[Health protection during heat waves: European recommendations and experience in Hesse].

BACKGROUND: In the course of climate change periods of extreme heat will probably happen more frequently. The aim of heat health action plans is to prevent the health consequences of heat.

OBJECTIVES: The purpose of the present work is to develop a proposal for a heat health action plan for Hesse, Germany.

MATERIALS AND METHODS: In 34 interviews with experts the existing heat health warning system was evaluated. Heat health action plans of 8 European countries were analysed. On this basis a concept for a heat health action plan for Hesse was developed.

RESULTS: In Hesse only nursing homes take preventative measures reliably, other health care sectors act along varying individual criteria. Heat health action plans include a heat health warning system and measures. They arrange competences and risk communication. Local authorities are responsible for implementation. Some plans include a surveillance system of mortality or morbidity. In a heat health action plan for Hesse measures should be specified and adapted to specific needs on the local level. Physicians in outpatient clinics are in a key position having contact with the vulnerable group of the elderly.

CONCLUSION: A heat health action plan offers opportunities for effective prevention if responsibilities are defined and evaluated, and monitoring of mortality and morbidity is integrated. In the structures of the German health care system efforts to prevent heat-related illness cannot succeed without reliable participation of the outpatient medical system.