COMMISSION STAFF WORKING DOCUMENT Adaptation to climate change impacts on human, animal and plant health Accompanying the document COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS An EU Strategy on adaptation to climate change
Date: 2013-04-16
Institutions: European Commission
Subjects: European Centre for Disease Prevention and Control, European Food Safety Authority, adaptation to climate change, common strategy, environmental impact, food safety, health risk, protection of animal life, protection of plant life, quality of the environment

EUROPEAN 
COMMISSION 

Brussels, 16.4.2013  
SWD(2013) 136 final 

COMMISSION STAFF WORKING DOCUMENT 

Adaptation to climate change impacts on human, animal and plant health 

Accompanying the document 

COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN 
PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL 
COMMITTEE AND THE COMMITTEE OF THE REGIONS 

An EU Strategy on adaptation to climate change 

{COM(2013) 216 final} 
{SWD(2013) 131 final} 
{SWD(2013) 132 final} 
{SWD(2013) 133 final} 
{SWD(2013) 134 final} 
{SWD(2013) 135 final} 
{SWD(2013) 137 final} 
{SWD(2013) 138 final} 
{SWD(2013) 139 final} 

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   EN 

 
 
 
 
  
 
 
COMMISSION STAFF WORKING DOCUMENT 

Adaptation to climate change impacts on human, animal and plant health 

Accompanying the document 

COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN 
PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL 
COMMITTEE AND THE COMMITTEE OF THE REGIONS 

An EU Strategy on adaptation to climate change 

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TABLE OF CONTENTS 

1. 

2. 

2.1. 

2.2. 

2.3. 

Introduction .................................................................................................................. 3 

Direct and indirect impacts of climate change on human health ................................. 4 

Extreme weather events – increased frequency and impact on human health............. 5 

Food- and vector-borne diseases.................................................................................. 6 

Feed and food safety issues.......................................................................................... 8 

2.4.  Water-related issues ..................................................................................................... 8 

2.5. 

2.6. 

2.7. 

2.8. 

2.9. 

Air quality .................................................................................................................... 8 

Allergies ....................................................................................................................... 9 

Ultraviolet radiation ................................................................................................... 10 

Increase of health inequalities.................................................................................... 10 

Vulnerable groups ...................................................................................................... 10 

2.10. 

Environmentally induced migration........................................................................... 11 

3. 

3.1. 

3.2. 

3.3. 

3.4. 

3.5. 

3.6. 

3.7. 

3.8. 

3.9. 

EU capacity to react to impacts of climate change on human health......................... 11 

Legal base .................................................................................................................. 11 

The International Health Regulation.......................................................................... 11 

Political context.......................................................................................................... 12 

The European Environment and Health Action Plan 2004-2010............................... 13 

The EU Health Strategy 2008-2013........................................................................... 13 

The EU Health Programme........................................................................................ 13 

The EU Statistical Programme................................................................................... 14 

Network for epidemiological surveillance and control of communicable diseases... 14 

The Health Security Committee (HSC) ..................................................................... 14 

3.10. 

The European Centre for Disease Prevention and Control (ECDC).......................... 15 

3.11. 

Food safety response mechanisms ............................................................................. 16 

3.12. 

European Food Safety Authority (EFSA) – Zoonoses and other foodborne risks..... 16 

3.13. 

The EU Framework Programmes for Research in relation to human health ............. 17 

4. 

5. 

6. 

7. 

8. 

Direct and indirect impacts of climate change on animal health ............................... 18 

EU capacity to react to climate change in relation to animal health.......................... 20 

Direct and indirect impacts of climate change on plant health .................................. 21 

EU capacity to react to climate change in relation to plant health............................. 22 

Evolution of the Union action on human, animal and plant health impact of climate 
change ........................................................................................................................ 24 

8.1. 

Tools for action: Human Health................................................................................. 24 

8.1.1.  The CEHAPIS project................................................................................................ 24 

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8.1.2.  Serious cross-border threats to health ........................................................................ 25 

8.1.3.  Reinforced role of the Health Security Committee.................................................... 25 

8.1.4.  Reinforced Early Warning and Response System (EWRS)....................................... 26 

8.1.5.  Health for Growth ...................................................................................................... 26 

8.2. 

Tools for action: Animal Health ................................................................................ 26 

8.2.1.  Emergency response to animal disease outbreaks ..................................................... 26 

8.2.2.  The New EU Animal Health Law.............................................................................. 26 

8.2.3.  Specific Animal health studies co-financed by the Commission............................... 27 

8.3. 

Tools for action: Plant Health .................................................................................... 27 

8.3.1.  The new EU Plant Health Law................................................................................... 27 

8.3.2.  The new EU Plant Reproductive Material Law ......................................................... 28 

9. 

9.1. 

9.2. 

9.3. 

Conclusions for human, animal and plant health....................................................... 28 

Human Health ............................................................................................................ 28 

Animal Health ............................................................................................................ 28 

Plant Health................................................................................................................ 28 

Annex I..................................................................................................................................... 30 

Annex II.................................................................................................................................... 34 

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In 2009 a Commission Staff Working Document (CSWD) was published in order to highlight 
the  main  effects  of  climate  change  on  human,  animal  and  plant  health1.  It  referred  to  the 
initiatives  taken  to  address  these  challenges  and  indicated  key  future  steps  to  be  considered 
for the Commission and Member State action. 

This document was based on the general framework set out in the White Paper "Adapting to 
climate change: Towards a European framework for action"2 which proposed to increase the 
resilience  of  health  and  social  systems  to  climate  change  and  underlined  the  need  to  ensure 
adequate  surveillance  and  control  of  the  human,  animal  and  plant  health  impacts  of  climate 
change.  

The  present  document  is  an  update  of  this  first  CSWD.  Follow-up  of  the  action  plan 
introduced by the 2009 CSWD as well as projects and actions launched since then are briefly 
presented highlighting the work performed on human, plant and animal health.  

It  further  introduces  the  potential  evolution  of  the  European  Commission  action  to  tackle 
impacts  of  climate  change  on  human,  animal  and  plant  health.  In  particular  by  pointing  out 
how  the  implementation  of  the  European  Parliament's  and  Council's  Decision  on  serious 
cross-border threats to health will address the impacts of climate change on human health and 
by  clarifying  how  existing  and/or  future  legislation  on  animal,  plant  health  and  plant 
reproductive material will address the impacts of climate change. 

1. 

INTRODUCTION 

The  processes  affecting  morbidity  and  mortality  are  very  complex;  they  are 
influenced  by  various  factors  like  behaviour,  social  determinants,  demographics, 
policy decisions, etc. The stresses created by climatic fluctuations add another layer 
of complexity to this already very intricate matter. 

However,  climate  change  is  on-going  and  amplifies  the  negative  health  impacts  of 
other  environmental  stressors  such  as  land  degradation,  soil  nitrification,  air 
pollution, depletion of freshwater stocks, ocean acidification and biodiversity loss3.  

Even if the available data and models are subject to a certain degree of uncertainty, 
the current state-of-the art confirms that the most important health effects from future 
climate  change  which  will  generate  changes  in  their  incidence  on  death  will  be 
originating  in  disease  and  injury  from  extreme  weather  events  such  as  storms  and 
heat waves, the spatial distribution and spread of communicable disease, particularly 
water-food  and  vector  borne  diseases,  and  the  frequency  of  cardio-respiratory 
diseases.  

Heat  related  mortality  and  morbidity  in  humans  depend  on  the  scenarios  being 
considered. Not all effects will be negative; health gains can be expected from milder 

1 

2 
3 

The Commission Staff Working Document accompanying the Communication Together for Health: A 
Strategic Approach for the EU 2008-2013{COM(2007) 630 final}: p.33 "The Commission will produce 
a report on Climate Change covering a range of areas of concern including health. The most up-to-date 
scientific information on health effects from extreme weather and events relating to climate change will 
be  gathered  and  analysed  to  support  effective  responses  in  preventing  and  responding  to  them.  The 
implementation of surveillance systems for the main effects of climate change such as heat-waves and 
flooding will be examined. The capacity of EU health systems and infrastructure to cope with different 
levels  of  climate-related  health  threats  will  be  estimated,  with  the  aim  of  supporting  contingency 
planning for hypothetically dangerous situations as necessary." 
COM(2009)147.  
McMichael T, Montgomery H, Costello A. Health risks, present and future, from global climate change. 
BMJ. 2012; 344. 

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winters in some regions. Nevertheless Mc Michael and colleagues have argued that 
the risk of negative health effects does outweigh the potential health benefits.3 

Impacts  on  animal  and  plant  health  are  mainly  characterised  by  changes  in  the 
occurrence, incidence, pattern of spread and geographical distribution of diseases and 
pests  that  are  influenced  by  climate  change,  as  well  as  emerging  animal  and  plant 
pathogens. Those impacts may also have a detrimental effect on agriculture, forestry 
and food security. 

In general, climate change is not creating many new or unknown health threats, but it 
will increase certain interactions between environment and human, animal and plant 
health with stronger and more pronounced effects than currently seen. Most public, 
animal and plant health measures and systems are already in place but they need to 
be tuned to the new situation and demands. 

2. 

DIRECT AND INDIRECT IMPACTS OF CLIMATE CHANGE ON HUMAN HEALTH 

Impact  assessments  conducted  in  a  number  of  European  countries  and  research 
funded  by  the  EU,  the  World  Health  Organisation  (WHO)'s  Regional  Office  for 
Europe  and  the  European  Centre  for  Disease  Control  and  Prevention  (ECDC)4 
confirm  that  climate  change  has  impacts  on  the  distribution  of  many  diseases  and 
health conditions. This assessment is further supported by reports5 from WHO6, the 
Intergovernmental  Panel  on  Climate  Change  (IPCC)7,  European  Environmental 
Agency  (EEA)/ECDC/WHO(2008)  and  the  EEA  Report  No  12/2012  -  Climate 
change, impacts and vulnerability in Europe 20128 describing the impact on human 
health.  

The nature  and scale of the final impacts will depend on the adaptive capacity and 
actions  of  health  systems  and  the  baseline  access  of  different  populations  to  these 
services. Some of the measures might be efficient enough under current climates, but 
might  need  to  be  strengthened  or  revised  in  a  situation  of  much  stronger  or 
accelerated climate change9.  

Climate  change  might  have  an  impact  on health  systems  by  increasing  the  demand 
for health services beyond the capacities of those systems. It may also interfere with 
their ability to cope with demand by undermining infrastructure, technology and the 
availability of workforce. This is linked to emergency preparedness and response. As 
a result of climate change, health systems will need to prepare for gradual changes in 
health  outcomes,  sudden  extreme  events  (e.g.  heat-waves,  infectious  disease 
outbreaks), an extra burden of disease and potential new conditions.  

Climate  change  will  affect  human  health,  either  directly  -  in  relation  to  the 
physiological effects of extreme weather events, or indirectly through altered human 
behaviours (e.g. environmentally induced migration, more time spent outdoors), the 
increased  transmission  of  food  or  vector-borne  diseases,  or  other  effects  of  climate 
change,  such  as  flooding.  An  increase  in  some  of  these  impacts  has  already  been 

4 
5 
6 
7 
8 
9 

ECDC mapped the impact of climate change on IDs on 27 MS and 3 EEA countries.  
http://www.euro.who.int/Document/E91865.pdf page 9. 
Menne et al, 2009.  
http://www.ipcc.ch/pdf/assessment-report/ar4/wg2/ar4-wg2-spm.pdf. 
http://www.eea.europa.eu/publications/climate-impacts-and-vulnerability-2012. 
Menne et al, 2009; Parma commitment to Act, 2010, et c. 

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observed  in  Europe  over  recent  decades  (for  example,  the  summer  heat  waves  in 
2003 alone are believed to have resulted in more than 70 000 excess deaths10).  

Not  all  climate  related  changes  are  negative  for  human  health  as  for  example  in 
temperate areas, milder winters will lead to less cold-related fatalities.  

2.1. 

Extreme weather events – increased frequency and impact on human health 

The primary concern in Europe is linked to heat-related morbidity and mortality , due 
to  increases  in  annual  temperature  and  extremes  of  heat,  although  these  issues  are 
also influenced by socio-economic changes due to population growth and the ageing 
of the population11. In Member States, it is estimated that mortality increases by 1–
4% for each one-degree rise in temperature, meaning that heat related mortality could 
rise by 30 000 deaths per year by the 2030s and by 50 000 to 110 000 deaths per year 
by the 2080s12.  
The  Climate-Trap13  project  has  estimated  that  by  2035  the  annual  mortality  will 
increase  by  1.25%  and  1.45%  (depending  on  the  scenario  used).  The  increase  in 
expected respiratory related hospital admissions attributed to the additional cases in 
2035 range beween 0.08% and 0.76% for the different countries studied. 

Certain causes of death linked to the environment play a major role in the outermost 
regions. Mortality caused by cardiovascular and respiratory diseases is far higher in 
the Azores, Madeira and Reunion Island than on the continent. These findings are a 
cause  for  concern  considering  that  the  cost  of  the  health  system  is  high  and 
preventive health measures are in their early stages in the OR14. 

The elderly, in which the ability to control and regulate body temperature is reduced, 
are most at risk of death from heat stroke and cardiovascular, renal, respiratory and 
metabolic  disorders.15  Whilst  the  numbers  of  total  deaths  are  strongly  related  to 
population  size,  the  change  in  death  rates  can  be  much  greater  in  regions  where 
conditions  are  conducive  to  greater  warming.  The  greatest  impact  is  expected  in 
central southern Europe. 

reduced  summer 
temperatures  combined  with 
These  punctual  higher 
precipitation, is expected to enhance the frecuency and intensity of droughts across 
Europe. For European Union populations the biggest projected impacts are from long 
term  environmental  and  economic  damage,  potential  population  displacements, 
potential  impacts  on  mental  health  of  farmers  and  livestock  producers  as  well  as 
threats from water quantity/quality and the subsequent disruption of public or private 
domestic  water  supplies.  Water  stress  is  projected  to  increase  over  central  and 
southern Europe, affecting 16-44 million additional people by 2070. 

the 

10 

11 

12 
13 
14 

15 

Robine  J-M,  Cheung  SL,  Le  Roy  S,  Van  Oyen  H,  Griffith  C,  Michel  J-P,  et  al.  Death  toll  exceeded 
70,000 in Europe during the summer of 2003. C R Biologies. 2008. 
It is increasingly agreed by scientists that the current emission pledges and commitments of countries 
will likely result in 3.5 - 4°C warming. The longer these pledges are unfulfilled, the likelier a 4°C world 
becomes, with the resulting health implications. 
PESETA report, http://peseta.jrc.ec.europa.eu/docs/Agriculture.html. 
http://www.climatetrap.eu. 
Study  'Demographic  and  migratory  trends  in  the  outermost  regions:  Impacts  on  economic,  social  and 
territorial 
INED, 
http://ec.europa.eu/regional_policy/activity/outermost/publications_en.cfm. 
Matthies  F,  Bickler  G,  Cardenosa  Marin  N,  Hales  S,  editors.  Heat-Health  Action  Plans.  Guidance. 
Copenhagen: WHO Regional Office for Europe; 2008. 

cohesion', 

by 

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Forest  fire  dangers  have  increased  over  the  past  50  years  especially  in  the  central, 
southern  and  a  small  portion  of  northen  Europe.  Longer  fire  seasons  are  expected 
particularly in the Mediterranean. Vegetation fires can create elevated levels of toxic 
gaseous  (Carbon  monoxide,  nitrogen  oxides,  sulphur  dioxide,  organic  compounds) 
and particulate air pollutants over a long period of time, leading to acute and chronic 
health effects. The effects of smoke range from eye and respiratory tract irritation to 
more  serious  disorders  including  reduced  lung  function,  bronchitis,  exacerbated 
asthma and premature death.  

