>> HELLO, WELCOME TO THE 21ST
YEAR OF A COURSE CALLED
DEMYSTIFYING MEDICINE HELD AT
THE NATIONAL INSTITUTES OF
HEALTH IN BETHESDA, MARYLAND.
THIS IS A COURSE THAT IS
DESIGNED TO BRIDGE EXCITING
DEVELOPMENTS IN BIOLOGY AND
ENGINEERING AND COMPUTER
SCIENCES WITH MEDICINE.
IT IS HELD TUESDAYS FROM JANUARY
TO EARLY MAY FROM FOUR TO SIX
AND YOU CAN WATCH IT LIVE ON THE
VIDEOCAST LISTED ON THE SLIDE.
AS YOU NOTED, THE CME CREDIT IS
AVAILABLE AND THE CODE NUMBER
FROM TODAY IS 52,093.
NEXT SLIDE, PLEASE.
THE SPEAKERS HAVE NO RELEVANT
FINANCIAL INTEREST.
NEXT SLIDE, PLEASE.
NOW, WOULD YOU PLEASE GO BACK TO
THE FIRST SLIDE OF MINE.
THE LOGO FOR THIS COURSE IS
SHOWN IN THE -- IN THE UPPER
RIGHT.
IT IS A PHOTOGRAPH OF WHAT MANY
OF US CONSIDER THE MOST
IMPORTANT BRIDGE OF THE WORLD,
THE BROOKLYN BRIDGE, CONNECTING
BROOKLYN AND MANHATTAN.
AND IT IS THE LOGO OF THIS
COURSE BECAUSE IT INDICATES TWO
INDIVIDUALS STANDING ON THE
CATWALK, ONE FROM EACH AREA,
DISCUSSING AN IMPORTANT AREA
ABOUT WHICH EACH HAS AN ENTIRELY
DIFFERENT EXPERIENCE AND
KNOWLEDGE.
AND SO THE WHOLE CONCEPT OF THE
BRIDGING IS ILLUSTRATED IN ALL
OF OUR PROGRAMS OVER THE PAST 21
YEARS.
NOW, ALL OF THE PREVIOUS
SESSIONS ARE ARCHIVED AND YOU
CAN VISUALIZE THEM BY GOING TO
THE LINK AS SHOWN HERE.
IF YOU HAVE ANY ADDITIONAL
QUESTIONS, GET IN TOUCH WITH US
AND WE HAVE LISTED THE
APPROPRIATE LINK.
NOW, WE URGE THE MANY OF YOU WHO
ARE ONLINE HERE AT NIH AND
ELSEWHERE, INCLUDING ABOUT 38
DIFFERENT COUNTRIES OF THE
WORLD, TO SUBMIT QUESTIONS VIA
THE "SEND LIVE FEEDBACK" ON YOUR
VIDEOCAST DISPLAY.
AND AFTER OUR SPEAKERS HAVE
PRESENTED THEIR -- MADE THEIR
PRESENTATIONS, WE WILL HAVE AN
ABUNDANT TIME FOR DISCUSSION OF
QUESTIONS, ANSWERS, PROBLEMS AND
WHATEVER YOU CHOOSE TO BRING UP.
NEXT SLIDE, PLEASE.
NEXT ONE.
OKAY, SO IN THINKING ABOUT
TODAY'S PROGRAM, WHICH CONCERNS
IN ONE SENSE ONE OF THE BROADEST
CHALLENGES FACING ALMOST ALL
ASPECTS OF OUR LIVES INCLUDING
MEDICINE AND HEALTH, AND THAT IS
THE ISSUE OF GLOBAL WARMING.
SO IN THINKING ABOUT IT, THESE
ARE SOME OF THE QUESTIONS I CAME
UP WITH, WHICH I SUSPECT OUR
SPEAKERS WILL ADDRESS.
ARE HUMAN ACTIVITIES INVOLVED?
AND OF ALL THE INFORMATION THAT
WE READ ABOUT AND HEAR ABOUT,
WHAT IS REAL?
AND WHAT IS SORT OF
DISINFORMATION?
IS WARMING INEVITABLE WITH ALL
OF ITS CONSEQUENCES IN ALMOST
EVERY AREA OF BIOLOGY?
IS IT LIKELY TO BE REVERSIBLE?
AND WHAT ARE THE MOST SERIOUS
EFFECTS OF GLOBAL WARMING?
AFFECTS THAT ALSO INFLUENCE
HUMAN HEALTH AND MEDICINE.
AND DO THE EFFECTS COMPOUND, FOR
EXAMPLE, THE CHANGING OF THE
TEMPERATURE OF THE OCEAN, AFFECT
ENVIRONMENTAL ACTORS ON DRY
LAND?
ALSO HOW MUCH WARMING CAN THE
HUMAN BODY ACTUALLY TAKE?
AND DO OTHER SPECIES TOLERATE
WARMING BETTER THAN WE DO?
AND THEN LOOKING TO THE EXCITING
POTENTIAL FRONTIERS, ASIDE FROM
AVOIDING WARMING FROM POLICIES
AND THINGS WE WILL HEAR ABOUT,
ARE THERE WAYS TO
PHYSIOLOGICALLY TO SOMEHOW
INCREASE THE ABILITY OF THE
HUMAN SPECIES TO TOLERATE MORE?
WELL, I AM SURE YOU ALL WILL
HAVE MANY, MANY MORE QUESTIONS
SO WE ENCOURAGE YOU TO PRESENT
THEM AS I INDICATED.
NEXT SLIDE, PLEASE.
SO OUR TWO SPEAKERS -- AND WE'RE
EXTREMELY FORTUNATE TODAY TO
HAVE TWO VISITORS WHO ARE
EXPERTS AT THE TOP OF THEIR
FIELD.
SO THE FIRST SPEAKER IS GOING TO
BE GABRIEL VECCHI WHO RECEIVED
A BACHELOR'S DEGREE FROM ROGERS
AND THEN MASTERS AND PH.D. IN
OCEANOLOGY AT THE UNIVERSITY OF
WASHINGTON.
HE IS PROFESSOR OF GEOSCIENCES
AT PRINCETON AND DIRECTOR OF THE
HIGH MEADOWS ENVIRONMENTAL
INSTITUTE WHICH IS, AS
INDICATED, A MULTIFACULTY
OPERATION CENTER INVOLVING 140
FACULTY IN 30 DIFFERENT
DEPARTMENTS AND ITS WHOLE GOAL
IS TO CREATE A COMPLEX SYSTEM TO
STUDY HOW THE INFLUENCES OF
GLOBAL HEALTH AND GLOBAL WARMING
INFLUENCES HUMAN ACTIVITY.
AND TO TRY AND COME UP WITH
SOLUTIONS TO LOCAL AND GLOBAL
CHALLENGES, ALL BASED ON JUST
ABOUT EVERY RESEARCH AND THIS OF
COURSE IS A RICH AREA FOR
TRAINING FOR FUTURE LEADERS IN
THE MULTIPLE FIELDS THAT ARE
EMBRACED IN THE OVERALL PILOT OF
GLOBAL WARMING.
NOW, HE IS ALSO ASSOCIATE --
DEPUTY DIRECTOR OF THE
COOPERATIVE INSTITUTE FOR
MODELING EARTH SYSTEMS AND THIS
INSTITUTE MODELS CLIMATE
SCIENCE, EXTREME WEATHER EVENTS,
HURRICANES, MECHANISMS OF
PRECIPITATION VARIABILITY, OCEAN
ATMOSPHERE INTERACTION,
DETECTION AND AT TRIBUTION.
WELL, THIS IS A BROAD AREA OF
EXPERTISE AND IS WELL-SUITED TO
SPEAK TO US TODAY ABOUT THE
IMPACT OF EXTREME WEATHER EVENTS
SUCH AS THE HORRIFIC
CONSEQUENCES OF CLIMATE CHANGE
AND EXPECTED DOMINANT DRIVERS OF
EXTREME WEATHER IN THE DECADES
TO COME.
NOW, OUR SECOND SPEAKER IS
MICHAEL SAWKA WHO GRADUATED FROM
EAST STROMBERG UNIVERSITY AND
RECEIVED A PH.D. AT SOUTHERN
ILLINOIS UNIVERSITY.
FOLLOWING POST-DOCTORAL
TRAINING, HE BECAME ULTIMATELY
THE CHIEF SCIENTIFIC OFFICER IN
ENVIRONMENTAL PHYSIOLOGY AND
HYDRATION IN CANTON, GEORGIA.
AND IS NOW AN ADJUNCT PROFESSOR
OF PRACTICE AT THE SCHOOL OF
BIOLOGICAL SCIENCES AND SCHOOL
OF APPLIED PHYSIOLOGY AT THE
GEORGIA INSTITUTE OF TECHNOLOGY.
MICHAEL HAS SPENT 32 YEARS AS A
RESEARCH PHYSIOLOGIST IN THE
U.S. ARMY MEDICAL RESEARCH
DEVELOPMENT COMMAND.
HE SERVED ON MANY IMPORTANT
EDITORIAL BOARDS, SCIENTIFIC
ADVISORY BOARDS, COUNCILS AND
PANELS FOR THE GOVERNMENT,
NONGOVERNMENT AGENCIES.
HE HAS RECEIVED MANY AWARDS FOR
THIS WORK.
AND HE IS AN EXPERT IN
ENVIRONMENTAL HEAT, COLD AND
HIGH ALTITUDE PHYSIOLOGY AND
MEANS TO COPE WITH IT.
SO HE WILL TALK TO US ABOUT
PHYSIOLOGICAL ADAPTATIONS,
MALADAPTATIONS AND ENGINEERING
INTERVENTIONS WITH EXTREME HOT
WEATHER.
SO WE WELCOME BOTH OF YOU TO THE
NIH AND GABI, IF YOU WOULD
PLEASE BEGIN?
>> ALL RIGHT, WELL, THANK YOU,
THANK YOU FOR HAVING ME HERE AND
FOR COMING AND TUNING IN TO THIS
PRESENTATION.
I WILL TRY AND SET A LITTLE BIT
OF THE STAGE FOR HOW IT IS THAT
WE UNDERSTAND CLIMATE CHANGES,
WHAT KIND OF CLIMATE CHANGES
HAVE OCCURRED AND ARE LIKELY TO
CHANGE IN THE FUTURE AND
ESPECIALLY TO CONNECT TO THE
NEXT TALK, A LITTLE BIT OF TIME
TALKING ABOUT HEAT WAVES,
EXTREME HEAT EVENTS.
SO JUST FOCUS ON WHAT THE
CLIMATE SYSTEM IS TELLING US.
NOW, I WILL SAY, LIKE MANY
PEOPLE, I GOT INTO THE FIELD
TRYING TO UNDERSTAND THE CLIMATE
AND ENVIRONMENTAL SCIENCES, NOT
FOR FOCUS ON GLOBAL WARMING OR
EXTREME EVENTS BUT BECAUSE I
THOUGHT IT WAS BEAUTIFUL.
AN OVERWHELMING EXERCISE TO TRY
TO UNDERSTAND THE ENTIRE SYSTEM
AND THAT IS WHY HERE ON THE
SLIDE AT THE BEGINNING, I HAVE A
VISUAL FROM SPACE OF A HURRICANE
BUT IT IS BEAUTIFUL.
AND TO START OUT WITH THE BOTTOM
LINE UP TOP, ALL OF YOU ARE
BUSY, THE GREEN HOUSE INCREASES
IN CO2 IN THE ATMOSPHERE, THESE
ARE DRIVEN BY BURNING FOSSIL
FUELS HAVE WARMED THE PLANET AND
WILL CONTINUE TO DO SO FOR
DECADES AND MAYBE CENTURIES TO
COME, RIGHT?
THERE IS A CERTAIN AMOUNT OF
WARMING YOU ARE COMMITTED TO
ALTHOUGH WE DO HAVE INFLUENCE
BASED ON OUR DECISIONS EXACTLY
HOW MUCH WE WILL GET.
GLOBAL WARMING HAS NOT ONLY
WARMED THE PLANET ON AVERAGE AND
REGIONALLY BUT IT CHANGED THE
ODDS OF CERTIFICATE OF EXTREME
STATISTICS AND IS GIVING US
REGIONAL IMPACTS.
SOME OF THESE CHANGES ARE
RELATIVELY WELL UNDERSTOOD AND
PREDICTABLE GOING INTO THE
FUTURE.
SOME OF THEM ARE NOT, AND WE'RE
WORKING TO UNDERSTAND THEM
BETTER BUT I THINK WE WILL LIVE
IN A WORLD OF SORT OF GROWING
UNCERTAINTY ON REGIONAL AND
EXTREME EVENTS.
AND THE CHANGE IN ODDS IS NOT
JUST SOMETHING FOR THE FUTURE
BUT SOMETHING THAT IS ALREADY
HAPPENING.
WE SEE THE HEAT WAVES AND A FEW
OTHER STATISTICS.
AND THE IMPACTS OF THESE EXTREME
CHANGES ARE REALLY SOMETHING
THAT SET THE STAGE AND MOTIVATE
A SERIES OF RESPONSES OF CLIMATE
CHANGE THAT ARE AVAILABLE TO
SOCIETY.
THESE INCLUDE ADAPTATION,
LEARNING TO LIVE IN A DIFFERENT
CLIMATE FROM THE ONES THAT MAYBE
WE WERE BORN INTO OR OUR PARENTS
GREW UP IN.
IT INVOLVES MITIGATION.
THIS INVOLVES A ENERGY
TRANSITION AND CHANGE IN LAND
USE SO WE CHANGE THE GREENHOUSE
GASES IN THE ATMOSPHERE AND THEN
IDEAS ABOUT CARBON
SEQUESTRATION, REMOVING CARBON
FROM THE ATMOSPHERE,
SEQUESTERING IT, ET CETERA, TO
REVERSE SOME OF THE CLIMATE
CHANGES.
AND THESE I ALSO SAY ARE
ALTERNATIVE STRATEGIES AND MUST
BE WORKED THROUGH BUT IF YOU
WANT TO MAKE CLIMATE CHANGE, YOU
HAVE TO DO OTHER THINGS.
LIKE IF YOU ARE A DOCTOR, YOU
KNOW IF YOU TWIST AN ANKLE, YOU
TAKE SOME IBUPROFEN, WRAP IT,
AND SO IF WE'RE GOING TO CHANGE
WEATHER, THERE ARE KEY ENERGY
RESOURCES.
WE HAVE CARBON SEQUESTERED
MILLIONS OF YEARS AGO TO FUEL
OUR EXPANSION AND GROWTH.
AS WE COME INTO THE FUTURE, WE
WILL GO BACK INTO TODAY'S
WEATHER PATTERNS AND TODAY'S
ENERGY AVAILABILITY.
SO LET'S DEAL WITH SOMETHING
VERY CONTROVERSIAL.
ANYBODY WHO HAS LOOKED AT THIS
AT ANY LEVEL, THE ATMOSPHERE HAS
HAD A GROWTH IN ITS GREENHOUSE
GASES.
THERE ARE MOLECULES IN THE
ATMOSPHERE, CARBON DIOXIDE,
WATER VAPOR, METHANE, THESE ARE
MOLECULES THAT HAVE MULTIPLE,
MORE THAN TWO ATOMS IN THEM AND
ARE VERY EFFICIENT IN ABSORBING
THE LONG WAVES IN THE SPECTRUM.
THE INFRA RED LIGHT WE FEEL AS
HEAT.
