescartes.fr Word count: Abstract word count: 299
Number of references: 21
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ABSTRACT
Introduction: For 28 years, the Intergovernmental Panel on Climate Change (IPCC) has been
assessing the potential risks associated with man-made climate change. Though interest in
climate change and health is growing, the implications arising from their interaction remain
understudied. Generating a greater understanding of the health impacts of climate change could
be a key step in inciting some of the changes necessary to decelerate global warming. A long
term and broad overview of existing scientific literature in the field of climate change and health
is currently missing in order to ensure that all priority areas are being adequately addressed. In
this paper we outline our methods to conduct a scoping review of published peer-reviewed
literature on climate change and health between 1990 and 2015.
Methods: A detailed search strategy will be used to search both the PubMed and Web of
Science databases. Specific inclusion and exclusion criteria will be applied in order to capture
the most relevant literature in the timeframe chosen. Data will be extracted, categorized and
coded to allow for statistical analysis of the results.
Results: A searchable database of climate change and health publications will be developed
and a manuscript will be complied for publication and dissemination of the findings. We
anticipate that this study will allow us to map the trends observed in publications over the 25
year time period as well as identify gaps in climate change and health research.
Conclusion: The threats posed by climate change to human health may be reduced by
research and investments in climate adaptation and mitigation strategies. Our long-term review
of the literature on climate change and health may serve as a first step in establishing the
foundations for a scientific research agenda for the future of our health in the presence of a
rapidly changing global climate.
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Table 1: Strengths and weaknesses of “Climate Change and Health” Scoping Review
Study strengths and limitations
- The review will cover a comprehensive time frame of 25 years
- Publications not restricted to any particular study type, geographical region or human health issue
- Findings will be systematically categorized and input into a searchable database
- The review will cover two data bases focusing on English language results
- Grey literature will not be included in the literature search but comments or opinion views published in peer-reviewed journal
- The quality of publications captured will not be assessed. This is beyond the peer-review process as selection criteria
Background
The phenomenon of climate change is a reality that is now universally acknowledged and better
understood than it was in 1988 when the Intergovernmental Panel on Climate Change (IPCC)
was formed by the World Meteorological Organisation (WMO) and the United Nations
Environmental Programme (UNEP).
There is growing evidence to support the scientific theories indicating that climate change is
adversely affecting human health. However, the impact of climate change on health is quite
complex and the same factor may sometimes act as a cause and other times as an effect. The
consequences of climate change are likely to lead to an increased demand on health services
which will require adaptation to the growing incidence of climate related health issues. The need
to identify and prevent adverse health impacts is rising to the forefront of climate change policy
debates and is becoming a growing priority of the public health community (1).
Introduction
For more than 28 years, the IPCC has been assessing the potential health risks associated with
climate change (2). In the six years between 2009 and 2015, climate change has gone from
being “the biggest global health threat of the 21st century” (3) to potentially “the greatest global
health opportunity of the 21st century” (4). To date, projections of the direction and scope of
health consequences induced by climate change involve a degree of uncertainty, which makes it
difficult to communicate scientific facts to policy makers or even to the general public (5,6). Clear
information and communication about the health consequences are crucial in order to ensure
that climate change is a high priority and receives sufficient commitment both financially and
politically. It presents an enormous governance challenge, with a need for greater new
integrated governance structures at national and international levels (8).
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Climate change and health is a growing area of research. There are direct and indirect
mechanisms by which climate change affects our health resulting in numerous health outcomes.
The 2014 IPCC report outlines the direct impact from extreme weather and indirect impacts
through ecosystem mediated effects and human system mediated effects as summarized in
Table 4 (9). Generating a greater understanding of these health impacts resulting from climate
change could be a key step in inciting some of the changes necessary to decelerate global
warming. There is a wide range of publications addressing various aspects of climate change
and health. We have identified a number of systematic literature reviews which summarize the
evidence of specific health impact related to climate change including nutrition, infectious
diseases etc. (10–15). A scoping review by Hoskins et al. provides insights into how the
published literature on climate change and health addresses the World Health Assembly (WHA)
priority research areas for climate change and health as specified in 2008 and expanded on in
2009 (16). This review is highly relevant in identifying the research relevant to the WHA priority
areas however the results cover a brief two-year of period 2008-2011. Each iteration of the IPCC
report presents evidence from the scientific literature covering the 6-7 years prior to the year of
publication with each report covering a different time period. The current literature is lacking a
long-term overview of existing scientific literature, which addresses all health outcomes in the
field of climate change. It is necessary to examine the historical trends and to identify the
research gaps as we enter a new era in the fight for climate action.
Objectives and hypotheses
With this scoping literature review we aim to collate published academic literature on climate
change and health. We will map the findings by categorising papers according to various
indicators and to provide a thematic analysis of their content. The specific objectives are:
� To provide an overview of existing scientific articles over time regarding climate change
and human health;
� To build a database of existing scientific papers that explore climate change and health
from 1990 – 2015 and to categorise them according to specified criteria;
� To make recommendations on the research gaps and prospective areas for future
research.
Thus, this review will not analyse in depth the detailed evidence of the impact of climate change
on human health in publications as carried out for systematic reviews, it will have a broader
approach by characterising the existing literature. This work may also help for future funding
projects underlining the need for research in certain areas.
Table 2: Research Questions for “Climate Change and Health” Scoping Review
Research Questions
1. Which health effects are being
studied?
- Direct Effects
- Indirect Effects
2. What is the geographical focus of
the publications?
- Africa
- North America
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- South America
- Antarctica
- Asia
- Australasia
- Europe
3. Which are the key target
populations of interest?
- Elderly
- Workers (Construction &
Agriculture)
- Low income
- High income
- Women
- Children
- Patients under medical treatment
4. What kind of settings are studied? - Urban
- Rural
5. What types of articles are published
on the topic?
- Original research
- Review
- Commentary/Opinion
6. What are the types of data being
studied?
- Primary
- Secondary
7. To whom is the corresponding
author affiliated with?
- Country
- Institution
Method
Databases
The databases used in this review will be PubMed and Web of Science. Through PubMed we
access primarily publications across in the field of medicine and life sciences. Web of Science is
a multi-disciplinary database, which will capture the non-clinical health aspects of the effects of
climate change across a broad range of research areas.
Search strategy
The search strategy will include broad terms to cover all areas of climate change exposure
alongside health outcome terms linked to climate change exposure. The search terms will be
used to identify literature that explores the link between climate change and human health. The
keywords that will be used for building the search strategy are outlined in Table 1 as well as the
range of publication dates. This range dates back to the first report from the IPCC in 1990 to end
of 2015, just after the last conference of parties (COP21) to capture as much relevant literature
as possible. The search strategy will consist of free text and MeSH terms.
