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Heatwaves: measurement and mitigation

THE WINSTON CHURCHILL MEMORIAL TRUST OF AUSTRALIA

Report by John Nairn ‐ 2012 Churchill Fellow

To investigate developments in heatwave services in Europe and the USA

and explore the potential for mutually beneficial collaborative research.

Hazard resilient governments and communities maintain risk registers and understand what treatment options they can deploy to reduce heatwave impact.

I understand that the Churchill Trust may publish this Report, either in hard copy or on the internet or both, and consent to such publication.

I indemnify the Churchill Trust against any loss, costs or damages it may suffer arising out of any claim or proceedings made against the Trust in respect of or arising out of the publication of any Report submitted to the Trust and which the Trust places on a website for access over the internet.

I also warrant that my Final Report is original and does not infringe the copyright of any person, or contain anything which is, or the incorporation of which into the Final Report is, actionable for defamation, a breach of any privacy law or obligation, breach of confidence, contempt of court, passing‐off or contravention of any other private right or of any law.

Signed

Dated 16 July 2013.

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CONTENTS

.......................................................................................................................................2 CONTENTS ........

....................................................................................................................................3 INTRODUCTION ................................................................................................................................3 PROJECT DETAILS .......

MMARY .............................................................................................................................4 EXECUTIVE SU...............................................................................................................................5 KEY FINDINGS...........

NDATIONS ...............................................................................................................................6 RECOMME............................................................................................................7 PROGRAM ....................................

UK ORATION.............................................................................................................8 HEATWAVE COLLABEngland ...........................................................................................................................8 Public Health

.................................................................................................11 UK Met Office.....................................GE ........................................13 RMAN HEATWAVE COLLABORATION .........................................................

....................13 Deutches Wetterdienst (DWD), Dept. of Human‐Biometeorology (Freiberg) ....................) European Centre for Environment and Health (Bonn) ....................14 World Health Organization (WHO

US ............................................................................................18 A HEATWAVE COLLABORATION........................................................................................................18 Centers for Disease Control (CDC) Atlanta.

..............................................................................20 Climate Prediction Center (CPC) Maryland ............ DC..............................................................................25 National Institutes of Health (NIH) Washington

S) Maryland .........................................................................................25 National Weather Service (NW....................................................................28 Columbia University, New York........................................

..................................29 New York City, Department of Health and Mental Hygiene..................................d Minneapolis Health Department ..................................30 Minnesota Department of Health (St Paul) an

er Service Minneapolis (Chanhassen)........................................................................................31 Weath.............................................................................................................................................32 THANKS ....

Appendix 1.............................................................................................................................................37

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INTRODUCTION

Health authorities across Australia have recently recognised heatwaves as a serious and increasingly hazardous threat to our communities. This threat was realized in 2009 when over four hundred people died across southeast Australia during the January/February extreme heatwave, immediately preceding the 173 deaths arising from the Victorian Black Saturday fires. In subsequent seasons Australian communities have continued to experience impacts from intense heatwaves. This is consistent with expected increases in heatwave duration, frequency and intensity under projected climate change. State authorities have engaged the Australian Bureau of Meteorology to explore effective mitigation and response strategies. The Australian Bureau of Meteorology has responded by developing a national heatwave intensity measure that enables tracking and alerting for severe and extreme impacts.

Creation of a heatwave intensity measure is only one of many ingredients required to implement and operate an effective Heat Health Warning System (HHWS). Analysis of existing HHWSs deployed across Europe and North America has been undertaken to learn what parameters have affected the establishment of effective heatwave services.

This investigation also considered the scientific methodologies employed to identify and alert for heatwave severity. Comment was invited on Australia’s new heatwave intensity measure. United Kingdom (UK) and United States of America (USA) contacts expressed great interest in this heatwave methodology leading to offers for collaborative studies to investigate impact sensitivity.

PROJECT DETAILS John Nairn

25 College Road, Kent Town SA, 5067

Ph 08 8366 2723 Mobile: 04 3887 3412

Project Title:

Define severe heatwaves in national and international context suitable for an Australian warning system.

Generous access to health and weather service agencies in the UK, Germany and the USA provided invaluable context for the current level of heatwave services across Europe and North America, including future aspirations. The people who assisted with my enquiries and have offered future collaborations are acknowledged in the body of this report.

The major lessons follow below:


EXECUTIVE SUMMARY

Commitment to heatwave services and research in Europe and North America has evolved following high impact heatwaves. This is yet to occur in Australia despite high impact heatwaves. Key factors driving northern hemisphere action include:

• public (political) expectations for reduced health impacts from heatwaves;

• strong partnerships between health authorities, essential weather services and executive levels of government;

• pursuit and review of evidence based, heat health mitigation plans supported by peer reviewed literature; and

• ongoing research on heatwave measures and health impacts.

Europe and North America’s development of heatwave services derived strong political support following a history of highly visible health impacts from heatwaves. This was particularly evident following the 2003 extreme heatwave impacts in Paris. Heatwave mortality awareness has built political support for government leadership to mitigate future heatwave health risk and put in place effective public health response for severe heatwave events.

Unitary states such as the UK, France and Macedonia operate well developed HHWSs supported by very effective partnerships across government agencies. These partnerships are less effective in countries with federated constituencies unless compensation measures are explicitly deployed. The USA is a good example where leadership across a partnership of federal agencies guides a program of research, training and development designed to establish best practice for state environmental public health practitioners.

Operational heatwave mitigation partnerships are strengthened in the UK and USA through the development and sharing of Syndromic Surveillance System (SSS) data. Collection of morbidity and mortality impact data is accelerated when extreme public health events are recognized (heatwave included). Shared real-time verification of impact data within government partnerships has built confidence in heatwave hazard response capabilities and commitment to ongoing review and improvement of mitigation plans.

Stakeholder engagement is most effective when supported by peer reviewed science publications. Community wide acceptance of heatwave mitigation and response plans has been effective when supported by well communicated science. Australia’s heatwave intensity science and impact studies (Excess Heat Factor intensity index and severity mapping), was well received with offers for collaborative investigations under discussion. Access has been offered to global weather and SSS data sets in the UK and USA providing an opportunity to test the impact sensitivity of Australia’s new heatwave methodology.

An Australian framework is required that will bring together a wide range of government agencies in partnership to addresses national and regional health risks arising from climate change. Facilitation of this development is a high priority.

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KEY FINDINGS

• hazard resilient governments and communities maintain risk registers and understand available treatment options they can deploy to reduce heatwave impact;

• Australian governments (state, territory and federal) must recognise and endorse strong partnerships between health and weather services and retain an executive role in monitoring and facilitating their achievements;

• development and sharing of real-time Syndromic Surveillance System (SSS) data within an Australian National Tracking Network would support and improve heatwave response and mitigation plans;

• heatwave plan governance must incorporate peer reviewed science as a decision-support principle;

• inclusion of EHF severity maps will be included in UK Global Hazards Map (GHM operational in 2015);

• GHM data will enable EHF sensitivity studies in Public Health England SSS data;

• Centers for Disease Control (CDC) will conduct a sensitivity study of Excess Heat Factor (EHF) component parameters in US National Tracking Network (mortality and morbidity) data; and

• New York City will study EHF impact sensitivity in SSS data.

Heatwave alerting systems currently rely upon temperatures (or temperature indices) that reach threshold criteria for activation of heatwave or heat health responses. This contrast with the new Australian heatwave methodology which relies upon the climatology of heatwave intensity to develop statistically determined severe and extreme thresholds. Users of the Australian heatwave methodology understand the degree to which heatwave intensity has exceeded severe and extreme thresholds for morbidity or mortality.

The National Weather Service (NOAA, USA) are currently formulating a new heatwave policy framework which includes review of their heatwave identification and warning threshold methodology. The Australian heatwave methodology could easily support at least part of their new service aspirations.

Extreme heatwaves are associated with dry soils derived from severe rainfall deficit or drought. Dry soils are responsible for high impact heatwaves. This raises an area ripe for research. Does extreme heatwave vulnerability increase due to the drier environment? It is tempting to think that warmer climates that normally experience humid heatwaves may have severe heatwave adaptation strategies that are dangerous when deployed during much rarer extreme (dry) heatwaves.

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International advances in heatwave services excel where strong partnerships have been developed between health and meteorological agencies. It is clear that these partnerships require constant exchange of information in order to build a strong multidisciplinary appreciation of the task that is being performed.

