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Urban, A.* ; Huber, V. ; Henry, S.* ; Plaza, N.P.* ; Tušlová, L.* ; Dasgupta, S.* ; Masselot, P.* ; Cvijanovic, I.* ; Mistry, M.* ; Pascal, M.* ; de'Donato, F.* ; Di Napoli, C.* ; Gosling, S.N.* ; Kohnová, S.* ; Kyselý, J.* ; Lüthi, S.* ; Pau, L.F.* ; Ragettli, M.S.* ; Ruuhela, R.* ; Ryti, N.* ; da Silva, S.D.N.P.* ; Zemah-Shamir, S.* ; Thiery, W.* ; Vicedo-Cabrera, A.M.* ; Wieczorek, J.* ; Sera, F.* ; Armstrong, B.* ; Gasparrini, A.*

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

Environ. Res. Lett. 20:124071 (2025)
Postprint DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
Heat-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.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Heat Adaptation ; Heat And Health Warning Systems ; Heat Prevention Plans ; Heat-related Mortality; Temperature; Cold
ISSN (print) / ISBN 1748-9318
e-ISSN 1748-9326
Journal Environmental Research Letters
Quellenangaben Volume: 20, Issue: 12, Pages: , Article Number: 124071 Supplement: ,
Publisher Institute of Physics Publishing (IOP)
Publishing Place No.2 The Distillery, Glassfields, Avon Street, Bristol, England
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)
Grants Czech Science Foundation
HORIZON EUROPE Climate, Energy and Mobility
Swiss National Science Foundation
European Research Council
Horizon 2020 Framework Programme
Medical Research Council
Marie Sklstrok
odowska-Curie Grant
Wellcome Trust
Czech Ministry of Education Youth and Sport