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"plaintext": "Preventable mortality from cold exposure warrants urgent action, from policies against energy poverty to cold-health action plans. Energy poverty , defined as a household reducing its energy consumption to a degree that negatively impacts the inhabitants' health and wellbeing, is worsening in Europe. With the effect of the COVID-19 crisis and the surge in energy prices compounded by the Russian invasion of Ukraine in February 2022, the proportion of EU-27 residents unable to keep their homes adequately warm has increased from under 6.9% in 2020 to 9.3% in 2022 and 10.6% in 2023. The situation varied across the EU, with the latest data showing the largest share of energy poverty occurring in Spain and Portugal (20.8%) and the smallest share in Switzerland (0.4%) (see Figure 4). It is important to note that several countries have experienced significant declines in this indicator of energy poverty in the last 10 years, notably Bulgaria (-19,8%), Malta (-15,5%), Greece (-13,7%), Cyprus (-10,6%) and Latvia (-10,2%).",
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"text": ", defined as a household reducing its energy consumption to a degree that negatively impacts the inhabitants' health and wellbeing, is worsening in Europe. With the effect of the COVID-19 crisis and the surge in energy prices compounded by the Russian invasion of Ukraine in February 2022, the proportion of EU-27 residents unable to keep their homes adequately warm has increased from under 6.9% in 2020 to 9.3% in 2022 and 10.6% in 2023. The situation varied across the EU, with the latest data showing the largest share of energy poverty occurring in Spain and Portugal (20.8%) and the smallest share in Switzerland (0.4%) (see Figure 4). It is important to note that several countries have experienced significant declines in this indicator of energy poverty in the last 10 years, notably Bulgaria (-19,8%), Malta (-15,5%), Greece (-13,7%), Cyprus (-10,6%) and Latvia (-10,2%). "
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"plaintext": "Cold is one of the largest environmental risks in terms of burden of disease in Europe, following only ambient air pollution and noise, and lying far above heat. The health effects of cold are also aggravated by energy poverty. Exposure to cold (including cold waves and generally cold temperatures) has a strong effect on the burden of chronic respiratory illness, causing over 11% of chronic respiratory deaths in Europe . In addition to its effect on chronic respiratory diseases, cold is responsible for almost one in five lower respiratory infection deaths in\u00a0 EEA member and collaborating countries. Most cold-related preventable mortality is due to respiratory causes (Diaz et al., 2005; Linares et al., 2015; Carmona et al., 2016).",
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"text": ". In addition to its effect on chronic respiratory diseases, cold is responsible for almost one in five lower respiratory infection deaths in\u00a0 EEA member and collaborating countries. Most cold-related preventable mortality is due to respiratory causes (Diaz et al., 2005; Linares et al., 2015; Carmona et al., 2016)."
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"text": "Next chapter: Cold"
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"text": "Next chapter: Occupational exposure"
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"plaintext": "The links between cold and ill health are complex. They involve not only direct impacts like hypothermia but also the aggravation of several types of chronic diseases, along with an increase in the transmission rates of various bacterial and viral infections. Colder temperatures have been linked with increased exposure to viral infection (Alahmari et al., 2015; Blondeel et al., 2023) and increased crowding indoors promotes the transmission of disease (M\u00e4kinen et al., 2009; Huang et al., 2023). Inhaling cold air, cooling the body\u2019s surface and experiencing cold stress from lowering the core body temperature trigger physiological reactions, such as vasoconstriction in the respiratory tract mucosa and suppression of immune responses (Schaefer et al., 1980; Koskela, 2007; D\u2019Amato et al., 2018). Increased exposure to viral infection is one possible explanation for COPD exacerbation by cold weather (Love and Proud, 2022; Donaldson et al., 2012). In addition, cold weather can cause bronchoconstriction, which can exacerbate COPD (Koskela et al., 1996).",
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"text": "The links between cold and ill health are complex. They involve not only direct impacts like hypothermia but also the aggravation of several types of chronic diseases, along with an increase in the transmission rates of various bacterial and viral infections. Colder temperatures have been linked with increased exposure to viral infection (Alahmari et al., 2015; Blondeel et al., 2023) and increased crowding indoors promotes the transmission of disease (M\u00e4kinen et al., 2009; Huang et al., 2023). Inhaling cold air, cooling the body\u2019s surface and experiencing cold stress from lowering the core body temperature trigger physiological reactions, such as vasoconstriction in the respiratory tract mucosa and suppression of immune responses (Schaefer et al., 1980; Koskela, 2007; D\u2019Amato et al., 2018). Increased exposure to viral infection is one possible explanation for COPD exacerbation by cold weather (Love and Proud, 2022; Donaldson et al., 2012). In addition, cold weather can cause bronchoconstriction, which can exacerbate COPD (Koskela et al., 1996)."
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"plaintext": "In Europe, temperature rise due to climate change has been particularly fast in the cold season (Rantanen et al., 2023). Though there is no current evidence that cold-related mortality has consistently decreased in Europe, studies generally predict that as the climate warms, the effects of cold on health will diminish. Assuming a 2.0\u00b0C average warming, the population annually exposed in Europe to extreme cold is projected to decrease by two thirds from around 10 million currently by 2100, with strongest absolute reductions projected for southern and northern European countries. Similarly, the number of deaths related to extreme cold events in Europe is projected to significantly decrease (Naumann et al., 2020). But climate change does not mean cold waves will no longer happen; moreover, the decrease in cold-related mortality is not projected to compensate for the expected increase in heat-related mortality (Martinez et al., 2018; Mart\u00ednez-Solanas et al., 2021; Staddon et al., 2014).",
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"text": "In Europe, temperature rise due to climate change has been particularly fast in the cold season (Rantanen et al., 2023). Though there is no current evidence that cold-related mortality has consistently decreased in Europe, studies generally predict that as the climate warms, the effects of cold on health will diminish. Assuming a 2.0\u00b0C average warming, the population annually exposed in Europe to extreme cold is projected to decrease by two thirds from around 10 million currently by 2100, with strongest absolute reductions projected for southern and northern European countries. Similarly, the number of deaths related to extreme cold events in Europe is projected to significantly decrease (Naumann et al., 2020). But climate change does not mean cold waves will no longer happen; moreover, the decrease in cold-related mortality is not projected to compensate for the expected increase in heat-related mortality (Martinez et al., 2018; Mart\u00ednez-Solanas et al., 2021; Staddon et al., 2014). "
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