This session invites contributions that investigate the different pathways linking climate extremes to human health and well-being worldwide. We particularly encourage studies that leverage diverse data sources, including observations, health and socio-economic data, reanalyses, climate models, large ensembles, and AI-based models, to deepen our understanding and improve prediction and projection across various time scales.
Works addressing vulnerability, inequality, early warning systems, and strategies for adaptation and resilience are especially welcome, as well as interdisciplinary approaches bridging climate science, epidemiology, economics, and public health.
Orals: Wed, 6 May, 10:45–12:20 | Room -2.62
Climate change is fundamentally altering the landscape of global health through more frequent and intense extreme events, complex exposure pathways, and widening health inequalities. Therefore, future health projections require an integrated framework that goes beyond single hazards and average populations, incorporating compound disasters, vulnerable groups, and adaptive capacity.
First, climate-related health risks often arise from compound hazards, such as hot nights combined with urban heat, droughts interacting with heatwaves, and cascading events like wildfires. These interacting exposures can amplify health impacts beyond what is expected from each factor alone, highlighting the need for multi-hazard approaches in health projection models.
Second, health impacts of climate change are not evenly distributed. Vulnerable populations, including people with disabilities and socioeconomically disadvantaged groups, experience disproportionately higher risks and healthcare burdens during extreme temperatures. These double disparities in both health outcomes and socioeconomic status indicate that equity-sensitive projections are essential for realistic health risk assessment and policy planning.
Finally, adaptation is a key determinant of future health risks. Emerging evidence shows that strengthening healthcare systems, improving early warning systems, and implementing environmental and social interventions can substantially reduce climate-related health burdens. Integrating adaptation into climate-health projections is therefore essential to move from impact estimation toward actionable and policy-relevant scenarios.
How to cite: Kim, H.: Toward integrated health projections under climate change: from compound hazards to vulnerability and adaptation, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-16465, https://doi.org/10.5194/egusphere-egu26-16465, 2026.
Epidemiological evidence on the effects of droughts on human health is limited and heterogeneous, and drivers of vulnerability are still uncertain. The IGIA-SETH project aims to address these research gaps by using advanced epidemiological models and unique health and climate datasets. In particular, the present study aims to estimate drought-related mortality risks and identify vulnerability patterns on a global scale, using a robust and common approach and a large multi-location mortality dataset.
We analyse mortality data from 832 locations distributed around the world with a wide range of climatic, demographic and socioeconomic characteristics over the period 1969-2019. We use a two-stage time series analytical design with a quasi-Poisson regression and a threshold function to model the association between droughts and mortality. Droughts at short and long- time scales are defined using the Standardized Precipitation Evaporation Index (SPEI) computed at one- and twelve-month accumulation periods. Potential effect modification by climatic, demographic, socioeconomic and environmental factors are also evaluated.
Our findings suggest that extreme short-term and long-term drought events are associated with an increased mortality risk at 1% (95% confidence interval: 0.7%-1.2%) and 0.7% (0.01%-1.3%), respectively, at a SPEI=-2 vs. SPEI=0. Countries with higher mean temperatures and lower annual precipitation show a higher vulnerability to short-term droughts, while for long-term droughts, higher vulnerability is mostly found in countries with lower temperature range, lower annual average precipitation, and with a higher Gross Domestic Product per Capita.
To our knowledge, this study represents the first comprehensive quasi-global analysis providing robust evidence of increased mortality risk associated with different drought exposures. Different mechanisms interacting at different levels, as well as different distribution of climatic, socioeconomic and demographic vulnerability factors between countries can driver disparities in drought-related mortality risks worldwide.
How to cite: Salvador, C., Vicente-Serrano, S. M., Gimeno, L., Nieto, R., Fernandez-Alvarez, J. C., and Vicedo-Cabrera, A. M.: How droughts affect human health: mortality impacts attributed to events of different time scales and vulnerability drivers , EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-10769, https://doi.org/10.5194/egusphere-egu26-10769, 2026.
The indoor residential environment is a critical yet underexamined determinant of public health, particularly during extreme heat events. People in the U.S. spend roughly 90% of their time indoors, making indoor thermal exposure a key yet often overlooked, component of heat vulnerability. The level of residential protection against climate hazards depends on socioeconomic factors, but in the U.S., decades of systemic housing discrimination mean that housing quality issues disproportionately fall on racialized minority and low-income populations.
The New Orleans Home, Environment, and Ambient Temperature: Measurements and Analysis for Preparedness (NOLA HEAT-MAP) Study assessed indoor thermal vulnerability to inform equitable resilience strategies. We enrolled 114 participants from high-urban-heat neighborhoods in New Orleans, LA, collecting demographic and housing data, continuous indoor temperature and humidity measurements over two- or four-week periods, and daily self-reported physical and mental health surveys.
Modeling results show that outdoor temperature, air conditioning type and use, and homeownership status are key predictors of indoor heat exposure. Notably, homeowners were twice as likely as renters to experience the highest overnight indoor temperatures (62% vs. 38%). Across tenure types, homes relying on window units struggled to maintain 80°F (26.6°C) once outdoor temperatures exceeded 90°F (32.2°C)—an important threshold given New Orleans’ residential cooling standard requiring rental units to maintain temperatures of 80°F (26.6°C) or below.
To understand how these challenges may change over time, we estimated the number of days exceeding 90°F in New Orleans using LOCA2 downscaled CMIP6 climate projections. We found that days exceeding 90°F (32.2°C) may rise by 50% by 2075, reaching approximately 150 days annually under SSP5-8.5. In this presentation, we will discuss how these findings suggest escalating cooling needs that could exacerbate existing inequities in thermal safety, and highlight the need for interdisciplinary, climate-informed research to support adaptive public health and resilience.
