Health risk assessment in the context of climate change

Abstract

Introduction The Republic of Moldova is highly vulnerable to climaterelated environmental risks that increasingly affect population health, particularly through the aggravation of non-communicable diseases. Climate change therefore represents a growing public health concern requiring evidence-based risk assessment and preventive interventions. Aim of the study To assess the impact of climate change-related environmental factors on population health in the Republic of Moldova, with a particular focus on health risk factors and implications for the prevention of non-communicable diseases. Material and methods A descriptive epidemiological study was conducted using monthly mean air temperature data and ambient air pollution indicators collected over the period 2002-2023 from three representative regions of the Republic of Moldova. Climate exposure variables comprised mean monthly air temperature and major ambient air pollutants (SO₂, NO₂, CO, hydrocarbons and total emissions). Health outcomes included general and cause-specific morbidity prevalence (per 10,000 population) for the same period. Pearson correlation analysis and descriptive comparisons between years with and without summer heat wave episodes were applied using aggregated annual and seasonal indicators. Results Mean general morbidity across all years was 11,195 per 10,000 population. In years with documented heat wave episodes, mean morbidity reached 11,395 per 10,000, compared to 10,806 per 10,000 in non-heat wave years, corresponding to an absolute increase of 589 per 10,000 (+5.5%). Cardiovascular disease prevalence ranged from 3,492 per 10,000 (2020) to 4,471 per 10,000 (2022), with a period mean of 4,041 per 10,000. Heat wave frequency showed a moderate positive correlation with general morbidity prevalence (r=0.39), while the association with cardiovascular morbidity was weak (r=−0.12). Mean annual temperature demonstrated weak correlations with general morbidity prevalence (r=0.22, p=0.680). In contrast, climate-related air pollution indicators exhibited strong associations with morbidity prevalence, particularly sulfur dioxide (r=0.93, p=0.006), nitrogen dioxide (r=0.90, p=0.013) and total air pollutants (r=0.84, p=0.035). Disease-specific analyses identified the highest correlation coefficients for cardiovascular, respiratory and endocrinemetabolic diseases (r up to 0.93), indicating a cumulative, environmentally mediated climate-health effect. Conclusion The analysis indicates a measurable association between heat wave frequency and increased population morbidity, supporting the relevance of heat-related climate hazards as a public health risk in the Republic of Moldova.