1. Climate Change and Health: the Effects of Heat Mona Sarfaty, MD MPH FAAFP Director, Program on Climate and Health Center for Climate Change Communication (4C) September 20, 2015

2. DECLARATIONS I Have No Commercial Interests to Declare Related to this Presentation Presentation is partially supported by the George Mason University Foundation

3. Health Effect: Heat Significant as Leading Cause of Mortality from Extreme Weather

4. U.S. Deaths Attributed to Weather Conditions 2000-2009* *NOAA 2010 in http://www.cdc.gov/climateandhealth/pubs/ClimateChangeandExtremeHeatEvents.pd f

5. 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?

6. 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: NOAANOAA

7. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

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

19. Adaptation is Saving Lives

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

22. Resource (and Tool Kit) http://www.cdc.gov/climateandhealth/pubs/ClimateChangeandExtremeHeatEvents.pdf

23. 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.

24. End of Heat Section Thank You! msarfaty@gmu.edu