Technical University of Denmark, Copenhagen, Denmark.
European Centre for Environment and Health, WHO Regional Office for Europe, Bonn, Germany.
Environ Res. 2022 Nov;214(Pt 1):113709. doi: 10.1016/j.envres.2022.113709. Epub 2022 Jun 30.
Adverse health effects from extreme heat remain a major risk, especially in a changing climate. Several European countries have implemented heat health action plans (HHAPs) to prevent ill health and excess mortality from heat. This paper assesses the state of implementation of HHAPs in the WHO European Region and discusses barriers and successes since the early 2000s. The results are based on a web-based survey among 53 member states on the current national and federal HHAPs in place. Guided by the eight core elements of HHAPs as outlined by the WHO Regional Office for Europe guidance from 2008, we analyzed which elements were fully or partially implemented and which areas of improvement countries identified. HHAP adaptations to account for COVID-19 were sought via literature search and expert consultations. 27 member states provided information, of which 17 countries reported having a HHAP. Five out of eight core elements, namely agreement on a lead body, accurate and timely alert systems, heat-related health information plans, strategies to reduce health exposure, and care for vulnerable groups, were at least partially implemented in all 17 plans. Alert systems were implemented most often at 94%. The least often implemented items were real-time surveillance, long-term urban planning, and preparedness of health and social systems. Five countries had published COVID-19 guidance online. Our findings suggest a progressive improvement in the development and rollout of HHAPs overall and awareness of vulnerable population groups in WHO/Europe, while integration of HHAPs into long-term climate change and health planning remains a challenge.
极端高温对健康的不利影响仍然是一个主要风险，尤其是在气候变化的情况下。一些欧洲国家已经实施了高温健康行动计划 (HHAP)，以预防高温引起的健康问题和超额死亡。本文评估了世卫组织欧洲区域 HHAP 的实施情况，并讨论了自 21 世纪初以来的障碍和成功因素。该结果基于对 53 个成员国就当前国家和联邦 HHAP 开展的在线调查。根据世卫组织欧洲区域办事处 2008 年指南中概述的 HHAP 的八项核心要素，我们分析了哪些要素已得到全面或部分实施，以及各国确定了哪些改进领域。通过文献检索和专家咨询，寻找了针对 COVID-19 的 HHAP 调整。27 个成员国提供了信息，其中 17 个国家报告称制定了 HHAP。在所有 17 项计划中，至少有五项核心要素得到了部分实施，即就牵头机构达成一致、准确和及时的警报系统、与热相关的健康信息计划、减少健康暴露的战略以及弱势群体的护理。警报系统的实施最常见，为 94%。实施最不常见的项目是实时监测、长期城市规划以及卫生和社会系统的准备情况。有五个国家在线发布了 COVID-19 指导意见。我们的研究结果表明，总体而言，HHAP 的制定和实施有所进展，世卫组织欧洲区域对弱势群体的认识有所提高，而将 HHAP 纳入长期气候变化和卫生规划仍然是一个挑战。
