Public Health Impacts of Climate Change in California ... · 3 Table of Contents Climate Change Public Health Impacts Assessment and Response Collaborative California Department of

1

Climate Change Public Health Impacts Assessment and Response CollaborativeCalifornia Department of Public Health and the Public Health Institute

Public Health Impacts of Climate Change in California:Community Vulnerability Assessments and Adaptation Strategies

Report No. 1:

Heat-Related Illness and MortalityInformation for the Public Health Network in California

2


3

Table of Contents


Executive Summary

I. Introduction

II. Spectrum of Heat-Related Illness

III. Community Vulnerability for Heat-Related Morbidity and Mortality

IV. Prevention, Adaptation, and Mitigation

V. Short-term and Long-term Recommendations

ReferencesSources of Additional InformationAppendices

888

4


5


List of Figures and Tables

6

Executive Summary


C

•

•

The primary objective of

this community vulnerability

assessment, the

is to identify locationsand/or

populationswith high risk for

heat-relatedillness.

7


•

•

•

•

Virtually all heat-related

illness and death is

preventableif the

appropriateprevention

strategies are adopted and implemented

bycommunities

and individuals.

8


A. Our Changing Climate and Impacts on Public Health in California

T

4

I. Introduction

B. California’s Actions to Address Climate Change

C

ordinations

As the number and duration of extreme heat events

increase,there will be a concomitantincrease in

heat-relatedillnesses and

deaths.

9


The purpose of the Climate Change Public Health Impacts

Assessmentand Response Collaborative

was to develop

the requisite knowledge to prepare for, prevent, and reduce the

health impacts of climate change in California.

10


A. Heat Stress

A

II. Spectrum of Heat-RelatedIllness

11


B. Heat Cramps, Heat Syncope, Heat Edema

H

C. Heat Exhaustion

H

Becauseuntreated

heatexhaustion

can progress to heat stroke,

the most serious form of heat-related

illness,treatment

should begin

signs of heat exhaustion.

12


D. Heat Stroke

H

Heat stroke is an extreme

medicalemergency

that if untreated can result in death or permanent neurologicalimpairment.

13


III. Community Vulnerability to Heat-RelatedMorbidity and Mortality

A

Indicators of Risk

I

1. Historic Heat Waves, Heat Islands, and Air Conditioner Ownership in California

Historic Heat Waves and Temperature Trends in California

A community’s overall

vulnerability

its constituent populations,

as well as the capacity of its public health and emergency

responseinfrastructure.

14


Figure 1:

Source: Smooth surface generated using data from Steve LaDochy, Richard Medina and William Patzert

15


Heat Islands

16


Impervious Surfaces in California

Impervious Surface (%)

Figure 2:

Source: U.S. Geological Survey

17


The 2006 Heat Wave

Impervioussurfaces are

anthropogenicfeatures that

limit the ability of water to

soil.

isto

ckph

oto.

com

18


Average Daily Maximum Temperature

July 2006

Temperature (ºF)

Figure 3:

Source: Oregon State University, PRISM Group

19

CountyMaximum

Temperature

Minimum

Temperature

1 Imperial 107.9 81.6

2 Riverside 102.2 73.3

3 Kings 100.6 68.5

4 Tulare 100.2 67.2

5 Fresno 99.0 65.7

6 Kern 98.2 66.6

7 Inyo 97.2 60.9

8 Colusa 97.0 62.9

9 Yolo 96.8 61.1

10 Merced 96.7 60.9

11 Glenn 96.3 63.0

12 Butte 95.8 62.2

13 Sacramento 95.8 62.2

14 Calaveras 94.9 61.6

15 San Bernardino 94.9 65.5

16 Mendocino 94.7 55.2

17 Solano 92.7 59.9

18 San Joaquin 92.7 59.0

19 Lake 92.5 54.7

20 Los Angeles 92.4 65.4


Air Conditioner Ownership in California

Top 20 Counties by Average Daily Maximum and Minimum Temperatures (ºF) , July 2006Table 1:

Source: University of California, IPM California Weather Database

The capacity to adapt to

elevatedtemperatures,

through the use of cooling mechanismssuch as air

conditioning,is a

component of vulnerability to heat morbidity and mortality.

20


.

