Successive record-breaking summer temperatures, both globally and in Europe, raise the urgent question of how to better protect vulnerable populations. Here we quantified the heat-related mortality burden during the summers of 2022-2024, and assessed the forecast skill of a new generation of continental-wide, impact-based early warning systems during health emergencies. We fitted epidemiological models with the newly created, format-homogeneous daily mortality database of the EARLY-ADAPT project, covering 654 contiguous regions across 32 European countries, which represents the entire urban and rural population of 539 million people. We estimated 62,775 (95% confidence interval = 36,765-84,379) heat-related deaths in 2024, largely exceeding the burden in 2023 (50,798; 29,442-68,610), but somewhat smaller than that of 2022 (67,873; 38,465-92,455). We demonstrated that health emergencies can be forecast with high confidence at least 1 week in advance, even for highly vulnerable regions and population subgroups. These findings have implications for public health agencies and end users, given that the adoption of the system would enable reliable heat-health emergency alerts within the time window that is relevant for stakeholders to take effective actions to reduce preventable deaths.

• Publication type
• Journal Article MeSH

BACKGROUND: Although several studies have investigated temperature-related mortality and morbidity, only a little is known about the short-term effects of temperature on ambulance dispatches. We aimed to conduct the first nationwide analysis of the association between temperatures and ambulance dispatches in Europe, including, for the first time, a detailed description of age-specific risks for 10-year age groups. METHODS: We collected daily data on ambulance dispatches and climate (i.e. temperature and relative humidity) for each district of Czechia (n = 77) during 2010-19. We estimated the relationship for each district by using a quasi-Poisson regression with distributed lag non-linear models. We then applied a multilevel multivariate random-effects meta-analysis to derive regional and countrywide average associations and calculated the burden of ambulance dispatches that was attributable to non-optimum temperatures. RESULTS: The susceptibility to low (high) temperatures increased (decreased) with age, except for the youth (<20 years), for whom the risks for both heat and cold were the highest. High temperatures contributed slightly to the risk of ambulance dispatches due to respiratory and cardiovascular causes, while the contribution of low temperatures was substantial. The overall ambulance dispatches burden that was attributable to non-optimum temperatures (optimum temperature = 7.9°C) was 3.55% (95% eCI: 3.43 to 3.67), with a predominant contribution of heat [2.32% (95% eCI: 2.15 to 2.46)] compared with cold [1.23% (95% eCI: 1.16 to 1.30)]. CONCLUSION: This data can be used as an early-warning indicator for temperature impacts, especially among vulnerable population subgroups, such as children, adolescents, and young adults. This evidence has important implications for healthcare system preparedness and management, and for the projections of climate change health impacts.

• Keywords
• ambulance, climate change, cold, emergency, heat, heat waves, temperature,
• MeSH
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Cold Temperature * adverse effects   MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Ambulances * statistics & numerical data   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Temperature * MeSH
• Age Factors MeSH
• Hot Temperature * adverse effects   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

Increased wildfire activity increases the demands on fire rescue services and firefighters' contact with harmful chemicals. This study aimed to determine firefighters' exposure to toxic metal(loid)s and its association with the lipid profile. CELSPAC-FIREexpo study participants (including 110 firefighters) provided urine and blood samples to quantify urinary levels of metal(loid)s (arsenic, cadmium (Cd), mercury, and lead (Pb)), and serum lipid biomarkers (cholesterol (CHOL), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides (TG)). The associations were investigated by using multiple linear regression and Bayesian weighted quantile sum (BWQS) regression. Higher levels of Pb were observed in firefighters. Pb was positively associated with CHOL and TG. Cd was negatively associated with HDL. In the BWQS model, the mixture of metal(loid)s was associated positively with CHOL (β = 14.75, 95% CrI = 2.45-29.08), LDL (β = 15.14, 95% CrI = 3.39-29.35), and TG (β = 14.79, 95% CrI = 0.73-30.42), while negatively with HDL (β = -14.96, 95% CrI = -25.78 to -1.8). Pb emerged as a key component in a metal(loid) mixture. The results suggest that higher exposure to lead and the mixture of metal(loid)s is associated with the alteration of the lipid profile, which can result in an unfavorable cardiometabolic profile, especially in occupationally exposed firefighters.

• Publication type
• Journal Article MeSH