Spain has just emerged from a heatwave that engulfed Madrid, Barcelona and Zaragoza, posing a health threat which extends far beyond the actual temperature, according to Julio Diaz, a researcher at Madrid's Carlos III Health Institute. Isn't heat what kills during a heatwave? "The impact of heat on health is far more than just temperature..

. its effect can be felt across income levels, age groups, socio-economic conditions, healthcare, and different cultural approaches to heat," says Diaz. "We divided Spain into 182 regions.

.. and in each one, we worked out the temperature at which people start to die as a result of the heat.

In Seville, 40 degrees Celsius is not even classed as a heatwave, whereas in A Coruna (in northwestern Spain), the temperature which defines a heatwave is 26 degrees. "When there is a heatwave, only 3.0 percent of mortality is due to heat stroke.

Heat kills by aggravating other illnesses." Why are the first heatwaves the most deadly? "In the first heatwave (of the year) much more people are likely to be susceptible (to death) than the second because it claims the frailest, leaving fewer susceptible people in the second and fewer still in the third..

. That's why the first heatwave always has a greater impact on mortality. This is what in epidemiology we call the 'harvest effect.

'" Why are living standards a factor? "It's clear that the impact of heat is much greater in poorer neighborhoods. It is not the same thing to experience a heatwave in a room with .