Departures from Average Maximum and Minimum Temperatures, California, July 2006Figure 4:

Average Maximum TemperatureDeparture from Average (ºF)

Average Minimum TemperatureDeparture from Average (ºF)

Source: Generated 8/1/2006 at the Western Regional Climate Center using provisional data. NOAA Regional Climate Centers.

21


Source: California Energy Commission

Figure 5:

22


2. Heat-related Deaths in California from the Summer 2006 Heat Wave

23


Figure 6:

Source: California Department of Public Health

24

Death rate

(per 100,000 population)

1 Stanislaus 23 4.6

2 San Joaquin 21 4.6

3 Fresno 20 2.3

4 Kern 15 2.0

5 Sacramento 13 0.9

6 San Bernardino 10 0.5

7 Imperial 10 6.4

CountyNumber of

Deaths



Figure 7: Deaths due to Extreme Heat in California and Typical Central Valley Temperature*, July 15- August 1, 2006

Table 2: Top Counties for Heat-Related Deaths, July 2006 Heat Wave


Temperature

Deaths

25


3. Demographic Determinants of Vulnerability

A) Vulnerable Populations

Elderly

T

Children Participants in Athletic EventsSocial

isolation and medication use are also factors

that are not uncommon

amongthe elderly that makes them more

susceptible to the effects of

heat.

26


Medically Compromised and Socially Isolated

•

•

•

•

Outdoor Workers

Californiaworkers in

agriculture and construction

industries have experienced

severeheat-related

illness and death in recent

years.

27


B) Demographic Analysis of California Counties

Our review of the published

literature

three main categories of host factors related to elevated

risk for these outcomes:

(1) social and behavioralfactors ; (2)

demographics;and (3) health

status.

28

Source: U.S. Census 2000


Figure 8:

29



Figure 9:

30



Figure 10:

31



Figure 11:

32


Figure 12:


33


Capacity

A. Air Conditioner Ownership and Demographic Determinants of Vulnerability by County

Analysis of vulnerability to heat morbidity and mortality must account for adaptation

to elevated temperature,

and air conditioner

ownership is a key aspect of this capacity.

34


Poverty and Social Isolation in California Counties Categorized by Air Conditioner OwnershipFigure 13:

Source: California Energy Commission, U.S. Census 2000

35


Figure 14:

Source: California Energy Commission

36


B. Geographic Analysis of Increased Temperatures, Elevation, and Ozone Levels Poor air quality

can affect the health of a

large portion of Californians,

with a disproportionate

effect on children, the elderly, those

withpre-existing

chronicdiseases, and those in lower

socioeconomicstrata.N

atio

nal P

ark

Ser

vice

37


Ozone (ppm)*

Intersection of Elevation, Increased Temperatures,

and Ozone Levels

Figure 15:

Source: California Air Resources Board and Steve LaDochy, Richard Medina, and William Patzert

38


IV. Prevention, Adaptation, and Mitigation

A. Prevention Strategies

1. Cooling Centers

A2. Public Education and Outreach

Mobilization of Social Contacts of Vulnerable Individuals

Education Regarding Personal Cooling Strategies

39


B. Strategies for Mitigation of Effects of Heat Islands

T

C. Strategic Implementation Plans and Emergency Response/Heat Warning Plans

•

•

•

S

The single strongest

message that has come from evaluation of prior deadly

heat waves is the need for all

communitiesto have

emergencyresponse plans

in place.

40


V. Recommendations for Short-term and Long-term Strategies

Short-term strategies

C

•

•

California will be confronted

with heat emergencies for the foreseeable

future and they will be

increasing in frequency.Weather

changes related to climate

change will only compound the risks to human health due to

heat.

41


Long-term strategies

•

...in the long-term

household air conditioning

will only exacerbatethe global warming

problem by increasing

energydemand,

unless more of California’s energy can come from renewable

sources.

42


•

•

•

43


References

44


45


Sources of Additional Information

Report design by Rosanne Hoyem,ZevRoss Spatial Analysis

Inset images provided by istockphoto.com

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48

Preventing Summer Heat Illness

California Department of Public Health – July 2007

Summer heat waves can be dangerous. A

very high body temperature can damage the

brain and other vital organs. Some health

conditions can make it harder for the body to

stay cool in hot weather. These include old

age, obesity, fever, dehydration, heart

disease, poor circulation, sunburn and drug

and alcohol use. To protect your health when

temperatures are very high:

Get Plenty to Drink

Sweating removes needed salt

and minerals from the body.

