Heat waves in the United States: definitions, patterns and trends

Spatiotemporal variation in heatwaves and elderly population exposure across China

Heatwaves have been intensified worldwide due to climate change, posing great health risks, especially to elderly populations. However, in China, limited studies have employed the heat index to decipher the spatiotemporal trends of heatwaves and their impacts on the elderly population. By comparing the three heatwave definitions, this study aimed to evaluate the long-term spatiotemporal variations in heatwaves from 1964 to 2022 across China using the Excess Heat Factor (EHF). We took advantage of high-resolution reanalysis temperature data on the Google Earth Engine (GEE) platform to efficiently calculate the heatwaves. Our results revealed that the frequency and duration of heatwaves increased significantly in approximately 77 % of China's total area, with South China experiencing the most frequent and prolonged heatwaves. Conversely, in most areas, no significant trend was discerned in the growth of the maximum and average heatwave intensities. The total number of elderly people affected by heatwaves surged from approximately 11.96 million in 2001 to over 30.31 million in 2020, with an estimated additional 1.12 million older adults exposed to heatwaves annually across the nation (R2 = 0.60, p < 0.05). The population factor exhibited largest effect on the exposure of heatwaves, followed by climate effects and combined factors, with the corresponding explanatory power about 42.84 %, 34.85 % and 22.31 %, respectively. These individuals predominantly resided in the Northeast China, Southwest China, and South China. We also found geographical variations in heatwave exposure along elevations and land use types. These insights underscore the pressing necessity for formulating strategic interventions to mitigate the health threats presented by mounting heatwave exposure, especially for susceptible groups like the elderly in China.

Exploring spatial heterogeneity in synergistic effects of compound climate hazards: Extreme heat and wildfire smoke on cardiorespiratory hospitalizations in California

Extreme heat and wildfire smoke events are increasingly co-occurring in the context of climate change, especially in California. Extreme heat and wildfire smoke may have synergistic effects on population health that vary over space. We leveraged high-resolution satellite and monitoring data to quantify spatially varying compound exposures to extreme heat and wildfire smoke in California (2006-2019) at ZIP Code Tabulation Area (ZCTA) level. We found synergistic effects between extreme heat and wildfire smoke on daily cardiorespiratory hospitalizations at the state level. We also found spatial heterogeneity in such synergistic effects across ZCTAs. Communities with lower education attainment, lower health insurance coverage, lower income, lower proportion of automobile ownership, lower tree canopy coverage, higher population density, and higher proportions of racial/ethnic minorities experienced higher synergistic effects. This study highlights the need to incorporate compound hazards and environmental justice considerations into evidence-based policy development to protect populations from increasingly prevalent compound hazards.

Impact of heatwaves on all-cause mortality in India: A comprehensive multi-city study

BACKGROUND

Heatwaves are expected to increase with climate change, posing a significant threat to population health. In India, with the world's largest population, heatwaves occur annually but have not been comprehensively studied. Accordingly, we evaluated the association between heatwaves and all-cause mortality and quantifying the attributable mortality fraction in India.

METHODS

We obtained all-cause mortality counts for ten cities in India (2008-2019) and estimated daily mean temperatures from satellite data. Our main extreme heatwave was defined as two-consecutive days with an intensity above the 97th annual percentile. We estimated city-specific heatwave associations through generalised additive Poisson regression models, and meta-analysed the associations. We reported effects as the percentage change in daily mortality, with 95% confidence intervals (CI), comparing heatwave vs non-heatwave days. We further evaluated heatwaves using different percentiles (95th, 97th, 99th) for one, two, three and five-consecutive days. We also evaluated the influence of heatwave duration, intensity and timing in the summer season on heatwave mortality, and estimated the number of heatwave-related deaths.

FINDINGS

Among ∼ 3.6 million deaths, we observed that temperatures above 97th percentile for 2-consecutive days was associated with a 14.7 % (95 %CI, 10.3; 19.3) increase in daily mortality. Alternative heatwave definitions with higher percentiles and longer duration resulted in stronger relative risks. Furthermore, we observed stronger associations between heatwaves and mortality with higher heatwave intensity. We estimated that around 1116 deaths annually (95 %CI, 861; 1361) were attributed to heatwaves. Shorter and less intense definitions of heatwaves resulted in a higher estimated burden of heatwave-related deaths.

CONCLUSIONS

We found strong evidence of heatwave impacts on daily mortality. Longer and more intense heatwaves were linked to an increased mortality risk, however, resulted in a lower burden of heatwave-related deaths. Both definitions and the burden associated with each heatwave definition should be incorporated into planning and decision-making processes for policymakers.

Heatwave Definition and Impact on Cardiovascular Health: A Systematic Review

Objectives: We aimed to analyze recent literature on heat effects on cardiovascular morbidity and mortality, focusing on the adopted heat definitions and their eventual impact on the results of the analysis. Methods: The search was performed on PubMed, ScienceDirect, and Scopus databases: 54 articles, published between January 2018 and September 2022, were selected as relevant. Results: In total, 21 different combinations of criteria were found for defining heat, 12 of which were based on air temperature, while the others combined it with other meteorological factors. By a simulation study, we showed how such complex indices could result in different values at reference conditions depending on temperature. Heat thresholds, mostly set using percentile or absolute values of the index, were applied to compare the risk of a cardiovascular health event in heat days with the respective risk in non-heat days. The larger threshold's deviation from the mean annual temperature, as well as higher temperature thresholds within the same study location, led to stronger negative effects. Conclusion: To better analyze trends in the characteristics of heatwaves, and their impact on cardiovascular health, an international harmonization effort to define a common standard is recommendable.

The Impact of Heat Waves on Health Care Services in Low- or Middle-Income Countries: Protocol for a Systematic Review

BACKGROUND

Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce.

OBJECTIVE

This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs.

METHODS

We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity.

RESULTS

This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs.

CONCLUSIONS

The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities.

TRIAL REGISTRATION

PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/44702.

Global future population exposure to heatwaves

The increasing exposure to extreme heatwaves in urban areas from both climate change and the urban heat island (UHI) effect poses multiple threats and challenges to human society. Despite a growing number of studies focusing on extreme exposure, research advances are still limited in some aspects such as oversimplification of human exposure to heatwaves and neglect of perceived temperature as well as actual body comfort, resulting in unreliable and unrealistic estimates of future results. In addition, little research has performed comprehensive and fine-resolution global analyses in future scenarios. In this study, we present the first global fine-resolution projection of future changing urban population exposure to heatwaves by 2100 under four shared socioeconomic pathways (SSPs) considering urban expansion at global, regional, and national scales. Overall, global urban population exposure to heatwaves is rising under the four SSPs. Temperate and tropical zones predictably have the greatest exposure among all climate zones. Coastal cities are projected to have the greatest exposure, followed closely by cities at low altitudes. Middle-income countries have the lowest exposure and the lowest inequality of exposure among countries. Individual climate effects contributed the most (approximately 46.4%) to future changes in exposure, followed by the interactive effect between climate and urbanization (approximately 18.5%). Our results indicate that more attention needs to be paid to policy improvements and sustainable development planning of global coastal cities and some low-altitude cities, especially in low- and high-income countries. Meanwhile, this study also highlights the impact of continued future urban expansion on population exposure to heatwaves.

Heat-Resilient Schoolyards: Relations Between Temperature, Shade, and Physical Activity of Children During Recess

BACKGROUND

Extreme heat may discourage physical activity of children while shade may provide thermal comfort. The authors determined the associations between ambient temperature, shade, and moderate to vigorous physical activity (MVPA) of children during school recess.

METHODS

Children aged 8-10 (n = 213) wore accelerometers and global positioning system monitors during recess at 3 school parks in Austin, Texas (September-November 2019). Weather data originated from 10 sensors per park. The authors calculated shade from imagery using a geographic information system (GIS) and time-matched physical activity, location, temperature, and shade data. The authors specified piecewise multilevel regression to assess relations between average temperature and percentage of recess time in MVPA and shade.

RESULTS

Temperature ranged 11 °C to 35 °C. Each 1 °C higher temperature was associated with a 0.7 percentage point lower time spent in MVPA, until 33 °C (91 °F) when the association changed to a 1.5 lower time (P < .01). Each 1 °C higher temperature was associated with a 0.3 percentage point higher time spent under shade, until 33 °C when the association changed to a 3.4 higher time (P < .001). At 33 °C or above, the direct association between shade and MVPA weakened (P < .05), with no interaction effect above 33 °C (P > .05). Children at the park with the most tree canopy spent 6.0 percentage points more time in MVPA (P < .01).