AS THE MOLECULE CONCENTRATIONS
INCREASE IN THE ATMOSPHERE, OUR
ABILITY TO RADIATE TO SPACE GETS
LESS EFFICIENT AND THE
CONSEQUENCE OF THAT IS THAT OUR
PLANET WARMS SO THAT IN A WARMER
SPACE, WE ARE EMITTING MORE
ENERGY IN SPACE SO WE CAN COOL
AND BALANCE THE NEXT AIR COMING
IN WHICH MEANS ESSENTIALLY WE
HAVE A GREEN HOUSE.
HERE SHOWING 10,000 BEFORE THE
COMMON AREA, SOME OF THESE DOTS
ARE REINSTRUCTED USING AIR
SAMPLES TRAPPED IN ICE.
OTHERS ARE INSTRUMENTAL SAMPLES
FROM THE AIR TAKEN IN.
AND WHAT THEY HAVE PAID, A VERY
CLEAR PICTURE OF CARBON DIOXIDE
INCREASING IN THE ATMOSPHERE AS
WE REBOUND FROM THE ICE AGES AND
ALSO SOME CHANGES IN LAND USE
BUT OVER THE LAST, SAY, 9000
YEARS, THERE WASN'T MUCH CHANGE
IN GREENHOUSE GAS IN THE
ATMOSPHERE.
AND THEN SINCE ABOUT 1900S,
THERE HAS BEEN AN INCREASE IN
GREENHOUSE GASES.
IT IS CLEAR THIS HAS HAPPENED.
AND WE KNOW BY LOOKING AT THE
ISOTOPIC COMPOSITION IN THE AIR,
IT HAS A SHARP INCREASE IN
MINERALS IN ITS SIGNATURE IN
TERMS OF RADIO ISOTOPES AND
CARBONS FROM A LONG TIME AGO
TAKEN INTO THE ATMOSPHERE.
SO WE KNOW THERE IS BEEN THIS
SHARP INCREASE IN GREENHOUSE
GASES AND CO AND THEY ARE
MINERAL SOURCED.
CARBON DIOXIDE HAS A LIFETIME OF
MILLIONS OF YEARS IN THE
ATMOSPHERE AND DEPENDS ON WHAT
WE WILL ADD TO THAT AND
EMISSIONS IN THE FUTURE.
SO WE ALREADY OWN ESSENTIALLY
THAT LEVEL OF GREENHOUSE GAS
CONCENTRATIONS.
NOW, WE HAVE PURCHASED ON HOW
MUCH MORE RAPIDLY IT WILL
INCREASE GOING FORWARD AND WHERE
WE CAN STABILIZE AND BRING IT
BACK DOWN.
ANOTHER CONTROVERSIAL
STATEMENT -- THE PLANET HAS BEEN
WARMING.
RIGHT?
THERE ARE MULTIPLE WAYS WE CAN
SEE THIS, SHOWN HERE ON THIS
PLOT ONE OF THE CLASSIC WAYS OF
MEASURING WARMTH OF OUR PLANET,
AND IT SHOWS THE TEMPERATURE OF
THE SURFACE OF THE EARTH GOING
BACK TO THE MID-19TH CENTURY
WHERE POSITIVE VALUES INDICATE
THE LINE MOVING UP FROM THE
1850s TO 2020 SHOWS THE PLANET
GETTING WARMER.
THERE HAS BEEN A STEADY WARMING
OF THE PLANET ALTHOUGH YEAR ON
YEAR, YOU CAN SEE THE
TEMPERATURE GOING UP AND GOING
DOWN.
SO IT IS NOT LIKE EVERY YEAR IT
WARMS FROM THE PREVIOUS YEAR BUT
THAT THERE IS A GENERAL
TRANSPORT OF WARMING.
THOSE YEAR OVER YEAR SWINGS ARE
LARGELY KNOWN OR TRANSPORTED BY
EL NINO.
WE'RE CURRENTLY AT THE END OF A
EL NINO YEAR, YOU MAY HAVE
NOTICED THAT IN THE NEWS, AND
2023 WAS THE WARMEST BECAUSE NOT
ONLY DID WE HAVE THE LONGEST
RANGE OF WARMING BUT EL NINO
HAPPENING AT THE SAME TIME.
SO GLOBAL WARMING DOESN'T MEAN A
CESSATION OF WEATHER AND
VARIABILITY, IT IS BECAUSE OF
THE VARIABILITY AND WEATHER WE
WILL HAVE THIS WARMING GOING ON.
WE KNOW A LARGE PART OF WARMING
OF THE PLANET HAS BEEN AN
INCREASE IN GREENHOUSE GASES.
SO THE CLIMATE MODEL WE USE TO
FORECAST EL NINO ARE ABLE TO
RECOVER.
THE WARMING OVER THE 20TH
CENTURY, WHAT WE KNOW ABOUT THE
INCREASING GREENHOUSE GASSES, WE
ARE UNABLE TO DO SO UNTIL WE
LOWER THE GREENHOUSE GASSES.
SO FROM A MECHANISTIC POINT OF
VIEW, WE TRACE THE GREEN HOUSE
GASSES AND FUTURE WARMING WILL
DEPEND ON PAST AND FUTURE
GREENHOUSE EMISSIONS.
THERE IS WARMING ON THE PAST
GREENHOUSE EMISSIONS WE HAVE
ALREADY MADE AND THEN THERE IS
THE FUTURE WARMING ON FUTURE
EMISSIONS.
SO THERE IS WARMING AND THEN THE
DECISIONS WE MAKE CAN CHANGE THE
AMOUNT OF WARMING WE HAVE GOING
FORWARD.
OH, HOW DO WE GO BACK?
THERE WE GO.
OKAY, SO ONE OF THE THINGS WE'RE
VERY PROUD OF IN PRINCETON AND
THE NOAA LAB I USED TO BE AT WAS
WE WERE AT THE BIRTH PLACE OF
THE CLIMATE MODEL.
THIS IS A TOOL THAT ALLOWS US TO
UNDERSTAND THE CLIMATE SYSTEM.
IT IS A MATHEMATICAL
REPRESENTATION OF THE LAWS
GOVERNING THE ATMOSPHERE, OCEAN,
LAND AND SEA ICE AND A TOOL THAT
ALLOWS US TO BOTH UNDERSTAND THE
EARTH SYSTEM.
IT IS SORT OF A MODEL SYSTEM,
SOMETIMES LIKE IN RESEARCH YOU
WILL -- YOU USE FRUIT FLIES IN
THE MODEL SYSTEM OR THERE ARE
THESE MODEL SOMETIMES THAT
REALLY CAPTURE THE ESSENCE OF A
MORE COMPLEX SYSTEM, THAT'S WHAT
A CLIMATE MODEL IS.
AND IN PARTICULAR, THE
INDIVIDUAL PICTURED HERE WITH
HIS STUDENTS ON THE DAY THE
NOBEL PRIZE IN PHYSICS WAS ONE,
2021, THERE WAS THE MODEL AND
NOW A TOOL TO MAKE PREDICTIONS.
ONE OF THE PREDICTIONS THAT CAME
OUT OF THAT IS SHOWN HERE FROM
TWO PAPERS, ONE IN 1980, ANOTHER
IN 1981 WHICH SHOWS THE AMOUNT
OF WARMING YOU PREDICT IN
DIFFERENT PARTS OF THE PLANET IN
RESPONSE TO A DOUBLING OF
GREENHOUSE PASS GEORGIA OR CO2
IN THE ATMOSPHERE.
AND THIS IS A PREDICTION WHICH
HAS NOT BEEN SEEN IN THE DATA
YET, IS THAT THE OVERALL WARMING
OF THE PLANET SHOULD BE MOST
PRONOUNCED IN NORTHERN HIGH
LATITUDES AND OVER LAND.
THAT IS A PHENOMENON KNOWN AS
POLAR AMPLIFICATION.
THE REASONS FOR IT ARE DUE TO
THE FACT THE LAND HAS A LIMITED
CAPACITY TO EVAPORATE SO THEY
WARM UP VERY RAPIDLY AND ALSO
YOU HAVE ICE AND SNOW ON IT
WHICH LEADS TO CONCENTRATED
WARMING.
THIS IS A PREDICTION.
THIS IS THE OBSERVED PATTERN OF
TEMPERATURE CHANGE FROM 2016 TO
2020.
CLASSIC SIGNS.
YOU HAVE MECHANISMS, YOU THINK
YOU UNDERSTAND IT, YOU MAKE A
PREDICTION AND LOOK AT THE DATA
AND COMPARE THAT.
SO IT IS NOT JUST THE SIGN OF
THE TEMPERATURE CHANGE WHICH IS
EITHER POSITIVE OR NEGATIVE, IT
IS A VERY LOW DIMENSION THING TO
GET RIGHT BUT THE STRUCTURE OF
WARMING OUR CLIMATE MODELS HAVE
GOT TEN RIGHT.
THIS IS JUST ONE COMPARISON BUT
THERE ARE MANY OTHERS PEOPLE
HAVE DONE LOOKING AT RAINFALL
CHANGE, CIRCULATION OF OCEAN
CHANGES, ALL OF WHICH GIVE US
CONFIDENCE THAT WE UNDERSTAND
MANY OF THE KEY ASPECTS OF THE
RESPONSE TO INCREASING CLIMATE
GREENHOUSE GAS.
SO I HAVE SPENT HOURS AND HEARS
AND IN FACT WE HAVE MANY CLASSES
THAT GO THROUGH ALL THAT AND IT
IS BEAUTIFUL TO UNDERSTAND.
ONE OF THE KEY EXTREMES IN
CLIMATE ARE HEAT WAVES.
THESE ARE PERIODS OF EXTENDED
EXTREME TEMPERATURE.
WHAT EXTREME MEANS IS, PEOPLE
WILL FIND OUT IN THE NEXT
SESSION IN PARTICULAR, A VERY
TRICKY ISSUE TO DEFINE.
BUT HERE ARE THREE RECENT HEAT
WAVES ALL OF WHICH WERE QUITE
DEADLY.
OVER HERE WAS THE 1995 HEAT WAVE
IN CHICAGO THAT KILLED IN EXCESS
OF 700 PEOPLE.
THEN THE WESTERN EUROPE HEAT
WAVE OF 2003 KILLED OVER 70,000
PEOPLE, RIGHT?
AND THIS IS AN INCREDIBLY DEADLY
DISASTER AND IN PART IT WAS A
HEAT WAVE THAT STRUCK A PLACE
THAT WASN'T USED TO THESE HEAT
EXTREMES.
THERE WAS NOT WIDE VARIETY OF
AIR CONDITIONING AND SUCH SO
THEY WERE SURPRISED WITH
NEGATIVE CONSEQUENCES AND THEN
IN RUSSIA, SIMILARLY, A HEAT
WAVE WHERE 50,000 PEOPLE DIED.
NOW, THERE IS EVIDENCE THAT
PEOPLE ARE ADAPTING.
A MORE RECENT HEAT WAVE IN
WESTERN EUROPE WHERE FATALITIES
WERE LESS WAS PARTLY BECAUSE
THEY HAVE MADE CHANGES IN
RESPONDING TO THE HEAT WAVES SO
THERE IS SOME LIMIT TO ADAPT BUT
I AM CURIOUS AND AS WE WILL GET
TO, WHAT ARE THE LIMITS OF
ADAPTABILITY?
NOW, WEATHER EVENTS HAPPENING
OVER A LONG PERIOD OF TIME,
LARGELY DRIVEN OVER A PROCESS
THAT IS VIEWED AS RANDOM,
ATMOSPHERES IN THE OCEAN AND
ATMOSPHERE THAT ARE
UNPREDICTABLE IN A MATTER OF
DAYS AND ONE OF THE WEATHER
PHENOMENONS THAT IS KNOWN FOR A
HEAT EVENT IS BLOCKING AREAS OF
HIGH WHERE THE HIGH PRESSURE
WILL SET UP STAGES ARY OVER
LAND, ASSOCIATED WITH DRY AIR SO
SUNLIGHT CAN COME IN, THE AIR
WARMS AND THEN FEEDBACK MAKES
THINGS STAGNATE AND IT WILL
BECOME WARMER AND WARMER SO IT
WILL BE STICKY THERE A FEW DAYS
AND HAVE AN IMPACT.
OUR UNDERSTANDING IS THAT HEAT
EVENTS WITH SPECIFIC BLOCKING
HIGHS ARE THE BEST UNDERSTOOD
RANDOMLY-OCCURRING ISSUE BUT WE
THINK THE INCREASING ODDS OF
HEAT WAVES DUE TO CLIMATE CHANGE
IS GOING TO BE EVIDENCE IN THE
NUMBER OF HEAT WAVEEVENTS BUT
CAN'T TELL YOU WHICH YEAR OR DAY
IT WILL GO FORWARD.
SO IN RUSSIA, YOU HAVE THIS
CLASSIC BLOCKING HIGH PATTERN.
YOU SEE IT HERE ON THE
MID-ATMOSPHERIC HIGH PRESSURE.
THE RED BLOB THERE TELLING YOU
THE MIDDLE OF THE ATMOSPHERE
WEIGHS ABOUT 1000 MILLIBARS, YOU
HAVE MORE HIGH PRESSURE, HIGHER
THAN USUAL AND BELOW THE
MICHIGAN SYSTEM, YOU SEE THIS
VERY LARGE SURFACE TEMPERATURE
ANOMALY, 6 DEGREES CELSIUS AND
HIGHER WHICH IS 10 DEGREES
FAHRENHEIT OR MORE, RIGHT?
SO FOR A NUMBER OF DAYS THE
TEMPERATURE IN THE SUMMER WAS
MORE THAN 10 DEGREES FAHRENHEIT
HIGHER THAN IT TYPICALLY IS.
SO THAT GIVES YOU A BIG EFFECT.
NOW, THERE ARE ALSO FACTORS THAT
MAKE THE URBAN ENVIRONMENT FEEL
A HEAT WAVE DIFFERENTLY THAN THE
SURROUNDING WORLD ENVIRONMENT,
RIGHT?
AND IN PARTICULAR WE HAVE
IMPERVIOUS SURFACES, WE HAVE
DARK SURFACES AND SO ARE ABLE TO
ABSORB MORE OF THE WATER ON LAND
AND DRY ITSELF.
OCEANS HAVE AN INFINITE ABILITY
TO SWEAT, LAND DOES NOT SO WE
PUT ON A WARM SWEATER, RIGHT?
WE ALSO HAVE DARK SURFACES.
TYPICALLY THEY ARE DARKER AND
VISIBLE, ABSORB MORE LIGHT FROM
THE SUN THAN THE SURROUNDING
NATURAL ENVIRONMENT AND ALSO
BLOCK THE CIRCULATION OF AIR
THAT CAN HELP COOL THINGS OFF.
AND THEN ONE OF THE RESPONSES TO
WARMING IS TO RUN AIR
CONDITIONING.
NOW, AIR CONDITIONING DOESN'T
CREATE COLD OUT OF NOTHING,
RIGHT?
SO THE FIRST AND SECOND LAW OF
TH*ERPLODYNAMICS, THERE IS A NET
HEATING OF THE ENVIRONMENT WHEN
YOU RUN A AIR CONDITIONER.
AS THE OVERALL TEMPERATURE
INCREASES, THE TEMPERATURE WILL
GO DOWN SO ALL OF THESE FACTORS
MAKE IT SO HEAT WAVES ARE MORE
PRONOUNCED IN URBAN AREAS.
