Journal articles on the topic 'Heat waves (Meteorology) – Health aspects'

The effect of the elevated temperatures on mortality experienced in Europe during the summer of 2003 was observed in several countries. This study, carried out in Spain, describes mortality between 1 June and 31 August and evaluates the effect of the heat wave on mortality. Observed deaths were obtained from official death registers from 50 provincial capitals. Observed deaths were compared with the expected number, estimated by applying a Poisson regression model to historical mortality series and adjusting for the upward trend and seasonality observed. Meteorological information was provided by the Instituto Nacional de Meteorología (National Institute of Meteorology). Spain experienced three heat waves in 2003. The total associated excess deaths were 8% (43 212 observed deaths compared with 40 046 expected deaths). Excess deaths were only observed in those aged 75 years and over (15% more deaths than expected for the age group 75 to 84 and 29% for those aged 85 or over). This phenomenon (heat-associated excess mortality) is an emerging public health problem because of its increasing attributable risk, the aging of the Spanish population and its forecasted increasing frequency due to global warming. The implementation of alert and response systems based on monitoring of climate-related risks, emergency room activity and mortality, and strengthening the response capacity of the social and health services should be considered.

Abstract Numerous studies in epidemiology, meteorology, and climate change research have demonstrated a significant association between abnormal ambient temperature and mortality. However, there is a shortage of research attention to a systematic assessment of potential mitigation measures which could effectively reduce the heat-related morbidity and mortality risks. This study first illustrates a conceptualization of a systems analysis version of urban framework for climate service (UFCS). It then constructs a system dynamics (SD) model for the UFCS and employs this model to quantify the impacts of heat waves on public health system in Shanghai and to evaluate the performances of two mitigation measures in the context of a real heat wave event in July 2013 in the city. Simulation results show that in comparison with the baseline without mitigation measures, if the hospital system could prepare 20% of beds available for emergency response to heat waves once receiving the warning in advance, the number of daily deaths could be reduced by 40–60 (15.8–19.5%) on the 2 days of day 7 and day 8; if increasing the minimum living allowance of 790 RMB/month in 2013 by 20%, the number of daily deaths could be reduced by 50–70 (17.7–21.9%) on the 2 days of day 8 and day 12. This tool can help policy makers systematically evaluate adaptation and mitigation options based on performance assessment, thus strengthening urban resilience to changing climate.

Heat waves are large-scale atmospheric phenomena that may cause heat stress in ecosystems and socio-economic activities. In cities, morbidity and mortality may increase during a heat wave, overloading health and emergency services. In the face of climate change and associated warming, cities need to adapt and mitigate the effects of heat waves. This study suggests a new method to evaluate heat waves’ impacts on cities by considering some aspects of heat waves that are not usually considered in other similar studies. The method devises heat wave quantities that are easy to calculate; it is relevant to assessing their impacts and permits the development of adaptation measures. This study applies the suggested method to quantify various aspects of heat waves in Lisbon for future climate projections considering future mid-term (2046–2065) and long-term (2081–2100) climates under the RCP8.5 greenhouse emission scenario. This is achieved through the analysis of various regional climate simulations performed with the WRF model and an ensemble of EURO-CORDEX models. This allows an estimation of uncertainty and confidence of the projections. To evaluate the climate change properties of heat waves, statistics for future climates are compared to those for a reference recent climate. Simulated temperatures are first bias corrected to minimize the model systematic errors relative to observations. The temperature for mid and long-term futures is expected to increase relative to the present by 1.6 °C and 3.6 °C, respectively, with late summer months registering the highest increases. The number of heat wave days per year will increase on average from 10, in the present climate, to 38 and 63 in mid and long-term climates, respectively. Heat wave duration, intensity, average maximum temperature, and accumulated temperature during a heat wave will also increase. Heat waves account for an annual average of accumulated temperature of 358 °C·day in the present climate, while in the mid and long-term, future climates account for 1270 °C·day and 2078 °C·day, respectively. The largest increases are expected to occur from July to October. Extreme intensity and long-duration heat waves with an average maximum temperature of more than 40 °C are expected to occur in the future climates.

AbstractUrbanization modifies atmospheric energy and moisture balances, forming distinct features [e.g., urban heat islands (UHIs) and enhanced or decreased precipitation]. These produce significant challenges to science and society, including rapid and intense flooding, heat waves strengthened by UHIs, and air pollutant haze. The Study of Urban Impacts on Rainfall and Fog/Haze (SURF) has brought together international expertise on observations and modeling, meteorology and atmospheric chemistry, and research and operational forecasting. The SURF overall science objective is a better understanding of urban, terrain, convection, and aerosol interactions for improved forecast accuracy. Specific objectives include a) promoting cooperative international research to improve understanding of urban summer convective precipitation and winter particulate episodes via extensive field studies, b) improving high-resolution urban weather and air quality forecast models, and c) enhancing urban weather forecasts for societal applications (e.g., health, energy, hydrologic, climate change, air quality, planning, and emergency response management). Preliminary SURF observational and modeling results are shown (i.e., turbulent PBL structure, bifurcating thunderstorms, haze events, urban canopy model development, and model forecast evaluation).

Climate change presents an unprecedented public health challenge as it has a great impact on population health outcomes across the global population. The key to addressing these health challenges is adaptation carried out in cities through collaboration between institutions, including public health ones. Through semi-structured interviews (n = 16), this study investigated experiences and perceptions of what public health aspects are considered by urban and public health planners and researchers when planning climate change adaptation in the coastal cities of Söderhamn (Sweden), Porto (Portugal) and Navotas (the Philippines). Results of the thematic analysis indicated that participating stakeholders were aware of the main climate risks threatening their cities (rising water levels and flooding, extreme temperatures, and air pollution). In addition, the interviewees talked about collaboration with other sectors, including the public health sector, in implementing climate change adaptation plans. However, the inclusion of the public health sector as a partner in the process was identified in only two cities, Navotas and Porto. Furthermore, the study found that there were few aspects pertaining to public health (water and sanitation, prevention of heat-related and water-borne diseases, and prevention of the consequences associated with heat waves in vulnerable groups such as children and elderly persons) in the latest climate change adaptation plans posted on each city’s website. Moreover, participants pointed to different difficulties: insufficient financial resources, limited intersectoral collaboration for climate change adaptation, and lack of involvement of the public health sector in the adaptation processes, especially in one of the cities in which climate change adaptation was solely the responsibility of the urban planners. Studies using larger samples of stakeholders in larger cities are needed to better understand why the public health sector is still almost absent in efforts to adapt to climate change.

