# Presentation: 098479

## Hot Times in Puget Sound:The New Heat Health Warning SystemPartners in Emergency Preparedness Conference

**Dr. Laurence S. Kalkstein****Center for Climatic Research****University of Delaware**

**Seattle, Washington****April 19, 2005**

**Presented at NLIEC, June 14, 2005****by Jon Skindlov****Salt River Project**

## 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 **

## Human Response to Weather is Relative, Not Absolute

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

## 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

## Chicago, Illinois: July 1995

**Daily Mortality**

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

## Would These People Have Died Shortly Afterward Regardless of the Heat Wave?

**Would These People Have Died Shortly Afterward Regardless of the Heat Wave?**

- New York, 1966

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

**Excess deaths associated with heat wave**

**Reduced mortality rate following heat wave**

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

**Use of air conditioning has increased from 10–90 percent during this period**

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

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

**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.....!!**

-  **Air Conditioning and Mortality in Philadelphia**

## 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

## 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**

## 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

- * New five-day forecast systems based on point forecast matrices

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

## 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?

## 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.

## Characteristics of SeattleAir Mass Types

- * Mean air mass frequency from 1 June through 31 August

## Removing Non-Climatological Noise from the Mortality Data

## Phoenix’s Rising Mortality

## Mean Deaths in Rome by Daystandardization is important

- Mean Deaths in Rome by Daystandardization is important

## Mean Mortality Increases Within Offensive Air Mass Types

- a MT+ does not occur in Seattle; the moist air mass that is oppressive is MT.
- * DT+ air mass for Phoenix

- Location (Freq)	      DT	         MT+

- +3.7 (8%)

## Development of Forecast Algorithms:  

- Within-Air Mass Category
- Mortality Variations

## ROME

- MT+ mortality decreases through summer

## ROME

- DT mortality vs. morning temperature

## Slide 22

## Slide 23

## Slide 24

## Slide 25

## Year-to-Year Variability:  Seattle, Washington

- * 1980 data are missing

**Warnings Called**

## 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

## Slide 28

## 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.

## 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.**

## Slide 31