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Abstract. Regional land carbon budgets provide insights on the spatial distribution of the land uptake of atmospheric carbon dioxide, and can be used to evaluate carbon cycle models and to define baselines for land-based additional mitigation efforts. The scientific community has been involved in providing observation-based estimates of regional carbon budgets either by downscaling atmospheric CO2 observations into surface fluxes with atmospheric inversions, by using inventories of carbon stock changes in terrestrial ecosystems, by upscaling local field observations such as flux towers with gridded climate and remote sensing fields or by integrating data-driven or process-oriented terrestrial carbon cycle models. The first coordinated attempt to collect regional carbon budgets for nine regions covering the entire globe in the RECCAP-1 project has delivered estimates for the decade 2000–2009, but these budgets were not comparable between regions, due to different definitions and component fluxes reported or omitted. The recent recognition of lateral fluxes of carbon by human activities and rivers, that connect CO2 uptake in one area with its release in another also requires better definition and protocols to reach harmonized regional budgets that can be summed up to the globe and compared with the atmospheric CO2 growth rate and inversion results. In this study, for the international initiative RECCAP-2 coordinated by the Global Carbon Project, which aims as an update of regional carbon budgets over the last two decades based on observations, for 10 regions covering the globe, with a better harmonization that the precursor project, we provide recommendations for using atmospheric inversions results to match bottom-up carbon accounting and models, and we define the different component fluxes of the net land atmosphere carbon exchange that should be reported by each research group in charge of each region. Special attention is given to lateral fluxes, inland water fluxes and land use fluxes.

To discuss current evidence of global climate change and its implications for allergic rhinitis and other allergic respiratory diseases.Global climate change is evidenced by increasing average earth temperature, increasing anthropogenic greenhouse gas levels, and elevated pollen levels. Pollutants of interest include carbon dioxide (CO2), ozone (O3), and nitrous oxide (NO2) because they can enhance the allergic response and lead to increased symptoms of allergic respiratory diseases. Heightened CO2 levels stimulate pollen production via photosynthesis and increased growth in multiple plant species investigated. Although worsened air quality appears to increase prevalence of allergic rhinitis, the effects of increased temperature are less certain. The findings of increased aeroallergen levels likely contribute to increases in presentation of allergic diseases, although more healthcare impact studies are necessary.Although recent literature indicates and strongly supports changes in temperature, pollution levels, and aeroallergen levels, more longitudinal epidemiologic surveillance of allergic diseases in relation to climate change as well as pathophysiologic studies on changing aeroallergen effects on allergic diseases are needed.

Xuanwei City (formerly known as Xuanwei County) locates in the northeastern of Yunnan Province and is rich in coal, iron, copper and other mines, especially the smoky (bituminous) coal. Unfortunately, the lung cancer morbidity and mortality rates in this region are among China's highest, with a clear upward trend from the mid-1970s to mid-2000s. In 2004-2005, the crude death rate of lung cancer was 91.3 per 100,000 in the whole Xuanwei City, while that for Laibin Town in this city was 241.14 per 100,000. The epidemiologic distribution (clustering patterns by population, time, and space) of lung cancer in Xuanwei has some special features, e.g., high incidence in rural areas, high incidence in females, and an early age peak in lung cancer deaths. The main factor that associates with a high rate of lung cancer incidence was found to be indoor air pollution caused by the indoor burning of smoky coal. To a certain extent, genetic defects are also associated with the high incidence of lung cancer in Xuanwei. Taken together, lung cancer in this smoky coal combustion region is a unique model for environmental factor-related human cancer, and the current studies indicate that abandoning the use of smoky coal is the key to diminish lung cancer morbidity and mortality.

In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988-2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008-2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers.