The US Global Change Research Program has fostered an environment which has allowed a wide range of government agencies to recognise their role in improving public health outcomes. Formal government agency partnerships have grown and continue to develop synergistic arrangements for health impact services.

An Australian framework is required that will bring health and weather disciplines together in a partnership that addresses national and regional needs. Facilitation of this development is a high priority.

Australian citizens require hazard awareness services at home. Do they want it when they are abroad? The UK is developing this capacity for their citizens.

Forecast centres with capacity to operationally support global models need to consider providing each other with fail-over support. Australia's remoteness to both the UK and USA makes it an attractive fail-over partner for northern hemisphere operational centres. The operational significance of accurate numerical weather prediction guidance and forecasts will continue to rise as weather systems produce increasingly hazardous impact events such as extreme heatwaves.

RECOMMENDATIONS

Bureau of Meteorology continues to develop heatwave service capability.

Bureau of Meteorology pursue national partnerships in environmental public health.

Explore potential for establishment of a National Risk Register.

Environmental public health agencies investigate Nowcasting of Syndromic Surveillance System data, including means of sharing with partner response and mitigation agencies.

Explore a national framework for climate change impacts on environmental public health across federal government agencies.

Bureau of Meteorology investigate capacity for provision of global hazard impact services.

Collaborative heatwave research is undertaken between public health agencies and the Bureau of Meteorology, nationally and internationally.

Bureau of Meteorology becomes a member of GEO CoP, Health and Environment, seeking to engage climate change issues impacting national and regional stakeholders.

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PROGRAM

I targeted health and weather service government agency partnerships vested with mitigation and response for heatwave impact. These visits extended into the United Kingdom, Germany and the United State of America. Earlier aspirations to include France in my program were thwarted by timing and cost considerations. I am grateful for the understanding of my Paris contacts who supplied me with useful information about their heatwave arrangements.

My partner Kerryn Mason accompanied me on several initial visits to these organisations. In Kerryn’s capacity as a forensic toxicologist with Forensic Science SA (state agency) we have investigated and published findings on the impacts of the 2009 extreme heatwave in South Australia. It is notable that Kerryn conducted a significant program of visits to centres of excellence in forensic hair analysis, gathering valuable information for South Australia’s fledgling program for the detection of drugs in hair.

In London we allowed a week to visit and familiarize myself with operational and service development systems employed by Public Health England. This was followed by a week at the Met Office in Exeter.

In Freiberg we spent two days with the German Weather Service (Deutsches Wetterdeinst, DWD) investigating public health services they provided. This was followed up by a one day visit with the European World Health Organisation division for Climate Change in Bonn.

In Atlanta we allowed a week to visit and familiarize with the Climate Change group’s activities at the USA’s Centers for Disease Control (CDC).

The following week we travelled to Washington DC, visiting the Climate Prediction Centre (CPC) at the National Centre for Climate and Weather Prediction, the National Weather Service (NWS) in Silver Springs, the National Aeronautics and Space Administration (NASA) and the National Institutes of Health (NIH).

The remainder of our investigations included the Department of Health and Mental Hygiene in New York City, the Environmental Health Division of the Minnesota Department of Health, the National Weather Service Minneapolis (Chanhassen) and the Minneapolis Health Department. Discussions during these visits focused less on policy and more on discussing practical issues involved with the implementation of heatwave services.

I am extremely grateful for the care and effort expended to permit access to these organisations. Extensive dialogue before departing Australia, during my travels and whilst attending these institutions ensured the successful completion of my mission. I was not always successful in conveying my intended availability during my planned visit which has provided me a valuable opportunity to improve my communication skills. My hosts were always gracious and very accommodating.

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UK HEATWAVE COLLABORATION

Public Health EnglandI am heavily indebted to Professor Virginia Murray (Head of Extreme Events and Health Protection, Public Health England) for her valuable time and profound insights into the operation of the United Kingdom public health system. Public Health England’s (PHE) pursuit of improved health outcomes for the UK populace is empowered through the International Health Regulations (2005, 2nd edition WHO). Cabinet support for these outcomes is secured once they are placed on the National Risk Register. It was clear that this risk register enables routine and emergency discussions with Cabinet Ministers and officials. Executive government participates directly in the management of national health risks such as heatwave impact once they have been registered.

The National Risk Register is based in legislation (Civil Contingencies Act 2004). The Civil Contingency Secretariat, housed within the Cabinet Office, is the lead coordination agency and coordinates multi-agency involvement. Risk scenarios are chosen by a cross-government group chaired by the Secretariat that includes all departments that are responsible for specific risks. The scientific community is involved throughout the process and signs off on results to demonstrate that a level of scientific rigor has been accomplished.

This process has resulted in the creation of the Natural Hazard Partnership that has since evolved within the UK over the last couple of years. Within the Natural Hazards Partnership the UK Met Office (national weather service provider) has entered into a strong partnership with PHE in establishment and renewal of health impacts services, rather than the weather hazard alone.

The UK’s first heatwave plan was written in response to the 2003 extreme heat event, and has been reviewed on an annual basis since then. The Climate Change Act (2008) identified the need for treatments of severe heat and heatwave. A very interesting approach has been taken in the development of supporting documents. Apart from standard operating procedures outlined in the heatwave plan, additional reports have been published designed to support and reinforce the requirement for the plan. Further supporting documentation breaks down materials into activities that can be undertaken by different categories of health practioners. Finally a series of evaluation reports have been published, examining the evidence of the effectiveness and value of the heatwave plan. It was interesting to note that users of the current plan wish to see higher resolution guidance from the Met Office on the locality and significance of each event. Mapping rural impact was seen as highly important. Also noted the desire to standardize data sets and coding systems so that information can be readily used in evaluation of impact and shared between organisations.

Effectiveness of the current Heatwave Plan1 is challenged by the general public’s response to heatwave warnings. The sun starved populace celebrates the arrival of summer and beach weather frequently ridiculing the need for protective measures. Presentation of the heatwave methodology proposed for Australia’s heatwave service was received well by Virginia’s team. This new methodology uses the

1 https://www.gov.uk/government/publications/heatwave-plan-for-england-2012

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https://www.gov.uk/government/publications/heatwave-plan-for-england-2012


climatology of heatwave intensity to identify low intensity, severe and extreme events that can be linked to improved education and warning strategies. This methodology would not be hard to integrate with attractive elements of their current heatwave warning service. Notably, Cold Weather and Heatwave Alerts have a similar structure, rising from level 0 to 4. Level 0 addresses long term preparedness planning, through to level 4 where a National Emergency is declared by the central government.

Quality management of Public Health England’s extreme Cold Weather and Heat health protection system involves:

• Forecasts from the Met Office for temperature and weather;

• Mortality surveillance data;

• Syndromic Surveillance data;

• Overviews of communication metrics and press feedback, web hits and Cold Weather/Heatwave Plan downloads;

• Cold Weather /Heatwave Plan evaluation survey – conducted on-line as a self-compliance questionnaire; and

• Stakeholder engagement workshops in a National Cold Weather/Heatwave Seminar.

PHE has developed systems for Syndromic Surveillance and Nowcasting health impacts. The Syndromic Surveillance System operated out of Birmingham tracks public health database entries for hospital admissions, General Practitioner home visits and emergency responses (ambulance) amongst others to characterize health impacts. This service operates on a weekly update until notified of a requirement for rapid updates once a health impact event has been detected or forecast. It is difficult and expensive to generate daily reports, but the verification of impact is seen as significant data to enable health administrators to appropriately allocate resources. The Nowcasting System operated out of London models the expected health impacts based on SSS reports and supporting meta-data. This information is continually updated to improve the level of information available to health administrators, including Cabinet and across government agency partnerships.

Discussion with PHE’s Nowcasting group focused on the value of pooling data. Special mention was made of euroMOMO2, a collaborative monitoring of excess mortality for public health action. This is an example of regional data sharing to build international awareness of public health impacts.

PHE‘s involvement with the 2012 London Olympic Games delivered important lessons on creation, maintenance and partnerships required for health services. Lessons have been captured in a book collaboratively written with WHO, ‘Learning from London 2012, A practical guide to public health and mass gathering’3.