CONCLUSIONS

Children engage in less MVPA and seek shade during extreme heat and engage in more MVPA in green schoolyards. With climate change, schools should consider interventions (eg, organizing shaded play, tree planting) to promote heat safe MVPA.

High ambient temperatures are associated with urban crime risk in Chicago

Urban crime (UC) seriously affects the security and stability of the communities and society. However, the effects of external temperatures on the risk of UC are still confusing. We quantitatively estimated the effects of high and low temperatures on UC in Chicago. After controlling for the confounding factors, we found that high temperature has a positive promoting effect on UC, for non-domestic crime, the effect occurs at lag day 0 with a maximum risk of 1.40 (95%CI, 1.34-1.46) compared to a risk of 1 at temperature of -12.3 °C, and decreased as the lag day increased. The effect of low temperature is not significant for UC. Heat waves above the 99th percentile with a duration of 4.5-5.5 days exert a significant positive impact on non-domestic crime of UC. Our findings confirm the adverse promotion effect of high temperature on UC risk, and effective individual behavior guidance and administrative intervention are of great significance for reducing the risk of UC under specific high temperature environment.

Evaluating the Sensitivity of Heat Wave Definitions among North Carolina Physiographic Regions

Exposure to extreme heat is a known risk factor that is associated with increased heat-related illness (HRI) outcomes. The relevance of heat wave definitions (HWDs) could change across health conditions and geographies due to the heterogenous climate profile. This study compared the sensitivity of 28 HWDs associated with HRI emergency department visits over five summer seasons (2011−2016), stratified by two physiographic regions (Coastal and Piedmont) in North Carolina. The HRI rate ratios associated with heat waves were estimated using the generalized linear regression framework assuming a negative binomial distribution. We compared the Akaike Information Criterion (AIC) values across the HWDs to identify an optimal HWD. In the Coastal region, HWDs based on daily maximum temperature with a threshold > 90th percentile for two or more consecutive days had the optimal model fit. In the Piedmont region, HWD based on the daily minimum temperature with a threshold value > 90th percentile for two or more consecutive days was optimal. The HWDs with optimal model performance included in this study captured moderate and frequent heat episodes compared to the National Weather Service (NWS) heat products. This study compared the HRI morbidity risk associated with epidemiologic-based HWDs and with NWS heat products. Our findings could be used for public health education and suggest recalibrating NWS heat products.

Climate change and physical activity: ambient temperature and urban trail use in Texas

Individuals in the USA are insufficiently active, increasing their chronic disease risk. Extreme temperatures may reduce physical activity due to thermal discomfort. Cooler climate studies have suggested climate change may have a net positive effect on physical activity, yet research gaps remain for warmer climates and within-day physical activity patterns. We determined the association between ambient temperatures (contemporary and projected) and urban trail use in a humid subtropical climate. At a trail in Austin, TX, five electronic counters recorded hourly pedestrian and cyclist counts in 2019. Weather data were acquired from World Weather Online. Generalized additive models estimated the association between temperature and trail counts. We then combined the estimated exposure-response relation with weather projections from climate models for intermediate (RCP4.5) and high (RCP8.5) emissions scenarios by NASA NEX-GDDP. From summer to autumn to spring to winter, hourly trail counts shifted from bimodal (mid-morning and early-evening peaks) to one mid-day peak. Pedestrians were more likely to use the trail between 7 and 27 °C (45-81°F) with peak use at 17 °C (63°F) and cyclists between 15 and 33 °C (59-91°F) with peak use at 27 °C (81°F) than at temperature extremes. A net decrease in trail use was estimated by 2041-2060 (RCP4.5: pedestrians =  - 4.5%, cyclists =  - 1.1%; RCP8.5: pedestrians =  - 6.6%, cyclists =  - 1.6%) and 2081-2100 (RCP4.5: pedestrians =  - 7.5%, cyclists =  - 1.9%; RCP8.5: pedestrians =  - 16%, cyclists =  - 4.5%). Results suggest climate change may reduce trail use. We recommend interventions for thermal comfort at settings for physical activity.

Ambient temperatures associated with increased risk of motor vehicle crashes in New York and Chicago

Motor Vehicle Crashes (MVC) are a major cause of death and disability worldwide. Yet it remains unknown to what extent changes in cold and hot temperatures affect the MVC. Here we quantify the linkage between ambient temperature exposure and the MVC risk of the driver in four cities of the United States. After adjusting for confounding factors, we find both a cold effect and a hot effect on MVC in New York, and a cold effect on MVC in Chicago. A 1 °C decrease in mean daily temperature below a cold threshold of -4.8 °C is associated with an increase in the overall cumulative relative risk of MVC by 11.59% (95% CI: 5.17%-16.43%) over 0-28 lag days for New York. The respective risk increase is 1.58% (95% CI: 0.36%-2.79%) over 0-2 lag days for a 1 °C increase in mean daily temperature above the hot threshold of 26.1 °C for New York. There is no significant heat wave or cold spell effects except for the heat wave effect on the consecutive heat wave days 7-10 in New York. Our study provides evidence of the association between driver exposure to low or high temperatures and the MVC risk. Improved public- administration preventive measures and policymaking are needed to minimize the negative consequences of abnormal temperatures on road safety driving.

Does air pollution modify temperature-related mortality? A systematic review and meta-analysis

INTRODUCTION

There is an increasing interest in understanding whether air pollutants modify the quantitative relationships between temperature and health outcomes. The results of available studies were, however, inconsistent. This study aims to sum up the current evidence and provide a comprehensive understanding of this topic.

METHODS

We conducted an electronic search in PubMed (MEDLINE), EMBASE, Web of Science Core Collection, and ProQuest Dissertations and Theses. The modified Navigation Guide was applied to evaluate the quality and strength of evidence. We calculated pooled temperature-related mortality at low and high pollutant levels respectively, using the random-effects model.

RESULTS

We identified 22 eligible studies, eleven of which were included in the meta-analysis. Significant effect modification was observed on heat effects for all-cause and non-accidental mortality by particulate matter with an aerodynamic diameter of <10 μm (PM₁₀) and ozone (O₃) (p < 0.05). The excess risks (ERs) for all-cause and non-accidental mortality were 5.4% (4.4%, 6.4%) and 6.3% (4.8%, 7.8%) at the low PM₁₀ level, 8.8% (7.5%, 10.1%) and 11.4% (8.7%, 14.2%) at the high PM₁₀ level, respectively. As for O₃, the ERs for all-cause and non-accidental mortality were 5.1% (3.9%, 6.3%) and 3.6% (0.1%, 7.2%) at the low O₃ level, 7.6% (6.3%, 9.0%) and 12.5% (4.7%, 20.9%) at the high O₃ level, respectively. Surprisingly, the heat effects on cardiovascular mortality were found to be lower at high carbon monoxide (CO) levels [ERs = 5.4% (3.9%, 6.9%)] than that at low levels [ERs = 9.4% (7.0%, 11.9%)]. The heterogeneity varied, but the results of sensitivity analyses were generally robust. Significant effect modification by air pollutants was not observed for heatwave or cold effects.

CONCLUSIONS

PM₁₀ and O₃ modify the heat-related all-cause and non-accidental mortality, indicating that policymakers should consider air pollutants when establishing heat-health warning systems. Future studies with comparable designs and settings are needed.

Mapping Heat Wave Hazard in Urban Areas: A Novel Multi-Criteria Decision Making Approach

Global population is experiencing more frequent, longer, and more severe heat waves due to global warming and urbanization. Episodic heat waves increase mortality and morbidity rates and demands for water and energy. Urban managers typically assess heat wave risk based on heat wave hazard, population exposure, and vulnerability, with a general assumption of spatial uniformity of heat wave hazard. We present a novel analysis that demonstrates an approach to determine the spatial distribution of a set of heat wave properties and hazard. The analysis is based on the Livneh dataset at a 1/16-degree resolution from 1950 to 2009 in Maricopa County, Arizona, USA. We then focused on neighborhoods with the most frequent, severe, earlier, and extended periods of heat wave occurrences. On average, the first heat wave occurs 40 days earlier in the eastern part of the county; the northeast part of this region experiences 12 days further extreme hot days and 30 days longer heat wave season than other regions of the area. Then, we applied a multi-criteria decision-making (MCDM) tool (TOPSIS) to evaluate the total hazard posed by heat wave components. We found that the northern and central parts of the metropolitan area are subject to the greatest heat wave hazard and that individual heat wave hazard components did not necessarily indicate heat hazard. This approach is intended to support local government planning for heat wave adaptation and mitigation strategies, where cooling centers, heat emergency water distribution networks, and electrical energy delivery can be targeted based on current and projected local heat wave characteristics.

