The Summers 2003 and 2015 in South-West Germany: Heat Waves and Heat-Related Mortality in the Context of Climate Change

High risk, high gain? Trade-offs between growth and resistance to extreme events differ in northern red oak (Quercus rubra L.)

Information about the resistance and adaptive potential of tree species and provenances is needed to select suitable planting material in times of rapidly changing climate conditions. In this study, we evaluate growth responses to climatic fluctuations and extreme events for 12 provenances of northern red oak (Quercus rubra L.) that were tested across three trial sites with distinct environmental conditions in Germany. Six provenances each were sourced from the natural distribution in North America and from introduced stands in Germany. We collected increment cores of 16 trees per provenance and site. Dendroecological methods were used to compare provenance performance and establish climate-growth relationships to identify the main growth limiting factors. To evaluate the provenance response to extreme drought and frost events, three site-specific drought years were selected according to the Standardized Precipitation Evapotranspiration Index (SPEI) and 2010 as a year with an extreme late frost event. Resistance indices for these years were calculated and assessed in relation to overall growth performance. We observed a high variation in growth and in the climate sensitivity between sites depending on the prevailing climatic conditions, as well as a high intra-specific variation. Overall, summer drought and low temperatures in the early growing season appear to constrain the growth of red oak. The resistance of provenances within sites and extreme years showed considerable rank changes and interaction effects. We did not find a trade-off between growth and resistance to late frost, namely, fast growing provenances had a high frost hardiness. Further, there was no evidence for a trade-off between growth and drought hardiness. Still, responses to drought or late frost differ between provenances, pointing to dissimilar adaptive strategies. Provenances from introduced (i.e. German) stands represent suitable seed sources, as they combine a higher growth and frost hardiness compared to their North American counterparts. Drought hardiness was slightly higher in the slow-growing provenances. The results provide a better understanding of the variable adaptive strategies between provenances and help to select suitable planting material for adaptive forest management.

Heat-Related Mortality in the Extreme Summer of 2022

BACKGROUND

Estimating the excess mortality attributable to heat is a central element of the documentation of the consequences of climate change for human health. Until now, estimates of heatrelated deaths in Germany by the Robert Koch Institute (RKI) have been based on weekly mortality records.

METHODS

Our study is the first to use higher resolution data-i.e. daily all-cause mortality linked to daily mean temperatures-from each of the German federal states to assess the heat-related mortality from 2000 to 2023 in Germany, employing quasi-Poisson models and multivariate meta-regression analyses. We focus our analysis on the extreme summer of 2022.

RESULTS

Our analysis yielded an estimate of 9100 (95% CI: [7300; 10 700]) heat-related deaths in Germany for the summer of 2022, whereas previous studies of the RKI estimated the number of heatrelated deaths at 4500 [2100; 7000]. When we set a higher temperature threshold in the definition of the heat risk, we arrived at a figure of 6900 [5500; 8100] heat-related deaths in 2022. In other summers that-similarly to 2022-were characterized by large fluctuations in daily mean temperatures, we also robustly estimated higher numbers of heat-related deaths than the RKI did. The exclusion of reported deaths due to COVID-19 had only a minor effect on our estimates.

CONCLUSION

Our findings suggest that previous studies based on weekly mortality data have underestimated the full extent of heat-related mortality in Germany, particularly in the extreme summer of 2022. The monitoring of heat-related mortality should be systematic and as comprehensive as possible if it is to enable the development of effective heat-health action plans.

[Climate Crisis: What Gastrointestinal Complications of this Medical Emergency Should We Be Aware Of?]

INTRODUCTION

The climate crisis has serious consequences for many areas of life. This applies in particular to human health - also in Europe. While cardiovascular, pneumological and dermatological diseases related to the climate crisis are often discussed, the crisis' significant gastroenterological consequences for health must also be considered.

METHODS

A literature search (Pubmed, Cochrane Library) was used to identify papers with relevance particularly to the field of gastroenterology in (Central) Europe. Findings were supplemented and discussed by an interdisciplinary team.

RESULTS

The climate crisis impacts the frequency and severity of gastrointestinal diseases in Europe due to more frequent and severe heat waves, flooding and air pollution. While patients with intestinal diseases are particularly vulnerable to acute weather events, the main long-term consequences of climate change are gastrointestinal cancer and liver disease. In addition to gastroenteritis, other infectious diseases such as vector-borne diseases and parasites are important in the context of global warming, heat waves and floods.