2 http://www.euromomo.eu/3 http://www.hpa.org.uk/Publications/EmergencyPreparationAndResponse/1303LearningfromLondon2

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http://www.hpa.org.uk/Publications/EmergencyPreparationAndResponse/1303LearningfromLondon2012/


Special note was made of the need to track and plan for the incidence of Ramadan as it commences approximately 11 days earlier every year. It takes about 33 years and five days for Ramadan to complete a twelve month move across the yearly calendar. As a consequence Muslims may require additional support as they become incrementally exposed to warm season heat events.

Professor Murray noted that a 2012 Cochrane Systemic Review4 found no reliable evidence on the effectiveness of electric fans in heatwaves. There is insufficient high quality research to guide policy but noted that the available evidence suggested that there could be adverse impacts once temperatures reached above 35 °C.

Key findings:

The UK National Risk Register builds Executive Government ownership of health hazard management.

The Natural Hazard Partnership has established ongoing cross government dialogue. New relationships are pursued with direct sanction of Cabinet.

Health impact Nowcasting based on Syndromic Surveillance System data underpins the operational relationship with Executive government and across government agency partnerships. Real-time data sharing is critical to strong partnerships.

There is a strong desire for better community understanding of heatwaves and for an improved heatwave warning system. The Australian heatwave intensity methodology offers PHE an alternative education and communication strategy.

PHE have developed a routine summary Bulletin for extreme events around the world in order to raise awareness of the frequency, variety and level of exposure of events that impact public health around the globe.5

PHE are prepared to share a new heatwave literature review that they are currently assembling.

I was introduced to the concept of fuel poverty. Commonly attributed to those unable to adequately heat their homes in the UK, there is no reason why the term would not apply to air conditioning in warmer countries such as Australia.

Special Note: Professor Virginia Murray is likely to visit Flinders University, South Australia in December 2013. Virginia’s presence in Australia presents an opportunity for a multi-disciplinary, cross-government agency workshop examining gaps, opportunities and benefits for partnerships focused on weather hazards and health impacts. Ideally this event would be jointly sponsored by the federal agencies with greatest mutual interest, the Department of Health and Ageing and the Australian Bureau of Meteorology.

012/4 http://ccnc.cochrane.org/news/media-alert-cochrane-finds-no-reliable-evidence-effectiveness-electric-fans-heatwaves5 [email protected]

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http://ccnc.cochrane.org/news/media-alert-cochrane-finds-no-reliable-evidence-effectiveness-electric-fans-heatwaveshttp://ccnc.cochrane.org/news/media-alert-cochrane-finds-no-reliable-evidence-effectiveness-electric-fans-heatwavesmailto:[email protected]


UK Met Office My visit to the Met Office was extremely productive and entirely dependent upon the interest and support offered by the Chief Meteorologist (Paul Davies). In the course of my visit I spent time with the following groups:

• Chief Meteorologist (Paul Davies);

• Public Weather Service – Emergency services liaison (Pat Boyle);

• Met Office Global and Regional Ensemble Prediction System (MOGREPS) (Ken Mylne and Helen Titley);

• Climate Hazards and Impacts Processing Team (Dr Carlo Buontempo);

• Climate Monitoring and Attribution (Kate Willett, Robert Dunn and Nikos Christidis);

• Public Health Service (Yolanda Clewlow, Dr Christophe Sarran);

• National Climate Information Centre (Mark McCarthy, Dan Hollis and Jack Eyre);

• Head Monthly to Decadel Prediction (Professor Adam Scaife).

• Head International (Dr Mike Gray).

My interactions within the Met Office were reasonably familiar and comfortable which is hardly surprising considering I am employed by the Australian Bureau of Meteorology, another national weather service organization.

It was clear that each of the groups I met were attracted to the heatwave intensity methodology that has been developed for Australia’s potential heatwave service. By the end of the second day of meetings it was resolved that this methodology would be adopted within a Global Hazards Map (GHM) project that is due to be delivered by the Met Office in 2015. I was advised that the creation of the GHM is based upon the belief that all UK citizens deserve to be alerted to impending natural hazards irrespective of their location in the world. This philosophy should be considered by the Australian Government, to see if this service principle could be resourced and extended to Australian citizens by the Australian Bureau of Meteorology.

Discussions then turned to understanding the requirements for establishing this system within MOGREPS (Met Office Global and Regional Ensemble Prediction System). This task is not trivial and will benefit from ongoing discussions and support. Adoption of Australia’s proposed heatwave methodology within the GHM project fosters a growing desire to establish a collaborative environment between the UK and Australian meteorological services. It is anticipated that data generated within this system would enable retrospective studies to be collaboratively conducted into heatwave intensity impacts on health outcomes, both within the UK and Australia, or with other nations considering the value of heatwave intensity services.

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Further discussions revealed great interest in securing national weather service security through an international resilience model. This concept would permit United Kingdom weather services to be supplied by the Australian weather service in the event of catastrophic system failure in the UK, with reciprocal failover arrangements for Australian weather services. Agreement on this level of mutual service security would entail high level intergovernmental discussions, supported by mutually robust super-computer capacity.

Discussions with both Public Health England and the Met Office Public Health team (Yolanda Clewlow and Dr Christophe Sarran) revealed that the existing heatwave service6 was not meeting stakeholder expectations. In contrast to the Australian heatwave methodology the UK’s current Heat Health Warning System is based upon temperature thresholds that lack the capacity to map impact or resolve sub regional scales.

In discussions with Pat Boyle it became clear that the existing warning system (level 0 to 4, figure 1) could easily adopt the Australian heatwave methodology, meeting PHE and Met Office operational requirements for an operational system with an objective assessment of impact risk.

Figure 1: UK Met Office Heat‐Health Watch service

Significant potential for collaborative research was also evident with the Climate Hazards and Impacts Processing team (Dr Carlo Buontempo) and the Climate Monitoring and Attribution team (Kate Willett, Robert Dunn and Nikos Christidis). Both groups have an expressed desire to establish a suitable heatwave methodology that would permit them to track heatwaves within their projects.

6 http://www.metoffice.gov.uk/weather/uk/heathealth/

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http://www.metoffice.gov.uk/weather/uk/heathealth/


GERMAN HEATWAVE COLLABORATION

Deutches Wetterdienst (DWD), Dept. of HumanBiometeorology (Freiberg) The German Met service (Deutches Wetter Deinst, DWD) main office is out of Frankfurt (Offenbach), with a few decentralized offices across Germany, including the Climate and Environment unit at Freiberg.

The Climate and Environment unit collect air quality data in support of government authorization of Bad accredited towns. The ‘Bad’ accreditation identifies a quality controlled spa town. German cultural pursuit of environmental quality is a significant economic driver for these tourist economies.

The Freiberg DWD BioMet service also provides advisory and warning services for UV, heat and cold stress. Messages range from no stress to extreme across four levels (levels 0 to 3). A range of general health outcomes are explicitly targeted;

• High and Low blood pressure (respiratory and cardiovascular response based on literature studies),

• Asthma,

• Rheumatism,

• Subjective (head ache, poor sleep) and

• 8 types of Pollen (allergies).

These services are in strong demand from the general public, media and private met services. Heat warnings are available through the internet in message and graphic formats.

DWD reported that the media are slow to utilize these messages. As DWD cannot be assured that media will transmit warnings there has been a strong push for apps. An app has been designed to target mobile carers and old age care facilities. It has been developed in house (Freiberg) and is regarded as the first of many that will soon appear from DWD. A wave of apps is under development through external contractors in DWD’s central office. It would appear that there is little appetite for an ensembled app. Warnings are issued for heat and UV for Today and Tomorrow for about 400 counties.

DWD Heatwave service: Gridded MOS data (Klima-Michel model) is used to generate a Perceived Temperature (Tp: temperature, humidity, wind speed and radiation) based on physiological adaptation principle. Forecaster generated data was used until 2 years ago. The shift to gridded MOS (Model Output Statistics) data has achieved higher density data coverage with a small drop in performance. Forecasts and warnings are generated on a county basis, with grid points interpolated to produce a weighted

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representative value. These are also generated at 200 m elevation intervals. A warning for extreme heat is generated when Tp reaches 38C (1 day) on the principle that this is over the core temperature. A warning for strong heat is generated when Tp reaches 32-34C over a two day period in combination with a bedroom threshold sleeping temperature (Tb). Tb is derived from a building simulation using the 8-hourly average temperature (10pm-6am) for a typical first or second level floor of a multi-storey German apartment block. German homes are rarely air conditioned for cooling and are heavily insulated for cold weather. Tp is archived for 30 days to permit the inclusion of an assessment for short term acclimatization and adaptation. This appears to be manually assessed by the Bio-Meteorologist when they intervene in the decision whether or not to warn. Thermal advisory service is provided for local times 0300, 0900, 1500 and 2100.

