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The effectiveness of heat prevention plans in reducing heat-related mortality across Europe

2025-12-01Artigo científico Acesso aberto
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dc.contributor.authorUrban, Aleš
dc.contributor.authorHuber, Veronika
dc.contributor.authorHenry, Salomé
dc.contributor.authorPlaza, Nuria Pilar
dc.contributor.authorTušlová, Lucie
dc.contributor.authorDasgupta, Shouro
dc.contributor.authorMasselot, Pierre
dc.contributor.authorCvijanovic, Ivana
dc.contributor.authorMistry, Malcolm
dc.contributor.authorPascal, Mathilde
dc.contributor.authorde'Donato, Francesca
dc.contributor.authorDi Napoli, Claudia
dc.contributor.authorGosling, Simon N.
dc.contributor.authorKohnová, Silvia
dc.contributor.authorKyselý, Jan
dc.contributor.authorLüthi, Samuel
dc.contributor.authorPau, Louis-François
dc.contributor.authorRagettli, Martina S.
dc.contributor.authorRuuhela, Reija
dc.contributor.authorRyti, Niilo
dc.contributor.authordas Neves Pereira da Silva, Susana
dc.contributor.authorZemah-Shamir, Shiri
dc.contributor.authorThiery, Wim
dc.contributor.authorVicedo-Cabrera, Ana-Maria
dc.contributor.authorWieczorek, Joanna
dc.contributor.authorSera, Francesco
dc.contributor.authorArmstrong, Ben
dc.contributor.authorGasparrini, Antonio
dc.date.accessioned2026-01-13T17:17:19Z
dc.date.available2026-01-13T17:17:19Z
dc.date.issued2025-12-01
dc.description.abstractHeat-health warning systems and action plans, referred to as heat prevention plans (HPPs), are key public health interventions aimed at reducing heat-related mortality. Despite their importance, prior assessments of their effectiveness have yielded inconsistent results. The objective of this study is to systematically assess the effectiveness of HPPs in reducing heat-related mortality risk across Europe. We analysed daily mortality and mean temperature data from 102 locations in 14 European countries between 1990 and 2019. Using data from national experts, we identified the year of HPP implementation and categorised their development class. A three-stage analysis was conducted: (1) quasi-Poisson time series models were used to estimate location-specific warm-season exposure-response functions in 3 year subperiods; (2) mixed-effect meta-regression models with multilevel longitudinal structures were employed to quantify changes in pooled exposure-response functions due to HPP implementation, adjusted for long-term trends in heat-related mortality risks; and (3) the heat-related excess mortality due to HPP was calculated by comparing factual (with HPP) and counterfactual (without HPP) scenarios. Estimates are reported by country, region, and HPP class. HPP implementation was associated with a 25.2% [95% CI: 19.8% to 31.9%] reduction in excess deaths attributable to extreme heat, corresponding to 1.8 [95% CI: 1.3-2.4] avoided deaths annually per 100 000 inhabitants. This equates to an estimated 14 551 [95% CI: 10 118-19 072] total deaths avoided across all study locations following HPP implementation. No significant differences in HPP effectiveness were observed by European region or HPP class. Our findings provide robust evidence that HPPs substantially reduce heat-related mortality across Europe, accounting for temporal changes and geographical differences in risks. These results emphasise the importance of monitoring and evaluating HPPs to enhance adaptation to a warming climate.eng
dc.description.sponsorshipThe collection of HPP data and the expert elicitation workshop were supported by COST Action ‘PROCLIAS’ (Grant ID: 19139). AU and JK were supported by the Czech Science Foundation (Grant ID: 22−24920S). AU acknowledges funding from the European Union’s Horizon Europe project ‘CROSSEU’ (Grant ID: 101081377) and the Czech Ministry of Education Youth and Sport’s programme ERC CZ (Grant ID: LL2410). VH was supported by the EU’s Horizon 2020 research and innovation programme (Marie Skłodowska−Curie Grant Agreement No.: 101032087). AMVC acknowledges funding from the Swiss National Science Foundation (Grant ID: TMSGI3_211626). WT received funding from the European Research Council (ERC) under the European Union’s Horizon Framework research and innovation programme (Grant ID: 101076909; ‘LACRIMA’ project). AG acknowledges funding from Medical Research Council−UK (Grant ID: MR/V034162/1), European Union’s Horizon 2020 Project ‘Exhaustion’ (Grant ID: 820655) and Wellcome Trust (Grant ID: 308914/Z/23/Z).
dc.identifier.citationEnviron Res Lett. 2025 Dec;20(12):124071. doi: 10.1088/1748-9326/ae2775. Epub 2025 Dec 23
dc.identifier.doi10.1088/1748-9326/ae2775
dc.identifier.eissn1748-9326
dc.identifier.pmid41446344
dc.identifier.urihttp://hdl.handle.net/10400.18/10691
dc.language.isoeng
dc.peerreviewedyes
dc.publisherIOP Publishing
dc.relationATTributing heAt-related excess mortality and morbidity to Climate cHange
dc.relationExposure to heat and air pollution in EUrope – cardiopulmonary impacts and benefits of mitigation and adaptation
dc.relation101076909
dc.relation820655
dc.relation.hasversionhttps://iopscience.iop.org/article/10.1088/1748-9326/ae2775
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectHeat Adaptation
dc.subjectHeat and Health Warning Systems
dc.subjectHeat Prevention Plans
dc.subjectHeat-Related Mortality
dc.subjectMCC
dc.subjectEurope
dc.subjectDeterminantes da Saúde e da Doença
dc.titleThe effectiveness of heat prevention plans in reducing heat-related mortality across Europeeng
dc.typejournal article
dcterms.referenceshttps://iopscience.iop.org/article/10.1088/1748-9326/ae2775/data
dspace.entity.typePublication
oaire.awardTitleATTributing heAt-related excess mortality and morbidity to Climate cHange
oaire.awardTitleExposure to heat and air pollution in EUrope – cardiopulmonary impacts and benefits of mitigation and adaptation
oaire.awardURIinfo:eu-repo/grantAgreement/EC/H2020/101032087/EU
oaire.awardURIinfo:eu-repo/grantAgreement/EC/H2020/820655/EU
oaire.citation.issue12
oaire.citation.startPage124071
oaire.citation.titleEnvironmental Research Letters
oaire.citation.volume20
oaire.fundingStreamH2020
oaire.fundingStreamH2020
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNamedas Neves Pereira da Silva
person.givenNameSusana
person.identifier.ciencia-idB718-8EF6-EBD8
person.identifier.orcid0000-0003-2524-0548
project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.nameEuropean Commission
project.funder.nameEuropean Commission
relation.isAuthorOfPublication49b180bc-3e03-4347-9e32-5725fd7142f8
relation.isAuthorOfPublication.latestForDiscovery49b180bc-3e03-4347-9e32-5725fd7142f8
relation.isProjectOfPublication92301729-57ae-47a4-bde2-8ed2d8fc20da
relation.isProjectOfPublication59609b8b-2750-43e0-8fe9-155a4915a572
relation.isProjectOfPublication.latestForDiscovery92301729-57ae-47a4-bde2-8ed2d8fc20da

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