Assessment versions

Published (reviewed and quality assured)

• 20 Dec 2016, 04:27 PM
  - Extreme temperatures and health

Rationale

Justification for indicator selection

Temperature affects human well-being and mortality. Both cold and heat have public health impacts in Europe.

Heat or hot weather that lasts for several days, often referred to as ‘a heat wave’, can have a significant impact on society, including a rise in mortality and morbidity. Heat waves have caused far more fatalities in Europe in recent decades than any other extreme weather event. The effects of exposure can be directly related to heat (heat stroke, heat fatigue and dehydration, or heat stress) or can be the result of a worsening of respiratory and cardiovascular diseases, electrolyte disorders and kidney problems. Heat-related problems are greatest in cities; among many interrelated factors, the urban heat island effect plays an important role. During hot weather, synergistic effects between high temperature and air pollution (particulate matter with a diameter ≤10 micrometres (PM₁₀) and ozone) were observed. Long warm and dry periods, in combination with other factors, can also lead to forest fires, which have been shown to have severe health impacts. Future climate change is very likely to increase the frequency, intensity and duration of heat waves.

Extreme cold can also significantly affect human health. The physiological and pathological effects of short-term exposure to cold are well known. People with cardiovascular and respiratory diseases and the elderly are potentially more susceptible to the effects of cold spells. Excess winter mortality in Mediterranean countries is higher than in northern European countries, and deaths often occur several days or weeks after the coldest day of a cold period.

As well as extreme temperature events, ‘non-extreme’ temperatures outside a local comfort temperature range are also linked to increased mortality and other adverse health outcomes. The effects of heat occur mostly on the same day and in the following three days, whereas cold effects were greatest two to three weeks after the event. A multi-country global observational study found that moderate temperatures, rather than extreme temperatures, represented most of the total health burden. The development of adaptation strategies according to local conditions should treat heat and cold extremes separately. 

The capacity to adapt to the effects of heat and cold in Europe is high compared with other world regions, but there are important differences in the impacts of heat and cold and in the capacity to respond between and within the European sub-regions. Adaptations to buildings or work practices are likely to be needed to maintain labour productivity during hot weather.

Scientific references

• IPCC, 2014a: Climate Change 2014: Impacts, Adaptation, and Vulnerability. Part A: Global and Sectoral Aspects. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Field, C.B., V.R. Barros, D.J. Dokken, K.J. Mach, M.D. Mastrandrea, T.E. Bilir, M. Chatterjee, K.L. Ebi, Y.O. Estrada, R.C. Genova, B. Girma, E.S. Kissel, A.N. Levy, S. MacCracken, P.R. Mastrandrea, and L.L. White (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA, 1132 pp.
• IPCC, 2014c: Europe. Kovats, R.S., R. Valentini, L.M. Bouwer, E. Georgopoulou, D. Jacob, E. Martin, M. Rounsevell, and J.-F. Soussana, 2014: Europe. In: Climate Change 2014: Impacts, Adaptation, and Vulnerability. Part B: Regional Aspects. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Barros, V.R., C.B. Field, D.J. Dokken, M.D. Mastrandrea, K.J. Mach, T.E. Bilir, M. Chatterjee, K.L. Ebi, Y.O. Estrada, R.C. Genova, B. Girma, E.S. Kissel, A.N. Levy, S. MacCracken, P.R. Mastrandrea, and L.L. White (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA, pp. 1267-1326.
• WHO 2011: Public health advice on preventing health effects of heat. World Health organization, Copenhagen, Denmark.

Indicator definition

• Associations between temperature and mortality in four European cities

Units

• Relative Risk (dimensionless)

Policy context and targets

Context description

In April 2013, the European Commission (EC) presented the EU Adaptation Strategy Package. This package consists of the EU Strategy on adaptation to climate change (COM/2013/216 final) and a number of supporting documents. The overall aim of the EU Adaptation Strategy is to contribute to a more climate-resilient Europe.

One of the objectives of the EU Adaptation Strategy is Better informed decision-making, which will be achieved by bridging the knowledge gap and further developing the European climate adaptation platform (Climate-ADAPT) as the ‘one-stop shop’ for adaptation information in Europe. Climate-ADAPT has been developed jointly by the EC and the EEA to share knowledge on (1) observed and projected climate change and its impacts on environmental and social systems and on human health, (2) relevant research, (3) EU, transnational, national and subnational adaptation strategies and plans, and (4) adaptation case studies.

Further objectives include Promoting adaptation in key vulnerablesectors through climate-proofing EU sector policies and Promoting action by Member States. Most EU Member States have already adopted national adaptation strategies and many have also prepared action plans on climate change adaptation. The EC also supports adaptation in cities through the Covenant of Mayors for Climate and Energy initiative.

In September 2016, the EC presented an indicative roadmap for the evaluation of the EU Adaptation Strategy by 2018.

In November 2013, the European Parliament and the European Council adopted the 7^th EU Environment Action Programme (7^th EAP) to 2020, ‘Living well, within the limits of our planet’. The 7^th EAP is intended to help guide EU action on environment and climate change up to and beyond 2020. It highlights that ‘Action to mitigate and adapt to climate change will increase the resilience of the Union’s economy and society, while stimulating innovation and protecting the Union’s natural resources.’ Consequently, several priority objectives of the 7^th EAP refer to climate change adaptation.