How to cite: Easton-Calabria, L., Chari, R., Ruder, T., Kumari Drapkin, J., Reed, C., Mychal, J., Scazzosi, J., and Madrigano, J.: Modeling Indoor Heat Vulnerability and Future Cooling Needs: Insights from the NOLA HEAT-MAP Study, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-5496, https://doi.org/10.5194/egusphere-egu26-5496, 2026.
The effects of climate change can be observed globally, and the hazards will rise in frequency and intensity. Modified atmospheric conditions affect morbidity and mortality rates and increase the pressure on healthcare systems. Especially, the intensive care unit (ICU) is vulnerable due to low buffer capacity and high utilization rate. Thus, this study analyzed the impact of regional atmospheric conditions on daily ICU in hospitals in Germany, identifying key factors as well as regional and age-gender differences.
Daily ICU cases for the period 2009-2023 were determined using secondary health data from a German health insurance. Cases were stratified by age and gender. Thirteen intensive care relevant diseases, that provide a comprehensive overview of the ICU, were analyzed using disease-specific predictor sets. A set of 31 predictor variables with predictor-specific time lags was used. Analyses were conducted for regions derived from a human-biometeorological characterization of Germany. Generalized additive models were used to investigate the associations, including the selection of disease-relevant predictors, lags, smoothing functions, variables for temporal trends, seasonality and days of the week. Model quality and performance were assessed using explained deviance and cross-validation.
Over the 15-year study period, 9,970,548 ICU patients were recorded (56% men, 44% women), 74.3% aged ≥60 years. Trauma was the most common ICU-related disease, followed by non-ST elevation heart attacks (NSTEMI), pneumonia and ischemic stroke. ICU demand was most sensitive (p ≤ .05) to pressure-related factors, thermo-physiological parameters and ozone concentration. In terms of gender and age differences, atmospheric factors affected men more frequently, while women were more impacted by cold weather and particulate matter (PM10). Heat was more relevant for patients aged 60 years and over. In total, at least one atmospheric factor influences the ICU cases despite regional, age and gender-specific differences. The model that best fit the data was for NSTEMI in central eastern Germany (weighted explained deviance of 49.3%).
The strong association between pressure-related factors and the ICU has already been investigated in literature. Therefore, the results of this study underscore the impact of air pressure on health. Gender differences could indicate that women are less susceptible to the influence of atmospheric factors due to health-conscious behaviour and thus lower exposure levels. The vulnerability of the elderly during heat periods affects not only the demand for ICU beds, but also general hospital admissions. Model performance improved for diseases or regions with a higher number of daily ICU cases. Overall, the study identified key atmospheric factors relevant to ICU, enabling the German healthcare system to prepare better for short-term impacts of atmospheric and air quality factors.
How to cite: Sasse, K., Merkenschlager, C., Johler, M., Baldenius, T., Dröge, P., Günster, C., Ruhnke, T., Escrihuela Branz, P., Pröll, L., Wein, B., Hettich, S., Ignatenko, Y., Öksüz, T., Soto-Rey, I., and Hertig, E.: The effects of atmospheric factors on daily intensive care unit cases in Germany - A Time Series Regression Study, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-7275, https://doi.org/10.5194/egusphere-egu26-7275, 2026.
Rising temperatures driven by anthropogenic climate change pose a substantial health risk to vulnerable populations, including newborns and pregnant people. Increased exposure to heat extremes can trigger a preterm birth event, which is associated with elevated risks of long-term adverse health, behavioural and cognitive outcomes for the premature individual. However, few studies have assessed how many preterm births are attributable to anthropogenic climate change and none have conducted a multi-country analysis. Our study addresses this gap by estimating the global contribution of human-induced warming to preterm birth incidence. We utilise the new Large Ensemble Single Forcing Model Intercomparison Project (LESFMIP) simulations, used here for the first time in a climate impact attribution study, and test multiple established bias correction methods on the simulations, assessing performance by employing the UNSEEN fidelity test. We apply the latest relationships between preterm birth and temperature, spanning multiple continents, to derive a historical estimate of the number of preterm births caused by anthropogenic climate change. This work provides one of the first multi-country estimates of the burden of preterm birth attributable to anthropogenic climate change, while demonstrating the suitability of LESFMIP simulations for health impact attribution.
How to cite: Adams, C., Birch, C., Maycock, A., Radebe, L., Brink, N., Marsham, J., Travill, D., Brennan, M., Chersich, M., and Walsh, C.: Attributing preterm births to anthropogenic climate change: a multi-country analysis, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-20111, https://doi.org/10.5194/egusphere-egu26-20111, 2026.
In 2025, chikungunya resurged across the Indian Ocean Region (IOR), with climate-driven increases in temperature and rainfall influencing vector ecology and transmission. To assess the influence of large-scale climate forcing on CHIKV transmission dynamics, we employed a comprehensive set of climate indices representing the dominant modes of climate variability that shape monsoon dynamics and modulate regional weather across the IOR. Using GeoSentinel traveler surveillance data from 2010 to 2024, which closely mirrors global chikungunya epidemiological trends, we examined associations between these climate indices and acute chikungunya cases acquired in the IOR. Chikungunya activity showed region-specific associations with the Mascarene Subtropical High (MSH): In South-Central Asia, outbreaks were strongly correlated with intensified MSH area during El Niño; in Sub-Saharan Africa, the relationship was weaker and spatially heterogeneous, suggesting that other climatic drivers, such as Indian summer monsoon onset and cross-equatorial flow may play a more dominant role; in Southeast Asia, elevated chikungunya activity typically followed moderate-to-large eastward expansions of the MSH, often with a temporal lag, consistent with a delayed positive association and frequently linked to anomalous westerly flow into the Maritime Continent. Improved understanding of these climate–disease linkages could strengthen early warning systems and support more targeted public health interventions to mitigate future chikungunya outbreaks.