Search terms
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Table 3: Search terms for “Climate Change and Health” Scoping Review
Climate change related terms
Health related terms Date of publication
Climate Change Global warming Climate variability Greenhouse effect GHGE
Health Disease
- Non-Communicable - Communicable
Epidemiology Lifestyle Co-Benefits Mortality Nutrition Malnutrition Dehydration Migration Mental disorders
1990-2015
The key search terms will be adapted according to the database.
Table 4: Search Strategy Syntax for databases
Database Search Strategy Syntax
PubMed ("climate change"[Title/Abstract] OR "global warming" [Title/Abstract] OR "climate variability" [Title/Abstract] OR "greenhouse effect" [Title/Abstract] OR "GHGE" [Title/Abstract]) AND (("health"[MeSH Terms] OR "health"[All Fields]) OR ("disease"[MeSH Terms] OR "disease" [All Fields]) OR ("Communicable" [MeSH Terms] OR "Communicable" [All Fields]) OR ("Non-Communicable Disease"[All Fields]) OR ("NCD" [All Fields]) OR ("Lifestyle" [MeSH Terms] OR "Lifestyle"[All Fields]) OR ("Co-Benefits" [All Fields]) OR ("epidemiology"[Subheading] OR "epidemiology"[All Fields] OR "morbidity"[All Fields] OR "morbidity"[MeSH Terms]) OR ("mortality"[Subheading] OR "mortality"[All Fields] OR "mortality"[MeSH Terms]) OR ("nutritional status"[MeSH Terms] OR ("nutritional"[All Fields] AND "status"[All Fields]) OR "nutritional status"[All Fields] OR "nutrition"[All Fields] OR "nutritional sciences"[MeSH Terms] OR ("nutritional"[All Fields] AND "sciences"[All Fields]) OR "nutritional sciences"[All Fields]) OR ("malnutrition"[MeSH Terms] OR "malnutrition"[All Fields]) OR ("dehydration"[MeSH Terms] OR "dehydration"[All Fields]) OR "emigration and immigration"[All Fields] OR "mental disorder"[All Fields]) AND ("1990/01/01"[PDAT] : "2015/12/31"[PDAT])
Web of Science TI=(("climate change"OR "global warming"OR "climate variability" OR "greenhouse effect" OR "GHGE")) AND TS= (("health" OR "disease" OR "Communicable" OR "Non-Communicable Disease"
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OR "NCD" OR "Lifestyle" OR "Co-Benefits" OR "epidemiology" OR "morbidity" OR "nutritional status" OR ("nutritional" AND "status") OR "nutritional status" OR "nutrit*"OR "nutritional sciences" OR ("nutritional"AND "sciences") OR "malnutrition" OR "dehydration"OR ("emigration AND immigration") OR "mental disorder"))
Criteria for inclusion and exclusion
Table 3 below outlines the inclusion and exclusion criteria that will be used to conduct the
literature review.
Table 5: Inclusion and Exclusion Criteria for Scoping Review
Inclusion Criteria
• Peer-reviewed articles (including
original quantitative and qualitative
studies, systematic reviews,
editorials, viewpoints)
• Indexed in PubMed and Web of
Science Databases
• Published between 1990 and 2015
• Focus on climate change and human health
• Publications in English only
• No restriction to country or population
Exclusion Criteria
• Book chapters and grey literature
(dissertations, conference
proceedings, reports etc.)
• Paper that do not mention any of
the search terms for climate
change in the keywords, title, or
abstract
Literature selection
First, two reviewers will independently screen titles and abstracts of identified papers for
relevance to the topic. Those articles considered not to be relevant on the grounds of topic will
be excluded.
Second, full text/papers will be sought for all studies appearing to meet the inclusion criteria and
a final selection will be made. If the two reviewers cannot reach an agreement, a third reviewer
will be involved. A flow chart will be produced to report the selection process.
Data collection and extraction
Screening of studies for eligibility
Results will be merged using citation software EndNote and duplicates will be removed.
Data will be extracted from the studies identified using the software R according to the
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categories presented in Table 4. The data will then be transferred into an excel file and coded to
facilitate analytics and the development of infographics. A second researcher will independently
check the data for accuracy and detail. Disagreements will be resolved by consensus or by
consulting a third reviewer. Tables of excluded studies will be prepared, detailing when exclusion
occurred and the reasons for exclusion.
As this scoping review is different from a systematic literature review by aiming at mapping the
current literature including opinion views on climate change and health, the Preferred Reporting
Items for Systematic review and Meta-analysis (PRISMA) statement checklist (17) cannot be
applied. However, this review will follow the AMSTAR checklist (Assessment of Multiple
Systematic Reviews) to ensure the methodological quality and to limit any bias (18). Indeed, a
scoping review of published reviewed articles is a novel approach for examining the breadth of
literature on this topic. According to Arksey and O’Malley, the ‘scoping’ study comprises a further
type of literature review and as a technique to ‘map’ relevant literature in the field of interest (19).
A strength of scoping studies includes the breadth and depth, or comprehensiveness, of
evidence covered in a given field (20).
The data extracted from publications will be characterised according to the indicators listed in
Table 4.
Table 6: Data Extraction Indicators for mapping of the literature
� Corresponding author
� Gender of corresponding
author
� Affiliation
� Academic/Industry/NGO/UN
agencies
� Country
� Scientific journal
� Year of Publication
� Year of Data Collection
� Geographical focus of research
� Study population
� Sample size
� Setting
� Urban/rural
� Inland/coastal
� Article type
� Viewpoint /commentary
� Literature review
- Systematic
- Non-systematic
� Original research study
� Study method
� Environmental Exposures
� Extreme events
- Flood
- Drought
- Heat wave
- Fire
- Air pollution
� Gradual change
- Temperature
- Rain patterns
- Sea level rise
- Ocean ecology
- Air quality
- Allergens
� Domain
� Measuring impact
� Adaptation
� Mitigation
� Health co-benefits
� Climate communication
� Economic analysis
� Health outcome (categorised according to the 2014 International Panel on Climate Change) � Mortality
� Direct impacts
- Injuries
- Drowning
- Heat effects
- Cardiovascular disease
- Cancer
� Effects mediated through
natural systems
- Respiratory disease
- Vector-borne disease
- Water-borne disease
- Food-borne disease
� Effects mediated by human
systems
- Malnutrition
- Mental health and
well-being
- Occupational impacts
- Migration
- Conflict
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� Qualitative
� Quantitative
� Data
� Primary data
� Secondary data
� Recommendation/Conclusion
� Recommendation to the public
� Policy recommendation
� Research recommendation
� No recommendation
Reporting of Results The extraction and categorization of publications for climate change and health will provide a
long-term overview of the published literature in this area. This may be, to the best of our
knowledge and if no other group undertakes the same work simultaneously, the first study of its
kind to provide such an overview. We will build an open searchable database of our findings,
which will be updated over time and serve as a useful source of information for researchers
working in this field. The coding of our results will allow for analysis of publications in the various
categories. We intend to write a manuscript for publication of our analysis to disseminate our
findings. This study will map the trends observed in publications over a 25-year time period. It
will also identify the research areas with the highest volume of publications as well as highlight
the research gaps in climate change and health. Assessing the quality of the publications
identified, as carried out for classic systematic reviews, is beyond the scope for this review.
