CLIMATE CHANGE
and EXTREME HEAT
What You Can Do to Prepare
ii ii ii
1,11 ii ii ii
II
EPA 430-R-16-061
October 2016
United States
Environmental Protection
Agency
-------
Extreme heat events in the United States are already occurring and expected to become more common, more severe,
and longer-lasting as our climate changes. The U.S. Environmental Protection Agency (EPA) and the Centers for Disease
Control and Prevention (CDC) developed this booklet to identify steps that you can take now to prepare for an extreme heat
event—and to help your families, friends, and neighbors, too.
This booklet answers some of the key questions about extreme heat in a changing climate: why extreme heat is on the rise,
how it might affect you, and what you can do before and during an extreme heat event to reduce your health risk.
Scientific information used in this document is derived from peer-reviewed synthesis and assessment products, including
those published by the United States Global Change Research Program and the Intergovernmental Panel on Climate Change,
as well as other peer-reviewed sources and federal agency resources.
For more information, contact EPA at ccdwebiaiepa.aov and CDC at climateandhealthiaicdc.aov.
Contents
What Is Extreme Heat? 3
Why Is Extreme Heat on the Rise? 4
What Might I Experience in the Future? 6
How Can Extreme Heat Affect Me? 9
How Common Are Heat-Related Illnesses and Deaths? 11
Who Is Most at Risk from Extreme Heat? 12
What Is the Urban Heat Island Effect? 14
What Should I Do During an Extreme Heat Event? 15
What Can I Do to Reduce My Risk Before an Extreme Heat Event? 16
For More Information 18
References 19
Acknowledgments
EPA and CDC would like to extend special thanks to the following state health department officials who assisted in reviewing
this document:
• Millicent Eidson, New York State Department of Health
• Stephanie Mack, New York State Department of Health
• Asante Shipp-Hilts, New York State Department of Health
• Kristin Raab, Minnesota Department of Health
• Matthew Roach, Arizona Department of Health Services
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What Is Extreme Heat?
We all expect it to be warm in the summer, but sometimes the heat can be severe
or even dangerous. A series of unusually hot days is referred to as an extreme
heat event.
Extreme heat conditions are defined as weather that is much hotter than average for a
particular time and place—and sometimes more humid, too. Extreme heat is not just a
nuisance; it kills hundreds of Americans every year and causes many more to become
seriously ill.
The heat index is a measure of how hot it feels when relative humidity is factored in
with the actual air temperature. Relative humidity is the percentage of moisture in
the air compared with the maximum amount of moisture the air can hold. Humidity is
an important factor in how hot it feels because when humidity is high, water doesn't
evaporate as easily, so it's harder for your body to cool off by sweating.
NOAA's National Weather Service Heat Index
Temperature (°F)
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Likelihood of heat disorders with prolonged exposure or strenuous activity
Caution Extreme caution Danger Extreme danger
The definition of
extreme heat varies
based on many
different factors,
such as location,
weather conditions (such as
temperature, humidity, and
cloud cover), and the time
of year. For example, a May
temperature of 92°F in Boston
is extreme heat, whereas a May
temperature in Phoenix would
have to reach more than 100°F
to be considered extreme.
Check out the figure on this
page to see how combinations
of two key weather
conditions—temperature and
humidity—can change how hot
it actually feels outside.
This chart shows that as the temperature (horizontal axis) and relative humidity (vertical axis) each increase,
they combine to create a heat index (colored values) that feels hotter than the actual temperature. For example,
when the temperature is 96°F, with 65 percent humidity, it actually feels like I2I0F (indicated by the blue lines in
the chart above). Source: NOAA National Weather Service, 2016'
3 | Climate Change and Extreme Heat: What You Can Do to Prepare
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Why Is Extreme Heat on
the Rise?
The chances are increasing that an extreme heat event could happen where you live, i hat's because average temperatures
are rising, both in the United States and around the world:
• Globally, the annual average temperature has been rising since the beginning of the 20th century, and temperatures are
expected to continue to rise through the end of this century.