DISCUSSION

Adaptation strategies must be consistently developed and implemented for vulnerable groups. Patients at risk should be informed about measures that can be implemented individually, such as avoiding heat, ensuring appropriate hydration and following hygiene instructions. Recommendations for physical activity and a healthy and sustainable diet are essential for the prevention of liver diseases and carcinomas. Measures for prevention and the promotion of resilience can be supported by the physicians at various levels. In addition to efforts fostering sustainability in the immediate working environment, a system-oriented commitment to climate protection is important.

The effects of summer ambient temperature on total mortality in Serbia

In the context of recent climate change, temperature-attributable mortality has become an important public health threat worldwide. A large number of studies in Europe have identified a relationship between temperature and mortality, while only a limited number of scholars provided evidence for Serbia. In order to provide more evidence for better management of health resources at the regional and local level, this study aims to assess the impact of summer temperature on the population in Serbia, using daily average temperature (Ta) and mortality (CDR (crude death rate) per 100,000). The analysis was done for five areas (Belgrade, Novi Sad, Niš, Loznica, and Vranje), covering the summer (June-August) period of 2001-2015. In order to quantify the Ta-related CDR, a generalized additive model (GAM) assuming a quasi-Poisson distribution with log as the link function was used. Five regression models were constructed, for each area, revealing a statistically significant positive relationship between Ta and CDR in four areas. The effect of Ta on CDR was defined as the relative risk (RR), which was obtained as the exponential regression coefficient of the models. RR indicates that a 1 °C increase in Ta at lag0 was associated with an increase in CDR of 1.7% for Belgrade, Novi Sad, and Niš and 2% for Loznica. The model for Vranje did not quantify a statistically significant increase in CDR due to Ta (RR=1.006, 95% CI 0.991-1.020). Similar results were confirmed for gender, with a slightly higher risk for women. Analysis across lag structure showed different exposure, but the highest effect of Ta mainly occurs over the short term and persists for 3 days.

Multivariate drought stress response of Norway spruce, silver fir and Douglas fir along elevational gradients in Southwestern Germany

The conifer tree species Norway spruce (Picea abies), silver fir (Abies alba) and Douglas fir (Pseudotsuga menziesii) are important elements in tree species composition and forest management of Central European forests, but their potential to thrive under anticipated climatic changes is still debated controversially. This study contributes a multivariate analysis of resilience components based on increment cores sampled at breast height of Norway spruce, silver fir and Douglas fir trees growing along elevational gradients in Southwestern Germany. We aimed to gain novel insights into the species-specific and elevational response of tree growth and wood density variables during the extreme drought events of the years 2003 and 2018. Our results for Norway spruce corroborate projections of its ongoing decline during climate change as the reductions of wood density and biomass production indicated high drought sensitivity at all elevations. Moreover, resilience indices of mean tree-ring density, maximum latewood density, tree-ring width and biomass production were even lower after the drought of 2018 compared to the previous drought of 2003. Silver fir, a potential substitute tree species for Norway spruce, showed unexpected results with resistance and resilience indices being significantly lower in 2018 compared to 2003 indicating that silver fir might be more vulnerable to drought than previously expected, especially at low elevations. In contrast, the superior growth rates and higher levels of drought tolerance of Douglas fir were especially pronounced during the drought of 2018 and visible across the entire elevational gradient, even though high coning intensity was present for all investigated tree species as a possible confounding factor to exacerbate the drought stress effects in the study region.

Heat-Related Mortality in Germany From 1992 to 2021

BACKGROUND

2018-2020 were unusually warm years in Germany, and the summer of 2018 was the second warmest summer since record-keeping began in 1881. Higher temperatures regularly lead to increased mortality, particularly among the elderly.

METHODS

We used weekly data on all-cause mortality and mean temperature from the period 1992-2021 and estimated the number of heat-related deaths in all of Germany, and in the northern, central, and southern regions of Germany, employing a generalized additive model (GAM). To characterize long-term trends, we compared the effect of heat on mortality over the decades.

RESULTS

Our estimate reveals that the unusually high summer temperatures in Germany between 2018 and 2020 led to a statistically significant number of deaths in all three years. There were approximately 8700 heat-related deaths in 2018, 6900 in 2019, and 3700 in 2020. There was no statistically significant heat-related increase in deaths in 2021. A comparison of the past three decades reveals a slight overall decline in the effect of high temperatures on mortality.