Conclusion Following the results of the negotiations on the United Nations Framework Convention on
Climate Change in Paris last December 2015, there is an onus on world leaders and their
populations to implement and adhere to climate change policies which reduce greenhouse gas
emissions and limit the impact of climate change for the coming decades. Health is a major co-
beneficiary to many climate mitigation strategies (21) and it is critical that both the short and long
term benefits are kept in mind when developing climate policies. We will provide a summary of
the research that has been done up to 2015 which can be useful to avoid repetition of failed
climate mitigation or adaptation strategies relating to human health and to promote the
expansion of successful strategies. It will also identify in which areas funding has been directed
over the past 25 years and where there is a need for future investment. Therefore our analysis
will be a useful resource for governments and research institutes looking to make valuable, cost-
effective investment decisions in research or implementation projects in the area of climate
change and health. It may also serve as a first step in establishing the foundations for a scientific
research agenda for the future of our health in the presence of a rapidly changing global climate.
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Contribution Statement NH wrote the first draft of the paper and initiated data collection. ABH advised on study methods and conducted preliminary analysis. GV contributed to the initial study methods. HF revised the draft paper. RS initiated the project, advised on study methods and revised the draft paper. AD revised the draft paper. AF advised on study methods and revised the draft paper. SS designed the study design, initiated data collection and wrote the first draft of the paper. All authors approved the final version of the paper. Competing Interests There are no competing interests References
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Climate Change and Human Health: What Are The Research
Trends?
A scoping review protocol
Journal: BMJ Open
Manuscript ID bmjopen-2016-012022.R1
Article Type: Protocol
Date Submitted by the Author: 08-Jul-2016
Complete List of Authors: Herlihy, Niamh; Centre Vircho-Villermé de Santé Publique, Paris-Berlin Bar-Hen, Avner; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Laboratoire MAP5, Univeristé Paris Descartes, France Verner, Glenn; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; French School of Public Health, Paris-Rennes, France Fischer, Helen; Institute of Psychology, University of Heidelberg Sauerborn, Rainer; Institute of Public Health, University of Heidelberg, Tropical Medecine and Public Health Depoux, Anneliese; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Université Paris Sorbonne-Celsa, Groupe de recherches interdisciplinaires sur les processus d\'information et de communication (EA 1498) Flahault, Antoine; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Institute of Global Health, University of Geneva Schutte, Stefanie; Centre Vircho-Villermé de Santé Publique, Paris-Berlin
<b>Primary Subject Heading</b>:
Global health
Secondary Subject Heading: Public health, Research methods
Keywords: Research Methods, Climate Change, Global Health
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Climate Change and Human Health: What Are The Research Trends? A scoping review protocol
Niamh Herlihly1, Avner Bar-Hen1,2, Glenn Verner1,3, Helen Fischer4, Rainer Sauerborn5,
Anneliese Depoux1,6, Antoine Flahault1,7, Stefanie Schütte1
1 Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, France
2 Laboratoire MAP5, Université Paris Descartes, France
3 French School of Public Health, Paris-Rennes, France
4 Institute of Psychology, University of Heidelberg, Germany
5 Institute of Public Health, University of Heidelberg, Germany
6 Groupe de recherches interdisciplinaires sur les processus d'information et de communication (EA
1498), Université Paris Sorbonne-Celsa, France 7 Institute of Global Health, University of Geneva, Switzerland
Corresponding author: Dr. Stefanie Schütte Centre Virchow-Villermé for Public Health Hôtel-Dieu AP-HP 1, parvis de Notre-Dame 75004 Paris – France stefanie.schutte@parisdescartes.fr Word count: Abstract word count: 293
Number of references: 20
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ABSTRACT
Introduction: For 28 years, the Intergovernmental Panel on Climate Change (IPCC) has been
assessing the potential risks associated with anthropogenic climate change. Though interest in
climate change and health is growing, the implications arising from their interaction remain
understudied. Generating a greater understanding of the health impacts of climate change could
be key step in inciting some of the changes necessary to decelerate global warming. A long term
and broad overview of existing scientific literature in the field of climate change and health is
currently missing in order to ensure that all priority areas are being adequately addressed. In this
paper we outline our methods to conduct a scoping review of published peer-reviewed literature
on climate change and health between 1990 and 2015.
Methods: A detailed search strategy will be used to search both the PubMed and Web of
Science databases. Specific inclusion and exclusion criteria will be applied in order to capture
the most relevant literature in the timeframe chosen. Data will be extracted, categorized and
coded to allow for statistical analysis of the results.
Results: A searchable database of climate change and health publications will be developed
and a manuscript will be complied for publication and dissemination of the findings. We
anticipate that this study will allow us to map the trends observed in publications over the 25
year time period in climate change and health research.
Conclusion: The threats posed by climate change to human health may be reduced by
research and investments in climate adaptation and mitigation strategies. Our long-term review
of the literature on climate change and health may serve as a first step in establishing the
foundations for a scientific research agenda for the future of our health in the presence of a
rapidly changing global climate.
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Strengths and weaknesses of “Climate Change and Health” Scoping Review
Study strengths and limitations
- The review will cover a comprehensive time frame of 25 years
- Publications not restricted to any particular study type, geographical region or human health issue
- Findings will be systematically categorized and input into a searchable database
- The review will cover two data bases focusing on English language results
- Grey literature will not be included in the literature search but will include comments or opinion views published in peer-reviewed journal
- The quality of publications captured will not be assessed.
Background
The phenomenon of climate change is a reality that is now universally acknowledged and better
understood than it was in 1988 when the Intergovernmental Panel on Climate Change (IPCC)
was formed by the World Meteorological Organisation (WMO) and the United Nations
Environmental Programme (UNEP).
There is growing evidence to support the scientific theories indicating that climate change is
adversely affecting human health. However, the impact of climate change on health is quite
complex and the same factor may sometimes act as a cause and other times as an effect. The
consequences of climate change are likely to lead to an increased demand on health services,
which will require adaptation to the growing incidence of climate related health issues. The need
to identify and prevent adverse health impacts is rising to the forefront of climate change policy
debates and is becoming a growing priority of the public health community (1).
