Heat-related emergency care in Flanders: current burden, future projections, monitoring

As climate change increases the frequency and intensity of extreme heat events, there is a growing need to quantify the associated health burden. This study assesses heat-related morbidity in Flanders across multiple outcomes, including emergency hospital admissions and ambulatory (non-hospitalized) emergency department visits, using data from 2016–2023. Heat–health relationships were estimated using quasi-Poisson Distributed Lag Non-Linear Models (DLNM) for the summer period (May–September), accounting for delayed effects up to 14 days, and additional analyses stratified by age group. The health burden was quantified using relative risks (RR), attributable fractions (AF), and attributable numbers (AN) above the minimum morbidity temperature and during extreme heat. Higher temperatures were linked to increased risks across a wide range of health outcomes, with varying magnitude. The strongest effects were observed for hospitalizations due to dehydration and kidney failure. Significant increases were also found for metabolic disorders, intestinal infections, several cardiovascular and respiratory diseases, acute urogenital conditions, and injuries related to accidents and trauma. In addition, ambulatory emergency department visits rose during hot days. Overall, across all heat-associated pathologies, an average of 2,390 emergency hospitalizations per summer were attributable to heat. Under a high-impact climate scenario (comparable to SSP5–8.5 in CMIP6), the summer heat-related health burden in Flanders is projected to more than double by 2050. Heat-attributable hospital admissions may rise to 4,800 per summer, or 5,800 when accounting for population growth and ageing, while ambulatory emergency department visits may reach 38,900 per summer (or 41,700 with demographic changes). These findings support the identification of vulnerable populations, targeted prevention strategies, emergency and hospital workload planning, and the development of heat–health indicators.

Key messages

• The risk of heat-related hospital admissions via emergency departments was estimated for different pathology groups using Distributed Lag Non-Linear Models (DLNM).

• Without adaptation measures, heat stress is expected to place a substantial burden on emergency departments, increasing both hospital admissions and ambulatory contacts for multiple pathology groups.