CONCLUSION

Although evidence suggests that there has been some adaptation to heat over the years, the data from 2018-2020 in particular show that heat events remain a significant threat to human health in Germany.

A Low-Cost Sensor Network for Real-Time Thermal Stress Monitoring and Communication in Occupational Contexts

The MoBiMet (Mobile Biometeorology System) is a low-cost device for thermal comfort monitoring, designed for long-term deployment in indoor or semi-outdoor occupational contexts. It measures air temperature, humidity, globe temperature, brightness temperature, light intensity, and wind, and is capable of calculating thermal indices (e.g., physiologically equivalent temperature (PET)) on site. It visualizes its data on an integrated display and sends them continuously to a server, where web-based visualizations are available in real-time. Data from many MoBiMets deployed in real occupational settings were used to demonstrate their suitability for large-scale and continued monitoring of thermal comfort in various contexts (industrial, commercial, offices, agricultural). This article describes the design and the performance of the MoBiMet. Alternative methods to determine mean radiant temperature (Tmrt) using a light intensity sensor and a contactless infrared thermopile were tested next to a custom-made black globe thermometer. Performance was assessed by comparing the MoBiMet to an independent mid-cost thermal comfort sensor. It was demonstrated that networked MoBiMets can detect differences of thermal comfort at different workplaces within the same building, and between workplaces in different companies in the same city. The MoBiMets can capture spatial and temporal differences of thermal comfort over the diurnal cycle, as demonstrated in offices with different stories and with different solar irradiances in a single high-rise building. The strongest sustained heat stress was recorded at industrial workplaces with heavy machinery.

Do Value Orientations and Beliefs Play a Positive Role in Shaping Personal Norms for Urban Green Space Conservation?

Urban Green Spaces (UGS) have a huge contribution to the health of urban ecosystems. However, they are threatened by numerous factors such as rapid urbanization, resource depletion, and climate change. These factors are inextricably linked to human behaviors, guided by the values and beliefs of people. According to value-belief-norm theory and norm activation model, personal norms are defined as self-expectations of pro-environmental behavior influenced by the ascription of responsibility and awareness of consequences in values and beliefs. When the conditions of responsibility and consequence awareness are met, individuals are more likely to experience a sense of moral obligation to exhibit environmentally responsible behavior. To address conservation and better enable UGS to have a positive function, we must explore how to promote the development of personal norms that are beneficial to UGS conservation. This study explored the influence that UGS values and beliefs have on personal norms. A questionnaire was administered to 1641 urban residents in Beijing, China, and Partial Least Square Structural Modeling was used to assess the causal relationship in the formation of personal norms on UGS conservation. The results showed that intrinsic, instrumental, and relational UGS value orientations contribute directly or indirectly to the formation of personal norms for the conservation of UGS through environmental beliefs as mediators, with the most significant effect being the relational value orientations. The results of the study can provide scientific guidance for future public participation in UGS conservation.

Biometeorological Conditions during the August 2015 Mega-Heat Wave and the Summer 2010 Mega-Heat Wave in Ukraine

The human-biometeorological conditions in Ukraine during two mega-heat waves were analyzed. The evaluation is based on physiologically equivalent temperature (PET). The calculation of PET is performed utilizing the RayMan model. The results revealed these two mega-heat waves produced strenuous human-biometeorological conditions on the territory of Ukraine. During the summer 2010 mega-heat wave, strong and extreme heat stress prevailed at about midday at the stations where this atmospheric phenomenon was observed. The mega-heat wave of August 2015 was characterized by a lower heat load. The diurnal variation of PET values during the researched mega-HW was similar to that of the diurnal variation of air temperature with minimum values in the early morning and maximum values in the afternoon. On the territory where mega-heat waves were observed, the number of days during which heat stress occurred for 9 h amounted to 97.6% for the period from 31 July to 12 August 2010 and 77.1% for the mega-heat wave of August 2015.

