Trends in population exposure to compound extreme-risk temperature and air pollution across 35 European countries: a modelling study

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• dc.contributor.author Chen, Zhaoyue
• dc.contributor.author Achebak, Hicham
• dc.contributor.author Petetin, Hervé
• dc.contributor.author Méndez Turrubiates, Raúl Fernando
• dc.contributor.author Guo, Yuming
• dc.contributor.author Pérez García-Pando, Carlos
• dc.contributor.author Ballester, Joan
• dc.date.accessioned 2025-06-20T06:59:04Z
• dc.date.available 2025-06-20T06:59:04Z
• dc.date.issued 2025
• dc.description.abstract Background: Despite ongoing efforts to reduce air pollution, the complex relationship between air pollution and climate change presents additional multifaceted challenges. The spatiotemporal co-occurrence of extreme temperatures and air pollution episodes remains understudied. Furthermore, current studies typically employ uniform temperature thresholds across broad areas, overlooking regional differences in health vulnerability. We aim to present a comprehensive assessment of extreme temperatures and air pollution, and to incorporate location-specific risk thresholds. Methods: In this time series modelling study we analysed the changes in extreme-risk temperature (ERT) days for heat and cold in Europe from Jan 1, 2003 to Dec 31, 2020, considering time-varying temperature-mortality relationships based on regional mortality data (from Eurostat) from 35 European countries (543 million people). We used daily estimates of PM2·5, PM10, NO2, and O3 concentrations from quantile machine learning estimations at 0·1-degree to identify of heat-compound and cold-compound days co-occurring with air pollution levels exceeding WHO guidelines. Findings: Cold-related mortality risk decreased over the study period across Europe, and adaptation to heat-related mortality was less pronounced. Between 2003 and 2020, annual cold-ERT days had decreased by 20·7 days per decade and annual heat-ERT days increased by 2·8 days per decade. Southeastern Europe had higher frequencies of both heat-ERT and cold-ERT days. Heat-O3 events were the only increasing heat-compound episodes, with 2·6 more days per decade. Conversely, cold-compound episodes decreased by 15·2 days per decade with cold-PM2·5 events remaining the predominant threat. Around 349 million Europeans were exposed to at least 1 cold-compound day annually, and around 295 million experienced at least one heat-compound day, including nearly 235 million affected by heat-O3 compound episodes. Interpretation: By identifying region-specific risk thresholds, our study reveals spatial disparities and changes in ERT events, particularly when coupled with air pollution. These findings are essential for developing targeted adaptation strategies, facilitating subsequent health assessments, and implementing effective measures to safeguard public health. Funding: European Research Council and Ministerio de Ciencia e Innovación.
• dc.description.sponsorship Z-YC, RFMT, HA, and JB gratefully acknowledge funding from the EU's Horizon 2020 and Horizon Europe research and innovation programmes under grant agreement 865564 (European Research Council [ERC] Consolidator Grant EARLY-ADAPT), 101069213 (ERC Proof-of-Concept HHS-EWS), and 101123382 (ERC Proof-of-Concept FORECAST-AIR). Z-YC also acknowledges support from the grant PRE2020-091985 funded by MCIN/AEI/10.13039/501100011033 and by European Social Fund invests in your future. HA also acknowledges funding from the EU's Horizon Europe research and innovation programme under grant agreement 101065876 (Marie Skłodowska-Curie Actions Postdoctoral Fellowship TEMP-MOMO). HP has received funding from the Ministerio de Ciencia e Innovación through the MITIGATE project (PID2020-113840RA-I00 funded by MCIN/AEI/10.13039/501100011033) and the Ramon y Cajal grant (RYC2021-034511-I, MCIN/AEI/10.13039/501100011033 and EUs NextGenerationEU–Plan de Recuperación, Transformación y Resiliencia). HP and CPG-P acknowledge funding from the Ministerio para la Transición Ecológica y el Reto Demográfico as part of the Plan Nacional del Ozono project (BOE-A-2021-20183), the Recovery, Transformation and Resilience Plan funded by the European Commission, Grant RED2022-134824-E (Aerosol, Clouds, and Trace Gases Research Infrastructure Spain) funded by MICIU/AEI/10.13039/501100011033, the AXA Research Fund, and the Department of Research and Universities of the Government of Catalonia through the Atmospheric Composition Research Group (code 2021 SGR 01550). YG was supported by the Leader Fellowship (APP2008813) of the Australian National Health and Medical Research Council. ISGlobal authors acknowledge support from the grant CEX2018-000806-S funded by MCIN/AEI/10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Programme. During the preparation of this work the authors used Claude in order to check grammar. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.
• dc.format.mimetype application/pdf
• dc.identifier.citation Chen ZY, Achebak H, Petetin H, Méndez Turrubiates RF, Guo Y, Pérez García-Pando C, et al. Trends in population exposure to compound extreme-risk temperature and air pollution across 35 European countries: a modelling study. Lancet Planet Health. 2025 May;9(5):e384-96. DOI: 10.1016/S2542-5196(25)00048-8
• dc.identifier.doi http://dx.doi.org/10.1016/S2542-5196(25)00048-8
• dc.identifier.issn 2542-5196
• dc.identifier.uri http://hdl.handle.net/10230/70736
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Lancet Planet Health. 2025 May;9(5):e384-96
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/865564
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101069213
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101123382
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101065876
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/PID2020-113840RA-I00
• dc.rights © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.other Aire--Contaminació
• dc.subject.other Canvis climàtics
• dc.title Trends in population exposure to compound extreme-risk temperature and air pollution across 35 European countries: a modelling study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion