Indicator Specification

Extreme temperatures and health

Indicator Specification
  Indicator codes: CLIM 036
Published 20 Nov 2012 Last modified 20 Dec 2016
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Daily mortality rates in 15 European cities by apparent temperature in summer time

Assessment versions

Published (reviewed and quality assured)
  • No published assessments


Justification for indicator selection

Temperature affects human well-being and mortality. Both cold spells and heat waves have public health impact in Europe. Heat waves have caused much higher fatalities in Europe in recent decades than any other extreme weather event. For example, in Spain, extreme heat accounted for 1.6 % of all deaths in the warm seasons, and about 40 % of these deaths occurred in periods that would not be classified as heat waves, that is on isolated hot days. The largest effect was observed among the elderly, but in some cities younger adults were affected as well. Heat-related problems are largest in cities; among many interrelated factors, the urban heat island effect plays an important role. Future climate change is very likely to increase frequency, intensity and duration of heat waves. During hot weather, synergistic effects between high temperature and air pollution (PM10 and ozone) were observed. Long warm and dry periods in combination with other factors can also lead to forest fires which have shown to have severe health impacts.

Extreme cold can also significantly affect human health. Excess winter mortality in Mediterranean countries is higher than in northern European countries, and deaths often occur several days or weeks after the coldest day of a cold period.

Besides extreme temperature events, temperatures outside a local comfort temperature range are linked to increased mortality and other adverse health outcomes. Several studies found J-shaped exposure-response relationships with mortality and morbidity, increasing at both ends of the temperature scale. Effects of heat occur mostly on the same day and in the following three days whereas cold effects were largest 2–3 weeks after the event.

Scientific references

Indicator definition

  • Daily mortality rates in 15 European cities by apparent temperature in summer time


  • Logarithm of mortality rate

Policy context and targets

Context description

In April 2013 the European Commission presented the EU Adaptation Strategy Package ( This package consists of the EU Strategy on adaptation to climate change /* COM/2013/0216 final */ and a number of supporting documents. One of the objectives of the EU Adaptation Strategy is Better informed decision-making, which should occur through Bridging the knowledge gap and Further developing Climate-ADAPT as the ‘one-stop shop’ for adaptation information in Europe. Further objectives include Promoting action by Member States and Climate-proofing EU action: promoting adaptation in key vulnerable sectors. Many EU Member States have already taken action, such as by adopting national adaptation strategies, and several have also prepared action plans on climate change adaptation.

The European Commission and the European Environment Agency have developed the European Climate Adaptation Platform (Climate-ADAPT, to share knowledge on observed and projected climate change and its impacts on environmental and social systems and on human health; on relevant research; on EU, national and subnational adaptation strategies and plans; and on adaptation case studies.


No targets have been specified.

Related policy documents

  • Climate-ADAPT: Adaptation in EU policy sectors
    Overview of EU sector policies in which mainstreaming of adaptation to climate change is ongoing or explored
  • Climate-ADAPT: Country profiles
    Overview of activities of EEA member countries in preparing, developing and implementing adaptation strategies
  • DG CLIMA: Adaptation to climate change
    Adaptation means anticipating the adverse effects of climate change and taking appropriate action to prevent or minimise the damage they can cause, or taking advantage of opportunities that may arise. It has been shown that well planned, early adaptation action saves money and lives in the future. This web portal provides information on all adaptation activities of the European Commission.
  • EU Adaptation Strategy Package
    In April 2013, the European Commission adopted an EU strategy on adaptation to climate change, which has been welcomed by the EU Member States. The strategy aims to make Europe more climate-resilient. By taking a coherent approach and providing for improved coordination, it enhances the preparedness and capacity of all governance levels to respond to the impacts of climate change.

Key policy question

What are health effects of temperature extremes across Europe, and how are they changing?



Methodology for indicator calculation

City-specific estimates of the relevant parameters were obtained from 15 years (1990-2004) of data by specifying a marginal Poisson model for the daily count of deaths.

Methodology for gap filling

Not applicable

Methodology references

  • Baccini et al. (2008): Heat effects on mortality in 15 European cities Baccini, M., Biggeri, A., Accetta, G., Kosatsky, T., Katsouyanni, K., Analitis, A., Anderson, H. R., Bisanti, L., D'Ippoliti, D., Danova, J., Forsberg, B., Medina, S., Paldy, A., Rabczenko, D., Schindler, C. et al. (2008) Heat effects on mortality in 15 European cities. Epidemiology 19(5), 711–719.

Data specifications

EEA data references

  • No datasets have been specified here.

External data references

Data sources in latest figures



Methodology uncertainty

Not applicable

Data sets uncertainty

Attribution of health effects to climate change is difficult due to the complexity of interactions, and potentially modifying effects of a range of other factors (such as land use changes, public health preparedness, and socio-economic conditions). Criteria for defining a climate-sensitive health impact are not always well identified and their detection sometimes relies on complex statistical or modelling studies (e.g. health impacts of heat waves). Furthermore, these criteria as well as the completeness and reliability of observations may differ between regions and/or institutions, and they may change over time. Data availability and quality is crucial in climate change and human health assessments, both for longer term changes in climate-sensitive health outcomes, and for health impacts of extreme events. The monitoring of climate-sensitive health effects is currently fragmentary and heterogeneous. All these factors make it difficult to identify significant trends in climate-sensitive health outcomes over time, and to compare them across regions. In the absence of reliable time series, more complex approaches are often used to assess the past, current or future impacts of climate change on human health.

Further information on uncertainties is provided in Section 1.7 of the EEA report on Climate change, impacts, and vulnerability in Europe 2012 (

Rationale uncertainty

No uncertainty has been specified

Further work

Short term work

Work specified here requires to be completed within 1 year from now.

Long term work

Work specified here will require more than 1 year (from now) to be completed.

General metadata


Indicator code
CLIM 036
Version id: 2

Frequency of updates

Updates are scheduled every 4 years


DPSIR: Impact
Typology: Descriptive indicator (Type A - What is happening to the environment and to humans?)


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