Climate change adaptation networks for small and medium-sized cities

Cities are particularly vulnerable to the impacts of climate change. Many larger cities have identified the potential impacts of different climate change adaptation scenarios. However, their smaller and medium-sized counterparts are often not able to address climate risks effectively due to a lack of necessary resources. Since a large number of cities worldwide are indeed small and medium-sized, this lack of preparedness represents a crucial weakness in global response systems. A promising approach to tackling this issue is to establish regional municipal networks. Yet, how might a regional network for small and medium-sized cities be systematically designed and further developed? Focussing on the German federal state of Baden-Wuerttemberg, we have explored this question by applying a participatory action research approach. As part of our research, we established a regional network framework for small and medium-sized cities. The framework supports small and medium-sized cities in identifying key regional actors, while taking local and regional contextual factors into account. Based on our findings, we suggest that other small and medium sized cities follow these steps: develop the knowledge base; build the network; and transfer and consolidate knowledge.

Summer UTCI variability in Poland in the twenty-first century

The paper analyses the temporal and spatial variability of the Universal Thermal Climate Index (UTCI) in Poland in summer. Summer is the season with the highest intensity of tourism traffic that is why it is important to determine biometeorological conditions, especially in popular tourist destinations such as coastal, mountain and urban areas, in the times of climate changes. The analysis was based on data from 18 stations of IMGW-PIB (Institute of Meteorology and Water Management-National Research Institute), distributed evenly in the territory of the country, and representing all eight bioclimatic regions. The data include air temperature, relative humidity, wind velocity and cloudiness at 12 UTC from summer months: June, July and August from the years 2001-2018. Thermoneutral zone was the most frequently occurring UTCI class in Poland. It was recorded during 56-75% of summer days (with the exception of mountain stations, where it occurred on 30-35% of days). Moderate heat stress is the second most frequently occurring category with a frequency from 18 to 29% with the exception of mountain and coastal areas. Extreme and very strong cold stress occurred particularly in high mountain stations, and was sporadically observed at the coast of the Baltic Sea; however, the occurrence of such conditions decreases, which if favourable for beach tourism. No cases of extreme heat stress were recorded in any of the stations. The most unfavourable bioclimatic conditions were characteristic of the Upland Region (IV), represented by Kraków and Sandomierz, where very strong heat stress occurred with a 10% frequency. This is a limitation for urban tourism in those regions. The highest UTCI values were recorded in Kraków on 17 July 2007 and 29 July 2005. The highest number of cases with strong and very strong heat stress was recorded in 2015 as a consequence of the heat wave observed in Poland in the first half of August. In the majority of the analysed stations, in the second half of the analysed period (2010-2018), an increase in the number of days with strong and very strong heat stress was observed in comparison with the first half of period (2001-2009). The highest frequency of such days was observed in July. Based on the data, there are 4 potential periods of occurrence of such days, with two most intense being 26. July-13 August and 14-22 July.

Evaluation of Tourism-Climate Conditions in the Region of Kłodzko Land (Poland)

Kłodzko Land is one of the most important regions of Poland in terms of tourism and health issues. Numerous tourism attractions and health resorts make the region attractive for both tourist and bathers. The goal of this paper was to evaluate the impact of weather conditions on tourism-related conditions and their changes in the multiannual period. In the analysis, the indices of heat days, the UTCI (Universal Thermal Climate Index) and CTIS (Climate Tourism Information Scheme) tools were used. The research on heat days and the UTCI indicated a significant increase in the heat-stress frequency over the last decades. Simultaneously, the number of weather types related to cold stress has considerably decreased. Such trends were noticed in the entire region, in all the considered hypsometric zones. The rising tendency was also observed for strong and very strong heat stress (UTCI > 32 °C), which negatively affects health problems. The analysis showed that the most extreme thermal and biothermal conditions, in terms of heat stress, occur under southern and eastern anticyclonic circulation. The CTIS analysis showed that favorable weather conditions for most of tourism activities are noticed in the warm half-year. The usefulness of weather conditions for tourism can vary depending on atmospheric circulation.

Heat Perception and Coping Strategies: A Structured Interview-Based Study of Elderly People in Cologne, Germany

The transdisciplinary project “Heat-Health Action Plan for Elderly People in Cologne” addresses the most heat-vulnerable risk group, people over 65 years of age. A quantitative study aimed to better understand heat perception and coping strategies of elderly people during heat waves to inform heat-health action plans. We conducted a representative quantitative survey via structured interviews with 258 randomly chosen people over 65 years old, living in their own homes in four areas of Cologne, Germany. These areas varied, both in terms of social status and heat strain. Data regarding demographics, health status, coping strategies, and heat perception were collected in personal interviews from August to October 2019. The majority of the participants perceived heat strain as moderate to very challenging. Women, people with a lower monthly income, and those with a lower health status found the heat more challenging. We found that participants adapted to heat with a number of body-related, home-protective, and activity-related coping strategies. The number of coping strategies was associated with perceived personal heat strain. There is a definite underuse of water-related heat adaption strategies among the elderly. This is of increasing relevance, as rising heat impact will lead to more heat-related geriatric morbidity. Our results are seminal to inform elderly-specific, socio-adapted local heat-health action plans.