• Worldwide, 15 of the 16 warmest years on record have occurred since 2000, with the exception of 1998.®
Temperatures Worldwide, 1901-2015
This graph shows global annual average
temperatures, compared With the 1901-2000
average. These data come from land-
based weatherstations and sea surface
temperature measurements. The red bars
indicate above-average surface temperatures
and the blue bars indicate below-average
temperatures (averaged across land and
ocean). Source: U.S. EPA, MSP
The United States is warming too, but some parts of the United States have experienced more warming than others. The
North, the West, and Alaska have seen temperatures increase the most, while some parts of the Southeast have experienced
little changed
Observed U.S. Temperature Change
Temperature
change (°F)
1.0 to 1.5
0.5 to 1.0
0.0 to 0.5
-0.5 to 0.0
J -1.0 to-0.5
1.5 to-1.0
The colors on this map show temperature
changes over the past 22 years (1991-2012)
compared with the 1901-1960 average for
the contiguous United States. Temperature
changes for Alaska and Hawaii were
compared With the 1951-1980 average for
those stateslhick borders represent National
Climate Assessment regions. Source: Melilto
et ah, 2014s
4 j Climate Change and Extreme Heat: What You Can Do to Prepare
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Along with this overall warming, the United States is experiencing more extreme heat
events. While you can expect to have an unusually hot day or night every so often
because of the normal, day-to-day variation in weather, hotter-than-usual days and
nights are becoming more common. Heat waves, which are prolonged periods of
extreme heat, are also occurring more frequently in major U.S. cities since the mid-20th
century. In addition to becoming more common, heat waves are also lasting longer and
becoming more severe.2
Area of the Contiguous 48 States With Unusually Hot Summer
Temperatures, 1910-2015
Temperatures are
usually cooler at night,
giving your body
some relief from hot
daytime temperatures.
But during an extreme heat event,
which typically lasts more than one
day, nighttime temperatures may
stay too warm to allow your body
to cool down, especially if you
live in an urban heat island (see
"What Is an Urban Heat Island?"
for more information). This places
a strain on your body, as your
heart increases circulation to try to
regulate your body temperature.
The strain is even worse if you are
dehydrated.
An increase in hot sum-
mer nights means less
"cooling off" occurs
at night. This trend is
of particular concern
because people can face serious
health risks if they cannot recover
from exposure to daytime heat.
you;
.KNOW/
This graph shows how larger parts of the contiguous 48 states are experiencing unusually hot temperatures
during the months of June, July, and August Unusually hot summer days (red line) have become more common
over the last few decades, while unusually hot daily low temperatures (orange line), usually at night, are
occurring in an even larger area of the United States Source: Adapted from U.S. EPA, 20162
A changing climate is driving these warming trends. Recent changes in climate have
been caused by carbon dioxide and other heat-trapping greenhouse gases that people
have added to the atmosphere through activities that use fossil fuels like oil, gasoline,
diesel, propane, coal, and natural gas. While natural variations continue to play an
important role in extreme heat events, climate change has shifted the odds, increasing
the likelihood that these events will occur.
With climate change,
extreme heat events
are on the rise. More
areas will likely be
affected by extreme
heat more often, more severely,
and for longer periods of time.
What Is Climate Change?
Although there is a relationship between climate and weather, the terms are in fact different.
Weather is a specific event or condition that happens over a period of hours or days. For
example, a thunderstorm, a snowstorm, and today's temperature all describe the weather.
Climate refers to the average weather conditions in a certain place over many years (usually
at least 30 years).
Climate change is a pattern of change in average weather that's happening over many years,
such as warming temperatures. A rise in the average global temperature has led to other
changes around the world—in the atmosphere, on the land, in the oceans—such as changing
rain and snow patterns, more extreme weather events, melting glaciers, and warmer seas.
5 | Climate Change and Extreme Heat: What You Can Do to Prepare
-------
What Might I Experience in
the Future?
Temperatures will continue to rise as people add more heat-trapping greenhouse
gases to the atmosphere. As a result, scientists expect heat waves to become
more common, more severe, and longer-lasting.3-4 More extreme heat wiii likely lead to
an increase in heat-related illnesses and deaths, especially if people and communities
don't take steps to adapt and protect themselves. Even small increases in extreme heat
can result in increased deaths and illnesses.®
Without big steps to reduce greenhouse gas emissions, the average number of ex-
tremely hot days in the United States is-projected to more than triple from the year
2050 to 2100:®'This means the potential heat wave season Will be longer, and extreme
heat could catch communities off-guard if it happens earlier or later than expected in a
particular area.
Increase in Average Temperature
Previous climate
New climate
More hot weather
More record hot weather
Less cold
weather
Cold Average Hot
When average temperatures increase, the average temperature of "hot weather"-md Record hot weather" wilt
become even hotter. Source: IPCC, 200F
6 | Climate Change and Extreme Heat: What You Can Do to Prepare
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Change in Summer Temperatures
As climate change continues, there
will be more hot days each year. For
instance, someone in Tampa, Florida,
may experience up to 40 more days
a year where the temperature is over
95 °F.
Become More Severe
Rising average summer temperatures
will make the hottest days even
hotter than they used to be, espe-
cially in the central United States. For
example, someone in Wichita, Kansas,
may experience summers that are 6°F
hotter than in the recent past.
Become More Common
Extreme Heat Events Will...
These maps compare the differences in extreme heat between the recent past (1980-2000) and the asBMP century (2041-2070) in a projected scenario With high
greenhouse gas emissions: Hatched areas indicate confidence that the projected changes are significant and consistent among models. Source: USGCRP, 2Qtff
Number of days per year
Change in Number of Days Above 95°F
Last Longer
Consecutive days of extreme heat
are projected to last even longer in
the future. For example, someone
in Tucson, Arizona, may experience
a stretch of days with temperatures
above 95°F that is 28 days longer
than the longest stretch of such
days in the recent past.
Number of days per year
i i i i
8 12 16 20 24 28
Change in Longest Stretch of Days Above 95°F
7 | Climate Change and Extreme Heat: What You Can Do to Prepare
-------
More Extreme Heat Events Are Likely to Cause More
Illnesses and Deaths
As extreme heat events become more common, more severe, and longer-lasting,
scientists expect to see an increase |n deaths and illnesses from heat, particularly
among vulnerable populations, such as children, the elderly, economically
disadvantaged groups, and those with chronic health conditions made worse by heat
exposure,®;
Projected Deaths Due to Extreme Temperatures
2000 Baseline
Combined
mortality rate
(deaths/100k)
• 0-2
O 3-4
• 5-8
{ ) 9-10
( ) 11-14
( ) 15-18
2100 Projection
While deaths from
extreme heat are
expected to increase,
the number of deaths,
caused by extremely
cold temperatures might drop in
certain areas as the climate gets
warmer, 9® However, any decrease
in cold-related deaths will very
likely be substantially less than the
increase in summertime heat-
related deaths overall,6
The map on the top shows actual deaths in 49 major U.S. cities in 2000 from extreme heat and extreme cold
combined, for every 100,000 people. The map on the bottom shows an increase in estimated deaths for 2100.
The increase in heat-related deaths is expected to far outweigh the decrease in cold-related deaths. These
results assume no significant reductions of greenhouse gas emissions ("business as usual"}, and they also
assume that people have not substantially adapted oracclimated to more extreme temperatures. (Ifa city
does not have a circle, it does not mean the city has no extreme temperature impact; it just means that city
was not included in this study.) Source: U.S, EPA, 2013s
-------
How Can Extreme Heat Affect
Me?
Heat affects everybody! A normal body temperature for adults is around 98.6°F.
When you are sick, you may get a fever with symptoms such as headache, sweat-
ing, or fatigue. Much like a fever, extreme heat stresses your body's ability to maintain
its normal temperature and can result in similar symptoms.
The most common health effects (or symptoms) caused by extreme heat include the
following:
Heat cramps are muscle spasms, often in the abdomen, arms, or calves, caused by
a large loss of salt and water in the body. Heat cramps can occur from prolonged
exposure to extreme heat combined with dehydration, and they commonly happen
while participating in strenuous outdoor activities such as physical labor or sports.
Heat exhaustion is a severe illness requiring emergency medical treatment. It can
occur from exposure to extreme heat over an extended period of time (usually
several days), especially when combined with dehydration.
Heat stroke is the most serious medical condition caused by extreme heat, requiring
emergency treatment. Heat stroke (or /lyperthermia) occurs when the body can no
longer regulate its temperature, and its temperature rises rapidly—up to 106°F or
higher. Heat stroke usually occurs as a progression from other heat-related illnesses,
such as heat cramps or heat exhaustion. It can also strike suddenly without prior
symptoms, however, and it can result in death without immediate medical attention.
Extreme heat is especially dangerous because people might not recognize their
symptoms as signs of a more serious condition. For example, symptoms like sweating
or fatigue may just appear to be normal reactions to a hot day. People may be in more
danger if they experience symptoms that alter their decision-making, limit their ability
to care for themselves, or make them more prone to accidents. If untreated, heat-
related illnesses can worsen and eventually lead to death.
Heat can also contribute to premature death from health impacts other than those
listed above. This is because extreme heat can worsen chronic conditions such as
cardiovascular disease, respiratory disease, and diabetes.
People have different
normal body tempera-
tures depending on
their age, the time of
day, and other factors.
What's your average temperature?
Log your temperature over the
course of a few weeks in the
morning, afternoon, and evening.
Does your temperature change
depending on whether you are
sitting outside or inside? Chart
your results!
Extreme heat, particu-
larly in urban areas, is
often associated with
very poor air quality.