Introduction
For more than 28 years, the IPCC has been assessing the potential health risks associated with
climate change (2). In the six years between 2009 and 2015, climate change has gone from
being “the biggest global health threat of the 21st century” (3) to potentially “the greatest global
health opportunity of the 21st century” (4). To date, projections of the direction and scope of
health consequences induced by climate change involve a degree of uncertainty, which makes it
difficult to communicate scientific facts to policy makers or even to the general public (5, 6).
Clear information and communication about the health consequences are a critical factor to
remove some of this uncertainty. This may also assist in elevating the importance of climate
change to ensure that it is a high priority which receives sufficient commitment both financially
and politically. Climate change presents an enormous governance challenge, with a need for
greater new integrated governance structures at national and international levels (7).
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Climate change and health is a growing area of research. There are direct and indirect
mechanisms by which climate change affects our health resulting in numerous health outcomes.
The 2014 IPCC report outlines the direct impact from extreme weather and indirect impacts
through ecosystem mediated effects and human system mediated effects (8). Generating a
greater understanding of these health impacts resulting from climate change could be a key step
in inciting some of the changes necessary to decelerate global warming. There is a wide range
of publications addressing various aspects of climate change and health. We have identified a
number of systematic literature reviews which summarize the evidence of specific health impact
related to climate change including nutrition, infectious diseases, etc. (9-14). A scoping review
by Hoskins et al. provides insights into how the published literature on climate change and
health addresses the World Health Assembly (WHA) priority research areas for climate change
and health as specified in 2008 and expanded on in 2009 (15). This review is highly relevant in
identifying the research relevant to the WHA priority areas; however, the results cover a brief
two-year of period 2008-2010. Each iteration of the IPCC report presents evidence from the
scientific literature covering the 6-7 years prior to the year of publication with each report
covering a different time period. The current literature is lacking a long-term overview of existing
scientific literature which addresses all health outcomes in the field of climate change. We are
seeking to fill this void through this scoping review covering 25 years of publications which
address the extensive health issues affected by climate change. We will examine the historical
trends and identify the research areas which are being addressed in scientific publications. This
study will provide a more extensive and inclusive overview in comparison with previously
published reports and reviews of the research areas.
Objectives and hypotheses
With this scoping literature review we aim to collate published academic literature on climate
change and health. We will map the findings by categorising papers according to various
indicators and to provide a thematic analysis of their content. The specific objectives are:
� To provide an overview of existing scientific articles over time regarding climate change
and human health;
� To build a database of existing scientific papers that explore climate change and health
from 1990 – 2015 and to categorise them according to specified criteria;
� To make recommendations based on the research trends observed and prospective
areas for future research.
This work may also be a useful resource for future funding projects underlining the need for
research in certain areas. Table 1 outlines the research questions to be addressed in
undertaking this review.
Table 1: Research Questions for “Climate Change and Health” Scoping Review
Research Questions
1. Which health effects are being
studied?
- Direct Effects
- Indirect Effects
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2. What is the geographical focus of
the publications?
- Africa
- North America
- South America
- Antarctica
- Asia
- Australasia
- Europe
3. What types of articles are published
on the topic?
- Original research
- Review
- Commentary/Opinion
4. To whom is the corresponding
author affiliated with?
- Country
- Institution
Method
Scoping review methodology
Scoping reviews are a relatively recent method of reviewing evidence-based research, particularly in health but also in other disciplines (16). There is no single definition of what a scoping review consists of. A frequently applied definition is that from Arskey and O’Malley, which states that the aim of a scoping review is to “Mmap rapidly the key concepts underpinning a research area and the main sources and types of evidence available” (17).This scoping review framework developed by Arskey and O’Malley in 2005 will be applied for this study. There have been a number of studies since 2005 which enhance the initial framework and have advanced our understanding of this methodology and how to produce a more efficient and effective study (16, 18, 19)
The key strength of the scoping review method as applied to our study is that it allows for the analysis of a broad research question. Climate change and health is a vast area of research and our intention is to map the breadth of the literature on this topic. The quality of the literature will not be assessed, which is a limitation of scoping reviews. Systematic reviews, which have more refined research questions and narrower study parameters, generally result in fewer, more homogenous citations which can be more efficiently assessed for quality. The large volume of diverse citations anticipated from our literature search will be compiled into a catalogued database. Reflecting on the experience of others and in the absence of official guidelines for scoping reviews, we will proceed with implementing the initial framework and gleaning insights from follow up studies to guide us in developing this study.
Databases
The databases used in this review will be PubMed and Web of Science. Through PubMed we access primarily publications across in the field of medicine and life sciences. Web of Science is a multi-disciplinary database, which will capture the non-clinical health aspects of the effects of climate change across a broad range of research areas.
Search strategy
The search strategy will include broad terms to cover all areas of climate change exposure and
health outcomes affected by climate change. The search terms will be used to identify literature
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that documents the human health impact of climate change. The keywords that will be used for
building the search strategy are outlined in Table 2 as well as the range of publication dates.
This range dates back to the first report from the IPCC in 1990 to the end of 2015, just after the
last Conference of Parties (COP21) to capture as much relevant literature as possible. The
search strategy will consist of free text and MeSH terms.
Search terms
Table 2: Search terms for “Climate Change and Health” Scoping Review
Climate change related terms
Health related terms Date of publication
Climate Change Global warming Climate variability Greenhouse effect GHGE
Health Disease
- Non-Communicable - NCD - Communicable
Epidemiology Lifestyle Co-Benefits Mortality Morbidity Nutrition Malnutrition Dehydration Migration Mental disorders
1990-2015
The key search terms will be adapted according to the database. Table 3 below outlines the detailed search syntaxes that were used to search each database.
Table 3: Search Strategy Syntax for databases
Database Search Strategy Syntax
PubMed ("climate change"[Title/Abstract] OR "global warming" [Title/Abstract] OR "climate variability" [Title/Abstract] OR "greenhouse effect" [Title/Abstract] OR "GHGE" [Title/Abstract]) AND (("health"[MeSH Terms] OR "health"[All Fields]) OR ("disease"[MeSH Terms] OR "disease" [All Fields]) OR ("Communicable" [All Fields]) OR ("Non-Communicable Disease"[All Fields]) OR ("NCD" [All Fields]) OR ("Lifestyle"[All Fields]) OR ("Co-Benefits" [All Fields]) OR ("epidemiology"[Subheading] OR "epidemiology"[All Fields] OR "morbidity"[All Fields] OR "morbidity"[MeSH Terms]) OR ("mortality"[Subheading] OR "mortality"[All Fields] OR "mortality"[MeSH Terms]) OR ("nutritional status"[MeSH Terms] OR ("nutritional"[All Fields] AND "status"[All Fields]) OR
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"nutritional status"[All Fields] OR "nutrition"[All Fields] OR "nutritional sciences"[MeSH Terms] OR ("nutritional"[All Fields] AND "sciences"[All Fields]) OR "nutritional sciences"[All Fields]) OR ("malnutrition"[MeSH Terms] OR "malnutrition"[All Fields]) OR ("dehydration"[MeSH Terms] OR "dehydration"[All Fields]) OR "emigration and immigration"[All Fields] OR "mental disorder"[All Fields]) AND ("1990/01/01"[PDAT] : "2015/12/31"[PDAT])
Web of Science TI=(("climate change"OR "global warming"OR "climate variability" OR "greenhouse effect" OR "GHGE")) AND TS= (("health" OR "disease" OR "Communicable" OR "Non-Communicable Disease" OR "NCD" OR "Lifestyle" OR "Co-Benefits" OR "epidemiology" OR "morbidity" OR "nutritional status" OR ("nutritional" AND "status") OR "nutritional status" OR "nutrit*"OR "nutritional sciences" OR ("nutritional"AND "sciences") OR "malnutrition" OR "dehydration"OR ("emigration AND immigration") OR "mental disorder"))
Criteria for inclusion and exclusion
Table 4 below outlines the inclusion and exclusion criteria that will be used to conduct the
literature review.