Associations of Urban and Green Land Covers and Heat Waves in 49 U.S. Cities between 1992 and 2019

The study aimed to examine how changing land use conditions are related to the occurrence of heat waves. The employed methods were (1) the Urban Expansion Intensity Index (UEII) and the Green Expansion Intensity (GEII) for 49 cities in the U.S. between 1992 and 2019; (2) Spearman correlation analyses of heat wave indicators including frequency, season, duration, and intensity for UEII, and GEII, respectively. Major findings include the following: (1) urban areas have increased rapidly with an average UEII value of 1.5; (2) green Areas have increased at a slow pace, which have a GEII average value of 0.017, where the median value is −0.1, meaning the green area is declining in most U.S. cities; (3) The UEII and heat wave duration show a negative relationship with a significant correlation (γs = −0.296 and ρ = 0.04); (4) UEII and heat wave intensity show a positive relationship with a significant correlation (γs = 0.32 and ρ = 0.027). It was found that heat wave intensity can be a public health issue in high urban expansion intensity areas. The results imply that cities would be better in a more compact pattern with more expanded green areas to mitigate the negative health impacts of heat waves on citizens in urban areas. It is noticeable that there are some patterns to be investigated further in the context of urban developments and heat wave characteristics.

Interannual variability of heat waves over the Korean Peninsula based on integrated approach

Heat waves can provide detrimental impacts on human society and the environmental system, and thus have received substantial attention in scientific research. Since heat waves are relevant to a wide range of stakeholders, definitions for heat wave events vary in terms of threshold values, durations, and utilized variables. While there is a value in this diversity of perspectives, the various definitions often complicate the assessment of heat wave risk, thereby underscoring the improved utility of a unified definition. In this study, we examine the interannual variability of heat wave patterns by using a proposed copula-based framework. From five observed temperature-related variables, this study first evaluates the individual changes of fifteen previously published heat wave indices focused on heat wave events across the Korean Peninsula for the last 49 years (1973-2021). We then extract the integrated signals to understand the overall trend patterns using the multiple heat wave indices. Results indicate that different heat wave definitions present distinctive attributes (e.g., in the magnitude of temporal changes) depending on the locations, implying that the diversity of heat wave definitions leads to potentially inconsistent conclusions. Using the integrated analysis, we identify that the expected heat wave day has increased across the majority of the regions in the Korean Peninsula. To be specific, substantial increases are shown in North Korea, while rapid increases in heat wave events have been observed after the year 2010 over South Korea. Finally, through the sensitivity analysis, we demonstrate the importance of choosing the heat wave definition in the integrated analysis.

Assessment of elevated CO2 concentrations and heat stress episodes in soybean cultivars growing in heavy metal polluted soils: Crop nutritional quality and food safety

The present study evaluated the interactive effects of global change and heavy metals on the growth and development of three soybean [Glycine max (L.) Merrill] cultivars and the consequences on yield and food safety. Soybean cultivars (Alim 3.14 from Argentina, and ES Mentor and Sigalia, from Germany) were grown until maturity in heavy metals polluted soils from the Rhine Valley, Germany, at two CO2 concentrations (400 and 550 ppm) and heat stress (HS) episodes (9 days with 10 °C higher than maximum regular temperature) during the critical growth period in controlled environmental chambers. Different morpho-physiological parameters, heavy metal concentration in aerial organs, seed quality parameters, and toxicological index were recorded. The results showed that no morphological differences were observed related to CO2. Moreover, Alim 3.14 showed the highest yield under control conditions, but it was more sensitive to climatic conditions than the German cultivars, especially to heat stress which strongly reduces the biomass of the fruits. Heavy metals concentration in soil exceeds the legislation limits for agricultural soils for Cd and Pb, with 1.6 and 487 mg kg-1 respectively. In all cultivars, soybeans accumulated Cd in its aerial organs, and it could be translocated to fruits. Cd concentration in seeds ranged between 0.6 and 2.4 mg kg-1, which exceed legislation limits and with toxicological risk to potential Chinese consumers. Pb levels were lower than Cd in seeds (0.03-0.17 mg kg-1), and the accumulation were concentrated in the vegetative organs, with 93% of the Pb incorporated. Moreover, pods accumulated 11 times more Pb than seeds, which suggests that they act as a barrier to the passage of Pb to their offspring. These results evidence that soybean can easily translocate Cd, but not Pb, to reproductive organs. No regular patterns were observed in relation to climatic influence on heavy metal uptake.

Comparison of Relative and Absolute Heatwaves in Eastern China: Observations, Simulations and Future Projections

Heatwaves can produce catastrophic effects on public health and natural systems, especially under global warming. There are two methods to measure heatwaves, computed by relative and absolute thresholds, namely relative and absolute heatwaves (RHWs and AHWs). Generally, AHWs mostly occur in hot areas because of fixed thresholds, while RHWs represent anomalous events for the local climate, making them possible everywhere in the warm season. Based on observations and CMIP6 outputs, this study compared AHWs and RHWs in Eastern China (EC) with five sub-regions [Northeast China (NEC), North China (NC), Lower Yangtze River (LYR), Middle Yangtze River (MYR) and South China (SC)]. Similarities among RHWs and AHWs were found in present-day trends (1995–2014) and spatial distributions. The heatwave intensity/days for RHWs and AHWs both displayed highest future increases in northern/southern EC, and the increases for 2081–2100 would be 1.5 times as high as 2041–2060. All these similarities illustrate that applying either relative or absolute thresholds in EC, historical temporal variations, changing future spatial patterns, and increasing ratio from 2081–2100 to 2041–2060, would show reliable results. As far as differences are concerned, RHWs were observed across the entire EC, while AHWs did not show up in parts of NC and NEC. Considering model performance, RHWs would perform better than AHWs in most areas of EC. The annual heatwave intensity/days were higher for RHWs than for AHWs during present-day and future periods, which might overestimate heat-related risks. Overall, this study recommended RHWs for heatwave analyses, particularly for future projections, but for risk assessment, the choice of thresholds is crucial. The results reinforced the necessity to further improve model performance to address various needs.

Retrospection of heatwave and heat index

The frequency and intensity of extreme events especially heat waves (HW) are growing all around the world which ultimately poses a serious threat to the health of individuals. To quantify the effects of extreme temperature, appropriate information, and the importance of HW and heat index (HI) are carefully discussed for different parts of the world. Varied definitions of the HW and HI formula proposed and used by different countries are carried out systematically continent-wise. Different studies highlighted the number of definitions of HW; however, mostly used Steadman's formulae, which was developed in the late 1970s, for the calculation of HI that uses surface air temperature and relative humidity as climatic fields. Since then, dramatic changes in climatic conditions have been observed as evident from the ERA5 datasets which need to be addressed; likewise, the definition of HW, which is modified by the researchers as per the geographic conditions. It is evident from the ERA5 data that the temperature has increased by 1-2 °C as compared to the 1980s. There is a threefold increase in the number of heatwave days over most of the continents in the last 40 years. This study will help the researcher community to understand the importance of HW and HI. Furthermore, it opens the scope to develop an equation based on the present scenario keeping in mind the basics of an index as considered by Steadman.

