Extreme Heat Events Climate Change Training Module

Extreme Heat Events Climate Change Training Module Extreme Heat Events, Climate Change and Public Health Minnesota Climate and Health Program Minnesota Department of Health Environmental Impacts Analysis Unit October 2012 625 Robert Street North PO Box 64975 St. Paul, MN 55164-0975

Notice MDH developed this presentation based on scientific research published in peer-reviewed journals. References for information can be found in the relevant slides and/or at the end of the presentation.

Learning Objectives • Discuss climate changes and temperature trends in Minnesota • Define extreme heat event (EHE) and the relationship between climate change/temp trends and EHE • Define Urban Heat Island (UHI) effect • Describe human health impacts of EHE and the populations most vulnerable to or risk factors of EHE • Discuss public health response and individual strategies

Objectives • Discuss climate changes and temperature trends in Minnesota • Define Extreme heat event (EHE) and the relationship between climate change/temp trends and EHE • Define Urban Heat Island (UHI) effect • Describe human health impacts of EHE and the populations most vulnerable to or risk factors of EHE • Discuss public health response and individual strategies

Weather versus Climate • Weather: conditions of the atmosphere over a short period of time • Climate: conditions of the atmosphere over long periods of time (30-year standard averaging period)

Climate Changes in Minnesota • There have been three recent significant observed climate trends in Minnesota: • The average temperature is increasing • The average number of days with a high dew point may be increasing • The character of precipitation is changing

Temperature Changes

Temperature Changes • Three significant observations in this overall warming: • Winter temperatures have been rising about twice as fast as annual average temperatures • Minimum or 'overnight low' temperatures have been rising faster than the maximum temperature, or ‘daytime high’ • Since the early 1980s, the temperature has risen slightly over 1°F in southern Minnesota to a little over 2°F in much of the northern part of the state

Dew Point Changes • Dew point definition: Dew point is a measure of water vapor in the air. • The higher the dew point, the more difficult it is for people's sweat to evaporate, which is how they would otherwise shed body heat. • The number of days with high dew point temperatures (≥ 70 °F) may be increasing in Minnesota.

Dew Point Changes Source: Dr. Mark Seeley, Climatologist, University of Minnesota

Precipitation Changes On average, the total precipitation in the state has increased since the Dust Bowl era of the 1930s.

Precipitation Changes • The character of precipitation in Minnesota is changing • More localized, heavy precipitation events • Potential to cause both increased flooding and drought

Definition of Extreme Heat Events Criteria shift depending upon: • Temperature • Dew Point/ Relative Humidity • Cloud cover • Different local standards for what is ‘unusually’ hot weather

Heat Index • The Heat Index (HI): calculation that describes how the air temperature and dew point are perceived the human body

National Weather Service

National Weather Service Greater MN Extreme Heat Warning System: Heat Advisory • Maximum heat index is expected to reach 100°F and/or the maximum temperature is ≥ 95°F • Warnings issued if advisory criteria are expected for ≥ 4 days and/or maximum heat index is ≥ 105°F with minimum heat index ≥ 75°F for at least 48 hours Source: NWS, 2011

National Weather Service Ramsey/Hennepin County Extreme Heat Warning System: Heat Advisory • ≥ 95°F heat index for at least 1 day, or • ≥ 95°F heat index with minimum overnight low temperature ≥ 75°F for at least 2 days • Warnings issued if conditions are expected for 4 or more days and/or maximum heat index reaches 100°F for at least 1 day. Source: NWS, 2011

Recent Extreme Heat Events • 5 heat episodes in summer 2011 worthy of issuances of warnings or advisories: • June 6-7 • June 30-July 1 • July 16-20 • July 23 • August 1

Extreme Heat Event Records July 19, 2011: • All-time heat index record for the Twin Cities. The air temperature reported at worst hour was 95°F and was paired with the 82°F dew point temperature • heat index of 119°F • Record state dew point temperature of 88°F with 93°F air temp • heat index of 130°F

Historical Minnesota EHE Red denotes dewpoint driven 1883, 1894, 1901, 1910, 1917, 1921, 1931, 1933, 1934, 1936, 1937, 1947, 1948, 1949, 1955, 1957, 1959, 1964, 1976, 1977, 1983, 1988, 1995,1999, 2001, 2005, 2006, 2007, 2010

EHE and Climate Changes • In Minnesota more EHE are led by high dew points, and dew points may be rising • Relief from EHE comes from overnight low temperatures, and overnight low temperatures are rising • Minnesota is at risk of more EHE

Urban Heat Islands (UHI) • Definition: Elevated temperatures in urban and suburban areas relative to outlying rural surroundings • Causes: • Reduced vegetation • Dark heat-absorbing surfaces • Reflective surfaces Effect is proportional to the size of the city – but all cities, large and small, have them On average, a city with 1M people can have a 2-6°F UHI On clear, calm nights, this can be as high as 20+°F

