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Temperature Extremes and Health: Impacts of Climate Variability and Change in the United States

O’Neill, Marie S. PhD; Ebi, Kristie L. PhD, MPH

Journal of Occupational and Environmental Medicine: January 2009 - Volume 51 - Issue 1 - p 13-25
doi: 10.1097/JOM.0b013e318173e122
Original Articles: Special Section on Climate Change and Health

Objective: We evaluated temperature-related morbidity and mortality for the 2007 U.S. national assessment on impacts of climate change and variability on human health.

Methods: We assessed literature published since the 2000 national assessment, evaluating epidemiologic studies, surveys, and studies projecting future impacts.

Results: Under current climate change projections, heat waves and hot weather are likely to increase in frequency, with the overall temperature distribution shifting away from the colder extremes. Vulnerable subgroups include communities in the northeastern and Midwestern U.S.; urban populations, the poor, the elderly, children, and those with impaired health or limited mobility.

Conclusions: Temperature extremes and variability will remain important determinants of health in the United States under climate change. Research needs include estimating exposure to temperature extremes; studying nonfatal temperature-related illness; uniform criteria for reporting heat-related health outcomes; and improving effectiveness of urban heat island reduction and extreme weather response plans.

From the Department of Epidemiology and Environmental Health (Dr Neill), University of Michigan School of Public Health, Ann Arbor, Mich; and ESS, LLC (Dr Ebi).

CME Available for this Article at

Marie S. O’Neill and Kristie L. Ebi received support from a US Environmental Protection Agency subcontract to ICF International, Inc.

This work was not reviewed by the U.S. Environmental Protection Agency and does not necessarily represent Agency policy.

Address correspondence to: Marie S. O’Neill, MS, PhD, Department of Epidemiology and Environmental Health, University of Michigan School of Public Health, 6631 SPH Tower, 109 South Observatory, Ann Arbor, MI 48109; E-mail:

©2009The American College of Occupational and Environmental Medicine