THIS IS ALL ON THE WEATHER AND
LOCAL FACTORS SURROUNDING HEAT
WAVES BUT YOU CAN THINK OF HEAT
WAVES AS THE EVENT LYING ON THE
FAR OUTER TAIL OF DISTRIBUTION
OF TEMPERATURES ON LAND -- YOU
CAN SORT OF SEE THAT CARTOON
THERE -- NOT A CARTOON, THAT IS
ACTUAL REAL DATA IN TEMPERATURE
DEVIATION ALL AROUND THE WORLD
FROM AFFECTED VALUE AND YOU GET
THIS CLASSIC BELL SHAPED CURVE.
THE HEAT WAVE EVENT IS FARTHERON
THE RIGHT.
WHEN YOU WARM THE PLANET OVER
THE LAST SEVERAL DECADES, THE
DIFFERENCE BETWEEN THE BLUE AND
THE RED, WE SHIFTED TEMPERATURE
BY MAYBE A DEGREE OR SO WHICH
NONE OF US WOULD RECOGNIZE A
DEGREE SHIFT, WELL, MAYBE THE
MOST SENSITIVE ONES MIGHT.
BUT WHAT WE HAVE DONE IS
INCREASE THE PROBABILITY OF THE
MORE EXTREME EVENTS.
BECAUSE WHEN YOU SHIFT NORMAL
DISTRIBUTION, YOU END UP
SHIFTING THE TAIL FROM WHAT
WOULD HAVE BEEN OBVIOUS THINKING
ABOUT THE MIDDLE OF THE CHANGE.
RIGHT?
SO ANOTHER CONSEQUENCE, WHEN YOU
WARM THE AIR, AIR CAN HOLD MORE
MOISTURE.
YOU SEE EVIDENCE OF THIS IF YOU
EVER SORT OF GO OUTSIDE IN THE
SUMMER.
HERE IN MARYLAND, YOU WILL DO IT
WITH A COLD DRINK AND YOU CAN
SEE THE WATER WILL FROST THE
OUTSIDE OF YOUR DRINK.
THAT IS EVIDENCE OF HIGH
MOISTURE AND WARM AIR COMING
INTO CONTACT WITH YOUR COLD
SURFACE AND LOSING ITS ABILITY
TO HOLD WATER AS COLD AIR GOES
DOWN.
AS WE WARM THE ATMOSPHERE, WE
MAKE IT MORE ABLE TO HOLD WATER.
THAT DOES TWO THINGS.
NUMBER ONE, IT INCREASES THE
INTENSITY OF THE MOST RAINY
EVENTS BECAUSE WHEN THE AIR
COMES TOGETHER, IT IS MORE
MOIST, CAN DROP MORE WATER.
THE OTHER THING IS THAT AIR IS
MORE EFFECTIVE WHEN IT IS
WARMER.
SO MOVING AIR FROM DRY PLACES TO
WET PLACES.
SO WHAT THAT MEANS IS THAT DRY
PLACES AND DRY TIMES BECOME
DRYER, RIGHT?
SO A COUNTERINTUITIVE EFFECT OF
THE WARM MOIST ATMOSPHERE IS
THAT DROUGHT ALSO INCREASES AND
THIS IS THE PHENOMENON THAT IS
DESCRIBED AS THE WET GET WETTER,
THE DRY GET DRIER, A VERY ROBUST
RESPONSE TO WARMING.
SO HERE YOU SEE THE CHANGE IN
CONSECUTIVE DRY DAYS AND MANY
AREAS IN THE WORLD ARE EXPECTED
TO HAVE BIG INCREASES IN DRYING.
DRY TIMES TEND TO BE WARM TIMES,
OKAY?
NOW, IT IS NOT JUST FOR THE
FUTURE THAT WE EXPECT THESE
THINGS WITH HEAT DISTRIBUTION.
HERE ARE SOME BEAUTIFUL MAPS
MADE BY NASA OF SOME VERY
CHALLENGING TIMES.
THESE ARE HEAT WAVES THAT
OCCURRED OVER THE LAST FEW
YEARS.
SOME OF YOU MAY RECALL IN THE
PACIFIC NORTHWEST HEAT WAVE OF A
COUPLE YEARS AGO WHERE SORT OF
THE TARMAC IN A FEW AIRPORTS IN
THE PACIFIC NORTHWEST GOT SOFT.
TEMPERATURES PEOPLE NEVER
EXPERIENCED, THERE IS NOT
WIDESPREAD AVAILABILITY OF AIR
CONDITIONING IN SEATTLE, TACOMA,
PORTLAND OR VANCOUVER SO THERE
WAS A LOT OF ADVERSE HEALTH
EFFECTS AS PEOPLE WERE EXPOSED
TO TEMPERATURES THEY WEREN'T
USED TO.
ALSO LIVESTOCK AND PLANTS
SUFFERED AS WELL.
THERE WAS A VERY BROAD SCALE
HEAT EVENT IN APRIL 2022.
YOU CAN SEE OVER HERE -- I THINK
I CAN POINT TO THIS, MAYBE?
YOU SEE THESE OTHER
TEMPERATURES, TWO METER AIR
TEMPERATURES IN EXCESS OF
40 DEGREES CELSIUS.
THAT IS ABOUT 98. 98.6
FAHRENHEIT, BODY TEMPERATURE AND
SO YOU WILL NOT BE ABLE TO SWEAT
SO REALLY INTERESTING CHALLENGES
TO LIVE WITH AND THEN OVER THE
SUMMER, MUCH OF THE UNITED
STATES WAS UNDER PERSISTENT HEAT
FOR A NUMBER OF WEEKS.
I THINK HERE IN MARYLAND IT WAS
WARM BUT NOT AS WARM AS OTHER
PLACES BUT IF YOU WERE IN TEXAS,
OKLAHOMA, ARIZONA, FLORIDA, AND
THE IMPACT OF THESE HEAT WAVES
TEND TO BE FELT MOST STRONGLY BY
THE PEOPLE WHO HAVE THE LEAST
RESOURCES TO ADAPT.
SO THE UNHOUSED, BOOM -- PEOPLE
WHO ARE TRANSITIONING AND DON'T
HAVE A LOT OF ACCESS TO AIR
CONDITIONING, PEOPLE WHO ARE
ALREADY IN PRECARIOUS SITUATIONS
TEND TO GET EXPOSED TO EXTREME
HEAT AND I MIGHT UNDERSTAND THE
UNDERLYING CONDITIONS IN THOSE
POPULATIONS ISN'T GOING TO BE
THE SAME AS THE RANDOM SAMPLING
OF THE POPULATION.
SO AS YOU MIGHT EXPECT, THERE IS
SORT OF A COMPOUNDED EFFECT
THROUGH OUR SOCIAL STATES,
RIGHT, ECONOMIC STATES.
NOW THESE HEAT WAVE EVENTS,
THROUGH THE USE OF CLIMATE
MODELS AND LONG-TERM RECORDS OF
DATA, AS A SCIENTIFIC COMMUNITY,
WE ARE STARTING TO BE ABLE TO
ATTRIBUTE THEM TO DO CLIMATE
CHANGE, ATTRIBUTE THEIR
INCREASED ODDS.
SO THERE IS A GROUP WHERE WHEN
THERE IS AN EXTREME EVENT WILL
TRY TO ASSESS THE ROLE CLIMATE
CHANGE MAY HAVE HAD AND VERY
OFTEN WE FIND THE SIGNATURE OF
CLIMATE CHANGE, GLOBAL WARMING
IN THE HEAT EVENTS.
FOR EXAMPLE, THIS IS A STUDY
PUBLISHED IN MAY 2022 THAT FOUND
THE HEAT WAVE EVENT THAT
HAPPENED IN PAKISTAN AND INDIA A
FEW WEEKS EARLIER HAD BEEN MADE
30 TIMES MORE LIKELY BY CLIMATE
CHANGE.
THAT IS NOT TO SAY IT WAS
CAUSED, RIGHT, BUT FOR CLIMATE
CHANGE THERE WOULD BE NO HEAT
WAVE EVENT IN PAKISTAN BUT THE
ODDS WERE CHANGED.
AND IN FACT SOME OF THE LANGUAGE
WE TAKE FROM EPIDEMIOLOGY WITH
FLOW RATES, MAY BE SOMETHING YOU
ARE FAMILIAR WITH.
IT IS NOT JUST GLOBAL WARMING
AFFECTING HEAT EVENTS.
OTHER GLOBAL FACTORS EXACERBATE
AND COMPLICATE EXTREME.
IN INDIA, THERE WAS A HEAT WAVE
IN 2019 BUT COUNTER VAILING THE
EFFECT OF GREEN HOUSE EVENTS ON
THAT PARTICULAR EVENT WAS THE
RESULT OF POLLUTION SOOT THAT
BLOCKS SUNLIGHT, THAT REDUCED
THE INTENSITY OF THE HEAT WAVE
AND ALSO IRRIGATION WHICH
ARTIFICIALLY INCREASES THE
AMOUNT OF MOISTURE ON THE
SURFACE OF THE EARTH SO IT CAN
SWEAT MORE, DECREASED THE
AMPLITUDE OF THIS HEAT WAVE.
SO AS WE TRY TO DECREASE THE
HEAT WAVES, WE HAVE TO
UNDERSTAND THESE COMPOUNDING
FACTORS.
SO NORMALLY YOU HAVE A NUMBER OF
FACTORS THAT WOULD PRODUCE THE
HEAT WAVE AND THEN THE OTHER
FACTORS THAT WILL ACTUALLY
MITIGATE THE HEAT WAVE.
NOW, IT IS NOT JUST HOT
TEMPERATURE EXTREMES THAT ARE
AFFECTED BY HEAT WAVES.
IT CAN STILL GET COLD IN THE
WINTER BUT NOT GETTING AS COLD
AS IT USED TO BE.
SO PLOTTED HERE IS THE TRENDS
SHOWN ON THE COLDEST DAY OF THE
YEAR AND THE WAY THIS IS SCALED
IS THE VALUE IS HOW MUCH MORE --
HOW MANY TIMES MORE THAN THE
GLOBAL WARMING WE HAVE SEEN DOES
THE TEMPERATURE OF THE COLDEST
DAY OF THE YEAR GO UP BY.
SO THESE DARKER BROWN -- SORT OF
BROWN AND BRIGHT RED MEANS THE
LOCAL COLDEST DAY OF THE YEAR
GOT WARMER AT A RATE SOMEWHERE 4
TO 5 TIMES THE RATE OF GLOBAL
INCREASE OF TEMPERATURE.
AND WHAT YOU CAN SEE IS OVER
MUCH OF THE EX TROPICAL LAND,
THE COLDEST DAY OF THE YEAR HAS
GOT TEN COLD THREE TO FIVE TIMES
AS MUCH AS THE PLANET HAS
WARMED.
THIS, YOU REMEMBER WHEN I SHOWED
THIS POLAR AMPLIFICATION?
THIS IS IN PART DUE TO POLAR
CAMP -- AMPLIFICATION AS MOST
OF THE WARMING OCCURS OVER LAND
AND THEN SOME OF IT HAS TO DO
WITH MELTING OF SNOW AND ICE
BECAUSE IT IS WARMER THAN
BEFORE.
SO IT CAN STILL GET COLD.
THIS HAS AN EFFECT ON THE VECTOR
WARMING OF THE ATMOSPHERE.
TICKS DON'T GO DORMANT LIKE THEY
DO WHEN IT IS COLDER SO WALKING
IN THE WOODS, I GOT A TICK AND
THEREFORE THE EXPOSURE TO LYME,
ROCKY MOUNTAIN FEVER, ET CETERA.
NOW, RSV, RESPIRATORY VIRUS, A
DIRECTLY TRANSMITTED RESPIRATORY
DISEASE.
IT IS I BELIEVE THE LEADING
CAUSE OF DEATH UNDER CHILDREN
UNDER 2 IN THE UNITED STATES.
IT IS SORT OF -- MOST PEOPLE
HAVE HAD IT AT SOME POINT.
IT IS LIKE A COLD THAT HITS YOU
LATER IN LIFE BUT CAN BE QUITE
SERIOUS IF IT GETS TO YOU EARLY
AND IT IS A DISEASE THAT YOU CAN
SEE ITS TRANSMISSION RATE
DEPENDS BOTH ON HUMIDITY AND
ALSO THE AMOUNT OF RAIL AND IT
HAS THIS U-SHAPE WHERE DRY AIR
INCREASES TRANSMISSION, SIMILAR
TO INFLUENZA, RIGHT, AND ALSO
VERY RAINY WEATHER TENDS TO
INCREASE TRANSMISSION RATES.
SO THERE ARE THESE LARGER
PATTERNS OF WHEN THE ONSET WEEK
OF RSV IS IN DIFFERENT PARTS OF
MEXICO AND THE UNITED STATES,
WHERE IT IS OCCURRING EARLIER IN
MORE TROPICAL REASONS AND THIS
TENDS TO BE ASSOCIATED WITH
HEAVY RAINFALL AND OCCURRING
LATER IN THE YEAR WITH DRYNESS
IN THE AIR.
AS THE PLANET WARMS, YOU GET AN
INCREASE IN WARMTH WHICH CAN
INCREASE THE RATE OF
TRANSMISSION IN TROPICAL REGIONS
BUT ALSO A MOIST THINNING OF THE
AIR IN HIGH LATITUDES SO YOU END
UP GETTING THIS REDISTRIBUTION
FROM THE HIGH LATITUDES TO THE
LOW LATITUDES AND IT ALSO
CHANGES THE SHAPE.
IT MOVES FROM A MORE CHAOTIC,
BENNIAL CHANGE IN REGIONS TO A
MORE ANNUAL CYCLE.
NOW, DROUGHT IS ANOTHER THING
WE'RE CONCERNED ABOUT.
THIS IS IN CALIFORNIA AND AFTER
THE PERSISTENT DROUGHT IN THE
U.S. IN THE LAST DECADE OR SO,
YOU CAN SEE FOLSOM POND.
CAN'T RUN FOR HYDRATION ANYMORE,
THEN WHEN YOU HAVE THE STAGNANT
WATER THERE, YOU HAVE THINGS
GROWING IN THERE.
SO FOR A WHILE NOW MODELS HAVE
PROJECTED THE SOUTHWESTERN U.S.
TO TRANSITION TO A MORE ARID
CLIMATE, THIS IS A SERIES OF
PREDICTIONS FOR ARIDITY IN THE
WESTERN UNITED STATES AND YOU
CAN SEE THE PREDICTION OF A
TRANSITION TO A MORE ARID STATE
AS CLIMATE WARMS, THE AIR IS
MORE CAPABLE OF REMOVING
MOISTURE FROM THE AIR IN THE
SOUTHWEST.
AND IN FACT THE ANALYSIS OF
ARIDITY IN THE WESTERN UNITED
STATES HAS FOUND THAT THE
EXTREME ARID PERIOD OVER THE
LAST DECADE OR SO IN THE WESTERN
UNITED STATES IS EXACERBATED BY
GLOBAL WARMING BUT NOT ENTIRELY
DUE TO GLOBAL WARMING.
THOSE WHO KNOW THE HISTORY OF
THE UNITED STATES KNOW THERE
HAVE BEEN DROUGHTS GOING BACK IN
TIME BUT THE CURRENT ENVELOPE IS
PAST THE ENVELOPE OF THE PAST
DROUGHT AND INCREASE DUE TO
GLOBAL WARMING.
