This paper analyses how recent trends in heat waves impact heat warning systems. We performed a retrospective analysis of the challenges faced by the French heat prevention plan since 2004. We described trends based on the environmental and health data collected each summer by the French heat warning system and prevention plan. Major evolutions of the system were tracked based on the evaluations organized each autumn with the stakeholders of the prevention plan. Excess deaths numbering 8000 were observed during heat waves between 2004 and 2019, 71% of these between 2015 and 2019. We observed major changes in the characteristics, frequency and the geographical spread of heat waves since 2015. Feedbacks led to several updates of the warning system such as the extension of the surveillance period. They also revealed that risk perception remained limited among the population and the stakeholders. The sharp increase in the number of heat warnings issued per year since 2015 challenges the acceptability of the heat warnings. Recent heat waves without historical equivalent interfere with the development of evidence-based prevention strategies. The growing public health impacts heat waves emphasize the urgent need to act to adapt the population, at different levels of intervention, from individual comportments to structural modifications. A specific attention should be given to increase the resources allocated to the evaluation and the management of heat-related risks, especially considering the needs to catch with the rapid rhythm of the changing climate.

本文分析了热浪的最新趋势如何影响高温预警系统。我们对2004年以来法国高温预防计划所面临的挑战进行了回顾性分析。我们根据法国高温预警系统和预防计划每年收集的环境和健康数据描述了趋势。根据每年秋季与预防计划的利益相关者组织的评估，跟踪了该系统的主要演变。 2004 年至 2019 年间，热浪造成的超额死亡人数达到 8000 人，其中 71% 发生在 2015 年至 2019 年期间。我们观察到自 2015 年以来热浪的特征、频率和地理分布发生了重大变化。反馈导致了警告的多次更新延长监视期限等制度。他们还透露，民众和利益相关者的风险认知仍然有限。自2015年以来，每年发布的高温预警数量急剧增加，对高温预警的可接受性提出了挑战。最近没有历史对应的热浪干扰了循证预防策略的制定。热浪对公共卫生的影响日益严重，强调迫切需要采取不同程度的干预措施来适应人口，从个人行为到结构调整。应特别注意增加分配给热相关风险评估和管理的资源，特别是考虑到需要赶上气候变化的快速节奏。