Current and Projected Heat-Related Morbidity and Mortality in Rhode Island.

BACKGROUND: Climate change is expected to cause increases in heat-related mortality, especially among the elderly and very young. However, additional studies are needed to clarify the effects of heat on morbidity across all age groups and across a wider range of temperatures. OBJECTIVES: We aimed to estimate the impact of current and projected future temperatures on morbidity and mortality in Rhode Island. METHODS: We used Poisson regression models to estimate the association between daily maximum temperature and rates of all-cause and heat-related emergency department (ED) admissions and all-cause mortality. We then used downscaled Coupled Model Intercomparison Project Phase 5 (CMIP5; a standardized set of climate change model simulations) projections to estimate the excess morbidity and mortality that would be observed if this population were exposed to the temperatures projected for 2046-2053 and 2092-2099 under two representative concentration pathways (RCP): RCP 8.5 and 4.5. RESULTS: Between 2005 and 2012, an increase in maximum daily temperature from 75 to 85°F was associated with 1.3% and 23.9% higher rates of all-cause and heat-related ED visits, respectively. The corresponding effect estimate for all-cause mortality from 1999 through 2011 was 4.0%. The association with all-cause ED admissions was strongest for those < 18 or ≥ 65 years of age, whereas the association with heat-related ED admissions was most pronounced among 18- to 64-year-olds. If this Rhode Island population were exposed to temperatures projected under RCP 8.5 for 2092-2099, we estimate that there would be 1.2% (range, 0.6-1.6%) and 24.4% (range, 6.9-41.8%) more all-cause and heat-related ED admissions, respectively, and 1.6% (range, 0.8-2.1%) more deaths annually between April and October. CONCLUSIONS: With all other factors held constant, our findings suggest that the current population of Rhode Island would experience substantially higher morbidity and mortality if maximum daily temperatures increase further as projected. CITATION: Kingsley SL, Eliot MN, Gold J, Vanderslice RR, Wellenius GA. 2016. Current and projected heat-related morbidity and mortality in Rhode Island. Environ Health Perspect 124:460-467; http://dx.doi.org/10.1289/ehp.1408826.

Primary prevention of lead poisoning: protecting children from unsafe housing.

OBJECTIVES: We examined the effects of changes in Rhode Island's Lead Hazard Mitigation Law in 2005 on children's blood lead levels. METHODS: We used 2005 to 2009 data from Rhode Island's Lead Elimination Surveillance System; city tax assessor records in Central Falls, Pawtucket, Providence, and Woonsocket, Rhode Island; and records of conformance to the state's lead hazard mitigation law, to assess the extent to which legislation changes resulted in minimizing children's exposure to lead. RESULTS: During the 5-year study, the proportion of properties that complied with the new law increased for properties that housed young children. However, the majority of rental properties did not comply with the law. Children's lead levels declined by approximately 1 microgram per deciliter on average in properties that did comply, demonstrating that the law could have a protective effect for children. CONCLUSIONS: Legislation changes increased the proportion of properties that were certified as nonhazardous, leading to decreased blood lead levels for children living in these properties. However, legislation cannot be a highly effective primary prevention strategy if it does not cover all properties where children live and is not strictly enforced.