How to cite: Dafka, S., Itani, O., Ciruelo, D. P., Connor, B. A., Barnett, E. D., Vaughan, S. D., Visser, B. J., Norman, F. F., Hamer, D. H., javelle, E., Rockloev, J., and Huits, R.: Climate variability is associated with chikungunya outbreaks across the Indian Ocean Region, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-6854, https://doi.org/10.5194/egusphere-egu26-6854, 2026.
Vector-borne diseases transmitted by Aedes mosquitoes such as dengue, Zika, and chikungunya pose significant public health challenges worldwide in the wake of climate change. However, while their transmission is known to be susceptible to climate variables like temperature, rainfall or humidity, the overall role of large-scale climate patterns on the emergence of these diseases is not so well understood. Establishing the most important timeframes for Aedes-borne disease prediction and identifying climate patterns that drive its emergence can be key in the development of actionable, climate-based dengue prediction systems.
In this work, we explore and analyse the response of the climate-driven component of Aedes-borne disease transmission. A timescale decomposition methodology characterises the main timescales over which processes condition transmissibility, while subsequent correlation and causality analyses identify the most relevant predictors for Aedes-borne diseases in the form of climate variability patterns.
We find Aedes-borne disease transmission to be susceptible to multiple factors: Long-term climate trends have a significant impact on dengue suitability in the tropics, where El Niño Southern Oscillation and the Indian Ocean Basin amplify or dampen emergence based on the sign of their respective phases. Temperate regions are more susceptible to year-round climate variability, where multi-scale climate patterns, through teleconnections and compound interactions, can influence transmission dynamics. The results of this study highlight the multi-faceted role of climate patterns in disease emergence, as well as their potential applicability to better inform public health strategies to manage future outbreaks.
How to cite: Corvillo Guerra, J., Torralba, V., Campos, D., and Muñoz, Á.: A causal-based analysis on the role of seasonal climate patterns in dengue disease transmission, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-17704, https://doi.org/10.5194/egusphere-egu26-17704, 2026.
Transmission of malaria, one of the world's deadliest infectious diseases, is highly sensitive to environmental conditions. Understanding the large-scale climate patterns that influence these conditions is crucial for developing forecasting tools, which could be especially valuable for prevention in low-resource nations like Malawi. Previous research has often focused on statistical correlations between local weather and disease trends but has rarely explored the underlying physical climate mechanisms. Here we show that two distinct ocean-based climate patterns are the primary drivers of interannual malaria variability in Malawi. A warm tropical Atlantic leads to wet conditions in Malawi and increased malaria cases. In contrast, a warm Indian Ocean drives hot, dry conditions and reduced malaria cases. We find that soil moisture is the crucial link between these remote climate drivers and local disease dynamics, and looking ahead, future climate change is expected to reduce soil moisture levels in the country by 2100 (magnitude uncertain), which could reshape transmission patterns. By identifying these climate drivers and the physical processes that link them to disease outbreaks, our work provides a foundation for building physically grounded, reliable early warning systems.
How to cite: Elling, M., Karnauskas, K., Kowalcyk, M., Mategula, D., Chirombo, J., Livneh, B., McCann, R., and Buchwald, A.: Tropical oceans drive Malawi's malaria risk, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-8334, https://doi.org/10.5194/egusphere-egu26-8334, 2026.
Extreme heat events pose significant threats to global public health, yet their future impacts remain uncertain due to the coarse spatial resolution of current climate models. This study investigates the effect of horizontal resolution of heatwave projections and related mortality risks using the coupled Earth system model OpenIFS-FESOM2 (AWI-CM3) with atmospheric resolutions of 9 km (TCo1279; HR) and 31 km (TCo319; MR).
Model validation based on the Spherical Convolutional Wasserstein Distance (SCWD) shows that the HR simulation more accurately captures observed temperature patterns over North America, Europe, and Australia. While both simulations accurately capture the heatwave distributions, the HR simulation shows improved agreement with observations. The HR simulation projects a substantial increase in heatwave frequency and duration toward the late 21st century. In densely populated regions such as Europe and East Asia, heatwave frequency and spatial extent are projected to increase rapidly, with prolonged events exceeding 100 days by the 2090s. Assessments of heatwave-related mortality risk consistently indicate substantial future increases, with broadly similar spatial distributions across both simulations. However, city-level discrepancies emerge due to variations in model resolution, highlighting the superior performance of high-resolution simulations in detecting and projecting heatwaves at the urban scale.
How to cite: Seo, Y.-W., Oh, J., Karwat, A., Lee, J.-Y., Lee, W., Franzke, C., Moon, J.-Y., and Ha, K.-J.: Future Changes in Extreme Heat Events and Their Impacts on Mortality Using Kilometer-Scale Global Climate Simulations, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-16627, https://doi.org/10.5194/egusphere-egu26-16627, 2026.
Background
Accurate estimation of temperature-related mortality under climate change may be influenced by the spatial resolution of climate data. Recently, the km-scale global warming simulations provide improved representation of regional climate processes. However, it remains unclear how differences in spatial resolution influence the quantification of health impacts. This study quantifies temperature-related mortality using climate simulations with different spatial resolutions and evaluates the sensitivity of mortality estimates to climate model resolution.
