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Doctors could warn vulnerable patients of dangerously hot weather with 'heat alerts'

JUANA SUMMERS, HOST:

Phoenix could see a high temperature of 109 degrees today. It'll be 98 in Jacksonville, Fla., and 96 in Medford, Ore. It has been a summer of successive heat waves.

MARY LOUISE KELLY, HOST:

Well, as the country sizzles, the dangers that heat poses to human bodies have become frighteningly clear, and the risks are much higher for some than others. An innovative pilot project is trying to address this by sending heat-alert emails to doctors and nurses in Massachusetts and six states across the country. Martha Bebinger at WBUR explains.

MARTHA BEBINGER, BYLINE: In Boston, the first heat alert popped into inboxes on June 1. It was 83 degrees that day, still not hot enough to trigger an official heat warning. But in Boston, when temperatures rise past the mid-70s, heat-related hospitalizations and deaths rise, too. Dr. Rebecca Rogers, a primary care physician at Cambridge Health Alliance, says it's particularly dangerous early in what doctors call the heat season.

REBECCA ROGERS: People are quite vulnerable 'cause their bodies haven't yet adjusted to heat.

BEBINGER: For Rogers, that first email and another that arrived as temperatures rose in July bumped heat to the forefront of her conversations in the exam room. And the emails suggest Rogers prioritize heat planning with specific patients.

ROGERS: Older individuals, outdoor workers, individuals with chronic medical conditions such as heart disease, diabetes or chronic kidney disease.

BEBINGER: Also, young athletes training on sweltering fields and people without air conditioning.

ROGERS: OK.

(SOUNDBITE OF DOOR OPENING)

ROGERS: I'm going to have you go straight through there.

LUCIANO GOMES: Thank you (ph).

BEBINGER: Her patient, Luciano Gomes, works construction.

ROGERS: If you were getting too hot at work and maybe you're starting to get sick, do you know some things to look out for?

GOMES: No.

BEBINGER: So Rogers describes signs of heat exhaustion - dizziness, weakness and sweating a lot. She hands Gomes some tip sheets she got with the email alerts. On one, a color band from pale yellow to dark gold is a sort of urine hydration barometer.

ROGERS: So if your pee is dark like this during the day when you're at work, probably means you need to drink more water.

UNIDENTIFIED INTERPRETER: (Speaking Portuguese).

BEBINGER: An interpreter translates into Portuguese for Gomes, who's from Brazil. He knows heat, but he has questions about staying hydrated.

GOMES: (Through interpreter) Because here, I've been addicted to soda. I'm trying to change to sparkling water, but I don't have too much knowledge on how much I can take of it.

ROGERS: Yeah. Sparkling water, you know, is fine. As long as it doesn't have sugar, it's totally good.

BEBINGER: Rogers has her own questions. Should patients taking meds that make them pee more often take less of the drug when it's hot? There's no firm answer yet, and Rogers knows that being unable to cool down overnight can trigger a health crisis. But she isn't sure how to help patients who cannot afford an air conditioner or who don't have stable housing.

CALEB DRESSER: Heat is the leading cause of death from natural hazards in the United States.

BEBINGER: This is Dr. Caleb Dresser, one of the people who sends the alerts.

DRESSER: And it is set to be an increasing problem in the years to come as a result of climate change.

BEBINGER: Dresser works out of Harvard's Center for Climate, Health and the Global Environment. Weather expertise comes from Climate Central, an independent source of climate science. Staff at 12 community health centers around the country are receiving alerts tailored to their location. In Portland, Ore., for example, an early heat wave triggered an alert on May 14. This month, alerts will only go out on the most excessively hot and humid days so they don't become too routine. Andrew Pershing is with Climate Central.

ANDREW PERSHING: So what we're just trying to say is, like, you really need to go into heat mode now.

BEBINGER: Pershing and colleagues are tweaking the language of alerts this summer, looking for messages that will change behavior because studies show many people don't take heat warnings seriously. Ashley Ward studies heat policy at Duke and says that has to change.

ASHLEY WARD: This is not your grandmother's heat, so we have to accept that our environment has changed. This might very well be the coolest summer for the rest of our lives.

BEBINGER: The pilot has limitations. Most clinicians are only discussing heat with the patients who have appointments. They do not have a way to flag all of their high-risk patients or send them individual alerts at home. That's one possible improvement researchers may explore before next summer rolls around.

For NPR News, I'm Martha Bebinger in Boston.

SUMMERS: This story comes from NPR's partnership with WBUR and KFF Health News. Transcript provided by NPR, Copyright NPR.

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