How to deal with heat stress at an open-air event? Exploring visitors’ vulnerability, risk perception, and adaptive behavior with a multi-method approach

AbstractHeat waves are increasingly common in many countries across the globe, and also in Germany, where this study is set. Heat poses severe health risks, especially for vulnerable groups such as the elderly and children. This case study explores visitors’ behavior and perceptions during six weekends in the summer of 2018 at a six-month open-air horticultural show. Data from a face-to-face survey (n = 306) and behavioral observations (n = 2750) were analyzed via correlation analyses, ANOVA, and multiple regression analyses. Differences in weather perception, risk awareness, adaptive behavior, and activity level were observed between rainy days (maximum daily temperature < 25°C), warm summer days (25 - 30°C), and hot days (> 30°C). Respondents reported a high level of heat risk awareness, but most (90 %) were unaware of actual heat warnings. During hot days, more adaptive measures were reported and observed. Older respondents reported taking the highest number of adaptive measures. We observed the highest level of adaptation in children, but they also showed the highest activity level. Based on our results we discuss how to facilitate individual adaptation to heat stress at open-air events by taking the heterogeneity of visitors into account. In order to mitigate negative health outcomes for citizens in the future, we argue for tailored risk communication aimed at vulnerable groups.

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Heat Stress in Indoor Environments of Scandinavian Urban Areas: A Literature Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040560 ◽

2019 ◽

Vol 16 (4) ◽

pp. 560 ◽

Cited By ~ 16

Author(s):

Karin Lundgren Kownacki ◽

Chuansi Gao ◽

Kalev Kuklane ◽

Aneta Wierzbicka

Keyword(s):

Heat Stress ◽

Literature Review ◽

Urban Areas ◽

Heat Waves ◽

Well Being ◽

Heat Index ◽

Vulnerable Groups ◽

Heat Radiation ◽

Indoor Environments ◽

Promising Alternative

Climate change increases the risks of heat stress, especially in urban areas where urban heat islands can develop. This literature review aims to describe how severe heat can occur and be identified in urban indoor environments, and what actions can be taken on the local scale. There is a connection between the outdoor and the indoor climate in buildings without air conditioning, but the pathways leading to the development of severe heat levels indoors are complex. These depend, for example, on the type of building, window placement, the residential area’s thermal outdoor conditions, and the residents’ influence and behavior. This review shows that only few studies have focused on the thermal environment indoors during heat waves, despite the fact that people commonly spend most of their time indoors and are likely to experience increased heat stress indoors in the future. Among reviewed studies, it was found that the indoor temperature can reach levels 50% higher in °C than the outdoor temperature, which highlights the importance of assessment and remediation of heat indoors. Further, most Heat-Health Warning Systems (HHWS) are based on the outdoor climate only, which can lead to a misleading interpretation of the health effects and associated solutions. In order to identify severe heat, six factors need to be taken into account, including air temperature, heat radiation, humidity, and air movement as well as the physical activity and the clothes worn by the individual. Heat stress can be identified using a heat index that includes these six factors. This paper presents some examples of practical and easy to use heat indices that are relevant for indoor environments as well as models that can be applied in indoor environments at the city level. However, existing indexes are developed for healthy workers and do not account for vulnerable groups, different uses, and daily variations. As a result, this paper highlights the need for the development of a heat index or the adjustment of current thresholds to apply specifically to indoor environments, its different uses, and vulnerable groups. There are several actions that can be taken to reduce heat indoors and thus improve the health and well-being of the population in urban areas. Examples of effective measures to reduce heat stress indoors include the use of shading devices such as blinds and vegetation as well as personal cooling techniques such as the use of fans and cooling vests. Additionally, the integration of innovative Phase Change Materials (PCM) into facades, roofs, floors, and windows can be a promising alternative once no negative health and environmental effects of PCM can be ensured.

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MECHANISMS FOR STRENGTHENING ECONOMIC SECURITY OF UKRAINIAN CITIZENS IN THE CONDITIONS OF SOCIO-POLITICAL CRISIS AND EXTERNAL CHALLENGES

Соціально-правові студії ◽

10.32518/2617-4162-2021-2-130-140 ◽

2021 ◽

Vol 12 (2) ◽

pp. 130-140

Author(s):

Olesia Datsko ◽

◽

Nataliya Nakonechna ◽

Olha Patsula ◽

◽

...