Variation in estimates of heat-related mortality reduction due to tree cover in U.S. cities

Heat-related mortality is one of the leading causes of weather-related deaths in the United States. With changing climates and an aging population, effective adaptive strategies to address public health and environmental justice issues associated with extreme heat will be increasingly important. One effective adaptive strategy for reducing heat-related mortality is increasing tree cover. Designing such a strategy requires decision-support tools that provide spatial and temporal information about impacts. We apply such a tool to estimate spatially and temporally explicit reductions in temperature and mortality associated with a 10% increase in tree cover in 10 U.S. cities with varying climatic, demographic, and land cover conditions. Two heat metrics were applied to represent tree impacts on moderately and extremely hot days (relative to historical conditions). Increasing tree cover by 10% reduced estimated heat-related mortality in cities significantly, with total impacts generally greatest in the most populated cities. Mortality reductions vary widely across cities, ranging from approximately 50 fewer deaths in Salt Lake City to about 3800 fewer deaths in New York City. This variation is due to differences in demographics, land cover, and local climatic conditions. In terms of per capita estimated impacts, hotter and drier cities experience higher percentage reductions in mortality due to increased tree cover across the season. Phoenix potentially benefits the most from increased tree cover, with an estimated 22% reduction in mortality from baseline levels. In cooler cities such as Minneapolis, trees can reduce mortality significantly on days that are extremely hot relative to historical conditions and therefore help mitigate impacts during heat wave conditions. Recent studies project highest increases in heat-related mortality in the cooler cities, so our findings have important implications for adaptation planning. Our estimated spatial and temporal distributions of mortality reductions for each city provide crucial information needed for promoting environmental justice and equity. More broadly, the methods and model can be applied by both urban planners and the public health community for designing targeted, effective policies to reduce heat-related mortality. Additionally, land use managers can use this information to optimize tree plantings. Public stakeholders can also use these impact estimates for advocacy.

Urbanization-driven increases in summertime compound heat extremes across China

Summertime extreme heat events exert severe impacts on the natural environment and human society, especially in densely populated and highly urbanized regions. While previous studies have focused on independent heat day/night, there is a lack of attention to the changes in compound events with cooccurring daytime and nighttime extreme temperature on the same day. In this study, we examine the spatio-temporal changes of summertime compound heat extremes (including compound heat day and compound heatwave) across China, with a particular focus on 20 major urban agglomerations (UAs), and quantify the urbanization effects on these changes. We find that the frequency and fraction of compound heat events show obvious spatial disparities across China. The compound heat events occur more frequently in highly populated and urbanized areas such as the Pearl River Delta. Moreover, the frequency and fraction of compound heat events have significantly increased in recent decades in most parts of China, especially in more developed UAs. These intensifying trends have even accelerated in more recent decades. Our further investigations suggest that most UAs of China experienced an intensifying urbanization effect on compound heat events, and few UAs in northwestern and central China (e.g., UAs of the north Tianshan mountain and the middle reaches of the Yangtze River) display a weakening effect of urbanization. Our findings highlight the important role of urbanization in increasing compound heat extremes and suggest that the increasing threats of compound events in urban areas should be given more attention under the context of global warming and local urbanization.

Global urban population exposure to extreme heat

Increased extreme heat exposure from both climate change and the urban heat island effect threatens rapidly growing urban settlements worldwide. Yet, because we do not know where urban population growth and extreme heat intersect, we have limited capacity to reduce the impacts of urban extreme heat exposure. Here, we leverage fine-resolution temperature and population data to measure urban extreme heat exposure for 13,115 cities from 1983 to 2016. Globally, urban exposure increased nearly 200%, affecting 1.7 billion people. Total urban warming elevated exposure rates 52% above population growth alone. However, spatially heterogeneous exposure patterns highlight an urgent need for locally tailored adaptations and early warning systems to reduce harm from urban extreme heat exposure across the planet’s diverse urban settlements.

Increased exposure to extreme heat from both climate change and the urban heat island effect—total urban warming—threatens the sustainability of rapidly growing urban settlements worldwide. Extreme heat exposure is highly unequal and severely impacts the urban poor. While previous studies have quantified global exposure to extreme heat, the lack of a globally accurate, fine-resolution temporal analysis of urban exposure crucially limits our ability to deploy adaptations. Here, we estimate daily urban population exposure to extreme heat for 13,115 urban settlements from 1983 to 2016. We harmonize global, fine-resolution (0.05°), daily temperature maxima and relative humidity estimates with geolocated and longitudinal global urban population data. We measure the average annual rate of increase in exposure (person-days/year⁻¹) at the global, regional, national, and municipality levels, separating the contribution to exposure trajectories from urban population growth versus total urban warming. Using a daily maximum wet bulb globe temperature threshold of 30 °C, global exposure increased nearly 200% from 1983 to 2016. Total urban warming elevated the annual increase in exposure by 52% compared to urban population growth alone. Exposure trajectories increased for 46% of urban settlements, which together in 2016 comprised 23% of the planet’s population (1.7 billion people). However, how total urban warming and population growth drove exposure trajectories is spatially heterogeneous. This study reinforces the importance of employing multiple extreme heat exposure metrics to identify local patterns and compare exposure trends across geographies. Our results suggest that previous research underestimates extreme heat exposure, highlighting the urgency for targeted adaptations and early warning systems to reduce harm from urban extreme heat exposure.

Present and future projections of heatwave hazard-risk over India: A regional earth system model assessment

The heatwave is a disastrous hazard having significant impacts on health and society. This study analyses the heatwave hazards and risk for India's current and future scenarios using socioeconomic vulnerability and temperature datasets during the summer (April-June) season. The Census of India (CoI) 2011 datasets were considered to assess current vulnerability and projected from the SocioEconomic Data And Application Center (SEDAC) population at Shared Socioeconomic Pathway (SSP) 4 for future vulnerability. Whereas IMD temperature data used for hazard assessment for the present scenario (1958-2005) while projected temperature data from regional earth system model REMO-OASIS-MPIOM (ROM) were used for the future (2006-2099) scenario. The study exhibited the most hazardous, vulnerable, and risk-prone regions identified as the south-eastern coast and Indo-Gangetic plains and some populous districts with metropolitan regions (Mumbai, Delhi, and Kolkata) under the current scenario. The coupled model ROM has efficiently captured the critical districts with higher and lower risk, showing its future projection capability. The study highlighted that the heatwave hazard-risk would significantly worsen in future scenarios in all districts under enhanced global warming and largely affecting the districts in the eastern and middle Indo-Gangetic plains and Malabar region. The present study will provide sufficient insights into designing mitigation strategies and future adaptive planning for the heatwave risk, which is one of the targets under Sustainable Development Goal 13 (Goal 13: Climate Action).

Linking climate niches across seasons to assess population vulnerability in a migratory bird

Global loss of biodiversity has placed new urgency on the need to understand factors regulating species response to rapid environmental change. While specialists are often less resilient to rapid environmental change than generalists, species-level analyses may obscure the extent of specialization when locally adapted populations vary in climate tolerances. Until recently, quantification of the degree of climate specialization in migratory birds below the species level was hindered by a lack of genomic and tracking information, but recent technological advances have helped to overcome these barriers. Here we take a genome-wide genetic approach to mapping population-specific migratory routes and quantifying niche breadth within genetically distinct populations of a migratory bird, the willow flycatcher (Empidonax traillii), which exhibits variation in the severity of population declines across its breeding range. While our sample size is restricted to the number of genetically distinct populations within the species, our results support the idea that locally adapted populations of the willow flycatcher with narrow climatic niches across seasons are already federally listed as endangered or in steep decline, while populations with broader climatic niches have remained stable in recent decades. Overall, this work highlights the value of quantifying niche breadth within genetically distinct groups across time and space when attempting to understand the factors that facilitate or constrain the response of locally adapted populations to rapid environmental change.

A heat-health watch and warning system with extended season and evolving thresholds

BACKGROUND

Many countries have developed heat-health watch and warning systems (HHWWS) or early-warning systems to mitigate the health consequences of extreme heat events. HHWWS usually focuses on the four hottest months of the year and imposes the same threshold over these months. However, according to climate projections, the warm season is expected to extend and/or shift. Some studies demonstrated that health impacts of heat waves are more severe when the human body is not acclimatized to the heat. In order to adapt those systems to potential heat waves occurring outside the hottest months of the season, this study proposes specific health-based monthly heat indicators and thresholds over an extended season from April to October in the northern hemisphere.

METHODS

The proposed approach, an adoption and extension of the HHWWS methodology currently implemented in Quebec (Canada). The latter is developed and applied to the Greater Montreal area (current population 4.3 million) based on historical health and meteorological data over the years. This approach consists of determining excess mortality episodes and then choosing monthly indicators and thresholds that may involve excess mortality.

