Background Literature reporting the association between heat stress defined by universal thermal climate index (UTCI) and emergency department visits is mainly conducted in Europe. This study aimed to investigate the association between heat stress, as defined by the UTCI, and visits to the accident and emergency department (AED) in Hong Kong, which represents a subtropical climate region.

Methods A retrospective study involving 13,438,846 AED visits in the public sector from May 2000 to September 2016, excluding 2003 and 2009, was conducted in Hong Kong. Age-sex-specific ANCOVA models of daily AED rates on heat stress and prolonged heat stress, adjusting for air quality, prolonged poor air quality, typhoon, rainstorm, year, day of the week, public holiday, summer vacation, and fee charging, were used.

Results On a day with strong heat stress (32.1 °C ≤ UTCI ≤ 38.0 °C), the AED visit rate (per 100,000) increased by 0.9 (95% CI: 0.5, 1.3) and 1.7 (95% CI: 1.3, 2.1) for females and males aged 19–64 and 4.1 (95% CI: 2.7, 5.4) and 4.1 (95% CI: 2.6, 5.6) for females and males aged ≥ 65, while keeping other variables constant. On a day with very strong heat stress (38.1 °C ≤ UTCI ≤ 46.0 °C), the corresponding rates increased by 0.6 (95% CI: 0.1, 1.2), 2.2 (95% CI: 1.7, 2.7), 4.9 (95% CI: 3.1, 6.7), and 4.7 (95% CI: 2.7, 6.6), respectively. The effect size of heat stress associated with AED visit rates was negligible among those aged ≤ 18. Heat stress showed the greatest effect size for males aged 19–64 among all subgroups.

Conclusion Biothermal condition from heat stress was associated with the health of the citizens in a city with a subtropical climate and reflected in the increase of daily AED visit. Public health recommendations have been made accordingly for the prevention of heat-related AED visits.

The precise building performance assessment of residential housings in subtropical regions is usually more difficult than that for the commercial premises due to the much more complicated behavior of the occupants with regard to the change in indoor temperature. The conventional use of a fixed schedule for window opening, clothing insulation and cooling equipment operation cannot reflect the real situation when the occupants respond to the change in thermal comfort, thus affecting the appropriateness of the assessment results. To rectify the situation, a new modeling strategy in which the modification of the various operation schedules was based on the calculated thermal comfort (TC), was developed in this study. With this new TC-based strategy, the realistic building performances under different cooling provision scenarios applied to a high-rise residential building under the near extreme weather conditions were investigated and compared. It was found that sole provision of ventilation fans could not meet the zone thermal comfort by over 68% of the time, and air-conditioning was essential. The optimal use of ventilation fans for cooling could only help reduce the total cooling energy demand by less than 12% at best which could only be realistically evaluated by adopting the present strategy. Parametric studies were conducted which revealed that some design factors could offer opportunities for reducing the total cooling energy under the near extreme weather conditions.

Microclimate research has seen significant growth in recent years, particularly in areas such as outdoor thermal comfort, urban ecology, and urban heat mitigation. However, the short-term nature of many studies in this field presents challenges in ensuring that the collected data accurately represents local climate conditions. This paper introduces a novel method to enhance the quality and applicability of microclimate research by quantifying the representativeness of short-term meteorological data. Our approach employs the Kolmogorov-Smirnov (KS) statistic to compare daily meteorological data from nearby stations against long-term climate trends. Key findings demonstrate that this method effectively identifies representative data periods. This method allows researchers to evaluate the representativeness of each day's data according to their specific study objectives, whether focusing on typical or extreme weather conditions. By implementing this framework, researchers can: (a) Post-filter existing data to identify the most representative samples. (b) Quantify the climate representativeness of their findings, enhancing result interpretation and applicability. (c) More confidently generalize conclusions from short-term studies. The paper also provides simplified alternatives to the full method, making it accessible to a wider range of researchers. By adopting this approach, microclimate studies can achieve greater confidence in their data's representativeness, leading to more robust and generalizable conclusions. Our method addresses a key methodological challenge in microclimate research and provides a flexible data assessment framework. This framework enables researchers to systematically evaluate climate data representativeness, enhancing the reliability and applicability of their findings across various urban climate studies, from thermal comfort assessments to climate adaptation strategies.

