Visitors' perception of thermal comfort during extreme heat events at the Royal Botanic Garden Melbourne.

Outdoor thermal comfort studies have mainly examined the perception of local residents, and there has been little work on how those conditions are perceived differently by tourists, especially tourists of diverse origins. This issue is important because it will improve the application of thermal indices in predicting the thermal perception of tourists. This study aims to compare the differences in thermal perception and preferences between local and overseas visitors to the Royal Botanic Garden (RBG) in Melbourne during summer. An 8-day survey was conducted in February 2014 at four sites in the garden (n = 2198), including 2 days with maximum temperature exceeding 40 °C. The survey results were compared with data from four weather stations adjacent to the survey locations. One survey location, 'Fern Gully', has a misting system and visitors perceived the Fern Gully to be cooler than other survey locations. As the apparent temperature exceeded 32.4 °C, visitors perceived the environment as being 'warm' or 'hot'. At 'hot' conditions, 36.8 % of European visitors voted for no change to the thermal conditions, which is considerably higher than the response from Australian visitors (12.2 %) and Chinese visitors (7.5 %). Study results suggest that overseas tourists have different comfort perception and preferences compared to local Australians in hot weather based at least in part on expectations. Understanding the differences in visitors' thermal perception is important to improve the garden design. It can also lead to better tour planning and marketing to potential visitors from different countries.

Exploring the influence of short-term temperature patterns on temperature-related mortality: a case-study of Melbourne, Australia.

BACKGROUND: Several studies have identified the association between ambient temperature and mortality; however, several features of temperature behavior and their impacts on health remain unresolved. We obtain daily counts of nonaccidental all-cause mortality data in the elderly (65 + years) and corresponding meteorological data for Melbourne, Australia during 1999 to 2006. We then characterize the temporal behavior of ambient temperature development by quantifying the rates of temperature change during periods designated by pre-specified windows ranging from 1 to 30 days. Finally, we evaluate if the association between same day temperature and mortality in the framework of a Poisson regression and include our temperature trajectory variables in order to assess if associations were modified by the nature of how the given daily temperature had evolved. RESULTS: We found a positive significant association between short-term mortality risk and daily average temperature as mortality risk increased 6 % on days when temperatures were above the 90th percentile as compared to days in the referent 25-75th. In addition, we found that mortality risk associated with daily temperature varied by the nature of the temperature trajectory over the preceding twelve days and that peaks in mortality occurred during periods of high temperatures and stable trajectories and during periods of increasing higher temperatures and increasing trajectories. CONCLUSION: Our method presents a promising tool for improving understanding of complex temperature health associations. These findings suggest that the nature of sub-monthly temperature variability plays a role in the acute impacts of temperature on mortality; however, further studies are suggested.

The relationship between housing and heat wave resilience in older people.

Older people have justifiably been highlighted as a high-risk group with respect to heat wave mortality and morbidity. However, there are older people living within the community who have developed adaptive and resilient environments around their home that provide some protection during periods of extreme heat. This study investigated the housing stock and self-reported thermal comfort of a group of older people living in a regional town in Australia during the summer of 2012. The results indicated that daily maximum living room temperature was not significantly correlated with outdoor temperature, and daily minimum living room temperature was very weakly correlated with outdoor temperature. Residents reported feeling comfortable when indoor temperature approximated 26 °C. As living room temperature increased, indoor thermal comfort decreased. Significant differences between indoor temperatures were noted for homes that were related to house characteristics such as the age of the house, the number of air-conditioning units, the pitch of the roof, home insulation and the number of heat-mitigation modifications made to the home. Brick veneer homes showed smaller diurnal changes in temperature than other building materials. With population ageing and the increasing focus on older people living in the community, the quality of the housing stock available to them will influence their risk of heat exposure during extreme weather.

The effects of summer temperature, age and socioeconomic circumstance on acute myocardial infarction admissions in Melbourne, Australia.

BACKGROUND: Published literature detailing the effects of heatwaves on human health is readily available. However literature describing the effects of heat on morbidity is less plentiful, as is research describing events in the southern hemisphere and Australia in particular. To identify susceptible populations and direct public health responses research must move beyond description of the temperature morbidity relationship to include social and spatial risk factors. This paper presents a spatial and socio-demographic picture of the effects of hot weather on persons admitted to hospital with acute myocardial infarction (AMI) in Melbourne. RESULTS: In this study, the use of a spatial and socio-economic perspective has identified two groups within the population that have an increased 'risk' of AMI admissions to hospital during hot weather. AMI increases during hot weather were only identified in the most disadvantaged and the least disadvantaged areas. Districts with higher AMI admissions rates during hot weather also had larger proportions of older residents. Age provided some explanation for the spatial distribution of AMI admissions on single hot days whereas socio-economic circumstance did not. During short periods (3-days) of hot weather, age explained the spatial distribution of AMI admissions slightly better than socioeconomic circumstance. CONCLUSIONS: This study has demonstrated that both age and socioeconomic inequality contribute to AMI admissions to hospital in Melbourne during hot weather. By using socioeconomic circumstance to define quintiles, differences in AMI admissions were quantified and demographic differences in AMI admissions were described. Including disease specificity into climate-health research methods is necessary to identify climate-sensitive diseases and highlight the burden of climate-sensitive disease in the community. Cardiac disease is a major cause of death and disability and identifying cardiac-specific climate thresholds and the spatio-demographic characteristics of vulnerable groups within populations is an important step towards preventative health care by informing public health officials and providing a guide for an early heat-health warning system. This information is especially important under current climatic conditions and for assessing the future impact of climate change.

Demographic, seasonal, and spatial differences in acute myocardial infarction admissions to hospital in Melbourne Australia.