This group both measure and act as a repository for air quality data, both particulate and pollens. They have developed a static, fall tube particulate sampler, which is slowly being recognized as an industry standard for measuring PM2.5 to PM10 particles. The sticky plate at the bottom of the fall tube is sent to the Freiberg lab for optical scanning. Improving algorithms and different forms of sample preparation now permit the characterization of particulate by combustion particle, pollen and salt crystals. Significant body of work is devoted to certifying 'Bad' classification for resort towns. This work is externally funded. A separate facility collects a national database for pollens counts for about 20 genuses. The lab counts for a local site. Attempts to automate this process have failed. Data collected is used for prediction and verification of pollen type concentrations and distribution. Birch pollen is modelled with Swiss support.

World Health Organization (WHO) European Centre for Environment and Health (Bonn)

The WHO European Centre for Environment and Health (ECEH) in Bonn is part of the WHO Regional Office for Europe, based in Copenhagen, Denmark. The Bonn ECEH is largely funded by the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU).

Australia is a member of the WHO Western Pacific Region, based in Manila. Heat-waves are not thought to be a major initiative within this Region, which includes China, South Korea, some of SE Asia (not Thailand or Indonesia), Japan, Philippines, Pacific island states, Australia and New Zealand (37 Member States).

The only other WHO Region thought to be focussed on heat-wave health outcomes is the WHO Region of the Americas (Pan American Health Organization, PAHO), based in Washington, DC.

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Key lessons:

Only a few sketchy European heat-wave plans were in existence before 2003. A great deal of political will was generated as a consequence of the impact of this heatwave. Public pressure has enabled governments to fund serious on-going research programs, and follow through with well-developed plans. Despite the investment in research, it is evident in most cases that temporal and spatial proximity to the 2003 event has resulted in best adoption. Of the 53 member states involved approximately only one third have developed and implemented quality plans. Even then the degree of success within this group is highly varied.

WHO Regional Office for Europe believes that key European contacts will provide valuable insights into navigation of the post 2003 political and research process. These contacts are being acquired.

WHO regard their heatwave evidence and planning development phase to be largely complete, and that they now have a residual role in facilitating take-up in Europe. Flooding is currently their next health-hazard priority requiring evidence and planning development. They currently maintain an update service where they provide an alert of heatwave potential for most member states, avoiding nations such as England, France, Germany and Macedonia where robust systems are established.

Adoption has been driven by jurisdictional structure; in the cases of England, France and FYR Macedonia the centralist control of health has resulted in coherent communication and implementation of a centrally derived plan. Other nations with a federal structure require strong local level planning to achieve good results. This was noted to be the case in Italy, where national initiatives and plans are highly decentralized. The best example was the surveillance incentive for GPs to identify at risk clients within a database in return for a €10 payment. Germany on the other hand has limited examples of strong heatwave plan adoption; the exception is the federal state of Hessen. The state of Hessen in western Germany was impacted by the 2003 event.

In Australia's case, the Italian and German experience could be significant. As a federated country, health initiatives are controlled at a state level. The ability of the Australian Bureau of Meteorology to deliver a single coherent service to the state-based health systems will require considerable dialogue, partnership development and stakeholder management that facilitate an effective production to consumer service environment.

Worthy of note was the enthusiasm with which the Macedonian heat–health plan of 2010 was endorsed. A country of 2 million people, located within a 26,000 square kilometre area divided into 5 zones. Meteo (national weather service) run the Heat–Health Action Plan7, providing up to 48 hours notice via SMS and emails of heat-wave conditions. Warnings incorporate four levels with each detailing required actions on the part of participating agencies. Media interest is very strong in ensuring that each agency has engaged with the plan when an alert is issued. In the event of a high impact event they also provide a 24-hour SOS telephone line. An English

7 http://www.toplotnibranovi.mk/en/

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http://www.toplotnibranovi.mk/en/


version of their service is available through their web site. The service is also provided for cold-waves.

WHO publish a Heat Information Sheet8 which includes an overview of a range of ISO standards for heat assessment, measurement and protection. Some of the measurement standards are difficult to measure with literature support in Australia for the use of Thermal Work Limit9,10.

WHO are about to publish a status of heat-wave plans and their adoption across Europe. This would be a great process for managing and building a shared awareness amongst Australian stakeholders and in building adoption across state and territory jurisdictions.

There was repeated emphasis of the need for collaboration and partnerships between agencies, at national and regional level and involvement of civil society. Europe strongly endorses the value of the Red Cross as a trans-border Non Government Organisation (NGO). Contributions of civil society are significant political aides in developing the heat-wave planning agenda. Madeleen Helmer ([email protected]) of the Red Cross/Red crescent Climate Centre in The Hague (Netherlands) was mentioned as a potential contact.

The Public Health Adaptation Strategies to Extreme weather events (PHASE11) project is a major European collaboration that will run from 2011 to 2014. It is building a framework of tools for the preparedness and response to extreme weather events and their environmental consequences.

Canadian Health Service - highly acclaimed literature review.

Key Australian contacts to be pursued:

• Tony McMichael (retired)

• Sally Forest (paediatrician, WA)

• Garnaut Review, 2008. Health assessment of costs considered to be very sound - look at contributors for other contacts.

Dot Point Summary:

Leadership and partnerships

Decentralized initiatives

Setting up heat–health plan from scratch needs clear lines of command and control once an event is underway - an accountable and active impact monitoring authority. 8 http://www.euro.who.int/__data/assets/pdf_file/0007/147265/Heat_information_sheet.pdf9 http://en.wikipedia.org/wiki/Thermal_work_limit10 http://annhyg.oxfordjournals.org/content/51/6/553.long

11 http://www.hpa.org.uk/Topics/EmergencyResponse/ExtremeWeatherEventsAndNaturalDisasters/PHASE/

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http://en.wikipedia.org/wiki/Thermal_work_limit


Clear descriptions of how civil groups are involved.

Economic value of heat-waves important to articulate; solid data impact assessment critical

6th June impact assessment tool: www.euro.who.int/climate-change-economic-tool

Systematic literature review

Heat–Health Action Plans – Guidance12:

Public Health Advice on preventing health effects of heat13.

12 www.euro.who.int/heat-health-action-plans-guidance13 www.euro.who.int/public-health-advice-on-heat

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https://owa.bom.gov.au/owa/redir.aspx?C=BZ9HP2jJ2Uyk1evswm-uyj_Bi7BER9BIyivWrs0xWuxOXAtx1zaV9yNqPZX_9wNWwvQU1CkhArU.&URL=http%3a%2f%2fwww.euro.who.int%2fclimate-change-economic-toolhttps://owa.bom.gov.au/owa/redir.aspx?C=BZ9HP2jJ2Uyk1evswm-uyj_Bi7BER9BIyivWrs0xWuxOXAtx1zaV9yNqPZX_9wNWwvQU1CkhArU.&URL=http%3a%2f%2fwww.euro.who.int%2fheat-health-action-plans-guidancehttps://owa.bom.gov.au/owa/redir.aspx?C=BZ9HP2jJ2Uyk1evswm-uyj_Bi7BER9BIyivWrs0xWuxOXAtx1zaV9yNqPZX_9wNWwvQU1CkhArU.&URL=http%3a%2f%2fwww.euro.who.int%2fpublic-health-advice-on-heat


USA HEATWAVE COLLABORATION

The US Global Change Research Program (USGCRP) aims to build a globally engaged nation which is guided by science in meeting the challenges of climate and global change. Under this umbrella the Climate Change and Human Health workGroup (CCHHG) coordinates federal research efforts on human health and climate change. CCHHG (chartered in 2009), is co-chaired by CDC, National Oceanic and Atmospheric Administration (NOAA) and National Institutes of Health (NIH), influencing the activities of USAID, Department of State, Department of Energy, Environmental Protection Agency, Department of Defense, US Geological Survey, US Department of Agriculture, National Institute of Environmental Health Services and National Aeronautical and Space Agency (NASA). In the program of my investigations with the CDC, NOAA, NIH and NASA it became clear that the over-arching framework provided by CCHHG has been pivotal in guiding the outreach, decision support, development and ongoing research programs for reducing the impact of extreme heat amongst other environmental health hazards. This work is designed to provide both national and international outcomes. Development of an Australian framework for reduction of extreme weather and climate impacts needs to consider whether it is able to reduce impacts beyond our immediate borders. There may be an opportunity to provide environmental public health benefits for our regional neighbours, particularly where diseases are spreading under changing climates.

