ISEE-233 Abstract: Since 2002, a Heat Health Watch Warning System (HHWWS) and a prevention program have been active in Rome during the summer period (15th May – 31st August) to reduce the impact of heat on mortality. Rome has an estimated population of 2.550.000 of which 14% are over 65 years of age. An evaluation of the performance of the HHWWS in 2003 during heat waves (defined as maximum apparent temperature above the 90th annual percentile and a +2°C compared to the previous day) in terms of excess mortality and the number of warnings predicted was carried out. The HHWWS is based on a synoptic climatological procedure that classifies each day into meteorologically homogeneous groups (air masses) and identifies “oppressive” conditions associated with an increase in mortality. Meteorological forecast data is then applied to the system to predict air masses and the related excess mortality three days in advance. The daily excess mortality observed (defined as the difference between observed mortality on a given day and the smoothed average daily value for the reference period, 1995–2002) was compared with excess mortality predicted by the HHWWS. During the summer of 2003 high temperatures persisted, and record excess mortality was observed during three heat wave periods (June 10th–July 3rd, July 11–31st, August 4–14th) exhibiting a strong association between temperature and daily mortality. Total excess mortality was 1094 deaths (+23%), observed especially among the elderly and increased dramatically with age, with the greatest impact in the over-85 age group (+46%). The HHWWS called a warning on 43 days (47%), with a maximum of 7 consecutive days during the summer of 2003. The system was efficient in predicting major peaks in mortality, but during heat wave periods it underestimated the total number of excess mortality by 414 units (−47%) for the age group >65. The HHWW system underestimated actual heat wave days (69) by 27, predicting only 42 warnings. This is attributable to the underestimation of forecast temperatures and secondly, the extreme meteorological conditions recorded during heat waves were not accounted for in the meteorological time series used to construct the model. To overcome these underestimations, the HHWWS air mass-based model will be integrated with a temperature-based model in summer 2004. An evaluation of the effectiveness of the HHWWS and the preventive strategies implemented will be performed to further reduce heat-related mortality in Rome.
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de’Donato et al. (2004) studied this question.