Why? Heat waves are
often accompanied by periods
of stagnant air, which increases
air pollution such as ground-level
ozone. The combination of heat
stress and poor air quality can
pose a major health risk to vulner-
able groups: young children, the
elderly, outdoor workers, and those
with pre-existing health conditions,
including asthma.3
9 | Climate Change and Extreme Heat: What You Can Do to Prepare
-------
Know the Symptoms of Heat-Related Illnesses
urn
o_
2
<
cc
SYMPTOMS
Heavy sweating
Painful muscle cramps
or spasms
TREATMENT
Stop activity for a few hours.
Move to a cooler location.
Drink water, clear juice, or a sports
beverage.
Seek medical attention if cramps do
not subside within one hour.
O
un
<
X
Heavy sweating
Weakness
Fatigue
Headache
Dizziness
Nausea or vomiting
Fainting
Irritability
Thirst
Decreased urine
output
Move to an air-conditioned
environment.
Lie down.
Loosen clothing or change into
lightweight clothing.
Sip cool, non-alcoholic beverages.
Take a cool shower or bath, or apply
cool, wet cloths to as much of the
body as possible.
Seek medical attention if symptoms
worsen or last longer than one hour, or
if the victim has heart problems or high
blood pressure.
o
cc
IN*
5
• Very high body temperature
• Altered mental state
• Throbbing headache qk
• Confusion
• Nausea
• Dizziness
• Hot, dry skin or profuse
sweating
• Unconsciousness
Source: CDC, 2012"
Call 911 immediately and follow the
operator's directions—
this is a medical emergency.
Reduce the person's body temperature
with whatever methods you can: wrap
the person in cool cloths, immerse
them in a cool bath, or spray them with
cool hose water.
After administering cooling methods,
move the person to a cooler place.
Do NOT give liquids.
if there is uncontrollable muscle
twitching, keep the victim safe, but
do not place any objects in his or her
mouth.
If there is vomiting, turn the victim on
his or her side to keep the airway open.
10 | Climate Change and Extreme Heat: What You Can Do to Prepare
-------
--nC
How Common Are Heat-Related
Illnesses and Deaths?
Extreme heat causes more deaths than any other weather-related hazard—more than hurricanes, tornadoes, or flood-
ing. In addition, thousands of people who are exposed to extreme heat seek medical treatment each year. In fact, each
summer more than 65,000 Americans on average visit an emergency room for acute heat illness.5
Fatalities by Hazard, 2006-2015
Heat Tornadoes Floods
"O ->
1
Wind
4
Cold
Numbers in each bar represent the total number of fatalities
by hazard. Source: NOAA National Weather Service, 2016'-
43
Lightning Winter Hurricanes
Storms
The numbers shown here do not capture the full extent of heat-related deaths. Many deaths associated with extreme heat
are not identified as such by the medical examiner (or coroners) and may not be correctly recorded on a death certificate.
For example, of the estimated 700 deaths that occurred during the 1995 heat wave in Chicago, only 465 were recorded
and attributed to the extreme heat event.
Even small temperature increases above seasonal normal levels can result in illnesses and deaths, though the temperature
may not be considered "extreme." A series of consecutive days with warmer-than-average temperatures often results in
more hospital admissions for respiratory, cardiovascular, and kidney-related diseases. This can especially occur in spring
and early summer, before people are accustomed to warm summer temperatures.5
Hospital Admissions Due to Heat, 2001-2010, CDC National Environmental Public Health Tracking Network
This map shows the number of hospital admissions for
heat-related illnesses per 100,000 people in 23 states that
participate in a national hospital data tracking program.
States shaded red have three to four cases per 100,000
people in a typical year. States without shading do not
participate in the data tracking program.
Source: U.S. EPA, 2016-
Average annual hospital admissions per 100,000 people:
A Nationwide Challenge
Although you might expect heat-related
illnesses and deaths to be more common in
hotter, more humid regions like the Southeast,
extreme heat affects every part of the country
to some degree. In fact, some of the deadliest
heat waves in the last few decades have
occurred in northern cities like Chicago, where
people are less accustomed to extreme heat,
and many houses and apartments lack air
conditioning.
No data
11 | Climate Change and Extreme Heat: What You Can Do to Prepare
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Who Is Most at Risk from
Extreme Heat?
"xtreme heat can affect everyone. However, three key factors put some people at a
.higher risk than others:
• Exposure: Some people are more exposed to high temperatures than others,
such as those who spend long hours working or exercising outside, those who
are homeless, or those who live in buildings without air conditioning.