Centers for Disease Control (CDC) Atlanta

During the visit we joined a webinar jointly organized by the American Public Health Association (APHA) and the CDC on “Beating the Heat: Preparing for Extreme Heat Events at the State and Local Level”. APHA provides free access for attendees (approximately 1000 tune-in every month) and retain these presentations on their web site14. The popularity of this resource has risen astronomically since strict travel restrictions have been imposed by various levels of government.

CDC has prepared a new Extreme Heat website15 which contains self-help information to assist public health organizations to prepare and appropriately respond to extreme heat.

A major public health education resource has been developed to enable county level data mining using their Public Health Tracking Network Reporting Tool. The CDC is mandated by Congress to operate a collection network that enables analysis, and interpretation of data about:

• environmental hazards,

14 http://www.apha.org/advocacy/reports/webinars/default.htm15 http://emergency.cdc.gov/disasters/extremeheat/index.asp

18

http://www.apha.org/advocacy/reports/webinars/default.htmhttp://emergency.cdc.gov/disasters/extremeheat/index.asp


• exposure to environmental hazards, and

• health effects potentially related to exposure to environmental hazards.

The CDC provides funds to 23 state and local health departments to develop local tracking networks. These networks feed into the National Tracking Network which currently has data for the period 2000 to 2009.

Detailed morbidity and mortality data is complimented by information about hazards through the ‘Explore Tracking Data’ on the National Tracking Network web site16. On this link the ‘Climate Change’ option on the ‘Select Content Area’ allows access to a diverse range of heat hazard measures and impacts. Results are display in a variety of formats and may also be downloaded. They are only made available where statistical significance is present in the data.

In the case of heatwaves it is possible for a user to identify past heat events and explore how at risk populations were impacted. As a student-centred learning experience this tool is central to CDC’s outreach and training program.

Research

CDC has a Memorandum of Understanding with NOAA (see CPC below) to work on Heat Warning Services that are customized to the impacts observed at county level. To date the CDC team has considered 92 different heat definitions from which 25 have been adopted for testing against their county level impact data. Only a few definitions have been selected with variations in lag patterns accounting for the total under investigation.

A very interesting observation was made about the mismatch between health encoded and weather encoded data. Investigation into how well past impact events would have been forecast using published weather forecasts has involved comparison of health data defined by county boundaries and forecast weather data defined by NWS forecast boundaries. The task in reconciling this mismatch has not been trivial. The more recent move to gridded weather observation and forecast data sets will significantly reduce this problem for examination of more contemporary health data.

CDC has examined observed weather events using 14 km resolution North American Land Data Assimilation System (N-LDAS) temperature data. This data is resolved to a county area average before being used to calculate various heat indices.

There was strong interest in the proposed Australian heatwave methodology. The simplicity and apparent sensitivity of this heatwave index immediately appealed to the CDC team. An investigation into how this index performs against the National Tracking Network data set has been proposed incorporating a sensitivity study of the parameters within the index. This generous offer has the potential to generate a significant peer reviewed publication which in turn can assist with health industry stakeholder engagement in Australia.

16 http://ephtracking.cdc.gov/showHome.action

19

http://ephtracking.cdc.gov/showStateTracking.actionhttp://ephtracking.cdc.gov/showStateTracking.actionhttp://ephtracking.cdc.gov/showHome.action


Climate Prediction Center (CPC) Maryland

I visited the National Centre for Climate and Weather Prediction located on the College of Maryland Campus. An initial meeting with Mike Halpert was followed by discussions with Wayne Higgins (a/Head CPC), John Gottschalck (Head of CPC Operational forecasting) and Dan Collins (sub-seasonal to seasonal hazard outlooks).

Strong emphasis was placed on the significance of strong partnerships between meteorological and health agencies. As an illustration, Wayne was keen to advise that approval had just been granted for $4M in new CPC modelling initiatives tackling coastal inundation ($2M) and extreme heat resulting in human impact ($2M). This was viewed as a green light to further initiatives development under a Memorandum of Understanding with the Climate Change Group at CDC. It was clear that research initiatives could include Australian collaborations, particularly where mutual interests improve prospects for seasonal predictions of heatwaves.

I was guided through CPC sectional activities where medium to long range forecasts contribute to extreme heat assessments. Climate assessments of drought and temperature are important collectively, as dry soils support higher temperatures: ENSO (El Nino Southern Oscilation) monthly updates are released as monthly updates with 8 week projections. Production is managed cooperatively with International Research Institute for Climate and Society (IRI) since January 2012. Drought Monitor product suite is released on Thursday mornings for 334 climate divisions across USA. Manual intervention to decide on Day0, D1, D2, D3 or D4 (zip, 20th%ile, 10, 5, 2) categories. There is input from up to approximately 300 people (reference group) to assist with impact interpretation (ground truth - photos are also lodged). Normal practice is to commence with last week's map (persistence). Objective short-term drought indices are blended with long-term percentile indicators. Assessment is filtered through considerations of land-use, time of year, ecology, soil type and soil moisture. Drought monitor is overlaid with stream-flow percentiles, which has problems where the flow is heavily managed - but easily interpreted when viewed in a map overlay. Drought Monitor is jointly authored with Department of Agriculture. Drought is declared when 8 consecutive weeks are D2 or when D2 fo 8 weeks in 12 week period. Monitor is responsible for approx $480M pa in farm aid. Drought Outlook product is released twice a month on Thursdays in GIS (spatial) format. Quite subjective but aided with some objective tools. Produced as 7 day fcst, then (CPC based) 6-10 day, 8-14 day, 1 and 3 month outlooks. Outlooks for 3-4 months produced twice a month. Intention is to alternatively release 1 month outlook, followed by high resolution of rapidly developing drought outbreaks that may not have been captured in conventional systems (statistical or dynamical models)17 18. 17 www.cpc.ncep.noaa.gov/products/predictions18 http://www.cpc.ncep.noaa.gov/products/Drought/

20

http://www.cpc.ncep.noaa.gov/products/predictions


Excessive Heat Outlook is determined through considering Max Heat Index or Mean Heat Index where 3 days in 5 with a daily mean heat index of at least 85F, combined with a Min Heat Index criteria. Further clarification was required once meeting happened with the National Weather Service (NWS, also part of NOAA). Interesting to note that NWS have responsibility for 1-7 day with aspirations to extend to 10 days whilst CPC look after 6-10 days (temperature and precipitation) as well as 8-14 days, monthly and seasonal and multi-seasonal time ranges. It is clear that NWS and CPC will reorganize and redistribute responsibilities for time ranges as current arrangement are confusing. The product below is produced by the NWS (figure 2) and clearly is in a transition zone with CPC’s 6-10 day guidance (figure 3)19. Considerable care is required to ensure that these products do not provide conflicting advice.

19 http://www.cpc.ncep.noaa.gov/products/predictions/short_range/heat/hi_610.php

21

http://www.cpc.ncep.noaa.gov/products/predictions/short_range/heat/hi_610.php


Figure 2. NWS 2-3 day Hazards Outlook.

Figure 3. CPC 6-10 day Max Heat Index Outlook.

22


National Aeronautics and Space Administration (NASA) Washington DC

NASA has a program of satellite studies aimed at improving understand and management of environmental health and air quality managed through the Applied Sciences Program, Earth Science Division, Science Mission Directorate.

Within this program NASA’s stated strategic goal is to “Advance Earth System Science to meet the challenges of climate and environmental change.”20 Typical examples of this work include satellite remote sensing of severe storm impact zones (ie. Severe Storm Sandy), Volcanic ash clouds (aviation hazard), sea surface heights (development of El Nino), sea ice thickness (Arctic Ocean environmental change) and wild fire smoke plumes.

NASA partners with private and public organizations to bring the benefits of remote sensing sciences to decision making activities.