A Comparative Analysis of Different Future Weather Data for Building Energy Performance Simulation

The building energy performance pattern is predicted to be shifted in the future due to climate change. To analyze this phenomenon, there is an urgent need for reliable and robust future weather datasets. Several ways for estimating future climate projection and creating weather files exist. This paper attempts to comparatively analyze three tools for generating future weather datasets based on statistical downscaling (WeatherShift, Meteonorm, and CCWorldWeatherGen) with one based on dynamical downscaling (a future-typical meteorological year, created using a high-quality reginal climate model). Four weather datasets for the city of Rome are generated and applied to the energy simulation of a mono family house and an apartment block as representative building types of Italian residential building stock. The results show that morphed weather files have a relatively similar operation in predicting the future comfort and energy performance of the buildings. In addition, discrepancy between them and the dynamical downscaled weather file is revealed. The analysis shows that this comes not only from using different approaches for creating future weather datasets but also by the building type. Therefore, for finding climate resilient solutions for buildings, care should be taken in using different methods for developing future weather datasets, and regional and localized analysis becomes vital.

Heat-Related Mortality

BACKGROUND

As a consequence of global warming, heat waves are expected to become more frequent, more intense, and longer. The elderly and persons with chronic diseases are especially vulnerable to health problems due to heat. This article is devoted to the question of the extent to which the effects of heat waves in Germany are changing over time, and whether preventive health measures are working.

METHODS

We use a statistical model to quantify the effect of high mean temperatures on mortality. Within this model, different exposure-response curves for the three temporal intervals 1992-2000, 2001-2010, and 2011-2017 are estimated. Attention is also paid to the delayed effect on mortality of high mean temperatures in the preceding week.

RESULTS

Our analysis reveals a clear, systematic association of the mean temperature in the current week, as well as the mean temperature in the preceding week, with weekly mortality. This association is more pronounced for higher age groups and decreases over the years under analysis, with the exception of a relatively weak effect of heat in southern Germany in 1992-2000. The strongest effects were related to the heat waves in 1994 and 2003, with approximately 10 200 and 9600 fatalities, respectively. Approximately 7800 fatalities were estimated for the summer of 2006, and 4700 and 5200 for 2010 and 2015, respectively.

CONCLUSION

In Germany, as elsewhere, climate change has been causing more frequent, more intense, and longer periods of heat in the summer. The harmful effect of heat on health is reduced by adaptive processes, presumably including successful preventive measures. Such measures should be extended in the future, and perhaps complemented by other measures in order to further diminish the effect of heat on mortality .

Urban Geometry Optimization to Mitigate Climate Change: Towards Energy-Efficient Buildings

The density of building blocks and insufficient greenery in cities tend to contribute dramatically not only to increased heat stress in the built environment but also to higher energy demand for cooling. Urban planners should, therefore, be conscious of their responsibility to reduce energy usage of buildings along with improving outdoor thermal efficiency. This study examines the impact of numerous proposed urban geometry cases on the thermal efficiency of outer spaces as well as the energy consumption of adjacent buildings under various climate change scenarios as representative concentration pathways (RCP) 4.5 and 8.5 climate projections for New Aswan city in 2035. The investigation was performed at one of the most underutilized outdoor spaces on the new campus of Aswan University in New Aswan city. The potential reduction of heat stress was investigated so as to improve the thermal comfort of the investigated outdoor spaces, as well as energy savings based on the proposed strategies. Accordingly, the most appropriate scenario to be adopted to cope with the inevitable climate change was identified. The proposed scenarios were divided into four categories of parameters. In the first category, shelters partially (25–50% and 75%) covering the streets were used. The second category proposed dividing the space parallel or perpendicular to the existing buildings. The third category was a hybrid scenario of the first and second categories. In the fourth category, a green cover of grass was added. A coupling evaluation was applied utilizing ENVI-met v4.2 and Design-Builder v4.5 to measure and improve the thermal efficiency of the outdoor space and reduce the cooling energy. The results demonstrated that it is better to cover outdoor spaces with 50% of the overall area than transform outdoor spaces into canyons.

