Extreme Heat Episodes Research Articles

Heat Awareness and Response among Montreal Residents with Chronic Cardiac and Pulmonary Disease

Persons affected by chronic heart and lung disease risk illness and death through exposure to extreme ambient heat. Here we describe their knowledge and awareness of the risks, and the degree to which they practice the protective behaviours recommended by public health and meteorological authorities. Over the course of a hot Montreal summer, chronic cardiac and/or pulmonary insufficiency patients were recruited sequentially on site or by telephone from among attendees at five Montreal university hospital clinics. A one-hour face-to-face structured interview was completed by 238 patients, of whom 78% were at least 60 years of age. Participants were well informed about extreme heat and its impact on health. Most see themselves as vulnerable to heat, recall extreme heat advisories, and all adopt at least one recommended protective measure. Of the participants, 68% spend time in an air-conditioned space during extreme heat episodes, and more than 75% reduce their physical activity and drink extra fluids. A small minority resists recourse to air conditioning: of those without, 32% have "little confidence in buying an air conditioner" even if so advised by their caregivers, and 25% would refuse to overnight in an air-conditioned shelter during a prolonged heat wave. These chronically ill respondents perceive themselves as susceptible to extreme heat, have confidence in prevention, and almost all adopt recommended protective behaviours. A minority resists protective messaging.

The Effect of Heat Waves on Mental Health in a Temperate Australian City

ObjectiveThe goal of this study was to identify mental, behavioral, and cognitive disorders that may be triggered or exacerbated during heat waves, predisposing individuals to heat-related morbidity and mortality.DesignUsing health outcome data from Adelaide, South Australia, for 1993–2006, we estimated the effect of heat waves on hospital admissions and mortalities attributed to mental, behavioral, and cognitive disorders. We analyzed data using Poisson regression accounting for overdispersion and controlling for season and long-term trend, and we performed threshold analysis using hockey stick regression.ResultsAbove a threshold of 26.7°C, we observed a positive association between ambient temperature and hospital admissions for mental and behavioral disorders. Compared with non–heat-wave periods, hospital admissions increased by 7.3% during heat waves. Specific illnesses for which admissions increased included organic illnesses, including symptomatic mental disorders; dementia; mood (affective) disorders; neurotic, stress related, and somatoform disorders; disorders of psychological development; and senility. Mortalities attributed to mental and behavioral disorders increased during heat waves in the 65- to 74-year age group and in persons with schizophrenia, schizotypal, and delusional disorders. Dementia deaths increased in those up to 65 years of age.ConclusionOur results suggest that episodes of extreme heat pose a salient risk to the health and well-being of the mentally ill.Relevance to Clinical or Professional Practice: Improvements in the management and care of the mentally ill need to be addressed to avoid an increase in psychiatric morbidity and mortality as heat waves become more frequent.