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HEAT'S DEADLY EFFECTS PRE-QUIZ QUESTION #1 Prior to Hurricane Katrina, what was the deadliest type of extreme weather event to strike the US? a) Tornadoes b) Floods c) Heat QUESTION #2 The urban heat island phenomenon causes warmer temperatures in cities during both the daytime and the nighttime. a. True b. False QUESTION #3 The European heat wave in 2003 caused how many deaths? a) 700 b) 7,000 c) 70,000 d) 700,000 QUESTION #4 According to the IPCC, heat waves are expected to increase in a. Frequency b. Magnitude c. Duration d. All of the above QUESTION #5 Describe 3 consequences of heat stroke. QUESTION #6 When high heat threatens, what anticipatory guidance can health practitioners give to patients and their families to help them stay safe? Give three examples. HEAT'S DEADLY EFFECTS 2012 IPCC SPECIAL REPORT The IPCC is “virtually certain” [99-100% certainty] that [by the end of this century] the earth will experience a decrease in the frequency and magnitude of cold days/nights and an increase in frequency and magnitude of unusually warm days and nights. IPCC PROJECTIONS Jami Dwyer, Wikimedia Commons Arvind Balaraman, freedigitalphotos.net IMPACTS ON HUMAN HEALTH HEAT CRAMPS Muscle pains or spasms Abdomen, arms, or legs Occur with strenuous activity in the presence of heat Due to salt imbalance Stop all activity, and sit in a cool place. Drink clear juice or a sports beverage. No strenuous activity for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke. Seek medical attention if heat cramps do not subside in 1 hour. HEAT EXHAUSTION Symptoms Intense Thirst Heavy sweating Weak, pale Headache Nausea/vomiting Dizziness/fainting Fatigue Core temp normal or slightly elevated Skin moist/cool HEAT STROKE Heat exhaustion may progress to heat stroke, which is a severe illness. Core body temperature of 105°F+ Hot, dry skin Delirium Convulsions Coma Possible death EXTREME HEAT CAN LEAD TO DEATH 750 people died from heat-related illness in the 1995 Chicago heat wave The number of reported heat-related deaths and illness is expected to rise due to the projected increase in frequency, duration, and magnitude of extreme heat events. HEAT, AIR POLLUTION, RESPIRATORY ISSUES As people turn on their air conditioning during heat waves, their use of fossil fuels increases the amount of air pollution in the atmosphere. This pollution may exacerbate preexisting conditions such as angina and asthma and may lead to increased death rates. RESPIRATORY ISSUES: OZONE Healthy Airway Inflamed Airway CARDIOVASCULAR ISSUES Heat increases skin blood vessel dilation, affects blood pressure, and increases effective blood volume Incidence of stroke and cardiovascular hospitalizations increase as temperature increases. Increased ozone due to increasing temperature affects the cardiovascular system and can increase the risk of heart arrhythmias and heart attack. CASE STUDY: 2003 EUROPEAN HEAT WAVE Final estimate: 70,000 excess deaths Greatest impact: elderly, the chronically ill and young children In typically cool Europe, many people had no air conditioning According to a study lead by climate expert, Dr. Peter Stott, “If greenhouse gas emissions continue to increase, by the 2040s more than half of European summers will be hotter than the summer of 2003, and by the end of this century, a summer as hot as that of 2003 will be considered unusually cool.” Jami Dwyer, Wikimedia Commons A. Davey, Flickr USDA, Wikimedia Commons HEAT’S INDIRECT IMPACTS ON HEALTH VECTOR-BORNE DISEASES • Prolonged higher average temperatures can increase transmission of vector-borne diseases PRECIPITATION EVENTS • • • Rising temperatures increase global evaporation rates. Increasing sea temperatures increase hurricane intensity and duration More intense hurricanes, flooding, and storms. IMPACTS ON AGRICULTURE Warmer temperatures: reduce overall crop yields; decrease rates of photosynthesis, reduce soil moisture; Increase water demand and survival of plant pests, diseases and weeds HEAT CONTRIBUTES TO WILDFIRES •Extended periods of drought and decreased soil moisture raise the risk of wildfires • Increasing wildfires can lead to death or injury, and increase fine particulate air pollution HEAT AFFECTS MENTAL HEALTH Heat waves contribute to more alcohol and substance abuse. Prolonged and more severe heat waves increase homicide, suicide, physical abuse, and spousal abuse. Just an increase of 1 degree F may increase the risk of violent behavior, especially in warm climates and the inner city. The mentally ill are also a vulnerable population. VULNERABLE POPULATIONS: Elderly About 0.5 - 2% of the annual deaths in older age groups in Europe is due to heat Pre-existing medical condition Immobile Mental illness Economically disadvantaged ADAPTATION STRATEGIES Expand local green spaces and plant more trees to reduce heat islands Paint surfaces white (roofs, asphalt, parking lots) Establish heat monitoring and warning systems Set up local cooling centers and provide transportation to these centers Create social support networks across vulnerable populations Physicians for Social Responsibility Work with local governments 31 HEAT WAVE ADAPTATION STRATEGIES: Anticipatory guidance for patients: When outdoors, limit physical exertion, stay in the shade, wear loose clothing and hats Take cool showers and baths Drink plenty of non-alcoholic, non-caffeinated fluids Eat lightly. Avoid using stoves or ovens to heat food Close curtains and blinds to keep out sunlight Use air conditioning when available or move to lower floors Identify location of and transportation to local cooling centers Establish a “buddy system” Be familiar with the signs and symptoms of heat cramps, heat exhaustion and stroke PREVENTING CLIMATE CHANGE: Alternative Energy Generation: Renewable energy makes good environmental and economic sense Use alternative energy sources for lighting, heating and powering your home Alternative sources of energy are less vulnerable to energy disruptions in the event of a disaster Photos: HCWH, Practice Greenhealth 33 CLINICIANS CAN PLAY A KEY ROLE COMBATING CLIMATE CHANGE Encourage green practices and energy efficiency in your medical facility Provide brochures, relevant literature and informational posters in waiting areas and lobbies to educate patients and their families about how they can reduce their emissions Make recommendations to patients that improve health and wellbeing and reduce greenhouse gas emissions (such as eat less meat, walk and bike more, use public transit) 34 POST-QUIZ QUESTION #1 Prior to Hurricane Katrina, what was the deadliest type of extreme weather event to strike the US? a) Tornadoes b) Floods c) Heat QUESTION #2 The urban heat island phenomenon causes warmer temperatures in cities during both the daytime and the nighttime. a. True b. False QUESTION #3 The European heat wave in 2003 caused how many deaths? a) 700 b) 7,000 c) 70,000 d) 700,000 QUESTION #4 According to the IPCC, heat waves are expected to increase in a. Frequency b. Magnitude c. Duration d. All of the above QUESTION #5 Describe 3 consequences of heat stroke. 1) Core body temperature of 105°F+ 2) Hot, dry skin 3) Delirium 4) Convulsions 5) Coma 6) Possible death QUESTION #6 When high heat threatens, what anticipatory guidance can health practitioners give to patients and their families to help them stay safe? Give three examples. When outdoors, limit physical exertion, stay in the shade, wear loose clothing and hats Take cool showers and baths Drink plenty of non-alcoholic, non-caffeinated fluids Eat lightly. Avoid using stoves or ovens to heat food Close curtains and blinds to keep out sunlight Use air conditioning when available or move to lower floors Identify location of and transportation to local cooling centers Establish a “buddy system” Be familiar with the signs and symptoms of heat cramps, heat exhaustion and stroke JOIN TOGETHER FOR CHANGE www.PSR.org 202-667-4260