Climate change is known to affect deaths and hospitalizations associated with heat exposure in Europe. There is a broad epidemiological knowledge base on the future impacts of climate change. However, studies that formally attribute heat-related mortality and morbidity to climate change that has already occurred in the past century are rare. ATTACH contributes to the closing of this important research gap, with a special focus on recent European heatwaves. The project makes use of death count and hospitalization statistics from major cities in Germany, and combines state-of-the-art epidemiological approaches with an innovative approach to climate impact attribution. This novel approach derives counterfactual climate data, mimicking a world without climate change, from detrended observations.

1. Determine heatwave-related excess mortality in 15 major German cities during the period 1993 to 2016, and quantify the contribution of past-century climate change to the estimated excess mortality. This analysis will differentiate between age groups, sex, and causes of death.
2. Assess warm-season associations between heat and cause-specific hospitalizations in 15 major German cities during the period 2000 to 2016, and determine the contribution of past-century climate change to the magnitude of observed heat-attributable hospitalizations. The analysis will account for effect modification by ambient air pollution.

Epidemiological models:

• Time-series regression models including distributed lag non-linear models.
• Meta-analytical methods to pool city-specific results and to study longitudinal changes.

Climate data:

• century-long temperature records from measurement stations combined with novel detrending methods to construct climate counterfactuals

Marie Skłodowska-Curie Actions Postdoctoral Fellowship awarded by the European Commission (Grant ID: 101032087) (funding period: 2021-2025)

• Ludwig-Maximilians-Universität München, IBE-Chair of Epidemiology/Helmholtz Zentrum München, Institute of Epidemiology