The Spanish heat paradox: temperatures soar but related deaths drop

By Manuel Ansede

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There is a striking paradox taking place in Spain: temperatures are rising, but there are fewer deaths linked to extreme heat. As the epidemiologist Julio Díaz, 61, points out, “it is not the bullet that kills us, but the speed at which it travels.” While temperatures are rising, with the maximum daily temperature in summer increasing by around 0.4ºC every decade, so is the threshold at which heat kills – currently by 0.6º C per decade. “It’s taking more and more heat for people to die,” he says.

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“In 2003 there was a brutal heat wave,” says Díaz, indicating the turning point. “In Spain, 6,600 people died in 15 days.” It was the summer that fans sold out in Paris and Rome and around 70,000 Europeans died. To avoid this happening again, in 2004 the Spanish Health Ministry launched a national plan that introduced preventive measures and these measures have been activated every summer since. Some of the recommendations may seem obvious, such as drinking plenty of water and avoiding physical activity in the sun, but they work. Now, heat waves kill about 1,300 people a year, a figure similar to that of deaths from cold snaps, which kill about 1,050 people a year.

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Both Díaz and Linares stress that heat does not usually kill directly. In 2003, only 140 of the 6,600 deaths were due to heat stroke. Most of the deaths involved elderly people with underlying diseases that were exacerbated by the unusually high temperatures. Linares points out that some kinds of medication, such as those administered for Parkinson’s disease or Alzheimer’s, can aggravate dehydration and heat stroke.

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