RESULTS

We obtain thresholds for the maximum and minimum temperature couple (in °C) that range from (respectively, 23 and 12) in April, to (32 and 21) in July and back to (25 and 13) in October. The resulting HHWWS is flexible, with health-related thresholds taking into account the seasonality and the monthly variability of temperatures over an extended summer season.

CONCLUSIONS

This adaptive and more realistic system has the potential to prevent, by data-driven health alerts, heat-related mortality outside the typical July-August months of heat waves. The proposed methodology is general and can be applied to other regions and situations based on their characteristics.

The risks of warm nights and wet days in the context of climate change: assessing road safety outcomes in Boston, USA and Santo Domingo, Dominican Republic

Background

There remains a dearth of cross-city comparisons on the impact of climate change through extreme temperature and precipitation events on road safety. We examined trends in traffic fatalities, injuries and property damage associated with high temperatures and heavy rains in Boston (USA) and Santo Domingo (Dominican Republic).

Methods

Official publicly available data on daily traffic outcomes and weather conditions during the warm season (May to September) were used for Boston (2002–2015) and Santo Domingo (2013–2017). Daily maximum temperatures and mean precipitations for each city were considered for classifying hot days, warm days, and warm nights, and wet, very wet, and extremely wet days. Time-series analyses were used to assess the relationship between temperature and precipitation and daily traffic outcomes, using a quasi-Poisson regression.

Results

In Santo Domingo, the presence of a warm night increased traffic fatalities with a rate ratio (RR) of 1.31 (95% CI [confidence interval]: 1.00,1.71). In Boston, precipitation factors (particularly, extremely wet days) were associated with increments in traffic injuries (RR 1.25, 95% CI: 1.18, 1.32) and property damages (RR 1.42, 95% CI: 1.33, 1.51).

Conclusion

During the warm season, mixed associations between weather conditions and traffic outcomes were found across Santo Domingo and Boston. In Boston, increases in heavy precipitation events were associated with higher traffic injuries and property damage. As climate change-related heavy precipitation events are projected to increase in the USA, the associations found in this study should be of interest for road safety planning in a rapidly changing environment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40621-021-00342-w.

Effects of Hot Nights on Mortality in Southern Europe

BACKGROUND

There is strong evidence concerning the impact of heat stress on mortality, particularly from high temperatures. However, few studies to our knowledge emphasize the importance of hot nights, which may prevent necessary nocturnal rest.

OBJECTIVES

In this study, we use hot-night duration and excess to predict daily cause-specific mortality in summer, using multiple cities across Southern Europe.

METHODS

We fitted time series regression models to summer cause-specific mortality, including natural, respiratory, and cardiovascular causes, in 11 cities across four countries. We included a distributed lag nonlinear model with lags up to 7 days for hot night duration and excess adjusted by daily mean temperature. We summarized city-specific associations as overall-cumulative exposure-response curves at the country level using meta-analysis.

RESULTS

We found positive but generally nonlinear associations between relative risk (RR) of cause-specific mortality and duration and excess of hot nights. RR of duration associated with nonaccidental mortality in Portugal was 1.29 (95% confidence interval [CI] = 1.07, 1.54); other associations were imprecise, but we also found positive city-specific estimates for Rome and Madrid. Risk of hot-night excess ranged from 1.12 (95% CI = 1.05, 1.20) for France to 1.37 (95% CI = 1.26, 1.48) for Portugal. Risk estimates for excess were consistently higher than for duration.

CONCLUSIONS

This study provides new evidence that, over a wider range of locations, hot night indices are strongly associated with cause-specific deaths. Modeling the impact of thermal characteristics during summer nights on mortality could improve decisionmaking for preventive public health strategies.

Assessing mortality risk attributable to high ambient temperatures in Ahmedabad, 1987 to 2017

BACKGROUND

Studies on high temperatures and mortality have not focused on underdeveloped tropical regions and have reported the associations of different temperature metrics without conducting model selection.

METHODS

We collected daily mortality and meteorological data including ambient temperatures and humidity in Ahmedabad during summer, 1987-2017. We proposed two cross-validation (CV) approaches to compare semiparametric quasi-Poisson models with different temperature metrics and heat wave definitions. Using the fittest model, we estimated heat-mortality associations among general population and subpopulations. We also conducted separate analyses for 1987-2002 and 2003-2017 to evaluate temporal heterogeneity.

FINDINGS

The model with maximum and minimum temperatures and without heat wave indicator gave the best performance. With this model, we found a substantial and significant increase in mortality rate starting from maximum temperature at 42 °C and from minimum temperature at 28 °C: 1 °C increase in maximum and minimum temperatures at lag 0 were associated with 9.56% (95% confidence interval [CI]: 6.64%, 12.56%) and 9.82% (95% CI: 6.33%, 13.42%) increase in mortality risk, respectively. People aged ≥65 years and lived in South residential zone where most slums were located, were more vulnerable. We observed flatter increases in mortality risk associated with high temperatures comparing the period of 2003-2017 to 1987-2002.

INTERPRETATION

The analyses provided better understanding of the relationship of high temperatures with mortality in underdeveloped tropical regions and important implications in developing heat warning system for local government. The proposed CV approaches will benefit future scientific work.

Large model structural uncertainty in global projections of urban heat waves

Urban heat waves (UHWs) are strongly associated with socioeconomic impacts. Here, we use an urban climate emulator combined with large ensemble global climate simulations to show that, at the urban scale a large proportion of the variability results from the model structural uncertainty in projecting UHWs in the coming decades under climate change. Omission of this uncertainty would considerably underestimate the risk of UHW. Results show that, for cities in four high-stake regions - the Great Lakes of North America, Southern Europe, Central India, and North China - a virtually unlikely (0.01% probability) UHW projected by single-model ensembles is estimated by our model with probabilities of 23.73%, 4.24%, 1.56%, and 14.76% respectively in 2061-2070 under a high-emission scenario. Our findings suggest that for urban-scale extremes, policymakers and stakeholders will have to plan for larger uncertainties than what a single model predicts if decisions are informed based on urban climate simulations.

How to stand the heat? Post-stress nutrition and developmental stage determine insect response to a heat wave

Organisms are increasingly confronted with intense and long-lasting heat waves. In insects, the effects of heat waves on individual performance can vary in magnitude both within (e.g. from one larval instar to another) and between life stages. However, the reasons underlying these stage-dependent effects are not fully understood. There are several lines of evidence suggesting that individual ability to withstand a heat stress depends on mechanisms based on nutrition and supporting energetically physiological stress responses. Hence, we tested the hypothesis that the efficiency of these food-based buffering mechanisms may vary between different larval instars of a phytophagous insect. Using larvae of the moth Lobesia botrana, we examined the importance of post-stress food quality in insect response to a non-lethal heat wave at two distinct larval instars. Three major conclusions were drawn from this work. First, heat waves induced an overall decline in larval performance (delayed development, depressed immunity). Second, food quality primarily mediated the insect's ability to respond to the heat stress: the reduction in performance following heat wave application was mostly restricted to individuals with access to low-quality food after the heat stress. Third, larval instars differed in their susceptibility to this combination of thermal and food stressors, but conclusions about the instar being the most vulnerable differed in a trait-specific manner. In a global warming context, this study may shed additional light on the combination of direct and indirect (through alteration of plant nutritional value) effects of rising temperatures on the ecology and the evolution of phytophagous insects.

Impact of different heat wave definitions on daily mortality in Bandafassi, Senegal

Objective

The aim of this study is to find the most suitable heat wave definition among 15 different ones and to evaluate its impact on total, age-, and gender-specific mortality for Bandafassi, Senegal.

Methods

Daily weather station data were obtained from Kedougou situated at 17 km from Bandafassi from 1973 to 2012. Poisson generalized additive model (GAM) and distributed lag non-linear model (DLNM) are used to investigate the effect of heat wave on mortality and to evaluate the nonlinear association of heat wave definitions at different lag days, respectively.

Results

Heat wave definitions, based on three or more consecutive days with both daily minimum and maximum temperatures greater than the 90^th percentile, provided the best model fit. A statistically significant increase in the relative risk (RRs 1.4 (95% Confidence Interval (CI): 1.2–1.6), 1.7 (95% CI: 1.5–1.9), 1.21 (95% CI: 1.08–1.3), 1.2 (95% CI: 1.04–1.5), 1.5 (95% CI: 1.3–1.8), 1.4 (95% CI: 1.2–1.5), 1.5 (95% CI: 1.07–1.6), and 1.5 (95% CI: 1.3–1.8)) of total mortality was observed for eight definitions. By using the definition based on the 90^th percentile of minimum and maximum temperature with a 3-day duration, we also found that females and people aged ≥ 55 years old were at higher risks than males and other different age groups to heat wave related mortality.

