Heat Awareness and Response among Montreal Residents with Chronic Cardiac and Pulmonary Disease

Abstract

ustained heat waves have struck both North America and Europe in the recent past. Impacts on human health have been dramatic: in August 2003, an estimated 1,067 Parisians died prematurely during the course of 9 uncharacteristically hot days; 1 an estimated 739 Chicago residents died as a consequence of a 7-day heat wave in 1995. 2 The ill and elderly are among those most vulnerable to the ravages of extreme heat. 3 On very hot days, older individuals 4 and persons with cardiac insufficiency, obstructive pulmonary disease and other chronic health conditions die in above-expected numbers. 5,6 Mortality may be preventable by measures taken before and by interventions taken during episodes of extreme heat. Health authorities recommend pre-event measures such as acquiring an air conditioner, learning the signs of heat-related illness, and identifying a friend or family member ready to monitor and assist when it is hot. 7 During heat episodes, news media join health authorities in advising the public to find cool spaces, to stay hydrated and to avoid strenuous activity. 8 Many cities now have programs to inform, assist and even shelter residents during prolonged heat episodes. 9 Despite the existence of advisories and interventions designed to protect vulnerable persons from the effects of extreme heat, we know little about how those targeted respond. Our objective was to fill this gap. METHODS Participants and proceduresThe study was conducted in Montreal between May 30 and October 6, 2005, when daily mean temperatures were 2.4°C above the long-term average. 10 Patients attending two specialized clinics for heart failure (CHF) and three for chronic obstructive pulmonary disease (COPD), all located at Montreal university hospitals, and who were resident in metropolitan Montreal (population 3,000,000), spoke French and/or English, and had a home telephone, were eligible. Contact was made with all patients waiting at the clinics, and by telephone drawing from lists of all clinic patients treated at home. At the participant's choice, face-to-face interviews were conducted either at the hospital clinic or the participant's home. MeasuresA preliminary version of the questionnaire (available from the corresponding author) was developed in collaboration with health professionals from two participating CHF and COPD clinics. Composed in French, the hour-long questionnaire was translated into English.

Vulnerability to heatwaves and implications for public health interventions – A scoping review

“…A qualitative study by Wolf et al (2010aWolf et al ( , 2010b interviewing persons aged over 75 in the United Kingdom (UK) learns that participants did not consider themselves as old, or threatened by heat while they identify others of the same age group as vulnerable (Wolf et al, 2010a). Interestingly, in a study on heat perception in people with chronic cardiac and pulmonary disease most of the chronically ill population did perceive themselves to be susceptible to heat and reported implementing preventive actions in response (Kosatsky et al, 2009).…”

Racial and Socioeconomic Disparities in Heat-Related Health Effects and Their Mechanisms: a Review

“…[36] Most respondents in Canadian studies did perceive heat as a personal risk and also reported that they would take actions to stay cool during extreme heat. [40, 98] Finally, the perceived risk of heat was not predictive of air conditioning use among residents with poor cardio-respiratory health in Montreal[37] suggesting that low perceived risk is not always a barrier to staying cool.…”

Staying cool in a changing climate: Reaching vulnerable populations during heat events

“…Researchers have investigated how and why the public and, more specifically, vulnerable populations, participate in heat preparedness (Abrahamsom et al, 2008;Kosatsky et al, 2009;Richard et al, 2011;Semenza et al, 2008;Sheridan, 2007). Related studies generally measure the frequency or likelihood of behaviors in heat events.…”