According to the United Nations Office for Disaster Risk Reduction (UNDRR), a heat-health action plan should address various impacts of hazards at different levels, including an early warning system to monitor risks and behaviour enhancement to increase disaster preparedness. It is necessary to comply with guidelines regarding heat duration/intensity. In this study, we developed a data-driven approach to rapidly and systematically estimate the impacts of various heat events on emergency admissions among the adult population (n = 7,086,966) in Hong Kong in order to enhance the heat-health action plan. Immediate, short-term, and long-term impacts determined by 1-day, 4-day, and 8-day windows were estimated to identify specific heat events suitable for early warnings. In addition, underestimated risk, determined by a continuous increase in heat risk after days without significant emergency admissions, was estimated to evaluate potential maladaptive behaviours among a specific subpopulation. Based on age- and gender-specific analyses, 1D, 1D1N, and 2D2N were observed to have a stronger immediate impact on emergency admissions. 1D1N and 2D2N also showed notable short-term and long-term impacts. Based on heat vulnerability factors (age and gender), 2D2N was a higher-priority extreme heat event for early warning measures than 1D1N. Furthermore, men aged 19 to 64 had the highest underestimated risk. Specifically, they had IRR values of 1.113 [1.087, 1.140], 1.061 [1.035, 1.087], and 1.069 [1.043, 1.095] during lag days 3-5 of 3D2N, respectively, possibly due to a lack of adaptive behaviour. By adopting our approach, the duration of heat events with significant health impacts can be identified in order to further enhance relevant heat stress information. This framework can be applied to other cities with a similar background for rapid assessment.

Osteoporosis is a major physical health issue in healthy ageing among urban populations. However, few studies have investigated how greenspace can influence osteoporosis, especially to those who lived in a compact city with high-density living environment. Furthermore, no studies have investigated how “planned greenspace” and “natural greenspace” can separately influence osteoporosis among senior population. We hereby conducted an empirical study to evaluate the relationship between osteoporosis, “planned greenspace” and “natural greenspace”, based on the use of land use data derived from local geospatial information and satellite images. Our results showed that seniors who were 1) aged, 2) female, 3) less educated, 4) smokers, and 5) with chronic respiratory diseases were associated with osteoporosis. Considering factors of greenspace, a higher percentage of planned greenspace surrounding the residence may be a protective factor while natural greenspace did not influence the individuals. Specifically, a 10% increase of planned greenspace within the 600-m radius area surrounding the residence was negative associated with osteoporosis (−2.8% [-5.1%, −0.5%]). Based on our results, development of planned greenspace may be necessary, as compact built environment of a high-density city often resulted in a lack of planned greenspace for physical activities. Along with the World Health Organization (WHO) guidelines for an age-friendly city, our findings suggest that improving the planned greenspace in a walkable distance around one's neighboring environment is a potential strategy for prevention of osteoporosis and related physical health issues as well as for life quality improvement among the senior population.

The urban heat island (UHI) effect exacerbates the adverse impact of heat on human health. However, while the UHI effect is further intensified during extreme heat events, prior studies have rarely mapped the UHI effect during extreme heat events to assess its direct temperature impact on mortality. This study examined the UHI effect during extreme heat and non-extreme heat scenarios and compared their temperature-mortality associations in Hong Kong from 2010 to 2019. Four urban heat island degree hour (UHIdh) scenarios were mapped onto Hong Kong's tertiary planning units and classified into three levels (Low, Moderate, and High). We assessed the association between temperature and non-external mortality of populations living in each UHIdh level for the extreme heat/non-extreme heat scenarios during the 2010–2019 hot seasons. Our results showed substantial differences between the temperature-mortality associations in the three levels under the UHIdh extreme heat scenario (UHIdh_EH). While there was no evidence of increased mortality in Low UHIdh_EH areas, the mortality risk in Moderate and High UHIdh_EH areas were significantly increased during periods of hot temperature, with the High UHIdh_EH areas displaying almost double the risk (RR: 1.08, 95%CI: 1.03, 1.14 vs. RR: 1.05, 95 % CI: 1.01, 1.09). However, other non-extreme heat UHI scenarios did not demonstrate as prominent of a difference. When stratified by age, the heat effects were found in Moderate and High UHIdh_EH among the elderly aged 75 and above. Our study found a difference in the temperature-mortality associations based on UHI intensity and potential heat vulnerability of populations during extreme heat events. Preventive measures should be taken to mitigate heat especially in urban areas with high UHI intensity during extreme heat events, with particular attention and support for those prone to heat vulnerability, such as the elderly and poorer populations.

