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A recent investigation conducted by the Barcelona Institute for Global Health (ISGlobal), with contributions from the Barcelona Supercomputing Centre (BSC), has revealed significant findings regarding Europe’s adaptation to temperature extremes over the past two decades. Published in The Lancet Planetary Health, the study indicates that Europe has exhibited a greater adaptive capacity to low temperatures compared to high temperatures, with a notable decline in cold-related mortality risk since the early 2000s. Although there has been a reduction in heat-related deaths, the progress has been less pronounced.
The researchers examined temperature and mortality data from more than 800 regions across 35 European countries spanning from 2003 to 2020. They discovered that the relative risk of death due to extreme cold decreased by 2% annually, while the risk associated with extreme heat saw a smaller decline of 1% per year.
New Perspective on Regional Vulnerability
Historically, analyses of temperature-related health impacts have used fixed temperature thresholds, failing to account for the variability in vulnerability across different European regions. To address this gap, the research team introduced a novel concept termed Extreme-Risk Temperature (ERT). By correlating regional data on temperature and mortality, this method allowed for determining the temperature at which the risk of mortality increases beyond a certain threshold for specific geographical areas. Additionally, the team factored in mortality variation over time to reflect evolving adaptive responses.
Through this innovative methodology, it was determined that from 2003 to 2020, Europe experienced an annual decrease of roughly 2.07 dangerously cold days (cold-ERT days), while the number of dangerously hot days (heat-ERT days) rose by 0.28 days per year.
Regional disparities were evident, particularly in Southeastern Europe, which, despite being warmer, faced a higher incidence of dangerously hot and cold days contributing to elevated mortality risks.
“Our findings indicate that we have become more adept at managing cold temperatures, a phenomenon referred to as adaptation in scientific terms. Conversely, while there is growing resilience to heat, this progress lags behind that seen in cold tolerance,” explains Zhao-Yue Chen, the lead researcher from ISGlobal.
“The susceptibility to extreme temperatures significantly differs by location, with Southern Europe exhibiting greater sensitivity to temperature variations than Northern regions. This variation can be attributed to socioeconomic conditions such as inadequate housing insulation, limited health care funding, and restricted access to support for at-risk populations,” adds Chen.
“Our findings suggest that while strides have been made in adapting to cold climates, the measures to mitigate heat-related mortality remain inadequate. A 2024 survey indicated that only 20 of 38 European countries have established temperature monitoring systems, and 17 lack comprehensive heat-health action plans (HHAPs). This underscores the urgency for advancements in heat adaptation strategies and targeted plans to safeguard vulnerable communities,” highlights Joan Ballester Claramunt, a senior researcher at ISGlobal.
Interactions Between Temperature and Air Quality
The study also explored the correlation of Extreme-Risk Temperatures with days experiencing pollution exceeding the World Health Organization (WHO) guidelines. These overlapping occurrences, known as ‘compound days’, were documented on 60% of heat-ERT days and 65% of cold-ERT days. Notably, although the incidence of compound days has generally declined, the combination of hot days with elevated ozone (O3) pollution levels has risen at a rate of 0.26 days per year.
Ozone, a secondary pollutant formed through the interaction of various atmospheric gases and solar radiation, poses increasing health risks as global warming escalates. “As the impact of climate change intensifies, the co-occurrence of extreme heat and ozone episodes becomes an urgent issue for Europe. It is essential to address these compound days and develop strategies targeted at secondary pollutants like ozone, given that the adverse health implications of extreme temperatures and air quality are interconnected and can exacerbate negative outcomes,” states Zhao-Yue Chen.
Context of the EARLY-ADAPT Project
The findings of this study are part of the EARLY-ADAPT project, which is funded by the European Research Council and is dedicated to understanding how populations adapt to public health challenges posed by climate change.
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