• Sensitivity: Some people are less tolerant of heat than others, such as infants,
young children, pregnant women, older adults, and those with certain health
conditions made worse by heat exposure. Certain medications can also affect
the body's ability to regulate temperature. People can be more sensitive to heat
If they are under the influence of alcohol or drugs that affect their ability to stay
hydrated. Elderly individuals are also less likely to perceive being overheated,
even though they are physiologically at greater risk,15-
• Ability to respond and prepare: Some people are less able to avoid heat than
others, such as those with limited incomes who cannot afford air conditioning
or the electricity to use it, people with mobility issues that prevent them from
seeking health care or going to a cooling center during a heat wave, or those
with outdoor jobs. Some people are less motivated to leave their homes for
cooler places due to unwillingness to leave pets, fear of crime, or concerns about
being a burden to others.
Hospitals report more
eases of kidney stones
during extreme heat
events. Why? Dehydra-
tion leads to a buildup
ofsalt in the body, which can
sometimes lead to kidney stones,5
Drink plenty of Water throughout
the day'when it's hot!
DID^
YOUi
KNOW/
Heat can also increase
the risk of workers
getting injured, as it
may result in sweaty
palms, fogged-up
safety glasses, dizziness, difficulty
staying focused, or burns from
accidental contact 'With hot
surfaces.®'
12 | Climate Change and Extreme Heat: What You Can Do to Prepare
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Extreme Heat: Who's at Risk?
People who live alone, in
housing without air
conditioning, or in cities
where there can be
urban heat islands
People who work inside
without air conditioning
People who have certain
health conditions, like
heart disease or mental
illness, or take certain
medications to treat
these conditions
People who are
under the
influence of drugs
oralcohol
People who work
outside
Tf ¦tM
Athletes who train
or compete outside
Infants, young children,
pregnant women, and people
olderthan 65
People whoare
homeless
People who have mobility
constraints or are obese
or bedridden
13 | Climate Change and Extreme Heat: What You Can Do to Prepare
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What Is the Urban Heat Island
Effect?
f you live in an urban area, you could be at even greater risk from the effects
of extreme heat. Urban areas, including big cities and smaller ones, are usually
warmer than their rural surroundings because of the "urban heat island" effect.
As cities develop, vegetation is often lost and more surfaces are paved or
covered with buildings. Less vegetation means less shade and moisture to keep
urban areas cool. Conventional roofs and pavement reflect less and absorb more
of the sun's energy, which leads to higher temperatures near these structures.
Additionally, tall buildings and narrow streets can reduce air flow, further trap-
ping the heat that gets absorbed during the day, as well as heat generated by
vehicles, factories, and air conditioning vents. All these factors contribute to
urban heat islands, which can worsen the impacts of climate change, particularly
as more extreme heat events occur.
Compared with surrounding rural areas, urban heat islands have higher daytime
maximum temperatures and less nighttime cooling. Temperatures in urban areas
can be 1.8-5.4°F warmer than their surroundings during the day. In the evening,
this difference can be as high as 22°F because the built environment retains heat
absorbed during the day1'3
Urban Heat Island Profile
Rural
Commercial
Suburban
residential
Urban
residential
Suburban
residential
Downtown
Park
This diagram represents how an urban heat island can increase local air temperatures by several degrees.
Source: U.S. EPA, 20Q616
Urban heat islands don't
just affect big cities. They
can occur in small cities and
suburban areas, too.
Heat affects all of us! Living
in a city may increase your
risk of experiencing extreme
heat from an urban heat
island, but living in a rural
area, far away from cooling centers and
hospitals, poses a potential risk to your
health in an extreme heat event as Well.
Urban Heat Island
July 1st, 2003 Brightness Temperature from Landsat 7, Band 6
The urban heat island effect is clearly visible in
this heat map of New York City on a summer day.
Temperatures are about TQ^F higher in built-up
areas than in the forested parts of Central Park.
The dark blue areas show the cooler waters o f
the Hudson and East Rivers. Source: Center for
Climate Systems Research, Columbia University,
2014i
'"blDON
you;
iKNOW/
'DID^
you;
.KNOW/'
14 | Climate Change and Extreme Heat: What You Can Do to Prepare
-------
--nC
What Should I Do During an
Extreme Heat Event?
Do
&
<35T
P
9
#
SL
Use air conditioners or spend time in air-conditioned places, such as
cooling centers, malls, or libraries.
Use electric fans to provide comfort when the temperature is below
95°F.18 Fans can make sweat evaporate more quickly from your body.
More evaporation means more heat can leave your body.
Take a cool shower or bath to help cool off.
Minimize direct exposure to the sun.
Stay hydrated—drink water or beverages without caffeine, sugar, or
alcohol throughout the day.
Eat light, cool, and easy-to-digest foods such as fruit or salads.
Wear loose-fitting, light-colored clothes.
Know the symptoms of heat-related illnesses and the appropriate
responses.
