Tanja Wolf

A time series study on the effects of heat on mortality and evaluation of heterogeneity into European and Eastern-Southern Mediterranean cities: results of EU CIRCE project

BackgroundThe Mediterranean region is particularly vulnerable to the effect of summer temperature.Within the CIRCE project this time-series study aims to quantify for the first time the effect of summer temperature in Eastern-Southern Mediterranean cities and compared it with European cities around the Mediterranean basin, evaluating city characteristics that explain between-city heterogeneity.MethodsThe city-specific effect of maximum apparent temperature (Tappmax) was assessed by Generalized Estimation Equations, assuming a linear threshold model. Then, city-specific estimates were included in a random effect meta-regression analysis to investigate the effect modification by several city characteristics.ResultsHeterogeneity in the temperature-mortality relationship was observed among cities. Thresholds recorded higher values in the warmest cities of Tunis (35.5°C) and Tel-Aviv (32.8°C) while the effect of Tappmax above threshold was greater in the European cities. In Eastern-Southern Mediterranean cities a higher effect was observed among younger age groups (0–14 in Tunis and 15–64 in Tel-Aviv and Istanbul) in contrast with the European cities where the elderly population was more vulnerable. Climate conditions explained most of the observed heterogeneity and among socio-demographic and economic characteristics only health expenditure and unemployment rate were identified as effect modifiers.ConclusionsThe high vulnerability observed in the young populations in Eastern-Southern Mediterranean cities represent a major public health problem. Considering the large political and economic changes occurring in this region as well future temperature increase due to climate change, it is important to strengthen research and public health efforts in these Mediterranean countries.

Performance Assessment of a Heat Wave Vulnerability Index for Greater London, United Kingdom

This study reports on the assessment of a multivariate heat wave vulnerability index (HVI) developed for London, United Kingdom. The HVI is assessed in terms of its ability to predict whether mortality and ambulance callout attain above average levels during heat wave events. Three approaches to assessment were adopted: 1) calculation of categorical statistics and associated skill scores for the dichotomous situation that above average mortality or ambulance callout occurred or not, 2) the degree to which relative risk of the aforementioned health outcomes changed with an increase in heat vulnerability as established using Poisson regression analysis, and 3) an independent samples test of the difference of mean mortality and ambulance callout between census units with and without high heat exposure and high vulnerability. The assessment results reveal that the HVI and a simple single variable index that represents age as a heat risk factor (the elderly index) offer potential as a priori indicators of the level of ambulance callout and mortality for all summer days and heat wave events, respectively. Based on the assessment results the utility of the HVI for heat risk management is discussed.

Protecting Health from Climate Change in the WHO European Region

“How far are we in the WHO European Region in implementing action to counter the health impacts of climate change?” This was the question posed to representatives of Member States in the WHO European Region of in the WHO working group on health in climate change (HIC). Twenty-two Member States provided answers to a comprehensive 2012 questionnaire that focused on eight thematic areas (governance; vulnerability, impact and adaptation (health) assessments (VIA); adaptation strategies and action plans; climate change mitigation; strengthening health systems; raising awareness and building capacity; greening health services; and sharing best practices). Strong development has been in climate change vulnerability and impact assessments, as well as strengthening health systems and awareness raising. Areas where implementation would benefit from further action are the development of national health adaptation plans, greening health systems, sharing best practices and reducing greenhouse gas (GHG) emissions in other sectors. At the Fifth Ministerial Conference on Environment and Health in Parma, Itatly in 2010, the European Commitment to Act on climate change and health and the European Regional Framework for Action to protect health from climate change were endorsed by the fifty-three European Member States. The results of this questionnaire present the most comprehensive assessment so far of progress made by European Member States to protect public health from climate change since the Parma Conference agreements.

Quantifying Projected Heat Mortality Impacts under 21st-Century Warming Conditions for Selected European Countries

Under future warming conditions, high ambient temperatures will have a significant impact on population health in Europe. The aim of this paper is to quantify the possible future impact of heat on population mortality in European countries, under different climate change scenarios. We combined the heat-mortality function estimated from historical data with meteorological projections for the future time laps 2035–2064 and 2071–2099, developed under the Representative Concentration Pathways (RCP) 4.5 and 8.5. We calculated attributable deaths (AD) at the country level. Overall, the expected impacts will be much larger than the impacts we would observe if apparent temperatures would remain in the future at the observed historical levels. During the period 2071–2099, an overall excess of 46,690 and 117,333 AD per year is expected under the RCP 4.5 and RCP 8.5 scenarios respectively, in addition to the 16,303 AD estimated under the historical scenario. Mediterranean and Eastern European countries will be the most affected by heat, but a non-negligible impact will be still registered in North-continental countries. Policies and plans for heat mitigation and adaptation are needed and urgent in European countries in order to prevent the expected increase of heat-related deaths in the coming decades.