Climate Change and Health: the Effects of Heat

Mona Sarfaty, MD MPH FAAFPDirector, Program on Climate and Health

Center for Climate Change Communication (4C)September 20, 2015

DECLARATIONS

I Have No Commercial Interests to Declare Related to this Presentation

Presentation is partially supported by theGeorge Mason University Foundation

Health Effect: Heat

Significant as Leading Cause of Mortality from Extreme Weather

U.S. Deaths Attributed to Weather Conditions 2000-2009*

Heat 24%

Hurricanes 23%

Flood 13%

Tornado 11%

Wind 9%

Lightning 8%

Winter Storm 7%Cold 5%

*NOAA 2010 in http://www.cdc.gov/climateandhealth/pubs/ClimateChangeandExtremeHeatEvents.pdf

Outline

• How is the temperature changing in the U.S.?• What is an extreme heat event?• Who is vulnerable to heat events?• What kinds of problems do heat events cause?• What can we do about them?

Global Heat Anomalies

The NOAA global climate record for land and ocean temperatures over the last 136 years in which June of 2015 is now the all-time hottest. Image source: NOAA

Heat in the U.S.?

• The August average temperature for contiguous U.S. was above average….• The August maximum temperature for contiguous U.S was above average….• The August minimum (nighttime) temperature for contiguous U.S was above

average….• But what about people’s individual experience where they live? (next slide)

*http://www.ncdc.noaa.gov/sotc/national/201508

Extreme Heat

• Extreme heat events are characterized by weather that is substantially hotter and/or more humid for a particular location at a particular time. Occur in all terrains (rural, surburban, urban).*

• Why hotter AND/OR more humid

*Hayhoe K, et al., PNAS 2004.

What are Extreme Heat Events:

9

Who is Vulnerable to Heat Injury

• Risk factors– Age: old and young– Chronic diseases (heart, pulmonary, renal, mental health)– Impaired mobility– Lack of air conditioning– People on certain medications– People engaged in outdoor activities– Homeless

Health Professionals Understand Why Risk Increases• Groups at increased risk:

• Elderly – sweat less, less thirst drive

• Non-ambulatory – May not seek cooler locations or hydrate

• Cardiopulmonary and renal conditions – Circulatory burden and dehydration

• Mental health medications – Thermoregulation

• Children (0-4) and older kids – thermoregulatory issues and activities• Sports Enthusiasts – may overdo• Laborers – may be placed at greater risk• Homeless – may not recognize the danger or have resources to cope

What You Should Do about Heat Illness

• If mild, hydrate and get away from heat• If more severe (heat exhaustion), hydrate, cool, move to a

better location• If heat stroke, seek emergency care

What does extreme heat mean for personal health? Mild Symptoms (rash, heat fatigue) Heat Exhaustion

Thirst, rapid heart beat Weak/Dizzy Cramps/Headache Nausea/Vomiting Profuse Sweating

Heat Stroke: Confusion, Fainting, Coma Skin dry or moist Core (rectal) temp>104⁰

Risk of Mortality

13*http://www.cdc.gov/extremeheat/warning.html

Preventing Heat Injury and Mortality

• Adequate protecting people requires clinical AND public health teams

• Clinical teams can reach the vulnerable directly• Public Health teams can also reach the vulnerable directly and

indirectly• Government has a role to play• Communication is key

Preventing Mortality, continued

• Risk Communication– Clinical teams: identify and warn those at risk, see them directly or contact them – Mass media (radio, television)

• Alerts• Awareness of the problem

– Neighborhood: buddy systems, block captains• Public Health Systems

– Cooling centers– Outreach teams

• Local government – can create more options

Less cooling green spaces, less air flow due to large buildings, more heat absorbing surfaces.

Adaptation is Saving Lives

Community strategies to reduce heat risks Cooler areas have vegetation and/or water

Resource (and Tool Kit)

http://www.cdc.gov/climateandhealth/pubs/ClimateChangeandExtremeHeatEvents.pdf

Bringing Adaptation and Mitigation Together

• To address the ongoing accumulation of greenhouse gas in the atmosphere that is causing warmer than average temperatures and an increasing number of days with extreme heat in many areas, we must address the underlying drivers of this change.

• This means policy change that will reduce the flow of greenhouse gases into the atmosphere that result from burning fossil fuels.

• More on this in the afternoon.

End of Heat Section

Thank You!msarfaty@gmu.edu