Based on the data of daily maximum temperature in 26 meteorological stations in the North Center Region, Vietnam over the period of 1980 to 2013, the authors conducted the research on the spatial distribution of the number of hot days. The initial result shows that in general, in the north of the study area, the large number of hot days occurred in the plain, and tended to decrease westward and eastward. In the south, this number tends to increase from the west to the east. Especially, the largest number occurred in two areas: The Ma and Ca River's valleys (Thanh Hoa and Nghe An provinces) and the coastal areas (Thua Thien Hue province), creating two heat centers in Tuong Duong district, Nghe An province and Nam Dong district, Thua Thien Hue province.ReferencesAdina-Eliza Croitoru, Adrian Piticar, Antoniu-Flavius Ciupertea, Cristina FlorinaRosca, 2016 Changes in heat wave indices in Romania over the period 1961-2015. Global and Plantary Change 146. Journal homepage: www. Elsevier.com/locate/gloplacha.Chu Thi Thu Huong et al., 2010. Variations and trends in hot event in Vietnam from 1961-2007, VNU Journal of Science and Technology, 26(3S).Climate Council, 2014a. Angry Summer 2013/2014. Accessed at http://www.climatecouncil.org.au/ angry-summer.Climate Council, 2014b. Angry Summer 2013/2014. Accessed at http://www.climatecouncil.org.au/ angry-summer.CSIRO and BoM, 2012. State of the Climate 2012.CSIRO and Bureau of Meteorology, Melbourne.Accessed at http://www.csiro.au/Outcomes/ Climate/Understanding/State-of-the-Climate-2012.aspx.D'Ippoliti D., Michelozzi P., Marino C., De'Donato F., Menne B., Katsouyanni K., Kirchmayer U., Analitis A., Medina-Ramon M., Paldy A., Atkinson R., Kovats S., Bisanti L., Schneider A., Lefranc A., Iñiguez C., Perucci C., 2010. The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project. Environ. Health 9, 37. http://dx.doi.org/10.1186/1476-069X-9-37.Gerald A. Meehl, 1992. Effect of tropical topography on global climate, Ann. Rev. Earth Planet. Sci., 20, 85-112.Hayhoe K., Cayan D., Field C.B., Frumhoff P.C., Maurer E.P., Miller N.L., Moser S.C., Schneider S.H., Cahill K.N., Cleland E.E., Dale L., Drapek R., Hanemann R.M., lkstein L.S., Lenihan J., Lunch C.K., Neilson R.P., Sheridan S.C., Verville J.H., 2004. Emissions pathways, climate change, and impacts on California. PNAS, 101(34), 12422-12427.Ho Thi Minh Ha, Phan Van Tan, 2009. Trends and variations of extreme temperature in Vietnam in the period from 1961 to 2007, VNU Journal of Science and Technology, 25(3S).IPCC, 2007: Climate Change 2007: Synthesis Report. Contribution of Working Groups I, II and III to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change [Core Writing Team, Pachauri R.K and Reisinger A. (eds.)]. IPCC, Geneva, Switzerland, 104p.IPCC, 2014. Climate Change 2014: Synthesis Report. Contribution of Working Groups I, II and III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Core Writing Team, R.K. Pachauri and L.A. Meyer (eds.)]. IPCC, Geneva, Switzerland, 151p.Liu G., Zhang L., He B., Jin X., Zhang Q., Razafindrabe B., You H., 2015. Temporal changes in extreme high temperature, heat waves and relevant disasters in Nanjing metropolitan region, China. Nat. Hazards, 76, 1415–1430. http://dx.doi.org/10.1007/s11069-014-1556-y.Manton M.J et al., 2001. Trends in extreme daily temperature in Southeast Asia Rainfall ad and the South Pacific, J. Climatol. 21.Nairn J.R., Fawcett R.J.B., 2015. Int. J. Environ. Res. Public Health 12, 227–253. http://dx.doi.org/10.3390/ijerph120100227.Nguyen Duc Ngu, 2009. Climate Change Challenges to development, Journal of Economy and Environment, No. 1.Perkins S.E., Alexander L.V., 2013. On the measurement of heat waves. J. Clim. 26, 4500–4517. http://dx.doi.org/10.1175/JCLI-D-12-00383.1.Peterson T.C., Heim Jr. R.R., Hirsch R., Kaiser D.P., Brooks H., Diffenbaugh N.S., Dole R.M., Giovannettone J.P., Guirguis K., Karl T.R., Katz R.W., Kunkel K., Lettenmaier D., McCabe G.J., Paciorek C.J., Ryberg K.R., Schubert S., Silva V.B.S., Stewart B.C., Vecchia A.V., Villarini G., Vose R.S., Walsh J., Wehner M., Wolock D., Wolter K., Woodhouse C.A., Wuebbles D., 2013. Monitoring and understanding changes in heat waves, cold waves, floods, and droughts in the United States: state of knowledge. Bull. Amer. Meteor. Soc., 94, 821–834.Pham Thi Ly, Hoang Luu Thu Thuy, 2015. Variation of heat waves in the North Central Region over the period of 1980-2013, Journal of natural resources and environment, 9, 81-89.Phan Van Tan et al., 2010. Study impact of global climate change on extreme weather phenomena and factors in Vietnam, prediction and adaptation strategies. Project final report, KC 08.29/06-10, Hanoi University of Science.Spinoni J., Lakatos M., Szentimrey T., Bihari Z., Szalai S., Vogt J., Antofie T., 2015. Heat and cold waves trends in Carpathian Region from 1961 to 2010. Int. J. Climatol, 35, 4197–4209. http://dx.doi.org/10.1002/joc.4279.Toreti A., Desiato F., 2008.Temperature trends over Italy from 1961 to 2004, Theor. Appl. Climatol 91.Tran Cong Minh, 2007. Principle of meteorology and climate, Book, Public House of Hanoi National University.Tran Quang Duc, Trinh Lan Phuong, 2013. Changes of Hot day and Fohn Activities at Ha Tinh- Central Vietnam, VNU Journal of Science, Science and Technology, 29(2S).Trewin B., Smalley R., 2013.Changes in extreme temperature in Australia, 1910 to 2011. In: 19th AMOS National Conference, Melbourne, 11-13.Unal Y.S., Tan E., Mentes S.S., 2013. Summer heat waves over western Turkey between 1965 and 2006.Theor. Appl. Climatol, 112, 339–350. http://dx.doi.org/10.1007/s00704-012-0704-0.Will Steffen, 2015. Quantifying the impact of climate change on extreme heat in Australia. Published by the Climate Council of Australia Limited. ISBN: 978-0-9942453-1-1 (print) 978-0-9942453-0-4 (web).

