Is heat (atmospheric) a health risk? The answer to this is almost certainly yes, but there are some important risk enhancement considerations to keep in mind including gender, ethnicity, and seniority. In these "dog days of summer," anyone who works outside will have to be conscious of the challenges of heat. For those unfamiliar, the "dog days" are the hottest of the summer season.
According to the CDC, more men suffer heat-related death than women, and those over 35 years old have a greater prevalence of heat-related death. The graph in the CDC report suggests the vastly greater death risk is for males over 45. The highest percentage of persons requiring hospital care for heat are 85 or older, and combined with those who are 65-84, the senior generation consistently comprises the vast majority of those seeking care. There are apparent racial disparities in the reported data. Whites suffer the lowest probable risk of heat death, while "other" males are at the highest risk.
The Center for Disease Control backs up that heat can be a health risk. Heat exhaustion can result in a number of symptoms that are worthy of surveillance and attention ("muscle cramping, fatigue, headache, nausea or vomiting, dizziness or fainting"). These are warnings. Unfortunately, some of them can as easily signal other maladies, and we might find ourselves failing to initially suspect heat. It is important to heed the warnings, as heat exhaustion symptoms can be a precursor to the more serious heat stroke. This means when the above symptoms appear, it is time to take remedial measures before things progress.
The heat stroke that can result is characterized by symptoms that may be similar (dizziness and nausea are listed by the CDC), but also some more significant such as "body temperature greater than 103°F (39.4°C); red, hot, and dry skin (no sweating); rapid, strong pulse; throbbing headache; confusion; unconsciousness. Thus, there are some we might look out for in ourselves ("do I have a headache" or "am I sweating") and some we might also be able to help co-workers look out for ("you seem confused,") or we might see someone lose consciousness.
How serious is heat?
Time contends that 20,000 deaths per year in North America are heat-related. The Time author suggests that heat is implicated in the greatest volume of "weather-related" deaths, citing data from the CDC. The article also concedes that many such "related" deaths also implicate some additional, or even primary, causation. It notes that half of heat-related deaths are "due to heart disease." Thus, heat plays a role in aggravating some underlying health challenge.
Time cites the Lancet for this contention. The Lancet research supports that many die of "non-optimal temperatures," about 9.43% of global deaths. The "non-optimal" refers to both cold and heat. The suggestion of the Time article is that heat is critical. However, the Lancet explains that "8.52% of all deaths were cold-related and 0.91% were heat-related." From these numbers, one might conclude that the "too cold" is the more pervasive challenge. The Lancet does note that cold-related death is trending toward decrease while heat-related are increasing over recent years.
The British Broadcasting Corporation (BBC) reported recently on a proposal to raise public awareness of the risks of heat. Climate change: Will naming heatwaves save lives? It notes that about 600 people die from heat-related illness each year in the US." Of the 3,383,729 total deaths reported by the CDC, this is a very small cohort (.0177%). Note the distinction (apparently) between Time's 20,000 "heat related" (.591%) and the BBC's "heat related illness." The distinction seems to cry out for more explanation or better definition.
The BBC article relates the circumstances of one such death that involved a driver in Los Angeles who either "collapsed" or "passed out" in a truck. Unfortunately, no coworker or passerby noticed his condition for over twenty minutes, and he died. In light of the heat challenges, "Los Angeles is among the cities that is considering naming heatwaves." The theory is that by naming them, "like storms," government will "raise public awareness of the dangers and help local officials roll out measures to mitigate the impact." Suggestions include "welfare checks" and opening of municipal pools. Cities in Spain have already instigated such efforts.
Mitigation might include provision of public facilities that are air-conditioned, swimming pools, etc. The article generally references alternative reactions, but provides no detail beyond a city having a "heat action plan." It notes that in a more general sense cities like Miami, Florida have designated a "heat season" to raise awareness and is also said to be contemplating naming heatwaves in the manner in which hurricanes are identified.
The awareness of the public may be only part of the civic reaction. The authors note that services, including hospital emergency rooms, may experience greater needs during warmer temperatures. The article cites "that emergency room visits rose tenfold during a heatwave that saw temperatures spike to highs of 49C (121F)." Death Valley recently exceeded 120 degrees, and it was newsworthy. Before too much stock is placed in the "tenfold" threat to emergency rooms, perhaps some explanation is in order as to how likely such temperatures over 120 degrees actually are?
A professor at the University of Washington is quoted. The conclusion is that the naming of heatwaves is a beginning. However, rating the intensity, again similar to the hurricane warning process, would also have merit. The proposal is to "categori(ze) on a scale of one to three." This would involve multiple factors that include the last 30 days of temperatures. And, such scales would be "tailored" for particular cities because people's preparedness would be expected to be less in cities in which heatwave occurrences are less frequent.
There are also critics of the idea. One is cited noting that "there's a lack of evidence that naming inclement weather events - even hurricanes - changes people's perception." Furthermore, these weather events are not linear like hurricanes (that follow a path), and therefore are more complex. Under the various discussions, there might be simultaneous heatwaves in various municipalities, yet each might have its own name. The critics note that a "heatwave() (may) cover multiple locations, with multiple thresholds, and start on different days."
At least one critic, Bruce Schenier, has published regarding the "color-coded alert system" that America adopted for terrorism risks after September 11th. He might be said to be a critic of that system. He notes
"The problem is that the warnings don’t do any of this. Because they are so vague and so frequent, and because they don’t recommend any useful actions that people can take, terror threat warnings don’t prevent terrorist attacks."
Ron White, a comedian, also took some issue with the terror alert system. In the early years after the system was put in place, he criticized it essentially on the basis that "no one knows what to do different when the color changes." He made fodder of his proposal, according to Texas Monthly, for a simpler system:
“If I were running Homeland Security, I would propose two states of heightened awareness: Go find a helmet. And put on the . . . helmet.”
The complex color system was scrapped in 2011. According to CNN, "In its place, DHS will move to a system that focuses on specific threats in geographical areas."
So, there are examples of warning systems working, in the hurricane example the path and severity are stated based on published NHC criteria. Local officials are vocal about interpreting the hurricane warning, advising "shelter" or "leave."
And, there are some examples of complex systems that were less effective, comedian fodder, and were scrapped. Time will tell if the naming of heat waves or hot days is successful in diminishing the demands on the medical facilities or decreasing heat-related deaths.
The complexities suggested in the BBC article are interesting for consideration. And in the end, how much will these efforts at warning programs cost? If launched in an absence of science to support their efficacy, will their existence scientifically substantiate their effectiveness at encouraging care and diminishing impacts/ill effects? Will it turn out this naming process is cost-effective, or will communities conclude they might have better invested in programs and facilities to provide actual local heat relief (air-conditioned shelters, pools, etc.)
The entire subject is, frankly, fascinating. Here's hoping the first heat wave is named for someone deserving, how about "heat wave Dave?" You have to admit, it has a nice ring to it. Maybe there will be T-shirts?
