Temperature related health burden in the Attica region, Greece, under two different climatic scenarios for the near and distant future

BACKGROUND AND AIM: The gradual increase in ambient temperature and in the frequency and intensity of heat waves, related to climate change, may lead to premature deaths. Our study aimed to evaluate temperature-related deaths in the Attica region, Greece, under two climate change scenarios for the periods 2031-2050 and 2081-2100. METHODS: We estimated the number of deaths from natural, cardiovascular and respiratory causes attributed to the change of temperature between a reference period (1991-2005), and two future periods (2031-2050 and 2081-2100) under two climatic scenarios (RCP4.5 -“medium” and RCP8.5 - “high”) using exposure response functions based on the literature. We also estimated the number of excess deaths due to heatwaves. RESULTS:Under the RCP4.5 scenario, the mean annual number of deaths from natural causes attributed to the increased temperature during the warm season (April-September) was 2 times higher in the 2031-2050 period and about 2.5 times higher in the 2081-2100 period compared to the reference period (230, 95% CI: 207-253 deaths).Under the RCP8.5 scenario, the number of attributable deaths was 511 (95% CI: 461-560) and 1316 (95% CI: 1191-1439) for the periods 2031-2050 and2081-2100, respectively. The excess number of deaths during heatwaves from 138 (95% CI: 118-159) in the reference period increased to 1145 (95% CI: 980-1314) under the RCP8.5 in the 2081-2100 period without taking into account population adaptation to climate change. The impact of increasing temperature was more severe on vulnerable populations, such as the elderly. The number of avoidable deaths due to increasing temperature in the cold season (October- March) did not compensate for the excess mortality in the warm season. CONCLUSIONS:The increase in temperature as a result of climate change is a major public health issue and urgent policies to mitigate its effects are crucial. KEYWORDS: climate, environmental epidemiology, mortality, temperature, temperature extremes