Heat-health warning systems and services are important preventive actions for extreme heat, however, global evidence differs on which temperature indicator is more informative for heat-health outcomes. We comprehensively assessed temperature predictors on their summer associations with adverse health impacts in a high-density subtropical city. Maximum, mean, and minimum temperatures were examined on their associations with non-cancer mortality and hospital admissions in Hong Kong during summer seasons 2010–2019 using Generalized Additive Models and Distributed Lag Non-linear Models. In summary, mean and minimum temperatures were identified as strong indicators for mortality, with a relative risk(RR) and 95% confidence interval(CI) of 1.037 (1.006–1.069) and 1.055 (1.019–1.092), respectively, at 95th percentile vs. optimal temperature. Additionally, minimum temperatures captured the effects of hospital admissions, RR1.009 (95%CI: 1.000- 1.018). In stratified analyses, significant associations were found for older adults, female sex, and respiratory-related outcomes. For comparison, there was no association between maximum temperature and health outcomes. With climate change and projected increase of night-time warming, the findings from this comprehensive assessment method are useful to strengthen heat prevention strategies and enhance heat-health warning systems. Other locations could refer to this comprehensive method to evaluate their heat risk, especially in highly urbanized environments and subtropical cities.

Recent advances in numerical tools and data for the study of urban microclimates have helped to evaluate countermeasures for urban heat in heterogeneous and high-rise cities such as Hong Kong. Thus, two ventilation strategy designs, point ('oases') and linear ('corridors') features, were numerically simulated during a typical heatwave using the multi-layer coupled MesoNH-SURFEX-TEB mesoscale atmospheric model.

These strategies proved to be effective at night with respect to thermal comfort but caused a localised increase in heat stress during the day in the ventilated areas, which were less shaded. There was no significant deterioration in the wind performance around the developments that were redesigned to accommodate the displaced population due to the construction of the ventilation features; however, an improvement was observed in thermal comfort during the daytime. The simulated impacts were relatively localised, suggesting the importance of increasing porosity across the entire urban fabric. The corridors, especially when built along the axis of the prevailing winds, exhibited better ventilation at the pedestrian level than the oases. Nevertheless, the oases remain interesting features in the context of progressive urban ventilation planning that involve the implementation of isolated, connected, and eventually a network of features to provide benefits at the megalopolis scale.

Background: Extreme hot weather events are happening with increasing frequency, intensity and duration in Hong Kong. Heat stress is related to higher risk of mortality and morbidity, with older adults being particularly vulnerable. It is not clear whether and how the older adults perceive the increasingly hot weather as a health threat, and whether community service providers are aware and prepared for such future climate scenario.

Methods: We conducted semi-structure interviews with 46 older adults, 18 staff members of community service providers and two district councilors of Tai Po, a north-eastern residential district of Hong Kong. Transcribed data were analyzed using thematic analysis until data saturation was reached.

Results: It was agreed upon among the older adult participants that the weather in recent years has become increasingly hot and this led to some health and social problems for them, although some participants perceived that hot weather did not have any impact in their daily lives and they were not vulnerable. The community service providers and district councilors reported that there is a lack of relevant services in the community to support the older adults in hot weather; and there is generally a lack of public education regarding the heat-health issue.

Conclusions: Heatwaves are affecting older adults' health in Hong Kong. Yet, discussions and education effort regarding the heat-health issue in the public domain remain scarce. Multilateral efforts are urgently needed to co-create a heat action plan to improve community awareness and resilience.

