abstract: Extreme hot-weather events have become life-threatening natural phenomena in many cities around the world, and the health impacts of excessive heat are expected to increase with climate change (Huang et al. 2011; Knowlton et al. 2007; Meehl and Tebaldi 2004; Patz 2005). Heat waves will likely have the worst health impacts in urban areas, where large numbers of vulnerable people reside and where local-scale urban heat island effects (UHI) retard and reduce nighttime cooling. This dissertation presents three empirical case studies that were conducted to advance our understanding of human vulnerability to heat in coupled human-natural systems. Using vulnerability theory as a framework, I analyzed how various social and environmental components of a system interact to exacerbate or mitigate heat impacts on human health, with the goal of contributing to the conceptualization of human vulnerability to heat. The studies: 1) compared the relationship between temperature and health outcomes in Chicago and Phoenix; 2) compared a map derived from a theoretical generic index of vulnerability to heat with a map derived from actual heat-related hospitalizations in Phoenix; and 3) used geospatial information on health data at two areal units to identify the hot spots for two heat health outcomes in Phoenix. The results show a 10-degree Celsius difference in the threshold temperatures at which heat-stress calls in Phoenix and Chicago are likely to increase drastically, and that Chicago is likely to be more sensitive to climate change than Phoenix. I also found that heat-vulnerability indices are sensitive to scale, measurement, and context, and that cities will need to incorporate place-based factors to increase the usefulness of vulnerability indices and mapping to decision making. Finally, I found that identification of geographical hot-spot of heat-related illness depends on the type of data used, scale of measurement, and normalization procedures. I recommend using multiple datasets and different approaches to spatial analysis to overcome this limitation and help decision makers develop effective intervention strategies. / Dissertation/Thesis / Ph.D. Sustainability 2013

Most epidemiological studies of high temperature effects on mortality have focused on urban settings, while heat-related health risks in rural areas remain underexplored. To date there has been no meta-analysis of epidemiologic literature concerning heat-related mortality in rural settings. This study aims to systematically review the current literature for assessing heat-related mortality risk among rural populations. We conducted a comprehensive literature search using PubMed, Web of Science, and Google Scholar to identify articles published up to April 2018. Key selection criteria included study location, health endpoints, and study design. Fourteen studies conducted in rural areas in seven countries on four continents met the selection criteria, and eleven were included in the meta-analysis. Using the random effects model, the pooled estimates of relative risks (RRs) for all-cause and cardiovascular mortality were 1.030 (95% CI: 1.013, 1.048) and 1.111 (95% CI: 1.045, 1.181) per 1 °C increase in daily mean temperature, respectively. We found excess risks in rural settings not to be smaller than risks in urban settings. Our results suggest that rural populations, like urban populations, are also vulnerable to heat-related mortality. Further evaluation of heat-related mortality among rural populations is warranted to develop public health interventions in rural communities.

As a result of climate change and urbanization, rising temperatures are causing increasing concern about extreme heat in cities worldwide. Urban extreme heat like other climate-related phenomena is a complex problem that requires expertise from a range of disciplines and multi-faceted solutions. Therefore, this study aims to develop a comprehensive understanding of urban heat issue by taking a multi-level approach that integrates science, technology, and policy. Throughout the three main papers of this dissertation, a variety of quantitative and qualitative methods, such as microclimate modeling, machine learning, statistical analysis, and policy content analysis, are used to analyze urban heat from different perspectives. The first paper of this dissertation focuses on the street canyon scale, aiming to identify the physical and vegetation parameters that have the greatest impact on changing thermal conditions in urban environments and to understand how these parameters interact with each other. Moving towards identifying applicable heat-related data and measurement techniques, the second paper assesses whether lower-resolution temperature data and novel sources of vulnerability indicators can effectively explain intra-urban heat variations. Lastly, the third paper of this dissertation reviews heat-related plans and policies at the Planning Districts level in Virginia, providing insights into how extreme heat is framed and addressed at the regional and local levels. This analysis is particularly important for states such as Virginia, which historically have not experienced multiple days of extreme heat during summers, as is common in southern and southwestern states of the United States. The results of this study provide insights into the contributing and mitigating factors associated with extreme heat exposure, novel heat-related data and measurement techniques, and the types of analysis and information that should be included in local climate-related plans to better address extreme heat. This dissertation explores new avenues for measuring, understanding, and planning extreme heat in cities, thereby contributing to the advancement of knowledge in this field. / Doctor of Philosophy / Due to climate change and fast city growth, temperatures are rising, and extreme heat is becoming a big worry in cities worldwide. Urban extreme heat is a challenging problem that needs expertise from different majors and diverse solutions. This dissertation aims to understand urban heat better by integrating science, technology, and policy. The three main research papers of this dissertation use various methods like modeling, statistics, and policy analysis to study urban heat from different angles. The first paper focuses on city streets and how certain physical features and vegetation affect citizens' thermal comfort. The second paper explores new ways to measure heat in urban areas, including using new sources of data and the application of lower-resolution data. Finally, the third paper reviews heat-related plans and policies in Virginia, helping us understand how extreme heat is addressed in areas that might not be accustomed to high temperatures. This dissertation's findings provide useful insights into why the severity of extreme heat is not the same in different parts of cities, present new ways to measure this difference and find solutions to lessen the negative impacts of exposure to heat. It also shows what information needs to be included in plans and policies to better deal with extreme hot weather at the local level such as in towns and cities. By exploring new ways to understand and handle extreme heat in cities, this research helps make progress in this important field. The goal of this research is to help cities prepare for and cope with urban extreme heat, keeping people safe and creating sustainable cities for the future.

