Health impacts and vulnerable groups

Climate change has noticeable impacts on our health. Heatwaves, extreme weather events, air pollution, and emerging pathogens pose growing risks, especially for people who are already disadvantaged due to health, social factors, or age.

Particularly affected are older adults, young children, people with pre-existing conditions, socially disadvantaged groups, and individuals who work outdoors. These vulnerable groups face a higher risk of harm from climate-related stressors.

Below, you will find detailed information on each of the assessed risks.

Health Risks from Heat:

Heat Exhaustion:
Prolonged exposure to high temperatures can lead to the body overheating. Typical symptoms include heavy sweating, weakness, dizziness, discomfort, possibly headache or nausea, and a core body temperature of up to 39.9°C (measured with a thermometer).

Heat Stroke:
Heat stroke is a serious medical emergency. It can occur after intense exertion in the heat or as a progression from heat exhaustion. The body temperature rises to 40°C or higher, leading to altered consciousness, coma, and other severe health complications.

Dehydration and Electrolyte Imbalance:
Excessive sweating without adequate fluid intake can result in dehydration—meaning a lack of body fluids. This may cause low blood pressure and circulatory problems. The body also loses vital salts, which can lead to muscle cramps and, in rare cases, dysfunction of other organs.

Heat Cramps:
Heavy sweating during physical exertion in hot conditions can cause painful muscle cramps due to loss of fluids and salts.

Concentration and Mood Fluctuations:
Heat can cause irritability, restlessness, anxiety, and impair overall well-being. Concentration problems are also possible.

Poor Sleep:
When nighttime temperatures remain high, sleep can be disrupted, leading to fatigue and further health problems.

Skin Problems:
High temperatures can increase the risk of heat rashes and skin inflammation.

Food Poisoning:
Heat accelerates the spoilage of food, raising the risk of gastrointestinal illness from contaminated food.

Blood Sugar Issues:
In people with diabetes, both high and low blood sugar levels occur more frequently during heatwaves. This is due to changes in eating habits and increased absorption of short-acting insulin caused by enhanced skin blood flow.

Worsening of Cardiovascular Diseases:
Heat puts strain on the heart, as blood vessels dilate to release heat. The heart has to work harder to circulate blood, which can worsen conditions such as heart failure. Dehydration also thickens the blood, increasing the risk of clots, which can lead to heart attacks or thrombosis.

Worsening of Respiratory Diseases:
Air quality often deteriorates during hot weather, which can exacerbate respiratory conditions like asthma or COPD. Additionally, heat itself increases lung sensitivity.

 

 

Who Is Especially at Risk from Heat?

Certain groups are particularly vulnerable to heat-related health issues:

  • People with pre-existing conditions – such as cardiovascular disease, lung disease, kidney disease, diabetes, neurological conditions (e.g., dementia, Parkinson's), and psychiatric disorders (e.g., schizophrenia)

  • Older adults – their bodies are less efficient at cooling

  • Young children – their ability to regulate body temperature is not yet fully developed

  • Pregnant women – pregnancy adds extra strain on the body

  • Urban residents – heat tends to accumulate in built-up areas; inner cities can be several degrees warmer than surrounding rural areas

  • People with low income – they often have fewer resources to protect themselves (e.g., lack of air conditioning)

  • Outdoor workers – such as those in construction, agriculture, or delivery services

  • Homeless individuals – who often lack access to cool, sheltered spaces

Health Risks from Flooding:

Injury and Drowning Hazards:
Strong currents, debris, or slippery surfaces can lead to cuts, falls, broken bones, or even drowning.

Risk of Electrocution:
Floodwaters can damage power lines. Water in combination with electricity poses a life-threatening danger.

Disruptions in Essential Services:
Healthcare facilities may be damaged and roads impassable, making it difficult to access medical care or essential medications.

Mold in Buildings:
Moisture in homes can lead to mold growth, which may cause or worsen respiratory problems and allergies.

