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Pathways of risk Direct Increasing temperature and frequency of heatwaves. Increasing drought. Increasing riverine flooding. Sea level rise. Increasing frequency of wildfires. Other extreme weather events.

Indirect (ecosystems) Air pollution. Allergens. Water availability and quality. Food and nutrition security. Infectious disease threats (host, vector, pathogen).

Indirect (societal) Migration. Damage to infrastructure and health services. Economic effects of declining labour productivity. Conflict.

Health effects Communicable diseases: vector-borne, water-borne and food-borne. Non-communicable diseases: especially cardiovascular, cerebrovascular, respiratory, including allergies. Mental health effects. Undernutrition. Hazard-related and violent injuries and death. Health outcomes due to harmful algal blooms.

Vulnerable groups Children. Elderly people. Expectant mothers. Persons with pre-existing medical conditions. Outdoor workers. Migrants and other marginalised groups.

Figure 3.3  Summary of implications of climate change for health in Europe.

Table 3.1  Mortality per one million people attributed to extreme weather events for 1991–2015 Heatwave

Cold

Flooding and landslides

Storm

Wildfire14

Eastern

11.4

28.3

8.6

1.7

0.54

Northern

11.2

1.7

1.0

2.5

0.01

Southern

178

0.9

6.8

1.2

0.97

Western

192

0.9

2.1

2.8

0.04

Region of Europe

Table is adapted from EEA (2017a), using data from EM-DAT (http://www.emdat.be/database), Eurostat (http://ec.europa.eu/eurostat/web/population-demography-migration-projections/population-data) and WHO (http://www.euro.who.int/en/data-and-evidence). Country groupings are listed in EEA (2017a) and include, for example, Balkan States in the southern region as well as EU Member States.

of the significance of this data set, including concern on lack of comparability in collecting data over time and the impact of single events on cumulative data. Furthermore, many heat- and cold-related deaths are not classified as being due to extreme events. Therefore, the total climate-induced burden of disease will represent much higher premature mortality than the particular effects of individual extreme weather events presented in Table 3.1. It should also be noted that data on premature deaths do not give information as to how premature and thus cannot give information on life-years lost. The focus in our report is on climate change but this exploration must be set into the context of the existing evidence base on climate and health. Further information on heat- and cold-related deaths in European countries is provided in the literature (for 14 

example, Ciscar et al. 2014; Gasparrini et al. 2015) and will be discussed in the following sections. There are many more cold- than heat-related deaths but it is unclear whether and, if so, by how much, cold-related deaths will decline in Europe with climate change. 3.2  Direct heat-related health effects Heat waves and cold spells are associated with increases in premature mortality and morbidity, especially in vulnerable groups. The main effects are on cardiovascular, respiratory and cerebrovascular disease. Among groups particularly susceptible to heat are the elderly, infants and young children, those with preexisting health problems and those in hospitals, nursing homes or who are bedridden. The size of the hazard

The mortality from wildfires is conservative because it does not include air-pollution effects.

14  |  June 2019  |  Climate change and health

EASAC

The imperative of climate action to protect human health in Europe  

Opportunities for adaptation to reduce the impacts and for mitigation to capitalise on the benefits of decarbonisation. The pace and extent...

The imperative of climate action to protect human health in Europe  

Opportunities for adaptation to reduce the impacts and for mitigation to capitalise on the benefits of decarbonisation. The pace and extent...