SO NOT JUST THE DRY STEAMS
AMPLIFIED BY GLOBAL WARMING BUT
ALSO WET EXTREMES.
HERE HURRICANE HARVEY, A BIG
LANDFALL IN HOUSTON DUMPED ABOUT
THREE TIMES THE AVERAGE 3-DAY
RAINFALL OVER HOUSTON IN A 3-DAY
PERIOD, DUMPED A WHOLE SEASON'S
WORTH OF RAIN OVER HOUSTON.
MULTIPLE STUDIES WERE ABLE TO
SHOW THE ODDS OF THAT KIND OF
HARVEY'S RAINFALL IS DUE TO
GLOBAL WARMING AND WE THINK THE
WARMING WE WILL GET IN THE
FUTURE WILL BE LARGER THAN
WARMING IN THE PAST.
NOW, IT IS NOT JUST GLOBAL
WARMING TO KNOW HOW THE HOUSTON
AREA HAS CHANGED.
ANYBODY WHO HAS BEEN TO HOUSTON
WILL SEE IT IS A VERY
WELL-DEVELOPED URBAN ENVIRONMENT
AND AS THE WIND BLOWS OVER THE
BUILDINGS, THEY ACT AS
MOUNTAINS.
THEY GENERATE MOTION IN THE AIR
THAT TENDS TO PUSH THE AIR
UPWARD AND MAKE IT RAIN.
SO THIS STUDY HERE WAS ABLE TO
SHOW IN ADDITION TO THE HUMAN
INDUCED EFFECT OF GLOBAL WARMING
ON HARVEY'S RAINFALL, YOU HAVE
THE EFFECT OF URBANIZATION THAT
CONCENTRATED RAINFALL OVER
HOUSTON BUT ALSO CON TRADED
FLOODING OVER HOUSTON AS THE
WATER COULDN'T INFILTRATE ON THE
GROUND AND RAN OFF ALONG PAVED
AREAS.
SO THE URBANIZATION INCREASED
THE ODDS OF FLOODING BY A FACTOR
OF 20 AND THESE TWO FACTORS,
GLOBAL WARMING AND URBANIZATION
COMBINED LINEARLY MADE FLOODING
40 TIMES MORE LIKELY FROM BOTH
URBANIZATION AND GREENHOUSE GAS
EMISSION.
WE EXPECT THE INTENSITY OF
HURRICANES MAKING LANDFALL IN
THE U.S. IS GOING TO CONTINUE TO
INCREASE AS WE GO FORWARD IN THE
21ST CENTURY, INCLUDING THE
POTENTIAL FOR UNPRECEDENTED
CATEGORIES, 3, 4, 5, THE MOST
EXTREME HURRICANES, IN THESE
BLACK AREAS.
SO PLACES LIKE MAINE THAT DON'T
NORMAL LY RECEIVE HURRICANES
WILL SEE MORE OVER A CENTURY AND
THAT WILL POSE A CHALLENGE
BECAUSE THE INFRASTRUCTURE ISN'T
ADAPTED TO THESE EXTREME STORMS
AND IT IS A QUESTION AS TO HOW
TO ADAPT TO THIS.
ALTHOUGH IT IS NOT CLEAR WHETHER
WE SEE THE IMPACT OF GLOBAL
WARMING ON PLANET HURRICANES IN
PART BECAUSE THE POST WORLD WAR
II INDUSTRIAL BOOM IN EUROPE AND
NORTH AMERICA WAS FUELED BY COAL
WHICH DUMPED A BUNCH OF SOOT
OVER THE OCEAN WHICH SEEMS TO
MASK DAYLIGHT.
CLEAN AIR REGULATIONS HAS
REMOVED THAT SOOT.
SO AT THE SAME TIME WHEN
WIDESPREAD AVAILABILITY LED
PEOPLE TO MOVE TO OTHER
LOCATIONS, WE MASKED IT AND NOW
WE HAVE UNMASKED IT AND SO I
THINK WE WILL SEE THE POTENTIAL
OF STRONGER HURRICANES GOING
FORWARD.
ONE OF THE WAYS TO CHANGE THE
WARMING WE WILL GET IN THE
FUTURE IS TO REUSE IT GREENHOUSE
EMISSIONS.
THAT WILL BE TO CHANGE THE
ECONOMY FROM FOSSIL FUELS TO
SOLAR BASED FUELS AND THE
PROBLEM IS AS WE GO INTO CERTAIN
CLIMATES, WE'RE TRANSITIONING
FROM A ENERGY SOURCE THAT CARED
ABOUT THE WEATHER MILLIONS OF
YEARS AGO TO AN ENERGY SOURCE
HERE, YOU KNOW, DAMNS, WIND
FARMS, THAT CARE ABOUT TODAY'S
WEATHER OR THE WEATHER RECENTLY,
RIGHT?
SO WE'RE GOING TO HAVE -- MOVE
FROM A PLACE WHERE WE ARE
DECOUPLED FROM THE WEATHER FOR
ENERGY IN SOME WAYS TO MOVE TO A
PLACE WHERE WEATHER AND ENERGY
WILL BE TRULY LINKED.
SO IN SUMMARY, GREEN HOUSE GAS
INCREASES, BOTTOM LINE AT THE
TOP, HAVE CONTINUED TO WARM OUR
PLANET.
WE HAVE PURCHASED BASED ON HOW
MUCH.
SOME EVENTS ARE UNDERSTOOD AND
PREDICTABLE, OTHERS ARE NOT AND
WE WILL HAVE TO LEARN HOW TO
LIVE IN THE SOMEWHAT CHANGING
WORLD THAT IS UNPREDICTABLE.
THE IMPACT FOR ENERGY
TRANSITION, CLIMATE
SEQUESTRATION AND THE TWO
CARTOONS I HAVE HERE, THE PAST
AND THE FUTURE, WE DON'T
UNDERSTAND THE PAST BUT ARE
GETTING A BETTER SENSE FOR THEM
WITH THESE DIE AND THEN IN THE
FUTURE, NOT ONLY DO WE HAVE THE
LOADING BUT MAY CHANGE THE SHAPE
OF THE DIE WE HAVE TO WORK WITH,
TO LIVE AND UNDERSTAND HOW THE
ATMOSPHERE WORKS TO MAKE
PREDICTIONS TO BETTER LIVE IN
THAT WORLD SO WITH THAT, I WILL
STOP AND THANK YOU.
>> THANK YOU VERY MUCH, GABRIEL.
SO NOW WE WILL HEAR FROM Dr.
SAWKA.
>>> ALL RIGHT, THANK YOU, IT IS
A PLEASURE TO BE HERE TODAY.
TODAY I HAVE BEEN CHARGED TO
PROVIDE A HIGH-LEVEL OVERVIEW OF
HUMAN EXPOSURE TO EXTREME HEAT.
AND THE OUTLINE I AM GOING TO
FOLLOW TO DO THIS IS FIRST TO
ADDRESS WHAT IS DRIVING THE HOT
WEATHER, THE PHYSIOLOGY OF THE
STRESS AND WE WILL SPEND TIME ON
THIS BECAUSE IT IS IMPORTANT TO
UNDERSTAND THAT INFORMATION.
ADAPTATION TO CHRONIC HEAT
STRESS, HYPERTHERMIA INDUCED
WORK IMPAIRMENTS AND I WILL
SPEND QUITE A BIT OF TIME ON
SERIOUS HEAT ILLNESS AND THEN
BIOENGINEERING TO MANAGE
KOUPGSAL HEAT STRAIN.
SO I WILL BE LOOKING AT THE
BIOPHYSICS, PHYSIOLOGY, ADAPTO
PHYSIOLOGY.
SO WHAT IS EXTREME WEATHER?
WE HAVE AN ELDERLY WOMAN AT THE
TOP SITTING IN FRONT OF A FAN.
EXTREME HOT WEATHER FOR HER MAY
BE DIFFERENT THAN A YOUNG ADULT
WORKING PROTECTIVE EQUIPMENT
WORKING OUTDOORS.
OR AN ELITE ATHLETE WEARING
HEAVY CLOTHES IN THE HEAT.
SO IT DEPENDS ON THE PERSON,
ACTIVITY LEVEL AND CLOTHING.
AND WE'LL TALK A LITTLE ABOUT
THAT IN THE NEXT FEW SLIDES.
THE FIRST SLIDE I WILL SHOW TO
DISCUSS THIS IS WHAT IS CALLED A
PSYCHOMETRIC CHART.
THE PSYCHOMETRIC CHART USED BY
HEATING AND VENTILATION
ENGINEERING TO EMPHASIZE THE
RESISTIBILITY.
YOU CAN SEE YOU HAVE A PLOT OF
DRY TEMPERATURE AND THEN SOME
MEASURE OF HUMIDITY.
AND WHAT WE HAVE THEN IS
DIFFERENT AREAS OF THERMAL
COMFORT BASED ON THE INDEX OF
EFFECTIVE TEMPERATURES.
AND YOU CAN SEE SOME AREAS ARE
SLIGHTLY UNCOMFORTABLE, WE WILL
LOOK AT THE AREAS THAT ARE
DEEMED TO BE UNCOMFORTABLE AND
THEN IN THE HIGHER LEVELS, YOU
CANNOT THERMAL REGULATE AS MUCH
AS YOU NEED.
SO THIS AREA OF THE CHART IS
BASED ON THE AMOUNT OF CLOTHES I
HAVE ON AND WHAT IS INTERESTING
IS Dr. HARDY IN THE 50s
CHARTED MILITARY HEAT STROKE
DEATHS AND THIS CHART FALLS INTO
AN AREA OF 35 FOR AREAS
UNCOMFORTABLE.
SO WE'RE SATURDAYSING THOSE
LIGHTLY DRESSED WITH MINIMAL
ACTIVITY, NOT EXTREMELY
UNCOMFORTABLE BUT FOR A ACTIVE
PERSON COULD BE CATASTROPHIC.
NOW MOVING FROM THIS CHART TO
SOME RECENTLY PUBLISHED DATA AND
THIS COMES OUT OF THE PENN STATE
LABS AND AGAIN WE HAVE THE IDEA
OF THE PSYCHOMETRIC CHART WITH
WET AND DRY FALL AND TAKE INTO
EFFECT THE MINIMAL ACTIVITY AND
THIS WOULD BE LIKE YOU WORKING
IN YOUR RESEARCH LABORATORY,
MOVING AROUND, NOT SWEATING AS
YOU WORK AND THEY WANT TO DEFINE
THE UPPER LIMITS TO THERMO
REGULATE, WHAT IS THE EXTREME.
SO HERE WE HAVE THE VALUES FOR
YOUNG INDIVIDUALS.
NOW, THEY ALSO GOT A GROUP OF
HEALTHY OLDER INDIVIDUALS --
SHOULDN'T SAY HEALTHY BECAUSE I
AM IN MY 70s, HAD THEM SITTING
IN THE CHAMBERS TO SEE THEIR
ABILITY TO THERMOREGULATE.
SO YOU SLIGHTLY INCREASE THE
ACTIVITY, GET A OLDER INDIVIDUAL
WHO IS BASICALLY STILL VERY
HEALTHY AND FIT WE BELIEVE AND
THE BIOPHYSICAL LIMITS OF THE
CHANGE OF WHAT WOULD BE
CONSIDERED UNCOMFORTABLE FOR A
YOUNG PERSON AND THEIR ABILITY
TO THERMOREGULATE.
SO YOU HAVE TO LOOK AT THE
CONDITIONS INVOLVED.
THE OTHER WAY WE LOOKED AT THIS,
THE THERMALIZATION WHERE THEY
PLOT THE TEMPERATURE AND
RELATIVE HUMIDITY.
THIS IS WHERE THEY STARTED
GETTING HOSPITALIZATION, NOT
MUCH MORBIDITY INVOLVED.
AND THEN THE LOWER PART OF THE
SLIDE THEY ARE SEEING MORE
MORBIDITY.
HERE AGAIN, THAT AFFECTS
TEMPERATURE, 35 DEGREES, WHICH
IS UNCOMFORTABLE.
SO AS POINTED OUT, THE
VULNERABLE POPULATION,
POPULATIONS MAYBE BASED ON
WEATHER REPORTING DATA AND
PEOPLE MAYBE THAT WERE IN AN
AREA THAT HAD EXTREME HEAT BUT
THESE INDIVIDUALS WHO WE WOULD
DESCRIBE AS BEING SLIGHTLY
UNCOMFORTABLE ARE STARTING TO
SEE LARGE NUMBERS OF MORTALITY
OCCUR.
SO AS YOU CAN SEE THERE IS NO
ONE IDEA OF WHAT EXTREME MEANS.
IT DEPENDS ON WHO YOU ARE.
THERE ARE OTHER APPROACHES I
WILL SHOW QUICKLY, FOR EXAMPLE,
OCCUPATIONALLY.
THIS IS FROM THE WORLD HEALTH
ORGANIZATION.
THEY DON'T LOOK AT YOUR ABILITY
TO THERMOREGULATE BUT HOW LONG
YOU CAN SUSTAIN FOUR HOURS OF
WORK IN EXTREME HEAT.
SO AS YOU WORK HARDER, THE WBGT
INDEX, IT GETS LOWER, YOU HAVE
TO GO TO COOLER WEATHER AND HERE
IS THE EFFECTS OF
ACCLIMATE-IZATION.
SO YOU HAVE TO ADJUST MORE AS WE
GET INTO THE LOWER ABILITY.
SO THERE IS NO ONE WAY TO
REGULATE AND WE COULD SPEND DAYS
TALKING ABOUT IT.
NOW A CARTOON THAT CAN SHOW YOU
THE HEAT WHEN WE WORK AND I
THINK THIS IS IMPORTANT WHEN WE
GET TO PATHOLOGY.
HUMANS WHEN WE HAVE A METABOLISM
OF 100WANNUAL TTS OF A LIGHT
BLUSH, YOU PRODUCE MORE HEAT AND
AS WE INCREASE OUR EXPENDITURE,
ONLY ABOUT 20 PERCENT GOES INTO
WORK.
UNDER 80 PERCENT IS RELEASED AS
METABOLIC HEAT THAT THE BODY HAS
TO DISTANCE.
SO AS YOU INCREASE ACTIVITY, YOU
INCREASE THE AMOUNT YOU HAVE TO
DISSIPATE.
SO THIS IS CALLED DRY HEAT SKIN.
YOU WARM THE SKIN AS YOU
INCREASE TEMPERATURE GRADIENT
FROM THE SKIN FOR HEAT LOSS.
THE SECOND MECHANISM IS
SWEATING.
IT EVAPORATES AT THE SKIN, THE
SKIN COOLS FROM EVAPORATION AND
BLOOD BEING BROUGHT TO THE SKIN
COOLS THE BODY.
NOW, DEPENDING ON THE
ENVIRONMENT, HOW YOU USE THAT IS
GOING TO VARY.
BUT THIS IS AN IMPORTANT POINT.
REGARDLESS OF HOW THE SYSTEM
WORKS, YOU ALWAYS HAVE TO
ACHIEVE A STEADY-STATE
TEMPERATURE, THAT IS JUST HOW IT
IS.
SO THE BODY WILL REGULATE TO
BRING TEMPERATURE DOWN TO
ACHIEVE SOME STEADY STATE CORE
TEMPERATURE.
SO HOW IS THE STEADY STATE CORE
TEMPERATURE IMPACTED AND WHAT
LEADS TO MISPERCEPTIONS BECAUSE
WE HAVE SEEN MANY MISPER S-PGSZ
IN THE MEDICAL AND PHYSIOLOGICAL
WORLDS.