Conclusion

The impact of heat waves was associated with total-, age-, gender-mortality. These results are expected to be useful for decision makers who conceive of public health policies in Senegal and elsewhere. Climate parameters, including temperatures and humidity, could be used to forecast heat wave risks as an early warning system in the area where we conduct this research. More broadly, our findings should be highly beneficial to climate services, researchers, clinicians, end-users and decision-makers.

Field-based body temperatures reveal behavioral thermoregulation strategies of the Atlantic marsh fiddler crab Minuca pugnax

Behavioral thermoregulation is an important defense against the negative impacts of climate change for ectotherms. In this study we examined the use of burrows by a common intertidal crab, Minuca pugnax, to control body temperature. To understand how body temperatures respond to changes in the surface temperature and explore how efficiently crabs exploit the cooling potential of burrows to thermoregulate, we measured body, surface, and burrow temperatures during low tide on Sapelo Island, GA in March, May, August, and September of 2019. We found that an increase in 1°C in the surface temperature led to a 0.70-0.71°C increase in body temperature for females and an increase in 0.75-0.77°C in body temperature for males. Body temperatures of small females were 0.3°C warmer than large females for the same surface temperature. Female crabs used burrows more efficiently for thermoregulation compared to the males. Specifically, an increase of 1°C in the cooling capacity (the difference between the burrow temperature and the surface temperature) led to an increase of 0.42-0.50°C for females and 0.34-0.35°C for males in the thermoregulation capacity (the difference between body temperature and surface temperature). The body temperature that crabs began to use burrows to thermoregulate was estimated to be around 24°C, which is far below the critical body temperatures that could lead to death. Many crabs experience body temperatures of 24°C early in the reproductive season, several months before the hottest days of the year. Because the use of burrows involves fitness trade-offs, these results suggest that warming temperatures could begin to impact crabs far earlier in the year than expected.

Heatwaves, medications, and heat-related hospitalization in older Medicare beneficiaries with chronic conditions

Background

Heatwaves kill more people than floods, tornadoes, and earthquakes combined and disproportionally affect older persons and those with chronic conditions. Commonly used medications for chronic conditions, e.g., diuretics, antipsychotics disrupt thermoregulation or fluid/electrolyte balance and may sensitive patients to heat. However, the effect of heat-sensitizing medications and their interactions with heatwaves are not well-quantified. We evaluated effects of potentially heat-sensitizing medications in vulnerable older patients.

Methods

US Medicare data were linked at the zip code level to climate data with surface air temperatures for June-August of 2007–2012. Patients were Medicare beneficiaries aged ≥65 years with chronic conditions including diabetes, dementia, and cardiovascular, lung, or kidney disease. Exposures were potentially heat-sensitizing medications including diuretics, anticholinergics, antipsychotics, beta blockers, stimulants, and anti-hypertensives. A heatwave was defined as ≥2 days above the 95^th percentile of historical zip code-specific surface air temperatures. We estimated associations of heat-sensitizing medications and heatwaves with heat-related hospitalization using self-controlled case series analysis.

Results

We identified 9,721 patients with at least one chronic condition and heat-related hospitalization; 42.1% of these patients experienced a heatwave. Heatwaves were associated with an increase in heat-related hospitalizations ranging from 21% (95% CI: 7% to 38%) to 33% (95% CI: 14% to 55%) across medication classes. Several drug classes were associated with moderately elevated risk of heat-related hospitalization in the absence of heatwaves, with rate ratios ranging from 1.16 (95% CI: 1.00 to 1.35) to 1.37 (95% CI: 1.14 to 1.66). We did not observe meaningful synergistic interactions between heatwaves and medications.

Conclusions

Older patients with chronic conditions may be at heightened risk for heat-related hospitalization due to the use of heat-sensitizing medications throughout the summer months, even in the absence of heatwaves. Further studies are needed to confirm these findings and also to understand the effect of milder and shorter heat exposure.

Intensity-duration-frequency relationship of WBGT extremes using regional frequency analysis in South Korea

The risk levels of heat-related extreme events need to be estimated for prediction and real-time monitoring to mitigate their impacts on air quality, public health, the ecosystem, and critical infrastructure. Many countries have adopted meteorological variable base thresholds for assessing the risk level of heat-related extreme events. These thresholds provide an approximate risk level for a specific event but do not consider its intensity and duration in the risk assessment. The current study provides a statistical tool to assess the risk of heat-related extreme events while concurrently considering their intensities and durations based on the wet-bulb globe temperature (WBGT). To this end, the intensity-duration-frequency (IDF) relationship of the extreme WBGT in South Korea was derived. Regional frequency analysis was employed to understand the IDF relationship. Return levels of heat-related extreme events in South Korea were calculated and their characteristics were investigated based on the annual maximum WBGT observations. The results showed that the IDF relationship could provide the risks of heat-related extreme events while concurrently considering their intensities and durations. The extreme WBGT in South Korea was used to categorize two regions such as coastal and inland based on their statistical characteristics. The return levels of the annual maximum WBGT events were found to vary largely by location. The return levels corresponding to 32 °C with 3-h duration for stations in the coastal and inland regions ranged from 1- to 100-years and 3- to 1000-years, respectively. Mean values of return levels for heatwave events in Seoul, Incheon, Daejon, Gwangju, Daegu, and Busan were 2.8-, 8.4-, 15.3-, 2.8-, 1.6-, and 2.2-years, respectively. The return levels of heatwaves for the warmer cities are smaller than those for cooler cities. The return levels of the heatwave events in South Korea showed a significant increasing trend in several cities, supporting the notion that the impact of heatwave events on South Korea might become more severe in the future.

Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota: An Exploration of the Intersection of Race and Education

Preterm birth (PTB) is common and has negative impacts on infant health. While some maternal risk factors have been identified, including age under 20 or over 40, substance abuse, low BMI, and racism, less is known about the impact of environmental exposures like high heat. We combined 154,157 records of live births occurring in Minnesota between 2009 and 2015 with hourly weather records collected from the Minneapolis–St. Paul airport. We tested if maternal heat wave exposure (a seven-day period with a mean daily high temp of 37 °C) immediately prior to birth leads to a higher risk of preterm birth. Additional covariates included maternal age, race/ethnicity, educational status, and residence in the seven-county Minneapolis–St. Paul metro area. Pregnant women exposed to a seven-day heat wave of 37 °C or higher experienced a higher relative risk of PTB compared to women who did not experience a heat wave (1.14 risk ratio (RR), 1.0–1.3 95% confidence interval (CI)). The result is robust to controls for a woman’s age, race/ethnicity, educational attainment, place of residence, and year of the birth. Children born to Black women with college degrees who are exposed to heat waves experience a higher relative risk of PTB compared to White women with college degrees in a heat wave (2.97 RR, 1.5–6.1 95% CI). Summer heat waves are associated with higher risk of PTB in late-term pregnancies in Minnesota.

Methods for Estimating Wet Bulb Globe Temperature From Remote and Low-Cost Data: A Comparative Study in Central Alabama

Heat stress is a significant health concern that can lead to illness, injury, and mortality. The wet bulb globe temperature (WBGT) index is one method for monitoring environmental heat risk. Generally, WBGT is estimated using a heat stress monitor that includes sensors capable of measuring ambient, wet bulb, and black globe temperature, and these measurements are combined to calculate WBGT. However, this method can be expensive, time consuming, and requires careful attention to ensure accurate and repeatable data. Therefore, researchers have attempted to use standard meteorological measurements, using single data sources as an input (e.g., weather stations) to calculate WBGT. Building on these efforts, we apply data from a variety of sources to calculate WBGT, understand the accuracy of our estimated equation, and compare the performance of different sources of input data. To do this, WBGT measurements were collected from Kestrel 5400 Heat Stress Trackers installed in three locations in Alabama. Data were also drawn from local weather stations, North American Land Data Assimilation System (NLDAS), and low cost iButton hygrometers. We applied previously published equations for estimating natural wet bulb temperature, globe temperature, and WBGT to these diverse data sources. Correlation results showed that WBGT estimates derived from all proxy data sources-weather station, weather station/iButton, NLDAS, NLDAS/iButton-were statistically indistinguishable from each other, or from the Kestrel measurements, at two of the three sites. However, at the same two sites, the addition of iButtons significantly reduced root mean square error and bias compared to other methods.

