Identifying susceptible populations for public health action. Results from the PHASE project.

Abstract

Background and aims: Extreme weather events (EWEs) have been increasing as a result of climate change. An objective of the European funded PHASE project, is to define subgroups of the population susceptible to EWEs such as heat waves, cold spells, floods, forest fires and air pollutants. Methods: Case-study analyses among PHASE cities were carried out to estimate the effects of EWEs and identify susceptible subgroups using different methodologies (time series, case cross over analysis and cohort approach). Where primary studies were not yet performed, a literature review was carried out to summarize susceptibility factors to EWEs. Results: Analyses from PHASE show: Heat. In the last decades, the effect of heat in the 65-74 age group is increasing while among the very old (75+ years) the effect is declining and there has also been a reduction in the harvesting effect. An effect of high temperatures among children was also observed, especially for respiratory diseases. Exposure to high temperatures increases the risk of preterm births (+2% for every 1°C increase). Among cohorts of adult patients within chronic diseases (Diabetes, COPD, MI survivors, CHF, Psychiatric disease) an increase in deaths during extreme heat days was observed. Floods. The indirect health effects of floods include respiratory disease, mental health, gastroenteritis; children and persons with chronic-related conditions are most at risk. Specific case studies within PHASE are ongoing. Air pollutionForest Fires. Through the use of satellite data, a EU map of the areas at-risk to fires was defined and an emissions inventory will allow to estimate the health effects of wild fires in selected case studies. The health effects of urban air pollution seem to be exacerbated during extreme temperatures, especially for respiratory and cardiovascular causes. Conclusions: Specific public health measures should be focused on subgroups that will suffer the greatest health burden through life as a consequence of exposure to EWEs. Results from the PHASE project on subgroups susceptible to EWEs need to be integrated in public health guidelines.