Table 1.
Potential adaptation and mitigation options for a response to heat in temperate regions
| Vulnerable | Strategy | Potential Intervention or Response Option | Example of Responsible Entity |
|---|---|---|---|
| Older people, chronically ill and mentally ill | Communication | Develop and disseminate risk communication materials for older people, chronically ill and mentally ill (or carers) on coping mechanisms during heat events (e.g. increase fluid intake, improve building ventilation). | Health promotion unit of the health sector |
| Communicate to patients the risks of heat to triggering or exacerbating chronic conditions such as cardiorespiratory diseases. | Doctors and General Practitioners (GPs) | ||
| Communicate to patients the risks of heat interacting with medications with suggested associated behaviour changes. | Pharmacists, GPs, doctors, health promotion unit of the health sector | ||
| Community | Develop and disseminate communication to the public on care for older people, chronically ill and mentally ill during heat events (e.g. check-in on neighbours and suggest / assist with coping options). | Health promotion unit of the health sector, community | |
| Capacity building | Provide targeted capacity building and refresher heat-health first aid courses for carers. | Health promotion unit of the health sector | |
| Planning & policy | Investigate financial assistance grants for home or common room (older people residential facilities) climate controlsa for the vulnerable (after a critical evaluation to avoid maladaptation). | Local government, government department responsible for climate action | |
| Research & Capacity building |
Further research is required on these topics which should be followed with adequate capacity building to disseminate and translate research findings for evidence-based implementation: • Heat-related mortality and morbidity statistics for the temperate region, particularly with reference to the current burden of disease and those suffering chronic conditions (e.g. NCDs, mental ill-health) • Quantification of the extent of personal heat exposure in the homes of the vulnerable (e.g. older people) • The interaction of drugs, heat stress and thermoregulation • Quantification of older people, chronically ill and mentally ill access to green and blue spaces |
Higher education institutions, research bodies, statistics body, government department responsible for health, funding bodies | |
| Infants, pregnant women and children | Communication | Develop and disseminate risk communication materials for pregnant women, parents, teachers and carers regarding the risks of heat stress to children and infants (including the unborn child) where appropriate. | Health promotion unit of the health sector, GPs, doctors |
| Engineering |
Various engineering and planning controls could be developed as appropriate (after a critical evaluation to avoid maladaptation): • Investigate climate controla in schools and improvements to ventilation (if needed). |
Local government, government department responsible for climate action, government department responsible for education | |
| Capacity building | Provide targeted capacity building and refresher first aid courses for teachers and carers around heat-health in schools. | Health promotion unit of the health sector, government department responsible for education | |
| Planning | Provide the scope and discussion regarding children wearing hats to and from school during hot days. | Health promotion unit of the health sector, local government, government department responsible for education | |
| Re-schedule sports days during heatwaves and hot days. | Local government, government department responsible for education | ||
| Research |
Further research is required on these topics which should be followed with adequate capacity building to disseminate and translate research findings for evidence-based implementation: • Exposure of pregnant women to heat stress and the implications on mother and unborn child health in a temperate climate • Health impacts of the exposure to heat stress in children living in temperate climates • Benefits or risks of climate controla in schools • Needs assessment of teachers and carers for heat-health in children |
Higher education institutions, research bodies, statistics body, government department responsible for health, funding bodies | |
| Outdoor workers | Capacity building | Develop and implement targeted heat-health capacity building, training and first aid (including self-monitoring and a buddy system) for outdoor workers and employers. | Government department responsible for health and safety, employers |
| Research |
Further research is required on these topics which should be followed with adequate capacity building to disseminate and translate research findings for evidence-based implementation: • The interaction of chemical toxicity (e.g. pesticides, herbicides) and temperature impacting worker health • Personal heat exposure of outdoor workers and those expected to wear personal protective equipment in temperate climates • Needs assessment of training and educational materials for heat-health amongst outdoor workers • A vulnerability assessment for outdoor workers working in hot conditions across sectors • Workplace surveillance of heat-related occupational injuries and mortalities • Safe exposure times and patterns specific to industries in temperate climates • Heat exposure and occupational health in temperate climates including mental health concerns of farmers and farm-workers |
Higher education institutions, research bodies, statistics body, government department responsible for health, funding bodies | |
| Policy |
The following should be critically evaluated for potential inclusion into health and safety policy: • Prepare a code of practice with guidelines and recommended standards for heat stress when working outdoors in Ireland, including a special focus on wearing PPE • Provide guidance on how to include heat-health into a risk assessment • Develop a heat alert programme activated when heatwaves are forecasted |
Government department responsible for health and safety, employers | |
| Engineering & planning |
Various engineering and planning controls could be developed as appropriate (after a critical evaluation to avoid maladaptation): • Use of fans (if appropriate) and heat shielding barriers • Re-organising work schedules and metabolic demands during hot times of the day • Introducing heat acclimatization plans if appropriate • Providing adequate rest breaks, shade and cool water on hot days • Organise and implement a medical monitoring programme (record keeping, surveillance, screening for heat intolerances) • Review the appropriateness of certain PPE and evaluate possible improvements • Provide engineered personal cooling garments, vests and devices if appropriate • Review and implement ISO standards as appropriate (e.g. ISO 7243, 9886, 15265, etc.) |
Government department responsible for health and safety, employers, occupational health practitioners | |
| Poor and urban dwellers | Communication | Provide risk communication to urban dwellers on the urban heat island and appropriate adaptive responses. | Health promotion unit of the health sector, local government |
| Disseminate town / city maps noting all public drinking fountain locations. | Health promotion unit of the health sector, local government | ||
