Heat awareness and response among Montreal residents with chronic cardiac and pulmonary disease.

OBJECTIVES Persons affected by chronic heart and lung disease risk illness and death through exposure to extreme ambient heat. Here we describe their knowledge and awareness of the risks, and the degree to which they practice the protective behaviours recommended by public health and meteorological authorities. METHODS Over the course of a hot Montreal summer, chronic cardiac and/or pulmonary insufficiency patients were recruited sequentially on site or by telephone from among attendees at five Montreal university hospital clinics. A one-hour face-to-face structured interview was completed by 238 patients, of whom 78% were at least 60 years of age. RESULTS Participants were well informed about extreme heat and its impact on health. Most see themselves as vulnerable to heat, recall extreme heat advisories, and all adopt at least one recommended protective measure. Of the participants, 68% spend time in an air-conditioned space during extreme heat episodes, and more than 75% reduce their physical activity and drink extra fluids. A small minority resists recourse to air conditioning: of those without, 32% have "little confidence in buying an air conditioner" even if so advised by their caregivers, and 25% would refuse to overnight in an air-conditioned shelter during a prolonged heat wave. CONCLUSIONS These chronically ill respondents perceive themselves as susceptible to extreme heat, have confidence in prevention, and almost all adopt recommended protective behaviours. A minority resists protective messaging.