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Outdoor workers are often subjected to thermal conditions beyond the comfort zone, but to what degree do such conditions affect the health and safety of those workers is still a matter requiring further investigation. The purpose of this study is to examine the relationship between thermal conditions and (1) heat-related disorders and (2) acute injuries using injury and illness data collected during the BP Deepwater Horizon clean-up operations. Over an eleven month period, 5,485 cases were identified as either heat-related or an acute injury (incident type) and further divided by severity. Daily weather data were used to estimate the wet bulb globe temperature (WBGT) based on the time of day. Heat Stress Levels intervals were defined using the estimated WBGT. Labor-hours by month were estimated by the prevailing shift length in the month and the number of workers. The incidents were assigned a Heat Stress Level and the number of labor-hours by heat stress level were determined. The next step was to calculate the incident rate ratio by Heat Stress Level against the baseline of thermal comfort. The results indicated that the rate ratios for heat-related disorders and acute injury increased for thermal conditions from 24⁰C-WBGT to 30⁰C-WBGT. There was a further significant increase in rate ratio for heat-related injury above 33 °C-WBGT. It was notable that the incident rates for both heat-related disorders and acute injuries increased at thermal conditions generally considered to be below the occupational exposure limit (OEL) at 30 ⁰C-WBGT. The rate of heat-related disorders increased substantially above the occupational exposure limit.

学位プログラム名: 京都大学大学院思修館 / 京都大学 / 新制・課程博士 / 博士(総合学術) / 甲第25460号 / 総総博第36号 / 新制||総総||6(附属図書館) / 京都大学大学院総合生存学館総合生存学専攻 / (主査)教授 IALNAZOVDimiter Savov, 教授 山敷 庸亮, 准教授 関山 健, 寶 馨 (防災科学技術研究所) / 学位規則第4条第1項該当 / Doctor of Philosophy / Kyoto University / DFAM

The rising global temperatures are a consequence of the increasing concentrations of the greenhouse gases (GHG) in our atmosphere. This unprecedented yet steady increase in GHG concentrations has led to an increase in the incidence of adverse high-temperature weather phenomena. The aim of this study was to perform a detailed and systematic literature review to study the global dynamic between elevated ambient Page 28 2016 Appalachian Student Research Forum temperatures and heat-related mortality. The review also aimed at exploring the effect of pollutants as possible confounders, to identify vulnerable populations and to study population adaptations to heat that might mitigate heat-related mortality in urban settings. The review was performed exclusively on PubMed. Only epidemiological studies were selected. A time constraint ranging from 2009 to 2015 was applied to the review findings. Only peer-reviewed journals published in the English language were included. The following key terms were used for heat-related mortality associations - heat, high temperature and mortality. Additional keywords were used for the confounders, vulnerable populations and adaptations sections, such as “ozone”, “vulnerable subgroups” or “adaptations”. Studies reporting data on cold effects were excluded from the review. The search resulted in a total of 83 studies, which were included in the review based on the selection criteria. These studies were categorized and presented in four sections - heatmortality associations, effects of pollutants as confounders, vulnerable populations and adaptations. It was found that elevated ambient temperature was associated with high mortality. Additionally, risks of mortality were found to be higher for certain populations, particularly the elderly (65 years or older), infants and the socioeconomically disadvantaged groups. In conclusion, the heat-associated risks of mortality have increased with the escalating climate-change scenario. However, it is important to note that these risks are dependent on factors such as geographical location, socioeconomic status, age, and occupational status. Adaptations to heat are possible in the form of increased use of air-conditioning and promotion of “green” living spaces.