Psychological Stress:
People who lose their belongings or are forced to evacuate due to flooding may experience severe stress, anxiety, sleep disturbances, or even post-traumatic stress disorder (PTSD). Studies have also shown increases in depression and substance abuse after extreme weather events.

Hazardous Substances in the Environment:
In industrial areas, floods may release dangerous substances, posing a threat to human health and the environment.

Rodent-Related Disease Risk:
Flooding can drive rats and mice into homes in search of shelter, increasing the risk of diseases such as leptospirosis or hantavirus infections.

Increase in Mosquitoes and Disease Risk:
Puddles and standing water create ideal breeding grounds for mosquitoes, which can be a nuisance. Due to climate change, tropical mosquito species have already established themselves in some parts of Germany and may transmit diseases in the future.

Contaminated Water and Food:
Flooding can limit access to clean drinking water. Dirty water may contain pathogens that cause gastrointestinal illnesses or hepatitis A. Food may also become contaminated and unsafe to eat.

 

 

Who Is Especially at Risk from Flooding?

  • People with mobility or cognitive impairments – such as older adults or individuals with disabilities, who may struggle to reach safety without assistance

  • Individuals in direct contact with floodwaters – such as emergency responders or volunteers

  • Residents of flood-prone areas – especially those living near rivers or streams

Health Risks from Air Pollution:

Pollutants such as particulate matter (PM0.1, PM2.5, and PM10), nitrogen dioxide (NO₂), and ground-level ozone (O₃) are produced by traffic, industry, agriculture, natural processes, and chemical reactions. These substances enter the body through the air we breathe and can penetrate deep into the lungs and even into the bloodstream.

Short-Term Health Effects:

  • Irritation of the respiratory tract, coughing, shortness of breath

  • General discomfort during physical exertion

  • Worsening of pre-existing conditions such as asthma or chronic obstructive pulmonary disease (COPD)

Long-Term Health Risks:

  • Development and worsening of chronic respiratory diseases (e.g., COPD, asthma)

  • Increased risk of cardiovascular diseases (e.g., high blood pressure, heart attacks, strokes)

  • Higher risk of lung cancer with prolonged exposure

  • Specific risks during pregnancy, such as premature birth or stillbirth

  • Increased mortality among highly exposed population groups

 

Who Is Especially at Risk from Air Pollution?

  • People with respiratory diseases or heart conditions

  • Older adults and children

  • Outdoor workers – such as those in agriculture or construction

  • Individuals engaging in outdoor activities – since they inhale more air (and thus more pollutants) during physical exertion

  • Residents of areas with heavy traffic or industrial activity

Health Risks from Allergens:

Respiratory Symptoms:
Pollen can trigger sneezing, nasal congestion or runny nose, and coughing. In people with allergic asthma, exposure to pollen can provoke asthma attacks.

Eye Irritation:
Many individuals experience itchy, red, watery, or irritated eyes during pollen season – a condition known as allergic conjunctivitis.

General Complaints:
Allergies can cause fatigue, headaches, and sleep disturbances – often due to the constant immune response and impaired breathing. These symptoms can negatively affect concentration, performance, and overall quality of life.

Exposure to Animal-Origin Allergens:
The fine hairs of the oak processionary moth caterpillar contain a toxic protein (thaumetopoein) that can trigger severe allergic reactions upon contact with the skin or mucous membranes – such as rashes, breathing difficulties, eye irritation, or even allergic asthma.

 

 

Who Is Especially Affected?

  • Children and adults with allergies or allergic asthma

  • People who work outdoors, such as in agriculture or construction

  • Individuals with weakened immune systems, due to illness or medication

  • Smokers and residents of high-pollution areas – air pollutants can intensify allergic reactions

Health Risks from Vectors:

Tick-Borne Diseases:

  • Lyme disease: Transmitted by Ixodes ticks. Only about 1–2% of tick bites lead to symptoms. When infection occurs, a characteristic rash called erythema migrans often appears. Later complications can include nerve damage (neuroborreliosis) or joint problems (Lyme arthritis). Lyme disease occurs throughout Germany. Due to climate change, the period when ticks are active has lengthened, and some regions now have a year-round risk. There is currently no vaccine against Lyme disease.

