This Thursday, the Ministry of Health activated the national plan for preventive actions against the effects of excess temperatures on health, which seeks to reduce deaths and illnesses during the hottest episodes. The plan, which is launched in collaboration with the autonomous communities, will be active until September 30, although it could be extended to October 15 if the heat persists as has happened years ago, a phenomenon linked to a climate crisis that is lengthening summers and triggering episodes of high temperatures. This 2024, Spain’s special heat plan turns 20 (it was launched in 2004, after the deadly summer of 2003 in Europe) and contains an important novelty: a new map to activate more precise alerts.
The Health heat warning system manages two main variables: the temperatures at which mortality shoots up in a statistically significant way in an area and the forecast of the duration of heat waves. Based on the forecasts of the State Meteorological Agency (Aemet), four alert levels are established for the population, paying special attention to the elderly and children, who are most exposed to health problems. The mortality trigger temperatures are not the same in all places and so far they have been used to activate 52 alerts: one for each province, in addition to the two autonomous cities. But within the same province there can be very large differences, so now an attempt is being made to refine the system further based on research from the Carlos III Health Institute coordinated by specialist Cristina Linares.
This year’s plan goes from 52 provincial thresholds to 182 corresponding to the so-called meteohealth zones (areas of territory that are homogeneous in terms of the behavior of daily temperatures). To understand the importance of this change, it must be taken into account that within each province there can be up to five different meteohealth zones or isoclimatic regions. And within the same province there can be differences of more than 11 degrees Celsius in temperature that trigger the number of deaths. This is the case of Lugo: the threshold established for the A Mariña area, on the north coast, is 25.5 degrees; while that in the south of the province is set at 37.1 degrees.
Below you can consult the thresholds that correspond to you according to the municipality in which you reside.
Threshold
Percentile improvement
Julio Díaz, another of the researchers at the Carlos III Health Institute who has participated in this project, explains that to determine these 182 meteohealth zones, data from hundreds of observatories have been taken into account and compared with the linked mortality figures. to heat during extreme episodes in the period from January 1, 2009 to December 31, 2018. There can be wide differences between areas taking into account a multitude of factors, such as how adapted the population is. For example, in the Córdoba countryside is where the shooting temperature is highest in the entire country: 40.4 degrees. That is, until a heat episode reaches that temperature, a statistically significant increase in deaths is not seen. On the other hand, in Asturias, where the limit is lowest in all of Spain, it begins to occur at 23.9 degrees, as reflected in the national plan activated this Thursday.
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Health sources explain that the plan was launched on May 16 still with the provincial map for logistical reasons, but they hope that on June 3 the alert system will be ready to launch warnings for the 182 meteohealth zones. In any case, the ministry does not expect any heat wave to occur in the next two weeks that would require warnings to be issued. Another thing is what may happen during the summer, because the European Copernicus satellite system has already warned that there is a high probability (above 70%) that this summer will once again be warmer than normal. The past was already the hottest ever recorded on the planet and in Spain more than half of the month of August there were declared heat waves.
Climate change caused by humans will make these types of episodes and torrid summers worse. “An increase in extreme temperatures, a decrease in precipitation and a decrease in snow coverage is expected,” the national plan notes regarding the forecasts for the European Mediterranean region in the coming years due to global warming. That is why increasingly efficient alert systems are needed so that the warnings are more effective, explains Díaz. This researcher highlights that Spain can be considered a pioneer in the establishment of a system based on meteohealth zones and highlights as one of the keys the collaboration of three ministries: Health, Science and Ecological Transition.
Old people
Excess temperature affects health through several mechanisms, which can even lead to death. Heat stroke can occur, leading to sudden death due to exposure to a very high temperature and can affect even healthy people, but it is not the most common. The victims are usually very old people (the risk increases above 80 years of age) with other pathologies and who may suffer organic failure after consecutive days of heat. The national plan activated this Thursday indicates that Momo estimates (the daily mortality monitoring system for all causes) of excess mortality attributable to temperature in Spain between 2015 and 2023 were 21,774 deaths. The year 2022, with 4,789 deaths attributable to heat, was the year with the most excesses, followed by 2023, with 3,009 deaths. Deaths are mainly concentrated in those over 65 years of age.
For the elderly group, plans like the one that has now been activated can be useful to know when they are most at risk and avoid going out during the middle of the day or take precautions such as drinking more fluids. “We suspect that they may be positive, but there is no scientific literature that clarifies it. We would need to do evaluations that tell us how effective they are, if they can be improved or what needs to be changed,” explains Hicham Achebak, who researches the effects of high temperatures on health at the National Institute of Health and Medical Research (Inserm) in Paris. . However, the Spanish national plan highlights that “the latest scientific evidence reinforces the idea that prevention plans have a real effect on reducing mortality associated with excess temperatures.”
Achebak points out that these alerts, however, are of little use in protecting vulnerable people in their own homes if they do not have air conditioning. “What these people would need is to provide material resources so that they can install and use it, since it is practically the only tool we have in these contexts,” says Achebak. A study published last December confirmed how Spanish homes are increasingly better adapted, which is why climate vulnerability has been reduced. This, in summer, is clearly correlated with the increase in air conditioning units.
“Extreme warm events will increase in frequency, unlike extreme cold events,” the plan now activated warns. However, this does not mean that cold spells do not also cause deaths. The next step that Health wants to take is to also establish trigger temperatures for mortality due to cold in order to also have an alert system. But, for that, it is still necessary to launch research such as the one that has allowed us to establish the thresholds for now the 182 meteohealth zones.
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