With public consultations well under way, the EU is ready to revise its climate adaptation strategy this year. The new strategy needs to include human health as an important climate adaptation measure.
Heat waves, cold spells and the increased frequency in extreme events due to climate change have a high impact on human health. Extreme temperatures are an immediate threat to human health in Europe, and adaptation measures are needed to tackle climate impacts and their associated socio-economic costs within EU. The cost perspective alone should give pause: the implementation of adaptation measures are likely to create savings in the long-term and increase the well-being of populations at large.
Extreme events have caused substantial economic losses in Europe, averaging up to 14 billion euros annually since 2000. The reported losses have so far focused on structural damages on physical assets. What we have failed to assess is the costs on human health and society.
An average length hospitalization from any cause costs approx. 4.200 euros in the EU. By the end of the century, it is estimated that over 170.000 annual hospital admissions in Europe will be caused by temperature increase. For comparison, South-East Asia registers 15 to 20 per cent loss to annual work hours due to climate conditions. EU member states can witness annual labor productivity losses of a few percentages of GDP already by 2030.
Climate change is reversing many of the improvements to human health gained over the last decades, making it more difficult for countries to achieve the Sustainable Development Goals and eradicate poverty, thus increasing economic inequality. Climate change affects vulnerable population groups disproportionally. Vulnerability to climate change is dependent on the level of exposure, access to resources and general health and lifestyle. With an aging population, the elderly are a particularly vulnerable group in Europe due to a loss in thermoregulatory functions, a high prevalence of chronic diseases and limited mobility. Small children, pregnant women, migrants, and workers in particular industries are also more vulnerable to changes in the environment.
Extreme heat is associated with a multitude of health issues. For example cardiovascular and respiratory diseases, dehydration, kidney failure, fatigue, heat stroke, and worker productivity loss. The heat wave that struck Europe in 2003 claimed tens of thousands of lives. So did the Russian heat wave in 2010.
High temperatures and the general instability of the global climate system raises concerns in most European countries. The Mediterranean and continental regions will be exposed to more frequent and intensive heat waves. The number of hot days and high temperature extremes have increased significantly since the pre-industrial time, with the greatest impact in the Iberian Peninsula and southern France. The IPCC warns in its latest report that extreme temperatures are ‘very likely’ to increase in magnitude and frequency in the upcoming decades. The WHO also says that heat is a major health concern in Europe.
Cold spells bear the responsibility for most extreme temperature related premature deaths today. While winters are expected to be milder in Europe in the coming decades,air mass circulation patterns can increase the occurrence of both intense extreme cold and hot events.
Moreover, disruption in precipitation patterns is expected to lead to droughts and flooding while the risk of forest fires will increase dramatically. Studies published in 2017 estimate that we will face a steep rise in heat-related mortality rates which will not be equaled by the corresponding reduction in cold-related mortality rates.
Among all environmental factors, air pollution has the most severe impact on human health in Europe today, being responsible for over 500.000 premature deaths annually. Atmospheric blocking and stagnating weather conditions are favorable for extreme temperatures and are often associated with high levels of air pollution, suggesting a synergistic co-occurrence between the two. During the European heat wave in 2003, as much as 50 percent of deaths were possibly associated with ozone exposure rather than with heat itself.
We expect to see more double-whammy’s in the future: more extreme temperature events coupled with air pollution. In fact, a range of studies show interacting physiological impacts of the two environmental stressors, where health damage from air pollution is enhanced in hot weather and, vice versa, the health effects from heat stress get worse when air pollution levels are high.
Policies on health impacts of climate change have largely focused on vector-borne and other communicable diseases. Non-communicable diseases have so far received little or no attention, partly because of perceived knowledge gaps and attribution problems. However, the negative impacts of climate change on human health are increasingly studied and attempts are made to estimate their extent. An open Horizon2020 call on climate change impacts on health in Europe aims to fill some of the existing knowledge gaps.
That is all good, but will it suffice? We do not think so.
Extreme events due to climate change and their impact on human health need to find a place in the revised EU adaptation strategy if it is to remain relevant for member states. The EU should emphasize the need for further identification and implementation of human health adaptation measures against extreme temperatures in the revised strategy, and work to fill the remaining knowledge gaps so that member states can implement cost effective adaptation strategies.