CENTRAL EUROPEAN JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 25 (1-2); · 75 EXTREME WEATHER EVENTS AND THEIR PUBLIC HEALTH RELEVANCE ZSÓFIA TISCHNER1, BÁLINT IZSÁK2, ANNA PÁLDY2 1Szent István University Doctoral School, Budapest, Hungary 2National Public Health Center, Budapest, Hungary ABSTRACT Nowadays more and more extreme weather events occur due to climate change. Hungary is extermely vulnerable to floods, inland water inundations and droughts; they can occur almost every year in any parts of the country due to the geographical position, geological and hydro- logical characteristics. Other events like wildfires are not so serious in Hungary as in the medi- terranean countries. As these extreme events can happen more and more frequently, there is a need to prepare for the reduction of health impacts of these events. The Hyogo Framework for Action, the WHO and the Public Health England have formulated recommendations for risk reduction and measures of prevention of health impacts of extreme weather events. In this paper the authors give a description of the different types of extreme weather events, of their health impacts in Europe and in Hungary and the possible preventive measures based on international recommendations. KEY WORDS: climate change, extreme weather events, mortality, vulnerability, adaptation Corresponding author: Zsófia Tischner Szent István University Doctoral School Budapest, Hungary E-mail: [email protected] Received: 5th May 2019 Accepted: 19th June 2019 INTRODUCTION Climate change is presumably the most serious environmental health problem of the 21st century (Watts et al., 2018). The impacts of climate extremes and the potential for disasters result from the climate extremes themselves and from the exposure and vulnerability of human and natural systems, as it was pointed out in the IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (Field et al., 2012). Climate change is occurring globally and in Europe, also; some of these observed changes (increases in tempera- ture, changes in precipitation and decreases in ice and snow) have established records in recent 76 ·EXTREME WEATHER EVENTS AND THEIR PUBLIC HEALTH RELEVANCE years. The mean temperature increased by 0.85 [0.65 to 1.06] °C over the period 1880 to 2012, the rate of the increase was steeper at the end of the last century and at the beginning of the 21st century: 0.05 [–0.05 to 0.15] °C per decade in the past 15 years (1998–2012); this increase is of anthropogenic origin (IPCC, 2014). The length of heat waves has also increased across Europe (EEA, 2012). Scientific publications increasingly conclude that the likelihood of an event such as the 2003 European heat wave was probably substantially increased by rising global temperatures. According to the above cited report there is a 66–100% probability that the intensity of heavy precipitation and the proportion of total rainfall will increase particularly in northern mid-latitudes and high latitudes of Europe. The highest total precipitation increases are projected to occur dur- ing the winter months. Although the IPCC states a general decrease in mean precipitation in the southern European region, rainfall may become more irregular and intense. Even in summer, when the frequency of wet days is projected to decrease, the intensity of extreme rain showers may still increase. In addition, the frequency of precipitation for several days is projected to increase. According to the IPCC statement on droughts some regions of the world have experienced longer and more intense droughts (southern Europe and West Africa) while in other regions droughts have become less frequent, less intense or shorter (central North America and north- western Australia), and it is more likely than not that human influence has contributed to the increase in droughts in the second half of the 20th century (Pachauri et al., 2014). The most re- cent available data (covering drought disasters from 1900-2012) from EM-DAT1, a worldwide disaster database maintained by the Centre for Research on the Epidemiology of Disasters, gives an indication of the devastating effects of drought on countries around the world. In the database it is indicated that approximately 30 per cent of the population was exposed to drought in Hungary per year between 1990-2012. Climate scenarios produced in support of the Fourth Assessment Report of the Intergovernmen- tal Panel on Climate Change (Solomon et al., 2007) suggest changes in regional climate condi- tions during the twenty-first century, such as drier and hotter summers over Central Europe. The climate models using different emission scenarios show that Europe is a very sensitive re- gion to global warming (Giorgi, 2006) and that the Carpathian Basin is located in a transition region of the precipitation change pattern (Giorgi and Coppola, 2007). According to the observation of the National Meteorological Service (Szalai et al., 2006) the temperature increase is significant