Cook County, Illinois: July 95

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Hot Times in Puget SoundThe New Heat Health
Warning SystemPartners in Emergency
Preparedness Conference
Seattle, WashingtonApril 19, 2005
Dr. Laurence S. KalksteinCenter for Climatic
ResearchUniversity of Delaware
Presented at NLIEC, June 14, 2005by Jon
SkindlovSalt River Project
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Goals

• Outline some bio-climatological principles that
  should be utilized in evaluating weather/human
  health issues
• Discuss the nature of our established heat/health
  watch warning systems
• Mention certain intervention activities that are
  useful in lessening the impact of heat on human
  health

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Human Response to Weather is Relative, Not
Absolute

• Thresholds vary from city to city
• Magnitude of responses vary from city to city

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Human Response Varies Within the Same City!
Mortality variation from
mean Air mass type Early season heat waves
Philadelphia 01 Jul 1994 05 Jul 1994
77 Hot, dry air mass
08 Jun 1996 14 Jun 1996 62
Hot, moist air mass Late season heat
waves Philadelphia 17 Sep 1987 19 Sep 1987
-33 Hot, dry air mass
04 Aug 1995 12 Aug 1995 -32
Hot, moist air mass __________________________
____________

• Given the same magnitude, early season heat waves
  are much more dangerous than late season heat
  waves
• Thus, thresholds vary within the same city during
  the season

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Chicago, Illinois July 1995 Daily Mortality

• Deaths can be over double baseline levels during
  very hot weather

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Would These People Have Died Shortly Afterward
Regardless of the Heat Wave?
New York, 1966
Excess deaths associated with heat wave
Reduced mortality rate following heat wave

• Approximately 20-40 percent of the population
  would have died during the following month
  regardless of the heat wave

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Human Mitigation Activities Does Air
Conditioning Reduce Heat-Related Mortality?

• The reduction of mortality over the last 40 years
  is greater within the hot, oppressive air masses,
  when air conditioning would be operating
• Use of air conditioning has increased from 1090
  percent during this period

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Human Mitigation Activities Does Air
Conditioning Reduce Heat-Related Mortality?
Air Conditioning and Mortality in Philadelphia

• We estimate a 26 percent decline in human
  mortality in Philadelphia and other U.S. cities
  attributed to increased air conditioning use over
  the last 40 years
• BUT..!!

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Question With these factors in mind, how
can we reduce heat/related illness and mortality
in large urban areas?Answer A possible
solution The development of operational
heat/health warning systems for urban areas
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How Are These Systems Unique?

• A custom-made system is developed for each urban
  area, based on specific meteorology for each
  locale, as well as urban structure and
  demographics
• These systems are based on actual weather-health
  relationships, as determined by daily variations
  in human mortality
• These systems are based on much more than just
  temperature and humidity

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Systems We are Presently Operating

• USA
• Chicago, IL
• Dallas/Ft. Worth, TX
• Dayton/Cincinnati, OH
• Jackson/Meridian, MS
• Lake Charles/Alexandria, LA
• Little Rock/Pine Bluff, AR
• Memphis, TN/Tupelo, MS
• New Orleans/Baton Rouge, LA
• Philadelphia, PA
• Phoenix, AZ
• Seattle, WA
• St. Louis, MO
• Shreveport/Monroe, LA
• Washington, D.C.
• Yuma, AZ

• International
• Bologna, Italy
• Milano, Italy
• Palermo, Italy
• Rome, Italy
• Shanghai, China
• Torino, Italy
• Toronto, Canada

• Proposed Systems
• Portland, OR
• Kansas City, MO
• three additional cities in Italy
• Phoenix evaporative cooler addendum

New five-day forecast systems based on point
forecast matrices
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Steps in System Development

• Step 1 Determine air masses daily over a city
  using newly-developed Spatial Synoptic
  Classification (SSC)
• Step 2 Are any of these air masses offensive?
• Characteristics
• Statistically significant higher
  mortality
• Greater within air mass standard
  deviation in mortality
• Step 3 What aspects of the offensive air mass
  make it most detrimental to human health?

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SSC Air Mass Types

• DP Dry Polar (cP)
• DM Dry Moderate (Pacific)
• DT Dry Tropical (cT)
• MP Moist Polar (mP)
• MM Moist Moderate (Overrunning)
• MT Moist Tropical (mT)
• MT Moist Tropical Plus
• TR Transition between air masses
• ----------------

Sheridan, S.C., 2002 The redevelopment of a
weather-type classification scheme for North
America. Int. J. Climatology, 22,
51-68. Kalkstein, L.S., C.D. Barthel, J.S. Greene
and M.C. Nichols, 1996. A New Spatial Synoptic
Classification Application to Air Mass
Analysis. Int. J. Climatology, 16, 983-1004.
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Characteristics of SeattleAir Mass Types
Mean air mass frequency from 1 June through 31
August
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Removing Non-Climatological Noise from the
Mortality Data
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Phoenixs Rising Mortality
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Mean Deaths in Rome by Daystandardization is
important
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Mean Mortality Increases Within Offensive Air
Mass Types
Location (Freq) DT MT
3.7 (8)
a MT does not occur in Seattle the moist air
mass that is oppressive is MT. DT air mass for
Phoenix
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Development of Forecast Algorithms Within-Air
Mass Category Mortality Variations
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ROME
MT mortality decreases through summer
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ROME
DT mortality vs. morning temperature
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Year-to-Year Variability Seattle, Washington
Warnings Called
1980 data are missing
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Intervention Actions When Health Warning is
Issued Philadelphia Department of Public Health

• Media announcement
• Promotion of the buddy system
• Activation of the heatline
• Home visits
• Nursing and personal care boarding home
  intervention
• Halt of utility service suspensions
• Increased emergency medical service staffing
• Daytime outreach to the homeless
• Air conditioned service facility capability

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Effectiveness of Philadelphia Heat Health System
(based on Ebi et. al.)

• Study evaluated effectiveness of Philadelphia
  system for the summers of 1995-98.
• It is estimated that 2.6 lives were saved on
  average, for each warning day and for the
  following three days.
• Therefore, based on the number of warnings called
  by the Philadelphia Weather Service Forecast
  Office, the watch warning system saved an
  estimated 117 lives over the four summer period

______________ K.L. Ebi, T.J. Teisberg, L.S.
Kalkstein, L.Robinson, R.F. Weiher, 2004. Heat
Watch/Warning Systems Save Lives Estimated Costs
and Benefits for Philadelphia 1995-1998.
Bulletin of the American Meteorological Society
85 1067-74.
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Improvements to be Made to the Seattle System

• Will be extended to a five-day forecast period
  through the use of Point Forecast Matrix (PFM)
  forecasts
• Will include multiple locations in the Seattle
  area, such as Tacoma. These are to be discussed.

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