There has been about a 20% increase in heavy precipitation in recent decades, with 
more heavy precipitation in Northern and Southern Europe16. This will influence the 
frequency  of  floods.  The  number  of  winter  floods  is  projected  to  rise  in  north-
western countries, and of flash floods throughout the EU. Coastal flooding is likely 
to threaten up to 1.6 million more people every year in the European Union. Over the 
past  30  years,  floods  killed  more  than  200.000  people  and  affected  more  than  2.8 
billion globally17. In Europe between 1998 and 2009, there were 1126 fatalities due 
to  floods.  Flooding  leads  to  an  increase  in  prevalence  of  mental  health  disorders 
(traumatic  stress  disorder,  serious  mental  illness  and  suicide)  which  affect  more 
younger  children  and  females  report  more  problems  than  males18,19.  The  Floods 
Directive establishes a framework for the assessment and management of flood risks. 
The Floods Directive 2007/60/EC20 establishes a framework for the assessment and 
management of flood risks. The CSWD 'Adapting infrastructure to climate change'21 
and  the  CSWD  'Climate  change  adaptation,  coastal  and  marine  issues'22  provide 
further information. 

Recent  climatic  change  events  resulted  in  periods  with  excess  mortality  in  many 
European countries and will affect Europe in the future. The timely assessment of the 
impact of such exposures is thus needed to guide public health measures. 
Food- and vector-borne diseases23 

Temperature-sensitive infectious diseases, such as food-borne infections (Salmonella 
sp., and others.) are likely to grow24, with potentially an extra 20 000 cases per year 
by the 2030s and 25,000 to 40,000 extra cases per year by the 2080s.  

Deliverable 8 report on capacity and impact assessment of Climate Trap project.  
Climate, Environment and Health Action Plan and Information System project summary (CEHAPIS). 
WHO Regional Office for Europe with the support of DG SANCO. 
Kronenberg  ME,  Cross  Hansel  T,  Brennan  AM,  Osofsky  HJ,  Osofsky  JD,  Lawrason  B,  Children  of 
Katrina: Lessons Learned about Postdisaster Symptoms and Recovery Patterns, Child Development 81 
(4), p 1241-1259,2010. 
Osofsky Hj, Osofsky JD, Kronenberg M, Brennan A, Cross Hansel T, Posttraumatic Stress symptoms in 
Children After Hurricane Katrina: Predicting the Need for Mental Health Services, American journal of 
Orthopsychiatry 79 (2), 212-220,2009. 
http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2007:288:0027:0034:EN:PDF 
CSWD  'Adapting  infrastructure  to  climate  change'  accompanying  the  document  'An  EU  Strategy  on 
adaptation to climate change' 
CSWD  'Climate  change  adaptation,  coastal  and  marine  issues'  accompanying  the  document  'An  EU 
Strategy on adaptation to climate change' 
Food-borne diseases: an infection acquired by consuming contaminated food or drink. Myriad microbes 
and toxic substances can contaminate foods. Most of the 250 known food-borne diseases are infectious 
and are caused by bacteria, viruses, and parasites. Other food-borne diseases are essentially poisonings 
caused  by  toxins,  chemicals  contaminating  the  food.  Nausea,  vomiting,  abdominal  cramps  and 
diarrhoea are frequent in food-borne infections. 
Kovats  RS,  Ebi  KL,  Menne  B.  Methods  of  assessing  human  health  vulnerability  and  public  health 
adaptation to climate change. Copenhagen: WHO/WMO/Health Canada.; 2003. 

2.2. 

16 
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A  great  deal  of  attention  has  been  devoted  to  changes  in  vector-borne  disease 
patterns in relation to climate change. The IPCC foresees climate change leading to 
changes in infectious disease transmission by vectors such as mosquitoes and ticks, 
as a  result of changes  in  their  geographic range, seasons  of  activity  and  population 
size.25  Land  use  changes  and  socio-economic  factors  (e.g.  human  behaviour,  the 
movement  of  people  and  goods)  will  continue  to  be  important  too.  A  number  of 
models  have  investigated  the  potential  increase  of  malaria  risk  in  parts  of  Europe. 
Although  accurate  predictions  are  difficult  at  the  present  time,  there  is  agreement 
nevertheless  that  the  overall  risk  of  transmission  of  malaria  related  to  localised 
climate change is very small, especially where there are adequate health services and 
good management of mosquito control26.  

Nonetheless,  new  challenges  may  emerge,  as  changes  in  vector  distribution  and 
capacity  -  particularly  in  combination  with  increased  human  mobility  –  could 
facilitate  the  introduction  and  local  transmission  of  new  emerging  pathogens.  As 
regards  other  mosquito-borne  diseases,  this  phenomenon  was  seen  in  the  2007 
Chikungunya virus outbreak in Europe.  

Climatic upheavals are currently increasing the risk of, and vulnerability to, tropical 
diseases in the outermost regions, where the spread of vector born disease is one of 
the most notable adverse effects of climate change14. Currently, a dengue outbreak is 
taking place in Madeira, Portugal since 4th October 2012, with 1,993 confirmed cases 
(as of 2nd December 2012). The Caribbean region, where Guadeloupe and Martinique 
are located, has seen a marked increase in the incidence of dengue fever over the last 
10 years. Increases in insect-borne diseases threaten ecological and human health. - 
French Guiana, where the Amazonian rainforest is, expected to be severely affected 
by drought27.  

Changes in tick distribution have also been observed. The limit of tick distribution in 
the  EU  is  shifting  northwards  and  also  to  higher  altitudes;  the  shift  towards  milder 
winters  may  lead  to  an  expansion  of  the  tick  population  and,  consequently,  to  an 
increase  of  human  exposure  to  Lyme  borreliosis  and  tick-borne  encephalitis.  There 
are also reports28 of changes in the geographical distribution of sand flies, which are 
a  vector  of  Leishmania  sp.  Further  work  needs  to  be  done  to  determine  the  role  of 
climate  change  in  the  future  epidemiology  of  other  diseases  and  it  may  take  many 
years before accurate estimates are available. 
The EDEN project29 has demonstrated that in general, climate change alone cannot 
explain  the  upsurge  or  emergence  of  vector  borne  diseases  in  Europe.  Socio-
economic  factors,  human  behaviour,  different  environmental  drivers  and  even  the 
management  of  agriculture  combined  with  climate  change  can  also  have  an  impact 
on upsurge and emergence of diseases like tick-borne encephalitis or malaria. 

25 

26 
27 

28 

29 

Confalonieri U, Menne B, Akhtar R, Ebi KL, Hauengue M, Kovats RS, et al. Human Health. In: Parry 
ML,  Canziani  OF,  Palutikof  JP,  Hanson  CE,  van  der  Linden  P,  editors.  Impacts,  Adaptation  and 
Vulnerability Working Group II contribution to the Intergovernmental Panel on Climate Change Fourth 
Assessment  Report  Cambridge,  United  Kingdom  and  New  York,  NY,  USA.:  Cambridge  University 
Press; 2007. p. 391-431. 
EEA/JRC/WHO, 2008; EEA/ECDC/WHO Climate Change Indicator Report 2012. 
Jérôme Petit & Guillaume Prudent. Changement climatique et biodiversité dans l’outre-mer européen. 
2008;http://www.cbd.int/islands/doc/idr/Climate%20Change%20and%20Biodiversity%20in%20EU%2
0overseas%20entities/Reunion%20publication-fr.pdf. 
T.  J.  Naucke,  B.  Menn,  D.  Massberg,  S.  Lorentz,  Sandflies  and  leishmaniasis  in  Germany. 
Parasitol. Res. 103.(Suppl. 1), S65 (2008).  
www.eden-fp6project.net. 

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There is now evidence that adult mosquitoes (Culex_spp.) can ensure overwintering 
of  the  West  Nile  virus  (WNV)  in  several  European  territories,  including  Romania 
and  Spain.  Understanding  and  quantifying  this  risk,  and  thorough  surveillance  of 
WNV strains circulating in Europe and Africa, is of major importance to prevent or 
alleviate large scale WNV epidemics.  

Considerable progress has been made for integrating low and high resolution satellite 
imagery,  as  well  as  statistical  and  mathematical  modelling,  to  build  quantitative 
prediction models for the establishment of vector borne diseases30. 

2.3. 

Feed and food safety issues  

Whereas there are many factors involved in mycotoxin (toxic substance produced by 
fungi) contamination, climate is the most important. The presence of mycotoxins on 
feed  and  food  is  highly  dependent  on  environmental  factors  (e.g.  temperature  and 
moisture)  pre-  and/or  post-harvest.  Consequently  climate  change  might  have  a 
significant influence on the presence of mycotoxins in feed and food. Climate change 
represents  the  key  agro-ecosystem  driving  force  of  fungal  colonization  and 
mycotoxin production. Climate change may threaten feed and food safety and might 
also affect the availability of feed and food as mycotoxins are present on major staple 
crops (e.g. cereals, oilseeds).  

As  an  example,  the  fungal  disease  head  blight  of  wheat  caused  by  a  complex  of 
Fusarium species affecting quality and food safety can be cited. Some climate-related 
changes  are  already  influencing  wheat  production.  Fusarium  culmorum  and 
Microdochium (Fusarium) nivale have been the prevalent species in cooler temperate 
climates  of  Europe,  but  in  the  last  decade  Fusarium  graminearum  has  become  the 
dominant  species  causing  head  blight  of  wheat  in  northwest  Europe,  because  its 
higher temperature optimum favours its dominance in the disease complex. Since M. 
nivale is non-toxigenic and F. culmorum generally produces less mycotoxin than F. 
graminearum, mycotoxin concentrations in wheat may consequently increase31.  

A  public  health  threat  of  particular  concern  for  the  territory  of  La  Réunion  is  the 
development  of  toxic  micro-algae  that  are  harmful  to  human  health  and  marine 
breeding grounds, and already caused massive fish kills or human poisonings24.  

2.4.  Water-related issues 

Heavy  precipitation  has  been  linked  to  a  number  of  outbreaks  of  water-borne 
diseases, due to the mobilising of pathogens or extensive water contamination from 
overflowing  sewage  pipes.  Increased  faecal  bacteria  contamination  is  also  likely  to 
affect  drinking  water  intakes  and  areas  of  water  used  for  recreation.  Reductions  in 
summer  water  flows  may  increase  the  potential  for  bacterial  and  chemical 
contamination. Higher water temperatures may also result in increased occurrence of 
harmful algal blooms. 

30 

31 

EN 

final 

results. 

European Research on Environment and Health Funded by the Sixth Framework Programme. Snapshots 
of 
online: 
http://ec.europa.eu/research/environment/pdf/european_research_on_environment_and_health_fp6.pdf#
view=fit&pagemode=none. 
S.  Chakrabortya  and  A.  C.  Newton,  2011.  Climate  change,  plant  diseases  and  food  security:  an 
overview. Plant Pathology 60, 2–14. 

Commission; 

Available 

European 

2012. 

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2.5. 

Air quality 

Whilst air pollution levels have fallen dramatically in recent decades in Europe, the 
health risks of air pollution are still significant, primarily from particulate matter and 
ozone (Thematic Strategy on Air Pollution, TSAP32,33).  

The most significant effects of climate change are likely to be in relation to ozone – 
which  is  a  major  pollutant  in  many  parts  of  Europe.  The  EEA/JRC/WHO  study26 
reports that climate variability and climate change have contributed to an increase in 
ozone  concentration  in  central  and  south-western  Europe,  and  the  climate-induced 
increase in ozone levels might be hampering current ozone abatement efforts.  

Climate  change  and  the  levels  of  ozone  have  a  reciprocal  effect.  Temperature, 
humidity  and  wind  currrents  influence  the  formation  and  levels  of  ozone.  The 
presence of ozone, in turn, affects those atmospheric variable.  
The epidemiological studies published by the Climate-trap project34 have shown the 
manifold effects of ground-level ozone on health resulting in increases in daily levels 
of  morbidity  and  mortality.  Significant  negative  health  effects  have  been 
demonstrated  for  different  causes,  mainly  for  respiratory  and,  to  a  lesser  extent, 
cardiovascular  diseases.35  These  epidemiological  studieshave  concentrated  on  acute 
health effects due to short-term very high levels of ozone. The relationship between 
acute  effects of  ozone  appearing as short-term  mortality has  been shown in  several 
studies36,37,38,39.  The  epidemiological  evidence  of  chronic  effects  is  much  less 
conclusive. 

Climate  change  might  also  impact  indoor  and  outdoor  air  quality,  the  level  of  air 
pollution  and  the  nature,  severity  and  timing  of  air  allergens,  such  as  pollen  or 
mould.  In  order  to  reach  children,  who  are  particularly  vulnerable,  the  two-year 
SINPHONIE40 work was commissioned. The partners have prepared guidelines and 
recommendations on indoor air quality in schools, taking into account the impact of 
the changing climate (increase of heat waves, cold waves and ambient air pollutants) 
and the road traffic situation, in order to improve the air that children breathe and to 
create a healthier school environment.  

2.6. 

Allergies 

Climate change might potentially increase the seasonability and duration of allergic 
disorders like hay fever or asthma with implications for direct costs in terms of care 

32 
33 

34 
35 

36 

37 

38 

39 

40 

http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=COM:2005:0446:FIN:EN:PDF. 
There  are  an  estimated  21000  premature  deaths  from  ozone  each  year  in  the  EU,  as  well  as  over  an 
estimated 100 millions respiratory symptoms days, see the TSAP.  
http://www.meduniwien.ac.at/umwelthygiene/hanns.moshammer/index.html.  
Anderson  HR,  Atkinson  RW,  Peacock  JL,  Marston  L,  Konstantinou  K.  Meta-analysis  of  time-series 
studies  and  panel  studies  of  particulate  matter  (PM)  and  Ozone  (O3)  Report  of  a  WHO  task  group. 
Copenhagen, WHO Regional Office for Europe, 2004. 
Bell ML, McDermott A, Zeger SL, Samet JM, Dominici F. Ozone and short-term mortality in 95 US 
urban communities, 1987-2000. Jama. 2004 Nov 17;292(19):2372-8. 
Gryparis A,  Forsberg  B, Katsouyanni  K, Analitis  A, Touloumi  G, Schwartz  J,  et  al. Acute  Effects of 
Ozone on Mortality from the "Air Pollution and Health: A European Approach" Project. Am J Respir 
Crit Care Med. 2004 November 15, 2004;170(10):1080-7. 
ItoK,  DeLeon  SF,  Lippmann  M.  associations  between  ozone  and  daily  mortality:  analysis  and 
meaanalysis. Epidemiology. 2005; 16:446-457. 
Levy JI, Chemerynski SM, Sarnat JA. Ozone exposure and mortality: an empiric bayes metaregression 
analysis. Epidemiology. 2005 Jul;16(4):458-68. 
http://www.sinphonie.eu/. 

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and medicines, as well as lost working hours. 'Progressively increasing temperatures 
may modify the global pollen load and affect the rate of allergic sensitization across 
long periods'.41 

Temperature  increase  and  changes  in  weather  patterns  will  have  an  impact  on  the 
incidence  of  allergies,  the  prevalence  of  allergic  persons  and  on  exacerbations  or 
severity of allergic illness. Allergic diseases to airborne allergens have been steadily 
increasing  over  the  past  few  decades.  The  general  population  is  at  risk,  especially 
children.  People  already  suffering  from  chronic  respiratory  conditions  such  as 
asthma,  serious  allergies  or  chronic  obstructive  pulmonary  disease  (COPD)  will 
particularly  suffer  from  increases  of  aeroallergens.  The  European  Academy  of 
Allergy and Clinical immunology has estimated that by 2040, 40% of the population 
will present an allergic predisposition in Europe. 

2.7. 

Ultraviolet radiation 

Another  indirect  impact  of  climate  change  on  health  comes  from  potentially 
changing ultraviolet radiation42. Stabilisation of ozone levels in the stratosphere leads 
to  a  reduction  in  average  UV  radiation  levels.  However,  increased  temperatures  in 
the  stratosphere  favour  faster  chemical  reaction  times  which  combined  with  more 
frequent  weather  events  create  ''ozone  mini-holes''  generating  higher  UV  radiation 
levels. 

Excessive  ultraviolet  exposure  has  been  correlated  with  the  incidence  of  skin 
cancers,  including  malignant  melanoma  and  cataracts43.  EUROSUN44  findings 
indicate clearly that the total cumulative UV exposure is mainly acquired at the place 
of residence. For example in late spring and early summer, Nordic countries are as 
much exposed to UV radiation as Germany or even France. 

2.8. 

Increase of health inequalities 

Climate  change  may  significantly  worsen  health  inequalities  within  and  among 
countries  and  put  additional  stress  on  poorer  groups.  In  this  way  it  jeopardizes  the 
results  and  impacts  of  many  development  efforts  and  further  compromises  the 
achievement of key development goals, including the Millenium Development Goals 
(MDGs)  in  particular  in  the  Eastern  part  of  the  WHO  European  region  and  in  the 
European  Neighbourhood  countries.  The  lack  of  achievement  will  aggravate 
consequences  for  the  most  vulnerable  populations,  but  also  contribute  to  rising 
inequalities17.  

2.9. 

Vulnerable groups 

As  already  estimated  in  relation  to  the  impact  of  heat  waves,  the  overall  health 
effects of climate change will be unevenly distributed across the regions of Europe. 
Since health and well being are also strongly related to socio-economic drivers such 
as  income,  housing,  employment,  education,  gender  and  lifestyle,  the  impacts  of 
climate  change  should  alter  health  inequalities  within  and  between  countries,  and 

41 

42 

43 

44 

Ariano  R  et  al  (2010):  Possible  role  of  climate  changes  in  variations  in  pollen  seasons  and  allergic 
sensitizations during 27 years. Ann Allergy Asthma Immunol. 104(3):2012-222. 
Andrady A et al. For the United nations Environment Programme, Environmental Effects Assessment 
panel  (2010):  Environmental  effects  of  ozone  depletion  and  its  interactions  with  climate  change 
progress report 2009, Photochem Photobiol Sci. 9(3):275294. 
Moreover, since early 1980's, the European Code against Cancer recommends “to avoid excessive sun 
prevention. 
Commission 
supporting 
exposure,” 
(http://www.cancercode.org/code_06.htm). 
http://www.eurosun-project.org/. 

European 

policies 

cancer 

of 

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lead  to  uneven  distribution  and  additional  burdens  for  lower  income  groups  and 
certain  vulnerable  groups,  such  as  children,  those  working  outdoors,  the  elderly, 
women, the homeless and people with a pre-existing illness and/or diability.  

As  an  example,  current  heat  related  mortality  has  been  shown  to  reveal  a  strong 
socio-economic dependence. For some effects, e.g. mortality related heat and to air 
pollution,  the  elderly  are  far  more  vulnerable,  and  there  may  be  additional  factors 
affecting this group which are linked to socio-economic status. 

2.10.  Environmentally induced migration 

The  complex  relationship  between  climate  change,  environmental  degradation  and 
international migration is explored in the specific Staff Working Paper45 on this topic 
which  is  accompanying  the  EU  Strategy  on  adaptation  to  climate  change.  Current 
evidence suggests that although future environmental change is likely to significantly 
impact  on  population  movements,  most  environmentally  induced  migration  will 
occur within or between developing countries rather than towards the EU.  

The potential impacts of climate change on internal mobility of EU citizens remain 
poorly  understood.  The  growing  needs  for  humanitarian  assistance  and  health 
protection  of  vulnerable  groups  migrating  within  the  EU  territory  could  require  an 
enhanced capacity of Member States' health systems. National health systems in the 
EU could benefit from preparedness planning to improve their capacity to deal with 
such challenges. 

3. 

EU CAPACITY TO REACT TO IMPACTS OF CLIMATE CHANGE ON HUMAN HEALTH 

3.1. 

Legal base 

The  Lisbon  Treaty  (TFEU)  addresses  human  health  protection  through  different 
prescriptions (articles 6, 9, 56 and 191); it empowers the EU to support, coordinate or 
supplement  the  action  of  Member  States  in  the  area  of  the  protection  and 
improvement  of  human  health  and  stipulates  that  “Community  actions  shall 
complement  national  policies,  shall  be  directed  towards  improving  public  health, 
preventing  human  illness  and  diseases,  and  obviating  sources  of  danger  to  human 
health''.  

In  application  of  the  general  principle  of  subsidiarity  defined  in  Article  5  of  the 
TFEU and by the legal base in the field of health, most health adaptation measures 
would be most appropriate at national, regional, and local level. Nevertheless, effects 
of  climate  change  and  their  impacts  are  transboundary  by  nature,  as  neither  the 
spread  of  infectious  diseases  nor  extreme  weather  events  are  hindered  by  political 
frontiers  (CEHAPIS)46.  This  requires  the  EU  to  exert  the  coordinating  role  it  has 
been  granted  by  TFEU  with  minimal  interference  in  the  competences  of  Member 
States. As the normal functioning of the European internal market could be affected 
by extreme cases (especially when considering issues such as food and water security 
in  a  changing  climate),  measures  will  need  to  be  taken  at  EU  level,  “to  encourage 
cooperation  between  the  Member  States”47  in  the  field  of  health,  and  to  support 
European solidarity. This is particularly important in the framework of sharing best 
practice and experiences between the Member States. 

45 

46 
47 

CSWD  'Climate  change,  environmental  degradation,  and  migration'  accompanying  the  document  'An 
EU Strategy on adaptation to climate change' 
Climate, Environment and Health Action Plan Information System. 
Article 168 of The Treaty Establishing the European Community. 

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3.2. 

The International Health Regulation 

3.3. 

All European Union Member States adopted and are implementing the International 
Health  Regulations  (2007).  This  is  a  multilateral  agreement  to  manage  collective 
defences  to  detect  disease  events  and  to  respond  to  public  health  risks  and 
emergencies,  including  those  resulting  from  climate  change  events.  This  would 
include  some  events  resulting  from  extreme  weather  conditions,  if  considered  of 
international concern, and would also play an important role in the early detection of 
disease distribution as a result of climate change. 

Political context 
In its Conclusions on Environment and Health48 the Council urged the Commission 
and the Member States to develop tools for anticipating, preventing and responding 
to potential threats from climate change49. 
With Resolution of 24 September 2008 on the mid term review of the Environment 
and Health Action Plan, the European Parliament called for enhanced multi-agency 
cooperation ‘in order to boost the early warning system and thus to curb the harmful 
effects which climate change has on health’50. It also called on Member States and 
the Commission to respond adequately to the new threats posed by climate change, 
such  as  the  increased  presence  of  emerging  viruses  and  undetected  pathogens,  and 
therefore  to  implement  new  existing  pathogen  reduction  technologies  that  reduce 
known and undetected viruses and other pathogens transmitted by blood51. 

Furthermore,  the  Joint  Decision  of  the  European  Parliament  and  the  Council 
established the Second Programme of Community action in the field of health (2008 
–  2013)52,  addressing  specifically  that  'Environmental  pollution  is  a  serious  risk  to 
health  and  a  major  source  of  concern  for  European  citizens.  Special  action  should 
focus  on  children  and  other  groups  which  are  particularly  vulnerable  to  hazardous 
environmental conditions. 

International Cooperation 

All EU Member States endorsed the first (Frankfurt in 1989), third (London in 1999) 
and  fourth  (Budapest  in  2004)  WHO  Ministerial  Conferences  on  Environment  and 
Health declarations highlighting the need for action on climate change and health. In 
1999,  it  was  recommended:  to  establish  a  Europe-wide  interagency  network  for 
monitoring,  researching  and  reviewing  the  early  human  health  effects  of  climate 
change; support the development of indicators and monitoring activities and national 
health  impact  assessments,  and  to  review  mitigation  and  adaptation  options  and 
strategies53. In 2004, further action was recommended to reduce the current burden 
of disease resulting from extreme weather and climate events through a proactive and 

48 
49 

50 

51 

52 

53 

http://www.consilium.europa.eu/uedocs/cms_Data/docs/pressdata/en/envir/97852.pdf :20.12.2007. 
Communication  from  the  Commission  to  the  Council,  the  European  Parliament,  the  European 
Economic  and  Social  Committee.  ''The  European  Environment  &  Health  Action  Plan  2004-2010''. 
Volume I. Brussels, 9.6.2004. 
Paragraph 24 of European Parliament Resolution of 4 September 2008 on the mid-term review of the 
European and Health Action Plan 2004-2010 (2007/2252(INI)). 
Paragraph 26 of European Parliament Resolution of 4 September 2008 on the mid-term review of the 
European and Health Action Plan 2004-2010 (2007/2252(INI)).  
Decision  N°  1350/2007/EC  of  the  European  Parliament  and  of  the  Council  of  23  October  2007, 
establishing a second programme of Community action in the field of health (2008-13). 
WHO,  1999.  Declaration  Third  Ministerial  Conference  on  environment  and  Health.  London,  16–18 
June 1999, p.10. 

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multidisciplinary approach, as well as to promote healthy energy efficient approaches 
in other sectors. 

At  the  Fifth  Ministerial  Conference  on  Environment  and  Health  in  Parma,  Italy,  in 
2010,  all  WHO  European  Member  States  adopted  the  Declaration  endorsing  a 
“Commitment  to  act”  which  welcomes  the  European  Regional  Framework  for 
Action54 entitled Protecting health in an environment challenged by climate change. 
The Commission endorsed its conclusions55, including:  

• 

• 

• 

• 

• 

Integration of health in all climate change mitigation and adaptation measures, 
policies and strategies at all levels and in all sectors. 

Strengenthing of health, social welfare and environmental systems and services 
to improve their response to the impacts of clmate change. 

Development and strengthening of early warning surveillance and preparedness 
systems for extreme weather events and disease outbreaks. 

Development  and  implementation  of  educational  and  public  awareness 
programmes on climate change and health. 

Collaboration  on  increasing  the  health  sector’s  contribution  to  reducing 
greenhouse gas emissions and management of energy and resources in a more 
efficient manner. 

• 

Encouraging research and development 

The European Environment and Health Action Plan 2004-2010 
The  European  Environment  and  Health  Action  Plan  2004-201056  specifically 
addressed  climate  change  and  human  health  under  Action  8  and  foresaw 
identification of emerging issues on environment and human health. It did not result 
in a follow-up programme.  

The EU Health Strategy 2008-2013  
The  EU  Health  Strategy57  acknowledges  climate  change  and  its  impact  on  human 
health as an important challenge in terms of protecting citizens from health threats. 
The  principles  and  objectives  of  the  Health  Strategy  remain  valid.  The  Member 
States have concluded that cooperative action at Union level is indispensable in areas 
such  as  major  health  threats  and  issues  with  a  cross-border  or  international  impact 
(for instance pandemics and bioterrorism), as well as those relating to free movement 
of goods, services and people. 

3.4. 

3.5. 

3.6. 

The EU Health Programme 

The  Health  Programme  (Second  Programme  of  Community  Action  in  the  field  of 
Health  2008-2013)  has  three  objectives:  1.  Improve  citizens'  health  security  2. 

54 

55 

56  

57 

Protecting health in an environment challenged by climate change: European Regional Framework for 
Action.  Copenhagen,  World  Health  Organization  Regional  Office 
for  Europe,  2010. 
http://www.euro.who.int/__data/assets/pdf_file/0005/95882/Parma_EH_Conf_edoc06rev1.pdf. 
Declaration  of  the  European  Commission.  Fifth  Ministerial  Conference  on  Environment  and  Health. 
Parma 
online: 
March 
http://ec.europa.eu/health/healthy_environments/docs/parma_declaration_en.pdf 
Available at: 
http://europa.eu/legislation_summaries/public_health/health_determinants_environment/l28145_en.htm
. 
http://europa.eu/legislation_summaries/public_health/european_health_strategy/c11579_en.htm. 

Available 

10-12 

2010. 

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Promote  health  and  reduce  health  inequalities  3.  Generate  and  disseminate  health 
information and knowledge. 

The Health Programme financed projects on health impact of climate change under 
its  three  strands.  It  supported  projects58  and  actions  to  improve  health  information 
and  knowledge  for  the  development  of  environmental  health  information  systems: 
addressing environmental exposures, urban air pollution or monitoring of ultraviolet 
exposure and its effects on incidence of skin cancers and cataracts.  

Under the second strand, emphasis is given to measures on the prevention of major 
diseases  and  focus  on  EU  added-value  action  in  areas  such  as  gender  issues, 
children's  health  or  rare  diseases.  In  addition  the  health  effects  of  social  and 
environmental determinants are addressed. 

The  actions  under  the  Health  Security  strand  focus  on  the  development  and 
coordination  of  early  warning  and  surveillance  systems  in  specific  areas  (e.g.  cold 
spells, health effects of flooding, airborne allergens, ultraviolet radiation and vector-
borne and other human and animal infectious diseases). 

In the areas of preparedness planning, risk assessment and response, a co-ordinated 
response during a public health emergency requires linking the relevant health crisis 
centres  at  the  level  of  Member  States,  Commission  and  EU  and  international 
agencies. This requires proper command and control including situational awareness 
of  casualties  and  resources,  co-ordination  of  the  response  and  of  communications, 
information analysis and management and simulation for event-analysis and training.  

In  order  to  be  prepared  for  any  emergency  or  crisis,  all  of  the  abovementioned 
aspects  have  to  be  evaluated  and  tested.  Specific  focussed  training  events  and 
exercises  were  organised  to  identify  the  gaps  in  the  preparedness  of  the  European 
Union. Since October 2009 seven exercises have been organised (Table 1 in Annex 
I).  

Table  2  in  Annex  I  provides  a  rapid  overview  of  all  projects  financed  under  the 
Health Programme 2008-2013 that focused on the health impact of climate change. A 
detailed presentation of the projects funded by the Health Programme can be found 
on the website of the Executive Agency for Health and Consumers (EAHC)15. 

3.7. 

The EU Statistical Programme 

The  European  Health  Interview  Survey  (EHIS)  –  of  which  the  first  wave  was 
implemented during the period 2006-2009 in the European Statistical System (ESS) - 
monitored  health  including  environment  related  variables  as  part  of  Eurostat's  data 
collections  on  health  status  and  health  determinants.  The  second  wave  will  be 
implemented in the period 2013-2015.  
The  implementation  of  the  Regulation  1338/200859  "establishing  a  framework  for 
Community statistics on public health and on health and safety at work" is key for a 
sustainable health monitoring system, which inter alia includes data on human health 
in relation to climate change.  

58 
59 

Public Health programme: http://ec.europa.eu/eahc/.  
The Regulation 349/2011 further defines the implementation of Regulation 1338/2008. 

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3.8. 

Network for epidemiological surveillance and control of communicable diseases 
The  Decision  2119/98/EC60  "setting  up  a  network  for  the  epidemiological 
surveillance  and  control  of  communicable  diseases  in  the  Community"  is  the 
preamble of the European Union's effort to set up a pan-European collaboration on 
infectious diseases. The network is responsible for the surveillance of communicable 
diseases and has established an early warning and response system for the prevention 
and control of these diseases (EWRS). 

3.9. 

The Health Security Committee (HSC) 

The  (HSC)  was  set  up  by  the  EU  health  ministers  in  the  aftermath  of  the  11 
September  2001  terrorist  attacks  in  the  United  States  as  an  informal  committee  to 
address  preparedness  for  and  responses  to  major  health  threats,  such  as  CBRN 
(chemical,  biological,  radiological  and  nuclear)  events  or  pandemic  influenza.  Its 
mandate was limited to tackling bioterrorism, but it has subsequently been extended 
to cover all types of health-related crisis. It focuses on three areas, each assisted by a 
section consisting of representatives of the Member States:  

(1)  generic preparedness and response for public health emergencies; 

(2) 

(3) 

response to chemical, biological and radionuclear (CBRN) attacks, 

influenza preparedness and response.  

On  the  basis  of  the  work  of  the  HSC,  the  Commission  adopted  a  Communication 
(COM  2005/605  final  of  28.11.2005)  on  strengthening  coordination  of  generic 
preparedness planning for public health emergencies at EU level.  

3.10.  The European Centre for Disease Prevention and Control (ECDC) 

One of the areas of competence of the European Centre for Disease Prevention and 
Control61,  concerns  emerging  health 
threats.  The  ECDC's  mandate  covers 
surveillance  and  risk  assessment  of  threats  to  human  health  from  communicable 
diseases and illnesses of unknown origin. ECDC has taken over the epidemiological 
surveillance  of  communicable  diseases  and  the  operation  of  the  EWRS  from  the 
network  for  epidemiological  surveillance  and  control  of  communicable  diseases 
referred to at point 3.9 above.  

Within  its  terms  of  reference,  the  ECDC  has  thoroughly  investigated  the  topic  of 
impacts on health caused by climate change. The ECDC developed a comprehensive 
feasibility  study  for  an  European  Environment  and  Epidemiology  Network  (the  E3 
network)  scheduled  to  be  launched  in  early  2013,  which  will  facilitate  European 
early  warning  for  climate-related  disease  events  by  supporting  the  risk  assessment 
and  rapid  detection  of  emerging  public  health  threats  related  to  environmental 
factors.  

In  addition to the E3 network, ECDC has  launched the following  projects focusing 
on  the  impacts  of  climate  change  on  the  spread  of  communicable  diseases.  ECDC 
has  commissioned  numerous  projects  aimed  at  assessing  the  magnitude  and 
significance  of  priority  vector-borne  diseases  in  Europe.  This  has  included  the 

60 

61 

Two  Commission  Decisions,  2003/534/EC  and  2007/875/EC  were  introduced  in  order  to  amend 
Decision 2119/98/EC. 
Established by Regulation 851/2004/EC; http://www.ecdc.europa.eu/en/Pages/home.aspx. 

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development of  risk  maps  for Dengue62 in the EU63 as well as projects specifically 
focused  on  Chikungunya,  West  Nile  Virus,  Tick-borne  Encephalitis,  and  Lyme 
disease. In addition, ECDC has conducted a risk assessment for malaria transmission 
in Greece based on environmental factors. 

including 

listeriosis, 

salmonellosis, 

cryptosporidiosis 

Meanwhile, ECDC has also published a comprehensive risk assessment specifically 
focusing on the impact of climate change on food- and water-related diseases in the 
EU64. This project assessed and helps prioritise the anticipated short- and long-term 
impacts of climate change on the patterns of transmission of food- and water-borne 
and 
diseases, 
campylobacteriosis.  Based  upon  the  findings  of  this  project,  ECDC  is  now 
developing tools for Member States to facilitate their own similar risk assessments in 
this field. 
ECDC  has  also  published  a  Handbook65 for EU Member States on how to conduct 
vulnerability  and  adaptation  assessments 
to  climate  change  and 
communicable  diseases.  The  Handbook  provides  Member  States  with  scientifically 
robust  methodologies  and  decision-making  algorithms  for  conducting  vulnerability 
assessments  and  developing  adaptation  strategies  focused  on  mitigating  the 
transmission of communicable diseases. The next phase of this project is to attempt 
to pilot test the toolkit in selected Member States, and to update the Handbook with 
evidence-based adaptation options. In parallel, ECDC has embarked upon a project 
seeking to identify EU-wide vulnerabilities. 

related 

The  emergence  of  new  diseases  may  call  for  the  establishment  of  new  advanced 
centres  for  microbiological  research  and  monitoring  in  areas  where  disease  is 
endemic. These centers would enable rapid and reliable diagnosis of pathogens and 
the  assessment  of  the  risks  of  their  emergence  and  spread.  The  outermost  regions 
already  have,  and  remain  in  a  position  to  further  develop,  research  infrastructures 
that may be used to enhance health protection in their regions as a whole, as well as 
in continental Europe. 

3.11. 

Food safety response mechanisms 

The  EU  legislative  framework  and  policies,  which  aim  at  ensuring  a  high  level  of 
food  safety  for  European  consumers  and  citizens  are  constantly  challenged  in  its 
capacity  to  respond  to  future  threats  to  global  Food  safety.  This  notably  includes 
challenges related to climate change and the subsequent impacts on human, animal, 
and plant health as well as production resource scarcity and resource competition. 

The  European  Commission  manages  the  Rapid  Alert  System  for  Food  and  Feed 
(RASFF)66 which is an effective tool for exchanging information between competent 
authorities of Member States and EEA countries on consignments of food and feed in 
cases  where  a  risk  to  human  health  has  been  identified  and  measures  have  been 
taken. Should climate change related impacts on food or feed safety occur, RASFF 

62 

63 
64 

65 

66  

Dengue fever is a virus-based disease spread by mosquitoes. It is caused by several related viruses (four 
different  arboviruses),  and  is  spread  by  the  bite  of  mosquitoes,  most  commonly  the  mosquito  Aedes 
aegypti, which found in tropic and subtropic regions. 
ECDC, 2012a Climatic suitability for dengue transmission in continental Europe. 
ECDC, 2012b; Assessing the potential impacts of climate change on food- and water-borne diseases in 
Europe. 
ECDC,  2010  Climate  change  and  communicable  diseases  in  the  EU  Member  States;  handbook  for 
national vulnerability, impact and adaptation assessments. 
http://ec.europa.eu/food/food/rapidalert/index_en.htm  

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will  continue  to  play  its  role  to  rapidly  circulate  the  information  related  to  the 
findings of serious risks identified in food and feed in order for competent authorities 
to take the appropriate and immediate actions to safeguard public health. 

The Commission works on a further harmonisation of data collection for food-borne 
infections  and  zoonoses  in  food  and  animals  to  allow  a  better  comparison  of  data 
between  Member  States.  Member  States  are  obliged  to  monitor  the  most  important 
zoonoses  and  zoonotic  agents  at  the  most  relevant  stages  of  the  food  chain  in 
accordance  with  Directive  2003/99/EC  (Salmonella,  Listeria,  Campylobacter, 
parasites …).  

3.12.  European Food Safety Authority (EFSA) – Zoonoses and other foodborne risks 
Besides the prominent task of carrying out risk assessments the EFSA67 coordinates 
the  EU-wide  data  collection  on  zoonoses,  zoonotic  agents  and  antimicrobial 
resistance  in  food  and  animals  as  well  as  on  food-  and  water-borne  outbreaks.  The 
monitoring  of  temporal  trends  in  prevalence  of  the  agents  (including  food-borne 
pathogens  and  vector-borne  zoonoses)  and  the  numbers  of  outbreaks  in  Member 
States are continuously further developed and harmonised. To this end the outcome 
of a project on an inventory of available data on vector-borne zoonoses in animals in 
Member  States  and  on  proposals  for  harmonised  data  reporting  was  published  in 
201168. 

The  Commission  has  mandated  EFSA  to  collect  and  compile,  inter  alia,  the 
occurrence of mycotoxins in feed and food. The trends in prevalence of mycotoxins 
in  feed  and  food  are  closely  followed  up  and  if  necessary  the  approprite  measures 
will  be  taken  to  address  occurrring  mycotoxin  problems  as  regards  safety  and/or 
availability of feed and food.  

3.13.  The EU Framework Programmes for Research in relation to human health 

Table  3  in  Annex  I  provides  a  rapid  overview  of  all  finalised  projects  financed 
under  the  6th69  and  7th  Framework  Programmes  for  Research  and  Development 
(FPRD) that focused on the health impact of climate change.  
The  6th  FPRD  mainly  concentrated  on  the  development  of  an  integrated  impact 
assessment methodology, the relationship between temperatures and air pollution and 
the health impact of floods. 

• 

• 

The  concept  of  integrated  environmental  health  impact  assessment  was 
developed through several projects (INTARESE70, URGENCHE71, PURGE72); 
clear  analytical  procedures  providing  the  framework  for  all  the  other  outputs 
and  results  were  established.  An  extensive  series  of  case  studies  have  been 
done  and  a  full  integrated  assessment  of  health  impacts  of  climate  change 
mitigation and adaptation policies was conducted . 
CIRCE73 assessed the effect of climate change in the Mediterranean and looked 
in  particular  at  the  temperature  and  air  pollution  relationship  in  ten 
Meditteranean  cities,  as  well  as  the  risks  of  infectious  diseases.  Climate 

67 
68 
69 
70 

71 

72 
73 

http://www.efsa.europa.eu/. 
http://www.efsa.europa.eu/en/supporting/pub/234e.htm. 
http://ec.europa.eu/research/environment/pdf/eur23460_en.pdf. 
http://www.intarese.org/. 
http://www.urgenche.eu/. 
http://purge.lshtm.ac.uk/node/3 
http://www.circeproject.eu/. 

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sensitive infectious diseases have been identified and state of the art knowledge 
has been gathered for each of them. A generalised additive model to study the 
relationship  between  zoonotic  cutaneous  leishmaniasis  (seasonal  vector-borne 
disease)  incidence  and  rainfall  was  used.  Full  climate  change  and  health  risk 
assessments have been achieved for Malta and Turkey. 

•  MICRODIS74  developed  an  integrated  protocol  with  a  social,  health  and 
economic core section, providing a descriptive analysis and mapping of various 
health  impacts  of  floods  across  Europe  and  third  countries.  These  protocols 
were then adapted to the specific country and site context. 
VIROCLIME75  focused  on  the  interrelationships  between  waterborne  viruses 
of importance in human diseases and predicted effects of climate change. The 
project  developed  an  operational  model  forced  by  environmental  and  water 
management changes based on five case studies performed at environmentally 
sensitive sites (Spain, Hungary, Sweden, Greece and Brazil).  

• 

•  Most projects funded in the area of health are only indirectly related to climate 
change such as projects on influenza, where changes in weather patterns might 
affect  bird  migration  routes  and  the  length  of  the  cold  season,  which  in  turn 
might  affect  onset  and  severity  of  influenza  pandemics.  Few  collaborative 
projects  specifically  deal with diseases  which  are directly  affected  by  climate 
change and where  the  climate change  component  is particularly addressed  by 
the  research  consortia.  Currently  the  European  Commission  funds  three 
(DENFREE76,  DENGUETOOLS77,  and 
projects  on  Dengue  Disease 
IDAMS78), one on West Nile and Chikungunya Virus (VECTORIE79), and one 
aiming at a generic response to emerging vector borne diseases (EDENEXT80). 
The  projects  deal  with  various  issues  related  to  emerging  climate  dependent 
vector  borne  diseases  such  as  modelling  of  vector  spread  due  to  climate 
change, vaccine development, disease and vector surveillance, vector ecology, 
clinical  measures  to  improve  care  for  patients,  improved  diagnostics,  and 
public health measures for vector control to be implemented in affected areas. 

Topics presented in the third call for proposals under the 6th FPRD deal with climate 
change  and  water-related  health  issues  with  the  quantification  of  climate  change 
impacts  on  health  in  low  income  countries.  A  substantial  number  of  projects  have 
been added on air pollutants and climate-related factors; exposure under the 4th and 
5th calls of the 7th FPRD.  
The  7th  FPRD  includes  on-going  projects  with  focus  on  human  health  impact  of 
climate change, presented in Table 4 in Annex I.  

On food safety the Commission is actively contributing to the DG RTD FP7 projects: 
'Resilient Food systems' looks at the development of more resilient food production 
and consumption in Europe and globally. 'CamCon' 'Campylobacter control - novel 
approaches  in  primary  poultry  production'  aims  at  improving  the  control  of 
Campylobacter  in  primary  poultry  production  in  various  parts  of  Europe  possibly 

74 
75 
76 
77 
78 
79 
80 

http://www.microdis-eu.be/. 
http://www.viroclime.org/ 
http://denfree.eu/about/ 
http://www.ncbi.nlm.nih.gov/pubmed/22451836 
http://www.idams.eu/index.php/idams 
http://cordis.europa.eu/search/index.cfm?fuseaction=proj.document&PJ_RCN=11618413 
http://www.edenext.eu/the-project 

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leading to Campylobacter-free/low level contaminated chickens for meat production. 
It  will  also  investigate  the  effect  of  different  climates  and  environments  on  the 
epidemiolog of this agent. The Commission is also currently examining together with 
JRC  the  appropriate  approach  to  develop  scenarios  of  future  change  of  the  main 
challenges to food safety, including climate change impacts, for the period until 2030 
and 2050. 

4. 

DIRECT AND INDIRECT IMPACTS OF CLIMATE CHANGE ON ANIMAL HEALTH 

There  are  new  challenges  to  face  such  as  animal  diseases  that  are  influenced  by 
climate  change  and  have  become  more  prevalent,  are  occurring  outside  their  usual 
range  of  distribution  or  have  newly  emerged.  Therefore  there  is  a  need  to 
continuously  re-evaluate  priorities  based  on  careful  risk  assessment  and  solid 
scientific advice. 

Recent evolutions have shown that climate change has an impact on animal health. 
Direct impacts on the animal's wellbeing derive from increased ambient temperature, 
floods  and  droughts.  Indirect  impacts  result  from  reduced  availability  of  water  and 
forage  and  changes  in  the  environment  that  promote  the  spread  of  contagious 
diseases  through  increased  contact  between  animals,  or  increased  survival  or 
presence  of  the  agent  or  its  intermediate  host.  Emergence  and  re-emergence  of 
infectious  diseases  transmitted  by  vectors  are  highly  dependent  on  climatic 
conditions. 

Recent  changes  in  the  epidemiology,  seasonality  and  geographic  distribution  of 
helminth infections have been attributed to climate change, which may increase the 
developmental success of parasites. Increased knowledge in this area is still needed. 

The  timing  of  recurring  seasonal  biological  cycles  of  some  plant  and  animal 
species  has  already  been  affected  by  climate  change81.  Some  migratory  birds  have 
changed  their  migration  patterns  in  response  to  climate  change  by  arriving  earlier 
than historic records show. 

During early 2006 it is thought that harsh weather conditions and feed scarcity had 
forced wild migratory birds off their normal flyways and therefore the H5N1 highly 
pathogenic avian influenza epidemic was spread to Europe through a higher density 
of  wild  birds  in  waters  that  remained  unfrozen82.  Virus  persistence  in  the 
environment including in water may also be influenced by changes in temperature83.  

In recent years, there have been reports of increased mortality in bees in the EU and 
elsewhere. A report published by EFSA84 suggests and all concerned agree that there 
are many factors such as stress linked to changes in nutrition and climatic conditions 
that  are  involved  in  the  causes  for  the  decline  in  the  bee  population.  In  2012  new 
scientific  information  and  their  assessment  by  the  EFSA  directed  the  focus  of 
attention to certain systemic pesticides (neonicotinoids) which are thought to play a 
role in higher than normal colony losses in the EU.85  

81 

82 

83 
84 
85 

Walther,  GR,  Post,  E,  Convey,  P,  Menzel,  A,  Parmesan,  C,  Beebee  TJC,  Fromentin,  JM,  Hoegh-
Culdberg, O and Bairlein, F, 2002, Ecological responses to recent climate change: Nature, v. 416, no. 
6879, p. 389-395. 
Hesterberg  et  al.,  2009,Avian  influenza  surveillance  in  the  European  Union  in  2006,  Influenza  and 
Other Respiratory Viruses, 3, 1-14. 
http://www.efsa.europa.eu/en/efsajournal/pub/715.htm. 
http://www.efsa.europa.eu/en/supporting/pub/27e.htm. 
http://ec.europa.eu/food/animal/liveanimals/bees/pesticides_en.htm 

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Changes in the distribution and prevalence of vector-borne animal diseases may be 
the  most  significant  effect  of  climate  change.  Those  most  frequently  referred  to  as 
influenced by climate change are bluetongue, Rift Valley Fever, West Nile Fever and 
African Horse Sickness. 

Bluetongue, a viral disease of ruminants (e.g. cattle, goats, sheep, deer), is present in 
large  parts  of  the  world  (USA,  Australia,  Africa  and  Asia)  and  has  previously  also 
occurred  in  Southern  Europe.  However,  the  emergence  of  a  new  serotype  of  the 
Bluetongue virus in the summer of 2006 in the Netherlands and its spread to several 
other Member States up to Sweden - outside its usual/known geographic distribution 
range - is thought to be linked to increased temperatures, which allow the insects to 
carry the virus to new regions and transmit it more effectively86.  

End of 2011 a newly emerging livestock virus caused by the Schmallenberg virus 
(SBV)  was  detected  in  Germany  which  is  transmitted  by  insect  vectors,  such  as 
midges and mosquitoes. The virus infects ruminants during vector-active season. It is 
often  asymptomatic  but  it  may  cause  transient  mild  clinical  signs  and  congenital 
malformations.  It  has  since  been  spreading  throughout  central  and  Western  Europe 
and  was  most  recently  also  detected  in  Scandinavia.  There  is  no  evidence  that  this 
virus may affect humans and the World Animal Health Organisation (OIE)87 has also 
recognised the very limited impact of the SBV infection on animal health. 

The abovementioned recent experiences with viral vector-borne infections of animals 
have clearly shown the difficulties to control their rapid spread throughout Europe. 
However, these unexpected events may increase in the future due to climate change 
and  they  should  therefore  be  considered  as  a  clear  warning  inducing  better 
preparedness and adaptation. 

5. 

EU CAPACITY TO REACT TO CLIMATE CHANGE IN RELATION TO ANIMAL HEALTH 

"Preventing rather than reacting to animal diseases" is the focus of the EU Animal 
Health  Policy  (2007-2013)88.  It  aims  at  reducing  the  likelihood  of  animal  disease 
occurrence  and  spread,  and  at  minimising  the  impact  of  outbreaks  of  diseases 
including those influenced by climate change. Early detection and reaction are key to 
avert  later  damage  costs.  The  Strategy's  Action  Plan  foresees  enhanced  data 
gathering and exchange and the strengthening of existing animal disease surveillance 
systems. 

Harmonised EU legislation and Member States' contingency plans are in place to 
ensure  an  effective  and  immediate  response  to  animal  disease  outbreaks.  A 
longstanding and well established network between the Commission and veterinary 
authorities of Member States already exists to manage animal health crises based on 
crisis  preparedness,  rapid  exchange  of  information  and  close  collaboration.  In 
particular  in  emergency  situations  the  Commission  often  makes  use  of  its  wide 
regulatory  powers  by  adopting  urgent  protection  measures  to  swiftly  respond  to 
outbreaks in Member States or third countries. 

86 

87 

88 

http://rsif.royalsocietypublishing.org/content/early/2011/06/22/rsif.2011.0255.full?sid=f860402b-1cc6-
41e8-8784-1d8b133e582f. 
http://www.oie.int/en/our-scientific-expertise/specific-information-and-
recommendations/schmallenberg-virus/. 
http://ec.europa.eu/food/animal/diseases/strategy/index_en.htm. 

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The development of the Animal Disease Information System (ADIS)89 will provide 
better and more comparable epidemiological data to risk managers, enabling them to 
better  identify,  evaluate  and  respond  to  changing  or  emerging  disease  situations. 
Existing  data  gathering  systems  were  evaluated  and  a  prototype  will  become 
available  in  early  2013.  ADIS  will  interoperate  with  the  World  Animal  Health 
Information  System  (WAHIS)90  of  the  World  Organisation  for  Animal  Health 
(OIE)’s notification and information system, and with TRACES (TRAde Control and 
Expert  System),  the  Commission's  IT  management  system  on  imports,  exports  and 
trade in animals and animal products.  

The  task  force  of  epidemiological  experts  on  animal  disease  surveillance 
(TFADS)91  is  an  ad  hoc  expert  group  which  advises  the  Commission  on 
improvements  to  current  EU  systems  for  animal  disease  surveillance  and  on  new 
surveillance strategies as done e.g. for West Nile Fever.  

Another task force group has issued a paper on the possibilities and feasibility of the 
establishment of further vaccine banks for certain infectious animal diseases92 which 
is  currently  under  scrutiny  by  Member  States  and  the  Commission.  Such  banks 
should ensure better preparedness in case of animal health emergencies.  

The network between the EU and the national reference laboratories is crucial to 
ensure  harmonised  and  reliable  diagnosis  of  disease  agents  by  Member  States' 
laboratories. In case of the emergence of a new disease the quick development and 
dissemination  of  suitable  testing  methods  is  essential.  In  2011  an  EU  Reference 
Laboratory was designated for bee health to provide diagnostic and scientific support 
to  the  Commission  and  Member  States  to  improve  surveillance  of  bee  colony 
mortalities.  

The  EU  Veterinary  Emergency  Team  (CVET)  can  be  quickly  called  upon  to 
support  the  authorities  of  the  Member  States  or  Third  Countries  in  dealing  with 
animal disease outbreaks that occur in a country for the first time.  

Better  Training  for  Safer  Food  (BTSF)  is  a  Commission  training  initiative 
covering food and feed law, animal health and welfare and plant health rules. It trains 
national  authorities'  staff  in  Member  States  and  candidate  countries  involved  in 
official controls to ensure harmonized controls compliant with EU law. The training's 
scope has been further expanded to include emerging animal diseases. 

The European Food Safety Authority's (EFSA) panel on animal health and welfare 
(AHAW)  carries  out  independent  risk  assessments  and  gives  scientific  advice  on 
animal health and related food safety issues to risk managers including the European 
Commission, European Parliament and Member States. EFSA provided for valuable 
scientific information on the role and geographical distribution of tick species in the 
epidemiology  of  African  swine  fever  and  Crimean-Congo  Haemorrhagic  Fever 
(zoonosis) in Eurasia93 and for a data collection proposal for vector-borne zoonoses 

89 

90 

91 
92 
93 

of 

20 

the 

action 

See 
http://ec.europa.eu/food/animal/diseases/strategy/index_en.htm 
http://www.oie.int/en/animal-health-in-the-world/the-world-animal-health-information-system/the-oie-
data-system/. 
http://ec.europa.eu/food/animal/diseases/surveillance/index_en.htm. 
http://ec.europa.eu/food/animal/diseases/strategy/pillars/antigen-vaccine-banks-task-force_en.htm. 
Scientific Opinion on the Role of Tick Vectors in the Epidemiology of Crimean-Congo Hemorrhagic 
Fever 
(2010) 
http://www.efsa.europa.eu/en/efsajournal/pub/1703.htm. 

programmimg 

document: 

African 

Eurasia 

Swine 

Fever 

and 

in 

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in  animals94.  EFSA  is  also  regularly  consulted  on  an  ad  hoc  basis  e.g.  for  vector-
borne  animal  diseases  such  as  bluetongue,  Schmallenberg  virus  and  Rift  Valley 
Fever95,96.  

The  EU  Framework  Programme  for  Research  with  projects  focussing  on  animal 
health including climate change impacts are financed under the European Research 
Co-operation 7th Framework Programme (Annex I, table 5). 

6. 

DIRECT AND INDIRECT IMPACTS OF CLIMATE CHANGE ON PLANT HEALTH 

Climate change is considered to be one of the main problem drivers in plant health, 
along  with  globalisation  of  trade  in  plants  and  plant  products  and  evolutionary 
adaptation  of  harmful  organisms  to  new  host  plants97.  The  increased  influx  of  new 
pests and diseases of plants through international trade causes ever increasing health 
problems in agriculture and forestry, which are exacerbated by climate change.  

Climate change may adversely affect plant health in the Union. Higher temperatures 
allow pests to have multiple, instead of single, life cycles per year, resulting in more 
frequent  and  more  severe  epidemics,  and  to  expand  their  range.  At  the  same  time, 
crops and trees become physiologically more vulnerable to certain pests and diseases 
as a consequence of climate change.  

New  pests  and  diseases  from  other  continents  are  more  apt  to  survive  European 
winters  with  increased  average  temperatures,  allowing  them  to  establish  where  this 
was not the case in the past. The increased influx of new pests and diseases into the 
EU that were not present in the past, combined with more favourable conditions for 
survival, multiplication and spread of those pests and enhanced vulnerability of crops 
and  trees,  has  been  shown  to  stimulate  the  adaptation  of  pests  and  diseases  to  new 
hosts and to overcome previous genetic barriers to plant infection. New biotypes and 
hybrids of pests and diseases are evolving, affecting crops and trees that previously 
had  no  serious  health  problems  at  all.  For  example,  European  alders  are  suffering 
from  the  evolution  of  new  hybrids  of  certain  species  of  Phytophthora,  a  genus  of 
damaging fungi that spread via waterways and kill the alders where no such disease 
of alders existed before98. 
Threats  exist  in  particular  as  regards  the  health  of  Europe's  trees  and  forests99.  For 
example, Europe's pine forests are threatened by the pine wood nematode, a pest that 
probably reached Europe with wood packaging material (pallets) and is spread with 
native vector beetles. Spread of the pine wood nematode from Portugal, where it is 
now  widely  established,  throughout  the  Union  would  result  in  losses  of  €39-49 

94 
95 
96 

97 

98 
99 

other 

Regions 

http://www.efsa.europa.eu/en/supporting/pub/234e.htm. 
http://www.efsa.europa.eu/en/publications.htm. 
Scientific Opinion on Geographic Distribution of Tick-borne Infections and their Vectors in Europe and 
the 
Basin(2010), 
http://www.efsa.europa.eu/en/efsajournal/pub/1723.htm. 
Waage,  J.K.,  Mumford,  J.D.,  Leach,  A.W.,  Knight,  J.D.  &  Quinlan,  M.M.,  2007.  Responsibility  and 
cost sharing options for quarantine plant health. Report to Department for Environment, Food and Rural 
Affairs, London, United Kingdom. Centre for Environmental Policy, Imperial College London, Ascot, 
United Kingdom. 
http://www.forestry.gov.uk/pdf/fcin6.pdf/$FILE/fcin6.pdf 
Moore, B. & Allard, G., 2008. Climate change impacts on forest health. FAO, Rome. 

Mediterranean 

the 

of 

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billion100  Increased  average  temperatures  due  to  climate  change  would  allow  pine 
wood nematode to move further northwards and cause even more damage.  
Plant  pests  have  caused  massive  damage  before.  During  the  20th  century,  the 
European  elm  was  subject  to  mass  extinction  due  to  the  entry,  establishment  and 
spread of a fungus from Asia, which reached Europe and spread inside it with vector 
beetles101.  In  that  same  period,  the  vast  North-American  chestnut  forests  have 
disappeared  because  of  the  entry  of  a  fungal  pathogen  of  Chinese  origin102. 
Currently, Europe's ash trees are being decimated by a new fungus from Asia103. 

Massive  forest  death  may  itself  stimulate  climate  change.  In  western  Canada,  the 
mountain  pine  beetle  in  recent  years  killed  70-80%  of  the  pine  forests  of  British 
Columbia. The extent of the extinction is such that these forests have changed from a 
carbon  sink  into  a  carbon  source104.  This  was  due  to  climate  change;  normally,  the 
beetle is killed by winter frost but average winter temperatures in British Columbia 
have gone up. The beetle does not occur in Europe; if it would reach Scandinavia or 
central Europe, it could similarly cause mass death of Europe's main pine forests. 

Varieties of plants and crops currently cultivated in the Union may be impacted by 
the  expected  increased  frequency  and  intensity  of  drought  episodes  across  Europe, 
potentially leading to significant reductions in yield and/or product quality. 

7. 

EU CAPACITY TO REACT TO CLIMATE CHANGE IN RELATION TO PLANT HEALTH 

The legal basis for action in the field of plant health is provided by Article 43 TFEU.  

The European Union capacity to react to the impact of climate change on plant health 
relies  on  its  legislation  concerning  plant  health,  plant  reproductive  material,  the 
placing on the market of plant protection products and their sustainable use, and the 
legislative  framework  for  the  placing  on  the  market  of  Genetically  Modified 
Organisms (GMOs).  
Council  Directive  2000/29/EC105  provides  the  legal  framework  to  inhibit  the  entry, 
establishment and spread in the Union of organisms that are harmful to plants. It was 
developed to protect the Union against the incursion of new harmful organisms from 
other parts of the world, and to help prevent spread of harmful organisms present in 
the  EU  only  locally  to  the  rest  of  the  Union.  It  provides  powerful  tools  for  this 
purpose;  however  it  cannot  address  problems  from  common  European  pests.  Thus, 
Directive  2000/29/EC  allows  mitigating  the  impacts  of  climate  change  on  plant 
health only to the extent that those impacts relate to the  introduction and spread of 
new pests and diseases. 

Under the ongoing Seventh Framework Programme for Research (FP7), one project, 
ISEFOR  (Increasing  Sustainability  of  European  FORests:  modelling  for  security 

100  

101 

102 
103 
104  

105 

Available at: 
http://ec.europa.eu/food/plant/plant_health_biosafety/rules/docs/fcec_final_report_economic_study_pla
nt_health_en.pdf 
Brasier, C.M. & Buck, K.W., 2001. Rapid evolutionary changes in a globally invading pathogen (Dutch 
elm disease). Biological Invasions 3: 223-233. 
http://ec.europa.eu/environment/forests/pdf/FBD_report_2012.pdf. 
http://www.eppo.int/QUARANTINE/Alert_List/fungi/Chalara_fraxinea.htm. 
Available at: 
http://ec.europa.eu/food/plant/plant_health_biosafety/rules/docs/fcec_final_report_economic_study_pla
nt_health_en.pdf. 
http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CONSLEG:2000L0029:20100113:EN:PDF. 

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against  invasive  pests  and  pathogens  under  climate  change),  developing  modelling 
software  enabling  the  prediction  of  geographical  areas  at  risk  of  attack  by  alien 
invasive pests and pathogens under climate change scenarios, has been launched in 
2010106. 
Twelve  so-called  Marketing  Directives  on  seed  and  plant  propagating  material107 
(now  'plant  reproductive  material')  are  in  force,  which  offer  further  instruments  to 
mitigate  plant  health  impacts  of  climate  change.  These  Directives  ensure  the 
availability  at  the  start  of  the  production  chain  of  healthy  plant  material  of  good 
overall  quality  and  adapted  to  the  local  conditions.  These  Directives  offer  the 
possibility  to  direct  plant  breeding  efforts  towards  drought  and  disease  resistant 
varieties and adaptation to agro-climatic conditions.  

The active participation of the EU in the work of the International Treaty for Plant 
Genetic  Resources  for  Food  and  Agriculture  in  terms  of  inclusion  of  genetic 
resources under the umbrella of the Treaty and of funding shows the importance of 
conserving,  characterising,  evaluating  and  using  plant  genetic  resources  for  further 
breeding,  in  order  to  enhance  the  sustainability  of  agricultural  systems  and  the 
adaptation to climate change. 

EFSA provides with its Panel on Plant Health scientific advice to risk managers on 
the  risk  to  plant  health  for  the  EU  territory  posed  by  new  plant  pests  and  diseases. 
The assessment of risks can also include future climate change scenarios, which are 
particularly important for forestry trees. Climate change as a driver of emerging plant 
health  risk  has  been  thoroughly  discussed  at  the  EFSA  Scientific  Colloquium  on 
emerging risks in plant health. 

In addition, for the control of pest and diseases, which are established in the EU and 
which risk to further spread as a result of climate change, plant protection products 
will continue to play an important role. The legal framework enables Member States 
not  only  to  react  quickly  to  emergency  situations  without  compromising  consumer 
safety  but  also  to  take  preventive  and  appropriate  measures.  The  compulsory 
introduction of "Integrated Pest Management"108 as of 1 January 2014, which aims at 
a  careful  consideration  of  all  available  plant  protection  methods  and  a  subsequent 
integration of appropriate measures that discourage the development of populations 
of  pests  and  diseases,  will  improve  the  capacity  of  professional  users  to  take 
appropriate control measures. Member States have to ensure that professional users 
have at their disposal information and tools for pest monitoring and decision making 
as well as advisory services. 

Biotechnology  can  be  used  for  developing  varieties  of  crops  that  are  resistant  to 
insect pests (e.g. corn borers) and plant diseases (e.g. viruses or fungi), or are more 
tolerant to hydric stress or degraded soils. The EU legislation on GMOs109 provides a 
comprehensive  framework  to  assess  these  crops  for  risks  for  health  and  the 
environment,  before  they  are  authorised  to  be  placed  on  the  market.  This  type  of 
crops could be part of the range of options made available to farmers to address the 
emerging plant health risks linked to climate change.  

106 
107 
108 
109 

http://www.isefor.com/. 
http://ec.europa.eu/food/plant/plant_propagation_material/eu_legislation/index_en.htm 
Article 55 of Regulation (EC) No 1107/2009 and Article 14 of Directive 2009/128/EC. 
Directive 2001/18/EC and Regulation (EC) No 1829/2003. 

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8. 

EVOLUTION  OF  THE  UNION  ACTION  ON  HUMAN,  ANIMAL  AND  PLANT  HEALTH 
IMPACT OF CLIMATE CHANGE 

Despite  the  raising  awareness  of  climate  change  impacts  and  the  mobilisation  of 
health authorities and stakeholders, a certain number of knowledge gaps still need to 
be  bridged.  For  instance  consistent  and  comparable  epidemiological  studies  and 
analysis including urban effects of heat related phenomenon and heat waves are still 
lacking. 

Further analysis is also needed on possible interactions between climate change and 
air pollution on ozone; on food-borne diseases, on salmonella, on the prevalence of 
mycotoxins in feed and food, on the necessity to envisage financial support in areas 
where  existing  financial  capacities  might  not  be  adequate  to  address  health  risks 
correctly. 

8.1. 

Tools for action: Human Health  

8.1.1.  The CEHAPIS project 

The  “Climate,  Environment  and  Health  Action  Plan  and  Information  System” 
(CEHAPIS)  project  was  a  co-funded  project  established  by  the  WHO  Regional 
Office for Europe and the European Commission to provide an evaluation of policy 
options  for  a  successful  health  adaptation  to  climate  change  and  monitor  trends.  It 
has identified three main areas for action: 

•  Area 1: Health intelligence and awareness on climate change and health with the 
objective  to  reinforce  European  citizens'  knowledge  and  awareness  on  climate 
change and health for responsive action.  

•  Area  2:  Integration  of  climate  change  into  health  policies  with  the  specific 
objective  to  increase  health  sector  and  system  action  on  climate  change  and 
health. 

•  Area 3: Integration of health into climate change related adaptation and mitigation 
policies  with  the  specific  objective  to  better  aim  at  population  health  benefits 
when developing climate change related adaptation and mitigation measures in a 
variety of sectors. 

The  definition  of  these  areas  is  based  on  the  White  Paper  ''Adapting  to  climate 
change: Towards a European framework action'' as well as the Parma commitment, 
the  WHO  European  Framework  for  Action,  the  WHO  Regional  Committee 
Resolution and the World Health Assembly Resolution. 

The  CEHAPIS  project  also  recommends  to  further  improve  cooperation  between 
European  Member  States  and  with  European  and  international  Agencies.  A  more 
detailed presentation of the results including specific objectives identified by area is 
available in Annex II110. 

8.1.2. 

Serious cross-border threats to health 

The  proposal  for  a  decision  on  serious  cross-border  threats  to  health  emphasises 
that  cross  border  health  threats  can  be  events  caused  by  communicable  diseases, 
biological  agents  responsible  for  non-communicable  diseases,  and  threats  of 
chemical,  environmental,  or  unknown  origin.  Threats  deriving  from  the  effects  of 

110 

Objectives  should  be  specific,  measurable,  achievable,  realistic  and  timed  (SMART);  Related  to  the 
timeframe  for  implementation  the  objectives  should  be  achieved  three  years  after  adoption  of  the 
proposal. 

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climate change are included in the scope of this Decision and are covered under the 
same heading as environmental threats.111 

This  inventory  will  require  identification  of  following  components  as  regards 
management of outbreaks related to climate change: 

• 

• 

• 

• 

Core capacities 

Awareness raising and communication to ensure availability of rapid data and 
information for European citizens 

Structures  put  in  place  to  ensure  preparedness,  risk-assessment  and  risk 
management in terms of governance and responsibilities 

Existence  of  cross-sector  action  and 
considerations of links between plant, animal and human health issues 

integrated  policies 

including 

The proposal foresees strengthening cooperation with WHO through coordination at 
EU level and implementation of the International Health Regulations.  

8.1.3.  Reinforced role of the Health Security Committee 

The Health Security Committee is currently an informal structure at EU level for the 
coordination of public health risk assessment and the management of serious cross-
border  threats  to  health.  Due  to  the  informal  nature  of  the  Committee,  the 
involvement and commitment of Member States is voluntary and there is insufficient 
coordination  of  public  health  responses  and  no  cross-sectoral  interlinking  of 
decision-making  processes  in  public  health.  The  Decision  on  serious  cross-border 
threats  to  health  aims  at  formalising  the  existing  Health  Security  Committee.  As  a 
result  public  health  preparedness  planning  and  crisis  management  can  be  taken 
forward  in  a  more  consistent  and  comprehensive  manner  at  EU  level.  In  addition 
Member States will benefit from pooling scarce resources related to risk assessment 
or  crisis  management.  The  Health  Security  Initiative  will  appropriately  take  into 
account  the  EU  external  cooperation  activities  for  health  crises  prevention  and 
the  Union's 
responses  with 
programmes  for  research,  and  explore  synergies  with  the  numerous  bilateral  EU 
assistance and cooperation programmes with a significant health component.111 

third  countries  and  activities  supported  under 

8.1.4.  Reinforced Early Warning and Response System (EWRS) 

A  system  enabling  notification  at  the  EU  level  of  alerts  related  to  serious  cross-
border threats to health in order to ensure that competent public health authorities in 
Member  States  and  the  Commission  are  duly  and  timely  informed  should  be  given 
further  consideration  as  to  whether  it  is  appropriate..  Therefore  the  Early  Warning 
and  Response  System  (EWRS),  established  under  Decision  No  2119/98/EC  for 
communicable diseases, could be extended to all the serious cross-border threats to 
health  covered  by  the  forthcoming  decision.  The  notification  of  an  alert  could  be 
required only where the scale and severity of the threat concerned are or may become 
so significant that the coordination of the response at the Union level is necessary.111  

8.1.5.  Health for Growth 

The  Health  for  Growth  Programme112  does  not  specifically  address 
the 
environmental  and  health  challenges  posed  by  climate  change.  Instead  a  more 

111 
112 

COM(2011) 866 – SEC(2011) 1519. 
COM(2011) 709 - SEC(2011) 1322. 

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holistic  approach  is  being  targeted  by  the  programme,  aiming  at  the  inclusion  of 
climate change and environmental factors in a wider category which encompasses a 
number of serious threats for human health. 

One of the four specific objectives of the upcoming Health for Growth Programme is 
to develop common approaches and demonstrate their value for better preparedness 
and coordination in health emergencies in order to protect citizens from cross border 
health  threats.  Actions  planned  under  this  objective  will  help  develop  common 
approaches to prepare for possible health emergencies, to co-ordinate a response to 
such health emergencies at European level, and to support national capacity building 
in  preparedness  and  management  of  health  crisis  taking  into  account  international 
initiatives.  Actions  will  also  support  measures  designed  to  protect  and  improve 
human  health  against  communicable  diseases,  major  cross-border  health  scourges; 
measures  concerning  monitoring,  early  warning  of  and  combating  serious  cross-
border threats to health required by or contributing to the objectives of EU legislation 
in these fields.  

8.2. 

Tools for action: Animal Health  

8.2.1.  Emergency response to animal disease outbreaks 

The  EU  rapid  response  network,  crisis  management  and  communication  capacity 
regarding  certain  transmissible  diseases  has  recently  been  evaluated  by  an  external 
consortium113.It  concludes  that  the  current  system  is  effective  in  mitigating  the 
impact  of  outbreaks  of  contagious  animal  diseases.  Room  for  improvement  was 
identified,  such  as  enhanced  collaboration  between  neighbouring  Member  States, 
increased  stakeholder  involvement  in  Member  States'  contingency  planning  and  an 
increased role of the Commission's Food and Veterinary Office (FVO) in reviewing 
and checking these plans on the spot and exchanging experiences on best practices. 
Contingency  plans  should  also  better  address  possibly  future  emerging  diseases. 
Retained recommendations will be addressed via an action plan.  

8.2.2.  The New EU Animal Health Law 

Animal  health  legislation  covers  many  different  policy  areas:  intra-Union  trade, 
imports  of  animals  and  their  products,  animal  disease  control,  animal  nutrition  and 
animal  welfare.  These  interrelated  policy  fields  will  be  replaced  by  a  single, 
simplified, transparent and clear regulatory framework, the new Animal Health Law. 
The  respective  Commission  proposal  is  scheduled  for  adoption  by  early  2013114.  It 
will  consolidate  the  exhaustive  existing  animal  health  legislation,  introduce  the 
objectives of the Animal Health Strategy and thus put more emphasis on preventive 
measures such as early detection, surveillance and biosecurity. Climate change may 
play an important role in the emergence of new diseases, the prevalence of existing 
diseases and the geographic distribution of disease agents and vectors. Therefore the 
rules in the Animal Health Law will be flexible, allowing for adaptation of disease 
prevention  and  control  measures,  including  those  of  surveillance  and  disease 
eradication, to the changes in disease patterns resulting from climate change. 

8.2.3. 

Specific Animal health studies co-financed by the Commission 

As  part  of  a  series  of  initiatives  to  closely  monitor  the  development  of  the  newly 
emerged  Schmallenberg  virus  (SBV),  the  Commission  supports  seven  Member 

113 
114 

http://ec.europa.eu/food/animal/diseases/strategy/pillars/docs/23_final_report_eu_rapid_response.pdf. 
http://ec.europa.eu/atwork/pdf/cwp2013_annex_en.pdf. 

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States115 to carry out scientific studies aiming at filling knowledge gaps. The studies 
focus  on  the  mechanisms  by  which  the  infection  is  caused,  the  transmission 
pathways,  the  role  of  vectors,  their  distribution  and  reservoirs  and  their  host  range 
also  taking  into  account  weather  conditions.  Furthermore,  these  studies  should 
develop suitable analytical methods which allow large-scale testing. The studies are 
expected to be finalised by end 2013. Additionally, the 2013 call of FP7 launched a 
topic  to  promote  research  on  emerging  viral  vector  borne  diseases,  with  a  specific 
reference to Schmallenberg virus and to Rift Valley Fever.  

In  order  to  better  determine  the  extent  of  honey  bee  mortalities  and  to  better 
understand  the  causes  and  extent  of  the  problem  the  Commission  launched  during 
2012  and  continuing  throughout  2013  a  programme  to  support  17  Member 
States116for  surveillance  studies117  on  honeybee  colony  losses.  In  addition  a  new 
research project on honeybee will be funded under a FP7 call and one objective will 
be to determine the role of environmental effects on bee populations and to protect 
their genetic diversity. 

8.3. 

Tools for action: Plant Health  

8.3.1.  The new EU Plant Health Law 

The  EU  plant  health  regime  was  reviewed  with  a  view  to  its  reinforcement  and 
modernisation,  so  as  to  better  address  the  increased  challenges  from  globalisation 
and  climate  change  to  agriculture  and  forestry118  and  a  legal  proposal  is  also 
scheduled  by  2013.  An  Action  Plan  for  the  review  of  the  legislation  on  seed  and 
plant propagating material (now 'plant reproductive material') was adopted in 2009. 
The new legal proposal on plant reproductive material is scheduled by 2013. 
The EU plant health regime was subject to an evaluation119 carried out in 2009-2010 
to  assess  the  success  of  the  regime  and  to  address  the  needs  for  change,  given  the 
increased  globalisation  of  trade  and  climate  change.  In  the  preparation  of  the  legal 
proposal,  further  consideration  should  be  given  as  to  whether  it  is  appropriate  to 
reflect the common understanding that the protection of the Union territory at import 
needs to be reinforced, that territorial surveys for new pests and diseases need to be 
put in place and that eradication measures in case of outbreaks require strengthening 
and harmonisation. 

8.3.2.  The new EU Plant Reproductive Material Law 

The  12  Directives  on  marketing  of  plant  reproductive  material  were  externally 
evaluated  in  2007-2008  to  assess  their  efficiency  and  efficacy  in  the  changing 
environment.  The  Action  Plan  of  2009  recognises  the  importance  of  improving  the 
consistency with the other EU policies such as on environment to ensure action at the 
beginning  of  the  production  chain.  In  the  preparation  of  the  legal  proposal,  further 
consideration should be given as to whether it is appropriate to include tools to better 
steer plant breeding in a more sustainable direction. 

115 
116 

117 
118 
119 

Belgium, Germany, Spain, France, Italy, the Netherlands and the United Kingdom. 
Belgium,  Denmark,  Estonia,  Finland,  France,  Germany,  Greece,  Hungary,  Italy,  Latvia,  Lithuania, 
Poland, Portugal, Slovak Republic, Spain, Sweden and the United Kingdom.  
http://ec.europa.eu/food/animal/liveanimals/bees/bee_health_en.htm 
http://ec.europa.eu/food/plant/plant_health_biosafety/rules/index_en.htm. 
http://ec.europa.eu/food/plant/plant_health_biosafety/rules/docs/final_report_eval_en.pdf. 

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9. 

CONCLUSIONS FOR HUMAN, ANIMAL AND PLANT HEALTH 

9.1. 

Human Health 

The  adoption  of  the  Commission  proposal  on  serious  cross-border  threats  to  health 
by  the  Council  and  the  European  Parliament  could  take  place  during  the  first 
semester  of  2013.  Its  implementation  will  require  the  identification  of  Member 
States'  preparedness,  early  warning  and  surveillance,  risk  assessment  and  risk 
management existing structures for the different serious cross-border threats to health 
including climate change.  

9.2. 

Animal Health 

Animal  Health  Law  –  the  adoption  of  the  Commission  proposal  is  scheduled  for 
2013 and the adoption by the Council and the European Parliament indicatively by 
2014/15.  In  the  preparation  of  the  legal  proposal,  further  consideration  should  be 
given as  to whether it is appropriate to take measures  in relation to  prevention  and 
control of future animal diseases including those impacted by climate change. 

Animal  Disease  Information  System  –  ADIS  –  will  provide  better  and  more 
comparable epidemiological data for better identification, evaluation and response to 
changing or emerging disease situations. A prototype will become available in 2013 
and the system should be fully operational by 2014. 

EU's  rapid  response  network  and  crisis  management  regarding  certain 
transmissible animal diseases - the recommendations of the external evaluation of 
this  mechanism  will  be  followed-up  by  delegated  and  implementing  acts  to  be 
adopted in the frame of the Animal Health Law. 

9.3. 

Plant Health 

Plant Health Law – the adoption of the Commission proposal is foreseen by 2013 
and  the  adoption  by  the  Council  and  the  European  Parliament  indicatively  by 
2014/15.  In  the  preparation  of  the  legal  proposal,  further  consideration  should  be 
given to providing a robust basis for preventing the entry, establishment and spread 
of  pests  of  plants  in  the  Union,  as  well  as  the  necessary  tools  for  action  in  case  of 
outbreaks of those pests due to globalisation and climate change. The new law will 
allow the Commission to adopt measures in relation to prevention and eradication of 
particular pests of plants, including emergency measures. 

Vigilance  at  EU  borders  –  the  controls  at  the  Union  borders  will  be  especially 
enforced  to  ensure  the  timely  detection  of  new  pests  on  consignments  of  plants, 
imported from third countries that do not occur naturally in Europe and threaten the 
Union's forests, crops and ornamental plants.  

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Table 1. Training and preparedness exercises to manage human health crisis 

Annex I 

Project 

AQUA UTOPIA 

IRIDIUM 1, 2, 3 

HERMES 

METIS 

ECLIPSE 

TOR 2  

TOR 1 

VACCINE 

Year 

2011 

2011 

2011 

2011 

2010 

2010 

2009 

2009 

Participants 

Type of project 

HSC  members,  HSC 
communicators, 
ECDC,  EMA,  EFSA,  WHO  EURO,  WHO 
HQ, DG HOME, DG SANCO 

Table top exercise 

HSC  members,  ECHA,  WHO  EURO, 
SANCO 

Table top exercise 

Member States, ECDC, SANCO 

Table top exercise 

HSC members, ECDC, WHO HQ, SANCO 

Table top exercise 

GHSAG Countries, WHO HQ 

Member States, ECDC, EMA, WHO EURO, 
WHO HQ 

Table top exercise 

Evaluation exercise 

Member States, ECDC, EMA, WHO EURO, 
WHO HQ 

Evaluation exercise 

HSC  communicators,  WHO  HQ,  EMA, 
Vaccine  manufacturers,  SANCO  (ECDC 
was invited, but refused to attend because of 
the participation of the vaccine industry) 

Table 
workshop 

top 

exercise 

and 

Table 2. Projects funded under the EU Health Programme 

Time period  

2005 - 2007 

2007 - 2010 

2007 - 2011 

2009 - 2011 

2009 - 2012 

2009 - 2012 

2008 - 2011 

Project 

Coordinator 

120

EuroHEAT
to extreme weather: heat-waves)* 

(Improving  Public  Health  responses 

121

EUROHEIS
(European Health and Environment 
Information  System  for  Risk  Assessment  and 
Disease Mapping) 

44

EUROSUN
Europe and its effects on health) 

(Quantification  of  sun  exposure  in 

122

EuroMOMO
mortality for public health action) 

(European  monitoring  of  excess 

123

HIALINE
Information Network) 

(Health Impacts of Airborne Allergen 

CLIMATE-TRAP
by Training, Assessment and Preparedness) 

(Climate  Change  Adaptation 

34

WHO  –  World  Health  Organization,  Regional 
Office for Europe 

Imperial  College  of  Science,  Technology  and 
Medicine, London 

International  Agency  for  Research  on  Cancer 
(until  31/12/2009); 
International  Prevention 
Research Institute (from 01/01/2010) 

Statens Serum Institut, Denmark 

Klinikum 
Universität München 

rechts  der 

Isar  der  Technischen 

Public  Health  Services  Gelderland-Midden 
(HGM) Arnhem, Netherlands 

CEHAPIS(Climate,  environment  and  health  action 
plan and information system) 

WHO  –  World  Health  Organization,  Regional 
Office for Europe 

124

Aphekom
(co-funded  by the  Community  Action 
in  the  Field  of  Public  Health  programme:  2003-
2008) 

French  Institute  for  Public  Health  Surveillance 
(InVS), France & Umea University, Sweden 

* 

120 
121 
122 
123 
124 

In line with the Environment and Health Action Plan, funding was provided for EuroHEAT which deals with 
actions  at  different  levels:  from  health  system  preparedness  coordinated  with  meteorological  early  warning 
systems  to  timely  public  and  medical  advice  and  improvements  to  housing  and  urban  planning.  Its  work  built 

www.who.dk.  
http://www.euroheis.org.  
http://www.euromomo.eu/.  
http://www.hialine.com/.  
http://www.aphekom.org/web/aphekom.org/home.  

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upon  the  results  of  the  cCASHh125  and  took  full  account  the  progress  and  the  outcome  of  the  PHEWE,  both 
projects funded by the 5th Framework Programme).  

Table 3. Finalised research projects co-funded by Directorate General of Research & Innovation 
with focus on human health  

Time period 

2005 - 2011 

2007 - 2011 

2004 - 2010 

2007 - 2011 

Project 
INTARESE126(Integrated  assessment  of  health  risks  from 
environmental stressors in Europe) 
CIRCE127(Climate  change  and 
Mediterranean environment) 
EDEN29(Emerging  Diseases 
Environment) 
MICRODIS128(Integrated  Health,  Social  and  Economic 
Impacts of Extreme Events: Evidence, Methods and Tools) 

in  a  Changing  European 

research: 

impact 

the 

2008 - 2010 

2010 - 2013 

COPACETIC129  (COPD  Pathology:  Addressing  critical 
gaps, early treatment and innovative concepts) 
VIROCLIME130( Impact of climate change on the transport, 
fate and risk management of viral pathogens in water) 

Coordinator 

Imperial  College  of  Science,  Technology 
and Medicine, London (UK) 

National 
Volcanology, Bologna (IT) 

Institute  of  Geophysics  and 

CIRAD (FR) 

Centre  for  Research  on  the  Epidemiology 
of  Disasters,  Catholic  University  of 
Louvain (BE) 

University  Medical  Center,  Utrecht, 
Netherlands 

University of Aberystwyth (UK) 

Table  4.  On-going  research  projects  co-funded  by  Directorate  General  of  Research  & 
Innovation with focus on human health  

Project 

Coordinator 

Time period  

2009 - 2013 

2009 - 2013 

2009 - 2013 

2008 - 2012 

2010 - 2013 

131

ARCRISK
(Arctic  Health  Risks:  Impacts  on  health  in  the 
Arctic  and  Europe  owing  to  climate-induced  changes  in 
contaminant cycling) 
132

(Climate  change,  environmental  contaminants  and 

CLEAR
reproductive health) 

133

ICEPURE
levels and its impact on human health) 

(Quantification  of  changing  surface  UV  radiation 

134

ESCAPE
Effects) 

(European  Study  of  Cohorts  for  Air  Pollution 

135

(Air  quality  monitoring  technologies  for 

AIRMONTECH
urban areas) 
136

2010 – 2014  ATOPICA
air quality) 

(Atopic diseases in changing climate, land use and 

2011 – 2016 

137

BREATHE
particles in school children) 

(Brain  development  and  air  pollution  ultrafine 

Arctic  Monitoring  and  Assessment 
Secretariat, 
(AMAP) 
Programme 
Norway 

Aarhus  University  Hospital,  Aarhus, 
Denmark 

King's College London, UK 

Institute 
for  Risk  Assessment 
Sciences  (IRAS),  Utrecht  University, 
Netherlands 

Institute of Energy and Environmental 
Technology e.V. (IUTA), Germany 

Medical University of Vienna, Austria 

Centre for Research in Environmental 
Epidemiology, Spain 

125 
126 
127 
128 
129 
130 
131 
132 
133 
134 
135 
136 
137 

http://ec.europa.eu/research/environment/themes/projects_en.htm#2. 
www.intarese.org. 
www.circeproject.eu. 
www.microdis-eu.be.  
http://www.copacetic-study.eu/english 
www.viroclime.org/ 
www.arcrisk.eu.  
www.inuendo.dk/clear. 
www.icepure.eu. 
http://www.escapeproject.eu/index.php.  
www.airmontech.eu.  
www.atopica.eu.  
This  project  is  funded  by  the  IDEAS  programme  and  does  not  have  a  website.  More  info  on 
http://cordis.europa.eu/projects/home_en.html.  

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2010 - 2014 

2010 - 2014 

2011 - 2013 

2011 - 2016 

2012 - 2017 

2012 - 2017 

2011 - 2015 

2008 - 2012 

2010 - 2015 

138

CETIEB
in retrofitted energy efficient buildings) 

(Cost-effective  tools  for  better  indoor  environment 

Stuttgart University, Germany 

139

INTASENSE
efficient environment control) 

(Integrated  air  quality  sensor 

for  energy 

C-TECH  INNOVATION  LIMITED, 
UK 

140

(On the reduction of health effects from combined 

OFFICAIR
exposure to indoor air pollutants in modern offices) 
SPHERE141(Susceptibility  to  particle  health  effects,  miRNAs 
and exosomes) 
EUPORIAS142(European  Provision  of  Regional 
Assessments on Seasonal and Decadal Timescales) 
RAMSES143(Reconciling Adaptation, Mitigation and Sustainable 
Development for cities) 

Impacts 

144

IMPACT2C
warming) 

(Quantifying  projected 

impacts  under  2°C 

EVA145  (Markers  for  emphysema  versus  airway  disease  in 
COPD) 
PREDICTA146  (Post-infectious  immune  reprogramming  and  its 
association with persistence and chronicity of respiratory allergic 
diseases) 

University  of  western  Macedonia, 
Greece 

Università degli studi di Milano, Italy 

UK Met Office 

PIK, Germany 

Helmholtz-Zentrum 
Geesthacht 
Centre  for  Materials  and  Coastal 
research 

German  Research  Centre 
Environmental Research, Germany 

for 

National  and  Kapodistrian  University 
of Athens, Greece 

Institut  National  de 
Recherche Medicale 
France 

Institut Pasteur, Paris 

la  Sante  et 
(INSERM), 

2010 - 2014  MEDALL147 (Mechanisms of the development of allergy) 

2012 - 2016 

DenFree ‒ Dengue research Framework for Resisting Epidemics 
in Europe 

2011 - 2015 

Dengue-Tools  ‒  Innovative tools  and  strategies  for  surveillance 
and control of dengue 

Umea University 

2011-2016 

IDAMS ¬‒ International Research Consortium on Dengue Risk 
Assessment, Management, and Surveillance 

University of Heidelberg 

2010 - 2013 

Vectorie ‒ Vector-borne Risks for Europe: Risk assessment and 
control of West Nile and Chikungunya virus (VECTORIE) 

Erasmus Medical Centre 

2011 - 2014 

EDENext  -  Biology  and  control  of  vector-borne  infections  in 
Europe  

Centre  de  coopération  internationale 
en  recherche  agronomique  pour  le 
(CIRAD), 
développement 
Montpellier, France 

AIRMONTECH,  ATOPICA,  CETIEB,  IMPACT2C,  INTASENSE,  OFFICAIR,  SPHERE,  RAMSES  and 
EUPORIAS. Two projects, ARCRISK and CLEAR examining the health risks resulting for Arctic populations 
from  climate  change  induced  changes  in  the  distribution  of  environmental  pollutants  have  been  launched  in 
2009148.  A  project  on  the  health  effects  of  changing  surface  UV  radiation  levels  ICEPURE  started  in  2012  as 
well149. A number of studies have been published after the initiation of ICEPURE with significant findings: In a 
study by Petersen et al. it was emphasized that it is of vital importance to integrate both personal behaviour and 

138 
139 
140 
141 
142 
143 
144 
145 
146 
147 
148 
149 

www.cetieb.eu.  
www.intasense.eu.  
www.officair-project.eu.  
http://www.unimi.it/.  
http://www.metoffice.gov.uk/.  
http://www.pik-potsdam.de/.  
www.cosmostox.eu.  
http://www.eva-copd.eu/eva/english/ 
http://cordis.europa.eu/projects/260895 
http://www.medall-fp7.eu/ 
ftp://ftp.cordis.europa.eu/pub/fp7/environment/docs/catalogue_projects_2008.pdf. 
ftp://ftp.cordis.europa.eu/pub/fp7/environment/docs/catalogue-projects-fp7envnmp_en.pdf. 

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ambient  UVR  levels/latitude  in  exposure  assessment  methodologies150.  In  another  study  it  was  depicted  that 
erythema is considerably underestimated and possibly neglected. Self-assessment of erythema from participants' 
diaries was unreliable and even researchers had difficulty in detecting erythema151. Finally, the integrated project 
ESCAPE will analyse air pollution effects on European populations. 

Table  5.  Research  projects  co-funded  by  Directorate  General  of  Research  &  Innovation  with 
focus on animal health  

Project 

Coordinator 

Outcome 

Time period  

2008 - 2011 

EMIDA 
Coordination of European research 
on emerging and major infectious 
diseases of livestock  

Department for the 
Environment 
Defra 
UNITED KINDOM 

2012 - 2015 

ANIHWA 
Era-Net Animal Health and Welfare  

INRA 
Paris Cedex 
FRANCE 

Systematic exchange of 
information, development of 
instruments for common calls 

ANIHWA is an extension of 
EMIDA 

2006 - 2012 

2009 - 2012 

2007 - 2010 

2008 - 2012 

EPIZONE 
Network of Excellence for Epizootic 
Disease Diagnostic and Control 

Central Veterinary Institute 
Lelystad 
NETHERLANDS 

Network for sharing knowledge 
and expertise, trainings and 
workshops, online databases 

ARBOZOONET 
Network for Capacity Building for 
the Control of Emerging Viral 
Vector Borne Zoonotic Diseases  

Institut Pasteur 
Paris 
FRANCE 

Risk maps, databases and 
models on vector-borne 
arboviruses, surveillance and 
vector control, vaccine 
development 

BTVAC 
Improved Vaccines for Bluetongue 
Disease 

London School of Hygiene &  
Tropical Medicine 
UNITED KINGDOM 

safe genetically inert 
vaccines for BTV, for 
serotypes identified in Europe 

ASFRISK 
Evaluating and controlling the risk of 
African swine fever in the EU  

2010 - 2011 

BEEDOC 
Bees in Europe and the Decline Of 
honeybee Colonies 

2012 - 2014 

2012 - 2015 

GLOWORM 
Strategies to mitigate the impact of 
global change on helminth infections 
in ruminants 

RISKSUR 
Scientific methodologies 
for cost-effective risk-based animal 
health surveillance 

Faculdade de Medicina 
Veterinária  
Universidade Técnica de 
Lisboa, PORTUGAL 

Martin-Luther University 
Halle-Wittenberg 
Halle (Saale) 
GERMANY 

Gent University 
Belgium 

Royal Veterinary College 
UNITED KINGDOM 

Knowledge of the 
epidemiology and risk factors, 
prevention and control of ASF, 
diagnostic and vaccine 
development 

Diseases and colony losses 

Control strategies and 
epidemiological model 
development 

Science-based  decision  making 
frameworks for improving the 
animal health surveillance 
systems 

150 

151 

Dadvand  P,  Basagana  X,  Barrera-Gomez  J,  Diffey  B,  Nieuwenhuijsen  M.  Measurement  errors  in  the 
assessment of exposure to solar ultraviolet radiation and its impact on risk estimates in epidemiological 
studies. Photochem Photobiol Sci. 2011;10(7):1161-8. 
Petersen B, Thieden E, Lerche CM, Wulf HC. Validation of self-reported erythema: comparison of self-
reports, researcher assessment and objective measurements in sun worshippers and skiers. J Eur Acad 
Dermatol Venereol. 2012. 

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CEHAPIS PROJECT FUNDED UNDER THE EU HEALTH PROGRAMME  

1. 

INTRODUCTION: 

Annex II 

The  “Climate,  Environment  and  Health  Action  Plan  and  Information  System” 
(CEHAPIS)  project  was  a  co-funded  project  established  by  the  WHO  Regional 
Office for Europe and the European Commission to provide an evaluation of policy 
options for a successful health adaptation to climate change and monitor trends.  

Based on consultations with WHO Member States and experts, three areas for action 
have been identified:  

• 

• 

• 

Area 1: Health intelligence and awareness on climate change and health; 

Area 2: Integration of climate change into health policies; 

Area 3: Integration  of  health  into  climate  change  related  adaptation  and 
mitigation policies; 

Pathways  of  the  health  effects  of  climate  change,  and  modifying  potentials  of  the 
three EU policy areas.  

2. 

GENERAL OBJECTIVES (for all three areas) 

The  overall  general  objectives  for  all  three  areas  are,  to  protect  European  Union 
citizens’ health from climate change, through: 

• 

• 

• 

• 

increase in knowledge and awareness on climate change and health; 

integration of climate change into health policies and mechanisms; 

integration of health into climate change related sectorial policies on mitigation 
and adaptation; 

improved  cooperation  between  European  Member  States,  and  with  European 
and international Agencies.  

3. 

SPECIFIC OBJECTIVES BY AREA 

3.1. 

Area 1: Health intelligence and awareness on climate change and health 

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The specific objective of this initiative is to reinforce European citizens’ knowledge 
and  awareness  on  climate  change  and  health,  for  responsive  action.  A 
comprehensive, coherent and common approach needs to be developed for:  

• 

• 

• 

Planning  and  implementing  research  and  monitoring  on  climate  change  and 
health;  

A climate change and health European wide communication strategy; 

A  climate  change  and  health  information  platform  to  (between  many  other 
scopes’s) feed the EU clearinghouse. 

3.2. 

Area 2: Integration of climate change into public health policies and action 

The specific objective of this initiative is to increase health sector and system action 
on  climate  change  and  health.  A  comprehensive,  coherent  and  common  approach 
needs to be developed for:  

• 

• 

• 

• 

• 

Integrating climate change into EU Generic Preparedness Planning and policies 
on trans-boundary threats; 

Strengthening  climate  –  sensitive  disease  surveillance  and  health  targeted 
weather early-warning;  

Developing a European training module on climate change and health;  

Developing  harmonized  guidance  and  assessment  procedures  on  greener  and 
more sustainable and safer health services and piloting national and local case 
studies of application;  

Understanding  health  systems  transformational  change  towards  full  health 
systems adaptation and sustainability. 

3.3. 

Area  3:  Integration  of  health  into  climate  change  related  adaptation  and  mitigation 
policies 

The specific objective of this initiative is to better aim at population health benefits 
when  developing  climate  change  related  adaptation  and  mitigation  measures  in  a 
variety of sectors. A more comprehensive, coherent and common approach needs to 
be  developed  for  supporting  European  Member  States  in  integrating  health  in  all 
climate change related mitigation and adaptation policies in other sectors.  

4. 

OPERATIONAL OBJECTIVES BY AREA 

4.1. 

Area 1: Health intelligence and awareness on climate change and health; 

In  Planning  and  implementing  research  and  monitoring  on  climate  change  and 
health, the following more operational objectives could be envisaged:  

4.1.1. 

Increasing joint planning and financial investments on research, on:  

• 

• 

• 

Health and social vulnerability, impact and adaptation assessment at regional, 
national and sub-national level; 

improved risk assessment (including scenarios) of the health effects of climate 
change and other environmental changes to inform decision-makers; 

comprehensive  evaluation  of  the  benefits  and  effectiveness  and  cost-
effectiveness  of  interventions  (including  co-benefits  for  health  of  mitigation 
and adaptation decisions and interventions in other sectors); 

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35 

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• 

• 

• 

effectiveness  of  climate  sensitive  infectious  disease  surveillance,  extreme 
events health action plans and other decision-support tools;  

Damage and adaptation costs;  

Social marketing, risk perception and risk communication; 

4.1.2.  Extending the Climate change and health monitoring systems 

• 

• 

• 

the ENHIS-integrated information platform 

the pilot EU wide monitoring of the climate change 

identified health indicators. 

4.1.3.  Climate change and health European wide communication strategy 

It  would  be  important  to  develop  a  harmonized  framework  at  EU  level  focusing  in 
particular at:  

• 

• 

• 

• 

• 

• 

Targeting different communities e.g. policy, science, public; 

Expanding  interaction  and  dialogue  with  stakeholders  through  dialogue 
workshops;  

Expanding the use of existing health information instruments and cooperation 
with journalists through European wide training;  

Enhancing  preparedness  for  crises  communication  (e.g.  have  communication 
material  ready  on  cold  waves  for  winter;  heat  waves  for  summer;  or  on 
potential disease outbreaks);  

Building on existing frameworks, tools and processes, e.g. weather warning in 
TV news; 

Exploring  the  use  of  the  European  information  platform  for  non-specialised 
users and innovative communication instruments. 

4.1.4.  Climate change and health information platform 

In order to properly feed the existing EU clearinghouse, it is planned to develop:  

• 

• 

• 

• 

• 

practical  tools  for  health  impact,  vulnerability  and  adaptation  assessments, 
health  impact  assessment  of  mitigation  and  adaptation  measures,  effective 
public  health  adaptation,  effective  preventive  measures,  economic  tools  for 
damage and adaptation health costs evaluation;  

preparedness and response actions for extreme events;  

early  warning  on  extreme  weather  events  and  potential  infectious  disease 
threats,  as  well  as  relevant  models  of  preparedness  and  response  or  action 
plans; 

adaptation/mitigation  measures  for  assessment  of  the  health  co-benefits  of 
adaptation and mitigation measures and identification of best practices; 

thorough  indicator  assessments  on  climate,  environment  and  health  impacts 
and response measures; 

4.2. 

Area 2: Integration of climate change into public health policies and action 

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4.2.1. 

Integrating  climate  change  into  EU  Generic  Preparedness  Planning  and  policies  on 
trans-boundary threats 

• 

• 

• 

• 

Revise  current  integration  of  climate  change  into  preparedness  and  response 
planning and collect good practices; 

Update comparable and coherent generic preparedness and response planning;  

Develop  and  agree  shared  standards  and  tailor-made  EU  criteria  for 
notification;  

To  revise  risk  assessment,  management  and  communication  practices  on 
climate change inclusion and agree on mechanisms for reinforced coordination 
among existing structures; 

• 

To provide public health advice at EU level in coordination with the WHO. 

4.2.2.  Strengthening  climate–sensitive  disease  surveillance  and  health  targeted  related 

weather early-warning 

• 

• 

Explore  necessity  to  reinforce  compulsory  disease  reporting  and  explore 
advantages/disadvantages  of  current  systems  and  agree  on  mechanisms  for 
reinforced coordination among existing structures;  

Analyse  weather  early  warning  for  its  applicability  in  seasonal  or  short  term 
health early warning. 

4.2.3.  Developing a European training module on climate change and health 

• 

• 

Develop a European training module based on a revision of current systems in 
place and pilot test it;  

Explore  means  of  communication  and  potential  inclusion  into  professional 
qualification. 

4.2.4.  Developing  harmonized  guidance  and  assessment  procedures  on  greener  and  more 

sustainable and safer health services  

• 

• 

Revise  current  advice  existing  and  identify  essential  elements,  develop  the 
guidance and test in pilot areas; 

Cooperate  with  various  EU  agencies  in  standard  setting,  to  develop  essential 
input criteria and agree on mechanisms for reinforced coordination. 

4.2.5.  Understanding  health  systems  transformational  change  towards  full  health  systems 

adaptation and sustainability 

• 

• 

Develop a series of dialogue workshops of European Health system leaders, to 
identify which transformational changes are requires; 

To revise innovation potential, standards and behavioural measures necessary 
to achieve a transformational change.  

4.3. 

Area  3:  Integration  of  health  into  climate  change  related  adaptation  and  mitigation 
policies 

To  support  European  Member  States  in  integrating  health  in  all  climate  change 
related  mitigation  and  adaptation  policies  in  other  sectors,  the  following  initiatives 
might be required:  

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• 

• 

• 

• 

Reinforce  the  impact  assessment  guidelines  with  greater  emphasis  on  health 
and equity in adaptation and mitigation policies; 

Support pilot projects and collect lessons learnt and best practices;  

Identify  how  certain  healthy  practices  (such  as  healthy,  energy-efficient 
buildings and renewable energy) improved outdoor and indoor air quality and 
allowed innovative production practices to be developed; 

Ensure  that  health  is  properly  addressed  in  national  and  European  adaptation 
strategies through the development of national/European action plans.  

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