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Adverse health effects from extreme heat remain a major risk, especially in a changing climate. Several European countries have implemented heat health action plans (HHAPs) to prevent ill health and excess mortality from heat. This paper assesses the state of implementation of HHAPs in the WHO European Region and discusses barriers and successes since the early 2000s. The results are based on a web-based survey among 53 member states on the current national and federal HHAPs in place. Guided by the eight core elements of HHAPs as outlined by the WHO Regional Office for Europe guidance from 2008, we analyzed which elements were fully or partially implemented and which areas of improvement countries identified. HHAP adaptations to account for COVID-19 were sought via literature search and expert consultations. 27 member states provided information, of which 17 countries reported having a HHAP. Five out of eight core elements, namely agreement on a lead body, accurate and timely alert systems, heat-related health information plans, strategies to reduce health exposure, and care for vulnerable groups, were at least partially implemented in all 17 plans. Alert systems were implemented most often at 94%. The least often implemented items were real-time surveillance, long-term urban planning, and preparedness of health and social systems. Five countries had published COVID-19 guidance online. Our findings suggest a progressive improvement in the development and rollout of HHAPs overall and awareness of vulnerable population groups in WHO/Europe, while integration of HHAPs into long-term climate change and health planning remains a challenge. [ABSTRACT FROM AUTHOR]

This paper reviews the knowledge on effects of climate change on agricultural productivity in Europe and the consequences for policy and research. Warming is expected to lead to a northward expansion of suitable cropping areas and a reduction of the growing period of determinate crops (e.g. cereals), but an increase for indeterminate crops (e.g. root crops). Increasing atmospheric CO2 concentrations will directly enhance plant productivity and also increase resource use efficiencies.In northern areas climate change may produce positive effects on agriculture through introduction of new crop species and varieties, higher crop production and expansion of suitable areas for crop cultivation. Disadvantages may be an increase in the need for plant protection, the risk of nutrient leaching and the turnover of soil organic matter. In southern areas the disadvantages will predominate. The possible increase in water shortage and extreme weather events may cause lower harvestable yields, higher yield variability and a reduction in suitable areas for traditional crops. These effects may reinforce the current trends of intensification of agriculture in northern and western Europe and extensification in the Mediterranean and southeastern parts of Europe.Policy will have to support the adaptation of European agriculture to climate change by encouraging the flexibility of land use, crop production, farming systems etc. In doing so, it is necessary to consider the multifunctional role of agriculture, and to strike a variable balance between economic, environmental and social functions in different European regions. Policy will also need to be concerned with agricultural strategies to mitigate climate change through a reduction in emissions of methane and nitrous oxide, an increase in carbon sequestration in agricultural soils and the growing of energy crops to substitute fossil energy use. The policies to support adaptation and mitigation to climate change will need to be linked closely to the development of agri-environmental schemes in the European Union Common Agricultural Policy.Research will have further to deal with the effect on secondary factors of agricultural production, on the quality of crop and animal production, of changes in frequency of isolated and extreme weather events on agricultural production, and the interaction with the surrounding natural ecosystems. There is also a need to study combined effects of adaptation and mitigation strategies, and include assessments of the consequences on current efforts in agricultural policy to develop a sustainable agriculture that also preserves environmental and social values in the rural society. [Copyright &y& Elsevier]