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Objectives: To provide perspectives from the HEAT-SHIELD project (www.heat-shield.eu): a multi-national, inter-sectoral, and cross-disciplinary initiative, incorporating twenty European research institutions, as well as occupational health and industrial partners, on solutions to combat negative health and productivity effects caused by working on a warmer world.Methods: In this invited review, we focus on the theoretical and methodological advancements developed to combat occupational heat stress during the last five years of operation.Results: We outline how we created climate forecast models to incorporate humidity, wind and solar radiation to the traditional temperature-based climate projections, providing the basis for timely, policy-relevant, industry-specific and individualized information. Further, we summarise the industry-specific guidelines we developed regarding technical and biophysical cooling solutions considering effectiveness, cost, sustainability, and the practical implementation potential in outdoor and indoor settings, in addition to field-testing of selected solutions with time-motion analyses and biophysical evaluations. All recommendations were adjusted following feedback from workshops with employers, employees, safety officers, and adjacent stakeholders such as local or national health policy makers. The cross-scientific approach was also used for providing policy-relevant information based on socioeconomic analyses and identification of vulnerable regions considered to be more relevant for political actions than average continental recommendations and interventions.Discussion: From the HEAT-SHIELD experiences developed within European settings, we discuss how this inter-sectoral approach may be adopted or translated into actionable knowledge across continents where workers and societies are affected by escalating environmental temperatures.

The frequency of extreme heat events, such as the summer of 2003 in Europe, and their corresponding consequences for human beings are expected to increase under a warmer climate. The joint collaboration of institutional agencies and multidisciplinary approaches is essential for a successful development of heat-health warning systems and action plans which can reduce the impacts of extreme heat on the population. The present work constitutes a state-of-the-art review of 16 European heat-health warning systems and heat-health action plans, based on the existing literature, web search (over the National Meteorological Services websites) and questionnaires. The aim of this study is to pave the way for future heat-health warning systems, such as the one currently under development in the framework of the Horizon 2020 HEAT-SHIELD project. Some aspects are highlighted among the variety of examined European warning systems. The meteorological variables that trigger the warnings should present a clear link with the impact under consideration and should be chosen depending on the purpose and target of the warnings. Setting long-term planning actions as well as pre-alert levels might prevent and reduce damages due to heat. Finally, education and communication are key elements of the success of a warning system.

Existing heat-health warning systems focus on warning vulnerable groups in order to reduce mortality. However, human health and performance are affected at much lower environmental heat strain levels than those directly associated with higher mortality. Moreover, workers are at elevated health risks when exposed to prolonged heat. This study describes the multilingual "HEAT-SHIELD occupational warning system" platform (https://heatshield.zonalab.it/) operating for Europe and developed within the framework of the HEAT-SHIELD project. This system is based on probabilistic medium-range forecasts calibrated on approximately 1800 meteorological stations in Europe and provides the ensemble forecast of the daily maximum heat stress. The platform provides a non-customized output represented by a map showing the weekly maximum probability of exceeding a specific heat stress condition, for each of the four upcoming weeks. Customized output allows the forecast of the personalized local heat-stress-risk based on workers' physical, clothing and behavioral characteristics and the work environment (outdoors in the sun or shade), also taking into account heat acclimatization. Personal daily heat stress risk levels and behavioral suggestions (hydration and work breaks recommended) to be taken into consideration in the short term (5 days) are provided together with long-term heat risk forecasts (up to 46 days), all which are useful for planning work activities. The HEAT-SHIELD platform provides adaptation strategies for "managing" the impact of global warming.

Within the FP7 EUPORIAS project we have assessed the utility of dynamical and statistical downscaling to provide seasonal forecast for impact modelling in eastern Africa. An ensemble of seasonal hindcasts was generated by the global climate model (GCM) EC-EARTH and then downscaled by four regional climate models and by two statistical methods over eastern Africa with focus on Ethiopia. The five-month hindcast includes 15 members, initialised on May 1 st covering 1991–2012. There are two sub-regions where the global hindcast has some skill in predicting June–September rainfall (northern Ethiopia – northeast Sudan and southern Sudan - northern Uganda). The regional models are able to reproduce the predictive signal evident in the driving EC-EARTH hindcast over Ethiopia in June–September showing about the same performance as their driving GCM. Statistical downscaling, in general, loses a part of the EC-EARTH signal at grid box scale but shows some improvement after spatial aggregation. At the same time there are no clear evidences that the dynamical and statistical downscaling provide added value compared to the driving EC-EARTH if we define the added value as a higher forecast skill in the downscaled hindcast, although there is a tendency of improved reliability through the downscaling. The use of the global and downscaled hindcasts as input for the Livelihoods, Early Assessment and Protection (LEAP) platform of the World Food Programme in Ethiopia shows that the performance of the LEAP platform in predicting humanitarian needs at the national and sub-national levels is not improved by using downscaled seasonal forecasts.