ROME -- At least 4,175 more elderly Italians died this summer compared with the same period last year, Italy said Thursday, in its first official report on the number of deaths related to the blistering heat wave that swept through Europe.
The toll was the second-highest after France, where the government reported a startling 11,435 deaths. The Italian Health Ministry warned the figure could go as high as 5,000 once all data are in.
While stopping short of blaming the deaths entirely on the heat, officials stressed the scorching temperatures played a key role.
"The relationship between heat and mortality can certainly be established," said Enrico Garaci, president of the ministry's Superior Health Institute, which compiled a report based on mortality data from Italy's 21 largest cities that was expanded to a national estimate.
Garaci said the heat may have directly caused some deaths and worsened existing illnesses and conditions. Health officials were still studying the data.
The institute estimated 34,071 people over 65 died nationwide from July 16 to Aug. 15, compared to 29,896 in 2002 -- a 14 percent increase.
Looking at people of all ages in the 21 cities, the report said 2,244 more people died compared with last year, up 36 percent. It did not estimate the total national death toll for people of all ages.
Health Minister Girolamo Sirchia said the typical victim was old and already ill, lived alone in a small home with no air conditioning, and had a low income. He placed part of the blame on lack of assistance for the aged during Italy's vacation period.
, when residents flood out of cities by the millions and doctors can be hard to find.
Sirchia acknowledged social services were unprepared to cope with the emergency.
"We need to create ... a system of active surveillance for the elderly," he said.
Social workers must regularly visit old people when they are alone and assess their needs, he added.
Italian media had widely reported the death toll rose dramatically this summer, when temperatures soared into the 100s in many parts of the country. But health officials initially refused to release data on deaths, saying it was impossible to determine if heat was the cause.
The government changed course late last month, following an outcry over the high figures reported by France. In addition to the French government estimate, the country's leading undertaker has said the death toll was as high as 15,000.
The deaths in France sparked a political uproar over who was to blame, with calls for the health minister to resign. The government blamed the deaths on hospital understaffing during summer holidays, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.
The Italian report said the north of the country suffered most from the heat wave, because people there are less used to extreme heat. It singled out Turin as the city with the worst record, with an 87 percent increase in elderly deaths compared with last year. Some 824 died there as opposed to 441 in the same period in 2002.
Turin had an average temperature of 93 degrees during the first two weeks of August, about 16 degrees higher than the same period last year, the report said.
Milan, Bologna, Rome and the central mountainous town of L'Aquila also registered high numbers of elderly deaths.
Elsewhere in Europe, Spain has reported 100 victims, while Portugal lowered its initial estimate of 1,300 to just four. Dutch authorities estimated 1,000 to 1,400 deaths. In Britain, there were 907 more deaths registered during the week ending Aug. 15, compared to the average from the same period over the previous five years.
German authorities have reported about 40 deaths, and in Belgium -- which registered its hottest summer since at least 1833 -- initial reports from hospitals indicate 150 more deaths between July 1 and Aug. 15 than the same period last year.