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

DOI
Publisher DOI
PubMed ID
41446344
Abstract
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.
Date Issued
2025-12-01
Publication Type
Article
Subject(s)
Subjects
heat adaptation
•
heat and health warning systems
•
heat prevention plans
•
heat-related mortality
Language(s)
en
Author(s)
Urban, Aleš
Huber, Veronika
Henry, Salomé
Plaza, Nuria Pilar
Tušlová, Lucie
Dasgupta, Shouro
Masselot, Pierre
Cvijanovic, Ivana
Mistry, Malcolm
Pascal, Mathilde
de'Donato, Francesca
Di Napoli, Claudia
Gosling, Simon N
Kohnová, Silvia
Kyselý, Jan
Pau, Louis-François
Ragettli, Martina S
Ruuhela, Reija
Ryti, Niilo
da Silva, Susana Das Neves Pereira
Zemah-Shamir, Shiri
Thiery, Wim
Wieczorek, Joanna
Sera, Francesco
Armstrong, Ben
Additional Credits
Journal
Environmental Research Letters
Publisher
IOP Publishing
ISSN
1748-9326
Funding(s)
Access(Rights)
Unknown
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