The World Health Organization (WHO) is urging European countries to move beyond emergency responses to extreme heat and adopt long-term prevention strategies because rising temperatures contribute to increasing illness and premature deaths across the continent.

Europe is warming at nearly twice the global average rate, and its health consequences are becoming increasingly apparent. According to the WHO, extreme heat has contributed to more than 200,000 premature deaths across Europe during the past 4 years, with Italy reporting the highest number of heat-related deaths on the continent.

In response, the WHO Regional Office for Europe released the second edition of its heat-health action plans (HHAPs) guidance, a framework designed to help policymakers and healthcare professionals shift from emergency response to long-term prevention.

New Reality

According to the WHO, population aging, rapid urbanization, and climate change are combined to increase heat-related illness and mortality across Europe.

To address what the organization describes as a growing public health challenge, the guidance outlines eight core elements of HHAPs. Among the most important is the development of integrated warning systems that extend beyond weather forecasts and are based on anticipated health impacts, with clear links to response measures.

The WHO also emphasized the need to identify vulnerable populations, including older adults, individuals with chronic diseases, pregnant women, and outdoor workers, so that preventive measures can be implemented before extreme heat events occur.

Another priority is strengthening healthcare system resilience to help hospitals, long-term care facilities, and primary care services manage surges in demand while maintaining continuity of care and protecting healthcare workers.

“Europe is warming faster than any other continent — and we are paying for it with human lives,” said Hans Henri Kluge, the WHO’s regional director for Europe, in Berlin, Germany. More than 200,000 people in Europe have died as a result of heat over the past 4 years.

He emphasized that many of these deaths are preventable and that the new evidence-based WHO guidance provides authorities with a practical framework for strengthening preparedness systems and reducing heat-related mortality. He added that the necessary tools are already available and called for their rapid implementation.

Italy’s Challenge

The WHO data indicate that Italy recorded the highest number of premature deaths linked to extreme heat in Europe, followed by Spain, Germany, and Greece. Greece, however, has the highest heat-related mortality rate per million inhabitants.

The findings highlighted a major challenge for Italy’s healthcare system, particularly given the country’s aging population.

At the same time, the WHO report identified Italy, alongside France, as a leading example of the best practices for integrating health warning systems with public health responses.

Unlike Switzerland, which uses a uniform national model, or Germany, which relies primarily on perceived temperature, Italy’s National Coordination Center uses city-specific impact models that determine heat alert levels based on the relationship between maximum temperatures and mortality in each city while accounting for seasonal acclimatization.

The WHO also highlighted initiatives implemented by local authorities and health agencies, including home visits by physicians and nurses, telehealth programs such as the Lazio ADVICE, a telemedicine platform, and home delivery of medications and groceries for older adults living alone.

In addition, real-time monitoring of emergency department visits and daily mortality data allows healthcare resources to be redistributed rapidly when needed.

Role of Clinicians

The WHO guidance includes several recommendations for healthcare professionals ahead of the summer season.

One recommendation is to proactively review medication regimens before heat waves, particularly for frail individuals and older adults receiving medications that may impair thermoregulation, disrupt fluid balance, or compromise kidney function. These include diuretics, anticholinergic agents, antipsychotics, and antihypertensive agents.

Healthcare professionals working in primary care and community settings also play a key role in helping patients recognize early signs of heat-related illness, including heat exhaustion, syncope, and dehydration, before these conditions progress to heat stroke.

Primary care also plays a central role in protecting vulnerable individuals during periods of extreme temperature. General practitioners are often the first to identify at-risk patients, provide timely advice, and ensure continuity of care through proactive follow-up, including the use of telemedicine when appropriate. These measures can help reduce unnecessary visits to emergency departments while enabling individuals with unstable chronic conditions to receive safe, ongoing care at home.

The WHO guidance also highlights the significant role of air conditioning. Although widespread reliance on air conditioning is not considered a sustainable long-term solution because it increases energy consumption, greenhouse gas emissions, and health inequities, the guidance emphasizes that access to air-conditioned environments should be regarded as a medical necessity for vulnerable individuals.

The WHO’s message is clear: Many heat-related illnesses and deaths are both medically and socially preventable. The physician’s role extends beyond treating acute heat-related illness. It also includes educating patients, improving health literacy, identifying individuals at increased risk, and proactively managing chronic conditions before periods of extreme heat.

This story was translated from Univadis Italy, part of the Medscape Professional Network.