Targets

No targets have been specified.

Related policy documents

• 7th Environment Action Programme
  DECISION No 1386/2013/EU OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 20 November 2013 on a General Union Environment Action Programme to 2020 ‘Living well, within the limits of our planet’. In November 2013, the European Parliament and the European Council adopted the 7 th EU Environment Action Programme to 2020 ‘Living well, within the limits of our planet’. This programme is intended to help guide EU action on the environment and climate change up to and beyond 2020 based on the following vision: ‘In 2050, we live well, within the planet’s ecological limits. Our prosperity and healthy environment stem from an innovative, circular economy where nothing is wasted and where natural resources are managed sustainably, and biodiversity is protected, valued and restored in ways that enhance our society’s resilience. Our low-carbon growth has long been decoupled from resource use, setting the pace for a safe and sustainable global society.’
• Climate-ADAPT: Country information
  Overview of activities of EEA member countries in preparing, developing and implementing adaptation strategies
• Climate-ADAPT: Mainstreaming adaptation in EU sector policies
  Overview of EU sector policies in which mainstreaming of adaptation to climate change is ongoing or explored
• DG CLIMA: Adaptation to climate change
  Adaptation means anticipating the adverse effects of climate change and taking appropriate action to prevent or minimise the damage they can cause, or taking advantage of opportunities that may arise. It has been shown that well planned, early adaptation action saves money and lives in the future. This web portal provides information on all adaptation activities of the European Commission.
• EU Adaptation Strategy Package
  In April 2013, the European Commission adopted an EU strategy on adaptation to climate change, which has been welcomed by the EU Member States. The strategy aims to make Europe more climate-resilient. By taking a coherent approach and providing for improved coordination, it enhances the preparedness and capacity of all governance levels to respond to the impacts of climate change.
• Implementing the European Regional Framework for Action to protect health from climate change
  How far have Member States in the WHO European Region progressed in implementing the European Commitment to Act on climate change and health? This was the question addressed to members of the Working Group on Health in Climate Change (HIC) of the European Environment and Health Task Force in summer 2012. The HIC members were asked to respond to a comprehensive questionnaire to assess the current status of health-relevant climate change mitigation and adaptation actions. A total of 22 Member States answered the questions focusing on eight thematic areas or topics: governance, vulnerability, impact and adaptation assessments, national and subnational adaptation strategies, climate-change mitigation, strengthening of health systems, awareness raising and capacity building, green health services and sharing best practices. This publication describes and analyses their responses.

Methodology

Methodology for indicator calculation

Daily temperature and mortality data for four locations in Europe from the period 1985–2012 have been used to fit a standard time-series Poisson model for each location, controlling for trends and day of the week. Temperature–mortality associations were estimated with a distributed lag non-linear model and a multivariate metaregression that included temperature average and range

Methodology for gap filling

Not applicable

Methodology references

• Gasparrini et al. (2015): Mortality risk attributable to high and low ambient temperature: a multicountry observational study. Gasparrini, A., Guo, Y., Hashizume, M., Lavigne, E., Zanobetti, A., Schwartz, J., Tobias, A., Tong, S., Rocklöv, J., Forsberg, B., Leone, M., De Sario, M., Bell, M. L., Guo, Y.-L. L., Wu, C., Kan, H., Yi, S.-M., de Sousa Zanotti Stagliorio Coelho, M., Saldiva, P. H. N. et al., 2015, 'Mortality risk attributable to high and low ambient temperature: a multicountry observational study', Lancet 386(9991), 369–375 (DOI: 10.1016/S0140-6736(14)62114-0).

Data specifications

EEA data references

• No datasets have been specified here.

External data references

• Associations between temperature and mortality in four European cities

Data sources in latest figures

Uncertainties

Methodology uncertainty

Not applicable

Data sets uncertainty

The attribution of health effects to climate change is difficult owing to the complexity of interactions and the potential modifying effects of a range of other factors (such as land-use changes, public health preparedness and socio-economic conditions). Criteria for defining a climate-sensitive health impact are not always well identified, and their detection sometimes relies on complex observational or prospective studies, applying a mix of epidemiological, statistical and/or modelling methodologies. Furthermore, these criteria, as well as the completeness and reliability of observations, may differ between regions and/or institutions, and they may change over time. Data availability and quality are crucial in climate change and human health assessments, both for longer term changes in climate-sensitive health outcomes and for health impacts of extreme events. The monitoring of climate-sensitive health effects is currently fragmentary and heterogeneous. All these factors make it difficult to identify significant trends in climate-sensitive health outcomes over time, and to compare them across regions. In the absence of reliable time series, more complex approaches are often used to assess the past, current and future impacts of climate change on human health.

The links between climate change and health have been the subject of intense research in Europe in the early 2000s (e.g. the projects cCASHh, EDEN, EDENext and Climate-TRAP); more recently health has been incorporated, to a minor extent, into some cross-sectorial projects (e.g. CIRCE, PESETA II, IMPACT2C and RAMSES). Furthermore, the World Health Organization (WHO) has a policy, country support and research mandate given by its 193 Member States through the World Health Assembly on all aspects of climate change and health.

Rationale uncertainty

No uncertainty has been specified