Methods
We used two simulations from the same fully coupled climate model (AWI-CM3) that differ only in atmospheric resolution: a medium-resolution setup (TCo319, ~31–38 km) and a high-resolution setup (TCo1279, ~9–10 km). Daily temperatures were statistically bias-corrected using the ISIMIP trend-preserving approach. The mortality data were obtained from the Multi-Country Multi-City Collaborative Research Network and were linked to climate data by matching each of the 761 cities worldwide to the nearest model grid cell.
Temperature–mortality associations were estimated through a two-stage time-series approach. In the first stage, distributed lag non-linear models with lag periods up to 21 days were fitted for each city to capture non-linear and delayed temperature effects on mortality. Relative risks were estimated using the minimum mortality temperature as the reference, distinguishing heat-related and cold-related risks. In the second stage, city-specific estimates were pooled using multivariate meta-regression to derive Best Linear Unbiased Predictions at the regional level.
Baseline temperature-attributable mortality for 2002–2012 was estimated using 1,000 Monte Carlo simulations. Future changes in attributable mortality were projected and compared between the TCo319 and TCo1279 simulations to assess the impact of spatial resolution.
Results
Despite sharing the same model structure and bias-correction method, the two simulations produced different estimates of temperature-attributable mortality. The TCo1279 simulation captured finer-scale temperature variability and extremes, leading to larger and more spatially heterogeneous estimates of heat-related mortality, particularly in future periods. These differences were most pronounced in regions with complex topography or strong climate variability, including Europe and the Americas. Cold-related mortality was generally less sensitive to spatial resolution, although regional differences remained.
Conclusions
Spatial resolution in km-scale global warming simulations plays a critical role in quantifying temperature-related mortality. High-resolution climate data improve the detection of heat-related mortality burden, especially for extreme temperature events, and provide more detailed regional patterns. Reliance on coarser-resolution data may underestimate both the magnitude and spatial heterogeneity of future health impacts. Incorporating fine-resolution climate projections is therefore essential for robust and policy-relevant assessments of climate change–related mortality.
How to cite: Oh, J., Seo, Y., Lee, J.-Y., Moon, J.-Y., Min, J., Kang, C., Kim, H., and Lee, W.: Quantifying temperature-related mortality from km-scale global warming simulation data with different spatial resolutions, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-9433, https://doi.org/10.5194/egusphere-egu26-9433, 2026.
Southeast Asia, characterized by climatologically high temperature and high humidity all-year round, has faced increasing challenges due to unprecedented levels of extreme heat events, which appear to be attributable to global warming. While many previous studies have attempted to measure human heat stress primarily using either temperature-centric indices or temperature-humidity combined indices, recent efforts to incorporate physiological factors into heat stress assessments have gained momentum, drawing increased attention to indices derived from biophysical models. Using bias-corrected, high-resolution regional climate projections, this study employs physiology-based liveability and survivability indices that account for diurnal variations in mean radiant temperature, while differentiating heat tolerances between young and older populations. The analysis focuses on a comparative assessment of changes in liveability and survivability in response to low (SSP1-2.6) and high (SSP5-8.5) emission scenarios to quantify the effects of emission reduction on heat vulnerability. Under SSP5-8.5, approximately 75% of Southeast Asia will become areas restricted to light activities for the older demographic, whereas this coverage could be reduced by 33% under SSP1-2.6. In addition, physiologic survivability, calculated as the fraction of time during which survival conditions are met, declines sharply under SSP5-8.5 compared to SSP1-2.6, indicating a significant collapse of thermal safety under the unmitigated scenario. Notably, while older adults face greater vulnerability to lower liveability and non-survivable heat, younger adults may also encounter distinct challenges due to larger diurnal fluctuations in liveability and a significant reduction in liveability. Our findings underscore the necessity of age-differentiated heat risk assessments, emphasizing the importance of mitigating future emissions.
[Acknowledgment]
This research was supported by Research Grants Council of Hong Kong through Theme-based Research Scheme (T31-603/21-N) and General Research Fund (GRF16308722).
How to cite: Im, E.-S., Liao, H., and Shen, H.: Human liveability and survivability in response to outdoor heat stress in Southeast Asia under different emission pathways, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-6242, https://doi.org/10.5194/egusphere-egu26-6242, 2026.
Variability and extreme conditions within the Earth system are major drivers of adverse population-level health outcomes. To better understand how these risks may evolve under future climate change, outputs from Earth System Models (ESMs) are increasingly integrated into research within the field of Planetary Health. This study builds on a systematic literature review that assessed the current state of ESM usage in planetary health research and extends it by examining two cross-cutting aspects that emerged as particularly underexplored.
The first aspect concerns how errors are handled between the two disciplines and which complications arise. Since in the majority of the studies reviewed the results were presented without a formal error analysis, we sought to identify the challenges of error propagation from the ESM over to the health model component and how uncertainties may be accounted for in different ways across studies. The results of this analysis show that the methodologies employed across different scientific disciplines vary in their treatment, quantification, and presentation of uncertainties. However, a proper error analysis is crucial for the credibility of scientific work, especially when communicating the results to a broad, including an non-academic, audience. Since climate change and its projected risks are already a highly politicized issue, particular care is required to not generate false assumptions.
As a second focus, the study investigates whether and how vulnerable groups are accounted for in climate-related health projections. Because of growing evidence that climate-sensitive parameters such as heat stress or apparent temperature affect different genders or ages in distinct ways, we examined the extent to which these aspects are considered in the reviewed literature and whether ESM-derived climatic outputs are used as inputs for health models representing diverse population groups. Inspecting the set of research papers showed that only a few even mentioned words like “gender/sex” or even “vulnerability” of different groups. The word “women” was not found at all. Health risk projections that do not account for gender and other population subgroups, such as children, women and older adults, may systematically over- or underestimate climate change-related risks.
