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Assessment and prevention of acute health effects of weather conditions in Europe, the PHEWE project: background, objectives, design

Paola Michelozzi1*, Ursula Kirchmayer1, Klea Katsouyanni2, Annibale Biggeri3, Glenn McGregor4, Bettina Menne5, Pavlos Kassomenos6, Hugh Ross Anderson7, Michela Baccini3, Gabriele Accetta1, Antonis Analytis2 and Tom Kosatsky5

Author Affiliations

1 Department of Epidemiology Local Health Authority Roma E, Rome, Italy

2 Department of Hygiene & Epidemiology, University of Athens Medical School, Athens, Greece

3 Department of Statistics, University of Florence, Florence, Italy

4 Department of Geography, King's College London, London, UK

5 WHO, Regional Office for Europe, Rome, Italy

6 Department of Astrogeophysics, University of Joannina, Joannina, Greece

7 Division of Community Health Sciences, St. George's, University of London, UK

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Environmental Health 2007, 6:12  doi:10.1186/1476-069X-6-12

Published: 24 April 2007



The project "Assessment and prevention of acute health effects of weather conditions in Europe" (PHEWE) had the aim of assessing the association between weather conditions and acute health effects, during both warm and cold seasons in 16 European cities with widely differing climatic conditions and to provide information for public health policies.


The PHEWE project was a three-year pan-European collaboration between epidemiologists, meteorologists and experts in public health. Meteorological, air pollution and mortality data from 16 cities and hospital admission data from 12 cities were available from 1990 to 2000. The short-term effect on mortality/morbidity was evaluated through city-specific and pooled time series analysis. The interaction between weather and air pollutants was evaluated and health impact assessments were performed to quantify the effect on the different populations. A heat/health watch warning system to predict oppressive weather conditions and alert the population was developed in a subgroup of cities and information on existing prevention policies and of adaptive strategies was gathered.


Main results were presented in a symposium at the conference of the International Society of Environmental Epidemiology in Paris on September 6th 2006 and will be published as scientific articles. The present article introduces the project and includes a description of the database and the framework of the applied methodology.


The PHEWE project offers the opportunity to investigate the relationship between temperature and mortality in 16 European cities, representing a wide range of climatic, socio-demographic and cultural characteristics; the use of a standardized methodology allows for direct comparison between cities.