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The global need for smart heat–health warning systems

2022; Elsevier BV; Volume: 400; Issue: 10362 Linguagem: Inglês

10.1016/s0140-6736(22)01974-2

1474-547X

Tiantian Li, Chen Chen, Wenjia Cai,

Thermoregulation and physiological responses

In 2022, heatwaves struck the world and broke many long-standing records.1National Aeronautics and Space AdministrationHeatwaves and Fires Scorch Europe, Africa, and Asia.https://earthobservatory.nasa.gov/images/150083/heatwaves-and-fires-scorch-europe-africa-and-asiaDate: July 13, 2022Date accessed: August 21, 2022Google Scholar These heatwaves seriously affect human health and life on Earth. The ripple effects of climate change will further trigger ozone pollution, droughts, wildfires, and other extreme events, which will also affect human health.2The Lancet2022 heatwaves: a failure to proactively manage the risks.Lancet. 2022; 400: 407Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar However, the health effects of heatwaves are grossly underestimated, and most countries, including China, have few effective measures to protect their residents from heatwaves. The Intergovernmental Panel on Climate Change, World Meteorological Organization, and WHO have agreed that a heat–health warning system could effectively reduce the risk of heat-related death.3Field CB Barros VR Dokken DJ et al.Climate change 2014: impacts, adaptation, and vulnerability. Part A: global and sectoral aspects. Working group II to the fifth assessment report of the Intergovernmental Panel on Climate Change. Cambridge University Press, Cambridge2014Google Scholar Heat–health warnings have been shown to effectively reduce premature deaths caused by heatwaves and achieve health benefits.4Toloo G FitzGerald G Aitken P Verrall K Tong S Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence.Int J Public Health. 2013; 58: 667-681Crossref PubMed Scopus (102) Google Scholar In July, 2006, during a severe heatwave in France, the Heat–Health Watch Warning System saved more than 4300 lives in 18 days.4Toloo G FitzGerald G Aitken P Verrall K Tong S Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence.Int J Public Health. 2013; 58: 667-681Crossref PubMed Scopus (102) Google Scholar The Hot Weather–Health Watch/Warning System in Philadelphia, PA, USA had a massive benefits-to-costs ratio.4Toloo G FitzGerald G Aitken P Verrall K Tong S Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence.Int J Public Health. 2013; 58: 667-681Crossref PubMed Scopus (102) Google Scholar However, heat–health warning systems have only in use in a few high-income countries, such as France, the UK, and Spain.5Kotharkar R Ghosh A Progress in extreme heat management and warning systems: a systematic review of heat-health action plans (1995–2020).Sustain Cities Soc. 2022; 76: 7Crossref Scopus (13) Google Scholar Yet most low-income and middle-income countries, especially those that are highly populated, are particularly vulnerable to frequent heatwaves and still implement the traditional high-temperature forecast warnings, which are insufficient to protect population health for several reasons. First, an absence of the concept of population-health-oriented management: traditional meteorological warnings are based on the strength of high-temperature signals and fail to consider the potential health risks due to heat exposure. Second, incomplete coverage of heat–health risk-management patterns: meteorological warnings are issued only for extreme heat, which ignores the severe health damage caused by low and moderate heat in summer. Third, failure to involve the health sector: warnings are issued from the meteorological service department and the health sectors fail to respond to these meteorological emergencies. The future is likely to see heatwaves increasing in frequency and intensity. We call for the immediate establishment of smart heat–health warning systems in both high-income and low-to-middle-income countries. The following four aspects should be strengthened to reduce the growing heat-related risk to health. First, by developing a smart population-health-oriented early warning system with full coverage of heat–health risk management, which allows identification of automatic warning signals on the basis of the characteristics of the health concerns due to heat, and implementation of targeted and proactive actions based on the early warning information of heat-related health risks throughout the summer. Second, by establishing a refined early warning system with detailed suggestions for the health protection of vulnerable populations, such as older people, children, pregnant women, and patients with chronic diseases. Third, by planning a compound heat and ozone health-risk warning system in advance; heatwaves will increase ozone pollution, and the synergistic effect will further aggravate the public health hazard. Fourth, by forming a joint multisectoral plan of action for the early heat–health risk warning management, led by the health sector, to manage heat-related health risks effectively. We declare no competing interests.