Box 81 The European heatwave 2003 impacts and adaptation

In August 2003, a heatwave in France caused more than 14,800 deaths (Figure 8.2). Belgium, the Czech Republic, Germany, Italy, Portugal, Spain, Switzerland, the Netherlands and the UK all reported excess mortality during the heatwave period, with total deaths in the range of 35,000 (Hemon and Jougla, 2004; Martinez-Navarro et al., 2004; Michelozzi et al., 2004; Vandentorren et al., 2004; Conti et al., 2005; Grize et al., 2005; Johnson et al., 2005). In France, around 60% of the heatwave deaths occurred in persons aged 75 and over (Hemon and Jougla, 2004). Other harmful exposures were also caused or exacerbated by the extreme weather, such as outdoor air pollutants (tropospheric ozone and particulate matter) (EEA, 2003), and pollution from forest fires.

Mortality in excess (%)

Mortality in excess (%)

i June

i June

15 M OS 10 June June Jul Jul

25 30 04 oa M 19 Jul Jul Aug Aug Aug Aug

Mean Daily Mortality 1999-2002

Mean Daily Mortality 2003

Mean Doily Summer Temperature 1999-2002

Mean Daily Summer Temperature 2003

15 M OS 10 June June Jul Jul

25 30 04 oa M 19 Jul Jul Aug Aug Aug Aug

©IGN-BDCARTO® 1999-AutwiMUon l GCQ0-30

Mean Daily Mortality 1999-2002

Mean Daily Mortality 2003

Mean Doily Summer Temperature 1999-2002

Mean Daily Summer Temperature 2003

Figure 8.2. (a) The distribution of excess mortality in France from 1 to 15 August 2003, by region, compared with the previous three years (INVS, 2003); (b) the increase in daily mortality in Paris during the heatwave in early August (Vandentorren and Empereur-Bissonnet, 2005).

A French parliamentary inquiry concluded that the health impact was 'unforeseen', surveillance for heatwave deaths was inadequate, and the limited public-health response was due to a lack of experts, limited strength of public-health agencies, and poor exchange of information between public organisations (Lagadec, 2004; Sénat, 2004).

In 2004, the French authorities implemented local and national action plans that included heat health-warning systems, health and environmental surveillance, re-evaluation of care of the elderly, and structural improvements to residential institutions (such as adding a cool room) (Laaidi et al., 2004; Michelon et al., 2005). Across Europe, many other governments (local and national) have implemented heat health-prevention plans (Michelozzi et al., 2005; WHO Regional Office for Europe, 2006).

Since the observed higher frequency of heatwaves is likely to have occurred due to human influence on the climate system (Hegerl et al., 2007), the excess deaths of the 2003 heatwave in Europe are likely to be linked to climate change.

waves can still cause substantial increases in mortality if electricity or heating systems fail. Cold-waves also affect health in warmer climates, such as in South-East Asia (EM-DAT, 2006).

8.2.13 Estimates of heat and cold effects

Methods for the quantification of heat and cold effects have seen rapid development (Braga et al., 2002; Curriero et al., 2002; Armstrong et al., 2004), including the identification of medical, social, environmental and other factors that modify the temperature-mortality relationship (Basu and Samet, 2002; Koppe et al., 2004). Local factors, such as climate, topography, heat-island magnitude, income, and the proportion of elderly people, are important in determining the underlying temperature-mortality relationship in a population (Curriero et al., 2002; Hajat, 2006). High temperatures contribute to about 0.5 - 2% of annual mortality in older age groups in Europe (Pattenden et al., 2003; Hajat et al., 2006), although large uncertainty remains in quantifying this burden in terms of years of life lost.

The sensitivity of a population to temperature extremes changes over decadal time-scales (Honda et al., 1998). There is some indication that populations in the USA became less sensitive to high temperatures over the period 1964 to 1988 (as measured imprecisely by population- and period-specific thresholds in the mortality response) (Davis et al., 2002, 2003, 2004). Heat-related mortality has declined since the 1970s in South Carolina, USA, and south Finland, but this trend was less clear for the south of England (Donaldson et al., 2003). Cold-related mortality in European populations has also declined since the 1950s (Kunstetal., 1991;Lerchl, 1998;Carson etal.,2006). Cold days, cold nights and frost days have become rarer, but explain only a small part of this reduction in winter mortality; as improved home heating, better general health and improved prevention and treatment of winter infections have played a more significant role (Carson et al., 2006). In general, population sensitivity to cold weather is greater in temperate countries with mild winters, as populations are less well-adapted to cold (Eurowinter Group, 1997; Healy, 2003).

8.2.2 Wind, storms and floods

Floods are low-probability, high-impact events that can overwhelm physical infrastructure, human resilience and social organisation. Floods are the most frequent natural weather disaster (EM-DAT, 2006). Floods result from the interaction of rainfall, surface runoff, evaporation, wind, sea level and local topography. In inland areas, flood regimes vary substantially depending on catchment size, topography and climate. Water management practices, urbanisation, intensified land use and forestry can substantially alter the risks of floods (EEA, 2005). Windstorms are often associated with floods.

Major storm and flood disasters have occurred in the last two decades. In 2003,130 million people were affected by floods in China (EM-DAT, 2006). In 1999, 30,000 died from storms followed by floods and landslides in Venezuela. In 2000/2001, 1,813 died in floods in Mozambique (IFRC, 2002; Guha-Sapir et al., 2004). Improved structural and non-structural measures, particularly improved warnings, have decreased mortality from floods and storm surges in the last 30 years (EEA, 2005); however, the impact of weather disasters in terms of social and health effects is still considerable and is unequally distributed (see Box 8.2). Flood health impacts range from deaths, injuries, infectious diseases and toxic contamination, to mental health problems (Greenough et al., 2001; Ahern et al., 2005).

In terms of deaths and populations affected, floods and tropical cyclones have the greatest impact in South Asia and Latin America (Guha-Sapir et al., 2004; Schultz et al., 2005). Deaths recorded in disaster databases are from drowning and severe injuries. Deaths from unsafe or unhealthy conditions following the extreme event are also a health consequence, but such information is rarely included in disaster statistics (Combs et al., 1998; Jonkman and Kelman, 2005). Drowning by storm surge is the major killer in coastal storms where there are large numbers of deaths. An assessment of surges in the past 100 years found that major events were confined to a limited number of regions, with many events occurring in the Bay of Bengal, particularly Bangladesh (Nicholls, 2003).

Populations with poor sanitation infrastructure and high burdens of infectious disease often experience increased rates of diarrhoeal diseases after flood events. Increases in cholera (Sur et al., 2000; Gabastou et al., 2002), cryptosporidiosis (Katsumata et al., 1998) and typhoid fever (Vollaard et al., 2004)

0 0

Post a comment