Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence

Abstract

Objectives

To review the existing research on the effectiveness of heat warning systems (HWSs) in saving lives and reducing harm.

Methods

A systematic search of major databases was conducted, using “heat, heatwave, high temperature, hot temperature, OR hot climate” AND “warning system”.

Results

Fifteen articles were retrieved. Six studies asserted that fewer people died of excessive heat after HWS implementation. HWS was associated with reduction in ambulance use. One study estimated the benefits of HWS to be $468 million for saving 117 lives compared to $210,000 costs of running the system. Eight studies showed that mere availability of HWS did not lead to behavioral changes. Perceived threat of heat dangers to self/others was the main factor related to heeding warnings and taking proper actions. However, costs and barriers associated with taking protective actions, such as costs of running air conditioners, were of significant concern particularly to the poor.

Conclusions

Research in this area is limited. Prospective designs applying health behavior theories should establish whether HWS can produce the health benefits they are purported to achieve by identifying the target vulnerable groups.

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Acknowledgments

This study was funded by an Australian Research Council (ARC) Linkage grant (LP882699) in partnership with the Queensland Department of Environment and Resources Management, Queensland Health and the Environmental Protection Agency. PA was partially supported by a Noel Stevenson Fellowship from the Queensland Emergency Medicine Research Foundation (QEMRF). ST was supported by an NHMRC research fellowship (#553043). The funding agencies played no role in the development, preparation and submission of this paper.

Conflict of interest

At the time of conducting the study, KV was a Principal Scientist at the Queensland Department of Environment and Resources Management, which partly funded this project. The department has since been restructured and KV is now affiliated with the Queensland Department of Science, Information Technology, Innovation and Arts.

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Correspondence to Ghasem Toloo or Shilu Tong.

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This article is part of the special issue “Environment and Health Reviews”.

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Toloo, G., FitzGerald, G., Aitken, P. et al. Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence. Int J Public Health 58, 667–681 (2013). https://doi.org/10.1007/s00038-013-0465-2

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Keywords

  • Heat warning system
  • Effectiveness
  • Mortality
  • Morbidity
  • Health beliefs
  • Health service utilization