Table 4: Inclusion and Exclusion Criteria for Scoping Review
Inclusion Criteria
• Peer-reviewed articles (including
original quantitative and qualitative
studies, systematic reviews,
editorials, viewpoints)
• Indexed in PubMed and/or Web of
Science Databases
• Published between 1990 and 2015
• Focus on climate change and human health
• Publications in English only
• No restriction to country or population
Exclusion Criteria
• Book chapters and grey literature
(dissertations, conference
proceedings, reports etc.)
Literature selection
First, two reviewers will independently screen titles and abstracts of identified papers for
relevance to the topic. Those articles considered not to be relevant on the grounds of topic will
be excluded. Second, full text/papers will be sought for all studies appearing to meet the
inclusion criteria and a final selection will be made. If the two reviewers cannot reach an
agreement, a third reviewer will be involved. A flow chart will be produced to report the selection
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process.
Data collection and extraction
Screening of studies for eligibility
Results will be merged using citation software EndNote and duplicates will be removed. Data will
be extracted from the studies identified using the software R. The data will then be transferred
into an Excel file and coded to facilitate analytics and the development of infographics. A second
researcher will independently check the data for accuracy and detail. Disagreements will be
resolved by consensus or by consulting a third reviewer. A flow chart of the study selection
procedure at each stage of the review will be prepared, detailing when exclusion occurred and
the reasons for exclusion.
Reporting of Results The extraction and categorization of publications for climate change and health will provide a
long-term overview of the published literature in this area. This may be, to the best of our
knowledge and if no other group undertakes the same work simultaneously, the first study of its
kind to provide such an overview. We will build an open searchable database of our findings,
which will be updated over time and serve as a useful source of information for researchers
working in this field. The coding of our results will allow for analysis of publications in the various
categories. We intend to write a manuscript for publication of our analysis to disseminate our
findings. This study will map the trends observed in publications over a 25-year time period. It
will also identify the research areas with the highest volume of publications as well as highlight
the research gaps in climate change and health.
The database will be part of a Climate Change and Health Resource that will be available on the
Centre Virchow-Villermé's (CVV) website. This study of the academic literature is one axis of a
larger overall study on the communication of climate change and health. Other axes include
reviews of national legislation and print media to better understand the role of the health
argument in the climate change discourse. The Climate Change and Health Resource will also
contain links to Massive Open Online Courses (MOOCs) that have been produced by the CVV
on the topic and other related MOOCs produced elsewhere. The database will therefore serve to
compliment the other information resources across different disciplines addressing climate
change and health.
Conclusion Following the results of the negotiations on the United Nations Framework Convention on
Climate Change in Paris last December 2015, there is an onus on world leaders and their
populations to implement and adhere to climate change policies which reduce greenhouse gas
emissions and limit the impact of climate change for the coming decades. Health is a major co-
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beneficiary to many climate mitigation strategies (20) and it is critical that both the short and long
term benefits are kept in mind when developing climate policies. We will provide a summary of
the research that has been done up to 2015 which can be useful to avoid repetition of previous
climate mitigation or adaptation studies relating to human health. It will also identify in which
areas funding has been directed over the past 25 years and where there is a need for future
investment. Therefore, our analysis will be a useful resource for governments and research
institutes looking to make valuable, cost-effective investment decisions in research or
implementation projects in the area of climate change and health. It may also serve as a first
step in establishing the foundations for a scientific research agenda for the future of our health in
the presence of a rapidly changing global climate.
Contribution Statement NH wrote the first draft of the paper and initiated data collection. ABH advised on study methods and conducted preliminary analysis. GV contributed to the initial study methods. HF revised the draft paper. RS initiated the project, advised on study methods and revised the draft paper. AD revised the draft paper. AF advised on study methods and revised the draft paper. SS designed the study design, initiated data collection and contributed tothe first draft of the paper. All authors approved the final version of the paper. Competing Interests There are no competing interests References 1. Keim ME. Building human resilience: the role of public health preparedness and response as an adaptation to climate change. American journal of preventive medicine. 2008;35(5):508-16. 2. Woodward A, Smith KR, Campbell-Lendrum D, Chadee DD, Honda Y, Liu Q, et al. Climate change and health: on the latest IPCC report. The Lancet.383(9924):1185-9. 3. Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, et al. Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet (London, England). 2009;373(9676):1693-733. 4. Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, et al. Health and climate change: policy responses to protect public health. Lancet (London, England). 2015;386(10006):1861-914. 5. Moser SC. Communicating climate change: history, challenges, process and future directions. Wiley Interdisciplinary Reviews: Climate Change. 2010;1(1):31-53. 6. Cardwell FS, Elliott SJ. Making the links: do we connect climate change with health? A qualitative case study from Canada. BMC Public Health. 2013;13(1):1-12. 7. Myers TA, Maibach E, Peters E, Leiserowitz A. Simple Messages Help Set the Record Straight about Scientific Agreement on Human-Caused Climate Change: The Results of Two Experiments. PLoS ONE. 2015;10(3):e0120985. 8. Smith KR, Woodward A. Human Health Impacts, Adaptation, and CoBenefits. Interngovernmental Panel on Climate Change 2014. Report No.:5. 9. Nichols A, Maynard V, Goodman B, Richardson J. Health, climate change and sustainability: A systematic review and thematic analysis of the literature. Environmental health insights. 2009;3:63.