The accessibility of hospital facilities is of great importance not only for maintaining social stability, but also for protecting the basic human right to health care. Traditional accessibility research often lacks consideration of the dynamic changes in transport costs and does not reflect the actual travel time of urban residents, which is critical to time-sensitive hospital services. To avoid these defects, this study considered the city of Kaifeng, China, as an empirical case, and directly acquired travel time data for two travel modes to the hospital in different time periods through web mapping API (Application Program Interface). Further, based on travel time calculations, we compared five baseline indicators. For the last indicator, we used the optimal weighted accessibility model to measure hospital accessibility for each residential area. The study discovered significant differences in the frequency and spatial distribution of hospital accessibility using public transit and self-driving modes of transportation. In addition, there is an imbalance between accessibility travel times in the study area and the number of arrivals at hospitals. In particular, different modes of transportation and different travel periods also have a certain impact on accessibility of medical treatment. The research results shed new light on the accessibility of urban public facilities and provide a scientific basis with which local governments can optimize the spatial structure of hospital resources.

Abstract We evaluated three Integrated Assessment Models (IAMs: IGSM, MERGE, MiniCAM) by: (i) comparing their global Primary Energy year-2000 initializations and projections for 2010 and 2015 to historical data; (ii) mapping their CO2 emissions projections against observations; and (iii) examining model-output diagnostics. The IAMs underestimated historical primary energy consumption and initial/projected CO2 emissions in both reference and stabilization scenarios (particularly for combustion fuels) but overestimated usage of non-biomass renewables, causing underestimates of future CO2 emissions that, for the stabilization scenarios, are wildly optimistic. Mitigation technology breakdowns in the policy scenarios vary enormously across IAMs, suggesting that confidence in their projections might be misplaced, or that options for mitigation have greater scope than is supposed. Most increases in carbon-free technologies in the stabilization scenarios are already captured in the reference cases. Energy-conversion efficiencies in electricity generation improve over time, but, (except for gas-powered generation in IGSM), efficiencies in the policy scenarios are less than in the reference. Electrification results diverge widely: IGSM has little change over the 21st century, while MiniCAM and MERGE have major electrification increases in their policy scenarios. We suggest: 1) comprehensive model output suitable for secondary analysis should be more readily available; 2) directly comparable reference and policy-driven mitigation scenarios are essential for assessing mitigation measures; 3) model validation using historical, source-specific energy data is crucial for assessing model credibility; 4) separation of mitigation contributions into no-policy and policy-driven amounts is needed to assess the effectiveness of mitigation policies; and 5) detailed inter-model comparisons can provide important insights into model credibility.

Pneumonia, a leading cause of childhood mortality, is associated with household air pollution (HAP) exposure. Mechanisms between HAP and pneumonia are poorly understood, but studies suggest that HAP may increase the likelihood of bacterial, instead of viral, pneumonia. We assessed the relationship between HAP and infant microbial nasal carriage among 260 infants participating in the Ghana Randomized Air Pollution and Health Study (GRAPHS).Data are from GRAPHS, a cluster-randomized controlled trial of cookstove interventions (improved biomass or LPG) versus the 3-stone (baseline) cookstove. Infants were surveyed for pneumonia during the first year of life and had routine personal exposure assessments. Nasopharyngeal swabs collected from pneumonia cases (n = 130) and healthy controls (n = 130) were analyzed for presence of 22 common respiratory microbes by MassTag polymerase chain reaction. Data analyses included intention-to-treat (ITT) comparisons of microbial species presence by study arm, and exposure-response relationships.In ITT analyses, 3-stone arm participants had a higher mean number of microbial species than the LPG (LPG: 2.71, 3-stone: 3.34, p < 0.0001, n = 260). This difference was driven by increased bacterial (p < 0.0001) rather than viral species presence (non-significant). Results were pronounced in pneumonia cases and attenuated in healthy controls. Higher prevalence bacterial species were Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Exposure-response relationships did not yield significant associations between measured CO and nasal microbial carriage.Our intention-to-treat findings are consistent with a link between HAP and bacterial nasal carriage. No relationships were found for viral carriage. Given the null results in exposure-response analysis, it is likely that a pollutant besides CO is driving these differences.