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ConclusionsĬlimate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent.

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In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions. The highest effect was observed for respiratory diseases and among women aged 75-84 years. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality) than in North Continental (+ 12.4%) cities. The increase was up to 3-times greater during episodes of long duration and high intensity. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The effect of heat waves showed great geographical heterogeneity among cities. City specific and pooled estimates by gender, age and cause of death were calculated.

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The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years.

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Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-20, separately, accounting for heat wave duration and intensity.













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