Keyword(s):

Total Population ◽

The Elderly ◽

Economic Security ◽

Vulnerable Groups ◽

Political Crisis ◽

Subsistence Level ◽

Economic Rights ◽

Social Standards ◽

High Level ◽

Autonomous Republic

The article outlines systemic threats, substantiates the need and highlights mechanisms for strengthening the economic security of the citizens of Ukraine in the context of exacerbation of socio-political crisis and external challenges. The existing in inconsistency of basic social standards in Ukraine and their institutional provision with real conditions and needs of citizens causes inadequate state guarantee of its beneficiaries (citizens) rights to life, earnings, housing, health care and, in general, - to self-reproduction and development. Given the aggravation of socio-political and socio-economic crises, deepened by hostilities in eastern Ukraine, the annexation of the Autonomous Republic of Crimea, ensuring economic security of citizens, especially vulnerable groups - migrants, large and young families, the elderly is highly important. The main reason for the high level of vulnerability of socio-economic rights of citizens is the imperfection of state and regional policy, inefficient management of state resources, which leads to their privatization or hidden unfair redistribution of shadow schemes in favor of political elites. As a result, this fact has led to excessive stratification of the population in terms of income, when about 80% of the total population of Ukraine receives a monthly income below the real subsistence level, the spread of poverty among workers. The analysis shows that the reforms in Ukraine are carried out without proper forecasting and assessment of the expected effectiveness, taking into account the key performance indicators (KRI) to ensure the economic security of the main beneficiary of the state - a citizen of Ukraine. Further reform of the socio-economic sphere requires the introduction of institutional changes with the obligatory priority of economic security of the citizens.

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Heat and Ozone Pollution Waves in Central and South Europe—Characteristics, Weather Types, and Association with Mortality

Atmosphere ◽

10.3390/atmos11121271 ◽

2020 ◽

Vol 11 (12) ◽

pp. 1271

Author(s):

Elke Hertig ◽

Ana Russo ◽

Ricardo M. Trigo

Keyword(s):

Heat Waves ◽

Weather Conditions ◽

The Elderly ◽

Vulnerable Groups ◽

Ozone Pollution ◽

Wave Type ◽

Air Masses ◽

Atmospheric Circulation Patterns ◽

North Eastern ◽

South Europe

Air pollution and hot temperatures present two major health risks, especially for vulnerable groups such as children, the elderly, and people with pre-existing conditions. Episodes of high ozone concentrations and heat waves have been registered throughout Europe and are expected to continue to grow due to climate change. Here, several different heat and ozone wave definitions were applied to characterize the wave-type extremes for two climatically different regions, i.e., Portugal (South Europe) and Bavaria (Central Europe), and their impacts were evaluated considering each type of hazard independently but also when they occur simultaneously. Heat and ozone waves were analyzed with respect to the underlying atmospheric circulation patterns and in terms of their association with human mortality. Heat waves were identified as the most frequent wave type and, despite different climate settings, a comparable exposure to heat and ozone waves was found in Central and South Europe. Waves were associated with in-situ built-up as well as with advection of air masses. However, in Bavaria waves showed the strongest connection with autochthonous weather conditions, while for Portugal, the strongest relationship appeared for eastern and north-eastern inflow. The most severe events, as measured by excess mortality, were always associated to compound heat-ozone waves.

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Eldre personer er sårbare i ekstreme værsituasjoner

Norsk Epidemiologi ◽

10.5324/nje.v14i2.244 ◽

2009 ◽

Vol 14 (2) ◽

Author(s):

Anette Hylen Ranhoff

Keyword(s):

