The WHO Regional Office for Europe EXTREME WEATHER AND CLIMATE EVENTS AND PUBLIC The World Health HEALTH RESPONSES Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout This expert meeting was organized by the WHO Regional Office for Europe the world, each with its and the European Environment Agency and hosted by the Ministry of Health own programme geared to of the Slovak Republic to exchange information and develop the particular health recommendations on public health and environmental responses to weather conditions of the countries it serves. and climate extremes, specifically floods, heat-waves and cold spells. The 54 participants included representatives of 20 countries from the European Member States Region, as well as of the European Commission, European Environment Agency, Red Cross, World Meteorological Organization, World Health Albania Andorra Organization and scientists from around the world. Armenia Austria The discussion on health effects in different countries of the heat-wave and Azerbaijan of the cold-waves occurred in 2003, as well as of the flooding in 2002, can Belarus Belgium be summarized as follows: Extreme weather and climate Bosnia and Herzegovina During the severe heat-wave that affected much of western Europe in Bulgaria summer 2003, women 75 years of age and older were at highest risk. Croatia Winter mortality is still higher than summer mortality. While some of this events and public health Cyprus Czech Republic wintertime excess relates to hypothermia, the greatest component is due to Denmark respiratory and cardiovascular diseases. Estonia Flooding in 2002 caused serious re-organization of health care services responses Finland and required advice on hygiene and immunization by health authorities. A France review of the health effects showed that fatalities are often caused by Georgia Germany entrapment in automobiles and behaviours that clearly disregard dangers. Greece Other health effects included gastrointestinal infections due to contamination Report on a WHO meeting Hungary of food and water, and psychological effects. Iceland Bratislava, Slovakia Ireland 09–10 February 2004 Israel The meeting developed the following recommendations: Italy Kazakhstan • emphasis must shift from post-disaster intervention to pre-disaster Kyrgyzstan Latvia planning; Lithuania • identifying and protecting vulnerable groups is particularly important; Luxembourg • meteorological agencies, health departments and civil protection Malta Monaco agencies must work together to develop early warning, surveillance Netherlands mechanisms, intervention plans and crisis management tools. Norway Poland This meeting contributed to the preparatory process for the Fourth Portugal Republic of Moldova Ministerial Conference on Environment and Health (Budapest, June 2004). Romania Its recommendations, providing actions addressing public health and Russian Federation environmental responses to weather and climate, were submitted to Member San Marino States as an input to a policy document and to the Conference declaration. Serbia and Montenegro Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine World Health Organization United Kingdom Uzbekistan Regional Office for Europe Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark EUR/04/5036794 Tel.: +45 39 17 17 17. Fax: +45 39 17 18 18. E-mail: E83004 [email protected] Original: English Web site: www.euro.who.int Extreme weather and climate events and public health responses Report on a WHO meeting Bratislava, Slovakia 09–10 February 2004 WHO European Centre for Environment and Health, Rome Office ABSTRACT This expert meeting was organized by the WHO Regional Office for Europe and the European Environment Agency and hosted by the Ministry of Health of the Slovak Republic to exchange information and develop recommendations on public health and environmental responses to weather and climate extremes, specifically floods, heat-waves and cold spells. The 54 participants included representatives of 20 countries from the European Region, as well as of the European Commission, European Environment Agency, Red Cross, World Meteorological Organization, World Health Organization and scientists from around the world. The discussion on health effects in different countries of the heat-wave and of the cold-waves occurred in 2003, as well as of the flooding in 2002, can be summarized as follows: 1) During the severe heat-wave that affected much of western Europe in summer 2003, women 75 years of age and older were at highest risk. 2) Winter mortality is still higher than summer mortality. While some of this wintertime excess relates to hypothermia, the greatest component is due to respiratory and cardiovascular diseases. 3)Flooding in 2002 caused serious re-organization of health care services and required advice on hygiene and immunization by health authorities. A review of the health effects showed that fatalities are often caused by entrapment in automobiles and behaviours that clearly disregard dangers. Other health effects included gastrointestinal infections due to contamination of food and water, and psychological effects. The meeting developed the following recommendations: • emphasis must shift from post-disaster intervention to pre-disaster planning; • identifying and protecting vulnerable groups is particularly important; • meteorological agencies, health departments and civil protection agencies must work together to develop early warning, surveillance mechanisms, intervention plans and crisis management tools. This meeting contributed to the preparatory process for the Fourth Ministerial Conference on Environment and Health (Budapest, June 2004). Its recommendations, providing actions addressing public health and environmental responses to weather and climate, were submitted to Member States as an input to a policy document and to the Conference declaration. Keywords CLIMATE METEOROLOGICAL FACTORS PUBLIC HEALTH ENVIRONMENTAL HEALTH NATURAL DISASTERS GREEN HOUSE EFFECT DISEASE TRANSMISSION HEAT STROKE - prevention and control ENVIRONMENTAL MONITORING FORECASTING RISK ASSESSMENT RISK MANAGEMENT EMERGENCY MEDICAL SERVICES EUROPE Address requests about publications of the WHO Regional Office to: • by e-mail [email protected] (for copies of publications) [email protected] (for permission to reproduce them) [email protected] (for permission to translate them) • by post Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark © World Health Organization 2004 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Where the designation “country or area” appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximate borderlines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. 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The views expressed by authors or editors do not necessarily represent the decisions or the stated policy of the World Health Organization. - 4 - WHO European Centre for Environment and Health, Rome Office Table of contents Acknowledgements...........................................................................................................................7 Introduction......................................................................................................................................8 Objectives of the meeting ................................................................................................................8 Session 1: Climate Variability and Extremes in Europe.............................................................9 The climate dilemma....................................................................................................................9 Projected changes in extreme weather and climate events in Europe ........................................11 Are the frequency and intensity of flooding changing in Europe?.............................................14 The exceptional meteorological conditions in summer 2003 in Europe....................................15 The observed meteorological changes in summer 2003.............................................................18 Discussion ..................................................................................................................................19