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European seasonal mortality and influenza incidence due to winter temperature variability


Recent studies have vividly emphasized the lack of consensus on the degree of vulnerability (see ref. 1) of European societies to current and future winter temperatures. Here we consider several climate factors, influenza incidence and daily numbers of deaths to characterize the relationship between winter temperature and mortality in a very large ensemble of European regions representing more than 400 million people. Analyses highlight the strong association between the year-to-year fluctuations in winter mean temperature and mortality, with higher seasonal cases during harsh winters, in all of the countries except the United Kingdom, the Netherlands and Belgium. This spatial distribution contrasts with the well-documented latitudinal orientation of the dependency between daily temperature and mortality within the season. A theoretical framework is proposed to reconcile the apparent contradictions between recent studies, offering an interpretation to regional differences in the vulnerability to daily, seasonal and long-term winter temperature variability. Despite the lack of a strong year-to-year association between winter mean values in some countries, it can be concluded that warmer winters will contribute to the decrease in winter mortality everywhere in Europe.

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Figure 1: Year-to-year correlation between winter (December to March) mean temperature and mortality.
Figure 2: Triple relationship between temperature, influenza and mortality.
Figure 3: Regression coefficient between daily temperature and mortality for winter (December to March) days (daily cases per million per 1 °C).


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J.B. acknowledges funding from the European Commission and the Catalan Government (projects MEMENTO and 00068 from the FP7-PEOPLE-2011-IOF and BP-DGR-2014-B calls, respectively), and X.R. from the project EUPORIAS. We acknowledge climate data from the project ENSEMBLES, mortality data from the EU Community Action Programme on Public Health (grant agreement 2005114), and influenza data from The European Surveillance System of the European Centre for Disease Prevention and Control.

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J.B. took the lead role in the design of the study, analysed the data and wrote the manuscript. X.R. contributed to the discussion of results and to the revision of the manuscript. F.R.H. and J.-M.R. collected the set of daily regional numbers of deaths.

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Correspondence to Joan Ballester.

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The authors declare no competing financial interests.

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Ballester, J., Rodó, X., Robine, JM. et al. European seasonal mortality and influenza incidence due to winter temperature variability. Nature Clim Change 6, 927–930 (2016).

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