Risk Factors ◽

High Risk ◽

Elderly People ◽

Heat Waves ◽

Weather Conditions ◽

Risk Groups ◽

The Elderly ◽

Extreme Weather ◽

Vulnerable Groups ◽

Font Size

I fjor sommer ble Europa rammet av en hetebølge og tusenvis av eldre mennesker døde. Sammenhengen mellom helsetilstand og påvirkning av klima er kompleks og medisinske, sosiale og miljømessige faktorer er involvert. Imidlertid er hete- og kulderelaterte sykdommer, skade og død i høy grad mulig å forebygge, og det er behov for å analysere denne situasjonen og andre ekstreme værsituasjoner for å kunne sikre helsen til eldre personer ved liknede hendelser i fremtiden. Artikkelen gir en oversikt over litteratur som omhandler sykelighet og dødelighet som følge av ekstreme værforhold: hete, kulde og situasjoner der transport, elektrisitet og andre leveranser er begrenset, som etter en orkan, enorme snøfall eller liknende. Sammenhenger mellom sykelighet, dødelighet og temperatur i alminnelighet bli også omtalt, med spesielt fokus på de eldre. Eldre som lever alene og er sosialt isolerte, og spesielt de som har funksjonshemning eller kognitiv svikt har høyest risiko for sykdom, skade og død i ekstreme værsituasjoner. Dette kan trolig i stor grad forebygges. Det anbefales at alle kommuner har kriseplaner for naturkatastrofer og ekstreme værsituasjoner som spesielt inneholder tiltak rettet mot sårbare eldre. Planene bør inneholde generell alarmering og informasjon samt systemer for oppsøkende virksomhet overfor risikogrupper. The 2003 heat wave in Europe was responsible for the deaths of thousands of elderly people. Heat- and cold-related illnesses, injuries and deaths are supposed to be largely preventable, and it is a need for analysing this situation and other situations with extreme weather conditions where elderly people are believed to be particularly vulnerableThis article is a review of the literature concerning morbidity and mortality in extreme weather conditions like heat, cold and situations where transportation, electricity, and other supplies are limited as a consequence of extreme weather such as after a hurricane or an enormous snowfall. Associations between mortality, morbidity and temperature in general are also discussed with focus on the elderly population. after a hurricane or an enormous snowfall. The frailest elderly are at the highest risk. In situati The elderly are at high risk for illnesses, injuries and death in extreme weather conditions. There are numerous reports from heat waves, but also cold-related problems are well documented. Other risk factors are disability, cognitive impairment, chronic disease, the use of special drugs and social isolation. Many risk factors are common for heat-, and cold-related problems, and also for other situations like ons with extreme weather conditions, we recommend local and central authorities to have emergency plans with special adaptations to the needs of elderly people and other vulnerable groups. These plans should include general warning and information and systems for preventive visits to high-risk groups..

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Experiences of heat stress while homeless on hot summer days in Adelaide

Australian Journal of Emergency Management - October 2021 ◽

10.47389/36.4.55 ◽

2021 ◽

Vol 10.47389/36 (36.4) ◽

pp. 55-61

Author(s):

Danielle Every ◽

Jim McLennan ◽

Elizabeth Osborn ◽

Chris Cook

Keyword(s):

Heat Stress ◽

Heat Waves ◽

Homeless People ◽

Stress Symptoms ◽

Protective Actions ◽

Hot Days ◽

Hot Weather ◽

Term Response

Historically, heat waves have resulted in more Australian deaths than any other natural hazard and continue to present challenges to the health and emergency management sectors. While people experiencing homelessness are particularly vulnerable to adverse effects of heat waves, little research has been reported about their hot weather experiences. This paper reports findings from interviews with 48 homeless people sleeping rough in Adelaide CBD on very hot days. While the majority reported drinking a litre or more of water in the previous 24 hours, 79% reported experiencing one or more heat stress symptoms. The research highlights that the protective actions people sleeping rough can take during hot weather are limited by their circumstances and may not be sufficient to prevent dehydration and heat stress. The levels of dehydration and heat stress symptoms suggest that immediate responses could include making drinking water more readily available. It may be helpful to provide information which highlights heat stress symptoms including indicators of dehydration. The role of outreach in providing connections, support and advice is most likely to ameliorate the risk of heat stress. However, the long-term response to protect people from heat stress is access to housing.