in each season. Summer is the season with the strongest warming and autumn is the least warming season. The warming tendency seems to acceler- ate since 90’s. The summer warming has been close to 2°C in the last 30 years. The long-term precipitation trend shows a decreasing pattern, however increasing precipitation tendencies can be also found in summer and in shorter term. The largest reduction in the seasonal precipita- tion sum was measured in spring. The regional model simulations predict further temperature increase for the entire 21st century. For the mid period of the century (2041-2060) there is no significant difference between the more optimistic (RCP4.5) and the more pessimistic (RCP8.5) scenarios, however, the latter scenarios predict considerable changes in the last period (2080- 1 Centre for Research on the Epidemiology of Disasters – CRED https://www.emdat.be/database CENTRAL EUROPEAN JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 25 (1-2); · 77 2099). The predicted greatest increase of the summer mean temperature is more than 6.5°C, which is twice as high as predicted by the RCP4.5 more optimistic scenario. The number of hot days (Tmax > 30°C) will increase and the distribution of the seasonal precipitation will change. During winter more precipitation is predicted while during summer there will be arid periods. These changes will affect - among others – the agriculture, forestry and water management; consequently will impact on the society (Bartholy and Pongracz, 2018). Climate change increasingly affects people’s health and well-being, increases the frequency and intensity of extreme weather events like heatwaves, droughts, extreme rainfall and severe cy- clones in many areas, and modifies the transmission of food-borne, water-borne and zoonotic infectious diseases. New environmental, climatic and health problems are emerging and require rapid identification and response. The WHO in its Thirteenth General Programme of Work, 2019–2023 “The health, environment and climate change strategy” addresses health emergen- cies. It emphasizes the need to improve the resilience of the health sector and communities to cli- mate change, to reduce vulnerabilities, and to enhance preparedness, surveillance and response to health emergencies – by these measures and actions the health impacts of environmental emergencies will be prevented and reduced (WHO, 2019). The adaptive capacity of the living organisms - including humans - is unique; however adaptation to quickly changing situations can be problematic. Disasters belong to this group of situations endangering basic needs, natural and built environment, human health and life. In this paper we aim to give an overview of the extreme events happened in the past 10 years in Hungary. We also describe the possible health impacts of these disasters and summarize the major tasks of the public health service based on the recommendations of the WHO and other international organizations. The climate and topography of Hungary Climate of Hungary is influenced by the continental and the oceanic climate2. The impact of these systems change very often therefore the weather is very changeable. The country is situ- ated in the Carpathian Basin; the mountains have a modifying effect on winds and the movement of air masses. The Gulf Stream also influences the weather; due to its effect the temperature is warmer than in the neigbouring Austria. The average temperature in Hungary is 8 to 11 °C, the difference between the north and the south is only 3°C because of the relatively small distance. The prevailing wind direction is northwest, resulting in a west-to-east spatial gradient of pre- cipitation modulated by local topography. Recently the frequency of southeast wind direction is increasing, over the river Tisza north wind prevails. The average annual precipitation across the country is 600 – 650 millimeters, however the spatial distribution of precipitation shows a great variability and the southwestern parts are more humid due to the effect of the Mediterranean Sea; while the eastern parts of Hungary are semiarid areas. The hydrography of the country is determined by the surrounding Carpathians, Alpes and Dinarian Mountains; 66.8% of its area has a lower height than the sea level and only 0.8% is higher than 500 m. We have 22 rivers, 90% of them have a catchment area in the mountains of 2 https://www.met.hu/eghajlat/magyarorszag_eghajlata/ 78 ·EXTREME WEATHER EVENTS AND THEIR PUBLIC HEALTH RELEVANCE the neighboring countries and 95% of the quantity of a flood arrives from abroad. Very often the floods occur on several rivers at the same time (e.g. on the Tisza, Körös rivers and Maros) increasing the water level in each of the rivers. DESCRIPTION OF EXTREME WEATHER EVENTS Severe storms Intense stormy or hurricane-like gusts occur if the speed of gusts is above 90 km/h and up to 120 km/h. The heavy shower is defined by more than 50 mm of rainfall in a region in 24 hours.