Extreme temperatures are an emerging public health concern in the Mediterranean, yet their full impact remains underexplored. Our study investigates the public health impacts of both heat and cold extremes in Cyprus, a Mediterranean country increasingly affected by climate variability.
While heatwaves during summer months are becoming more frequent and better studied, cold spells—though less common—continue to pose significant and often overlooked health risks. Using high resolution climate data alongside national mortality and hospitalization records from 2004 to 2019, we applied advanced statistical models—including Distributed Lag Non-Linear Models (DLNMs) and Generalized Additive Models (GAMs) — to quantify health risks across seasons. Heatwave and coldwave events were identified through a detailed climatological analysis of long-term temperature data. The health impact analysis captures both the immediate and delayed effects of temperature extremes and evaluates how prolonged heatwaves and coldwaves influence health outcomes. We assessed impacts across major health causes, including cardiovascular, respiratory, diabetes and cancer-related conditions. This is the first study in Cyprus to jointly assess mortality and hospitalizations across a wide range of causes and seasons, offering a comprehensive view of how temperature variability affects population health in a climate-sensitive region.