SO WE HAVE A DRY CLIMATE, OKAY,
AND REST.
MODERATE WORK, YOU HAVE A WET
CLIMATE AND MODERATE WORK.
I AM NOT VERY GOOD AT THIS.
WE ALSO HAVE DIFFERENT
ENVIRONMENTAL CONDITIONS GOING
FROM A COOL TO 40 DEGREES
ENVIRONMENT.
SO IF I AM RESTING IN A DRY
ENVIRONMENT AND CAN HAVE
EVAPORATIVE HEAT LOSS, THERE IS
NOT MUCH CHANGE IN MY CORE
TEMPERATURE.
WHAT IF I AM DOING WORK?
MY BODY TEMPERATURE IS GOING TO
RISE, IT WILL TAKE A WHILE
BEFORE YOU SEE THE STORE RAGE OF
HEAT BUT I CAN SEE A SLIGHTLY
HIGHER CORE TEMPERATURE.
WHAT HAPPENS IF I GO TO A WET
CLIMATE?
HERE I HAVE A INDIVIDUAL AT
REST, OKAY?
AND YOU CAN SEE THERE IS QUITE A
BIT OF IMPACT ON CORE
TEMPERATURE, EVEN ACCENTUATED
MORE IN THE MODERN WORK THAT MAY
NOT BE ABLE TO ACHIEVE THIS.
WHY IS THIS?
THE REASON IS THE CORE
TEMPERATURE IS ELEVATED BECAUSE
YOU CAN'T DEPEND ON DRY HEAT
LOSS.
YOU NEED TO ELEVATE THE CORE
TEMPERATURE TO THE WIDEST POINT
ON THE GRADIENT.
HEAT LOSS IS DEPENDENT ON THE
BLOOD TO SURFACE AND TEMPERATURE
OF THE HEAT GRADIENT.
SO IT IS A STRATEGY TO SUPPORT
CARDIOVASCULAR STABILITY WHICH
WE WILL TALK ABOUT LATER, OKAY,
AND OFTEN INTERPRETED IN
THERMOREGULATORY FAILURES WITH
ATHLETES AND WHAT NOT.
AND SOME OFF THE ENVELOPE
CALCULATION IF YOU LOSE THE BODY
HEAT TO DRY HEAT EXCHANGE TO
CALCULATE THE CORE SKIN, HERE
YOU HAVE A COOL TEMPERATURE AND
CORE GRADIENT ABOUT THE SAME.
IF I GO TO A HOTTER ENVIRONMENT,
THE CORE TEMPERATURE COMES UP, I
CAN DRIVE THE CORE SKIN DOWN
QUITE A BIT.
SO YOU SEE THE HEAT LOSS
MECHANISM AND WHAT I WILL SHOW
YOU IS EVERY MECHANISM HAS A
PENALTY RELYING ON PHYSIOLOGY
THAT IS NOT THERE.
SO YOU HAVE THE MAXIMAL SKIN
BLOOD FLOW, AT REST AND DURING
EXERCISE AND WE HAVE TALKED
ABOUT THE BENEFITS.
BUT WHAT ARE THE PENALTIES OF
HAVING TO HAVE A HIGH WARM SKIN
BLOOD FLOW?
WELL, THE BENEFIT IS YOU ARE
INCREASING CIRCULATION, THE SKIN
BECOMES WARM, THEY BECOME MORE
COMPLIANT, HAVING THIS BLOOD
HANG OUT.
BUT THERE IS A PENALTY AND WE
SAW THIS INCREASED VASCULAR
SPACE, MOVEMENT OF BLOOD FLOW
RELATIVE TO HYPOVOLEMIA.
LIKEWISE IF WE'RE GOING TO
DEPEND ON EVAPORATION WHICH IS
VERY EFFECTIVE, YOU HAVE
SWEATING WHERE YOU CAN LOSE UP
TO TWO LITERS PER HOUR AND THAT
COOLS THE SKIN.
BUT YOU ALSO HAVE DEHYDRATION AS
TEMPERATURES WARM AND THAT
REDUCES BLOOD VOLUME.
SO FROM A PHYSIOLOGY POINT OF
VIEW, YOU HAVE TWO DIFFERENT
THINGS GOING ON.
YOU HAVE VASODILATION WHERE YOU
INCREASE THE VASCULAR SPACE AND
THEN DECREASE THE HYPOVOLEMIA.
SO LET'S LOOK AT WHAT IS THE
IMPACT OF THIS.
HERE'S SOME SLIDES WHERE WE LOOK
AT THE HEAT STRESS ON CUTANEOUS
AND SKELETON MUSCLE
VASODILATION.
SO YOU HAVE OXYGEN UPTAKE HERE
AND THIS IS OUTPUT.
IF I AM IN THE HEAT AND THIS IS
A FAIRLY ACUTE HEAT, I CANNOT
INCREASE MY CARDIAC OUTPUT AS
MUCH.
IT IS ACTUALLY HERE.
NOW ALSO WHAT WE HAVE IS REDUCED
REGULATION, REDUCING BLOOD FLOW
DUE TO EXERCISE AND HEAT STRESS
SO IT CAN MOVE THE BLOOD FLOW TO
THE SKIN.
AND HERE WE LOOK AT THE AMOUNT
COMPARED TO NORMAL, YOU CAN SEE
THE INCREASE IN THE ENVIRONMENT,
AND IF I ADD HEAT, YOU GET MORE
AND IF I ADDED DEHYDRATION WITH
HEAT, YOU WOULD GET EVEN MORE.
SO YOU HAVE THIS CHANGE IN BLOOD
FLOW JUST BASED ON RELATIVE
HYPOVOLEMIA.
SO WHAT HAPPENS IF YOU HAVE
RELATIVE AND ABSOLUTE
HYPOVOLEMIA?
WELL, IN THE FIRST CARDIAC
OUTPUT, IT IS ABOUT THE SAME.
BUT NOW IF THEY START
DEHYDRATING OVER TIME, UP TO A
4 PERCENT BODY MASS WHICH IS
COMP TO BELIEVE WHAT AN ATHLETE
OR WORKER HAS OCCUR, YOU CAN SEE
THE CARDIAC ABILITY DROPPING.
SO IT BECOMES MORE AND MORE
DIFFICULT.
BUT MORE IMPORTANTLY, WE TALKED
ABOUT BLOOD FLOW.
IF YOU EXERCISE IN THE HEAT NO
ONE HAS EVER SHOWN MUSCLE BLOOD
FLOW WILL BE COMPROMISED BUT IF
YOU ADD IN THE HEAT, YOU CAN SEE
EVEN SKELETAL BLOOD FLOW IS
AFFECTED.
SO IN TIME YOU CAN SEE THAT THE
HYPOVOLEMIA IS CHANGED DUE TO
VARYING RANGES OF HEAT.
SO WHAT ARE THE ADAPTATIONS OF
CHRONIC HEAT STRESS?
WELL, QUITE GOOD BECAUSE WE ARE
ADAPTABLE ANIMALS BUT THERE IS A
LIMIT TO IT.
SO WHEN WE LOOK AT ADAPTATIONS
TO THE HEAT, THERE ARE TWO TYPES
THAT OCCUR.
FIRST WE HAVE ACCLIMATIZATION
WHERE WE REDUCE OUR RESPONSE TO
HEAT.
THAT IS WELL-KNOWN.
WE ALSO HAVE ACQUIRED THERMAL
TOLERANCE AND THESE ARE THE
CHANGES THAT PROTECT CELLS AND
THIS IS ALSO RESOLVING IN AN
AREA THAT IS EMERGING.
SO HOW DO YOU REDUCE THESE
ADAPTATIONS?
WELL, THESE ARE SIMPLE
GUIDELINES THAT I THINK OCCUR
OVER MANY DAYS OF THE EXPOSURE.
THAT HEAT STRESS HAS TO BE
SUFFICIENT TO INCREASE BODY
TEMPERATURE AND SWEATING.
THE DURATION, ABOUT 100 MINUTES
A DAY.
PEOPLE SAY DO I HAVE TO LIVE IN
THE HEAT, NO, BUT YOU HAVE TO BE
OUT IN IT FOR A POURED.
THE EXPOSURE TAKES 4 TO 14 DAYS
BUT WE'RE ALSO LEARNING THAT THE
LONGER IS BETTER BECAUSE THERE
IS AN EPIGENETIC ADAPTIVE
MEMORY.
AND IT IS ALSO HEAT STRESS
SPECIFIC.
IF YOU ADAPT FOR REST, IT WILL
NOT BE THE SAME AS EXERCISE AND
THERE IS ALSO THE DIFFERENCE
BETWEEN DESERT AND TROPIC
BECAUSE OF THE DIFFERENT
STRESSES ON THE BODY.
SO LET'S LOOK AT THE EFFECTS OF
THE HEAT ACCLIMATIZATION BASED
ON PERFORMANCE.
SO HERE WE HAVE THE' SO HAVE
DEAL WITH TEMPERATURE TAKEN AT
THE TIME THAT REPRESENTS THE
BLOOD CORE.
THEN YOU HAVE THE HEAT
ASSIGNMENTIZATION AND TIME TO
EXHAUSTION.
AS EACH DAY GOES ON, THEY CAN
WORK OUT LONGER BUT THEN THEY
ALSO HAVE REDUCED CORE
TEMPERATURE.
SO THEY CAN HAVE LESS THERMAL
STRENGTH, WORK LONGER.
YOU APPLY ANOTHER VARIABLE SUCH
AS HEART RATE, YOU CAN SEE THE
SAME TYPE OF THING SO THERE IS
AN ABATEMENT OF STRAIN AND
INCREASE WORK AS THE LIMITATION.
WHAT IS THE BIOLOGY OF THIS?
WELL, THERE ARE A VARIETY OF
MECHANISMS THAT RESULT IN THIS.
THE OBVIOUS ONE FROM THE
THERMOREGULATORY, LIKE MYSELF,
THE HEART RATE IS LOWERED
MEANING REST, THE CARDIAC OUTPUT
IS BETTER SUSTAINED WHICH IS
WITH EXERCISE LOWERED.
YOU FIND AS THE HEART RATE IS
LOWER, CARDIAC ABILITY IS
INCREASED.
BLOOD PRESSURE IS INTERDEPENDENT
AND THE CONS STATUTE VALUE
OVERLOAD INVOLVED WITH THAT.
YOU ALSO SEE THE RED BLOOD CELL
VOLUME WILL GO UP A LITTLE BIT.
[INDISCERNIBLE]
ELECTROLIGHTS LOSS, AFFECTED BY
SODIUM, THE BODY WATER WILL BE
INCREASED AND PLASMA VOLUME.
THERE IS ALSO SOME METABOLIC AND
NEEDS TO BE LOOKED AT MORE AS
THE LOW ENERGY COST OF WORK AND
THEN THE MUSCLE GLYCOGEN USE AND
LACTATE LOWERED.
REQUIRED THERMAL TOLERANCE,
THESE ACTUALLY AFFECT THE CELLS
FROM MULTIPLE STRESSORS.
SOME PEOPLE CALL THIS MON SITE
CYTOXICITY.
THERE IS ALSO THE HEAT SHOCK
PROTEINS AND EPIGENETIC ADAPTIVE
MEMORY.
SO HERE IS THE SLIDE WE SHOW
FROM A 10-DAY ACCLIMATIZATION
PROGRAM.
AND YOU CAN SEE BOTH GO UP
FAIRLY QUICKLY FROM BASELINE
LEVEL.
SO HUMANS CAN ADAPT.
THEY ADAPT TO A VARIETY OF
DIFFERENT MECHANISMS, AT THE
WHOLE SYSTEMS LEVEL AND CELLULAR
LEVEL BUT YOU WILL STILL HAVE
REDUCED PERFORMANCE.
THIS IS ESTIMATED TO RESULT IN
BILLIONS OF DOLLARS LOST IN THE
ECONOMY DUE TO LOSS OF WORK.
SO WE NOT ONLY NEED TO PROTECT
WORKERS WITH PATHO PHYSIOLOGY
BUT ALSO THEIR ABILITY TO WORK.
I PUT THESE TWO STUDIES UP
BECAUSE WE DID A STUDY IN 2014,
MANY YEARS TO BE SEEN AND WHAT
IS INTERESTING, WE ALREADY HAVE
AN ADVANCED SLIDE AND WE ARE
ARGUING BASICALLY THE SAME
STUFF.
BUT THE CENTRAL NERVOUS SYSTEM
TENDS TO BE INVOLVED AND WILL
REDUCE MOTOR DRIVE BUT AS WE
WILL TALK ABOUT LATER IN SPORTS
MEDICINE, THE CENTRAL GOVERNOR
CATASTROPHIC THEORY WAS THOUGHT
TO BE A RESULT OF THIS BUT THAT
IS NONSENSE.
AND THIS I THINK HAS APPLICATION
IN THE METABOLISM FORCE BUT
PREDOMINANTLY MECHANISMS OF
FATIGUE IN THE CENTRAL NERVOUS
SYSTEM ARE IN THE CARDIOVASCULAR
SYSTEM AND THAT IS THE INABILITY
TO SUSTAIN CARDIAC OUTPUT,
INABILITY TO SUSTAIN BLOOD
PRESSURE AND AFFECT THE MUSCLE
PER FUSION TISSUE.
SO WE LOOK AT THE PHYSICAL WORK
CAPACITY AND AT 25, 30 DEGREES
WHICH IS WHAT WE SEE THAT WE
CONSIDER TO BE THE START OF WARM
WEATHER, YOU CAN GET A VERY
SUBSTANTIAL AMOUNT OF WORK.
YOU MIGHT BE ABLE TO IMPROVE IN
A BIT BUT WILL STILL HAVE A
LARGE REDUCTION.
AND THAT IS FROM AN INDIVIDUAL
IN THE HEAT.
WHAT HAPPENS IF YOU HAVE
DEHYDRATION?
AND WE HAVE ALL SEEN THE
ADVERTISEMENTS THAT WE SHOULD BE
HYDRATED ALL THE TIME.
AND IN FACT SITTING HERE
ALTHOUGH WE'RE NOT EXERCISING
RIGHT NOW, JUST SITTING IN THIS
ROOM, YOU MIGHT NEED A DRINK OF
WATER.
SO HERE IS SOME EXPERIMENTS
WHERE WE HAD INDIVIDUALS DOING
PERFORMANCE AND YOU CAN SEE THAT
DEPENDS ON SKIN TEMPERATURES.
WHEN SKIN TEMPERATURES GO UP,
YOU HAVE HIGHER VIOLATION.
FOR PERFORMANCE, ATHLETIC TYPE
OF PERFORMANCE ON TRIALS, YOU
HAVE THESE DIFFERENT SKIN
TEMPERATURES.
SO HERE WE HAVE 90 PERCENT AND
AS WE INCREASE SKIN TEMPERATURE,
THE BASELINE WILL SHOW HOW MUCH
THE DEHYDRATION IS AFFECTING
PERFORMANCE.
AND AS YOU KNOW, THERE IS NO
MEASURABLE IMPACT ON PERFORMANCE
UNTIL THE SKIN STARTS GETTING
WARM TO 27, 28 DEGREES.
SO HYDRATION IS IMPORTANT BUT
ONLY WHEN YOU HAVE THIS RELATIVE
HYPOGPHDREMIA.