Overall this study highlights the need for good and close collaboration and communication between scientific disciplines to guarantee reliable and unambiguous publications.
How to cite: Voss, P., Thiele-Eich, I., and Falkenberg, T.: Bridging Disciplines: A Review of Uncertainty Treatment and Representation of Vulnerable Groups in Planetary Health Projections Based on Earth System Models, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-20105, https://doi.org/10.5194/egusphere-egu26-20105, 2026.
Background: Kidney diseases impose a substantial and growing healthcare burden worldwide, and emerging evidence suggests that heat exposure may exacerbate acute renal conditions. People with disabilities are known to be particularly vulnerable to heat-related health risks; however, few studies have examined heterogeneity in heat-related kidney outcomes by specific disability type.
Methods: We conducted a nationwide time-stratified case-crossover study using the Korean National Health Insurance Database from 2015 to 2023. Emergency department (ED) visits for kidney and urinary tract diseases (ICD-10 N00–N39) during summer months (June–September) were analyzed among 3,866,115 individuals with disabilities and 1:1 matched non-disabled controls. Disabilities were classified into five categories: physical, brain lesion, sensory, developmental, and mental disabilities. Daily mean temperature was obtained from ERA5-Land reanalysis data and expressed as local percentiles to account for climatic acclimatization. Distributed lag non-linear models combined with conditional logistic regression were applied, adjusting for PM₂.₅ and ozone concentrations. Heat-related risks were estimated by comparing the 99th percentile temperature to the 75th percentile.
Results: Overall, heat exposure was associated with increased ED visits for kidney diseases, with substantial heterogeneity by disability type. Individuals with mental disabilities exhibited the most pronounced vulnerability, particularly for kidney disease and urinary tract infections, showing significantly elevated odds compared with non-disabled counterparts. Physical and brain lesion disability groups demonstrated increased risks for acute kidney injury, although similar trends were observed among non-disabled individuals. Sex-stratified analyses revealed stronger heat-related kidney risks among men, especially those with mental disabilities.
Conclusions: Heat-related kidney disease risks differ markedly by disability type and sex, underscoring the importance of disaggregated analyses. These findings highlight the need for disability-specific heat adaptation strategies and targeted public health interventions to mitigate climate-related renal health inequities among people with disabilities.
How to cite: Kim, Y., Kim, S., and Lee, W.: Heat-Related Risks of Kidney Disease Among People With Disabilities: A Nationwide Case-Crossover Study in South Korea, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-15827, https://doi.org/10.5194/egusphere-egu26-15827, 2026.
As climate change (including global warming) intensifies the frequency and intensity of extreme weather events, ambient heat (high temperature) has emerged as a key factor determining global health risks. Chronic kidney disease (CKD), which affects approximately 10% of the world's population, is an important public health challenge as it contributes significantly to comorbidities and socioeconomic burdens. The kidneys play an essential role in maintaining fluid homeostasis and electrolyte balance. However, individuals with decreased kidney function are more susceptible to physiological vulnerabilities in situations of heat stress. Although it is known that patients with CKD may be vulnerable to environmental stress factors, including heat, large-scale empirical evidence to quantify the impact of ambient high temperature exposure as a clinical risk factor is still limited.
Using a national population-based dataset incorporating ERA-5 Land high-resolution reanalysis temperature data and National Health Insurance Service (NHIS) records in South Korea, this study investigated the association between extreme ambient heat and all-cause mortality in patients with CKD. Based on sex and age, 1,145,237 CKD patients with 1:1 matching with the non-CKD cohort were identified and bidirectional, time-stratified case-crossover study was conducted. Distributed Lag Non-linear Model (DLNM) was applied to capture nonlinear exposure-response relationships and lag effects (lag 0 to 6 days) together. Extreme heat was defined as the 99th percentile of the temperature distribution by district (si-gun-gu) and compared with the 75th percentile as the reference temperature (Temperature percentile was used to take into account regional temperature adaptations).
Analysis of 223,949 confirmed deaths in the CKD group revealed that extreme heat exposure was significantly associated with an increased risk of all-cause mortality (Odds Ratio[OR] 1.041; 95% CI 1.002–1.081; p=0.041). On the other hand, no significant association was observed in the matched non-CKD group (OR 0.993; 95% CI 0.951–1.036). Subgroup analysis revealed greater vulnerability in females, the elderly (≥65 years), and those with hypertension. These results suggest that heat stress may exacerbate vascular endothelial dysfunction and fluid volume dysregulation, especially in patients with decreased renal concentration capacity, thereby increasing the risk of fatal outcomes. Furthermore, sensitivity analysis with various model settings (alternative reference temperature, shorter lag structures) also confirmed the robustness of the results.
Taken together, this study provides a robust basis for supporting that CKD patients are disproportionately vulnerable to the negative effects of short-term extreme heat waves. From an interdisciplinary perspective, this study highlights the need for environmental risk profiling in CKD population groups. In a situation where the climate is warming more rapidly, it emphasizes the need for targeted prevention strategies such as customized heat wave-health alert systems and preemptive clinical monitoring to reduce the health burden on vulnerable CKD populations.
How to cite: Roh, Y., Kwon, J. K., Han, S. H., Jang, H., Kim, H., Lee, W., and Lee, J. P.: Extreme heat exposure and all-cause mortality in patients with chronic kidney disease : A nationwide time-stratified case-crossover study of more than one million patients, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-8653, https://doi.org/10.5194/egusphere-egu26-8653, 2026.
