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The record-breaking 2003 heat wave has been described as an extremely unlikely event given the observed warming, and to share similar characteristics with future summers simulated by state-of-the-art climate models for the end of the 21st century. Updates of summer heat-related mortality raised the initial estimates up to 70000 excess deaths.

The risk of death under heat stress conditions is exacerbated in the elderly (impaired thermoregulation) living in urban areas (pollution, heat island effect) with pre-existing or chronic cardiovascular (heart attack, stroke) and respiratory diseases, while exposure to cold can lead to direct effects such as hypothermia, or indirect pathologies such as cardiovascular disorders (hypertension, thrombosis) or respiratory infections (influenza, pneumonia).

The effect of temperatures can be reduced by means of physiological, behavioral and cultural adaptations of the society, such as improvements in prevention, health care and early warning systems, the design of action plans for deprived people, a systematic vaccination against influenza, a change for healthier diets, or a better acclimatization and insulation of buildings.

There is evidence suggesting that these and other factors have already induced a reduction of mortality in some countries, but the potential of these strategies varies greatly according to factors such as political decision making, technological development, profile demographics and underlying climatological conditions. Constraints to human adaptability further stress the need for mitigation strategies contributing together with adaptation plans to tackle the problem of climate change. These strategies, in turn, would ultimately maximize other co-benefits for health, for example through improved air, water or food quality.


CMTool is a climate driven mortality prediction tool, which aims to strengthen public health decision making ahead of extreme temperature events, such as heat waves and cold snaps across Europe.