Review of Biometeorology of Heatwaves and Warm Extremes in Europe

Numerous extreme heatwaves producing large impacts on human health, agriculture, water resources, energy demand, regional economies, and forest ecosystems occurred during the first twenty years of the 21st century. The present study strives to provide a systematic review of recent studies of warm biometeorological extremes in Europe. The main aim of this paper is to provide a methodical summary of the observed changes in warm extremes, duration, and variability in different parts of Europe. During the last decade, much attention has been paid to the negative impacts of heat and humidity on human health. Therefore, the human biometeorology is required to appraise the human thermal environment in a way that human thermoregulation is taken into account. In many European countries and regions, future heat exposure will indeed exceed critical levels, and a steep increase in biometeorological heatwaves and warm extremes are expected. The indices that take into account human energy balance along with weather conditions should be used to examine the impacts of extreme heatwaves on human health and should be used as a basis for the determination of acclimatization to high-heat-stress conditions. A detailed description of recent studies that have used biometeorological indices such as Physiological Equivalent Temperature (PET) and Universal Thermal Climate Index (UTCI) for the estimation of warm extremes and their influence on human health is provided. Additionally, a short overview of the existence of the heat-health warning systems (HHWS), their conceptualization, and implementation across the European continent is considered, as well as the possibilities for further investigations and implementation of effective measures and programs that could reduce the adverse health impacts.

The Influence of Urban Climate on Bioclimatic Conditions in the City of Iași, Romania

This study was carried out in order to outline the human bioclimatic stress/comfort conditions within the area of Iași city, Romania. The meteorological data were obtained over a 7-year period (December 2012–November 2019) from an observation network relying on 8 fixed observation points located in selected spots, relevant for the urban climate conditions in the region. The results demonstrate firstly that throughout the entire analyzed period, using the thermo-hygrometric index (THI), “very cold” conditions characterize 4% of the entire year in the inner parts of the city and 6% in the rural area, while the “hot” THI conditions vary from 18% in the middle of the urban heat island to 15% in the rural area. Overall, the rural areas are generally more comfortable than the inner city, especially during summer, when the urban heat island (UHI) core is starting to develop from the evening and persists during the night. On the contrary, the UHI renders the inner city more comfortable than the rural surroundings from October to April. Similar bioclimatic conditions are also presented in detail for the summer by the relative strain index (RSI), which exceeds the stress threshold value mostly during heat waves, when a significant contrast between urban and rural areas is felt. In brief, it has been determined that the most suitable area for human comfort in Iași city is inside the urban area during the winter and in the rural areas during the summer.

Heat Extremes, Public Health Impacts, and Adaptation Policy in Germany

Global warming with increasing weather extremes, like heat events, is enhancing impacts to public health. This essay focuses on unusual extreme summer heat extremes occurring in Germany at higher frequency, longer duration, and with new temperature records. Large areas of the country are affected, particularly urban settlements, where about 77% of the population lives, which are exposed to multiple inner-city threats, such as urban heat islands. Because harm to public health is directly released by high ambient air temperatures, local and national studies on heat-related morbidity and mortality indicate that vulnerable groups such as the elderly population are predominantly threatened with heat-related health problems. After the severe mortality impacts of the extreme summer heat 2003 in Europe, in 2008, Germany took up the National Adaptation Strategy on Climate Change to tackle and manage the impacts of weather extremes, for example to protect people’s health against heat. Public health systems and services need to be better prepared to improve resilience to the effects of extreme heat events, e.g., by implementing heat health action plans. Both climate protection as well as adaptation are necessary in order to be able to respond as adequate as possible to the challenges posed by climate change.