Extreme heat episodes and risk of preterm birth in California, 2005-2013

BACKGROUND

Preterm birth is a leading cause of infant morbidity and mortality. Identifying potentially modifiable triggers toward the end of gestation, such as extreme heat, can improve understanding of the role of acute stress on early deliveries and inform warning systems. In this study we examined the association between extreme heat, variously defined during the last week of gestation, and risk of preterm birth among mothers in California.

METHODS

We created a population-based cohort comprised of 1,967,300 mothers who had live, singleton births in California, from May through September 2005-2013. Daily temperature data estimated at the maternal zip code of residence was used to create 12 definitions of extreme heat with varying relative temperatures (75th, 90th, 95th, and 98th percentiles) and durations (at least 2, 3, or 4 consecutive days). We estimated risk of preterm birth (<37 gestational weeks) in relation to exposure to extreme heat during the last week of gestation with multi-level Cox proportional hazard regression models, adjusting for maternal characteristics, sex of neonate, and seasonality. We also included randomly generated data, SAS code, and estimates for reproducibility purposes.

RESULTS

Approximately 7% of the cohort had a preterm birth. For all definitions of extreme heat, the risk of preterm birth was consistently higher among mothers who experienced an extreme heat episode during their last week of gestation. Hazard ratios ranged from 1.008 (95% CI: 0.997, 1.021) to 1.128 (95% CI: 1.052, 1.210), with increasing associations as the relative temperature and duration of extreme heat episode increased.

CONCLUSION

This study adds to the previous literature by considering multiple definitions of extreme heat and applying a time-to-event framework. Findings suggest that acute exposure to extreme heat during the last week of gestation may trigger an earlier delivery. Implementing heat warning systems targeted toward pregnant women may improve birth outcomes.

Spatial patterns of recent US summertime heat trends: Implications for heat sensitivity and health adaptations

Heat is known to cause illness and death not only at extreme temperatures, but also at moderate levels. Although substantial research has shown how summer time temperature distributions have changed over recent decades in the United States, less is known about how the heat index-a potentially more health-applicable metric of heat-has similarly evolved over this period. Moreover, the extent to which these distributional changes have overlapped with indicators of social vulnerability has not been established, despite the applicability of co-varying climatic and sociodemographic characteristics to heat-related health adaptations. Presented here is an analysis of trends in the median, 95th percentile, and 'warm-tail spread' (i.e., intra-seasonal range between the upper extreme and median) of warm-season (May-September) maximum heat index between 1979and 2018 across the conterminous US. Using40 years of data from the North American Regional Reanalysis dataset, it is shown that most of the US has experienced statistically significant positive trends in summertime heat, and that both the magnitude of trends and the shape of the frequency distributions of these measures vary regionally. Comparisons with data from the Social Vulnerability Index show that the most socially vulnerable counties appear to be warming faster than the least vulnerable, but that opposite patterns hold for trends in warm-tail spread. These findings may be applicable to further studies on climate change, heat adaptations, and environmental justice in the US.

Impact of Natural Disasters on Health Outcomes and Cancer Among Older Adults

There is growing evidence that older adults exposed to natural disasters are at disproportionate risk for adverse health events such as all-cause mortality, injury, hospital admissions, stroke, displacement, cardiopulmonary distress, stress-related mental health problems, and exacerbation of chronic illnesses. Typically, analyses of the health consequences of natural disasters focus only on the populations impacted for the duration and immediate aftermath of the disaster. With few exceptions, the long-term effects of natural disasters on older adult health have not been examined. This article describes the potential consequences of exposure to natural disasters that contribute to cancer and disruption of cancer care treatment systems for older adults. It is argued that exposures to floods and wildfires in particular present an underestimated threat to the onset and/or progression of cancer and cancer care management in older adults. We propose that these impacts should be examined not only from an emergency preparedness perspective during the event but also from a public health focus that prospectively assesses risks for cancer and other health disparities. Recommendations for comprehensive longitudinal risk assessment and emergency preparedness models that address the full impact of natural disasters on the health and well-being of vulnerable, at risk, older adults are offered.

Response of Urban Heat Stress to Heat Waves in Athens (1960–2017)

The increasing frequency, intensity and duration of heat waves seem to follow the observed global warming in recent decades. Vulnerability to heat waves is expected to increase in urban environments mainly due to population density and the effect of the urban heat island that make cities hotter than surrounding non-urban areas. The present study focuses on a vulnerable area of the eastern Mediterranean, already characterized as a ‘hot spot’ with respect to heat-related risk and investigates the change in heat stress levels during heat wave compared to non-heat wave conditions as well as the way that heat stress levels respond to heat waves in urban, compared to non-urban, environments. The adoption of a metric accounting for both the intensity and duration of the hot event yielded a total of 46 heat wave episodes over a nearly 60-year period, but with very rare occurrence until the late 1990s and a profound increased frequency thereafter. The results reveal a difference of at least one thermal stress category between heat wave and non-heat wave periods, which is apparent across the entire range of the thermal stress distribution. The analysis demonstrates a robust intensification of nighttime heat stress conditions in urban, compared to non-urban, sites during severe heat waves. Nevertheless, severe heat waves almost equalize heat stress conditions between urban and non-urban sites during midday.

Effects of weather factors on recreation participation in a humid subtropical region

This study examines effects of weather, temporal factors, and gasoline price on outdoor recreation participation by using a time series model. We obtained more than 5 years of daily outdoor recreation visitation data by using infrared mechanical counters on a section of the Florida National Scenic Trail (FNST). Results showed that days with daily maximum temperatures of 16-22 °C brought the largest number of visitors, which suggests this is the most comfortable range of daily maximum temperatures to recreate on the FNST. Daily maximum temperatures below 6 °C and above 31 °C and heat index values above 38 °C brought significantly lower visitor numbers, suggesting these values are temperature thresholds for this region in a recreation context. A seasonal autoregressive integrated moving average model showed significant negative effects of temperature, relative humidity, cold snaps, and gasoline price and a positive effect of weekends and public holidays on recreational visitations to this trail. Days with heavy rainfall (> 2.54 cm) or a high heat index (≥ 35 °C) were likely to negatively affect recreation participation not only on the same day, but also on the next normal weather day. These findings imply that managers of facilities that need staffing and other resources should expect to receive fewer visitors on days following adverse weather conditions, even if that day has normal weather conditions.

Regional Temperature Response in Central Asia to National Committed Emission Reductions

National committed greenhouse gas emission reduction actions are the center of the Paris Agreement, and are known as 'Intended Nationally Determined Contributions' (INDC) that aim to slow down global warming. The climate response to INDC emission reduction is a focus in climate change science. In this study, data from 32 global climate models from the Coupled Model Intercomparison Project Phase 5 (CMIP5) were applied to investigate the changes in the mean and extreme high temperatures in Central Asia (CA) under the INDC scenario above the present-day level. The results show that the magnitude of warming in CA is remarkably higher than the global mean. Almost all the regions in CA will experience more intense, more frequent, and longer-lasting extreme high-temperature events. In comparison with the INDC scenario, the reduced warming of the 2.0 °C/1.5 °C target scenarios will help avoid approximately 44-61%/65-80% of the increase in extreme temperature events in terms of the intensity, frequency, and duration in CA. These results contribute to an improved understanding of the benefits of limiting global warming to the 2.0 °C/1.5 °C targets, which is paramount for mitigation and adaptation planning.