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10. Phalkey RK, Aranda-Jan C, Marx S, Hofle B, Sauerborn R. Systematic review of current efforts to quantify the impacts of climate change on undernutrition. Proceedings of the National Academy of Sciences of the United States of America. 2015;112(33):E4522-9. 11. Brown L, Murray V. Examining the relationship between infectious diseases and flooding in Europe: A systematic literature review and summary of possible public health interventions. Disaster Health. 2013;1(2):117-27. 12. Patz JA, Frumkin H, Holloway T, Vimont DJ, Haines A. Climate change: challenges and opportunities for global health. JAMA. 2014;312(15):1565-80. 13. Huang C, Barnett AG, Wang X, Vaneckova P, FitzGerald G, Tong S. Projecting future heat-related mortality under climate change scenarios: a systematic review. Environmental health perspectives. 2011;119(12):1681. 14. Naish S, Dale P, Mackenzie JS, McBride J, Mengersen K, Tong S. Climate change and dengue: a critical and systematic review of quantitative modelling approaches. BMC infectious diseases. 2014;14(1):1. 15. Hosking J, Campbell-Lendrum D. How well does climate change and human health research match the demands of policymakers? A scoping review. Environmental health perspectives. 2012;120(8):1076. 16. Pham MT, Rajić A, Greig JD, Sargeant JM, Papadopoulos A, McEwen SA. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Research synthesis methods. 2014;5(4):371-85. 17. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology: Theory & Practice. 2005;8. 18. Daudt HM, van Mossel C, Scott SJ. Enhancing the scoping study methodology: a large, inter-professional team’s experience with Arksey and O’Malley’s framework. BMC Medical Research Methodology. 2013;13(1):1-9. 19. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implementation Science. 2010;5. 20. Cheng JJ, Berry P. Health co-benefits and risks of public health adaptation strategies to climate change: a review of current literature. International journal of public health. 2013;58(2):305-11.
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Climate Change and Human Health: What Are The Research
Trends?
A scoping review protocol
Journal: BMJ Open
Manuscript ID bmjopen-2016-012022.R2
Article Type: Protocol
Date Submitted by the Author: 11-Aug-2016
Complete List of Authors: Herlihy, Niamh; Centre Vircho-Villermé de Santé Publique, Paris-Berlin Bar-Hen, Avner; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Laboratoire MAP5, Univeristé Paris Descartes, France Verner, Glenn; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; French School of Public Health, Paris-Rennes, France Fischer, Helen; Institute of Psychology, University of Heidelberg Sauerborn, Rainer; Institute of Public Health, University of Heidelberg, Tropical Medecine and Public Health Depoux, Anneliese; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Université Paris Sorbonne-Celsa, Groupe de recherches interdisciplinaires sur les processus d\'information et de communication (EA 1498) Flahault, Antoine; Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité; Institute of Global Health, University of Geneva Schutte, Stefanie; Centre Vircho-Villermé de Santé Publique, Paris-Berlin
<b>Primary Subject Heading</b>:
Global health
Secondary Subject Heading: Public health, Research methods
Keywords: Research Methods, Climate Change, Global Health
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Climate Change and Human Health: What Are The Research Trends? A scoping review protocol
Niamh Herlihly1, Avner Bar-Hen1,2, Glenn Verner1,3, Helen Fischer4, Rainer Sauerborn5,
Anneliese Depoux1,6, Antoine Flahault1,7, Stefanie Schütte1
1 Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, France
2 Laboratoire MAP5, Université Paris Descartes, France
3 French School of Public Health, Paris-Rennes, France
4 Institute of Psychology, University of Heidelberg, Germany
5 Institute of Public Health, University of Heidelberg, Germany
6 Groupe de recherches interdisciplinaires sur les processus d'information et de communication (EA
1498), Université Paris Sorbonne-Celsa, France 7 Institute of Global Health, University of Geneva, Switzerland
Corresponding author: Dr. Stefanie Schütte Centre Virchow-Villermé for Public Health Hôtel-Dieu AP-HP 1, parvis de Notre-Dame 75004 Paris – France stefanie.schutte@parisdescartes.fr Word count: Abstract word count: 293
Number of references: 21
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ABSTRACT
Introduction: For 28 years, the Intergovernmental Panel on Climate Change (IPCC) has been
assessing the potential risks associated with anthropogenic climate change. Though interest in
climate change and health is growing, the implications arising from their interaction remain
understudied. Generating a greater understanding of the health impacts of climate change could
be key step in inciting some of the changes necessary to decelerate global warming. A long term
and broad overview of existing scientific literature in the field of climate change and health is
currently missing in order to ensure that all priority areas are being adequately addressed. In this
paper we outline our methods to conduct a scoping review of published peer-reviewed literature
on climate change and health between 1990 and 2015.
Methods and Analysis: A detailed search strategy will be used to search both the PubMed and
Web of Science databases. Specific inclusion and exclusion criteria will be applied in order to
capture the most relevant literature in the timeframe chosen. Data will be extracted, categorized
and coded to allow for statistical analysis of the results.
Ethics and Dissemination: No ethical approval was required for this study. A searchable
database of climate change and health publications will be developed and a manuscript will be
complied for publication and dissemination of the findings. We anticipate that this study will allow
us to map the trends observed in publications over the 25 year time period in climate change
and health research. It will also identify the research areas with the highest volume of
publications as well as highlight the research trends in climate change and health.
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Strengths and weaknesses of “Climate Change and Health” Scoping Review
Study strengths and limitations
- The review will cover a comprehensive time frame of 25 years
- Publications not restricted to any particular study type, geographical region or human health issue
- Findings will be systematically categorized and input into a searchable database
- The review will cover two data bases focusing on English language results
- Grey literature will not be included in the literature search but will include comments or opinion views published in peer-reviewed journal
- The quality of publications captured will not be assessed.
Background
The phenomenon of climate change is a reality that is now universally acknowledged and better
understood than it was in 1988 when the Intergovernmental Panel on Climate Change (IPCC)
was formed by the World Meteorological Organisation (WMO) and the United Nations
Environmental Programme (UNEP).
There is growing evidence to support the scientific theories indicating that climate change is
adversely affecting human health. However, the impact of climate change on health is quite
complex and the same factor may sometimes act as a cause and other times as an effect. The
consequences of climate change are likely to lead to an increased demand on health services,
which will require adaptation to the growing incidence of climate related health issues. The need
to identify and prevent adverse health impacts is rising to the forefront of climate change policy
debates and is becoming a growing priority of the public health community (1).
Introduction
For more than 28 years, the IPCC has been assessing the potential health risks associated with
climate change (2). In the six years between 2009 and 2015, climate change has gone from
being “the biggest global health threat of the 21st century” (3) to potentially “the greatest global
health opportunity of the 21st century” (4). To date, projections of the direction and scope of
health consequences induced by climate change involve a degree of uncertainty, which makes it
difficult to communicate scientific facts to policy makers or even to the general public (5, 6).
Clear information and communication about the health consequences are a critical factor to
remove some of this uncertainty. This may also assist in elevating the importance of climate
change to ensure that it is a high priority which receives sufficient commitment both financially
and politically. Climate change presents an enormous governance challenge, with a need for
greater new integrated governance structures at national and international levels (7).