To tackle urban overheating induced by the combined effect of global warming and intensive urbanization, researchers have recommended assimilating microclimate-related strategies into urban design practices. Field measurements, playing a central role in urban climatology, have been widely applied worldwide. Reviewing the last five years' field measurement studies and existing guidelines and standards from WMO (World Meteorological Organization) and ISO (International Organization for Standardization), this study identified a gap between available guidelines and researchers' practical needs to ascertain the collection of high caliber data. Therefore, dedicated guidelines are required to explain the crucial conceptual and application issues and refine systematic field measurement methods. This demand is particularly acute for microscale and urban environments. This study proposed and explained integrated and comprehensive guidelines for systematic microclimate field measurements. The suggested workflow included four main steps: formulating field measurement plan, preparing for field measurements, sustaining measurement quality, and curating data. The complex and heterogeneous environment in urban areas was carefully evaluated to hone the data acquisition campaign and ascertain data quality. Relevant concepts and practices learned from existing guidelines and standards, experiences from actual field studies, and professional recommendations were distilled and incorporated into the guidelines. The significance of a complete report with full metadata was emphasized. Detailed hints, precautions, recommendations, examples, and a metadata checklist were provided as a helpful and actionable package of research procedures.

Urban overheating (due to climate change and urbanization) and COVID-19 are two converging crises that must be addressed in tandem. Fine-scale, place-based, people-centric biometeorological and behavioral data are needed to implement context-specific preventative measures such as mask-wearing. This study collected local biometeorological measurements in diverse urban spaces (square, urban park, river quay) in Novi Sad, Serbia on hot sunny summer days (27–30 August 2020) during the COVID-19 pandemic. Observations were supplemented by an online survey asking questions about thermal sensation, comfort, and concurrent protective behavior of the local population. Biometeorological measurements show that the main square in the city center was the most thermally uncomfortable area. According to the survey, it was also perceived as the least safe space to not contract the virus. The urban park was perceived as the most thermally comfortable area in the morning and during midday. It was also considered the safest urban space for outdoor activities. In the evening, the river quay was the most thermally comfortable area in the city. Intra-urban differences in Physiologically Equivalent Temperatures were highest during midday, while differences in air temperatures were highest in the evening. More than 70% of the respondents did not wear face masks when it was hot because of breathing issues and feeling warmer than without mask. Most people wearing a mask felt “slightly warm” in the morning and evening, while the majority of respondents felt “hot” during midday. Only 3% of the respondents felt comfortable while wearing a mask, while 97% experienced some degree of discomfort (from slight discomfort to very uncomfortable). Our study shows that fine scale temporal and spatial urban biometeorological data and population surveys should be included in decision-making processes during the pandemic to develop climate-sensitive health services that are place-based, people-centric, and facilitate planning towards green, resilient, and inclusive cities.

Mean radiant temperature (MRT) is a significant variable for outdoor thermal comfort studies. Two measurement-based methods can estimate MRT, one is globe thermometer – cheap, easily-applied but relatively inaccurate, another is integral radiation measurement method (also known as the six-directional method) - accurate but expensive. Due to low-cost and convenience, the globe thermometer has been widely used. Previous studies have improved its estimation accuracy by recalibrating the convection coefficients in the ISO method. Thus, it is pending to cross-compare the performance of these recalibrated methods.

This study aims to investigate the transferability of the recalibrated methods for estimating MRT in outdoor environment. First, field measurement was conducted in a subtropical city, Hong Kong. MRT was obtained through two methods: globe thermometer and integral radiation method. Second, the existing recalibrated convection coefficients were summarized, and the localized convection coefficient was recalibrated. Third, all recalibrated methods were compared for their performance. The impacts of measurement locations, devices, analysis time intervals were examined.

The results showed that the newly recalibrated method achieved the lowest estimation errors (RMSE = 3.84 °C). Other recalibrated methods presented higher RMSE (3.84–17.52 °C), similar as conventional ISO method (7.91 °C). Especially for open spaces, the coefficients from other cities should be cautiously applied when the accuracy requirement is less than ±2 °C. Kestrel and Grey globe are more recommended in subtropical cities. This study shed light on the application of globe thermometer for outdoor environment, and emphasized the necessity in recalibrating the convection coefficients locally.

