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      The health effects of hotter summers and heat waves in the population of the United Kingdom: a review of the evidence

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          Abstract

          It is widely acknowledged that the climate is warming globally and within the UK. In this paper, studies which assess the direct impact of current increased temperatures and heat-waves on health and those which project future health impacts of heat under different climate change scenarios in the UK are reviewed.

          This review finds that all UK studies demonstrate an increase in heat-related mortality occurring at temperatures above threshold values, with respiratory deaths being more sensitive to heat than deaths from cardiovascular disease (although the burden from cardiovascular deaths is greater in absolute terms). The relationship between heat and other health outcomes such as hospital admissions, myocardial infarctions and birth outcomes is less consistent. We highlight the main populations who are vulnerable to heat. Within the UK, these are older populations, those with certain co-morbidities and those living in Greater London, the South East and Eastern regions.

          In all assessments of heat-related impacts using different climate change scenarios, deaths are expected to increase due to hotter temperatures, with some studies demonstrating that an increase in the elderly population will also amplify burdens. However, key gaps in knowledge are found in relation to how urbanisation and population adaptation to heat will affect health impacts, and in relation to current and future strategies for effective, sustainable and equitable adaptation to heat. These and other key gaps in knowledge, both in terms of research needs and knowledge required to make sound public- health policy, are discussed.

          Electronic supplementary material

          The online version of this article (10.1186/s12940-017-0322-5) contains supplementary material, which is available to authorized users.

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          Most cited references96

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          Two decades of urban climate research: a review of turbulence, exchanges of energy and water, and the urban heat island

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            Heat stress and public health: a critical review.

            Heat is an environmental and occupational hazard. The prevention of deaths in the community caused by extreme high temperatures (heat waves) is now an issue of public health concern. The risk of heat-related mortality increases with natural aging, but persons with particular social and/or physical vulnerability are also at risk. Important differences in vulnerability exist between populations, depending on climate, culture, infrastructure (housing), and other factors. Public health measures include health promotion and heat wave warning systems, but the effectiveness of acute measures in response to heat waves has not yet been formally evaluated. Climate change will increase the frequency and the intensity of heat waves, and a range of measures, including improvements to housing, management of chronic diseases, and institutional care of the elderly and the vulnerable, will need to be developed to reduce health impacts.
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              Heat Waves in the United States: Mortality Risk during Heat Waves and Effect Modification by Heat Wave Characteristics in 43 U.S. Communities

              Background Devastating health effects from recent heat waves, and projected increases in frequency, duration, and severity of heat waves from climate change, highlight the importance of understanding health consequences of heat waves. Objectives We analyzed mortality risk for heat waves in 43 U.S. cities (1987–2005) and investigated how effects relate to heat waves’ intensity, duration, or timing in season. Methods Heat waves were defined as ≥ 2 days with temperature ≥ 95th percentile for the community for 1 May through 30 September. Heat waves were characterized by their intensity, duration, and timing in season. Within each community, we estimated mortality risk during each heat wave compared with non-heat wave days, controlling for potential confounders. We combined individual heat wave effect estimates using Bayesian hierarchical modeling to generate overall effects at the community, regional, and national levels. We estimated how heat wave mortality effects were modified by heat wave characteristics (intensity, duration, timing in season). Results Nationally, mortality increased 3.74% [95% posterior interval (PI), 2.29–5.22%] during heat waves compared with non-heat wave days. Heat wave mortality risk increased 2.49% for every 1°F increase in heat wave intensity and 0.38% for every 1-day increase in heat wave duration. Mortality increased 5.04% (95% PI, 3.06–7.06%) during the first heat wave of the summer versus 2.65% (95% PI, 1.14–4.18%) during later heat waves, compared with non-heat wave days. Heat wave mortality impacts and effect modification by heat wave characteristics were more pronounced in the Northeast and Midwest compared with the South. Conclusions We found higher mortality risk from heat waves that were more intense or longer, or those occurring earlier in summer. These findings have implications for decision makers and researchers estimating health effects from climate change.
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                Author and article information

                Contributors
                Katherine.arbuthnott@lshtm.ac.uk
                Journal
                Environ Health
                Environ Health
                Environmental Health
                BioMed Central (London )
                1476-069X
                5 December 2017
                5 December 2017
                2017
                : 16
                Issue : Suppl 1 Issue sponsor : Publication of this supplement has not been supported by sponsorship. Information about the source of funding for publication charges can be found in the individual articles. The articles have undergone the journal's standard peer review process for supplements. The Supplement Editor declares that they have no competing interests. Dr Sari Kovats, Department of Social and Environmental Research in the Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine and LWEC fellow, organized this project and supplement.
                : 119
                Affiliations
                [1 ]ISNI 0000 0004 0425 469X, GRID grid.8991.9, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, ; 15-17 Tavistock Place, London, WC1H 9SH UK
                [2 ]Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ UK
                Article
                322
                10.1186/s12940-017-0322-5
                5773858
                29219088
                c26e736f-cb44-414a-95f4-8eaf8c9fbec3
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2017

                Public health
                climate change,heat,summer,heat-wave,temperature,mortality,morbidity,united kingdom,adaptation
                Public health
                climate change, heat, summer, heat-wave, temperature, mortality, morbidity, united kingdom, adaptation

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