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Climate change and health is a growing area of research. There are direct and indirect
mechanisms by which climate change affects our health resulting in numerous health outcomes.
The 2014 IPCC report outlines the direct impact from extreme weather and indirect impacts
through ecosystem mediated effects and human system mediated effects (8). Generating a
greater understanding of these health impacts resulting from climate change could be a key step
in inciting some of the changes necessary to decelerate global warming. There is a wide range
of publications addressing various aspects of climate change and health. We have identified a
number of systematic literature reviews which summarize the evidence of specific health impact
related to climate change including nutrition, infectious diseases, etc. (9-14). A scoping review
by Hosking et al. provides insights into how the published literature on climate change and
health addresses the World Health Assembly (WHA) priority research areas for climate change
and health as specified in 2008 and expanded on in 2009 (15). This review is highly relevant in
identifying the research relevant to the WHA priority areas; however, the results cover a brief
two-year of period 2008-2010. Each iteration of the IPCC report presents evidence from the
scientific literature covering the 6-7 years prior to the year of publication with each report
covering a different time period. The current literature is lacking a long-term overview of existing
scientific literature which addresses all health outcomes in the field of climate change. We are
seeking to fill this void through this scoping review covering 25 years of publications which
address the extensive health issues affected by climate change. We will examine the historical
trends and identify the research areas which are being addressed in scientific publications. This
study will provide a more extensive and inclusive overview in comparison with previously
published reports and reviews of the research areas.
Objectives and hypotheses
With this scoping literature review we aim to collate published academic literature on climate
change and health. We will map the findings by categorising papers according to various
indicators and to provide a thematic analysis of their content. The specific objectives are:
� To provide an overview of existing scientific articles over time regarding climate change
and human health;
� To build a database of existing scientific papers that explore climate change and health
from 1990 – 2015 and to categorise them according to specified criteria;
� To make recommendations based on the research trends observed and prospective
areas for future research.
This work may also be a useful resource for future funding projects underlining the need for
research in certain areas. Table 1 outlines the research questions to be addressed in
undertaking this review.
Table 1: Research Questions for “Climate Change and Health” Scoping Review
Research Questions
1. Which health effects are being
studied?
- Direct Effects
- Indirect Effects
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2. What is the geographical focus of
the publications?
- Africa
- North America
- South America
- Antarctica
- Asia
- Australasia
- Europe
3. What types of articles are published
on the topic?
- Original research
- Review
- Commentary/Opinion
4. To whom is the corresponding
author affiliated with?
- Country
- Institution
Method
Scoping review methodology
Scoping reviews are a relatively recent method of reviewing evidence-based research,
particularly in health but also in other disciplines (16). There is no single definition of what a
scoping review consists of. A frequently applied definition is that from Arskey and O’Malley,
which states that the aim of a scoping review is to “Mmap rapidly the key concepts underpinning
a research area and the main sources and types of evidence available” (17).This scoping review
framework developed by Arskey and O’Malley in 2005 will be applied for this study. There have
been a number of studies since 2005 which enhance the initial framework and have advanced
our understanding of this methodology and how to produce a more efficient and effective study
(16, 18, 19)
The key strength of the scoping review method as applied to our study is that it allows for the
analysis of a broad research question. Climate change and health is a vast area of research and
our intention is to map the breadth of the literature on this topic. The quality of the literature will
not be assessed, which is a limitation of scoping reviews. Systematic reviews, which have more
refined research questions and narrower study parameters, generally result in fewer, more
homogeneous citations which can be more efficiently assessed for quality. The large volume of
diverse citations anticipated from our literature search will be compiled into a catalogued
database. Reflecting on the experience of others and in the absence of official guidelines for
scoping reviews, we will proceed with implementing the initial framework by Arskey and O’Malley
and gleaninsights from the proceeding studies aimed at enhancing this methodolgy to guide us
in developing this study.
Databases
The databases used in this review will be PubMed and Web of Science. Through PubMed we
access primarily publications across in the field of medicine and life sciences. Web of Science is
a multi-disciplinary database, which will capture the non-clinical health aspects of the effects of
climate change across a broad range of research areas.
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Search strategy
The search strategy will include broad terms to cover all areas of climate change exposure and
health outcomes affected by climate change. The search terms will be used to identify literature
that documents the human health impact of climate change. The keywords that will be used for
building the search strategy are outlined in Table 2 as well as the range of publication dates.
This range dates back to the first report from the IPCC in 1990 to the end of 2015, just after the
last Conference of Parties (COP21) to capture as much relevant literature as possible. The
search strategy will consist of free text and MeSH terms.
Search terms
Table 2: Search terms for “Climate Change and Health” Scoping Review
Climate change related terms
Health related terms Date of publication
Climate Change Global warming Climate variability Greenhouse effect GHGE
Health Disease
- Non-Communicable - NCD - Communicable
Epidemiology Lifestyle Co-Benefits Mortality Morbidity Nutrition Malnutrition Dehydration Migration Mental disorders
1990-2015
The key search terms will be adapted according to the database. Table 3 below outlines the detailed search syntaxes that were used to search each database.
Table 3: Search Strategy Syntax for databases
Database Search Strategy Syntax
PubMed ("climate change"[Title/Abstract] OR "global warming" [Title/Abstract] OR "climate variability" [Title/Abstract] OR "greenhouse effect" [Title/Abstract] OR "GHGE" [Title/Abstract]) AND (("health"[MeSH Terms] OR "health"[All Fields]) OR ("disease"[MeSH Terms] OR "disease" [All Fields]) OR ("Communicable" [All Fields]) OR ("Non-Communicable Disease"[All Fields]) OR ("NCD" [All Fields]) OR ("Lifestyle"[All Fields]) OR ("Co-Benefits" [All Fields]) OR ("epidemiology"[Subheading] OR "epidemiology"[All Fields] OR
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"morbidity"[All Fields] OR "morbidity"[MeSH Terms]) OR ("mortality"[Subheading] OR "mortality"[All Fields] OR "mortality"[MeSH Terms]) OR ("nutritional status"[MeSH Terms] OR ("nutritional"[All Fields] AND "status"[All Fields]) OR "nutritional status"[All Fields] OR "nutrition"[All Fields] OR "nutritional sciences"[MeSH Terms] OR ("nutritional"[All Fields] AND "sciences"[All Fields]) OR "nutritional sciences"[All Fields]) OR ("malnutrition"[MeSH Terms] OR "malnutrition"[All Fields]) OR ("dehydration"[MeSH Terms] OR "dehydration"[All Fields]) OR "emigration and immigration"[All Fields] OR "mental disorder"[All Fields]) AND ("1990/01/01"[PDAT] : "2015/12/31"[PDAT])
Web of Science TI=(("climate change"OR "global warming"OR "climate variability" OR "greenhouse effect" OR "GHGE")) AND TS= (("health" OR "disease" OR "Communicable" OR "Non-Communicable Disease" OR "NCD" OR "Lifestyle" OR "Co-Benefits" OR "epidemiology" OR "morbidity" OR "nutritional status" OR ("nutritional" AND "status") OR "nutritional status" OR "nutrit*"OR "nutritional sciences" OR ("nutritional"AND "sciences") OR "malnutrition" OR "dehydration"OR ("emigration AND immigration") OR "mental disorder"))
Criteria for inclusion and exclusion
Table 4 below outlines the inclusion and exclusion criteria that will be used to conduct the
literature review.
