Climate Resilience of Care Settings

由于全球气候变化，预计英国将经历更炎热、更干燥的夏季，预计热浪发生的频率、强度和持续时间都将增加。根据英国气象局最近的气候变化预测，在高排放情景下，到2070年，夏季日平均气温可能上升5.4摄氏度，冬季上升4.2摄氏度。2003年，据报道，仅英国就有2091人因热浪死亡，这意味着未来气温升高可能导致与热浪相关的死亡率上升。英国目前的老年人数量也在迅速增长，预计到2035年，75岁及以上的老年人将占总人口的13%，而2012年这一比例为8%。老年人更容易受到气候引起的影响，因为他们更有可能患有潜在的慢性健康并发症，使他们更容易受到热应激的影响。2003年的热浪表明，护理机构中的老年人因高温死亡的风险最高。65岁以上的老年人80%以上的时间在居住环境或护理机构中度过，85岁以上的老年人90%以上的时间在居住环境或护理机构中度过。因此，室内环境是老年人热暴露的一个巨大调节因素：糟糕的建筑设计和护理环境中缺乏有效的热管理可能会导致室内热暴露增加，对最脆弱的居民产生有害的健康影响。护理设施既是居民的家，也是工作人员的工作场所，这意味着共享这些空间的人们可能有不同的需求和偏好，这使得防止过热的措施难以实施。工作人员和居民之间的互动在防止护理环境中的过热方面发挥着重要作用，以前曾指出，由于普遍认识到寒冷天气可能对老年人健康产生不利影响，导致过热风险被忽视，工作人员往往被要求优先考虑温暖。了解导致养老院室内夏季过热的因素对于制定预防过热及其对健康的负面影响的方法至关重要。申请人之前的研究表明，即使在非极端的夏天，护理设施也已经过热，强调有必要制定及时的预防措施，因为预计下个世纪英国的气温将上升。护理环境中气候适应的一个关键目标是通过建筑设计和居住者行为引入被动冷却策略来限制此类风险。被动冷却策略的发展将减少采用机械冷却的可能性，这将破坏政府减少温室气体排放的努力。因此，该项目的主要目的是开展初步工作，开发方法，支持英国的护理提供系统，为气候变化下不断上升的热压力做好充分准备。该项目将在英国的五个护理机构进行试点工作，监测热环境，并对居民、一线护理人员和护理院经理进行调查。在这些建筑中，它将测试新的方法来理解居民的舒适度，并将其与热环境联系起来。它还将测试新的测量技术，以评估热量对居民健康的影响。通过详细的建模工作，它将测试评估未来过热风险和评估缓解过热战略有效性的方法。在整个项目中，这项工作将把多学科的研究观点与护理院从业人员和其他利益相关者的观点结合起来。通过这些一揽子工作，将为该地区迫切需要的大型项目制定计划。

As a result of global climate change, the UK is expected to experience hotter and drier summers and heatwaves are expected to occur with greater frequency, intensity and duration. According to recent climate change projections by the MetOffice, increases in mean daily temperatures could be up to 5.4 deg. C during the summer months and 4.2 deg. C during winter by 2070 under a High emissions scenario. In 2003, 2,091 heat-related deaths were reported in the UK alone as a result of the European heatwave, meaning future temperature increases could lead to a parallel rise in heat-related mortality. The UK also currently has a rapidly growing number of old people, with people aged 75 or over expected to account for 13% of the total population by 2035, compared with 8% in 2012. Older populations are more vulnerable to climate-induced effects as they are more likely to have underlying, chronic health complications, making them more vulnerable to heat stress. The 2003 heatwave demonstrated that older people in care settings are at the highest risk of heat-related mortality.People aged over 65 years spend more than 80% of their time in residential environments or care settings, and people aged over 85 years more than 90%. Therefore, the indoor environment is a huge moderator of heat exposure in older populations: Poor building design and the lack of effective heat management in care settings may contribute to increased indoor heat exposure with detrimental health impacts falling on the most vulnerable residents. Care facilities function as both a home for residents and a workplace for staff, meaning that the people sharing those spaces can have diverging needs and preferences making overheating prevention measures difficult to enforce. Interactions between staff and residents play an important role in preventing overheating in care settings and it has previously been noted that staff are often made to prioritise warmth due to wide recognition of the detrimental effect cold weather can have on old-age health, leading to overheating risks being overlooked.Understanding factors that contribute to indoor summertime overheating in care homes is crucial in developing methods to prevent overheating and the subsequent negative health impacts. Previous research by the applicants has indicated that care facilities are already overheating even under non-extreme summers, highlighting the need to develop timely prevention measures given the way temperatures are expected to rise in the UK over the next century. A key target for climate adaptation in care settings is to limit such risks by introducing passive cooling strategies via building design and occupant behaviour. Development of passive cooling strategies will reduce the likelihood of uptake of mechanical cooling, which would undermine government efforts to reduce greenhouse gas emissions. Therefore, the principal aim of the project is to undertake preliminary work to develop methods that will support a system of care provision in the UK that is adequately prepared for rising heat stress under climate change. The project will undertake pilot work in five care settings in the UK to monitor the thermal environment and conduct surveys with residents, frontline care staff and care home managers. Within these buildings, it will test novel approaches for understanding the comfort levels of the residents and relating this to the thermal environment. It will also test novel measurement techniques for assessing impact of heat on the health of the residents. Via detailed modelling work, it will then test methods to assess future overheating risks and to evaluate the effectiveness of overheating mitigation strategies. Throughout the project the work will bring together multidisciplinary research perspectives with those of care home practitioners and other stakeholders. Via these packages of work, plans for the large-scale project that is so urgently needed in this area will be developed.