Heat-health warning systems: a comparison of the predictive capacity of different approaches to identifying dangerously hot days.
OBJECTIVE
We compared the ability of several heat-health warning systems to predict days of heat-associated mortality using common data sets.


METHODS
Heat-health warning systems initiate emergency public health interventions once forecasts have identified weather conditions to breach predetermined trigger levels. We examined 4 commonly used trigger-setting approaches: (1) synoptic classification, (2) epidemiologic assessment of the temperature-mortality relationship, (3) temperature-humidity index, and (4) physiologic classification. We applied each approach in Chicago, Illinois; London, United Kingdom; Madrid, Spain; and Montreal, Canada, to identify days expected to be associated with the highest heat-related mortality.


RESULTS
We found little agreement across the approaches in which days were identified as most dangerous. In general, days identified by temperature-mortality assessment were associated with the highest excess mortality.


CONCLUSIONS
Triggering of alert days and ultimately the initiation of emergency responses by a heat-health warning system varies significantly across approaches adopted to establish triggers.
Hajat
Shakoor
S
Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK. shakoor.hajat@lshtm.ac.uk
Sheridan
Scott C
SC
Allen
Michael J
MJ
Pascal
Mathilde
M
Laaidi
Karine
K
Yagouti
Abderrahmane
A
Bickis
Ugis
U
Tobias
Aurelio
A
Bourque
Denis
D
Armstrong
Ben G
BG
Kosatsky
Tom
T
D002641:Chicago / Q000453:epidemiology; D005544:Forecasting; D018882:Heat Stress Disorders / Q000401:mortality / Q000517:prevention & control*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D006813:Humidity; D008131:London / Q000453:epidemiology; D009026:Mortality; D011634:Public Health / Q000379:methods; D011792:Quebec / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology
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