The Report That No One Wants To Read Because It's Not Political Like You Want It To Be said:
Across the 854 urban areas in Europe, we estimated an annual excess of 203 620 (empirical 95% CI 180 882–224 613) deaths attributed to cold and 20 173 (17 261–22 934) attributed to heat.
Across the 30 countries, we estimated an annual average excess of 203 620 (empirical 95% CI 180 882 to 224 613) deaths due to cold and 20 173 (17 261 to 22 934) due to heat, which amount to attributable fractions of 7·01% (6·23 to 7·73) and 0·69% (0·59 to 0·79), respectively.
For both cold and heat, the effect was noticeably larger for the oldest age group, with 82 (72 to 91) and seven (six to eight) excess deaths per 100 000 person-years.
In contrast, there was around one death per 100 000 person-years in the youngest age group for cold, and less than one per 100 000 person-years for heat.
Cold-related standardised excess rates are important in the eastern-most countries as well as the UK and Ireland, with a maximum of 353 (empirical 95% CI 272–429) deaths per 100 000 person-years in Vidin (Bulgaria). Regarding heat-related effects, there was a clear northwest–southeast gradient, with relatively small standardised excess rates in Ireland and the UK, but large standardised excess rates in the southeastern countries. The highest heat-related standardised excess death rate was 58 (37–76) per 100 000 person-years in Osijek (Croatia).
Results indicated large vulnerability differences between ages and low vulnerability to cold for younger ages, indicated by lower MMPs and a flatter exposure–response function at lower percentiles. The vulnerability to heat also increased with age, although the difference was less steep than it was for cold, suggesting that the effect of heat affected all ages more homogeneously. Overall, the population aged older than 85 years contributed around 60% of the total mortality burden.