The merits and legacy of the EXHAUSTION project are manyfold. The project has advanced the science related to the integrated assessment of climate change and health effects and associated socioeconomic costs, reflected by the high number of peer reviewed journal papers, new models and model modules developed, and open access climate datasets (incl at the Copernicus Climate Data Store). The project has demonstrated how interdisciplinary collaboration and co-design of knowledge products can advance communication approaches, create engagement and reach a broad audience. Finally, the results and outreach activities in the project are having lasting impacts through impacts on policy making processes, such as those related to new Air Quality Standards for Europe and the development of the upcoming Horizon Europe research agenda. EXHAUSTION consortium partners have already been engaged in several joint research proposals, building on the work in EXHAUSTION, which are expected to lead to continued collaboration and further scientific advancements in the future.
Major scientific advancements and results of EXHAUSTION are related to the following: 1) Exposure-response functions for the relationship between ambient temperature and mortality and hospitalization are established for the European population. 2) Evidence on strong interactive effects between temperature and air pollutants on mortality have been established for Europe, pointing to particularly strong modifying effects for respiratory endpoints and for particulate air pollution (PM2.5) effects on heat-related mortality. 3) Evidence on the impact of a range of contextual and individual vulnerability factors on the heat-health relationship have been established for Europe, pointing to particularly strong modifying effects of urban characteristics (high population density, lack of green space, air pollution). People with chronic pre-existing diseases and the elderly were shown to be at higher risk. 4) High-resolution projections of health relevant meteorological indices and air pollutants have been established, including for cities. 5) A new fire forecasting model has been developed and applied to historical periods and to three CESM scenarios (SSP126, SSP245, SSP370) 2015-2099 to produce global emission time series. Fire emission data were applied in global simulations and to regional European runs. 6) Evidence on increasing contribution of fire emissions to PM2.5 pollution over Europe and associated increased fire-attributable health effects was established. 7) Projections for temperature-related mortality in Europe at city, country, and regional level for the three scenarios towards 2100 has been established, showing a net increase (i.e. the net effect of decreased cold-related deaths and increased heat-related deaths) of more than 2 million excess deaths attributable to climate change for SSP370. For SSP126, projections indicate that lives claimed by climate change would peak around 2060 and could sum to about 0.73 million lives by 2100. 8) Findings related to the modifying effects of PM2.5 for heat-related deaths were used to estimate the benefit achieved from complying with WHO’s Air Quality Guidelines: 150,000 heat-related deaths can be avoided over the next 25 years if the WHO AQG are achieved in Balkan and Mediterranean. 9) The economic consequences of the health effects of increasing temperatures over Europe were estimated by the means of empirical relationships (work presenteeism and sick leaves) and by modelling techniques. Using bottom-up modelling (EVA model) and exposure-response functions based on the city level data, historical and future heat-health burden was estimated and monetized (via VSL), indicating that the annual cost of heat-related cardiopulmonary deaths could reach up to nearly 3% of the national GDP for some countries by the mid-century. The GRACE model, a computable general equilibrium model frequently employed in various climate change studies ahead of the EXHAUSTION project, was further developed by adding a module enabling analyses of health-related impacts of climate change on the labor market. The model was implemented for three countries, Norway, UK and Italy. The cost of health services is anticipated to rise in all three countries, whereas socioeconomic impacts generally showed large variations.
