In addition to the number of attributable cases, our HIA has estimated the potential gain in life expectancy for long-term exposure to fine particles, contributing to a better quantification of the impact of AP on PH in Europe.

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Abstract:The influence of future climate change on the occurrence of heat waves and its implications for heat wave-related mortality due to ischemic heart diseases (IHD) in Germany is studied. Simulations of 19 regional climate models with a spatial resolution of 0.25° × 0.25° forced by the moderate climate change scenario A1B are analyzed. Three model time periods of 30 years are evaluated, representing present climate , near future climate , and remote future climate . Heat waves are defined as periods of at least three consecutive days with daily mean air temperature above the 97.5th percentile of the all-season temperature distribution. Based on the model simulations, future heat waves in Germany will be significantly more frequent, longer lasting and more intense. By the end of the 21st century, the number of heat waves will be tripled compared to present climate. Additionally, the average duration of heat waves will increase by 25%, accompanied by an increase of the average temperature during heat waves by about 1 K. Regional analyses show that stronger than average climate change effects are observed particularly in the southern regions of Germany. Furthermore, we investigated climate change impacts on IHD mortality in Germany applying temperature projections from 19 regional climate models to heat wave mortality relationships identified in a previous study. Future IHD excess deaths were calculated both in the absence and presence of some acclimatization (i.e., that people are able to physiologically acclimatize to enhanced temperature levels in the future time periods by 0% and 50%, respectively). In addition to OPEN ACCESSClimate 2015, 3 101 changes in heat wave frequency, we incorporated also changes in heat wave intensity and duration into the future mortality evaluations. The results indicate that by the end of the 21st century the annual number of IHD excess deaths in Germany attributable to heat waves is expected to rise by factor 2.4 and 5.1 in the acclimatization and non-acclimatization approach, respectively. Even though there is substantial variability across the individual model simulations, it is most likely that the future burden of heat will increase considerably. The obtained results point to public health interventions to reduce the vulnerability of the population to heat waves.

The impact of heat waves on ischemic heart disease (IHD) mortality and morbidity in Germany during 2001-2010 is analyzed. Heat waves are defined as periods of at least three consecutive days with daily mean temperature above the 97.5th percentile of the temperature distribution. Daily excess mortality and morbidity rates are used. All calculations were performed separately for 19 regions to allow for the investigation of regional differences. The results show that IHD mortality during heat waves is significantly increased (+15.2% more deaths on heat wave days). In stark contrast, no heat wave influence on hospital admissions due to IHD could be observed. Regional differences in heat wave IHD mortality are present, with the strongest impact in Western Germany and weaker than average effects in the Southeastern and Northwestern regions. The increase in mortality during heat waves is generally stronger for females (+18.7%) than for males (+11.4%), and for chronic ischemic diseases (+18.4%) than for myocardial infarctions (+12.2%). Longer and more intense heat waves feature stronger effects on IHD mortality, while timing in season seems to be less important. Since climate change will most likely enhance the number and intensity of heat waves, the obtained results point to public adaptation strategies to reduce the future heat wave impact on mortality.

For nearly a decade, the majority of the world's population has been living in cities, including a considerable percentage of people suffering from pollen allergy. The increasing concentration of people in cities results in larger populations being exposed to allergenic pollen at the same time. There is almost no information about spatial distribution of pollen within cities as well as a lack of information about the possible impact to human health. To obtain this increasing need for pollen exposure studies on an intra-urban scale, a novelty screening network of 14 weekly changed pollen traps was established within a large metropolitan area-Berlin, Germany. Gravimetric pollen traps were placed at a uniform street-level height from March until October 2014. Three important allergenic pollen types for Central Europe-birch (Betula), grasses (Poaceae), and mugwort (Artemisia)-were monitored. Remarkable spatial and temporal variations of pollen sedimentation within the city and the influences by urban local sources are shown. The observed differences between the trap with the overall highest and the trap with the overall lowest amount of pollen sedimentation were in the case of birch pollen 245%, grass pollen 306%, and mugwort pollen 1962%. Differences of this magnitude can probably lead to different health impacts on allergy sufferers in one city. Therefore, pollen should be monitored preferably in two or more appropriate locations within large cities and as a part of natural air quality regulations.