When it is hot, drink more

water, juice and sports drinks.

Avoid drinks with caffeine (tea, coffee, and

cola) and alcohol. Be sure to eat regularly.

Wear Light Clothing and Sunscreen

Wear as little clothing as possible when you

are at home. Choose lightweight, light-

colored, loose-fitting clothing.

In the hot sun, a wide-

brimmed hat will keep the

head cool.

If you will be in direct sun, use a

sunscreen with a sun

protection factor (SPF) of 15 or

higher and follow package

directions. Reapply every 2

hours while in the sun.

Warning: If your doctor limits the amount of fluid you drink or if you take water pills, ask him or her how much you should drink when the weather is hot. If you are on a low-salt diet, talk with your doctor before drinking a sports beverage.

Stay Cool Indoors

The best way to beat the heat is to stay in an

air conditioned area. If you don’t have an air

conditioner, go to a shopping mall or public

building for a few hours. A cool shower or

bath is also a good way to cool off.

Schedule Outdoor Activities Carefully

Try to be less active during the hottest part of

the day, late afternoon. If you must be out in

the heat, plan your activities so that you are

outdoors either before noon or in the evening.

While outdoors, rest often in a shady area.

Never leave kids or pets in a parked car.

Pace Yourself

If you are not used to working or exercising in

hot weather, start slowly and pick up the pace

gradually. Take frequent, regularly scheduled

breaks. If activity in the heat makes your heart

pound or leaves you gasping for breath, stop

activity, get into a cool or shady area, and

rest. Especially if you become lightheaded,

confused, weak or feel faint.

Use a Buddy System

During a heat wave, check on your friends

and family and have someone do the same

for you. If you know someone who is elderly

or has a health condition, check on them

twice a day during a heat wave. Watch for

signs of heat exhaustion or heat stroke.

High temperatures can cause serious health

problems. Know the symptoms of heat-related

illness and be ready to help.


49

Treating Summer Heat Illness

California Department of Public Health – July 2007

Heat stroke happens when the body can no

longer control its temperature. The body’s

temperature rises fast. The body cannot

sweat and is unable to cool itself. Warning

signs include red, hot, dry skin; very high

body temperature, dizziness, nausea,

confusion, strange behavior or

unconsciousness, rapid pulse or throbbing

headache. Heat stroke can cause death or

disability if treatment is not given. What to do:

Get medical help quickly.

Get the victim to a shady area.

Cool the person off with a cool shower,

garden hose, etc.

Do not give the victim fluids to drink.

If emergency medical personnel are

delayed, call the hospital for further

instructions.

Heat exhaustion is a milder illness that

happens when the body has lost too much

water and salt in sweat. Warning

signs include heavy sweating, cramps,

headache, nausea or vomiting, tiredness,

weakness, dizziness and fainting. If heat

exhaustion is not treated, it can turn into heat

stroke. Get medical help if the symptoms are

severe or if the victim has heart problems or

high blood pressure. Help the victim cool off

with:

Cool, nonalcoholic beverages,

Rest, lying down,

Cool shower, bath or sponge bath,

Air-conditioning,

Lightweight clothing.

Heat cramps are muscle

pains and spasms due to heavy activity.

They usually involve the stomach muscles or

the legs. It is generally thought that the loss

of water and salt from heavy sweating causes

the cramps. If you have heart problems or

are on a low-sodium diet, get medical

attention for heat cramps. What to do:

Stop. Sit quietly in a cool place.

Drink clear juice or a sports beverage.

Rest for a few hours to avoid heat

exhaustion or heat stroke.

Get medical help if heat cramps do not

stop after one hour.

Sunburn is when skin becomes red, painful

and unusually warm after being in the sun.

Sunburn should be avoided because it

damages the skin and could lead to more

serious illness. What to do:

See a doctor if the sunburn affects an

infant younger than one year old or if

the victim has fever, blisters or severe

pain.

Stay out of the sun.

Bathe the sunburned area with cool

water.

Use moisturizing lotion on sunburn, do

not use salve, butter or ointment.

Do not break blisters.

For more information… Call CDC for info in English or Spanish:800-CDC-INFO (800-232-4636) 888-232-6348 (TTY) Or visit: www.cdc.govwww.bepreparedcalifornia.ca.gov


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