BACKGROUND: Seasonal patterns in cardiac disease in the northern hemisphere are well described in the literature. More recently age and gender differences in cardiac mortality and to a lesser extent morbidity have been presented. To date spatial differences between the seasonal patterns of cardiac disease has not been presented. Literature relating to seasonal patterns in cardiac disease in the southern hemisphere and in Australia in particular is scarce. The aim of this paper is to describe the seasonal, age, gender, and spatial patterns of cardiac disease in Melbourne Australia by using acute myocardial infarction admissions to hospital as a marker of cardiac disease. RESULTS: There were 33,165 Acute Myocardial Infarction (AMI) admissions over 2186 consecutive days. There is a seasonal pattern in AMI admissions with increased rates during the colder months. The peak month is July. The admissions rate is greater for males than for females, although this difference decreases with advancing age. The maximal AMI season for males extends from April to November. The difference between months of peak and minimum admissions was 33.7%. Increased female AMI admissions occur from May to November, with a variation between peak and minimum of 23.1%. Maps of seasonal AMI admissions demonstrate spatial differences. Analysis using Global and Local Moran's I showed increased spatial clustering during the warmer months. The Bivariate Moran's I statistic indicated a weaker relationship between AMI and age during the warmer months. CONCLUSION: There are two distinct seasons with increased admissions during the colder part of the year. Males present a stronger seasonal pattern than females. There are spatial differences in AMI admissions throughout the year that cannot be explained by the age structure of the population. The seasonal difference in AMI admissions warrants further investigation. This includes detailing the prevalence of cardiac disease in the community and examining issues of social and environmental justice.

The impact of "unseasonably" warm spring temperatures on acute myocardial infarction hospital admissions in Melbourne, Australia: a city with a temperate climate.

The effects of extreme temperatures on human health have been well described. However, the adverse health effects of warm weather that occurs outside the summer period have had little attention. We used daily anomalous AMI morbidity and daily anomalous temperature to determine the impact of "unseasonable" temperature on human health. The "unseasonably" warm weather was attributed to a slow moving high pressure system to the east of Melbourne. No morbidity displacement was noted during either of these periods suggesting that morbidity due to "unseasonable" temperatures is avoidable. An increase in warmer weather during the cooler months of spring may result in increased morbidity, and an alert system based on summer thresholds may not be appropriate for early season heat health warnings. A straightforward alert system based on calculating anomalous temperature from daily weather forecasts may reduce the public health impact of "unseasonably" warm weather.

Learning from our older people: pilot study findings on responding to heat.

AIMS: With the advent of climate change, it is important that strategies be put in place to minimise the effects of heat. These impacts can be compounded by other factors such as location and age. This exploratory pilot study focuses on older people in a rural Victorian community that regularly experiences hot weather. METHOD: Mixed methods - including a focus group, household interviews, daily diaries and collection of meteorological data. RESULTS: The community is generally well adapted to heat with all having modified their homes and behaviours to cope with extreme heat. There was, however, little understanding or planning regarding the potential health impacts of heat. CONCLUSIONS: There is a clear need for community-directed adaptation to best meet the needs of older people, particularly those living in urban areas, and for targeted public health campaigns to increase awareness of heat-health risks and disseminate the strategies identified in this community.

The effects of extreme heat on human mortality and morbidity in Australia: implications for public health.

Most regions of Australia are exposed to hot summers and regular extreme heat events; and numerous studies have associated high ambient temperatures with adverse health outcomes in Australian cities. Extreme environmental heat can trigger the onset of acute conditions, including heat stroke and dehydration, as well as exacerbate a range of underlying illnesses. Consequently, in the absence of adaptation, the associated mortality and morbidity are expected to increase in a warming climate, particularly within the vulnerable populations of the elderly, children, those with chronic diseases, and people engaged in physical labour in noncooled environments. There is a need for further research to address the evidence needs of public health agencies in Australia. Building resilience to extreme heat events, especially for the most vulnerable groups, is a priority. Public health professionals and executives need to be aware of the very real and urgent need to act now.

Mortality-temperature thresholds for ten major population centres in rural Victoria, Australia.

Mortality-temperature relationships in small regional towns in Victoria, Australia, were used to ascertain whether the effects of high ambient temperatures documented in the literature for major population centres in Europe and America are also noted in small rural communities in Australia. The establishment of threshold temperatures in all major rural regions of Victoria indicate that hot weather results in an increase in mortality in persons aged 65 years and older. This adds considerable strength to the argument that human populations are vulnerable to heat events regardless of location. Heat alerts can be issued through local health and welfare agencies, to increase awareness of 'hot' weather as a health hazard for elderly people by providing education campaigns involving local authorities based on these simple thresholds.

A simple heat alert system for Melbourne, Australia.

A simple heat alert system, based solely on predicted maximum and minimum daily temperatures, has been developed for the city of Melbourne in southeast Australia. The system is based upon a demonstration that, when mean daily temperature exceeds a threshold of 30 degrees C (mean of today's maximum temperature and tonight's minimum temperature), the average daily mortality of people aged 65 years or more is about 15-17% greater than usual. Similar numbers of excess deaths also occur when daily minimum temperatures exceed 24 degrees C (increases of 19-21% over expected death rate), so a heat alert system based solely on this widely available weather forecast variable is also feasible. No strong signal of excess heat-related deaths appears when the data are stratified using daily maximum temperatures. This may be because in Melbourne some days with very high maximum temperatures will be affected by the passage of cool changes and cold fronts in the afternoon, leading to a rapid drop in temperature (i.e., some days with high maximum temperatures will not continue to be hot throughout the day and into the evening). A single day with temperatures exceeding the thresholds noted above is sufficient to cause this increase in mortality, rather than requiring an extended heat wave. The increased daily mortality does not appear to represent a short-term advancement of mortality.