In the Netherlands, between 1400 and 2200 deaths in the summer of 2003 may have been heat-related. The fact that the maximum temperatures were lower than in some other European countries, and occurred in less heavily populated areas, may have led to mortality figures that were relatively less dramatic. The temporarily increased death rates are only partly due to a forward shift of mortality. Heat-related mortality was most pronounced among the elderly in nursing homes. (R.A.)