Urban Heat Islands • Results in higher daytime temperatures and reduced nighttime cooling (pavement releases heat at night) – year round effect • Consequences • Economic cost of cooling buildings because of UHI in summer • Lack of bitterly low temps in winter • Increased severe weather • Precipitation changes - ~30% increase in precipitation downwind • Production of air pollutants (ground-level ozone) • Worsen heat waves in the urban areas • Overall effect urban ecosystems Source: EPA, 2008

Atlanta: It’s hotter in the city! Image from NASA

Mitigating Urban Heat Islands • Green roofs: • Vegetative layer grown on a rooftop • Reduces temperatures on roof surface through shade and evapotrans- piration • Cool roofs/pavements: • Highly reflective materials • Can remain 50-60°F cooler than traditional materials during peak summer heat • Permeable pavements: • Moisture within the pavement structure evaporates as the surface heats, thus drawing heat out of the pavement, similar to evaporative cooling from vegetated land cover Target Center Roof in Minneapolis

Mitigating Urban Heat Islands • Adding trees and vegetation Thermal image of New York City Vegetation in New York City Images from NASA

EHE and Human Health Extreme heat events can cause: • Heat tetany (hyperventilation) • Heat rash • Heat cramps • Heat exhaustion • Heat edema (swelling) • Heat syncope (fainting) • Heat/sun stroke • Death

Deaths from EHE • From 1979 to 2003, more people in America died from extreme heat than from floods, hurricanes, lightning, tornadoes, and earthquakes combined • The 1995 Chicago heat wave caused more than 600 heat- related deaths over 5 days • France, summer of 2003: 14,802 excess deaths The 2010 Moscow heat wave caused more than 11,000 excess deaths (Hurricane Katrina: 1,833 confirmed deaths, World Trade Center: 2,726 deaths)

Populations At Risk to EHE • Everyone • Elderly persons 65 years and older • Especially who live alone • Children • Persons with pre-existing disease conditions • Persons taking certain medications that hinder thermo- regulation or cause dehydration

EHE Deaths by Age Group Source: Adcock et al, 2000 – CDC MMWR

Risk Factors • Lack of air conditioners in homes • Low socioeconomic status • Living in urban areas: urban heat island effect • Living in topmost floor • Living in nursing homes / being bedridden • Living alone / Lack of social or family ties • Prolonged exposure to sun • Drinking alcohol

Minnesota’s Urban Areas

Public Health Response to EHE Six key steps for responding to extreme heat events: • Develop a heat response plan • Predict the extreme heat event • Assess risk and determine activation of the response plan • Activate the response plan and notify the public • Implement the response plan • Evaluate the response plan

Heat Response Plan A heat response plan should be developed before an extreme heat event. Heat response plan may be added as annex to local all-hazard plan. Response Plan Critical Elements: • Identification of a lead agency responsible for the response plan • Defined criteria for activating and deactivating the plan • Defined roles and activities of agencies and organization involved with the plan • A communications plan for communicating heat-related information to partners and the public before, during and after an extreme heat event • Identification of high-risk and vulnerable persons • Strategies for preventing morbidity and mortality from extreme heat • Evaluation of the response plan

Identification of high-risk and vulnerable persons • Map populations at risk to assist development of strategies for targeted outreach in heat response plan. • See MDH Climate Change website for statewide maps of vulnerable populations and data sources for risk factors. • http://www.health.state.mn.us/divs/climatechange/index.html

Strategies for preventing morbidity and mortality • Promote pre-summer awareness education & ongoing communication with the public • Dissemination information & plan with local partners (e.g., local Red Cross chapter, social service organizations, etc.) • Activate a heat line • Designate community ‘cooling centers’ • Suspend utility shutoffs and provide transportation and financial assistance • And more!

Strategies for Individuals • Stay Hydrated! • Drink plenty of fluids • Avoid alcoholic beverages • Avoid drinks that are high in sugar • Stay Cool! • Stay indoors, in air-conditioned places • Fans are not effective in high 90s°F • Wear lightweight, light-colored, loose fitting clothing • If you must be outside: • Schedule outdoor activities carefully • Take time to adjust to the heat • Pace yourself

Strategies for Individuals • Check on persons at more risk to heat: • Do not leave children or pets in cars • Check on elderly neighbors • Stay informed! • Listed to the local news for daily weather forecast • Get health and safety info from local public health department

Summary • Minnesota’s climate has become warmer and more humid • Minnesota may experience more frequent and/or intense EHE • Minnesota may experience higher morbidity and mortality due to EHE • Certain populations are more vulnerable to EHE • Public health practitioners should be aware of where those populations are located and know how to mitigate the risks to EHE

