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Ann N Y Acad Sci. 2016 Oct;1382(1):21-30. doi: 10.1111/nyas.13258. Epub 2016 Oct 27.

Iterative management of heat early warning systems in a changing climate.

Hess JJ1,2,3, Ebi KL1,2.

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Department of Environmental and Occupational Health Sciences, School of Public Health.
Department of Global Health, Schools of Medicine and Public Health.
Division of Emergency Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington.


Extreme heat is a leading weather-related cause of morbidity and mortality, with heat exposure becoming more widespread, frequent, and intense as climates change. The use of heat early warning and response systems (HEWSs) that integrate weather forecasts with risk assessment, communication, and reduction activities is increasingly widespread. HEWSs are frequently touted as an adaptation to climate change, but little attention has been paid to the question of how best to ensure effectiveness of HEWSs as climates change further. In this paper, we discuss findings showing that HEWSs satisfy the tenets of an intervention that facilitates adaptation, but climate change poses challenges infrequently addressed in heat action plans, particularly changes in the onset, duration, and intensity of dangerously warm temperatures, and changes over time in the relationships between temperature and health outcomes. Iterative management should be central to a HEWS, and iteration cycles should be of 5 years or less. Climate change adaptation and implementation science research frameworks can be used to identify HEWS modifications to improve their effectiveness as temperature continues to rise, incorporating scientific insights and new understanding of effective interventions. We conclude that, at a minimum, iterative management activities should involve planned reassessment at least every 5 years of hazard distribution, population-level vulnerability, and HEWS effectiveness.


adaptation; climate change; climate variability; heatwaves; iterative management

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