title: Beating the heat: development and evaluation of a Canadian hot weather health-response plan.
abstract: An increasing number of cities subject to hazardous summer weather in the United States and Canada have begun to develop and implement hot weather response plans to prevent heat-related illnesses and deaths. In this study we focus on heat-mortality relationships in Toronto, Ontario, between 1980 and 1996 and evaluate the potential effectiveness of the city's interim hot weather-health response plan. Using two heat stress indexes--humidex and apparent temperature--we identified excess mortality associated with hot and humid weather and then estimated excess deaths for hot and cool summers. Mortality rates for all ages and for > 64 years age groups rose with increasing humidex and apparent temperature, with no significant increase for the population < 65 years. Excess mortality occurred as low as the 30-35 degrees C humidex range, which is below the 40 degrees C humidex used to issue a heat warning under Toronto's interim hot weather response plan. During a hot summer (such as 1988 or 1995), 32 excess deaths would be expected, whereas 34 fewer deaths than baseline levels would be expected during a cool summer like 1982 or 1992. Days with high humidex levels occur infrequently in Toronto, and thus exposure is limited under current climatic conditions. In the event of a warming climate, more days with dangerously high humidex levels are likely to occur, and summer deaths are expected to increase. Toronto's hot weather health-response plan is an important early step for adaptation to climate change.
authors.affiliation: Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Canada. karen.tomic@ualberta.ca
authors.forename: K E
authors.initials: KE
authors.lastname: Smoyer-Tomic
authors.forename: D G
authors.initials: DG
authors.lastname: Rainham
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002170:Canada; D004189:Disaster Planning; D005260:Female; D006291:Health Policy; D006293:Health Promotion; D018882:Heat Stress Disorders; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D010353:Patient Education as Topic; D016730:Program Development; D015397:Program Evaluation; D011634:Public Health; D012621:Seasons; D014505:Urban Population