Check the local news for health and safety updates.13
Don't
*
*
M
*
£
Leave children, pets, or persons with mobility problems alone in cars
for any amount of time.
Drink alcohol to try to stay cool.
Use the stove or oven to cook—it will make you and your house
hotter.13
Eat heavy, hot, or hard-to-digest foods.
Wear heavy, dark clothing, which absorbs heat from the sun.
Exercise outdoors during the hottest hours of the day (usually 10 a.m.
to 5 p.m.).
Use an electric fan when the temperature is over 95°F. When the
temperature is in the mid-90s or higher, electric fans will not prevent
heat-related illness.
Help Others Cope with
Extreme Heat
Check on older, sick, or
disabled people, including
neighbors, family members,
or friends who may need help
responding to the heat. Be
sure to check on those who
live alone to ensure that they
stay hydrated and cool. Some
chronic conditions, such as
diabetes or kidney disorders,
can be made worse by heat ex-
posure, and individuals affected
by those conditions should be
closely monitored in an extreme
heat event.5
Call your local public officials
if you see homeless people in
need of help. In some places,
the non-emergency services
hotline is 311, but check your
local availability. Homeless
people can be at great risk
during extreme heat events,19
especially if they are elderly
or disabled, struggle with
alcohol or drug addiction, or
suffer from medical conditions
such as diabetes, high blood
pressure, or mental illness.
Limit strenuous outdoor activity
for young children, and make
sure they take regular water
breaks when playing outside.
If possible, bring outdoor
activities inside.
Schedule workouts for athletes
earlier or later in the day when
the temperature is cooler. If
possible, limit outdoor activity
or bring outdoor events inside.
If you are an athlete or work
outside, monitor your team-
mates or co-workers, and watch
for symptoms of heat-related
illnesses.
15 | Climate Change and Extreme Heat: What You Can Do to Prepare
-------
-rv<
What Can I Do to Reduce My Risk
Before an Extreme Heat Event?
Extreme heat events are on the rise, but there are things you can do now—in your
own home, workplace, or neighborhood—to reduce your current and future risks.
Here are some ideas (also see "For More Information" below):
• Be prepared at home. The best time to prepare for an extreme heat event is
before it happens. Each spring, check your household's fans, air conditioners,
and other cooling equipment to make sure they are in good working order. Write
down a list of family, friends, and neighbors who might need assistance in an
extreme heat event, and make sure you have their phone numbers. Look up the
location of your nearest cooling center(s) in case you need to go there.
• Be prepared in your community. If you work outdoors or in a physically de-
manding job without air conditioning, work with your employer to establish a
committee at your workplace to develop a heat response plan. Get involved in
children's school and athletic organizations to ensure that proper measures are in
place for extreme heat days and outdoor athletic practices take place during the
coolest part of the day.
• Plant a green roof. -: Green roofs are gardens planted on rooftops that provide
shade and reduce the temperature of the roof surface, as well as the surrounding
air. On hot summer days, green roofs can actually be cooler than the air. Many
kinds of buildings—commercial, residential, and industrial—can support green
roofs, and green roofs can be especially useful In cities to counter the urban heat
isiand effect. Consider building your own at home, work, or school!
• Install a cool roof,21 A cool roof is made of materials or coatings that reflect
sunlight and heat away from your home, reducing roof temperatures. This makes
your home cooler, increasing your comfort and reducing the amount of air
conditioning needed during hot days.
• Plant trees or erect shade structures in strategic locations.22 Trees and vegeta-
tion that directly shade your home can lower surrounding temperatures; this can
decrease the need for air conditioning, make your home more comfortable, and
reduce your energy bili. Trees also protect your family's health by improving air
quality, providing cooling shade for outdoor activities, and reducing your expo-
sure to the sun.
• Use cool paving materials in your driveway.® If you've ever walked barefoot on
hot pavement, you know it can heat up quickly in the sun Hot pavement also
transfers heat to the surrounding air, adding to the urban heat island effect. Cool
pavement stays cooler in the sun than traditional pavement by reflecting more
solar energy or enhancing water evaporation, Cool pavement can be created
from asphalt and concrete, as well as through the use of coatings or grass
paving.
• Replace your old air conditioner?4 Old or damaged window-unit air conditioners
are inefficient, meaning you're paying more money for less actual cooling ability.
Don't wait until the next heat wave—when supplies are likely to be low and prices
high—to replace an inefficient or broken air conditioner; purchase an efficient unit
before you need it.
*
What Is a Cooling Center?