The global concern over the interplay between climate mitigation, urban structures, and city energy usage underscores a pressing need for innovative solutions. This research delves into the relationship between urban layouts, energy dynamics, and the thermal comfort of public spaces between buildings. Focusing on the contrasting climates of Luleå, Sweden, and Limassol, Cyprus, the study employs ENVI-met, a microscale urban climate simulation tool, for a parametric exploration at the city block scale. Assessing eight distinct scenarios across morning, noon, and afternoon timeframes, the research considers the impact of Building-Integrated Photovoltaics (BIPVs) on user thermal comfort. Contrary to expectations, the study reveals that BIPV integration alone may not be the primary driver of improved thermal comfort during peak heat periods. Instead, factors like urban density and urban morphology emerge as influential contributors. For instance, increasing the urban fabric density by doubling the building height resulted in greater PET fluctuations ranging from −3 to +3 degrees, compared to the modest PET fluctuations ranging from 0 to +3 degrees observed with the simple integration of PVs onto buildings. These findings offer valuable insights for urban planners and policymakers, guiding decisions in considering the issue of thermal comfort in public spaces between buildings, while optimizing energy consumption in urban areas.

The ongoing climate crisis and turbulence on the world stage has highlighted the need for sustainability and resilience in the development and maintenance of urban areas regarding climate comfort and energy access. Local production of green energy increases both the sustainability and resilience of an area. Traditionally, photovoltaic (PV) panels are deployed wherever the amount of sunlight is highest but lowering costs for PV panels makes them cost-effective even in colder climates. Within the broader umbrella of positive energy districts, façade mounted building-integrated PV panels in urban areas additionally present unique opportunities and challenges, as factors such as wind, solar irradiance, or nearby obstructions can have either a positive or negative effect on the performance of the PV panels. In this article, we aimed to answer the question: What factors inform the optimization of vertical PV panels? To answer this, we developed a method for the optimization of placement of PV panels. By building upon readily available weather data, local panel conditions were examined, and field-driven aggregation algorithm used to guide panel placement. Performance of the resulting panel configurations were then compared to a baseline case. Results indicate that our developed method helped mitigate negative impacts of the aforementioned factors, and often improved performance over baseline.

The research performed attempts to answer the question of how building integration of active solar systems may affect the thermal comfort in open areas and the interstitial space between buildings in urban environments. This is done by using computer simulation and in-situ observations at the extreme northern and southern geographies of Europe, namely in Luleå, Sweden and in Limassol, Cyprus. A typical example of the urban grid of each city is chosen and active solar systems are integrated on the facades of buildings, respectively foreach case. The thermal conditions at street level are then simulated, using Envi-MET, before and after systems integration, with the aim of assessing the differences between low and high insolation conditions, using the Physiological Equivalent Temperature (PET) indicator. Subsequently, the thermal conditions in the public space between buildings were once again assessed, with reduced emissivity values for the building integrated PV panels. The results point to the fact that the building integration of PVs lacking low emissivity coatings can have an impact in the thermal comfort of users in the locations specified, especially in the summer, wherein it is shown to be negligible in the southern case study but more significant in the northern one.

Previous evidence suggests that temperature is associated with the number of emergency department (ED) visits. A predictive system for ED visits, which takes local temperature into account, is therefore needed. This study aimed to compare the predictive performance of various machine learning methods with traditional statistical methods based on temperature variables and develop a daily ED attendance rate predictive model for Hong Kong. We analyzed ED utilization among Hong Kong older adults in May to September from 2000 to 2016. A total of 103 potential predictors were derived from 1- to 14-day lag of ED attendance rate and meteorological and air quality indicators and 0-day lag of holiday indicator and month and day of week indicators. LASSO regression was used to identify the most predictive temperature variables. Decision tree regressor, support vector machine (SVM) regressor, and random forest regressor were trained on the selected optimal predictor combination. Deep neural network (DNN) and gated recurrent unit (GRU) models were performed on the extended predictor combination for the previous 14-day horizon. Maximum ambient temperature was identified as a better predictor in its own value than as an indicator defined by the cutoff. GRU achieved the best predictive accuracy. Deep learning methods, especially the GRU model, outperformed conventional machine learning methods and traditional statistical methods.