Paper Reviewed
Carmona, R., Diaz, J., Miron, I.J., Ortiz, C., Leo, I. and Linares, C. 2016. Geographical variation in relative risks associated with cold waves in Spain: The need for a cold wave prevention plan. Environment International 88: 103-111.

In setting the stage for reporting their study of this important topic, Carmona et al. (2016) make a point of noting that "studies undertaken in the United Kingdom, Australia and the Netherlands indicate that cold-related deaths are an order of magnitude greater than those related to heat," citing Vardoulakis et al. (2014) and Huynen et al. (2001), while further noting that the life-robing effect of low temperatures at ground level is "20 times, and in the case of Spain, 5 times greater than that of heat," citing the work of Gasparrini et al. (2015).

In their more recent study of the subject, the six Spanish scientists determined the impact of daily minimum temperatures on mortality in each of Spain's 52 provincial capitals; and they report that this effort revealed relative cold-induced mortality increases of 1.13 due to natural causes, 1.18 due to circulatory causes, and 1.24 due to respiratory causes, which numbers they found to be "slightly greater than those obtained to date for heat."

In commenting on their findings, Carmona et al. state that in the case of Spain, and "from a public health standpoint, there is a need for specific cold wave prevention plans at a regional level which would enable mortality attributable to low temperatures to be reduced." And with the gowning number of studies that have revealed a warming of the globe over the course of the past century or so, it can be appreciated that this phenomenon is just what the doctor ordered -- see Health Effects (Temperature - Hot vs. Cold Weather) in our Subject Index -- as it produces a greater warming of nighttime minimum temperatures than it does of daytime maximum temperatures, which two-fold phenomenon is said by Carmona et al. to be "essential for reducing cold-related effects on morbidity and mortality," which are typically far more numerous than are heat-related illness and death.

References
Gasparrini, A., Guo, Y., Hashizume, M., Lavigne, E., Zanobetti, A., Schwartz, J., Tobias, A., Tong, S., RocklÕv, J., Forsberg, B., Leone, M., De Sario, M., Bell, M.L., Guo, Y.L., Wu, C.F., Kan, H., Yi, S.M., de Sousa, Z., et al. 2015. Mortality risk attributable to high and low ambient temperature: a multi-country observational study. Lancet 386: 369-375.

Huynen, M.M., Martens, P., Schram, D., Weijenberg, M.P. and Kunst, A.E. 2001. The impact of heat waves and cold spells on mortality rates in the Dutch population. Environmental Health Perspectives 109: 463-467.

Vardoulakis, S., Dear, K., Hajat, S., Heaviside, C., Eggen, B. and McMichael, A.J. 2014. Comparative assessment of the effects of climate change on heat- and cold-related mortality in the United Kingdom and Australia. Environmental Health Perspectives 122: 1285-1292.