Healthcare organizations under heat stress: Risk assessment and solutions in Austria

The increase in the number of heat days caused by climate change leads to intensified thermal heat stress for the human population, especially for vulnerable groups such as the elderly, children, and people with chronic illnesses. As climate change progresses, the demand for healthcare services will rise sharply in the coming years, considering that the number of heat days (Tmax > 30 °C) and tropical nights (Tmin > 20 °C) has already doubled or tripled in recent decades in Austria.

A transdisciplinary team of health, climate, and complexity scientists is needed to comprehensively investigate the effects and risks of climate change, with the focus on heat, on the health system. In a first step, the correlations between meteorological conditions (temperature, humidity, etc.) and health outcomes are analysed. To assess the effect of heatwaves on hospital admissions and deaths, data of daily maximum temperature, deaths, and hospital admissions per care region in Austria for the months June-September of the period 2007-2019 are used. In the detailed analyses, various definitions of heat waves, latency periods, and other factors are examined.

The investigated correlations between prevailing climate conditions and their effects on health are used to investigate future climate scenarios with respect to their conditions. Thus, projections can be made about imminent risks for people and consequently healthcare organisations. For this purpose, the different impacts of heat stress on staff, clients and management assessed with the participating healthcare organizations of the research project. Climate impact chains are developed and applied to ensure a systemic understanding of the risk, exposure and vulnerabilities. Derived adaptation measures  are subsequently identified at an institutional level. In addition, areas are identified in which the institutions have no influence and need support, for example through urban planning (e.g. greening and unsealing of outdoor areas not owned by the institutions, shaded path to an existing cooling center).

The results of the correlation analysis show significantly higher risk ratios for deaths in hospitals and for hospital admissions during heatwaves. This applies both to the population as a whole and to elderly people (>= 75 years). However, the increased burden is not only noticeable for clients, but also for healthcare staff, as analysed with the healthcare organisations within climate impact chains. The results indicate that there are some fields of action in which the institutions can take measures, such as regular training on the topic of heat, adapted uniforms, or adapting work processes and medication during heatwaves.

However, there are also areas in which healthcare organisations are dependent on the support and implementation of measures at city/regional level. For example, Nature-based solutions (Nbs) such as large-scale greening and unsealing are measures to reduce heat stress in the long term, thus reducing the strain on people – positively impacting health conditions. Furthermore, outdoor retreats are created in this way, reducing the burden of poor living standards.