Background: Tropical cyclones (TCs) are one of the most destructive climate disasters, which can cause injuries and mortality due to strong winds and flooding. In addition to the direct impact, TCs can also indirectly induce adverse health outcomes such as infectious diseases, mental disorders, and deterioration of chronic diseases resulting from contaminated food and water, property loss, or poor accessibility to healthcare. However, the research on the disease outbreaks attributable to TCs and related socioeconomic burden is limited. We aimed to investigate the risk and medical cost of cause-specific hospitalization associated with TC exposures.
Methods: This study used the Korea National Health Information Database from June to October between 2010 and 2023, which is a nationwide claim-based database on healthcare utilization for the entire population of South Korea. In order to focus on the short-term impact of TCs, we only considered hospital admissions via the emergency department (ED admissions). TC days were defined as the days with the TC-related maximum wind speeds ≥17.5 m/s, which were calculated using a TC track data and a wind field model. To estimate the association between TC and cause-specific ED admission, we applied a case time series design by conducting a fixed-effects model with a quasi-Poisson family and a distributed lag linear model for each disease category. The association with TC exposures was specified using a distributed lag linear model considering lag impact of seven days.
Results: The average number of TC days per decade among the entire 250 districts was 5.3 times, ranging from 1.4 to 18.6 times. TC exposures were associated with increased risk of ED admissions due to mental disorders, neurological diseases, endocrine diseases, and cardiovascular diseases, with relative risks (95% confidence intervals [CI]) of 1.22 (1.00–1.49), 1.19 (0.99–1.24), 1.11 (0.99–1.24), and 1.08 (1.00–1.17), respectively. Medical cost of ED admissions attributable to TCs was highest for cardiovascular diseases (2349.5 million KRW, 95% empirical CI: 51.2–4475.4 million KRW), followed by neurological diseases and endocrine diseases.
Conclusions: This nationwide study provides evidence that TCs can have an impact on the outbreaks of some diseases and impose a substantial medical cost burden in South Korea. Our findings suggest that the health impacts of TCs extend beyond immediate injuries, underscoring the importance of incorporating various diseases management into TC preparedness and response strategies to mitigate the growing health and economic burdens associated with TCs.
How to cite: Min, J., Oh, J., Min, H., Kang, C., Lee, W., and Franzke, C.: Cause-specific hospitalization risk and cost attributable to tropical cyclones in South Korea, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-6288, https://doi.org/10.5194/egusphere-egu26-6288, 2026.
Climate predictability offers an opportunity to anticipate malaria risk, yet the sources of multi-year forecast skill remain poorly understood. We evaluate malaria prediction skill across Africa by forcing a mathematical–dynamical malaria transmission model (VECTRI) with CESM2-MP multi-year climate hindcasts for 1991–2020. Five major African subregions—accounting for more than half of the continent’s malaria burden—show consistently high predictive skill across lead years 1–5, although detrended skill exhibits substantial regional differences.
The dominant sources of predictability vary by region and lead time. In Sub-Saharan Africa, including Malai, Burkina Faso, and South Sudan, malaria prediction skill is higher at longer lead times (LY1–5), resulting from the long-lived oceanic memory in the North Atlantic. In contrast, Central African regions such as the Democratic Republic of the Congo and Angola reveal peak skill at short lead time (LY1-2), reflecting a stronger dependence on El Niño-Southern Oscillation-related climate variability. Across all regions, surface temperature and precipitation emerge as the primary drivers of malaria predicability. These results demonstrate that distinct oceanic modes govern short- and long-lead malaria predictability across Africa, providing a physically grounded basis for climate-informed malaria early warning.
How to cite: Oh, H., Karwat, A., Franzke, C., and Kim, Y.-Y.: Footprints of Climate Predictabilityin Multi-year Malaria Risk over Africa, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-6334, https://doi.org/10.5194/egusphere-egu26-6334, 2026.
Climate change–related weather and extreme events are increasing in intensity and frequency, affecting the transmission of infectious diseases worldwide. Dengue, a climate-sensitive vector-borne disease to which more than half of the global population is at risk, has expanded its geographical range over recent decades. The 2023/24 season marked the largest dengue outbreak ever recorded in the Americas, with over 6 million cases in Brazil, and more than 5,000 deaths, coinciding with the hottest year on record in the region. To investigate the effect of climate on dengue transmission, we fit a Poisson generalized linear model for more than 5,000 municipalities in Brazil, using over 20 years of data available from DATASUS, to investigate the 2023/24 dengue season and attribute the role of anthropogenic climate change. We use simulations from the UK Met Office HadGEM3-A model, which includes two scenarios: a natural-forcing-only scenario (NAT) and a scenario including both natural and anthropogenic forcings (ACT). Temperature and precipitation from these simulations are then used as inputs to the Poisson model to estimate differences in dengue case counts between the NAT and ACT scenarios. We find that observed temperature anomalies in municipalities in southeastern and southern Brazil pushed these regions into optimal thermal conditions for dengue transmission during the 2023/24 season, amplifying the epidemic. In contrast, in northern Brazil, temperatures during the same period became too high for effective transmission, resulting in lower dengue incidence compared to a counterfactual scenario without anthropogenic climate change, although uncertainties remain high due to the lower number of cases in this region. We further test the generalizability of our model in high-altitude regions of Mexico, where dengue has been expanding. Overall, our results provide empirical evidence that climate change–related temperature anomalies contributed to the expansion and intensification of dengue transmission across diverse ecological and socio-economic contexts, with important implications for preparedness, adaptation, mitigation, and resilience planning.
