Current Evidence on the Effectiveness of Interventions During Heat Episodes
This summary provides current evidence on the effect iveness of a variety of described heat interventions by highlighting the strengths and weaknesses of each. The authors argue that in the absence of a formal evaluation of effectiveness, and given the limited evaluations of interventions so far accomplished, it is difficult to present a complete review on this topic. The authors also caution that in general there have not been evaluations of effectiveness of heat interventions because interventions such as cooling centres, while efficacious, have not been evaluated for effectiveness by monitoring the profile of those using them (specifically, whether high risk populations use them), nor has the benefit of the intervention been estimated in terms of change in quantitative morbidity and mortality figures. Also, because each heat event is rare and unique, well-documented comparisons between the interventions utilized were difficultto come by and even more difficult to assess. As a result, evidence supporting the assertions in this review is limited.
Heat events have been associated with a diverse range of adverse health effects including excess mortality from a variety of causes as well as many symptoms falling under the broad umbrella of “heat-related illness”. Although these effects are most marked in vulnerable populations like the elderly, socially isolated, and homeless, everyone is at risk to varying degrees. The impact of heat on health was clearly evident following the Chicago heat wave in 1995, which resulted in over 700 excess deaths and more recently, the heat waves in Europe in 2003, which resulted in over 45,000 heat-related deaths. This negative impact of heat on health continues to be a persistent concern and is expected to become even more pressing in the future, given the predicted increase in heat waves linked to climate change. Thus, mitigating this negative impact is an important task. Public health practitioners are faced with the challenge of developing and implementing effective interventions to address the immediate effects of heat, and devising longer-term strategies to reduce the impact of future heat events.