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Published March 14, 2023 | Version 1.0.0
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Temperature-related mortality exposure-response functions for 854 cities in Europe

  • 1. London School of Hygiene & Tropical Medicine


This repository contains data to reconstruct the exposure-response functions (ERF) of temperature-related mortality by five 5 age groups in 854 cities in Europe.

These ERFs have been derived in the study by Masselot et al. 2023, Excess mortality attributed to heat and cold: a health impact assessment study in 854 cities in Europe, The Lancet Planetary Health ( An associated semi-replicable GitHub repository is available at to reproduce part of the analysis and the full results, as well as to provide technical details on the derivation of these ERFs.

Extraction of the ERFs

The ERFs are provided as coefficients of B-spline functions that can be used to reconstruct the ERFs, along with variance-covariance matrices and quantiles from location-specific temperature distributions. The parametrisation associated with these coefficients is a quadratic B-spline (degree 2), with knots located at the 10th, 75th and 90th percentiles of the temperature distribution. In R, the associated basis can be constructed using the dlnm package, with a temperature series x, as follows:

basis <- onebasis(x, fun = "bs", degree = 2, knots = quantile(x, c(.1, .75, .9)))

The main files in this repo are the following:

coefs.csv: The B-spline coefficients for each age group and city.

vcov.csv: The variance-covariance matrix of the coefficients in each city and age group. It is provided here as the lower triangular part of the matrix with names indicating the position of each value (v[row][column]). In R, assuming x is a row of this file, the matrix can be reconstructed as follows.


coef_simu.csv: 1000 simulations from the distribution of each city and age-specific coefficients. Useful to derive empirical confidence intervals for derived measures such as excess deaths or attributable fractions.

tmean_distribution.csv: The city-specific temperature percentiles representing the distribution of the data derived from the ERA5-Land dataset.

city_results.csv: A summary of the results from the health impact assessment reported in the analysis. The dataset includes several impact measures for each city and age group.

metadata.csv: City-specific metadata used to create the ERFs and perform the health impact assessment.

In addition, this repo includes the zip file containing further data used to replicate the second stage of the analysis and the final health impact assessment. Please note that due to restrictive data-sharing agreements for the mortality series, only a part of the code is reproducible. See the associated GitHub repository for more details.


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Additional details

Related works

Is published in
Journal article: 10.1016/S2542-5196(23)00023-2 (DOI)


EXHAUSTION – Exposure to heat and air pollution in EUrope – cardiopulmonary impacts and benefits of mitigation and adaptation 820655
European Commission
Half a degree Additional warming: Prognosis and Projected Impacts on Health (HAPPI-Health) NE/R009384/1
UK Research and Innovation
Current and future temperature-related mortality and morbidity in the UK: a public health and climate change perspective MR/V034162/1
UK Research and Innovation