NOW, WE ALSO KNOW WORKING IN
HEAT HAS A LOT OF INDUSTRIAL
ACID AND WHEN YOU LOOK AT THE
LITERATURE, IT IS DIFFICULT TO
SEE MUCH.
IF YOU LOOK AT THE SPORTS
MEDICINE STUFF WHERE THEY HAVE
PEOPLE SHOOTING A BASKETBALL AND
STUFF, FINISH MORE.
SO THIS IS THE VISUAL MOTOR
PACING TASK, THEY LOOK AT THE
IMPACT OF WHAT HAPPENS NORMALLY,
WHAT IS THE EFFECT OF DEEP
STRESS AND DEHYDRATION AND WHAT
YOU CAN SEE IS IF WE LOOK AT THE
FIRST FIVE TO TEN MINUTES OF THE
PATH AND THEN THE LAST 15 TO 20
MINUTES.
HERE IS YOUR CONTROL AND IF YOU
HAVE HEAT STRESS, YOU GET A
LITTLE REDUCTION IN APATHY, MATT
SKILLS.
IF YOU COMBINE THEM, YOU ARE
STARTING OFF AT THAT HYDRATION.
SO THERE IS EMERGING LITERATURE
THAT SHOWS THAT HYDRATION OR
LACK OF IT, YOU INCREASE HEAT
DEHYDRATION.
SO NOW I WILL MOVE ON TO HEAT
STROKE.
THEY CONTRIBUTE 9 TO 37 PERCENT
OF DEATHS DURING HEAT WAVE.
HOWEVER WHEN YOU LOOK AT ICD
CODES, IT IS REALLY UNCLEAR
WHETHER IT IS THE CARDIOVASCULAR
SYSTEM AND IN FACT THE ICD CODES
HAVE NOT CAUGHT UP.
WHAT I WANT TO SHOW YOU IS WHAT
WE USE, EMERGING IN THE MEDICAL
LITERATURE, IN THE DOD, GONE TO
OCCUPATIONAL MEDICINE AND SPORTS
CENTER.
AND IT BREAKS UP TWO CATEGORIES,
HEAT EXHAUSTION, INJURY AND
STROKE WHEN THE TEMPERATURE IS
SEVERE.
SO HEAT EXHAUSTION, YOU HAVE THE
INABILITY TO SUSTAIN ADEQUATE
CARDIAC OUTPUT WITH MODERATE
HIGH BODY TEMPERATURE.
HEAT INJURY, YOU MIGHT SEE AN
INCREASE IN CPKS AND THIS IS
WHERE THE BODY IS AT A HIGH
TEMPERATURE.
THEN YOU HAVE HEAT STROKE,
DISFUNCTION, DELIRIUM,
CONVULSION, COAGULOPATHY,
ENDOTOXEMIA, INFLAMMATORY
RESPONSE SYNDROME AND ORGAN
FAILURE.
THEY ALL HAVE TO BE TREATED FOR
HEAT STROKE.
THEY CAN LOOK TERRIBLE WITH HEAT
EXHAUSTION BUT THEY PRESENT
DIFFERENTLY.
THERE ARE TWO TYPES OF HEAT
STROKE, FIRST BEING CLASSIC, THE
OTHER EXERTIONAL.
CLASSIC-- THIS IS REVERSED, SOME
OF THIS IS.
[LAUGHTER]
I JUST NOTICED THE MISTAKE.
THE CLASSIC ARE USUALLY THE
ELDERLY, OLDER PEOPLE AND THAT
IMPAIRS THEM IN THE WAY OF
CHRONIC ILLNESS, MAY BE
MEDICATION THEY ARE USED.
WITH EXERTIONAL, IT IS THE
HEALTHY YOUNG POPULATION,
GENERALLY ADULTS.
I GUESS I DID HAVE THAT RIGHT.
THE WEATHER COULD BE VARIABLE
BECAUSE IT IS PRODUCING SUCH
HIGH METABOLIC RATE.
THE TYPES OF DRUGS THAT MAY BE
LEADING TO THE LIKELIHOOD, THE
SWEATING, YOU MAY SEE FEVER
AFTERWARDS OR HYPOTHERMIA.
YOU GET ACCUSE RENAL FAILURE,
RHABDOMYOLYSIS AND DISSEMINATED
INTRAVASCULAR COAGULATION.
SO IF YOU LOOK AT THE HEAT
STROKE, YOU FIND THE EXE RTIONAL
RESULTS IN GREATER MORTALITY.
YOU CAN SEE THE LD HERE, THE
TIME OF HEAT, ABOVE 40 DEGREES,
YOU CAN SEE THE CLASSIC HERE
WITH LD50 SO EXERTIONAL HAS MORE
IMPLICATION ON THE
PATHOPHYSIOLOGY WITH THE HIGHER
RATE.
SO YOU LOOK AT THE PROGRESSION,
YOU REALLY HAVE TWO THINGS GOING
ON.
YOU HAVE THE HIGH HEAT AND
EXERTION AND THIS RULDZ IN
HYPOTHERMIA BUT ALSO RESULTS IN
UNDER-PERFUSION.
YOU HAVE BLOOD FLOW, THIS CAN
RESULT IN LOSS OF INTEGRITY IN
THE LINING, THEN YOU HAVE
ENDOTOXINS RELEASED, YOU ALSO
GET REDUCED BLOOD FLOW IN THE
MUSCLE.
THESE THINGS ALL WORK TOGETHER.
HYPERTHERMIA, OF COURSE, CAN
RESULT ALONE BUT IT IS REALLY
THE HYPERTHERMIA ISCHEMIA.
BECAUSE YOU CAN HAVE AN ATHLETE
RUNNING, EXERCISING AT 40,
41 DEGREES AND THERE IS REALLY
NO PROBLEM TILL THEY START
GETTING PERFUSE.
WHAT DO WE KNOW?
WE KNOW THAT DAMAGE CAN OCCUR IN
A LOT OF PLACES -- BRAIN,
PRESPIRATORY SYSTEM, MUSCLE AND
BLOOD.
THIS IS A STUDY DONE BY
UNIVERSITY OF INDIANA WHERE THEY
ARE TRYING TO LOOK AT DIFFERENT
BIOMARKERS THAT ARE EARLY
INDICATORS OF HEAT STROKE.
SO YOU ARE STILL MANAGING THIS
PERSON AS THESE VALUES COME DOWN
AND YOU BELIEVE THAT THE SYSTEM
IS HELPING, MANAGING IT SHORT
TERM.
BUT WHAT IS EMERGING IS THERE
ARE LONG-TERM CONSEQUENCES.
HEAT STROKE CAN, MUCH LATER IN
LIFE, AFFECT MORE ORGAN DAMAGE.
THERE HAVE BEEN AT LEAST A HALF
DOZEN STUDIES, I WILL SHOW TWO
HERE, YOU SEE THE CHRONIC KIDNEY
DISEASE, MYOCARDIAL INFARCTION.
HERE YOU HAVE THE PRIOR HEAT
STROKE, THE CONTROL AND YOU CAN
SEE IT INCREASED IN LONG-TERM
EFFECTS.
SO WE DON'T REALLY UNDERSTAND
WHAT THOSE LONG-TERM EFFECTS ARE
AND WHAT THE BIOMARKERS
INDICATORS ARE GOING TO BE THAT
YOU WILL HAVE DAMAGE LATER.
HERE ARE SOME STUDIES THAT CAME
OUT OF THE UNIVERSITY OF FLORIDA
WHERE THEY USED THE MURINE
MODEL, THE DNA BEFORE THE
EXERTION HEAT STROKE AND THEN 30
DAYS AFTER THE EXERTIONAL HEAT
STROKE, IT IS AFFECTING
IMMUNOSUPPRESSION AND THERE IS
ALSO ANOTHER STUDY THAT CAME OUT
IN THE LAST SEVERAL WEEKS THAT
IT REDUCES MUSCLE FUNCTION 30
DAYS LATER.
THERE SEEMS TO BE SOME
MALADAPTATION AND THOSE
MECHANISMS ARE NOT FULLY
UNDERSTOOD.
HOW THE HEAT STROKE OCCURRED, WE
HAVE LOOKED AT THE DIFFERENCES
OF THAT.
WE HAVE ALWAYS THOUGHT OF HEAT
STROKE BEING PRESENTABLE.
THERE IS SOME HUMAN EFFECT WHERE
THE INDIVIDUAL OVERHEATS,
PHYSIOLOGICAL COMPENSATION DID
WELL AND BELIEVED TO BE
PREVENTABLE.
WELL, WE'RE STARTING TO
UNDERSTAND THIS IS NOT ALWAYS
THE CASE.
THERE IS THE MULTIPLABLE-HIT
HYPOTHESIS, MEANING SOMETHING
HAPPENED THAT DAY THAT MAKES THE
PERSON MORE AT RISK TO
SUBSEQUENT HEAT STRESS.
MINOR INFECTION IN SOME CASES
AFFECT HYPERTHERMIA.
A STUDY LOOKING AT MARINE CORPS
RECRUITS WHO HAD HEAT STROKE
FOUND THAT THEY HAD VIRAL
INFECTIONS THE DAY BEFORE.
THERE IS ONE LABORATORY
SITUATION WHERE A PERSON HAD
CELL LIGHTS AND THERE IS ALSO
EXPOSURE TO HEAT IN HISTORY.
THE PERSON WHO GOT PEOPLE TO
THINKING ABOUT THIS, BRUCE
RECRUITED MARINE CORPS RECRUITS.
THE PERSON WOULD GO OUT THE SAME
TIME EVERY DAY, COUPLE TIMES A
WEEK.
ONE DAY THEY WENT OUT AND THE
CORE TEMPERATURES TOOK OFF.
SO WHAT WAS DIFFERENT ABOUT THAT
DAY?
THEY FOUND OUT A DAY BEFORE THEY
HAD A VIRAL LOAD.
THEN WHEN YOU START GOING BACK
AND LOOKING AT THE EPIDEMIOLOGY,
THERE IS EVIDENCE WHEN YOU LOOK
AT IT.
BOTH OF THESE CAME OUT OF ISRAEL
AND DURING THE FIRST
10 KILOMETERS OF THE MARCH,
EARLY IN THE PORTION OF THE
MARCH OR RUN, SOMETHING IS
OCCURRING THAT CAUSES THE CORE
TEMPERATURE TO GO UP OR ONCE IT
GOES UP, BASICALLY REDUCING THE
PROTECTIVE MECHANISM.
SO I TALKED QUITE A BIT ABOUT
WHAT ARE THE LIMITS, WHAT IS THE
PHYSIOLOGY, WHAT IS THE
PATHOPHYSIOLOGY.
WHAT CAN WE DO FROM WHAT WE KNOW
TO IMPROVE OCCUPATIONAL ABILITY
TO MANAGE HEAT STROKE?
ONE AREA IS CALLED MICRO CLIMATE
COOLING AND I BELIEVE THE
SPEAKER BEFORE ME TALKED ABOUT
THAT.
THIS IS AN APPROACH BY THE
DEPARTMENT OF DEFENSE AND USED
OCCUPATIONALLY WHERE YOU HAVE
MATERIAL THAT PROVIDES COOLING
OF THE BODY.
THE PROBLEM WITH THAT IS IT CAN
OVERCOOL THE BODY, HAS SOME
DISCOMFORT, DEEING RESTRICTION
AND OVERCOOLS THE SKIN.
THE OTHER IS PHYSIOLOGICAL
SENSORS.
A LOT OF THEM ARE BULKY BUT MORE
IMPORTANTLY THEY FOCUS ON THE
VITAL SIGNS.
THE NERVOUS SYSTEM IS EXTREMELY
POOR IN TERMS OF PREDICTING HEAT
ILLNESS.
YOU CAN SPEND MILLIONS OF
DOLLARS DOING THIS KIND OF THING
BUT THIS REALLY IS NOT THE WAY
TO GO.
SO LET'S TALK ABOUT SOME OF THE
ADVANCEMENTS IN MICRO CLIMATE
COOLING.
THERE IS SOMETHING CALLED SKIN
TEMPERATURE FEEDBACK IN COOLING.
SO WHEN WE OVERCOOL THE SKIN,
THAT CAUSES RESTRICTION OF THE
SKIN SO YOU ARE INCREASING
RESISTANCE TO HEAT LOSS.
SO THE TRICK THEN IS TO PROVIDE
AN AREA OF SKIN TEMPERATURE THAT
YOU MINIMIZE THE RESISTANCE AND
MAINTAIN CARDIOVASCULAR
STABILITY.
THESE PEOPLE ARE WORKING AN
DIFFERENT TASKS, THE SKIN
TEMPERATURE-DRIVEN FEEDBACK LOOP
AND YOU CAN MAINTAIN THE SKIN
TEMPERATURE.
IF YOU MAINTAIN IN THIS UNDER
33 DEGREESS IN A TASK, YOU
REDUCE CARDIOVASCULAR STRAIN.
THIS ALSO HAS THE BENEFIT OF
REDUCING POWER, LIKE IF SOMEONE
IS WORKING.
SO THE IDEA IS DEPENDING ON
WHERE YOU EXERCISE, THE MUSCLES
HEAT UP AND IF YOU MOVE THIS
SYSTEM AROUND, YOU CAN STAY
WITHIN THE LOOP AND DECREASE
COMFORT AND THIS IS NOT ONLY
WITHIN THE CONTROL SYSTEM BUT
EMERGING IN THE MERCURIAL
ENVIRONMENT.
SO THE NEXT ONE IS THE
ADVANCEMENT IN WEARABLE
PHYSIOLOGICAL MONITORING.
ROUGHLY, YOU MEASURE THE PTT
MEASURES, YOU HAVE AN ANA LOG,
HE CAN APPLY THE MACHINE
LEARNING AND PREDICT AHEAD WHEN
YOU ARE GOING TO HAVE STRESS TO
THE POINT OF COLLAPSE SO IF YOU
USE THIS TO IDENTIFY TRAUMA
PATIENTS, YOU KNOW WHEN THAT
WILL HAPPEN.
YOU CAN ALSO DO THIS WITH HEAT
AND SOME OF THE APPROACHES ARE,
SINCE YOU CAN'T ALWAYS GET TO A
FINGER, GOING TO EEG AND THIS IS
ONE OF THE MEASURES TO LOOK AT
THE IMPACT OF HEAT STRESS.
SO LOOKING AT NOTE ONLY ARTERIAL
PRESSURE WAVE FORMS BUT ALSO
CENTRAL DYNAMICS AND COMBINE
THIS WITH MACHINE LEARNING.
THIS SHOWS GREAT PROMISE.
IN FACT, IF YOU LOOK AT JUST
SIMPLE PHYSIOLOGICAL MEASURES
SUCH AS MEASURING THINGS THAT
ARE DONE IN HEART RATE, HERE IS
A STUDY RECENTLY TON AND IT TOOK
A BUNCH OF -- HUNDREDS OF PIECES
OF DATA THE MILITARY HAD
COLLECTED WITH INDIVIDUALS DOING
WARM WEATHER BACKPACK TRAINING,
ALL RIGHT?
AND THERE WERE SEVERAL
INDIVIDUALS THAT HAD HEAT
STROKES.
GOING BACK AND LOOKING AT THIS,
THEY MEASURED HEART RATE AND THE
BEST THEY COULD DO WAS PREDICT
THE TIME OF DAY.
