Exhaustion

Heat stress in cities is projected to strongly increase due to climate change. The associated health risks will be exacerbated by the high population density in cities and the urban heat island effect. However, impacts are still uncertain, which is among other factors due to the existence of multiple metrics for quantifying ambient heat and the typically rather coarse spatial resolution of climate models. Our results emphasise the value of high-resolution climate model simulations for analysing climate extremes at the city level. At the same time, they highlight that improving the predominantly rather simple representations of urban areas in climate models would make their simulations even more valuable for planning adaptation measures in cities.

We used a risk matrix approach to develop heat-related hazard, impact, and risk maps.  We used satellite-derived land surface temperatures (MODIS LSTs) to cope with the need for a fine horizontal resolution for the climate index. We have defined the impact index as emergency (paramedic) interventions for daytime and nighttime, from the period June-August 2012-2017 (SMURD – Emergency Situation Inspectorate Bucuresti-Ilfov) and June-August 2018 (Service of Ambulance Bucuresti-Ilfov).

• Heat effect modification by air pollution on cardiovascular and respiratory mortality was investigated across 482 cities.
• Heat effect was seen to be significantly modified by air pollutants PM10, PM2.5, O3, and NO2.
• This study is the most extensive research to date investigating the heat effect modification on cardiovascular and respiratory mortality.
• This is the first-ever study to deeply investigate effect modifications by air pollutants such as PM2.5 and NO2.

Heat and cold are established environmental risk factors for human health. However, mapping the related health burden is a difficult task due to the complexity of the associations and the differences in vulnerability and demographic distributions. In this study, we did a comprehensive mortality impact assessment due to heat and cold in European urban areas, considering geographical differences and age-specific risks.