European Commission, Joint Research Centre, Seville, Spain.
Environment and Health Modelling Laboratory, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
Lancet Public Health. 2024 Sep;9(9):e644-e653. doi: 10.1016/S2468-2667(24)00179-8. Epub 2024 Aug 21.
Excessively high and low temperatures substantially affect human health. Climate change is expected to exacerbate heat-related morbidity and mortality, presenting unprecedented challenges to public health systems. Since localised assessments of temperature-related mortality risk are essential to formulate effective public health responses and adaptation strategies, we aimed to estimate the current and future temperature-related mortality risk under four climate change scenarios across all European regions.
We modelled current and future mortality due to non-optimal temperatures across 1368 European regions, considering age-specific characteristics and local socioeconomic vulnerabilities. Overseas territories were excluded from the analysis. We applied a three-stage method to estimate temperature-related risk continuously across age and spatial dimensions. Age and city-specific exposure-response functions were obtained for a comprehensive list of 854 European cities from the Urban Audit dataset of Eurostat. Regional aggregates were calculated using an aggregation and extrapolation method that incorporates the risk incidence in neighbouring cities. Mortality was projected for present conditions observed in 1991-2020 and for four different levels of global warming (1·5°C, 2°C, 3°C, and 4°C increase) by regions, and subregions using an ensemble of 11 climate models produced by the Coordinated Regional Climate Downscaling Experiment-CMIP5 over Europe, and population projection data from EUROPOP2019.
Our results highlight regional disparities in temperature-related mortality across Europe. Between 1991 and 2020, the number of cold-related deaths was 2·5 times higher in eastern Europe than western Europe, and heat-related deaths were 6 times higher in southern Europe than in northern Europe. During the same time period, there were a median of 363 809 cold-related deaths (empirical 95% CI 362 493-365 310) and 43 729 heat-related deaths (39 880-45 921), with a cold-to-heat-related death ratio of 8·3:1. Under current climate policies, aligned with 3°C increase in global warming, it is estimated that temperature-related deaths could increase by 54 974 additional deaths (24 112-80 676) by 2100, driven by rising heat-related deaths and an ageing population, resulting in a cold-to-heat-related death ratio of 2·6:1. Climate change is also expected to widen disparities in regional mortality, particularly impacting southern regions of Europe as a result of a marked increase in heat-related deaths.
This study shows that regional disparities in temperature-related mortality risk in Europe are substantial and will continue to increase due to the effects of climate change and an ageing population. The data presented can assist policy makers and health authorities in mitigating increasing health inequalities by prioritising the protection of more susceptible areas and older population groups. We identify the projected areas of heightened risk (southern Europe), where policy intervention aimed at building adaptation and enhancing resilience should be prioritised.
European Commission.
过高或过低的温度都会对人类健康产生重大影响。预计气候变化将加剧与热有关的发病率和死亡率，这对公共卫生系统带来前所未有的挑战。由于局部评估与温度相关的死亡风险对于制定有效的公共卫生应对措施和适应策略至关重要，因此我们旨在根据四个气候变化情景评估全欧洲区域目前和未来与温度相关的死亡风险。
我们通过考虑特定年龄和当地社会经济脆弱性的 1368 个欧洲区域模型，评估了非最佳温度下的当前和未来死亡率。我们排除了海外领土进行分析。我们应用了一个三阶段的方法，在年龄和空间维度上连续估计与温度相关的风险。从欧盟统计局的城市审计数据集中，我们为 854 个欧洲城市的综合列表获得了与年龄和城市特定的暴露-反应函数。通过使用包含邻近城市风险发生率的聚合和外推方法，计算了区域汇总数据。根据欧洲协调区域气候降尺度实验（CMIP5）产生的 11 个气候模型的集合以及来自 EUROPOP2019 的人口预测数据，我们为目前 1991-2020 年的观测条件和四个不同的全球变暖水平（1.5°C、2°C、3°C 和 4°C 增加）进行了区域和子区域的死亡率预测。
我们的结果突出了欧洲与温度相关的死亡率的区域差异。在 1991 年至 2020 年期间，东欧与西欧相比，与寒冷相关的死亡人数高出 2.5 倍，与炎热相关的死亡人数在南欧比北欧高出 6 倍。在同一时期，有 363809 例与寒冷相关的死亡（经验 95%CI 362493-365310）和 43729 例与炎热相关的死亡（39880-45921），寒冷与炎热相关的死亡比例为 8.3:1。在当前的气候政策下，与全球变暖 3°C 的增幅一致，预计到 2100 年，与温度相关的死亡人数将增加 54974 例（24112-80676），这主要是由于与炎热相关的死亡人数增加和人口老龄化，导致寒冷与炎热相关的死亡比例为 2.6:1。气候变化预计还会扩大区域死亡率的差异，特别是由于与炎热相关的死亡人数显著增加，这将对欧洲南部地区产生重大影响。
这项研究表明，欧洲与温度相关的死亡率风险的区域差异很大，并且由于气候变化和人口老龄化的影响，这种差异将继续增加。本研究提供的数据可以帮助政策制定者和卫生当局通过优先保护更脆弱的地区和老年人群体来减轻不断增加的健康不平等。我们确定了预测的高风险地区（欧洲南部），在这些地区应优先考虑采取政策干预措施，以建立适应能力并增强弹性。
欧盟委员会。