Resources • Minnesota Department of Health (MDH) Climate & Health Program • http://www.health.state.mn.us/divs/climatechange/index.html • MN State Climatology Office • http://climate.umn.edu/ • National Weather Service – Twin Cities • http://www.crh.noaa.gov/mpx/ • Centers for Disease Control & Prevention (CDC) Climate & Health Program • http://www.cdc.gov/climatechange/

MDH Extreme Heat Toolkit • Introduction to extreme heat events • Why care? • Minnesota is warming • Defining extreme heat events • Extreme Heat Events and Public Health • Health issues caused by extreme heat • Characteristics that negatively affect health outcomes from extreme heat • Preparing Minnesota for Extreme Heat Events • Key steps for responding to extreme heat events • Developing a heat response plan • Additional strategies to prevent heat-related morbidity and mortality • Mitigation/adaptation to extreme heat • Training and resources for extreme heat • Appendices: • Draft language for heat response plan/excessive heat annex • A tip sheet for individuals • Data sources for characteristics that increase the risk of heat-related illnesses • Extreme heat mapping: using GIS to identify populations at risk & resources

Acknowledgements This work was supported by cooperative agreement 5UE1EH000738 from the Centers for Disease Control and Prevention Special thanks to the following people for their contributions to the creation of this training module: Pam Blixt, Minneapolis Health & Family Support Geri Maki, MDH Myrlah Olson, MDH Dr. Mark Seeley, University of Minnesota Don Sheldrew, MDH Dr. Peter Snyder, University of Minnesota Dr. Tracy Twine, University of Minnesota

Thank You Contact the Minnesota Climate and Health Program: 651-201-4893 health.climatechange@state.mn.us http://www.health.state.mn.us/divs/climatechange/ Questions? October 10, 2012

References Adcock MP, Bines WH, Smith FW (2000), “Heat-Related Illnesses, Deaths, and Risk Factors – Cincinnati and Dayton, Ohio, 1999, and United States, 1979-1997,” Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control and Prevention. Available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4921a3.htm. Anderson GB and Bell ML (2011), “Heat waves in the United States: Mortality risk during heat waves and effect modification by heat wave characteristics in 43 US communities,” Environmental Health Perspectives, 119(2), 210. Centers for Disease Control and Prevention (CDC) (2009), “Extreme Heat: A Prevention Guide to Promote Your Personal Health and Safety,” Available online: http://www.bt.cdc.gov/disasters/extremeheat/heat_guide.asp Centers for Disease Control and Prevention (CDC) (2002), “Deaths in World Trade Center Terrorist Attacks – New York City, 2001,” Morbidity and Mortality Weekly Report (MMWR) 51 (Special Issue); 16-18. Available online:http://www.cdc.gov/mmwr/preview/mmwrhtml/mm51SPa6.htm EPA (2008), “Reducing Urban Heat Islands: Compendium of Strategies,” Available online: http://www.epa.gov/heatisld/resources/compendium.htm. Galatowitsch S, Frelich L, and Phillips-Mao L (2009), “Regional Climate Change Adaptation Strategies for Biodiversity Conservation in a Midcontinental Region of North America,” Biological Conservation 142: 2012–2022. Horstmeyer, SL. 2008. Relative humidity . . . Relative to what? The dew point temperature . . . a better approach. Available online: http://www.shorstmeyer.com/wxfaqs/humidity/humidity.htm IPCC (2007), “Climate Change 2007: The Physical Science Basis.” Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change [Solomon S, Qin D, Manning M, Chen Z, Marquis M, Averyt KB, Tignor M and Miller HL (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA, 996 pp. Knabb RD, Rhome JR, and Brown DP (2005, Updated 2006 and 2011), “Tropical Cyclone Report Hurricane Katrina 23-30 August 2005,” National Hurricane center. Available online: http://www.nhc.noaa.gov/pdf/TCR-AL122005_Katrina.pdf Kovats RS and Hajat S (2008), “Heat stress and public health: a critical review,” Annu Rev Public Health; 29:41-55. Larsen, Janet (2006), “Setting the Record Straight: More than 52,000 Europeans Died from Heat in Summer 2003,” Plan B Updates, Earth Policy Institute. Available online: http://www.earth-policy.org/plan_b_updates/2006/update56 Matt Friedlein, Meteorologist, National Weather Service - Twin Cities/Chanhassen, MN, Personal communication, August 29, 2011 Michael Timlin, Regional Climatologist, Midwestern Regional Climate Center. Retrieved on June 23, 2011 from http://mcc.sws.uiuc.edu/climate_midwest/mwclimate_change.htm MN State Climatology Office (2011a), “Record Dew Point Temperature in the Twin Cities: July 19, 2011,” Available online: http://climate.umn.edu/doc/journal/dew_point110719.htm MN State Climatology Office (2011b), “Record Dew Point Temperature for Minnesota,” Available online: http://climate.umn.edu/doc/journal/record_state_dew_point.htm, National Parks Service (NPS) (2010), “What is Climate Change?” Available online: http://www.nps.gov/goga/naturescience/climate-change-causes.htm

