Skip to main content
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 2001 May;109(Suppl 2):191–198. doi: 10.1289/ehp.109-1240666

The potential impacts of climate variability and change on health impacts of extreme weather events in the United States.

G Greenough 1, M McGeehin 1, S M Bernard 1, J Trtanj 1, J Riad 1, D Engelberg 1
PMCID: PMC1240666  PMID: 11359686

Abstract

Extreme weather events such as precipitation extremes and severe storms cause hundreds of deaths and injuries annually in the United States. Climate change may alter the frequency, timing, intensity, and duration of these events. Increases in heavy precipitation have occurred over the past century. Future climate scenarios show likely increases in the frequency of extreme precipitation events, including precipitation during hurricanes, raising the risk of floods. Frequencies of tornadoes and hurricanes cannot reliably be projected. Injury and death are the direct health impacts most often associated with natural disasters. Secondary effects, mediated by changes in ecologic systems and public health infrastructure, also occur. The health impacts of extreme weather events hinge on the vulnerabilities and recovery capacities of the natural environment and the local population. Relevant variables include building codes, warning systems, disaster policies, evacuation plans, and relief efforts. There are many federal, state, and local government agencies and nongovernmental organizations involved in planning for and responding to natural disasters in the United States. Future research on health impacts of extreme weather events should focus on improving climate models to project any trends in regional extreme events and as a result improve public health preparedness and mitigation. Epidemiologic studies of health effects beyond the direct impacts of disaster will provide a more accurate measure of the full health impacts and will assist in planning and resource allocation.

