Heat Waves and Human Health Mitigation Measures

1. Heat Waves and Human HealthMitigation Measures Balatonföldvár, 5 September 2003 Tanja Cegnar

2. Thermal environment plays an important role in human health and well being. Extremes in temperature can cause physiological disturbance and organ damage, leading to illness and death. The increase in mortality and morbidity during hot weather in cities with temperature climate can be significant. Summer 2003!!!

3. International agencies (WHO, WMO, UNEP) some years ago have decided to promote and financially support Show case projects dealing with the impact of extreme heat events on human health. (WMO & WHO expert group, WMO TD No. 822, WCASP 42, 98)City selection criteria: Over a million inhabitants Irregular heat waves Meteorological and mortality/morbidity data for at least 10 years Local interest and implementation capability

4. EU Commission: PHEWE PROJECT: • Budapest • Rome (Show case city) • Paris • Barcelona • London

5. Mitigation measures in ancient Rome?The seasonal exodus of the rich from cities to the cleaner and more comfortable environment occurred also in ancient Rome. During height of the summer Rome was notorious for its unhealthy conditions.

6. Facts: • Most casualties among people above 65 • In hot climate adaptations in lifestyle, physiological acclimatization and adoption of particular mental approach • Cultural and social adjustments, including design of houses • Individuals with a low adaptive capability suffer first and foremost from heat load of any magnitude • It appears that virtually all causes of death increase under stressful weather • Individual lifestyle, clothing habits, occupational conditions influence exposure levels • Heat stress can be aggravated by inappropriate behaviour • Distinction should be made between the heat stress for a population and that for individual

7. Early behavioural signs of prolonged heat stress in densely populated areas include: discomfort, social intolerance, irritability, industrial accidents. Heat waves present special problems in urban areas because of the retention of heat by buildings, if ventilation for cooling at night is inadequate.

8. What have we learned in Rome? • Importance of long set of data • Standardisation of data • The most difficult part of each project are good intervention measures • Forecast skills • Representative data • High standard deviation within oppressive air mass

9. The most impressive heat wave in Rome beside the ones in 1983, 1994 and 2003

10. City structureCustoms/habits Climate

11. Study each particular case, analyse in details some of the heat waves in the past • Develop predicting algorithms on historical data • Choose thresholds, ratio false alarms : missed heat waves • Adapt common intervention strategies to Budapest, specific ones to be determined • Make the best us of the already existing structures and potentials • Estimate costs of intervention measures

12. Prediction algorithms • Based on historical data • Including only predicted weather elements • Prediction skills • Input data should be for the same site as historical data - if not: check represetativnes and provide for a statistical correction if necessary

13. Optional predicting parameters: • day in the season • day in sequence • temperature (also minimum!)/ perceived temperature or any other measure based on heat budget models • humidity • wind • cloudiness • sunshine (duration, global radiation) • selection based on statistical analysis

14. Actions to be taken: • At starting point • During heat wave • Maintenance • Long-term

15. Before starting study details of: • climate, • available historical data & forecasts • population, • social structure, • what is already in place for such purpose, • identify the most vulnerable groups, • structure of heat island, • public health care structure, • political perception, • state of the art - awareness • media - co-operative, interested ? • partners?

16. Beginning: • Press conference to present the project, intervention measures, communication channels (different for different groups) • City’s web page on HHWWS • Promotional and educational material (brochures, video clips, articles, …), • Introduction of partners

17. Media have the power to educate and inform, and they will play an extremely important role in the implementation phase of the HHWWS

18. During heat wave: • Not only warning, but also recommendation and help! • Warnings/advice via channels: media, use health and meteorological infrastructure, • Structures to be involved: police, health organisations, volunteers, opening air-conditioned halls for everybody, • Recommendation about food, drinks, clothing, time table activities, ventilation, areas in the city and neighbourhood, ...

19. Special groups: • Children, • Seniors, handicapped, • Patients, • Homeless people • Particular measures for each of these groups, different channels of communication, different measures • BUT: General discomfort present, everybody could take advantage of good piece of advice

20. Don’t forget tourists, sportsmen, heat load in public transportation vehicles!

21. US experience: • Media announcements • Buddy system • Heat line (free number for advice) • Home visits • Nursing and personal care boarding • halt of utility service suspensions • Increased medical emergency stuffing • Daytime outreach to the homeless

22. It is extremely important to give the population all the necessary information when the heat load will increase over the threshold and how to act.The information should be clear; concrete recommendations and advice should be given, without inducing panics and should reach everybody in the city, also tourists and occasional visitors.

23. Media are the most efficient way to reach the whole population.

24. Maintenance: • Refresh memory at the beginning of the season each year • Continue with education process • Keep media interested - press communications at each event, • Performance assessment • Science articles • Efficiency assessment in number of lives and life quality • Cost benefit analysis

25. Long-term measures: • Education • Rise the awareness • City architecture and city structure (green areas, air circulation, materials, water bodies, energy consumption, take into account interactions: trees:allergies…) • Keep political interest vivid

26. Make the best use of knowledge of urban climatology!

27. Who is taking the responsibilities?How are they distributed and co-ordination? Who is able to implement HHWWS measures?Who is interested in HHWWS?Who is gaining, who could lose?

28. Think about future! • Extremes are projected to get worse (IPCC) • Extremes are expected to be more frequent (WMO) • Higher maximum air temperatures and more hot days over nearly all land areas are very likely • Reduced diurnal temperature range over most land areas

29. Impacts(crucial: variability, extremes): • Initial impact effects • Expected adaptation • Residual net impacts Depend on: • Exposure to extreme events • Adaptive capacity

30. Role of nonclimatic factors!We can not change climate, but we can change our behavioural patterns, buildings, city’s structure,...Danger/impacts depend on ability to adapt!Tasks: • Reduce vulnerability • Relate to existing management processes • Incorporate in city’s development initiatives