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Deadly heat, dirty air and the cost to European lives
How much will deadly heat cost European societies in the coming decades – not only in lives lost but in economic welfare terms? A recent paper from the EXHAUSTION project “What are the costs of heat spell mortality in Europe’s urban areas up to 2050?” addresses that question.
The authors estimate the welfare costs of heat-related premature deaths due to heart and lung diseases in Europe and Asia Minor under a “middle-of-the-road” warming scenario (SSP2-4.5).
Background
Using data from 1994–2018 covering more than 30 million people, the analysis develops region-specific exposure–response relationships linking temperature, air pollution (PM₂.₅) and daily cardiopulmonary disease (CPD) mortality. These functions capture how heat sensitivity varies across Europe’s climate zones and how local populations, buildings and cities are adapted to past climates. Heat exposure is measured through Eurostat’s cooling degree-days, a metric that better reflects short, intense heat spells than average summer temperatures.
By combining these health relationships with high-resolution climate and population projections for urban areas in 317 regions across 39 countries, the study projects heat-related CPD mortality for 2030–34 and 2045–49 and also provides separate calculations for “heat wave years” when temperatures are expected to peak.
Results:
The results indicate that heat-related CPD mortality, attributable to global warming from 1990 and onwards could triple by mid-century compared with the pre-1990 baseline. Using OECD mortality valuation guidelines, this corresponds to around EUR 90 billion annually in welfare economic costs across Europe. In ten countries of south-eastern Europe, yearly costs may exceed 1% of GDP, reaching 3–4% in extreme heat years. These impacts come in addition to other climate-related losses, including work productivity losses.
Epidemiological analyses in EXHAUSTION showed that air pollution (PM₂.₅) substantially amplifies heat-related mortality risks (Schneider et al. 2023). By integrating the heat–air pollution interaction effects into detailed regional mortality projections and welfare-cost estimates, the new study reveals major policy implications: accelerated air-pollution reduction emerges as a powerful adaptation strategy.
Simulations indicate that lowering air pollution (PM₂.₅) concentrations to the WHO guideline of 5 µg/m³ could prevent up to 190,000 heat-related CPD deaths in Mediterranean and Balkan countries over the next 25 years, significantly reducing the economic burden of heat-related mortality.
Challenges common assumptions in economic modelling
The study also challenges common assumptions in economic modelling. The findings show an exponential increase in heat-related mortality with rising temperatures in Europe, whereas many models used to estimate the social cost of carbon, assume linear or minimal impacts in high-income regions.
This implies that the benefits of strong climate mitigation—through avoided mortality and reduced welfare losses—are likely considerably larger than previously estimated, even under moderate warming scenarios.
The summary is based on the following paper:
Andersen, M. S., Aunan, K., Christensen, J. H., Im, U., Stafoggia, M., Suhrcke, M., Zhuyun, Y., Zafeiratou, S., Zhang, S. (2025). What Are the Costs of Heat Spell Mortality in Europe’s Urban Areas up to 2050? Weather, Climate, and Society, 17(4), 1043-1059. doi:10.1175/wcas-d-25-0026.1
The implications of this study are especially significant for Balkan and Mediterranean countries, which show some of the highest heat-related CPD fatality rates and some of Europe’s worst air quality in many regions. In 2021, more than 20 provinces* in these areas had air pollution (PM₂.₅) concentrations of 20–30 µg/m³—four to six times the WHO guideline. The analysis contrasts projected heat-related fatalities under current pollution conditions with a scenario in which PM₂.₅ is reduced to the WHO guideline of 5 µg/m³. Achieving this cleaner-air pathway could avoid up to 190,000 heat-related cardiopulmonary disease deaths over the next 25 years—reducing annual heat-related deaths from roughly 19,000–21,000 to 12,000–13,000, i.e. close to a 40% reduction. Impacts would be even more pronounced in the western Balkans.
*NUTS2-classification
Related projects
EXHAUSTION
Increasing temperatures and heat waves due to climate change, combined with air pollution, constitute major health risks, and could cause an increase in cardiovascular and respiratory diseases across Europe. EXHAUSTION (Exposure to heat and air pollution in Europe – cardiopulmonary impacts and benefits of mitigation and adaptation) aims to quantify the changes in cardiopulmonary mortality and morbidity due to extreme heat and air pollution (including from wildfires) under selected climate scenarios.
EXHAUSTION has its own project website at EXHAUSTION.EU
Health | Air pollution | Heat waves
References
Schneider, A. et al, 2023: Exposure-response functions for interactive effects of temperature and air pollution. EXHAUSTION Rep. D2.4., 83 pp., https://cordis.europa.eu/ project/id/820655/results.