Public health effects associated with rising temperatures resulted from global climate change are expected to increase significantly in this century. Projecting future heat-related mortality is challenging due to some considerable uncertainties, and national-level impacts under the latest greenhouse gas emission scenarios remain unexplored. This study investigates future excess heat-related mortality in two large countries: The United States and China in 2050s under the latest Representative Concentration Pathways (RCPs) emission scenarios. Using model-simulated future and present climate variables that were dynamically downscaled, we quantify the potential increase in heat-related mortality during the warm season. We study the entire continental U.S. and 51 largest urban areas in China, which roughly account for one third of population in China. We derive heat mortality risk estimates and adaptation assumptions from a comprehensive review of current literature of temperature-mortality relationships in both countries. We incorporate the latest population projection in both countries, and also investigate geographical variations in heat mortality risk and sources of uncertainty including population adaptation. Our findings suggest that future heat mortality risk attributable to elevated warm season temperature is likely to be significant in both countries studied, with substantial geographic variations, highlighting the significance of climate mitigation and local-level heat risk management.

Studies of the adverse impacts of high temperature on human health have been primarily focusing on urban areas, due in part to the facts that urban centers generally have higher population density and are often significantly warmer than its surrounding rural areas (Heat Island Effect), and thus urban areas are considered to be more vulnerable to summer heat. However, heat vulnerability can also be affected by other population characteristics such as age, education, income and social isolation, which are likely to mark greater vulnerability among rural population. Here we explore the vulnerability to heat-related mortality in rural areas through a systematic review and meta-analysis of existing evidence. We searched studies that examined the association between high ambient temperature and morality in rural areas published in English between 2000 and 2016. Heat-mortality effect estimates from selected studies are grouped into two: (1) Rural effect estimates (RRrural) and their corresponding urban effect estimates (RRurban), from studies that reported risk estimates for both urban and their surrounding rural areas (7 studies included); (2) Rural effect estimates only (12 studies included). For Group 1, we performed a meta-analysis of the ratio of the rural estimate to the urban estimate in order to compare the magnitude of effects in rural versus urban areas. For Group 2, we performed a meta-analysis of the effect estimates in rural areas only. The pooled ratio estimate (RRrural/RRurban) for Group 1 is 1.051 (95% CI: 0.954, 1.160), which indicates the rural relative risk is about 5% larger than the urban relative risk. The pooled estimate for Group 2 is 1.191 (95% CI: 1.13, 1.251). Our preliminary results suggest that vulnerability to heat in rural areas may be similar to or even higher than urban areas, indicating that more studies are needed to understand rural vulnerability to heat-related hazards.

Indiana University-Purdue University Indianapolis (IUPUI) / Extreme Heat Events are the leading cause of weather-related mortalities in the continental United States. Recent publications have suggested that vulnerability to extreme heat is impacted by variations in environmental and socioeconomic conditions, even across small spatial units. This study evaluated the usefulness of socioeconomic variables and satellite-derived environmental measurements as predictors of heat-related vulnerability during the July 14-17, 1995 heat wave in Chicago, IL. Geospatial analysis and statistical processes were implemented to identify and rank characteristics of vulnerable populations. Results suggest population density, educational attainment, age, and financial indicators are among the best predictors of heat vulnerability. Proximity to and intensity of Urban Heat Islands also appears to influence neighborhood vulnerability levels. Identification and mapping of vulnerability variables can distinguish locations of increased vulnerability during extreme weather conditions. These vulnerability maps could be utilized by city officials to plan and implement aid programs to specific high risk neighborhoods before an extreme heat event, and resulting health implications, occur. Continued study and implementation of these variables could also assist in identifying vulnerable populations in other urban environments, improve utilization of location-specific heat warning systems and impact new building policies to decrease vulnerability variables across the country.