A very interesting anecdote during our discussions was offered on the high rewards of outreach activities. NASA’s public health initiatives enjoyed limited success whilst they worked within familiar physical sciences circles. A shift was noted when NASA presented their environmental studies at a major health industry conference. Their capabilities received national media coverage with headlines announcing how NASA scientists were working on improving health outcomes. A broad range of enquiry from the health science community was generated. Whilst not all new proposals were feasible, many of those that could be tackled came with fresh funds. A shift in NASA’s engagement with partners has been extremely rewarding.

Remote sensing of the radiative qualities of surfaces informs analysts of the impact of built and natural environments on how hazards are evolving and how they might be managed.

NASA supports CDC’s public health decision support system. Observed and modelled hazards (dust, extreme temperatures, mosquito and meningitis areas, pollens, algal blooms, nitrogen dioxide and ozone) are mapped.

An Applied Remote Sensing Training program (ARSET) provides end-users with professional technical workshops that enable access, interpret and use NASA satellite images for decision support. Online courses are free.

NASA has funded the I-HEAT project (Internet-based Heat Evaluation and Assessment Tool) to evaluate the feasibility of integrating multi-scale remotely sensed imagery, demographic, and health data in Internet-based software to enable health professionals to rapidly identify populations at risk from extreme heat events.

I-HEAT involves Indiana University, CDC & NASA in the application of the Extreme Heat Vulnerability Index (EHVI) in a spatially enabled assessment system.

20 http://science.nasa.gov/media/medialibrary/2010/08/30/2010SciencePlan_TAGGED.pdf

23

http://science.nasa.gov/media/medialibrary/2010/08/30/2010SciencePlan_TAGGED.pdf


Developers note that the system provides a hyper-dimensional decision matrix that:

• Improved identification of locations that are particularly vulnerable

• Improved ability to mitigate the health-related impacts. Especially, when coupled with currently developing heat-health communication toolkits. http://www.bt.cdc.gov/disasters/extremeheat/

• Improved communication of events to especially vulnerable individuals/communities

• Disaster prevention funding documentation

• Continue interaction with focus groups

• Implement the ensemble of models and begin full implementation in each city

• Automation of process

• Collect mortality/911 data for this past summer; further enhance interface for model re-runs

• Continue work on MODIS downscaling for daily guidance in each city

• Explore new cities that would be very good test areas for spatial expansion of the system (Indianapolis, Chicago have already been identified, NYC, Oklahoma City are future possibilities)

• Explore expansion spatially to statewide system

24

http://www.bt.cdc.gov/disasters/extremeheat


National Institutes of Health (NIH) Washington DC An interesting discussion with John Balbus provided a better understanding of the peak bodies enabling partnership arrangements between federal agencies.

National Weather Service (NWS) Maryland

My visit to the NWS Headquarters was a high pressure event with four meetings and my presentation on the Australian heatwave methodology filling the day. I am very grateful for the organising and support provided by Jenna Meyers.

NOAA’s Ocean and Human Health initiative21 was discussed with Juli Trtanj. The report “A Human Health Perspective On Climate Change, A Report Outlining the Research Needs on the Human Health Effects of Climate Change”22, (Interagency Working Group on Climate Change and Health, IWGCCH, 2009) was coordinated by National Institutes of Environmental Health Services authors, with lead authors from the CDC, US GCRP, US EPA, US Dept. of Agriculture and NOAA. Juli was the NOAA lead author. The coordination of agencies through this publication set the research agenda for all aspects of the research-decision making needs to address climate change, including heatwave impacts.

Juli identified GEO CoP23 Health and Environment (Group on Earth Observation Communities of Practice) as a peak body developing the use of environmental observations to improve health decision-making at the international, regional, country and district levels. This group has facilitated the development of a Cholera Early Warning System in Bangladesh with some discussion now extending to Indonesia. Australia is a participant in several other CoP groups under GEO, but not Health and Environment. There is potential for Australia to participate in regional GEO Health and Environment CoP initiatives that would immediately benefit our neighbours and develop capabilities that may be needed domestically under climate change.

Juli also noted that NOAA is facilitating the reach of the CDC through including health messages in Tornado Watch and Warning messages. Whole of government cooperation on health initiatives has been made possible by the foundation work of the IWGCCH and the ongoing recognition of the link between weather extremes and public health impacts.

21 http://oceansandhumanhealth.noaa.gov/22 http://oceansandhumanhealth.noaa.gov/media/docs/HHCC_Final_508.pdf23 http://www.earthobservations.org/cop_he_henv.shtml

25

http://oceansandhumanhealth.noaa.gov/http://oceansandhumanhealth.noaa.gov/media/docs/HHCC_Final_508.pdf


Current NWS operational heat services planning:

Excessive Heat Products, Services and Activities

Operational Products/Ongoing efforts

Provide national guidance on issuance of heat products. Minimum guidance provided in directive 10-515

• Watch issued when conditions favourable for heat warning event to occur in the next 24-72 hrs

• Advisory issued when the heat index (H.I.) meets or exceeds locally defined criteria for one to two days (typically H.I. >= 100 “north”, 105 “south”, night-time lows >= 75)

• Warning issued when H.I. meets or exceeds locally defined criteria for two days (typically H.I. >= 105 “north”, 110 “south”, night-time lows >= 75)

• Local Weather Forecast Offices (WFOs) are strongly encouraged to develop local criteria in cooperation with local emergency and health officials, and/or utilize detailed heat/health warning systems based on scientific research

Supported the development of operational Heat Health Warning Systems (HHWS) – measures oppressive air masses that impact human health; predicts additional deaths attributable to heat. The operation of this system is funded by NOAA in 14 cities: Chicago, IL, Dallas/Ft. Worth, TX, Dayton/Cincinnati, OH, Houston, TX, Kansas City, MO/KS, Los Angeles, CA, Minneapolis, MN, New York, NY, Oklahoma City, OK, Portland, OR, San Francisco/San Jose, CA, Seattle, WA, St. Louis, MO, Washington/Baltimore, MD.

but not its use in these cities: Detroit, MI, Hanford (Fresno), CA, Indianapolis, IN, Jackson/Meridian, MS, La Crosse, WI, Lake Charles/Alexandria, LA, Little Rock/Pine Bluff, AR, Memphis, TN/Tupelo, MS, New Orleans/Baton Rouge, LA, Philadelphia, PA, Philadelphia, PA (cold system), Phoenix, AZ, San Jose, CA (cold system), Shreveport/Monroe, LA, Yuma, AZ,

High heat indices which do not meet advisory criteria are included in beach hazards statements with messages on heat safety on the NWS web page.

Description of the NWS heatwave has been appended to the back of this report.

Partnerships

Don’t Fry Day – Memorial Day weekend effort to raise awareness about exposure to extreme heat and UV radiation. Partners include National Council on Skin Cancer prevention, EPA, OSHA, CDC and the National Highway Traffic Safety Administration

OSHA – Partnership to include heat safety information for outdoor workers in heat products

26


Current Studies

Pacific NW Heat Health Program – OR and WA State Climatologists leading a study to refine heat criteria for their area

Heat waves and health impacts – study at UC Davis to analyse implications for heat warning systems and responses; engaging NWS Sacramento

Western Region developing a Heat Awareness Index based on heat climatology; colour coded threat level and thresholds developed in coordination with health experts

Internal Review of NWS Heat Products24 and Communication of Heat Hazards

Gathering best practices and other ideas on how we might improve our communication of expected extreme heat events to our partners and the public

• Document variations in the usage of heat-based WWA products across the country

• Learn of the degree to which local criteria are applied to WFO decision-making processes in issuing these products

• Assess the level of usage of Heath Health Warning Systems for WFOs that have them

• Gather ideas for enhancing communication of expected excessive heat events in general

NOAA-wide Strategic Planning and Priorities

Impact of extreme heat stress events on public health

• Engage the user community on additional current and future needs related to health and extremes

• Develop operational heat stress information products, as well as integrate health information into existing products

• Engage in research activities to improve predictions and projections for future heat stress events across timescales (weeks to decades)

NWS-related Activities:

• Needs assessment

• Development of week-2 (8-14 days) excessive heat watch-warning outlook (CPC)

24 http://www.hpc.ncep.noaa.gov/heat_index.shtml

27

http://www.hpc.ncep.noaa.gov/heat_index.shtml


Columbia University, New York Brief visits were made with Radley Horton at the Center for Climate Systems Research, New York City Campus and with Bradfield Lyon at the International Research Institute for Climate and Society (IRI), Lamont Campus. It was interesting to understand how climate sciences are connected into heatwave research.

The Center for Climate Systems contributes to the National Climate Assessment25 which is updated every four years (due in early 2014) and administered by the US Global Change Research Program26. They have also provided a regionally downscaled climate projection to the State and City of New York which was in the process of being re-done during our visit. Publications are available through their web site27.

The Agricultural Model Inter-comparison and improvement Project (AgMIP) is highly inter-disciplinary global program involving UKaid, USDA, USAID, Consultative Group on International Agricultural Research (CGIAR), research program on Climate Change, Agriculture & Food Security (CCAFS) and NASA. Comment on disproportionate impact of modern cropping infrastructure and various climate hazards. Bangladesh could raise its food production six fold with available technologies, whilst climate extremes (apart from inundation) vary the current production by 10%. A challenging environment where economic modelling of crop yield is determined by shifts in land production type. These models are extremely difficult to operate and lack the sophistication of available climate models. The difference means it is very hard to generate multiple economic scenarios. Alex Ruane recommended Peter Thorburn for his agricultural climate modelling in the CSIRO (Queensland).

Discussions with Stuart Gaffin centred on urban adaptation to a warming climate. A lot of research now focuses on roofing materials. Special note made of C40Cities28, a Climate Leadership Group dedicated to promoting how large cities can adapt and mitigate the effects of climate change as well as reduce their carbon footprint.

IRI collaborate in the production of the CPC ENSO assessments.

Activity within universities is heavily dependant upon successful grants.

25 http://www.globalchange.gov/what-we-do/assessment26 http://www.globalchange.gov/home27 http://ccsr.columbia.edu/28 http://www.c40cities.org/

28

http://www.globalchange.gov/what-we-do/assessmenthttp://www.globalchange.gov/homehttp://ccsr.columbia.edu/http://www.c40cities.org/


New York City, Department of Health and Mental Hygiene

Very interesting discussion that covered a range of relevant topics and confirmed details picked up in heatwave discussions with other USA agencies.

New York City has a heat response plan under the Office of Emergency Management which coordinates and leads emergency response. This plan details access arrangements for cooling centres, public advisory messaging, protection of key infrastructure including the power grid and water supply. Examples were given where avoidable excavations are put on hold to avoid accidental power disruption, or water hydrant spray caps are distributed to permit play, and maintenance of water pressure.

Once weather leading to a heat advisory or warning is established they increase monitoring in their Syndromic Surveillance System. This is used to communicate a impact through providing advice on impact as a percentage increase in morbidity and morbidity. Actual numbers are not released as they are difficult to interpret by the public or other government agencies. It was noted that the SSS information is important for providing evidence of impact to other agencies, to build confidence in the requirement for response.

Activation of alerts or warnings occurs when a maximum Heat Index of 95F occurs for two days or one day of 100F. This involves consultation with the local NWS forecast office to gain early information on these criteria. An early threshold of a one day maximum Heat Index of 105F was deemed to be too high. Kalkstein’s spatial synoptic system is also available but is considered to only add complexity and is difficult to use operationally.

A Panel on Climate Change was convened by the Mayor, and authorized the production of a report on projected climate change hazard trends in 2009. This report which down-scaled climate projections to the scale of the region and New york City was produced by Columbia University and is being updated in 2013.

Mitigation activities include the city giving an air conditioning unit to those considered to be at risk. The city surveys have established that 87% of the public have air conditioning. The city is constantly trying to evaluate the best way to activate an alert. Seasonal heat deaths in New York City are a normal burden requiring long-term mitigation, excess heat deaths are addressed by the advisory and warning system.

It was noted that public messaging requires further work. During heatwaves television stations focus on youth activities, promoting the benefits of shade. The group feel that vulnerable groups and their protective measures should be shown. Unscripted messages on reduction of power use to protect the grid also fail to prioritize the need for vulnerable groups to continue using their air conditioning.

Surveys have also identified that only 10 to 15% of the most vulnerable utilise cooling centres. It would seem that these people do not consider they are at risk. There is also evidence from standardized tests that student performance during heatwaves is impacted. Most schools are not air conditioned, which is an area that will require investigation and possible mitigation.

29


Finally, New York City is a participant in the CDC’s Climate and Health program. Federal funding is allocated to assist the city develop their heat response capabilities.

Minnesota Department of Health (St Paul) and Minneapolis Health Department

Similar visits were paid to the Minnesota Department of Health (MDH) and Minneapolis Health Department in the twin cities of St Paul and Minneapolis over two days.

A diverse group of attendees were present at both meetings.

In St Paul the meeting included Kristin Raab (Climate & Health Director, MDH), Jack Brondum (Epidemiologist, Hennepin County), Deb Radi (Emergency Manager, MDH), Greg Spoden (State Climatologist), Mark Seeley (Climatologist, University of Minnesota), Todd Krause (Services Manager, National Weather Service), Carol Hajicek (Vital Records, MDH), Katie Muehe (MN Climate & Health Program, MDH). James Kelly (Manager, MDH), Dan Symonik (Supervisor, MDH), Chris Greene (Exposure Scientist (water), MDH), Janet Mengelkoch and D’Ana Tijerina (Emergency response, City of Minneapolis).

It was interesting to learn that Minnesota was interested in the new Australian heatwave methodology as a candidate for initiating their heatwave response plan. Their investigations to date have considered mean rate of hospitalisation against mean summer temperatures. They next plan to examine what has happened during particular heat events.

They have been assembling a toolkit to help planners within the state29. This is a formidable training resource with fully scripted slide presentations permitting train-the-trainer capabilities. Video conferences are available to assist planners acquire understanding. The tool kit includes a draft plan that can be tailored to local use, a tip sheet, data sources, case study and sample media release. Included is an extreme heat training module supported by statewide data in spreadsheet or map formats that show vulnerable populations and risk factors. Technical assistance is also provided for how the user can work with this data in GIS (spatial data) mapping format.

MDH have a workgroup to evaluate the work required to develop and operate a Syndromic Surveillance System. This workgroup has recognised that it is not possible to create this system with current resources, but convenes to consider whether the investment is worthwhile and what benefits could be realized. There are connections available to a national and international work group that is tackling climate change related events. It is possible to sign up to a list server which currently has around 500 subscribers.

29 http://www.health.state.mn.us/divs/climatechange/

30

http://www.health.state.mn.us/divs/climatechange/


In Minneapolis the meeting was attended by representatives of the local Federal Emergency Management Authority (FEMA) contact (emergency service director), managers of 311 (non-emergency version of 911) and public health managers for community and emergency preparedness.

This group identified that extreme heat planning commenced in 2006 and indicated that the twin cities are recognized to be in the top 20 American cities for heat planning.

Weather Service Minneapolis (Chanhassen) It was very rewarding to visit an operational NWS forecasting office, to see operations that closely reflected Australia’s forecast operations. In this environment it was easy to relate to the operational issues faced by forecasters when considering the need to release an extreme heat advisory or warning product. It was clear that forecasters are uncomfortable using the air mass technique (Kalkstein), which reaffirmed other appraisals. This system provides an assessment of how many deaths per 10,000 should be expected after the air mass technique was used. It was described as time consuming and not a data type that weather forecasters were confident in using. As a consequence it would seem that this advice was normally heavily discounted or possibly ignored. Temperature thresholds were normally used to make decisions, with consultations with health authorities carried out at set criteria before products were issued.

The Australian heatwave methodology was discussed with a local manager who supported the utility of this form of decision tool. It was considered to be the type of tool they would prefer to utilize for extreme heat services.

31


THANKS

I would like to thank The Winston Churchill Memorial Trust for accepting my nomination and for their local induction program. The value, opportunity and companionship of Churchill Fellows are an ongoing asset in my endeavours.

I would like to thank The Bureau of Meteorology for supporting this tour. Not every employer will permit their staff to draw salary whilst conducting a Churchill Fellowship. I would encourage other organisations to see the asset value of the knowledge gained.

My sponsors Alasdair Hainsworth (Bureau of Meteorology) and Roger Beale (PricewaterhouseCooper) endorsed my program. Their support and belief enabled was important.

