WHO Europe Heat Health Action Plan guidance: an update of the evidence ten years on.

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Backround: Future climate change and the increasing frequency and intensity of heat waves poses a serious health threat to populations worldwide and the need to promote adaptation strategies. The European Centre for Environmental Health - WHO Regional Office for Europe, has carried out an update of the scientific evidence and a survey on European heat health plans currently in place. Our aim is to update the WHO Heat Health Action Plans (HHAP) guidance document.Methods/results. The document includes most relevant evidence from recent epidemiological research and lessons learned from implementation in practice. The evidence update is focused on the eight core components of a HHAP as defined by the WHO: Lead body, warning systems, information plan, reduction in indoor heat exposure, particular care for vulnerable subgroups, preparedness of the health and social services, long-term urban planning, surveillance and evaluation.The survey was disseminated via national focal points and WHO EURO Country Offices, members of the WHO EURO working group and subnational networks. Results from the survey provide an overview of current plans in place among European Member States. Over 80% of HHAPs are either a formal part or mentioned in national Climate Change policy. Most plans identify a lead body, have an information plan and a warning system in place. The latter, helps raise awareness on the health risk during heat waves at population level, while ensuring the timely planning of prevention and emergency measures. Plans acknowledge the need to target vulnerable subgroups, however who these are and what specific measures are adopted is very much heterogeneous. The formal inclusion of long-term policy addressing indoor heat reduction or urban planning has the lowest level of coverage in current HHAPs. Conclusion: The WHO document will help promote the update of HHAPs taking into account the changing climate, shifting demographics and urbanization.