Cooling centers are public
buildings (e.g., libraries, shelters,
community buildings) or specific
private buildings (e.g., shopping
malls, movie theaters) with air
conditioning that are designated
as a safe location during extreme
heat. During extreme heat events,
some communities may offer free
public transportation to these
locations. Check online or call your
local officials to find out where
your cooling centers are and if
your community provides free
transportation.
16 | Climate Change and Extreme Heat: What You Can Do to Prepare
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• Contribute to a community-wide heat response plan. Many state and local
governments have already developed plans that identify locations, infrastructure,
and people that are vulnerable to climate change and extreme heat. These pians
also describe actions a community can take to improve resilience. Check online
or call your local representatives to see if your community has a plan f you are
interested in heat response planning efforts in your community, your town or city
hall is a great place to start. Ask how you can get involved1
• Find out about local heat alert systems and subscribe to them. Local gov-
ernments, weather stations, medical providers, or others may have systems for
issuing heat alerts through the television, radio, newspapers, phone calls, social
media, texts, emails, or the internet. Find out what systems are in place for your
community, and sign up to receive alerts.
• Determine whether there are resources for support in your community. Some
agencies can provide air conditioners to those who cannot afford them or
subsidies for purchases. In some areas, utility companies are not permitted to
suspend power for non-payment during heat events. Some groups may provide
support for paying utility bills or transportation to cooling centers. Check online
Or ask your local representatives whether these services are available in your
community.
Many communities
have already taken / "!P*r\
{ YOU •
steps to decrease their
risk of heat-related
illness and death Has
yours? Here are some examples:
The Arizona Department of Health
Services implemented a heat
emergency response plan to help
protect the health of Arizona
residents during heat waves. The
plan sends heat warnings and
safety tips to health department
staff, school personnel, and the
general public using email and
social media. The plan includes
heat safety toolkits for schools.
outdoor workers, and older adults
to educate them on preventing,
recognizing, and treating heat-re-
lated illness,
The Heat Is On... Get Ready; Get Set, Go
!
As the climate warms in the United States and around the world, extreme heat is on the rise.
You: will very likely experience more frequent, more severe, and longer heat waves in the years
ahead. Exposure to elevated heat levels can be a hazard to your health—whether you live in a
City town, or rural area.
The best defense against extreme heat is to be prepared, and remember:
Get ready: Take steps now-to prepare your home, workplace, and community for future
heat events.
Get set: Know the symptoms of heat-related illnesses and what to do in an emergency.
Go: Check on those who may need help during an extreme heat event, like children,
elderly family members, homebound neighbors, or outdoor workers.
The New York City Department
of Health and Mental Hygiene^
Climate and Health Program works
with the government, the com-
munity, and health care providers
to increase communities' ability
to prepare for and respond to
extreme heat events. The program
releases health and safety informa-
tion, alerts, and social media posts
on how to stay safe during Very
hot weather.
17 | Climate Change and Extreme Heat: What You Can Do to Prepare
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For More Information
Understanding the Health Risks of Extreme Heat Events
• See CDC's website for resources on extreme heat emergency preparedness and response, as well as tips on how to
protect yourself and others from heat-related illness. CDC also provides free online training on recognizing, preventing,
and treating heat-related illness. This training is designed especially for coaches, school nurses, parents, and others who
train or provide athletic training in the heat.
• The National Oceanic and Atmospheric Administration's (NOAA's) National Weather Service website contains informa-
tion and resources on preparing for extreme heat events.
• See the National Institute for Occupational Safety and Health's website for resources on heat stress in the workplace.
The Impact of Climate Change on Extreme Heat Events and Human Health
• See the U.S. Global Change Research Program's 2016 Climate and Health Assessment for more information on the
impacts of climate change on human health.
• See EPA's climate change website for information and other resources, including fact sheets illustrating the threats that
climate change poses to human health, especially in populations of concern.
• See EPA's Climate Change Indicators in the United States report to learn more about how changes in the Earth's climate
are affecting trends in extreme temperatures in the United States and how this may lead to human health impacts.
Resources for Developing Extreme Heat Programs
• See EPA's "Heat Island Effect" website for information on how to keep cool in an urban heat island.
• CDC's Building Resilience Against Climate Effects (BRACE) framework helps health officials develop strategies and
programs for communities to prepare for the health effects of climate change.
• The U.S. Climate Resilience Toolkit provides a framework and tools to understand and address climate issues that
impact people and their communities.
• The World Health Organization's guidance on heat-health action plans provides examples from European countries that
have begun to implement and evaluate heat-health action plans.
• EPA's 2006 Excessive Heat Events Guidebook provides useful perspectives for local health officials on planning for
extreme heat events. This document builds on that 2006 publication.