Table 4: Inclusion and Exclusion Criteria for Scoping Review
Inclusion Criteria
• Peer-reviewed articles (including
original quantitative and qualitative
studies, systematic reviews,
editorials, viewpoints)
• Indexed in PubMed and/or Web of
Science Databases
• Published between 1990 and 2015
• Focus on climate change and human health
• Publications in English only
• No restriction to country or population
Exclusion Criteria
• Book chapters and grey literature
(dissertations, conference
proceedings, reports etc.)
Literature selection
First, two reviewers will independently screen titles and abstracts of identified papers for
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relevance to the topic. Those articles considered not to be relevant on the grounds of topic will
be excluded. Second, full text/papers will be sought for all studies appearing to meet the
inclusion criteria and a final selection will be made. If the two reviewers cannot reach an
agreement, a third reviewer will be involved. A flow chart will be produced to report the selection
process.
Data collection and extraction
Screening of studies for eligibility
Results will be merged using citation software EndNote and duplicates will be removed. Data will
be extracted from the studies identified using the software R. The data will then be transferred
into an Excel file and coded to facilitate analytics and the development of infographics. A second
researcher will independently check the data for accuracy and detail. Disagreements will be
resolved by consensus or by consulting a third reviewer. A flow chart of the study selection
procedure at each stage of the review will be prepared, detailing when exclusion occurred and
the reasons for exclusion.
Ethics and Dissemination No ethical approval was required for this literature based study. The extraction and categorization of publications for climate change and health will provide a
long-term overview of the published literature in this area. This may be, to the best of our
knowledge and if no other group undertakes the same work simultaneously, the first study of its
kind to provide such an overview. We will build an open searchable database of our findings,
which will be updated over time and serve as a useful source of information for researchers
working in this field. The coding of our results will allow for analysis of publications in the various
categories. We intend to write a manuscript for publication of our analysis to disseminate our
findings. This study will map the trends observed in publications over a 25-year time period. It
will also identify the research areas with the highest volume of publications as well as highlight
the research trends in climate change and health.
The database will be part of a Climate Change and Health Resource that will be available on the
Centre Virchow-Villermé's (CVV) website. This study of the academic literature is one axis of a
larger overall study on the communication of climate change and health. Other axes include
reviews of national legislation and print media to better understand the role of the health
argument in the climate change discourse. The Climate Change and Health Resource will also
contain links to Massive Open Online Courses (MOOCs) that have been produced by the CVV
on the topic and other related MOOCs produced elsewhere. The database will therefore serve to
complement the other information resources across different disciplines addressing climate
change and health.
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Contribution Statement NH wrote the first draft of the paper and initiated data collection. ABH advised on study methods and conducted preliminary analysis. GV contributed to the initial study methods. HF revised the draft paper. RS initiated the project, advised on study methods and revised the draft paper. AD revised the draft paper. AF advised on study methods and revised the draft paper. SS designed the study design, initiated data collection and contributed to the first draft of the paper. All authors approved the final version of the paper. Competing Interests There are no competing interests References 1. Keim ME. Building human resilience: the role of public health preparedness and response as an adaptation to climate change. American journal of preventive medicine. 2008;35(5):508-16. 2. Woodward A, Smith KR, Campbell-Lendrum D, Chadee DD, Honda Y, Liu Q, et al. Climate change and health: on the latest IPCC report. The Lancet.383(9924):1185-9. 3. Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, et al. Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet (London, England). 2009;373(9676):1693-733. 4. Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, et al. Health and climate change: policy responses to protect public health. Lancet (London, England). 2015;386(10006):1861-914. 5. Moser SC. Communicating climate change: history, challenges, process and future directions. Wiley Interdisciplinary Reviews: Climate Change. 2010;1(1):31-53. 6. Cardwell FS, Elliott SJ. Making the links: do we connect climate change with health? A qualitative case study from Canada. BMC Public Health. 2013;13(1):1-12. 7. Myers TA, Maibach E, Peters E, Leiserowitz A. Simple Messages Help Set the Record Straight about Scientific Agreement on Human-Caused Climate Change: The Results of Two Experiments. PLoS ONE. 2015;10(3):e0120985. 8. Smith KR, Woodward A. Human Health Impacts, Adaptation, and CoBenefits. Interngovernmental Panel on Climate Change 2014. Report No.:5. 9. Nichols A, Maynard V, Goodman B, Richardson J. Health, climate change and sustainability: A systematic review and thematic analysis of the literature. Environmental health insights. 2009;3:63. 10. Phalkey RK, Aranda-Jan C, Marx S, Hofle B, Sauerborn R. Systematic review of current efforts to quantify the impacts of climate change on undernutrition. Proceedings of the National Academy of Sciences of the United States of America. 2015;112(33):E4522-9. 11. Brown L, Murray V. Examining the relationship between infectious diseases and flooding in Europe: A systematic literature review and summary of possible public health interventions. Disaster Health. 2013;1(2):117-27. 12. Patz JA, Frumkin H, Holloway T, Vimont DJ, Haines A. Climate change: challenges and opportunities for global health. JAMA. 2014;312(15):1565-80. 13. Huang C, Barnett AG, Wang X, Vaneckova P, FitzGerald G, Tong S. Projecting future heat-related mortality under climate change scenarios: a systematic review. Environmental health perspectives. 2011;119(12):1681. 14. Naish S, Dale P, Mackenzie JS, McBride J, Mengersen K, Tong S. Climate change and dengue: a critical and systematic review of quantitative modelling approaches. BMC infectious diseases. 2014;14(1):1.
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15. Hosking J, Campbell-Lendrum D. How well does climate change and human health research match the demands of policymakers? A scoping review. Environmental health perspectives. 2012;120(8):1076. 16. Pham MT, Rajić A, Greig JD, Sargeant JM, Papadopoulos A, McEwen SA. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Research synthesis methods. 2014;5(4):371-85. 17. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology: Theory & Practice. 2005;8. 18. Daudt HM, van Mossel C, Scott SJ. Enhancing the scoping study methodology: a large, inter-professional team’s experience with Arksey and O’Malley’s framework. BMC Medical Research Methodology. 2013;13(1):1-9. 19. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implementation Science. 2010;5.
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