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POLITICAL TRUST AND SOCIAL COHESION AT A TIME OF CRISIS The Impact of COVID-19 on Kurdistan Region-Iraq

Academic Journal of Nawroz University ◽

10.25007/ajnu.v10n2a999 ◽

2021 ◽

Vol 10 (2) ◽

pp. 86-112

Author(s):

Mohammedali Yaseen Taha ◽

Juline Beaujouan ◽

Amjed Rasheed

Keyword(s):

Social Cohesion ◽

Political Trust ◽

Direct Consequence ◽

The Elderly ◽

Government Support ◽

Vulnerable Groups ◽

The Media ◽

High Level ◽

The Impact ◽

Source Of Information

COVID-19 has attracted much attention in Kurdish neighbourhoods and has been relayed massively by the media across the KRI. Kurdistanis put their trust mostly in television as the most accessible source of information across the region. Conversely, social media was not considered a reliable source of information during the pandemic. The results of this survey highlight a strong lack of trust in federal political figures and institutions. At the regional level, Kurdistanis are divided along lines of political affiliation and geography. While respondents from Duhok and Erbil expressed a high level of trust in the KRG, people of Silemani are openly distrustful of the KRI government. The institutions responsible for mitigating the impact of the pandemic attract the highest level of trust across governorates. This is the case with the KRG Ministry of Health and Ministry of Interior, including the security forces and the police. Conversely, participants expressed strong rejection of both parliaments that sit in Baghdad and Erbil. The legislative body attracted the least trust among the population surveyed. The COVID-19 pandemic has fostered social cohesion in the KRI. The majority of respondents believed that all Kurdistanis, including both vulnerable and non-vulnerable groups, should be treated equally and should receive the same amount of government support during the pandemic. That being said, a significant number of respondents recognized the importance of caring for those most vulnerable, such as the elderly, Syrian refugees, and International Displaced Persons (IDPs) more broadly. Finally, respondents have been shown to rely mostly on their social circles and family throughout the crisis, rather than regional and federal institutions. Those surveyed strongly supported the preventive measures in general imposed by the KRG on the three governorates. Yet, answers to the survey reveal that such measures have had an impact on the personal economic circumstances of Kurdistanis, especially among the younger portion of the population, who expected to face financial difficulties in the near future as a direct consequence of the pandemic and its impact.

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Obravnava vročinskih valov in primer toplotne obremenitve delavcev v kmetijstvu v času vročinskih valov 2017

Acta agriculturae Slovenica ◽

10.14720/aas.2018.111.3.13 ◽

2018 ◽

Vol 111 (3) ◽

pp. 647

Author(s):

Tjaša POGAČAR ◽

Lučka KAJFEŽ BOGATAJ ◽

Zalika ČREPINŠEK

Keyword(s):

Heat Stress ◽

Heat Waves ◽

Labour Productivity ◽

Temperature Threshold ◽

Temperature Index ◽

Wet Bulb Globe Temperature ◽

Air Temperatures ◽

Globe Temperature ◽

High Level ◽

Continental Climate

Workers in agriculture are regularly exposed to heat stress during summer, which can affect reduced labour productivity and income losses. Air temperatures in Slovenia have been rising in recent decades, and climate change projections show that this trend will continue along with an increase in the number of days with heat stress risk. Changes in the number of heat waves in central and south-western Slovenia for the period 1961–2017 were analysed as well as the risk of the heat stress for workers during heat waves in the year 2017. The heat wave occurs if the temperature threshold for the average daily temperature is reached or exceeded on at least three consecutive days, with the threshold for the mild continental climate (Ljubljana) 24 °C and the mild Submediterranean climate (Bilje) 25 °C. The WBGT (Wet Bulb Globe Temperature) index, assessing the risk of heat stress, was calculated from relative humidity and air temperatures. At both locations, the number of days in heat waves increased as well as their intensity, average daily air temperatures were significantly higher than in the first half of the considered period. The time span, in which the heat waves occur, also extended, as until 1990 they did not appear in early June and late August, as in recent years. The calculated values of the WBGT show that for most days in the heat waves in 2017 in Ljubljana and Bilje, the WBGT 23 °C threshold was exceeded practically all day, which shows a high level of heat stress risk for physically intense work. In the case of exceeded WBGT reference values, employers or farmers themselves should take actions to reduce the risk of heat stress.

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Hot days and Covid-19 – unusual heat stress for nursing professions in Germany

10.1101/2021.01.29.21250592 ◽

2021 ◽

Author(s):

Yvette Jegodka ◽

Lena Lagally ◽

Hanna Mertes ◽

Katharina Deering ◽

Julia Schoierer ◽

...