References (cont.) (NWS, 2009a) National Oceanic and Atmospheric Administration’s National Weather Service (June 25, 2009). Retrieved on June 22,2011 from http://nws.noaa.gov/glossary/index.php?letter=h (NWS, 2009b) National Oceanic and Atmospheric Administration’s National Weather Service (Modified June 25, 2009). Retrieved on June 22, 2011 from http://www.epa.gov/heatisld/resources/glossary.htm#u (NWS, 2010) Image from National Oceanic and Atmospheric Administration’s National Weather Service (Modified August 19, 2010). Retrieved on June 23, 2011 from http://www.nws.noaa.gov/om/heat/index.shtml (NWS, 2010b) Service area map for the six National Weather Service stations serving Minnesota and Western Wisconsin, http://www.crh.noaa.gov/images/mpx/nwsmn_wi_responsibility.gif (NWS, 2011) National Weather Service Weather Forecast Office, Twin Cities MN, http://www.crh.noaa.gov/mpx/?n=wwadef, Page last modified: October 31st 2011 7:44 PM, Retrieved on November 4, 2011 (NWS, 2011b) National Weather Service Weather Forecast Office. Grand Forks, ND. “Hottest Place On Earth?” July 2011. Available online: http://www.crh.noaa.gov/news/display_cmsstory.php?wfo=fgf&storyid=71074&source=2 (NWS, 2012) NOAA/NWS Climate Prediction Center. 2012. US Seasonal Drought Outlook. April 5 – June 30, 2012. Available online: http://www.cpc.ncep.noaa.gov/products/expert_assessment/seasonal_drought.html Russian City Official, EvegenyaSmirnova (as reported by Agence France Presse [AFP]) says nearly 11,000 more people died in Moscow during July and August 2010 than at the same time in 2009. Scott, Michon (2006), “Beating the Heat in the World’s Big Cities,” NASA, Earth Observatory. Available online: http://earthobservatory.nasa.gov/Features/GreenRoof/greenroof.php Seeley M (2011), “Climate Trends in Minnesota: Current Trends and Projections,” MN State Climatology Office, Available online: http://climate.umn.edu/seeley/ Seeley M (2012), “Twin Cities Annual Number of Days Where Dewpoint Temperature => 70 degrees F.” (chart) Snyder P (2012), “Islands in the Sun,” presented January 19, 2012. University of Minnesota Department of Soil, Water, and Climate. Western Regional Climate Center. 2011a. Minnesota Temperature 1890 – 2010: 12 month period ending in December. Generated online November 2011. Available online: http://www.wrcc.dri.edu/spi/divplot1map.html Western Regional Climate Center. 2011b. Minnesota Precipitation 1890 – 2010: 12 month period ending in December. Generated online November 2011. Available online: http://www.wrcc.dri.edu/spi/divplot1map.html Whitman, S., Good, G., Donoghue, E. R., Benbow, N., Shou, W., & Mou, S. (1997). “Mortality in Chicago attributed to the July 1995 heat wave,” American Journal of Public Health, 87(9), 1515. ZandloJ. 2008. Observing the climate. Minnesota State Climatology Office. Available online: http://climate.umn.edu/climateChange/climateChangeObservedNu.htm

Photo Credits • Slide 5: Microsoft Clipart • Slide 14: Microsoft Clipart • Slide 19: Summer by Juxxo, 2006 on Deviantart.com • Slide 24: Arizona State Department of Agriculture (provided by Peter Synder) • Slide 25: Page 14 (EPA, 2008) • Slide 26: Image courtesy NASA/Goddard Space Flight Center Scientific Visualization Studio (1997). Available online: http://earthobservatory.nasa.gov/Features/GreenRoof/Images/atlanta_thermal.jpg • Slide 27: Image source - Pam Blixt, City of Minneapolis, Department of Health and Family Support • Slide 30: Microsoft Clipart • Slide 31: AFP/Getty Images (provided by Peter Synder) • Slide 32: Image from the University of Virginia Institute on Aging. Available online: http://www.virginia.edu/insideuva/2005/02/aging.html • Slide 34: Microsoft Clipart • Slide 41: Microsoft Clipart • Slide 42: Microsoft Clipart

Extreme Heat Events Climate Change Training Module