18 | Climate Change and Extreme Heat: What You Can Do to Prepare
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1 NOAA (National Ocean and Atmospheric Administration) National Weather Service. 2016. Heat index.
www.nws.noaa.gov/om/heat/heat index.shtml.
2 U.S. EPA (U.S. Environmental Protection Agency). 2016. Climate change indicators in the United States, www.epa.gov/climate-indicators.
3 Melillo, J.M., T.C. Richmond, and G.W. Yohe (eds.). 2014. Climate change impacts in the United States: The third National Climate Assessment.
U.S. Global Change Research Program. http://nca2014. global change.gov.
4 National Research Council. 2011. Climate stabilization targets: Emissions, concentrations, and impacts over decades to millennia. Washington,
DC: National Academies Press.
5 USGCRP (U.S. Global Change Research Program). 2016. The impacts of climate change on human health in the United States: A scientific
assessment, https://health2016.globalchange.gov.
6 U.S. EPA. 2015. Climate change in the United States: Benefits of global action. Office of Atmospheric Programs. EPA 430-R-15-0001.
7 IPCC (Intergovernmental Panel on Climate Change). 2001. Climate change 2001: Synthesis report. A contribution of Working Groups I, II, and
III to the IPCC Third Assessment Report. Cambridge, United Kingdom: Cambridge University Press. www.iDcc.ch/iDccreports/tar.
8 USGCRP. 2016. Scenarios for climate assessment and adaptation: Data library. SRES A2 scenario, httos://scenarios.globalchange.gov/data-
librarv/1068: https://scenarios.globalchange.gov/data-librarv/1072: https://scenarios.globalchange.gov/data-librarv/1075.
9 IPCC. 2014. Climate change 2014: Impacts, adaptation, and vulnerability. Working Group II contribution to the IPCC Fifth Assessment Report.
Cambridge, United Kingdom: Cambridge University Press, www.ipcc.ch/report/ar5/wg2.
10 Medina-Ramon, M., and J. Schwartz. 2007. Temperature, temperature extremes, and mortality: A study of acclimatization and effect
modification in 50 U.S. cities. Occup. Environ. Med. 64(12): 827-833.
11 CDC (U.S. Centers for Disease Control and Prevention). 2012. Extreme heat prevention guide. Last reviewed May 2012.
https://www.cdc.gov/disasters/extremeheat/heat guide-page-3.html.
12 NOAA National Weather Service. 2016. Natural hazard statistics: 76-year list of severe weather fatalities.
www.nws.noaa.gov/om/hazstats/resources/weather fatalities.pdf.
13 CDC. 2011. Extreme heat and your health: Heat and the elderly, www.cdc.gov/extremeheat/seniors.html.
14 CDC. 2016. Heat stress, www.cdc.gov/niosh/topics/heatstress.
15 U.S. EPA. 2016. Heat island effect, www.epa.gov/heat-islands.
16 U.S. EPA. 2006. Excessive heat events guidebook, www.epa.gov/heat-islands/excessive-heat-events-guidebook.
17 Center for Climate Systems Research, Columbia University. Reprinted in: Melillo, J.M., T.C. Richmond, and G.W. Yohe (eds.). 2014. Climate
change impacts in the United States: The third National Climate Assessment. U.S. Global Change Research Program.
http://nca2014.globalchange.gov.
18 CDC. 2015. Frequently asked questions about extreme heat, www.cdc.gov/disasters/extremeheat/faa.html.
19 CDC. 2013. Climate change and extreme heat events. www.cdc.gov/climateandhealth/pubs/ClimateChangeandExtremeHeatEvents.pdf.
20 U.S. EPA. 2015. Using green roofs to reduce heat islands, www.epa.gov/heat-islands/using-green-roofs-reduce-heat-islands.
21 U.S. EPA. 2015. Using cool roofs to reduce heat islands, www.epa.gov/heat-islands/using-cool-roofs-reduce-heat-islands.
22 U.S. EPA. 2015. Using trees and vegetation to reduce heat islands.
www.epa.gov/heat-islands/using-trees-and-vegetation-reduce-heat-islands.
23 U.S. EPA. 2015. Using cool pavements to reduce heat islands, www.epa.gov/heat-islands/using-cool-pavements-reduce-heat-islands.
24 U.S. EPA. 2015. What you can do to reduce heat islands, www.epa.gov/heat-islands/what-vou-can-do-reduce-heat-islands.
19 | Climate Change and Extreme Heat: What You Can Do to Prepare
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A ERA
United States
Environmental Protection
Agency
EPA 430-R-16-061
October 2016
www.epa.gov/climatechange/extreme-heat-guidebook
www.cdc.gov/climateandhealth/pubs/extreme-heat-guidebook.pdf
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