We studied the potential synergy between air pollution and meteorology and their impact on mortality in nine European cities with data from 2004 to 2010. We used daily series of Apparent Temperature (AT), measurements of particulate matter (PM10), ozone (O3), and nitrogen dioxide (NO2) and total non-accidental, cardiovascular, and respiratory deaths. We applied Poisson regression for city-specific analysis and random effects meta-analysis to combine city-specific results, separately for the warm and cold seasons. In the warm season, the percentage increase in all deaths from natural causes per °C increase in AT tended to be greater during high ozone days, although this was only significant for all ages when all causes were considered. On low ozone days, the increase in the total daily number of deaths was 1.84% (95% CI 0.87, 2.82), whilst it was 2.20% (95% CI 1.28, 3.13) in the high ozone days per 1 °C increase in AT. Interaction with PM10 was significant for cardiovascular (CVD) causes of death for all ages (2.24% on low PM10 days (95% CI 1.01, 3.47) whilst it is 2.63% (95% CI 1.57, 3.71) on high PM10 days) and for ages 75+. In days with heat waves, no consistent pattern of interaction was observed. For the cold period, no evidence for synergy was found. In conclusion, some evidence of interactive effects between hot temperature and the levels of ozone and PM10 was found, but no consistent synergy could be identified during the cold season.

As the world overheats—potentially to conditions warmer than during the three million years over which modern humans evolved—suffering from heat stress will become widespread. Fundamental questions about humans’ thermal tolerance limits are pressing. Understanding heat stress as a process requires linking a network of disciplines, from human health and evolutionary theory to planetary atmospheres and economic modeling. The practical implications of heat stress are equally transdisciplinary, requiring technological, engineering, social, and political decisions to be made in the coming century. Yet relative to the importance of the issue, many of heat stress's crucial aspects, including the relationship between its underlying atmospheric drivers—temperature, moisture, and radiation—remain poorly understood. This review focuses on moist heat stress, describing a theoretical and modeling framework that enables robust prediction of the averaged properties of moist heat stress extremes and their spatial distribution in the future, and draws some implications for human and natural systems from this framework. ▪ Moist heat stress affects society; we summarize drivers of moist heat stress and assess future impacts on societal and global scales. ▪ Moist heat stress pattern scaling of climate models allows research on future heat waves, infrastructure planning, and economic productivity.

Abstract Many cities are undergoing urban heat challenges because of heat waves and urban heat islands (UHIs). During urban planning and design, properly adding cooling interventions, namely urban heat mitigation strategies, into cities and communities are essential to address urban heat challenges. However, cities are required to provide a variety of functions (e.g., buildings, transportation, park) and meet the requirements convenience, safety, health, comfort and wellbeing. Such functions and requirements result in some co-benefits, conflicts and trade-offs, promoting and constraining the application of urban heat mitigation strategies. However, the possible co-benefits, conflicts and trade-offs have not been well documented, where the improper use of cooling strategies may lead to unintended consequences. Therefore, it is essential to understand the co-benefits, conflicts and trade-offs of different cooling interventions. In particular, this study aims to develop an analytical framework for the analysis of the co-benefits, conflicts and trade-offs of different mitigation techniques. Mitigation techniques considered includes four clusters such as green infrastructure, blue infrastructure, white/grey infrastructure and urban design. The scope of urban functions and requirements, related to urban lives and urban operation, in ten aspects including economy, policy, ecology, environment, technology, space, urban beauty, practicality, culture, and transportation. The analytical framework was further applied to analyze the co-benefits, conflicts and trade-offs of cooling strategies in ten aspects of urban functions. Furthermore, it was used in environmental functions (e.g. local temperature regulation, stormwater regulation, waste treatment, air quality regulation, pollination, and recreation & aesthetic appreciation) and space functions (e.g. activity venue/entertainment venue, neighborhood vitality, resident satisfaction, space utilization and city identity), respectively. The results reveal that green infrastructure can provide the most aspects of benefits in ten aspects, and also in environmental and space aspect. Green infrastructure was followed by blue infrastructure, urban design and then white/grey infrastructure. Overall, the analytical framework offers a new perspective of the feasibility analysis of urban heat mitigation strategy and provides a reference for urban planners and designers to select proper urban heat mitigation techniques, with possible additional benefits of addressing other urban challenges.