Keyword(s):

Heat Stress ◽

Nursing Staff ◽

Personal Protective Equipment ◽

Heat Waves ◽

Protective Equipment ◽

List Type ◽

Heat Protection ◽

New Findings ◽

Hot Days ◽

The Impact

AbstractObjectivesOur aim was to identify whether working during hot days alongside with Covid-19 related personal protective equipment causes heat stress for nursing professionals in Germany.MethodsUsing an online survey, we assessed the impact of hot weather on nursing staff performing in personal protective equipment. A random selection of nursing staff from hospitals, nursing homes and outpatient care participated in the survey.ResultsOut of 428 participants, 6.3% were between 16 and 25 years old, 22.8% between 26 and 35 years, 21.9% between 36 and 45 years, 30.5% between 45 and 55 years, 18.2% between 56 and 65 years, and 0.3% were older than 65 years. Out of all participants, 18.2% were male and 82.5% female. The results of the survey showed that 48.3% had more than 20 years of experience in nursing and 46.2% cardiac, pulmonary, or other pre-existing conditions. Work was found exhaustive while working in PPE by 96.5% of the participants, and 93% complained of worse breathing. We found out that 85.8% reported difficulties to focus. Many workplaces turned out to lack adequate heat protection, with distinct differences concerning the amount of prophylactic and heat mitigating measures across institutions.ConclusionsOur results clearly show that employers must make more of an effort to provide adequate heat protection for their nursing staff. In order to secure the public health care, there is a need for action, especially in the case of previous conditions of caregivers.What is already known about this subject?►Working in personal protective equipment is often needed during pandemics, to protect nurses, doctors and staff from an infection.►However, the equipment can also hamper efficiency and productivity of healthcare workers and lead to personal discomfort, for example, during heat waves.What are the new findings?►According to our study, nurses and nursing assistants in Germany are often older than 45 years and, in many cases, suffer from pre-existing conditions, which exacerbate the problems with personal protective equipment during periods of hot temperatures.►Many healthcare institutions do not offer adequate ways to mitigate heat stress for their staff.How might this impact on policy or clinical practice in the foreseeable future?►The results from this study can inform policy makers and clinical practitioners to modify their protocols to include better protective measures during extreme heat or other adverse environmental conditions.

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Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults

Current Aging Science ◽

10.2174/1874609813666200928141220 ◽

2020 ◽

Vol 13 ◽

Author(s):

Lucia Maria Andreis ◽

Fernando de Aguiar Lemos ◽

Lorenna Walesca de Lima Silva ◽

Cassiana Luiza Pistorello Garcia ◽

Gabrielli Veras ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Activity Level ◽

Area Under The Curve ◽

The Elderly ◽

Activity Level ◽

General Motor ◽

Body Scheme ◽

Significant Difference ◽

Global Coordination

Background: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity level can be associated differently with each motor domains. Objective: We analyzed the relationship between physical activity level and motor aptitude, and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. Methods: Participated in the study 385 elderly people of both sexes. For the evaluation of the subjects were adopted the International Questionnaire on Physical Activity and the Motor Scale for Older Adults. Results: The majority of the elderly were active. In the comparison of motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the area under the curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

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Corticobasal Degeneration Misdiagnosed As Musculoskeletal Disease: A Challenging Diagnosis of Higher-Level Gait Disease

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0040-1716773 ◽

2020 ◽

Vol 11 (04) ◽

pp. 640-642

Author(s):

Halil Onder

Keyword(s):

Corticobasal Degeneration ◽

The Elderly ◽

Gait Disorders ◽

Physiological Changes ◽

Gait Abnormality ◽

Age Related ◽

Musculoskeletal Problems ◽

Neurological Exam ◽

Long Time ◽

High Level

AbstractGait disorders are common in the elderly as there are various causes of neurological and non-neurological conditions. On the other hand, most of the gait parameters do change with advancing age which is identified as age-related physiological changes in gait. At this point, the discrimination between age-related physiological changes and gait disorders may be strictly challenging. After identifying gait as an abnormal pattern, classification of it and making the responsible pathophysiology also require high-level expertise in this regard. Herein, we present a rare patient with corticobasal degeneration (CBD) who had admitted initially due to complaints of gait problems. Over a long time, the patient had received the misdiagnosis of gait abnormality due to musculoskeletal problems by multiple physicians. However, the detailed neurological exam showed a higher level gait disorder (HLGD). Further investigations at this point yielded the diagnosis of CBD.

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