Climate change impacts on human health over Europe through its effect on air quality.

This review examines the current literature on the effects of future emissions and climate change on particulate matter (PM) and O air quality and on the consequent health impacts, with a focus on Europe. There is considerable literature on the effects of climate change on O but fewer studies on the effects of climate change on PM concentrations. Under the latest Intergovernmental Panel on Climate Change (IPCC) 5th assessment report (AR5) Representative Concentration Pathways (RCPs), background O entering Europe is expected to decrease under most scenarios due to higher water vapour concentrations in a warmer climate. However, under the extreme pathway RCP8.5 higher (more than double) methane (CH) abundances lead to increases in background O that offset the O decrease due to climate change especially for the 2100 period. Regionally, in polluted areas with high levels of nitrogen oxides (NO), elevated surface temperatures and humidities yield increases in surface O - termed the O climate penalty - especially in southern Europe. The O response is larger for metrics that represent the higher end of the O distribution, such as daily maximum O. Future changes in PM concentrations due to climate change are much less certain, although several recent studies also suggest a PM climate penalty due to high temperatures and humidity and reduced precipitation in northern mid-latitude land regions in 2100.A larger number of studies have examined both future climate and emissions changes under the RCP scenarios. Under these pathways the impact of emission changes on air quality out to the 2050s will be larger than that due to climate change, because of large reductions in emissions of O and PM pollutant precursor emissions and the more limited climate change response itself. Climate change will also affect climate extreme events such as heatwaves. Air pollution episodes are associated with stagnation events and sometimes heat waves. Air quality during the 2003 heatwave over Europe has been examined in numerous studies and mechanisms for enhancing O have been identified.There are few studies on health effects associated with climate change impacts alone on air quality, but these report higher O-related health burdens in polluted populated regions and greater PM health burdens in these emission regions. Studies that examine the combined impacts of climate change and anthropogenic emissions change under the RCP scenarios report reductions in global and European premature O-respiratory related and PM mortalities arising from the large decreases in precursor emissions. Under RCP 8.5 the large increase in CH leads to global and European excess O-respiratory related mortalities in 2100. For future health effects, besides uncertainty in future O and particularly PM concentrations, there is also uncertainty in risk estimates such as effect modification by temperature on pollutant-response relationships and potential future adaptation that would alter exposure risk.