Climate change will increase the frequency and severity of hazard events such as heat waves, with important effects in several European regions. It is of importance to consider overall effects as well as specific impact on vulnerable population groups such as outdoor workers. The agricultural and construction sectors represent two strategic occupational fields that in relatively recent years involve an increasing number of migrant workers, and therefore require a better management of cultural aspects, that may interact with and impact on heat-related health risk. For this reason, the present study evaluated heat-stress perception and management among native and immigrant workers in Europe. As part of the EU’s Horizon 2020 HEAT-SHIELD project (grant agreement No. 668786), two agricultural and one construction companies, traditionally employing migrant workers, were evaluated with a questionnaire survey during the summer months of 2017. The data collected (104 case studies) were analyzed using descriptive statistics (Chi-squared tests) and the analysis of variance was performed with ANOVA test. From the results, migrant workers declared that work required greater effort than do native Italian workers (χ2 = 17.1, p = 0.001) but reported less impact from heat on productivity (χ2 = 10.6; p = 0.014) and thermal discomfort. In addition, migrant workers were mainly informed through written or oral communications, while native workers received information on heat-health issues through training courses. These findings are of importance for future information and mitigation actions to address socio-cultural gaps and reduce heat-stress vulnerability.

Frequent severe heat waves have caused a series of health problems for urban dwellers. Swimming, an exercise that combines both cooling off and moderate to vigorous physical activity (MVPA), is one solution for alleviating the conflict between urban heat problems and public health. Therefore, the distribution and spatial accessibility of swimming pools are worth examining. Using open-source data we scraped from the Baidu Map API (Application Programming Interface), we designed and constructed a grid-based accessibility index. We analyzed pool accessibility in three aspects: distribution of pools, catchment area of pools, and spatial disparities of the accessibility index. The results are as follows. (a) The pools are clustered, dense in the central area, and sparse in the peripheral areas. (b) 53.16% of the residents can access a pool within 5 minutes by cycling, and the number is only 12.03% when they travel on foot. The poor situation is highly improved with the extension of time, these figures are up to 97.62% and 70.71% when the time cost is 15 minutes. The overall circular buffer significantly mismatches the real catchment area of the pools. (c) The spatial disparity in accessibility is significant and shows a sharply decreasing trend outward from the center. (d) Pool accessibility is mainly influenced by the distribution of pools and ground obstacles such as rivers, mountains, and elevated roads. The method used here has high precision and can be used for accessibility assessments of other facilities in the city.

Abstract. Urban areas are an important part of the climate system and many aspects of urban climate have direct effects on human health and living conditions. This implies that reliable tools for local urban climate studies supporting sustainable urban planning are needed. However, a realistic implementation of urban canopy processes still poses a serious challenge for weather and climate modelling for the current generation of numerical models. To address this demand, a new urban surface model (USM), describing the surface energy processes for urban environments, was developed and integrated as a module into the PALM large-eddy simulation model. The development of the presented first version of the USM originated from modelling the urban heat island during summer heat wave episodes and thus implements primarily processes important in such conditions. The USM contains a multi-reflection radiation model for shortwave and longwave radiation with an integrated model of absorption of radiation by resolved plant canopy (i.e. trees, shrubs). Furthermore, it consists of an energy balance solver for horizontal and vertical impervious surfaces, and thermal diffusion in ground, wall, and roof materials, and it includes a simple model for the consideration of anthropogenic heat sources. The USM was parallelized using the standard Message Passing Interface and performance testing demonstrates that the computational costs of the USM are reasonable on typical clusters for the tested configurations. The module was fully integrated into PALM and is available via its online repository under the GNU General Public License (GPL). The USM was tested on a summer heat-wave episode for a selected Prague crossroads. The general representation of the urban boundary layer and patterns of surface temperatures of various surface types (walls, pavement) are in good agreement with in situ observations made in Prague. Additional simulations were performed in order to assess the sensitivity of the results to uncertainties in the material parameters, the domain size, and the general effect of the USM itself. The first version of the USM is limited to the processes most relevant to the study of summer heat waves and serves as a basis for ongoing development which will address additional processes of the urban environment and lead to improvements to extend the utilization of the USM to other environments and conditions.

Abstract The International Panel on Climate Change (IPCC, 2013) and almost the entire scientific community agreed to consider the Mediterranean Area as one of the most vulnerable regions in the world to the impacts of global warming. In this scenario, heat waves, defined by the World Meteorological Organization as five or more consecutive days of heat reaching a daily maximum temperature at least 5 °C higher than the average maximum temperature, have been recently foreseen to be particularly frequent and intense in Portugal. As a consequence, agriculture constitutes one of the most sensitive sectors that could be affected by the climate change. Among the xenobiotics contaminating agricultural crops, mycotoxins (MY) are the most challenging since their presence represents an economic burden due to crops loss and a serious health effects related for animal and human with severe repercussions. Many fungal plant pathogens species from Aspergillus and Fusarium genera produce MY harmful to animal and human health. The contamination of cereals grains is commonly reported, and the climate change scenario can also influence significantly the contamination during postharvest phase having implications in food security and safety aspects. Additionally, it is foreseen that specific species increase due to climate change leading to higher use of azole-based fungicides. Azole-based fungicides are the most used antifungals to control fungi and MY production in crops. However, excessive and long-term use of azole fungicides in agriculture has led to the emergence of acquired azole resistance in some plant pathogenic fungi and also trigger in potential pathogenic fungi for humans and the toxigenic potential. Overall, climate changes can trigger crops contamination by toxigenic fungal species, increase human exposure to mycotoxins, promote the acquired azole resistance and, consequently, the occurence of life-threatening infections.

Abstract Climate change (CCh) is having an impact on people's health and health systems, directly and indirectly. Drastic and sudden changes in climatic conditions with heat waves and rapid temperature variations, an increased risk of floods, droughts and forest fires are some of the direct impacts related to CCh, with important consequences on health (e.g. heatstroke, electrolyte imbalance, kidney, respiratory as well as infectious related diseases) and mental well-being (e.g. stress and anxiety for an uncertain future). Some indirect effects include the alteration of natural ecosystems, changing vector patterns, air pollution and aeroallergens, or increased food insecurity. For certain sectors of the population and some regions, these direct and indirect impacts overlap with many other environmental and socioeconomic stressors (e.g. overcrowded megacities, poverty and poor nutrition, living in highly contaminated sites, increased dependence on a remote global market, growing gender and class inequalities), increasing the already large vulnerability of those affected populations. Low- and middle-income countries are under greater threat, but more developed economies can be- and in fact are- severely affected as well. This is of particular concern in relation to children together with the elderly, both considered the most vulnerable population groups affected by CCh as highlighted by the Intergovernmental Panel on Climate Change (IPCC). Adverse effects of altered environments during fetal or child developmental stages can result in irreversible and long-lasting health sequelae; uncertainty and loss of control in the face of CCh can have mental health consequences. Gathering best scientific evidence-based information on current and future health threats related to CCh from the perspective of the most vulnerable population subgroups is essential for an effective preparedness of the public health system, and therefore for lessening or avoiding many of those health impacts by applying well-designed and innovative adaptation measures. Health vulnerability and adaptation assessments to CCh requires establishing partnerships among different scientific domains (e.g. public health experts, environmentalists, meteorologists, social scientists), and stakeholders, including community representatives and policy makers. Present workshop, with 3 presenters and one panellist, aims at analysing and sharing expertise on the following aspects: Approaches for characterising health and well-being vulnerability and adaptation measures in the context of CCh by integrating future climatic and socio-economic drivers. Analysis of children's health vulnerability in a CCh context. European initiatives for promoting multidisciplinary scientific evidence analysis, and the interconnection with the decision-making process for the development of innovative and effective adaptation programs that enables diminishing health vulnerability against CCh. Key messages Expanded efforts in the health impact assessment of vulnerable groups against growing risks from climate change is needed for developing effective public health adaptation and preparedness programs. Addressing climate change health vulnerability requires of gathering scientific evidence and collaboration from multiple sectors and stakeholders adapted to regional/local context.