| Community | Encourage a sense of community to provide assistance to the poor during heat events such as providing drinking water and protection from the sun and heat. | Health promotion unit of the health sector, community | |
| Planning & policy |
Various engineering and planning controls could be developed as appropriate (after a critical evaluation to avoid maladaptation): • Provide financial assistance grants for home climate controlsa for those living in urban heat islands. |
Local government, government department responsible for climate action | |
| Mapping of high-risk and densely populated areas for targeted prioritizing of heat-adaptation strategies. | Local government, government department responsible for climate action, national body responsible for environmental protection | ||
| Erect emergency shelter venues during heatwaves. | Government department responsible for health | ||
| Engineering | Ensure public spaces in towns and cities (e.g. libraries) have adequate climate controlsa. | Local government | |
| Create public green and blue spaces in and around cities and towns and ensure adequate transportation infrastructure to enable access particularly from impoverished areas. A thorough critical evaluation of actions must be undertaken before implementation to avoid maladaptation. | Local government, government department responsible for transport and environmental protection, urban planners | ||
| Food Systems | Research |
Further research is required in the following areas: • Direct and indirect impacts of heat on the food system in temperate climates and subsequent food and nutrition security • Evaluating adaptation mechanisms to protect livestock from excessive heat • Agricultural pest populations in a changing climate and an analysis and evaluation of pest control measures amongst farmers • Alternative heat-tolerant, nutritional food production with lower associated greenhouse gas emissions |
Higher education institutions, research bodies, government department responsible for climate action, government department responsible for agriculture, funding bodies |
| Engineering & policy | Heat-related mitigation and adaptation strategies should be utilized within the agricultural sector such as carbon sequestration and use of sustainable fertilizers. | Government department responsible for agriculture, local government | |
| Community | Sharing of knowledge between farmers on successful heat-related adaptation and mitigation strategies. | Government department responsible for agriculture, community | |
| Health sector | Planning for preparedness | Access should be available for suitable parties to anonymised secondary data for analysis in identifying anticipated heat-related direct and indirect health outcomes, vulnerable groups, lag structures and health sector capacity and heat-specific resource needs. | Government department responsible for health, research institutions, funding bodies, statistics body |
| Specific heat-related monitoring and surveillance should be implemented. | Government department responsible for health, research institutions, funding bodies, national body responsible for environmental protection | ||
| Capacity building | Prepare / refresh frontline healthcare workers to manage the signs and symptoms of heat-related illnesses. | Government department responsible for health | |
| Engineering | Ensure back-up power supplies for critical infrastructure during hot days in healthcare services with low emission climate controlsa. | Government department responsible for health | |
| Implement hospital site heat-smart landscaping to reduce the heat island effect. | Government department responsible for health, urban planners, national body responsible for environmental protection | ||
| Energy audit should be conducted to analyse and reduce emissions from the health sector as well as to investigate possible over-heating of facilities during summer. | Government department responsible for health | ||
| Research |
Further research is needed in the following areas: • Analysis of secondary data for associations of disease burden in response to increased temperatures • Analysis of the burden of heat on health and subsequent health sector capacity during hot events |
Government department responsible for health, research institutions, funding bodies, statistical bodies | |
| General actions | Planning & policy | Develop and implement a heat-health alert service including pre-recorded heat-health messages. | Health promotion unit of the health sector |
| Develop and implement early warning systems for heatwave predictions. | National meteorological body, national body responsible for environmental protection | ||
| Develop a heat-health action plan in accordance with WHO guidelines. For successful implementation, the plan should include eight core elements: i) agreement on a lead body; ii) accurate and timely alert systems; iii) heat-related health information plan; iv) strategies to reduce indoor heat exposure; v) consideration of vulnerable groups; vi) health and social care system preparedness; vii) long-term urban planning and viii) real-time surveillance and evaluation. The heatwave plan for England would provide a good model that could be adapted locally and includes: i) strategic planning; ii) alert system; iii) preparedness; iv) communication; v) working with service providers; vi) engaging with the community; vii) monitoring and evaluation. | Government department responsible for health and climate action | ||
| Develop emergency protocols for vulnerable sectors such as older people care homes, schools etc. | Local government, government department responsible for health | ||
| Implement a “health and climate change in all policies” approach [108]. | All government departments | ||
| Provide a telephone hotline for specific heat-related emergencies including over the phone advice on preventing the escalation of heat strain to heat stroke. | Government department responsible for health | ||
| Monitor water supply (including essential maintenance of public drinking fountains in preparation) and quality during summer and heatwaves. | National body responsible for environmental protection, government department responsible for climate action | ||
| Engineering |
Various engineering and planning controls could be developed as appropriate (after a critical evaluation to avoid maladaptation): • Invest in shade creation (site landscaping) and improve climate controla in public buildings (e.g. libraries) and public transport vehicles with improved access for vulnerable groups to blue and green spaces. Opening hours to green and blue spaces could also be extended during hot days. |
Local government, government department responsible for transport, national body responsible for the environment, urban planners | |
| • Collaborate with the housing sector to ensure appropriate housing design and retrofit with good ventilation in summer and insulation in winter. | Local government, urban planners, architects | ||
| Communication & community | Develop and disseminate heat-related risk communication using traditional (e.g. pamphlets, advertisements, radio) and new media (e.g. social media, SMS, website) tools including what to do to avoid heat-related morbidity and mortality. | Health promotion unit of the health sector |
Table Acronyms: GPs General practitioners, NCDs Non-communicable diseases, WHO World Health Organization
aNote: it is essential that the environmental impact of “climate controls” is minimal / negligible (e.g. zero emission)