The generosity of my hosts was marvellous. It is wonderful to find people on the other side of the world willing to introduce me to their organisations, endure my questions and in turn offer their thoughts on the state of heatwave impact science.

Arranging meetings was at times onerous for my hosts and I am indebted for their perseverance and kindness. I would like to thank the following people and assure them that I feel the time we spent together as extremely valuable. I hope to repay any kindness if asked.

1) Public Health England

Prof Virginia Murray, Sari Kovats, Aileen Kitching

32


2) UK Met Office

Paul Davies

3) Deutches Wetterdienst

Christina Koppe, Jochen Blasing

33


4) WHO Europe

Vladimir Kendrovski, Bettina Menne, Kerryn Mason (FSSA), Gerardo Sánchez, Marina Ostheimer (intern CGS), James Creswick,

5) Centers for Disease Control

Eric Lahr, Gino Arinucci, Shubhayu Saha, Ambarish (Rish) Vaidyanathan, George Luber, Paul Schramm (Jeremy Hess and Arie Manangan).

34


6) Climate Prediction Center (NOAA) Wayne Higgins, Mike Halpert, Jon Gottschalck, Dan Collins, Anthony Artusa, Brad Pugh, Richard Tinker. Michelle L'heureux 7) National Weather Service (NOAA) Michelle Hawkins, Juli Trtanj, Eli Jacks, Paul Stokols, Fiona Horsfall, Wendy Marie Thomas, Jenna Meyers 8) NASA John Haynes 9) National Institutes of Health John Balbus 10) New York City Dept Health and Mental Hygiene

Kerryn Mason (FSSA), Katie Lane, Kizzy Charles-Guzman, Nathan Graber, Kaz Ito, 11) Columbia University (NYC and Palisades) Radley Horton, Alex Ruane, Jonathon Winter, Bradfield Lyon (IRI) and Anthony Barnston (IRI).

35


12) Minnesota Department of Health

Kristin Raab, Mark Seeley, Deb Radi, Jack Brondum, Greg Spoden, Todd Krause, Carol Hajicek, James Kelly, Chris Greene, Katie Muehe, Janet Mengelkoch and D’Ana Tijerina

13) Minneapolis Department of Health

Toni Hauser

14) Chanhassen Forecast Office (NWS), Minnesota Todd Krause.

John Nairn June 2013

36


Appendix 1

NWS Heat Definitions and Alert Criteria

May 2013

Definitions

Extreme Heat Event or Heat wave

A heat wave is a prolonged period of excessive heat, often combined with excessive humidity. Generally, excessive heat is defined as temperatures that hover 10 degrees or more above the average high temperature for the region during summer months, last for a prolonged period of time, and often are accompanied by high humidity.

Memorial Day generally marks the beginning of Excessive heat season.

The Heat Index is used by NWS forecasters and others to help forecast when extreme heat may be hazardous.

Heat Index

The heat index is the temperature the body feels when the effects of heat and humidity are combined. Exposure to direct sunlight can increase the heat index by up to 15̊F.

NWS Heat Policy From NWSI 10-51530 November 18, 2011 Non-Precipitation Weather Warning and Advisory Criteria WFOs will issue non-precipitation weather warnings or advisories when hazardous non-precipitation weather is occurring, imminent, or has a high probability of occurrence over part or all of the forecast area. WFOs should issue non-precipitation weather warnings and advisories with as much lead time as possible for the first and second period, and occasionally third or fourth forecast periods, when there is an 80 percent or greater chance of a hazardous non-precipitation weather event meeting or exceeding local warning, advisory and/or impact criteria. Impact Criteria The following is an example of impact vs. strict criteria: A Heat Wave is forecasted but temperature and humidity combined will not meet traditional heat index criteria. However, if it is early in the season or unusually warm at night when the impact will likely be high, then a Heat Advisory or Excessive Heat Warning might be warranted. The forecaster has the discretion and should not be held back from issuing what best mitigates the impending non-precipitation hazard even if traditional criteria are not met. WFOs will coordinate with adjacent WFOs regarding the warning type.

30 http://www.nws.noaa.gov/directives/sym/pd01005015curr.pdf

37

http://www.nws.noaa.gov/directives/sym/pd01005015curr.pdf


Non-Precipitation Weather Products

WFOs will issue the following non-precipitation weather products, as appropriate: Product Name

Description

Excessive Heat Watch Conditions are favourable for an excessive heat event to meet or exceed local Excessive Heat Warning criteria in the next 24 to 72 hours.

Heat Advisory *Heat Index values forecast to meet or exceed locally defined advisory criteria for one to two days (Typical values: 1) Maximum daytime HI>=100 F north to105 F south 2) Minimum night-time lows>=75F).

Excessive Heat Warning *Heat Index (HI) values forecast to meet or exceed locally defined warning criteria for at least two days (Typical values: 1) Maximum daytime HI>=105 F north to110 F south and 2) Minimum night-time lows >=75F).

* Note: The Excessive Heat Warning/Heat Advisory criteria are highly variable in different parts of the country due to climate variability and the effect of excessive heat on the local population. WFOs are strongly encouraged to develop local criteria in cooperation with local emergency and health officials, and/or utilize detailed heat/health warning systems based on scientific research.

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Eastern Region Criteria (2012)

Heat – Eastern Region heat index criteria are based on national guidelines associated with recommendations from the 1995 Chicago Heat Service Assessment. Excessive heat products will be issued when criteria are expected to be met for two hours or more. Heat related criteria can be found on the Eastern Region Heat Thresholds Maps below.

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Central Region Criteria (NWS CRS 06-2003 March 18, 2011)

Non-Precipitation Warning Criteria. Excessive Heat Warning – an Excessive Heat Warning (NPW) should be issued when conditions are observed or anticipated, and are expected to persist for at least a 48-hour period as seen in the graphic below. Several CR offices have additional guidance available through Heat Health Warning System algorithms. This tool is separate from the guidance criteria established in this supplement. Blending all available guidance into a cohesive decision making process is left to local management.

Fig. 1. Central Region office groups for Excessive Heat Warning Criteria Central Region Excessive Heat Warning criteria: 1. North and Eastern (yellow shaded area)

磊 Max Heat Index (HI) around 105 F &

磊 Min HI around 75 F or higher

2. Central (red shaded area) 磊 Max HI around 110 F &


3. Western (green shaded area)* 磊 High Plains/Front Range/Valleys

磊 Max HI around 105 F &

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Mountains Min HI around 75 F or higher

* WFO Grand Junction does not issue Excessive Heat Warnings for their four Utah counties. If Advisory criteria are expected for 4 or more consecutive days, WFOs should issue an Excessive Heat Warning. The use of the word ‘round’ conveys a range of +/- two degrees on either side of the base criteria to give WFO forecasters flexibility especially during marginal events. Base criteria may also be adjusted, typically in urban areas, to match agreements with health NWS CRS 06-2003 March 18, 2011 3 care partners. Adjustments to base criteria should not be made for cities with less than 200,000 people. Non-Precipitation Weather Advisories (product category NPW). Non-Precipitation Weather Advisory Products. Heat Advisory – a Heat Advisory should be issued when conditions are observed or anticipated as seen in the graphic below. Several CR offices have additional guidance available through Heat Health Warning System algorithms. This tool is separate from the guidance criteria established in this supplement. Blending all available guidance into a cohesive decision making process is left to local management.

Fig. 2. Central Region office groups for Heat Advisory Criteria Central Region Heat Advisory criteria: 1. Northern and Eastern (yellow shaded area) Max HI around 100 F or higher 2. Central (red shaded area)

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Max HI around 105 F or higher

3. Western (green shaded area)* Plains/Front Range/Valleys

Max HI around 100 F or higher & Min HI around 75 F or higher

Mountains

Max HI around 95 F or higher & Min HI around 75 F or higher

* WFO Grand Junction will issue a Heat Advisory for their four Utah counties when the Max HI is >= 105 F and the overnight temperature is >=80 for at least two consecutive days. If Advisory criteria are expected for 4 consecutive days or more, WFOs should issue an Excessive Heat Warning. Longer durations of heat conditions just under advisory criteria can also pose a risk to the public. WFOs should collaborate with their neighbours and consider issuing a heat advisory to cover these conditions if they are expected to last for 4 consecutive days or more. These conditions are: 1. Northern and Eastern (yellow shaded area)

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