How to cite: Cesario de Abreu, R., Perez Fernandez, I., Mitchell, D., C Castro, M., Kraemer, M., and Sparrow, S.: The Role of Climate Change in the Expansion of Dengue, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-5815, https://doi.org/10.5194/egusphere-egu26-5815, 2026.
Dengue is a climate-sensitive mosquito-borne infectious disease with a rapidly increasing incidence and global transmission. Climate change alters the suitability of mosquito vectors, affecting viral transmission. We assessed global dengue transmission potential and suitable months under future climate scenarios by integrating the mosquito-borne virus suitability index (Index P) with temperature and humidity projections from 12 global climate models. We project a substantial expansion of dengue risk zones from tropical to temperate regions. The magnitude and pace of dengue risk escalation in China and the U.S. far exceed other temperate regions, with a considerable increase in at-risk population and exposed land areas. In contrast, Europe exhibits a more delayed and moderate increase in dengue risk. In the SSP245 scenario for the 2050s, high dengue suitability zones are prominently located in Latin America, Southeast Asia, and sub-Saharan Africa with emergent areas in southern North America and East Africa. By 2100, these zones expand to southern China and northern Australia. Under the SSP585 high-emission scenario, the global dengue risk landscape shifts dramatically, with extensive risk zones emerging in the southeastern United States, China, and southern Europe, while some tropical regions such as Brazil and India experience a notable decline in transmission suitability due to extreme heat stress. By extending Index P to long-term projections, this study uncovers both underappreciated early surges in temperate regions and unexpected declines in overheated tropics. These insights are critical for improving early warning systems in newly exposed populations.
How to cite: Ma, Y.: Global Dengue Transmission Risk under Future Climate , EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-4784, https://doi.org/10.5194/egusphere-egu26-4784, 2026.
Labor is a fundamental driver of economic productivity but is increasingly threatened by rising heat exposure under climate change. While mitigation policies are often framed around avoided damages and health co-benefits, the persistence of labor productivity losses under negative CO₂ emission pathways remains poorly understood. Here, we use the Community Earth System Model version 1.2 (CESM1.2) large ensemble simulations to investigate hysteresis in Wet Bulb Globe Temperature (WBGT), labor productivity, and associated economic impacts under a CO₂ overshoot scenario. Our results show that midday heat exposure produces the most severe productivity reductions, with WBGT recovery lagging behind surface temperature due to humidity-driven hysteresis. Even after atmospheric CO₂ return to present climate levels, global labor losses remain above 100 billion hours annually, with South Asia, Central Africa, and the Middle East experiencing the strongest irreversibility. These persistent damages account for more than 60% of total climate-related economic losses. We provide the global assessment of hysteresis in labor productivity under overshoot pathways. The findings demonstrate that mitigation alone cannot fully restore labor capacity and highlight the necessity of complementary adaptation strategies—including heat-resilient infrastructure, work-rest scheduling, and legal protections for outdoor workers. Our study emphasizes the importance of incorporating hysteresis effects into benefit–cost assessments of climate policies to more accurately capture long-term economic and social risks, particularly for vulnerable populations in tropical and low-income regions.
How to cite: Yang, Y.-M.: Hysteresis in Heat-Related Labor Productivity under CO₂ Overshoot Scenarios: Economic and Policy Implications, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-16738, https://doi.org/10.5194/egusphere-egu26-16738, 2026.
Ambient fine particulate matter (PM2.5) pollution is the principal environmental risk factor for health burdens in China. Identifying the sectoral contributions of pollutant emissions sources on multiple spatiotemporal scales can help in the formulation of specific strategies. In this study, we used sensitivity analysis to explore the specific contributions of seven major emission sources to ambient PM2.5 and attributable premature mortality across mainland China. In 2016, about 60% of China’s population lived in areas with PM2.5 concentrations above the Chinese Ambient Air Quality Standard of 35 μg/m3. This percentage was expected to decrease to 35% and 39% if industrial and residential emissions were fully eliminated. In densely populated and highly polluted regions, residential sources contributed about 50% of the PM2.5 exposure in winter, while industrial sources contributed the most (29–51%) in the remaining seasons. The three major sectoral contributors to PM2.5-related deaths were industry (247,000 cases, 35%), residential sources (219,000 cases, 31%), and natural sources (87,000, 12%). The relative contributions of the different sectors varied in the different provinces, with industrial sources making the largest contribution in Shanghai (65%), while residential sources predominated in Heilongjiang (63%), and natural sources dominated in Xinjiang (82%). The contributions of the agricultural (11%), transportation (6%), and power (3%) sources were relatively low in China, but emissions mitigation was still effective in densely populated areas. In conclusion, to effectively alleviate health burdens across China, priority should be given to controlling residential emissions in winter and industrial emissions all year round, taking additional measures to curb emissions from other sources in urban hotspots, and formulating air pollution control strategies tailored to local conditions.
How to cite: Tao, Y.: Exploring the contributions of major emission sources to PM2.5 andattributable health burdens in China, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-4818, https://doi.org/10.5194/egusphere-egu26-4818, 2026.
Contaminants delivered to the marine environment in twentieth century, including those in wrecks and lost or dumped munitions, are the point sources of contaminants to the benthic ecosystems. Climate change related processes, such as oxygen concentration shifts, organic matter delivery and frequency of extreme events may impact those legacy deposits and enhance their release rate to the ecosystem.
Chemical and conventional ammunition dumped in the Baltic Sea and the Skagerrak contain a wide range of hazardous substances. Climate related factors may enhance their corrosion rates, causing direct emissions to the surrounding environment and risk of human and wildlife exposure, is increasing. In addition, the degradation processes may lead to increased mobility in unstable environmental settings.
Munition constituents are degrading in the environment, producing compounds, of which some are even more toxic than parent substance. Such compounds were identified in sediments next to dumped munitions up to several hundred meters away. Preliminary chemical data indicate exposure of fish in the dumpsite to chemical warfare agents. Studies in a dumpsite of conventional munitions in Kiel Bight reveal an elevated prevalence of neoplastic lesions (liver tumours and pre-stages) in flatfish (dab, Limanda limanda) from the area.
Both corrosion rate and biochemical degradation pathways are depending on environmental parameters controlled directly or indirectly by climate factors, therefore historical contamination reemission is considered one of climate change consequences by the Helsinki Comission, which is responsible for the protection of the marine environment of the Baltic Sea area.
Acknowledgements
Results presented in this study were partially funded by European Regional Development fund in the frame of MUNIMAP INTERREG BSR project, Horizon Europe Mmine-SWEEPER project and EMFAF MUNI-RISK project. It was also partially funded by the polish Ministry of Science and Higher Education funds for science in years 2022-2027.
How to cite: Korejwo, E., Bełdowski, J., Jędruch, A., Siedlewicz, G., Jakacki, J., Popiel, S., Nawała, J., Brenner, M., Lehtonen, K., Vanninen, P., and Fabisiak, J.: Climate change impact on historical contamination – underwater munitions, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-18756, https://doi.org/10.5194/egusphere-egu26-18756, 2026.
Volatile organic compounds (VOCs) such as trichloroethene (TCE) and tetrachloroethene (PCE) are commonly detected in urban environments with legacy contamination. Pathways of indoor VOC exposure through sewer infrastructure remain underexplored, particularly in the context of rising groundwater driven by seasonal rainfall and climate change in coastal settings. This study investigates how seasonal groundwater fluctuations influence VOC concentrations in sewers in the San Francisco Bay Area in the United States at a site characterized by shallow, unconfined groundwater and vulnerable sewer infrastructure in a setting with soil known to be contaminated by TCE/PCE. Passive air sampling was conducted across three time periods: one in the dry season and two during the wet season, defined by precipitation totals and differences in depth to groundwater. 8 samples were analyzed using Wilcoxon rank-sum tests and results indicate significantly elevated concentrations of TCE/PCE in sewer air during wetter conditions, with PCE showing a marginally significant wet season increase (p = 0.057). No remarkable detections were observed in corresponding indoor or ambient air samples, suggesting that well-maintained plumbing seals in older buildings are critical for limiting indoor exposure to VOCs from contaminated sewer systems. These findings demonstrate that seasonal hydrological dynamics can influence VOC transport in sewers in coastal settings. With sea-level rise and extreme precipitation events intensifying internationally, similar risks will emerge in other coastal cities with legacy contaminants, aging underground infrastructure, and aging buildings. This study highlights the need for increased investigations of sewer systems as preferential pathways for vapor intrusion where groundwater levels are changing and underscores the importance of integrating hydrological and climatic variables into risk assessments for contaminated coastal environments.
How to cite: Lasky, E. and Hill, K.: Seasonal variation of volatilized tetrachloroethene and trichloroethene concentrations in sewer systems in contaminated coastal landscapes, EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-3607, https://doi.org/10.5194/egusphere-egu26-3607, 2026.
The Anthropocene as the current period of Earth history is characterized by a globally pervasive influence of human activities on the planet - from the equator to the poles and from the land surface, atmosphere and biosphere to the oceans and deep sea. The intensive use of land and water as well as large emissions of air pollutants, aerosols, and greenhouse gases lead to climate change and adverse effects on ecosystems, biodiversity, and human health. Since industrialization in the 18th century and the great acceleration in the mid-20th century, the atmospheric concentration levels and the global biogeochemical cycles of carbon, reactive nitrogen, and sulfur in the Earth system have been substantially altered by human interference. Among the first studies to quantify regional and global impacts of sulfate aerosols on atmospheric radiation, clouds, and climate were seminal papers published in the journal Tellus. Assessing the climate impacts of atmospheric aerosols requires a quantitative and predictive understanding of their sources, including the formation of sulfate and organic aerosols by oxidation and gas-to-particle conversion of gaseous precursors in the atmosphere. These multiphase processes include chemical reactions, mass transport, and phase transitions of gaseous, liquid, and solid substances. For sulfate aerosols, a number of formation pathways have been identified and quantitatively described in atmospheric chemistry and transport models. These pathways comprise reactions of sulfur dioxide and dimethyl sulfide with hydroxyl radicals in the gas phase, or with ozone, hydrogen peroxide, and transition metal ions in aerosol or cloud water. More recently, the reaction of sulfur dioxide with nitrogen dioxide has been discovered as another pathway of high relevance for haze formation under polluted environmental conditions. The reaction rates and relative importance of different sulfate formation pathways are strongly dependent on aerosol acidity (pH), which in turn depends on aerosol water content and is widely buffered by anthropogenic ammonia. Different reaction pathways, phase changes, and gas-particle partitioning are also relevant for the formation, growth and effects of secondary organic aerosols in the atmosphere. Historic and recent developments will be outlined and discussed.
How to cite: Pöschl, U., Berkemeier, T., Cheng, Y., and Su, H.: Atmospheric multiphase chemistry influencing climate and health in the Anthropocene: from sulfate production to secondary organic aerosol formation and related effects , EGU General Assembly 2026, Vienna, Austria, 3–8 May 2026, EGU26-3190, https://doi.org/10.5194/egusphere-egu26-3190, 2026.
