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Floods are the most common natural disaster in Europe. The adverse human health consequences of flooding are complex and far-reaching: these include drowning, injuries, and an increased incidence of common mental disorders. Anxiety and depression may last for months and possibly even years after the flood event and so the true health burden is rarely appreciated (1).
Effects of floods on communicable diseases appear relatively infrequent in Europe. The vulnerability of a person or group is defined in terms of their capacity to anticipate, cope with, resist and recover from the impact of a natural hazard. Determining vulnerability is a major challenge. Vulnerable groups within communities to the health impacts of flooding are the elderly, disabled, children, women, ethnic minorities, and those on low incomes (1).
Austria is among the most strongly affected countries in Central Europe, but the annual number of cases has strongly declined due to vaccination. In Austria, the high vaccination coverage (more than 80% of the total population has received at least one TBE vaccination) has led to a substantial decline in the number of annual cases. The incidence in the unvaccinated population, however, remained constant at ca 6 per 100,000, suggesting no major changes in the countrywide overall risk of human exposure to TBE virus-infected ticks (18).
The outcomes from the two European heat waves of 2003 and 2006 have been summarized by the IPCC (2) and are summarized below. They include public health approaches to reducing exposure, assessing heat mortality, communication and education, and adapting the urban infrastructure.
1. Public health approaches to reducing exposure
A common public health approach to reducing exposure is the Heat Warning System (HWS) or Heat Action Response System. The four components of the latter include an alert protocol, community response plan, communication plan, and evaluation plan (3). The HWS is represented by the multiple dimensions of the EuroHeat plan, such as a lead agency to coordinate the alert, an alert system, an information outreach plan, long-term infrastructural planning, and preparedness actions for the health care system (4).
The European Network of Meteorological Services has created Meteoalarm as a way to coordinate warnings and to differentiate them across regions (5). There are a range of approaches used to trigger alerts and a range of response measures implemented once an alert has been triggered. In some cases, departments of emergency management lead the endeavor, while in others public health-related agencies are most responsible (6).
2. Assessing heat mortality
Assessing excess mortality is the most widely used means of assessing the health impact of heat-related extreme events.
3. Communication and education
One particularly difficult aspect of heat preparedness is communicating risk. In many locations populations are unaware of their risk and heat wave warning systems go largely unheeded (7). Some evidence has even shown that top-down educational messages do not result in appropriate resultant actions (8).
More generally, research shows that communication about heat preparedness centered on engaging with communities results in increased awareness compared with top-down messages (9).
4. Adapting the urban infrastructure
Several types of infrastructural measures can be taken to prevent negative outcomes of heat-related extreme events. Models suggest that significant reductions in heat-related illness would result from land use modifications that increase albedo, proportion of vegetative cover, thermal conductivity, and emissivity in urban areas (10). Reducing energy consumption in buildings can improve resilience, since localized systems are less dependent on vulnerable energy infrastructure. In addition, by better insulating residential dwellings, people would suffer less effect from heat hazards. Financial incentives have been tested in some countries as a means to increase energy efficiency by supporting those who are insulating their homes. Urban greening can also reduce temperatures, protecting local populations and reducing energy demands (11).
Numerous concepts have been developed to mitigate the heat load in urban areas, such as customizing urban vegetation for shading and evaporative cooling (12), introducing open water surfaces (13), planning of built structures that support ventilation by choosing an appropriate geometry and size of buildings and street areas (14), and applying suitable materials and colours for buildings to reduce the heat storage and the absorption of solar radiation (15). Increase in vegetation and water surfaces, known as green and blue infrastructure, is of particular interest due to their multiple functionality and benefits for the urban environment, such as increasing urban biodiversity and improving air quality in case of urban vegetation (16).
The cooling potential of the blue and green infrastructure to reduce the urban heat island effect has been assessed for Vienna, the capital of Austria (17). In Vienna, a warming trend has been observed between 1961 and 2010. A model simulation for Vienna with green infrastructure shows that a substantial reduction in temperature is achieved only by incorporating an extensive amount of vegetation. Heat load mitigation measures should be applied extensively in order to reach substantial reduction in urban heat load on a city scale. With the application of several heat load mitigation measures such as decrease in building density by 10% and pavement by 20%, enlargement in green and water spaces by 20%, it is possible to achieve a substantial cooling effect. A relatively small change in infrastructure may reduce the annual number of summer days with a maximum temperature ≥ 25°C by 10 or more. Temperature reduction due to implementation of green and blue infrastructure in urban areas depends on multiple factors: terrain, prevailing wind direction and wind conditions, neighbouring areas and the size of the applied measures. By concentrating the parks in the city centre, the cooling effect could be amplified as compared to locating parks in the low-density residential areas in the outer districts of the city (17).
The potential of urban roofs to mitigate the heat load in the summer period by changing their surface properties was studied for the City of Vienna as an example. Results show that a moderate increase in reflectivity of roofs reduces the mean summer temperatures in the densely built-up environment by approximately 0.25 °C. Applying high reflectivity materials leads to average cooling in densely built-up area of approximately 0.5 °C. Green roofs yield a heat load reduction in similar order of magnitude as the high reflectivity materials. However, only 45 % of roof area in Vienna is suitable for greening and the green roof potential mostly applies to industrial areas in city outskirts and is therefore not sufficient for substantial reduction of the urban heat island effect, particularly in the city centre which has the highest heat load (20).
The best way to protect against TBE is vaccination. Other ways to protect against TBE is preventing tick bites, by avoiding tick risk areas, being informed about how to remove ticks and recognize early symptoms, using insect repellent on skin and clothing when in risk areas, and wearing protective clothing with long sleeves, and long trousers tucked into socks or boots (19).
The references below are cited in full in a separate map 'References'. Please click here if you are looking for the full references for Austria.
- Hajat et al. (2003)
- IPCC (2012)
- Health Canada (2010), in: IPCC (2012)
- WHO (2007), in: IPCC (2012)
- Bartzokas et al. (2010), in: IPCC (2012)
- McCormick (2010b), in: IPCC (2012)
- Luber and McGeehin (2008), in: IPCC (2012)
- Semenza et al. (2008)), in: IPCC (2012)
- Smoyer-Tomic and Rainham (2001), in: IPCC (2012)
- Yip et al. (2008); Silva et al. (2010), both in: IPCC (2012)
- Akbari et al. (2001), in: IPCC (2012)
- Spronken-Smith and Oke (1998); Solecki et al. (2005); Gill et al. (2007); Memon et al. (2008); Bowler et al. (2010); Oliveira et al. (2011); Fallmann et al. (2014), all in: Žuvela-Aloise et al. (2016)
- Hathway and Sharples (2012); Theeuwes et al. (2013), both in: Žuvela-Aloise et al. (2016)
- Ali-Toudert and Mayer (2007a, b); Middel et al. (2014), both in: Žuvela-Aloise et al. (2016)
- Hamdi and Schayes (2008); Krayenhoff and Voogt (2010); Santamouris et al. (2012), all in: Žuvela-Aloise et al. (2016)
- Akbari et al. (2001), in: Žuvela-Aloise et al. (2016)
- Žuvela-Aloise et al. (2016)
- Heinz et al. (2015)
- WHO (2016)
- Žuvela-Aloise et al. (2018)