BUT IF YOU TAKE THESE CHANGES
AND LOOK AT THE CHANGE IN
METABOLIC RATE, THESE PEOPLE
WERE CHANGING AND THEN LOOKING
WITH MACHINE LEARNING ON THIS
PREDICTION, YOU ARE ABLE TO
PREDICT AHEAD 30, 60 MINUTES
BEFORE.
SO THIS IDEA OF USING
CARDIOVASCULAR SENSORS, MACHINE
LEARNING AND CHANGING THE
EXERCISE AND HEAT, HAS A LOT OF
PROMISE WITH THE LITERATURE AND
SO AT EARLY PREDICTION THE HEAT
STROKE, YOU TAKE THESE PEOPLE
OUT AND THIS IS WHERE WE SHOULD
BE GOING WITH THE MONITORS.
SO FINAL THOUGHTS, THERE ARE
MANY MISCONCEPTIONS TO THE
LITERATURE THAT
MEMORYOREGULATORY TEMPERATURE IS
MORE THAN JUST THE HEAT
MEASURED.
I THINK WE NEED MORE WORK ON
AND UNDERSTANDING OF THE
MISCONCEPTION.
AS WE LOOK TO THE FUTURE, HEAT
STROKE MANAGEMENT, WEARABLE
AIDS, PERSONAL COOLING,
BIOMARKERS OF HEAT ILLNESS
RECOVERY AND RETURN TO WORK
CRITERIA.
WHERE A PERSON IS ABLE TO RETURN
AND CERTAINLY CUSTOMIZE THAT
ADAPTATION PROGRAM.
WE FOCUSED ON ATHLETES AND
WORKERS BUT NOT ON THE
VULNERABLE POPULATION.
AND WE HAVE ALWAYS FOCUSED ON
REDUCING STRAIN.
HOW DO WE REDUCE STRAIN AND
PROTECTION AIDS OPTIMALLY?
I THINK WE DO THIS BY
CONSIDERING IT ALTOGETHER.
WE NEED CLEAR IDENTIFICATION
FROM DIFFERENT ORGANIZATIONS
WORKING TOGETHER ON THE
POPULATION AND BRINGING IN
TECHNOLOGY.
THANK YOU.
>>> THANK YOU, THANK YOU VERY
MUCH FOR THAT.
WE HAVE A FLOOD OF QUESTIONS SO
IT MIGHT BE BEST IF BOTH OF YOU,
MICHAEL HAS AN INTERESTING
QUESTION OF IS THE SAUNA GOOD
FOR YOU?
>> MAYBE.
IT CAN BE DISASTEROUS LIKE
ANYTHING.
THERE IS A STUDY OUT OF THE
UNIVERSITY OF OREGON IN A HEAT
CASE THAT SHOWS HEAT EXPOSURE
WITH DIABETES.
SO IT MAY BE SOME HEAT EXPOSURE
HAS SOME BENEFIT, OKAY?
NOW THE SAUNA, YOU HAVE A
CARDIOVASCULAR PROBLEM, YOU
CAN'T THERMOREGULATE IN THE
SHAWN I SAUNA SO A LITTLE IS
GOOD BUT IF YOU CAN'T
THERMOREGULATE, NO.
>> AND ANOTHER QUESTION FOR YOU.
DURING ANOTHER -- IN THIS PART
OF THE WORLD SHOULD WE ALTER OUR
CLOTHING AND DRESS MORE LIKE IN
THE MIDDLE EAST?
>> OBVIOUSLY YOU WANT TO ADOPT
THE CLOTHING.
THE MIDDLE EAST, YOU NOTICE THEY
DON'T WEAR HEAVY CLOTHING
OUTSIDE BECAUSE THE RADIANT HEAT
LOAD IS SO HIGH SO THAT MAY BE
DIFFERENT THAN IN THE TROPICAL
ENVIRONMENT WHERE YOU WANT TO
MAXIMIZE RADIATION.
SO CERTAINLY THERE IS SOME WORK
TO BE DONE IN THE WAY OF HUMAN
EPIDEMIOLOGY AND BIOPHYSICS.
>> IS IT POSSIBLE, THE QUESTION,
CAN THE SCIENCE OF DOWN SIDING
GLOBAL FORECAST, CAN IT BE
ADAPTED TO BE CONSISTENT WITH
SOME PUBLIC HEALTH POLICY, FOR
EXAMPLE, IS THERE A MODEL THAT
COULD COME UP WITH SAYING THAT
SOMETHING IS GOING TO HAPPEN IN
FIVE YEARS, COVERING A 5-MILE
AREA, IS IT POSSIBLE TO TAKE THE
TYPE OF FORECASTING INFORMATION
THAT YOU HAVE AND MODEL IT IN
SOME WAY THAT RELATES IT
POTENTIALLY TO PUBLIC HEALTH
POLICY?
>> NO I THINK IN
>> SO -- SO I THINK IN GENERAL
THE ANSWER IS YES ALTHOUGH THE
SPECIFIC WAYS IT IS DONE WILL
DEPEND ON LIMITATIONS AND OUR
ABILITY TO GET REGIONAL
INFORMATION.
WE TEND TO BE MORE CONFIDENT
ABOUT THE LARGER SCALES AND LONG
R TIME SCALES AS WELL AS WHAT
THE LEVERS ARE ON THE PUBLIC
POLICY ARE.
OFTEN THERE IS A DISCONNECT
THERE AND I THINK IN ORDER
REALLY TO MAKE PROGRESS IN THAT
AREA, IT DOES INVOLVE SORT OF
PRACTITIONERS IN BOTH
DISCIPLINES WORKING SIDE-BY-SIDE
OVER AN EXTENDED PERIOD OF TIME
TO CREATE THAT BRIDGE AND
LANGUAGE.
SO WE HAVE BEEN VERY SUCCESSFUL
AT PRINT TON. PRINCETON.
WE HAVE A GROUP WORKING ON
CLIMATE AND INFECTIOUS DISEASE
BUT IN ORDER TO GET THERE IT
TOOK MULTIPLE YEARS SITTING NEXT
TO EACH OTHER AND UNDERSTANDING
THE CONTEXT.
>> I WAS IMPRESSED, IF MY
NUMBERS ARE CORRECT, THAT AN
ARMY PERSONNEL UNDERGOING A RUN
UNDER NORMAL CONDITIONS GETS THE
BODY TEMPERATURE UP TO 104,
105 DEGREES?
>> WELL, THEY ARE PROBABLY
RUNNING IN HOT WEATHER TO BEGIN
WITH.
IF YOU ARE ACCLIMATIZED AND YOU
ARE FIT, YOU KNOW, IF YOU GO
BACK TO SID ROBINSON AT THE
UNIVERSITY OF INDIANA
LABORATORY, GET PEOPLE RUNNING,
THEY GET PEOPLE UP TO
41 DEGREES.
THEY HAD PEOPLE RUNNING
MARATHONS AND AGAIN THERE IS A
LITTLE BIAS BUT 41, 41-1/2.
SO THERE ARE PEOPLE THAT EASILY,
YEAH.
IN A LABORATORY YOU ARE KIND OF
LIMITED TO 39-1/2 BECAUSE WE
KNOW BELOW 40 DEGREES, YOU ARE
NOT GOING TO HAVE HEAT STROKE SO
WE CAN DO ALMOST ANYTHING WE
WANT TO IF WE KEPT IT BELOW
40 DEGREES.
AND YOU KNOW ROUTINELY, I COULD
SHOW EXPERIMENTS, WHERE WE COULD
INDUCE HEAT EXHAUSTION.
WITH HEAT EXHAUSTION, YOU GET
INTO THIS OCCUPATIONAL STUFF AND
LOOK AT HOW HIGH THE CORE
TEMPERATURE IS, IT IS A BELL
SHAPED CURVE.
YOU KNOW, THE MEANS IN THE
MIDDLE AND YOU HAVE PEOPLE THAT
ARE FALLING DOWN AT 38.5 BECAUSE
THE CARDIOVASCULAR SYSTEM CAN'T
HANDLE IT AND THEN YOU HAVE SOME
HIGHER ONES.
SO YOU NEED TO DO MORE THAN JUST
SETTING GUIDANCE AND LIMITS
BECAUSE THEY ARE TOO
CONSERVATIVE FOR SOME PEOPLE AND
TOO AGGRESSIVE FOR OTHERS SO YOU
NEED TO GO TO AN
INDIVIDUALIZATION WAY TO MONITOR
PEOPLE WHERE THEY ARE AND SAY
WHO IS AT STRESS AND WHO IS NOT
AND THEN GET THOSE ATTENTION.
>> WE ALSO HAVE -- BY THE WAY,
THERE IS A MICROPHONE HERE FOR
THOSE IN THE ROOM ASKING
QUESTIONS.
HOW HIGH DO YOU THINK THE CO2
LEVEL CAN GO WITHOUT DEVELOPING
WHAT WE MIGHT CALL, I DON'T
KNOW, SEVERE ENVIRONMENTAL
TOXICITY?
>> SO I THINK WE'RE NOT TALKING
ABOUT SORT OF INCREASING
GREENHOUSE GASSES ANY TIME IN
THE NEAR TERM WHERE OUR ABILITY
TO BREATHE WOULD BE IMPACTED IN
ANY WAY.
NOW, ONE AREA WHERE THERE MIGHT
BE SOMETHING THAT WOULD RESEMBLE
TOXICITY IS IN THE OCEAN, ONE OF
SORT OF ABOUT -- WELL, ANYWHERE
FROM A THIRD TO HALF CO
EMISSIONS END UP IN THE OCEAN
AND THEY SORT OF DECREASE THE
PH, MAKE THE OCEANS MORE ACIDIC
WHEN CO2 IS ABSORBED IN WATER SO
THEN SHELLS HAVE TO USE MORE OF
THEIR ENERGY TO FORM CELLS AND
THERE ARE TRADEOFFS IN OTHER
THINGS THEY WANT TO USE ENERGY
FOR.
BUT AS FAR AS BREATHING, WE'RE
NOT SEEING THESE LIMITS ON
AVAILABILITY, AT LEAST NOT ANY
TIME IN THE FORESEEABLE FUTURE.
>> WE HAVE A QUESTION?
>> I HAVE A COUPLE OF QUESTIONS,
ONE FOR GABRIEL AND ONE FOR
MIKE.
SO I WILL START WITH PERHAPS A
NAIVE QUESTION FOR GABRIEL AND
THAT IS YOU TALKED ABOUT THE
HIGH PRESSURE AREAS ASSOCIATED
WITH HEAT WAVES.
IS THERE ANYTHING THAT WE COULD
DO, YOU KNOW, LIKE IN TERMS OF
GETTING AN AIRPLANE THROUGH IT,
SEED THE CLOUDS, WHATEVER, SOME
KIND OF INTERVENTION THAT WE
COULD DO THAT WOULD DISRUPT THE
HIGH PRESSURE DEVELOPMENT AND
GET RID OF THE HEAT WAVE OR AT
LEAST SHORTEN IT.
>> THE IDEA OF WEATHER
MODIFICATION, RIGHT?
IT IS ONE THAT HAS BEEN EXPLORED
A LOT.
YOU KNOW, MID-20sTH CENTURY,
KURT VONOGUT LOOKED INTO SILVER
FOR CLOUD SEEDING.
FOR A BLOCKING HIGH, I THINK IT
WOULD BE DIFFICULT TO FIND A WAY
TO MODIFY IT.
WE'RE TALKING ABOUT AN AREA THE
SIZE OF A CONTINENT SO THE
ENERGY REQUIRED AND ABILITY TO
CONCENTRATE THE ENERGY IN THE
ATMOSPHERE IN THE RIGHT WAY
ISN'T THERE YET.
THERE IS AN AREA OF RESEARCH
WHICH IS EXPLORING THE
POSSIBILITY OF USING SOLAR
RADIATION MANAGEMENT TO MODIFY
THE AMOUNT AND TYPE OF SUNLIGHT
THAT IS REACHING THE EARTH OR
STAYING IN THE ATMOSPHERE.
THE WAY I LOOK AT IT IS AS A
PARACHUTE.
IF WE FIND OUT IN A COUPLE OF
DECADES THAT EFFECTS OF GLOBAL
WARMING ARE MORE THAN SOCIETY
CAN BEAR, YOU MIGHT WANT TO
CONSIDER -- AND THERE ARE IDEAS
OUT THERE ANYWHERE FROM STRING
LING DUST IN THE STRATOSPHERE,
SEEDING CLOUDS TO MAKE THEM MORE
REFLECTIVE, TO PUTTING MIRRORS
IN SPACE THAT MIGHT CHANGE THE
AMOUNT OF SUNLIGHT.
THESE ARE IDEAS OUT THERE AND AS
A COMMUNITY WE'RE TRYING TO
EXPLORE THEM AND UNDERSTAND THE
LIMITATIONS AND WHAT UNINTENDED
SIDE EFFECTS AND I THINK RIGHT
NOW THE EXTENT TO WHICH WE HAVE
GOOD OPTIONS AND BAD OPTIONS IS
NOT YET CLEAR, ALL RIGHT?
I THINK ALL OPTIONS ARE STILL
SUBOPTIMAL AT THIS STAGE.
>> AND I HAVE A PRACTICAL
QUESTION I GUESS FOR MIKE AND
THAT IS YOU WERE TALKING A BIT
ABOUT THE SORT OF LOW-TECH WAYS
OF SCREENING PEOPLE FOR
SUSCEPTIBILITY TO HEAT STROKE.
AND MY OWN EXPERIENCE WITH THIS
IN TEXAS, PEOPLE WE SAW COMING
INTO THE MERGES REROOM WITH HEAT
STROKE WERE CONSTRUCTION
WORKERS, PEOPLE WHO DIDN'T HAVE
A LOT OF RESOURCES AVAILABLE TO
THEM, SOME OLDER, SOME WERE NOT.
ARE THERE ANY THINGS ONE COULD
DO TO REDUCE FREQUENCY OF HEAT
STROKE BY SCREENING PEOPLE OR,
IS IT SO INDIVIDUAL AS YOU SAID,
THAT THERE JUST ISN'T ANYTHING?
>> WELL, THERE IS A WHOLE LIST
OF RESISTANT FACTORS BUT IF YOU
HAVE SOMEBODY WORKING, THEY
COULD STILL GET HEAT STROKE.
SO THE IDEA IS IF THEY ARE AT
HIGH RISK --
[ OFF MIC ]
-- SITUATIONS AND I REALLY THINK
IT COMES DOWN TO INDIVIDUAL
MONITORING AND I REALLY BELIEVE
THERE ARE WAYS YOU CAN GO ABOUT
IT -- INAUDIBLE, AWAY FROM MIC ]
SO I THINK THERE IS WAYS TO GO
ABOUT IT, OKAY?
[ INAUDIBLE AND AWAY FROM MIC.
>> SO YOUR ADVICE FOR A
70-YEAR-OLD MAN IN TERMS OF
GOING OUT IN HOT TEMPERATURES IN
THE SUMMERTIME --
>> IT DEPENDS ON THE
PHYSIOLOGICAL CONDITIONING BUT
YOU ALSO HAVE BEHAVIORAL
THERMOREGULATION.
MAYBE YOU SHOULD PAY ATTENTION
TO YOU ARE FEELING TOO HOT AND
NOT DOING WELL AND SLOWING DOWN.
AND UNFORTUNATELY WITH A WORKER
OR MILITARY PERSONNEL OR ATHLETE
WOULD IGNORE THE BEHAVIORAL
ASPECTS OF IT BECAUSE THEY HAVE
TO DO THINGS.
SO I WOULD SAY THE AVERAGE
PERSON, AND THIS IS AN AREA YOU
WANT TO DO IS HOW DO WE
CUSTOMIZE ADAPTATION FOR CERTAIN
POPULATIONS THAT BRING IN BOTH
THE MOLECULAR AND ABATEMENT RISK
TO THE BRAIN, WHAT THEY WILL BE
EXPOSED TO, RISK FACTORS AND
THEN WEARING TECHNOLOGY.
BUT IF IT KEEPS GETTING HOTTER
AND HOTTER, LIKE EXTREME, YOU
WILL HAVE TO AVOID IT, LIKE GO
NORTH.
YEAH, AT NIGHT, BUT EVEN AT
NIGHT, THE HUMIDITY GOES UP.
>> MICHAEL, WE HAVE A QUESTION
ASKING WHETHER AT THE PRESENT
TIME IS PREEXISTEN EXPOSURE TO
HEAT SHOCK OR SOMETHING CLOSE TO
IT CONSIDERED AS A RISK FACTOR
FOR VARIOUS HUMAN DEGENERATIVE
DISEASES?
AND YOU DID POINT OUT THAT
PEOPLE WHO HAVE CARDIOVASCULAR
AND SO FORTH, THESE ARE MORE AT
A RISK OF EXPERIENCING TOXICITY
AT EXTREME TEMPERATURES THAN
OTHERS.
BUT WHAT IS THE STATUS -- YOU
ALLUDED TO IT AND PRESENTED SOME
INFORMATION BUT YOU WANT TO
ELABORATE IT?
>> NOT SURE I FULLY UNDERSTAND
THE QUESTION AS FAR AS
LIMITATION BUT WE KNOW AND THERE
ARE MANY PAPERS OUT THERE FROM
ER ROOMS, PEOPLE WITH
CARDIOVASCULAR DISEASE, LUNGS,
YOU SEE ALL OF THESE INCREASING
BECAUSE OF STRESS.
BUT IT DOESN'T ALWAYS GO DOWN TO
THE HEAT ELEMENT, OKAY?
IT WILL CAUSE OTHER THINGS.
HEAT SHOCK, WHEN YOU PUT A SALAD
AT 41-1/2 1/2 DEGREES, SEE WHAT
IT WILL DO.
WHEN YOU TALK HEAT EXPOSURE, IT
NEEDS TO BE INTEGRATED AND GET
OFF OF THE RESPONSE BECAUSE AS
POINTED OUT WHAT MIGHT BE
UNCOMFORTABLE FOR ONE PERSON
MIGHT BE DEADLY FOR ANOTHER AND
THAT WE DON'T EXACTLY
UNDERSTAND.
WE UNDERSTAND HOW TO CLIMATETIZE
AN ATHLETE OR YOUNGER PERSON BUT
NOT HOW TO CLIMATIZE A
UNHEALTHY80-YEAR-OLD.
>> GABRIEL, COULD YOU COMMENT
THAT IT SEEMS LIKE 20, 25 YEARS
AGO GLOBAL WARMING WAS SOMETHING
PEOPLE TALKED ABOUT OVER COFFEE
AND COCKTAILS.
WHAT ACTUALLY HAPPENED TO BRING
US TO SUCH A HIGH STATE OF
PUBLIC AWARENESS AND FEAR?
>> WELL, I WOULD CAUTION AGAINST
FEAR.
I WOULD CAUTION AGAINST SORT OF
FEELING DESPARATION.
IT IS A VERY SERIOUS SET OF
CONCERNS BUT I THINK, YOU KNOW,
SOMETIMES PEOPLE DO GEORGIA --
AND IT IS NOT PRODUCTIVE TO
MAKING GOOD DECISIONS TO BE
FEARFUL OF IT.
WE NEED TO BE RATIONAL
ESPECIALLY WHEN DEALING WITH
SOMETHING SO CHALLENGING.
BUT I THINK THE EVIDENCE OF
GLOBAL WARMING OVER THE LAST
DECADE HAS BECOME SO COMPELLING
AND UNDENIABLE IN A REASONABLE
WAY THAT THOSE OF US WHO KNEW
THE EVIDENCE AND PREDICTIONS AND
SORT OF GROWING CONCERNS SAW IT
DECADES AGO BUT SOMETIMES, YOU
KNOW, YOU NEED TO ACTUALLY SEE
THE SORT OF MORE EXTREME
SYMPTOMS FOR PEOPLE TO REACT.
AND IN MANY WAYS, I THINK THERE
IS MAYBE ANALOGY BETWEEN THE
HEAT STRESS AND ALL THE WAY
GOING TO HEAT STROKE IN A
INDIVIDUAL AND SORT OF THIS
LARGER SCALE ISSUE ON THE
PLANET, RIGHT, WHEN SOMEBODY CAN
TELL YOU THAT EXERCISING
OUTDOORS IN THE HEAT MAY HAVE
VARIOUS IMPACTS ON YOU BY MAYBE
NOT TILL YOU SEE THE SYMPTOMS
WOULD YOU REACT AND SOMETIMES
THAT MIGHT BE A LITTLE TOO LATE.
I THINK UNFORTUNATELY FOR THE
PLANET, WE ARE SEEING THE
SYMPTOMS BUT ARE STILL AT THE
STAGE WHERE I THINK CORRECTIVE
MEASURES CAN BE TAKEN, NOT TO
AVOID GLOBAL WARMING ALTOGETHER
OR EVEN MORE GLOBAL WARMING OVER
THE NEXT FEW DECADES BUT YES TO
BRING IT WITHIN MANAGEABLE
LEVELS, RIGHT?
SO I THINK IT IS ONE OF THESE,
YOU KNOW, THOSE OF YOU WHO ARE
PRACTICING DOCTORS, YOU PROBABLY
SEE THIS IN INDIVIDUALS ALL THE
TIME.
YOU WARN -- AND MYSELF, RIGHT?
I KNEW BEFORE I TURNED 40 I
NEEDED TO START EXERCISING MORE
BUT IT WAS ONLY AFTER YOUR
METABOLISM SLOWS DOWN ON YOU
THAT YOU BELIEVE YOU ARE LIKE
EVERY OTHER HUMAN BEING ON THE
PLANET AND THEN IT IS ONLY TILL
WE START SEEING THE TEMPERATURE
RECORDS AND ALL THESE THINGS
THAT WE REALIZE THAT YEAH, THERE
IS SORT OF AN ENERGY BALANCE TO
THE PLANET AND WE KNOW HOW IT
WORKS.
>> MARIE?
>> THE EFFECT OF THE MELTING
ICEBERGS AND RISING OCEAN DEPTH,
HOW DOES THAT PLAY WITH RESPECT
TO HEALTH?
HOW SERIOUS IS THE NOTION OF
FLOODING ON THE LAND?
>> SO WE -- IT IS VERY CLEAR
THAT SEA LEVEL HAS RISEN.
ANYBODY HERE IN COASTAL
MARYLAND, OF ALL PLACES, SHOULD
SEE THAT.
SO AS YOU WARM THE PLANET, TWO
KEY THINGS HAPPEN TO RISE SEA
LEVEL.
ONE, WATER EXPANDS AS YOU WARM
IT, LIKE ANY FLUID WOULD.
AND THE SECOND EFFECT IS YOU
MELT ICE ON LAND AND THAT RUNS
OFF INTO THE OCEANS AND THAT
RISES THE MASS OF THE OCEAN AND
BOTH OF THOSE WE HAVE OBSERVED
TO HAPPEN.
WE HAVE ROBUST EXPANSION OF THE
OCEAN, MEASURED TEMPERATURE AND
DENSITY AND THEN WE HAVE
SATELLITES THAT CAN MEASURE THE
MASS OF THE OCEAN.
SO WE HAVE SEEN SEA LEVEL RISE
AND SEEN THINGS THAT ARE
REFERRED TO AS NUISANCE FLOODING
OR SUNNY DAY FLOODING, YOU KNOW,
IN PLACES ESPECIALLY IN SOME
COASTAL MARYLAND, COASTAL
VIRGINIA, DELAWARE, BECAUSE THAT
IS A HOT SPOT FOR SEA LEVEL RISE
AND NOW THERE IS A GREAT DEAL OF
UNCERTAINTY AS SORT OF WHAT THE
STABLE LEVEL OR OVER THE NEXT
CENTURY HOW MUCH SEA LEVEL RISE
WE WILL GET.
UP TILL NOW, IT HAS BEEN ON THE
ORDER OF CENTIMETERS.
WE THINK OVER THE COMING
CENTURY, IT COULD BE METERS OF
SEA LEVEL RISE SO IF YOU LIVE
WHERE THE ELEVATION IS ABOVE
MANY METERS, MAYBE THAT IS NOT A
CONCERN BUT MANY CITIES WITH
CRUCIAL PIECES OF INFRASTRUCTURE
ARE BUILT WITHIN METERS OF
CURRENT SEA LEVEL ESPECIALLY IF
YOU START THINKING ABOUT STORM
SURGE ON TOP OF SEA LEVEL RISE.
SO CHANGING SEA LEVELS ARE A BIG
CONCERN AND HOW TO DEAL WITH THE
FLOODING EFFECTS OF RISING SEES
REQUIRES ENGINEERING AND IS A
POLITICAL CHALLENGE.
IT MAY REQUIRE RELOCATING PEOPLE
AND HOW DO YOU SORT OF DO IT IN
A WAY THAT IS JUST AND NOT VERY
ECONOMICALLY DISRUPTIVE, IS THE
KEY QUESTION.
SO YES, RISING SEA LEVELS ARE A
BIG DEAL.
>> JUST TO ASK, COULD YOU LANE
EXPLAIN THE EL NINO EFFECT
AGAIN?
>> WELL, TOO -- TO FULLY EXPLAIN
IT TAKES QUITE A BIT OF TIME BUT
EVERY FEW YEARS THE EASTERN
EQUATORIAL TEMPERATURE GETS
WARMER THAN IT USUALLY IS AND
THAT IS ASSOCIATED THE RAINFALL
PATTERNS AT THE TROPICAL PACIFIC
OCEAN AND HAS LARGE SCALE
EFFECTS AROUND THE PLANET.
YOU CAN THINK OF IT AS WEATHER
THAT LASTS A LOT LONGER THAN
DAYS BUT LASTS MONTHS.
SORT OF THE WAY THAT EL NINO
HAPPENS, ONE OF THE CONSEQUENCES
OF IT IS IS THAT RAINFALL MOVES
FROM LAND TO THE OCEAN AND THAT
DRIES TROPICAL LAND AND ONE OF
THE CONSEQUENCES OF THAT IS YOU
WARM THE PLANET.
SO EL NINO, THE SYMPTOM OF IT IS
A WARMING YOU HAVE PLANET THAT
LASTS ON THE ORDER OF A FEW
SEASONS TO A YEAR AND THEN IS
FOLLOWED BY A RELATIVE COOLING.
SO IF WE HAD HAD LONG-TERM
MEASUREMENTS OF TEMPERATURES
THOUSANDS OF YEARS AGO, WE WOULD
HAVE SEEN ON TIME SCALES OF
SEASONS AND YEARS, TEMPERATURES
GOING UP AND DOWN BY A FEW
TENTHS OF CELSIUS.
UNDER THE CURRENT WARMING, WE
HAVE THIS LONG-TERM TREND AND ON
TOP OF IT, YOU HAVE THESE
LONG-TERM CYCLES AS TEMPERATURES
CHANGE.
SO EL NINO IS THE WEATHER THAT
LASTS LONGER TIME PERIODS.
>> SO WE'RE ALMOST RUNNING OUT
OF TIME BUT WE HAVE A VERY
IMPORTANT QUESTION THAT IS
PARTICULARLY RELEVANT HERE AT
THE NATIONAL INSTITUTES OF
HEALTH.
WHAT DO YOU BOTH THINK IS THE
ROLE AND WILL LIKELY BE IN THE
NEAR FUTURE OF WHAT YOU MAY CALL
BASIC BIOLOGY, MOLECULAR BIOLOGY
AND SO FORTH IN UNDERSTANDING
HOW CELLS, ORGANS AND SPECIES
REACT TO CHANGES IN THE
ENVIRONMENT INCLUDING THE HEAT?
SO UNDERSTANDING THIS ACTIVE
AREA OF VEST TKPWAEUGS AND --
INVESTIGATION AND HOW IMPORTANT
YOU THINK IT MIGHT BE IN TERMS
OF FUTURE DECISIONS WE HAVE TO
MAKE.
>> SO I AM NOT -- I WILL LET
MIKE TALK ABOUT THE CELLS AND
THE PEOPLE.
WHAT I WILL SAY IS AT THE GLOBAL
SCALE, UNDERSTANDING SORT OF
ECOSYSTEM RESPONSE TO CLIMATE
CHANGE AND UNDERSTANDING EVEN
BASICS OF CLIMATE CHANGE,
THERE'S A LOT OF FUNDAMENTAL
RESEARCH THAT NEEDS TO BE DONE.
OUR ABILITY TO MAKE ACCURATE
PREDICTIONS AT A REGIONAL SCALE
DEPENDS ON THINGS THAT WE DON'T
FULLY UNDERSTAND YET, THE
PROCESS AT THE MICRO SCALE AND
NANOSCALE THAT LEAD TO CLOUD
FORMATION, HOW ORGANISMS TAKE UP
CARBON DIOXIDE AND THEN HOW THAT
GETS SEQUESTERED DEEPER IN THE
OCEAN AND A NUMBER OF OTHER
THINGS AND I THINK BASIC
RESEARCH THAT SPANS TRADITIONAL
DISCIPLINES IS GOING TO BE IT.
AND ON THE LARGER SCALE, WE NEED
MORE BASIC RESEARCH AND I THINK
EVEN AT THE SMALLER LEVEL.
>> ON THE MOLECULAR LEVEL, WE
DESCRIBED THE SURFACE AND I
TOUCHED ON A MEMORY OF THINGS
THAT ARE EXTREMELY IMPORTANT AND
THAT IS UNDERSTANDING THE
MECHANISMS OF CELL PROTECTION,
HOW TO OPTIMIZE THAT.
UNDERSTANDING RECOVERY FROM
ILLNESS AND LOOKING AT THE
FUTURE, WE HAVE TO BE CARRYING
ON THE PROBLEMS, ADAPTIVE
MEMORY.
AND TO MY KNOWLEDGE, THERE ARE
ONLY A HANDFUL OF LABS THAT ARE
STUDYING THIS THROUGHOUT THE
WORLD.
BUT I THINK THROUGH THIS, IT
REQUIRES AN INTERDISCIPLINARY
APPROACH.
RETURN TO DUTY, RETURN TO WORK,
LONG-TERM RECOVERY.
THAT IS WHY I THINK THERE IS AN
INTERDISCIPLINARY AND
INTERAGENCY PROBLEM THAT PEOPLE
HAVE TO WORK THROUGH TOGETHER.
>> WELL, I THINK WE HAVE
EXHAUSTED MOST OF THE QUESTIONS
THAT WERE SUBMITTED AND I JUST
WANT TO THANK YOU BOTH ON BEHALF
OF THE FOLKS HERE AND THE MANY,
MANY, MANY AROUND THE WORLD WHO
ARE LISTENING AND BENEFITTING
FROM YOUR WONDERFUL
PRESENTATION, SO THANK YOU VERY
MUCH. 2600 01:58:08,815 REALLY HAS BEEN AN EXCITING