Comparison of Respiratory and Ischemic Heart Mortalities and their Relationship to the Thermal Environment

Chronic respiratory and ischemic heart diseases are globally important parts of total mortality. This study focuses on the occurrence of mortality due to these disease groups in Germany and possible effects of the thermal environment. A retrospective analysis on the mortality rates of chronic lower respiratory diseases (CLRD) and ischemic heart diseases (IHD) at the regional level in Germany for the period 2001–2015 was done in combination with meteorological observations from the network of the German Meteorological Service. In order to control the mortality data for long-term and seasonal trends, a 365-day Gaussian low-pass filter with a filter response function was applied. The thermal environment was analysed using 2 m air temperature (Ta) and the human biometeorological index Perceived Temperature (PT). The relationship of the Relative Risk (RR) of mortality to the thermal environment is displayed as an exposure–response curve, with threshold values at which RR increases significantly towards higher and lower temperature values. CLRD mortality increases above 17.6 °C, at approximately 4.4%/°C (CI: ± 0.3). The increase of IHD mortality above the threshold of 18.8 °C is less steep, at 3.5%/°C (CI: ± 0.2). During hot periods, CLRD mortality increases by 19.9%, which is twice as much as IHD mortality, with an increase of 9.8%. However, cold days and cold periods affect IHD slightly more than CLRD. The results highlight the concerns of CLRD patients during hot days as well as heat waves. This could lead to better precautions being taken for respiratory patients, which are already established for cardiac patients in Germany.

Temperature-related excess mortality in German cities at 2 °C and higher degrees of global warming

BACKGROUND

Investigating future changes in temperature-related mortality as a function of global mean temperature (GMT) rise allows for the evaluation of policy-relevant climate change targets. So far, only few studies have taken this approach, and, in particular, no such assessments exist for Germany, the most populated country of Europe.

METHODS

We assess temperature-related mortality in 12 major German cities based on daily time-series of all-cause mortality and daily mean temperatures in the period 1993-2015, using distributed-lag non-linear models in a two-stage design. Resulting risk functions are applied to estimate excess mortality in terms of GMT rise relative to pre-industrial levels, assuming no change in demographics or population vulnerability.

RESULTS

In the observational period, cold contributes stronger to temperature-related mortality than heat, with overall attributable fractions of 5.49% (95%CI: 3.82-7.19) and 0.81% (95%CI: 0.72-0.89), respectively. Future projections indicate that this pattern could be reversed under progressing global warming, with heat-related mortality starting to exceed cold-related mortality at 3 °C or higher GMT rise. Across cities, projected net increases in total temperature-related mortality were 0.45% (95%CI: -0.02-1.06) at 3 °C, 1.53% (95%CI: 0.96-2.06) at 4 °C, and 2.88% (95%CI: 1.60-4.10) at 5 °C, compared to today's warming level of 1 °C. By contrast, no significant difference was found between projected total temperature-related mortality at 2 °C versus 1 °C of GMT rise.

CONCLUSIONS

Our results can inform current adaptation policies aimed at buffering the health risks from increased heat exposure under climate change. They also allow for the evaluation of global mitigation efforts in terms of local health benefits in some of Germany's most populated cities.

The Heat Health Warning System in Germany—Application and Warnings for 2005 to 2019

During intense heat episodes, the human population suffers from an increased morbidity and mortality. In order to minimize such negative health impacts, the general public and the public health authorities are informed and warned by means of an advanced procedure known as a “heat health warning system” (HHWS). It is aimed at triggering interventions and at taking preventive measures. The HHWS in Germany has been in operation since 2005. The present work is aimed at showing the updated structure of an advanced HHWS that has been developed further several times during its 15 years of operation. This is to impart knowledge to practitioners about the concept of the system. In Germany, dangerous heat episodes are predicted on the basis of the numerical weather forecast. The perceived temperature as an appropriate thermal index is calculated and used to assess the levels of heat stress. The thermo-physiologically based procedure contains variable thresholds taking into account the short time acclimatization of the people. The forecast system further comprises the nocturnal indoor conditions, the specific characteristics of the elderly population, and the elevation of a region. The heat warnings are automatically generated, but they are published with possible adjustments and a compulsory confirmation by the biometeorology forecaster. Preliminary studies indicate a reduction in the heat related outcomes. In addition, the extensive duration of the strongest heat wave in summer 2018, which lasted three weeks, highlights the necessity of the HHWS to protect human health and life.

[Estimation of heat-related deaths in Germany between 2001 and 2015]

BACKGROUND

During the summers of 2003 and 2015, heat was found to be the cause of a substantial number of deaths in Germany. Until now, estimates for the total number of heat-related deaths were only available regionally in Germany. For the summer of 2003, an analysis for Baden-Württemberg was extrapolated to the whole of Germany.