Full Text

The Full Text of this article is available as a PDF (420.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aghababian R. V., Teuscher J. Infectious diseases following major disasters. Ann Emerg Med. 1992 Apr;21(4):362–367. doi: 10.1016/s0196-0644(05)82651-4. [DOI] [PubMed] [Google Scholar]
  2. Beelman F. C. Disaster planning. Report of tornado casualties in Topeka. J Kans Med Soc. 1967 Apr;68(4):153–161. [PubMed] [Google Scholar]
  3. Bener A., Abdulrazzaq Y. M., Al-Mutawwa J., Debuse P. Genetic and environmental factors associated with asthma. Hum Biol. 1996 Jun;68(3):405–414. [PubMed] [Google Scholar]
  4. Bohonos J. J., Hogan D. E. The medical impact of tornadoes in North America. J Emerg Med. 1999 Jan-Feb;17(1):67–73. doi: 10.1016/s0736-4679(98)00125-5. [DOI] [PubMed] [Google Scholar]
  5. Bouma M. J., Kovats R. S., Goubet S. A., Cox J. S., Haines A. Global assessment of El Niño's disaster burden. Lancet. 1997 Nov 15;350(9089):1435–1438. doi: 10.1016/s0140-6736(97)04509-1. [DOI] [PubMed] [Google Scholar]
  6. Carter A. O., Millson M. E., Allen D. E. Epidemiologic study of deaths and injuries due to tornadoes. Am J Epidemiol. 1989 Dec;130(6):1209–1218. doi: 10.1093/oxfordjournals.aje.a115449. [DOI] [PubMed] [Google Scholar]
  7. Cooper M. A. Electrical and lightning injuries. Emerg Med Clin North Am. 1984 Aug;2(3):489–501. [PubMed] [Google Scholar]
  8. Duclos P. J., Ing R. T. Injuries and risk factors for injuries from the 29 May 1982 tornado, Marion, Illinois. Int J Epidemiol. 1989 Mar;18(1):213–219. doi: 10.1093/ije/18.1.213. [DOI] [PubMed] [Google Scholar]
  9. Duclos P. J., Sanderson L. M. An epidemiological description of lightning-related deaths in the United States. Int J Epidemiol. 1990 Sep;19(3):673–679. doi: 10.1093/ije/19.3.673. [DOI] [PubMed] [Google Scholar]
  10. Duclos P., Sanderson L. M., Lipsett M. The 1987 forest fire disaster in California: assessment of emergency room visits. Arch Environ Health. 1990 Jan-Feb;45(1):53–58. doi: 10.1080/00039896.1990.9935925. [DOI] [PubMed] [Google Scholar]
  11. Durry E., Pappagianis D., Werner S. B., Hutwagner L., Sun R. K., Maurer M., McNeil M. M., Pinner R. W. Coccidioidomycosis in Tulare County, California, 1991: reemergence of an endemic disease. J Med Vet Mycol. 1997 Sep-Oct;35(5):321–326. doi: 10.1080/02681219780001361. [DOI] [PubMed] [Google Scholar]
  12. Eidson M., Lybarger J. A., Parsons J. E., MacCormack J. N., Freeman J. I. Risk factors for tornado injuries. Int J Epidemiol. 1990 Dec;19(4):1051–1056. doi: 10.1093/ije/19.4.1051. [DOI] [PubMed] [Google Scholar]
  13. Engelthaler D. M., Mosley D. G., Cheek J. E., Levy C. E., Komatsu K. K., Ettestad P., Davis T., Tanda D. T., Miller L., Frampton J. W. Climatic and environmental patterns associated with hantavirus pulmonary syndrome, Four Corners region, United States. Emerg Infect Dis. 1999 Jan-Feb;5(1):87–94. doi: 10.3201/eid0501.990110. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Etzel R. A., Montaña E., Sorenson W. G., Kullman G. J., Allan T. M., Dearborn D. G., Olson D. R., Jarvis B. B., Miller J. D. Acute pulmonary hemorrhage in infants associated with exposure to Stachybotrys atra and other fungi. Arch Pediatr Adolesc Med. 1998 Aug;152(8):757–762. doi: 10.1001/archpedi.152.8.757. [DOI] [PubMed] [Google Scholar]
  15. French J., Ing R., Von Allmen S., Wood R. Mortality from flash floods: a review of national weather service reports, 1969-81. Public Health Rep. 1983 Nov-Dec;98(6):584–588. [PMC free article] [PubMed] [Google Scholar]
  16. Glass G. E., Cheek J. E., Patz J. A., Shields T. M., Doyle T. J., Thoroughman D. A., Hunt D. K., Enscore R. E., Gage K. L., Irland C. Using remotely sensed data to identify areas at risk for hantavirus pulmonary syndrome. Emerg Infect Dis. 2000 May-Jun;6(3):238–247. doi: 10.3201/eid0603.000303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Glass R. I., Craven R. B., Bregman D. J., Stoll B. J., Horowitz N., Kerndt P., Winkle J. Injuries from the wichita falls tornado: implications for prevention. Science. 1980 Feb 15;207(4432):734–738. doi: 10.1126/science.207.4432.734. [DOI] [PubMed] [Google Scholar]
  18. Glass R. I., Zack M. M., Jr Increase in deaths from ischaemic heart-disease after blizzards. Lancet. 1979 Mar 3;1(8114):485–487. doi: 10.1016/s0140-6736(79)90835-3. [DOI] [PubMed] [Google Scholar]
  19. Gorjanc M. L., Flanders W. D., VanDerslice J., Hersh J., Malilay J. Effects of temperature and snowfall on mortality in Pennsylvania. Am J Epidemiol. 1999 Jun 15;149(12):1152–1160. doi: 10.1093/oxfordjournals.aje.a009770. [DOI] [PubMed] [Google Scholar]
  20. Harris L. F. Hospitalized tornado victims. Ala Med. 1992 Jan;61(7):12–16. [PubMed] [Google Scholar]
  21. Harrison R., Materna B. L., Rothman N. Respiratory health hazards and lung function in wildland firefighters. Occup Med. 1995 Oct-Dec;10(4):857–870. [PubMed] [Google Scholar]
  22. Ivy J. H. Infections encountered in tornado and automobile accident victims. J Indiana State Med Assoc. 1968 Dec;61(12):1657–1661. [PubMed] [Google Scholar]
  23. Kirkland T. N., Fierer J. Coccidioidomycosis: a reemerging infectious disease. Emerg Infect Dis. 1996 Jul-Sep;2(3):192–199. doi: 10.3201/eid0203.960305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Leibovich M. The December 2, 1982 tornado of Saline and Pulaski counties: implications for injury prevention. J Ark Med Soc. 1983 Jul;80(2):98–102. [PubMed] [Google Scholar]
  25. Lipsett M., Waller K., Shusterman D., Thollaug S., Brunner W. The respiratory health impact of a large urban fire. Am J Public Health. 1994 Mar;84(3):434–438. doi: 10.2105/ajph.84.3.434. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Logue J. N., Hansen H., Struening E. Emotional and physical distress following Hurricane Agnes in Wyoming Valley of Pennsylvania. Public Health Rep. 1979 Nov-Dec;94(6):495–502. [PMC free article] [PubMed] [Google Scholar]
  27. Mandelbaum I., Nahrwold D., Boyer D. W. Management of tornado casualties. J Trauma. 1966 May;6(3):353–361. doi: 10.1097/00005373-196605000-00005. [DOI] [PubMed] [Google Scholar]
  28. McGeehin M. A., Mirabelli M. The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United States. Environ Health Perspect. 2001 May;109 (Suppl 2):185–189. doi: 10.1289/ehp.109-1240665. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Morris B. A., Armstrong T. M. Medical response to a natural disaster: the Barrie tornado. CMAJ. 1986 Apr 1;134(7):767–769. [PMC free article] [PubMed] [Google Scholar]
  30. Nasci R. S., Moore C. G. Vector-borne disease surveillance and natural disasters. Emerg Infect Dis. 1998 Apr-Jun;4(2):333–334. doi: 10.3201/eid0402.980227. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Rosenfield A. L., McQueen D. A., Lucas G. L. Orthopedic injuries from the Andover, Kansas, tornado. J Trauma. 1994 May;36(5):676–679. doi: 10.1097/00005373-199405000-00013. [DOI] [PubMed] [Google Scholar]
  32. Roth P. B., Vogel A., Key G., Hall D., Stockhoff C. T. The St Croix disaster and the National Disaster Medical System. Ann Emerg Med. 1991 Apr;20(4):391–395. doi: 10.1016/s0196-0644(05)81661-0. [DOI] [PubMed] [Google Scholar]
  33. Schwartz J., Norris G., Larson T., Sheppard L., Claiborne C., Koenig J. Episodes of high coarse particle concentrations are not associated with increased mortality. Environ Health Perspect. 1999 May;107(5):339–342. doi: 10.1289/ehp.99107339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Shusterman D., Kaplan J. Z., Canabarro C. Immediate health effects of an urban wildfire. West J Med. 1993 Feb;158(2):133–138. [PMC free article] [PubMed] [Google Scholar]
  35. Staes C., Orengo J. C., Malilay J., Rullán J., Noji E. Deaths due to flash floods in Puerto Rico, January 1992: implications for prevention. Int J Epidemiol. 1994 Oct;23(5):968–975. doi: 10.1093/ije/23.5.968. [DOI] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES