1. ΥΓΕΙΑ/ΔΥΓΕΙΑ/0609/BIE 20 Δέσμη Προγραμμάτων για Έρευνα, Τεχνολογική Ανάπτυξη και Καινοτομία 2009-2010», του Ιδρύματος Προώθησης Έρευνας (ΔΕΣΜΗ 2009-2010) συγχρηματοδοτείται από την Κυπριακή Δημοκρατία και το Ευρωπαϊκό Ταμείο Περιφερειακής Ανάπτυξης (ΕΤΠΑ). November 2 nd, 2011 Dr Edna Yamasaki Patrikiou University of Nicosia

3.  Climate change is the major environmental problem facing the globe.  World Health Organization - Health effects of global warming is one of the major problems of the century.

4.  In recent years, interest in the impact of weather on human health has increased ◦ Climatic change ◦ Correlation between extreme weather events and thermal stress to populations  Specifically ◦ Larger temperature fluctuations, resulting in increased occurrence of heat waves and cold spells in certain regions.  The thermal stress caused by the increased intensity, frequency and duration of such phenomena is expected to lead to an increase in heat related mortality and morbidity in southern Europe, Middle East and North Africa.

5.  Populations tend to adapt to the local prevailing climate through physiological, behavioral, cultural and technological responses,  HOWEVER extreme weather events may stress populations beyond their adaptation limits.

6.  Impacts of climate on human health will not be evenly distributed around the world. ◦ Greatest in urban areas - urban heat island effect, city geographical location, housing conditions. ◦ Affecting elderly and sick people, who have diminished physiological capacity for thermoregulation, pregnant women, children and workers in thermally stressful fields.

7.  There is an optimum temperature at which the daily death rate is at lowest.  Mortality rates rise at temperatures outside this comfort temperature range.  A U-shaped relationship between outdoor temperature and mortality has been reported in many studies in Europe and the USA.  Such a U-shaped trough represents the comfort zone, whereas the arms of the trough represent the mortality increase at extremely hot and cold temperatures.

8.  A U-shaped relationship between outdoor temperature and mortality has been reported in many studies in Europe and the USA.  Such a U-shaped trough represents the comfort zone, whereas the arms of the trough represent the mortality increase at extremely hot and cold temperatures. U

9.  Although in most industrialized countries, death rates are higher in winter months, a summer peak in mortality associated with heat waves has also been observed in several urban areas.  This has also been the case in typical Mediterranean urban environments such as Rome, Athens and Barcelona.

10.  Substantial research - effects of heat-waves on cardiovascular, cerebrovascular and respiratory diseases.  PHEWE project - a large-scale European study, including 30 million European citizens was the first to apply standardized scientific approaches to investigate the health effects of extreme weather and the role of several effect modifiers.

11.  However no similar research has been done so far for Cyprus, a typical Mediterranean environment which is well known for extreme thermal stress during summertime.

12. Our project aims at protecting public health and improving quality of life through Establishing the association between climate- change-driven extreme weather and acute health effects, in terms of daily death rates and hospital admissions in the warm season in Cyprus, and Developing a framework of innovative prevention and mitigation strategies to reduce the public health impact of thermal stress in Cyprus.

13. Through close co-operation between 3 multi- disciplinary groups:  (a) the epidemiology and statistics group,  (b) the meteorology and air quality group, and  (c) the public and environmental health group.

14. University of Nicosia Research Foundation (HO) Dr Edna Yamasaki Patrikiou Dr Haritini Tsangari Dr Zoi Konsoula Ms Stephani Christou Mr Haris Pavlides (IR) Environmental Service, Ministry of Agriculture, Natural Resources and Environment (PA1) Dr Theodoulos Mesimeris Ms Nikoletta Kythreodotou Department of Environmental Engineering, Democritus University of Thrace (PA2) Dr Anastasia Paschalidou Dr Glykeria Loupa Department of Physics, University of Ioannina (PA3) Dr Pavlos Kassomenos UK Health Protection Agency (PA4) Dr Sotiris Vardoulakis Dr Clare Heaviside

15.  Specifically, through the following actions: ◦ (a) the analysis of the meteorological data which will provide a synoptic classification index for meteorologically homogeneous days in terms of the prevailing air mass types, ◦ (b) the analysis of the mortality and hospital admission data related to respiratory, cardiovascular and cerebrovascular disease in Cyprus, ◦ (c) the detection of the potential synergies between thermal stress and air pollution variables on mortality and morbidity,

16.  Specifically, through the following actions: ◦ (d) the development of a HHWWS which will include validated algorithms for the predictions of heat stress-related mortality and morbidity and a set of protocols for the operation of the system, and ◦ (e) the analysis of public health implications, including a health impact assessment, a survey of current policies and practices, as well as a set of generic and tailored mitigation measures in the form of intervention plans.

17.  The protection of public health in urban areas in Cyprus, contributing significantly to the improvement of quality of life of the population and the enhanced management of health services.

18.  Additionally, the proposed HHWWS and guidelines could be fully exploited on an operational basis by the local policy-makers for the development of warning systems and intervention policies, as well as for harmonisation with relevant EU guidelines and directives.  Finally, the project will contribute to the technological development of Cyprus in the field of public health, and the dissemination of scientific knowledge to Cyprus through the development of a European network of experts.

19. https://earthobservatory.nasa.gov/NaturalHazards/view.php?id=10349

20. Dust blew off the coast of Turkey toward the island of Cyprus in late August 2008.