OBJECTIVES

Our analysis tries to prove a stable statistical relationship between heat and mortality and to use this to quantify the number of heat-related deaths in Germany between the years 2001 and 2015.

MATERIALS AND METHODS

By fitting a nonlinear statistical model, we estimated exposure-response curves that describe the influence of heat on the mortality rate. The performance of different indicators for heat stress was compared.

RESULTS

The comparison of the different indicators for heat showed that the weekly mean temperature was most useful to explain the course of the weekly mortality during the summer. The relation between mortality rate and weekly mean temperature varied between age groups and regions in Germany (north, middle, south). The age groups (75-84) and (85+) were most affected by heat. The highest number of heat-related deaths was 7600 (95% CI 5500-9900), found for the summer 2003, followed by 6200 (4000; 8000) in the summer 2006 and 6100 (4000; 8300) in the summer 2015.

CONCLUSIONS

We could show that even in weekly data on mortality, a clear influence of heat could be identified. A national surveillance of mortality that allows real-time monitoring would be desirable.

Observations and Projections of Heat Waves in South America

Although Heat Waves (HWs) are expected to increase due to global warming, they are a regional phenomenon that demands for local analyses. In this paper, we assess four HW metrics (HW duration, HW frequency, HW amplitude, and number of HWs per season) as well as the share of extremely warm days (TX95, according to the 95th percentile) in South America (SA). Our analysis included observations as well as simulations from global and regional models. In particular, Regional Climate Models (RCMs) from the Coordinated Regional Climate Downscaling Experiment (CORDEX), and Global Climate Models (GCMs) from the Coupled Model Intercomparison Project Phase 5 (CMIP5) were used to project both TX95 estimates and HW metrics according to two representative concentration pathways (RCP4.5 and RCP8.5). We found that in recent decades the share of extremely warm days has at least doubled over the period December-January-February (DJF) in northern SA; less significant increases have been observed in southern SA. We also found that by midcentury, under the RCP4.5 scenario, extremely warm DJF days (as well as the number of HWs per season) are expected to increase by 5-10 times at locations close to the Equator and in the Atacama Desert. Increases are expected to be less pronounced in southern SA. Projections under the RCP8.5 scenario are more striking, particularly in tropical areas where half or more of the days could be extremely warm by midcentury.

The predictability of heat-related mortality in Prague, Czech Republic, during summer 2015-a comparison of selected thermal indices

We compared selected thermal indices in their ability to predict heat-related mortality in Prague, Czech Republic, during the extraordinary summer 2015. Relatively, novel thermal indices-Universal Thermal Climate Index and Excess Heat Factor (EHF)-were compared with more traditional ones (apparent temperature, simplified wet-bulb globe temperature (WBGT), and physiologically equivalent temperature). The relationships between thermal indices and all-cause relative mortality deviations from the baseline (excess mortality) were estimated by generalized additive models for the extended summer season (May-September) during 1994-2014. The resulting models were applied to predict excess mortality in 2015 based on observed meteorology, and the mortality estimates by different indices were compared. Although all predictors showed a clear association between thermal conditions and excess mortality, we found important variability in their performance. The EHF formula performed best in estimating the intensity of heat waves and magnitude of heat-impacts on excess mortality on the most extreme days. Afternoon WBGT, on the other hand, was most precise in the selection of heat-alert days during the extended summer season, mainly due to a relatively small number of "false alerts" compared to other predictors. Since the main purpose of heat warning systems is identification of days with an increased risk of heat-related death rather than prediction of exact magnitude of the excess mortality, WBGT seemed to be a slightly favorable predictor for such a system.

Impact of Atmospheric Circulation on the Occurrence of Hot Nights in Central Europe

The main goal of the study is to determine the pressure conditions that cause waves of hot nights in Central Europe. The goal was implemented on the basis of data from 1966 to 2015, made available by the Institute of Meteorology and Water Management—National Research Institute, Deutscher Wetterdienst and the National Center for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR). A hot night was defined as a day with the minimum air temperature above 18 °C. In the analysed years, an increase in the number of hot nights was found, which was predominantly statistically significant within the studied area. The study shows that the occurrence of waves of hot nights in Central Europe was associated on average with the ridge of high pressure, within which a local high-pressure area developed. During the waves of hot nights, there were positive anomalies of heights of isobaric surfaces over the study area with a maximum in the upper troposphere.