Heatwaves and hospitalizations due to hyperthermia in defined climate regions in the conterminous USA

Heatwaves are one of the deadliest natural disasters that occur annually with thousands of people seeking medical attention. The spatio-temporal synchronization between peaks in disease manifestation and high temperature provides important insights into the seasonal timing of the heatwave and the response it may cause with respect to emergence, severity, and duration. The objectives of this study are to examine the association between hospitalizations due to heat stroke in older adults and heat in the United States (US) and explore synchronization with respect to heatwave sequence, time of arrival, and regional climate. Three large data sets were utilized: daily hospitalization records of the US elderly between 1991 and 2006, annual demographic summaries on Medicare beneficiaries maintained by the Centers for Medicare and Medicaid Services (CMS), and nationwide daily meteorological observations. We modeled seasonal fluctuations in health outcomes, such as the timing and intensity of the seasonal peak in hospitalizations using refined harmonic GLM for eight climatically similar regions. During the 16-year study period, there were 40,019 heat-related hospitalizations (HRH) in the conterminous  US. The rates of HRH varied substantially across eight climatic regions: with the highest rate of 7.05 cases per million residents observed in areas with temperate arid summers and winters (TaTa) and the lowest rate of 0.67-in areas with cold moderately dry summers and arid winters (CdCa), where summer temperatures are about  18.3 °C and 12.1 °C, respectively. We detected 400 heatwaves defined as any day when the night time temperature is above its 90th percentile for the current and previous nights. The first seasonal heatwave in a season resulted in 4274 hospitalizations over 342 heatwave-days: 34.3% of 12,442 hospitalizations occurred in 26% of 1308 heatwave-days. The relative risks of increased HRH associated with the first and second heatwaves were 10.4 (95%CI: 8.5; 12.3) and 11.4 (95%CI: 9.6; 13.3), respectively, indicating the disproportional effects of early heatwave arrivals. The seasonal spike in heat stroke hospitalizations in regions with relatively similar annual temperatures, e.g. in areas with temperate moderately dry summers and winters (TdTa: 12.8 °C) and (TaTa: 11.1 °C) ranged between 4.5 (95%CI: 3.3; 5.5) and 11.0 (95%CI: 8.2; 14.9) cases per million residents, respectively, indicating substantial regional differences. The differences in heat-related hospitalizations and response to heatwaves are substantial among older adults residing in different climate regions of the conterminous US. The disproportionally high response to the early seasonal heatwave deserves special attention, especially in the context of prevention and decision support frameworks.

Compound Droughts and Heat Waves in China

Droughts and heat waves both are natural extreme climate events occurring in most parts of the world. To understand the spatio-temporal characteristics of droughts and heat waves in China, we examine changes in droughts, heat waves, and the compound of both during 1961–2017 based on high resolution gridded monthly sc_PDSI and daily temperature data. Results show that North China and Northwest China are the two regions that experience the most frequent droughts, while Central China is the least drought-affected region. Significant drought decreasing trends were mostly observed Qinghai, Xinjiang, and Tibet provinces, while the belt region between Yunnan and Heilongjiang provinces experienced significant drought increasing trends. Heat waves occur more frequently than droughts, and the increase of heat wave occurrence is also more obvious. The increasing of heat wave occurrence since the 2000s has been unprecedented. The compound droughts and heat waves were mild from the 1960s to 1980s, and began to increase in 1990s. Furthermore, the significant increasing trends of the percentage of compound droughts and heat waves to droughts are observed in entire China, and more than 90% drought occurrences are accompanied by one or more heat waves in the 2010s. The results highlight the increased percentage of compound droughts and heat waves and call for improved efforts on assessing the impact of compound extremes, especially in an era of changing climate.

Public perceptions of the health risks of extreme heat across US states, counties, and neighborhoods

Incidents of extreme heat due to global warming pose a growing threat to human health. The health effects of extreme heat depend not only on exposure, however, but also on behavioral responses, which are related to perceived risk. We show that risk perceptions vary at multiple scales across the United States. Some vulnerable populations have higher risk perceptions, such as low-income urban residents, whereas risk perceptions are lower among other vulnerable populations, including places with high proportions of elderly residents. This paper also extends multilevel regression and poststratification methods to a high spatial resolution and independently validates the results. Detailed risk-perception maps can facilitate urban and rural planning for heat waves, targeted risk communication, and resource management in local contexts.

Extreme heat is the leading weather-related cause of death in the United States. Many individuals, however, fail to perceive this risk, which will be exacerbated by global warming. Given that awareness of one’s physical and social vulnerability is a critical precursor to preparedness for extreme weather events, understanding Americans’ perceptions of heat risk and their geographic variability is essential for promoting adaptive behaviors during heat waves. Using a large original survey dataset of 9,217 respondents, we create and validate a model of Americans’ perceived risk to their health from extreme heat in all 50 US states, 3,142 counties, and 72,429 populated census tracts. States in warm climates (e.g., Texas, Nevada, and Hawaii) have some of the highest heat-risk perceptions, yet states in cooler climates often face greater health risks from heat. Likewise, places with older populations who have increased vulnerability to health effects of heat tend to have lower risk perceptions, putting them at even greater risk since lack of awareness is a barrier to adaptive responses. Poorer neighborhoods and those with larger minority populations generally have higher risk perceptions than wealthier neighborhoods with more white residents, consistent with vulnerability differences across these populations. Comprehensive models of extreme weather risks, exposure, and effects should take individual perceptions, which motivate behavior, into account. Understanding risk perceptions at fine spatial scales can also support targeting of communication and education initiatives to where heat adaptation efforts are most needed.

Mining Social Media to Identify Heat Waves

Heat waves are one of the deadliest of natural hazards and their frequency and intensity will likely increase as the climate continues to warm. A challenge in studying these phenomena is the lack of a universally accepted quantitative definition that captures both temperature anomalies and associated mortality. We test the hypothesis that social media mining can be used to identify heat wave mortality. Applying the approach to India, we find that the number of heat-related tweets correlates with heat-related mortality much better than traditional climate-based indicators, especially at larger scales, which identify many heat wave days that do not lead to excess mortality. We conclude that social media based heat wave identification can complement climatic data and can be used to: (1) study heat wave impacts at large scales or in developing countries, where mortality data are difficult to obtain and uncertain, and (2) to track dangerous heat wave events in real time.

Assessing Heat Waves over Greece Using the Excess Heat Factor (EHF)

Heat waves are considered one of the most noteworthy extreme events all over the world due to their crucial impacts on both society and the environment. For the present article, a relatively new heat wave index, which was primarily introduced for the study of extreme warming conditions over Australia (Excess Heat Factor (EHF, hereafter)), was applied over Greece (eastern Mediterranean) for a 55-year period in order to examine its applicability to a region with different climatic characteristics (compared to Australia) and its ability to define previous exceptional heat waves. The computation of the EHF index for the period 1958–2012 demonstrated that, during the warm period of the year (June, July, August, and September (JJAS)), Greece experiences approximately 20 days per year with positive anomalous conditions (EHF > 0) with positive statistically significant trends for all stations under study. Moreover, an average of 128 spells with a duration of 3 to 10 consecutive days with positive EHF values were found during the examined 55-year period. As the duration of the spell was extended, their frequency lessened. Finally, it was found that the EHF index not only detected, identified, and described efficiently the characteristics of the heat waves, but it also provided additional useful information regarding the impact of these abnormal warming conditions on the human ability to adapt to them.

The added effects of heatwaves on cause-specific mortality: A nationwide analysis in 272 Chinese cities

BACKGROUND

The evidence was limited and inconclusive about the added effects of heatwaves, especially in developing countries.

OBJECTIVE

To evaluate the added effects of heatwaves on cause-specific mortality in China.

METHODS

We designed a nationwide time-series analysis based on daily data from 272 main Chinese cities to from 2013 to 2015. We adopted 12 definitions by combining 4 heat thresholds (90th, 92.5th, 95th, 97.5th percentile of city-specific daily mean temperature) and duration of ≥2, 3 and 4 days. We applied overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative effects of heatwaves over lags of 0-10 days after controlling for daily temperature. We then, used a meta-regression model to pool the effect estimates at national and regional levels.

RESULTS

Heatwaves could significantly increase risk for mortality from total and cardiopulmonary diseases, including coronary heart disease, ischemic stroke (rather than hemorrhagic stroke) and chronic obstructive pulmonary disease. The effects increased with higher thresholds, but were not appreciably influenced by the duration of heat. The risks generally occurred immediately and lasted for 3 to 5 days. The risks were much larger in the temperate continental zone and the temperate monsoon zones than in the subtropical monsoon zone where there was an evident mortality displacement. The elderly, females and less-educated people were more vulnerable.

CONCLUSIONS

This analysis provided ample evidence for the added mortality risk associated with heatwaves, which had important implications for designing heatwave-warning systems and predicting the disease burden of future heatwaves.