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Article

Advancing our Understanding of Heat Wave Criteria and Associated Health Impacts to Improve Heat Wave Alerts in Developing Country Settings

1
Yale School of Forestry & Environmental Studies, New Haven, CT 06511, USA
2
Department of Family Medicine and Public Health and Scripps Institute of Oceanography, University of California at San Diego, La Jolla, CA 92093, USA
3
Pardee RAND Graduate School, Santa Monica, CA 90401, USA
4
Healis-Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra 400 701, India
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(12), 2089; https://doi.org/10.3390/ijerph16122089
Received: 16 April 2019 / Revised: 1 June 2019 / Accepted: 7 June 2019 / Published: 13 June 2019
(This article belongs to the Special Issue Temperature Variability and Mortality/Morbidity)
Health effects of heat waves with high baseline temperatures in areas such as India remain a critical research gap. In these regions, extreme temperatures may affect the underlying population’s adaptive capacity; heat wave alerts should be optimized to avoid continuous high alert status and enhance constrained resources, especially under a changing climate. Data from registrars and meteorological departments were collected for four communities in Northwestern India. Propensity Score Matching (PSM) was used to obtain the relative risk of mortality and number of attributable deaths (i.e., absolute risk which incorporates the number of heat wave days) under a variety of heat wave definitions (n = 13) incorporating duration and intensity. Heat waves’ timing in season was also assessed for potential effect modification. Relative risk of heat waves (risk of mortality comparing heat wave days to matched non-heat wave days) varied by heat wave definition and ranged from 1.28 [95% Confidence Interval: 1.11–1.46] in Churu (utilizing the 95th percentile of temperature for at least two consecutive days) to 1.03 [95% CI: 0.87–1.23] in Idar and Himmatnagar (utilizing the 95th percentile of temperature for at least four consecutive days). The data trended towards a higher risk for heat waves later in the season. Some heat wave definitions displayed similar attributable mortalities despite differences in the number of identified heat wave days. These findings provide opportunities to assess the “efficiency” (or number of days versus potential attributable health impacts) associated with alternative heat wave definitions. Findings on both effect modification and trade-offs between number of days identified as “heat wave” versus health effects provide tools for policy makers to determine the most important criteria for defining thresholds to trigger heat wave alerts. View Full-Text
Keywords: climate change; extreme temperature events; heat waves; human health; mortality; PSM; temperature-mortality relationships climate change; extreme temperature events; heat waves; human health; mortality; PSM; temperature-mortality relationships
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MDPI and ACS Style

Nori-Sarma, A.; Benmarhnia, T.; Rajiva, A.; Azhar, G.S.; Gupta, P.; Pednekar, M.S.; Bell, M.L. Advancing our Understanding of Heat Wave Criteria and Associated Health Impacts to Improve Heat Wave Alerts in Developing Country Settings. Int. J. Environ. Res. Public Health 2019, 16, 2089. https://doi.org/10.3390/ijerph16122089

AMA Style

Nori-Sarma A, Benmarhnia T, Rajiva A, Azhar GS, Gupta P, Pednekar MS, Bell ML. Advancing our Understanding of Heat Wave Criteria and Associated Health Impacts to Improve Heat Wave Alerts in Developing Country Settings. International Journal of Environmental Research and Public Health. 2019; 16(12):2089. https://doi.org/10.3390/ijerph16122089

Chicago/Turabian Style

Nori-Sarma, Amruta, Tarik Benmarhnia, Ajit Rajiva, Gulrez S. Azhar, Prakash Gupta, Mangesh S. Pednekar, and Michelle L. Bell 2019. "Advancing our Understanding of Heat Wave Criteria and Associated Health Impacts to Improve Heat Wave Alerts in Developing Country Settings" International Journal of Environmental Research and Public Health 16, no. 12: 2089. https://doi.org/10.3390/ijerph16122089

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