  • Tick-borne encephalitis (TBE/FSME): Transmitted by various tick species. Often symptom-free or causing flu-like symptoms, but can lead to serious brain or spinal cord diseases such as meningitis or encephalitis. TBE risk areas have been expanding in recent years, partly linked to climate change. A current risk map is available here: https://www.rki.de/DE/Themen/Infektionskrankheiten/Infektionskrankheiten-A-Z/F/FSME/Karte.html. People who spend time in risk areas for work or leisure can protect themselves through vaccination.

 

Mosquito-Borne Diseases:

  • West Nile virus: Transmitted by native Culex mosquitoes in Germany. Symptoms include fever, headache, muscle pain, and in severe cases neurological diseases. Humans are usually dead-end hosts. Several human cases have occurred recently in Brandenburg.

  • Malaria: Transmitted by Anopheles mosquitoes. Causes high fever, chills, anemia, and can be fatal if untreated. Malaria is eradicated in Germany, and no re-emergence is currently expected.

  • Dengue fever: Transmitted by Aedes mosquitoes (e.g., Asian tiger mosquito). Symptoms include high fever, severe headaches, joint pain, rash, and mild bleeding. Due to establishment of the tiger mosquito, several hundred locally transmitted cases have occurred in Europe recently (mainly Italy, France, Spain). Isolated cases of local transmission in Germany are possible in the coming years. However, widespread outbreaks are unlikely due to good healthcare infrastructure.

  • Zika virus: Also transmitted by Aedes mosquitoes. Causes fever, rash, conjunctivitis, and joint pain. Particularly dangerous for pregnant women as it can cause birth defects. Only three local cases occurred in France in 2019; no current local transmission in Europe.

  • Chikungunya: Transmitted by Aedes mosquitoes. Causes fever and severe joint pain, rarely fatal. Occasional local transmissions have been reported in Europe.

 

Who Is Especially at Risk?

  • Young children: Their immune systems are not fully developed, making them more vulnerable to severe disease courses, e.g., dengue fever.

  • Older adults: Weaker immune responses and chronic illnesses can worsen outcomes of vector-borne diseases.

  • People who spend a lot of time outdoors: Farmers, foresters, construction workers are often exposed to mosquitoes and ticks, increasing their risk of infection.

Health Risks from Wildfires:

Injuries and Burns:
Direct contact with fire or intense heat can cause severe burns. Accidents such as bruises, wounds, or broken bones can also occur while fleeing from the fire.

Irritation of Eyes and Skin:
Smoke can cause burning, watery eyes. Skin contact with ash or fine dust can lead to redness or itching – existing skin conditions like eczema may worsen.

Inhalation of Smoke:
Smoke from wildfires contains tiny pollutants such as fine particulate matter, carbon monoxide, and other toxic gases. Inhaling it can cause coughing, throat and nasal irritation, shortness of breath, and carbon monoxide poisoning. Long-term exposure to poor air quality from frequent fires can promote chronic respiratory diseases.

Worsening of Existing Conditions:
People with asthma, COPD, or other lung diseases are particularly sensitive to smoke – their symptoms may significantly worsen.

Cardiovascular Problems:
Fine smoke particles can enter the bloodstream through the lungs, increasing the risk of heart attack, stroke, or other cardiovascular diseases.

Contaminated Water:
After a wildfire, ash and chemicals can enter water pipes or wells – this can degrade water quality and lead to health problems.

Psychological Stress:
Fear of an approaching fire and the psychological strain from evacuations or loss of home and possessions can cause anxiety disorders, depression, and post-traumatic stress disorders.

 

 

Who is especially at risk during wildfires?

  • People with limited mobility – e.g., elderly or disabled individuals

  • Emergency responders

  • Children and elderly people – as their airways are more sensitive

  • Pregnant women – because airborne pollutants can also affect the development of the unborn child

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