Materiały źródłowe

• #1 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Estimating the public health impact of extreme heat is difficult because healthcare providers are not required to report heat-related illnesses. In the United States, from 2006 to 2010, there were at least 3332 deaths attributed to heat stroke. However, these numbers are believed to be largely under-reported. Mortality correlates with the degree of body temperature elevation, time to initiate cooling, and the number of organ systems affected. […] Patients presenting with heat stroke have high mortality depending on the etiology of the presentation. However, the death rate from exertional heat stroke is relatively low (3 to 5%) compared to classic heat stroke (10 to 65%). The increased mortality rate is likely due to the higher prevalence of comorbidities and older age in the classic population. If immediate rapid cooling is successful, there has been a zero-fatality rate for young exertional heat-stroke patients.

• #2 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Estimating the public health impact of extreme heat is difficult because healthcare providers are not required to report heat-related illnesses. In the United States, from 2006 to 2010, there were at least 3332 deaths attributed to heat stroke. However, these numbers are believed to be largely under-reported. Mortality correlates with the degree of body temperature elevation, time to initiate cooling, and the number of organ systems affected. […] Patients presenting with heat stroke have high mortality depending on the etiology of the presentation. However, the death rate from exertional heat stroke is relatively low (3 to 5%) compared to classic heat stroke (10 to 65%). The increased mortality rate is likely due to the higher prevalence of comorbidities and older age in the classic population. If immediate rapid cooling is successful, there has been a zero-fatality rate for young exertional heat-stroke patients.

• #3 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Estimating the public health impact of extreme heat is difficult because healthcare providers are not required to report heat-related illnesses. In the United States, from 2006 to 2010, there were at least 3332 deaths attributed to heat stroke. However, these numbers are believed to be largely under-reported. Mortality correlates with the degree of body temperature elevation, time to initiate cooling, and the number of organ systems affected. […] Patients presenting with heat stroke have high mortality depending on the etiology of the presentation. However, the death rate from exertional heat stroke is relatively low (3 to 5%) compared to classic heat stroke (10 to 65%). The increased mortality rate is likely due to the higher prevalence of comorbidities and older age in the classic population. If immediate rapid cooling is successful, there has been a zero-fatality rate for young exertional heat-stroke patients.

• #4 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  In the United States, heat waves claim more lives each year than all other weather-related exposures combined (hurricanes, tornadoes, floods, and earthquakes). According to the Centers for Disease Control and Prevention (CDC), from 2004-2018, an average of 702 heat-related deaths occurred in the United States annually. This timeframe included a total of 10,527 deaths resulting from exposure to heat-related conditions. Of these, approximately 90% occurred from May through September. Approximately one third (37%) occurred in Arizona, California, and Texas, despite these states comprising only 23% of the US population. Heat stroke and deaths from excessive heat exposure are more common during summers with prolonged heat waves. […] Heat stroke is uncommon in subtropical climates. The condition is recognized increasingly in countries that experience heat waves rarely (eg, Japan), and it commonly affects people who undertake a pilgrimage to Mecca, especially pilgrims who come from a cold environment. In 1998, one of the worst heat waves to strike India in 50 years resulted in more than 2600 deaths in 10 weeks. Unofficial reports described the number of deaths as almost double that figure.

• #5

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  Heat is an important environmental and occupational health hazard. Heat stress is the leading cause of weather-related deaths and can exacerbate underlying illnesses including cardiovascular disease, diabetes, mental health, asthma, and can increase the risk of accidents and transmission of some infectious diseases. Heatstroke is a medical emergency with a high-case fatality rate. […] The number of people exposed to extreme heat is growing exponentially due to climate change in all world regions. Heat-related mortality for people over 65 years of age increased by approximately 85% between 20002004 and 20172021. […] Between 20002019 studies show approximately 489 000 heat-related deaths occur each year, with 45% of these in Asia and 36% in Europe. In Europe alone in the summer of 2022, an estimated 61 672 heat-related excess deaths occurred. High intensity heatwave events can bring high acute mortality; in 2003, 70 000 people in Europe died as a result of the JuneAugust event. In 2010, 56 000 excess deaths occurred during a 44day heatwave in the Russian Federation.

• #6

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  Heat is an important environmental and occupational health hazard. Heat stress is the leading cause of weather-related deaths and can exacerbate underlying illnesses including cardiovascular disease, diabetes, mental health, asthma, and can increase the risk of accidents and transmission of some infectious diseases. Heatstroke is a medical emergency with a high-case fatality rate. […] The number of people exposed to extreme heat is growing exponentially due to climate change in all world regions. Heat-related mortality for people over 65 years of age increased by approximately 85% between 20002004 and 20172021. […] Between 20002019 studies show approximately 489 000 heat-related deaths occur each year, with 45% of these in Asia and 36% in Europe. In Europe alone in the summer of 2022, an estimated 61 672 heat-related excess deaths occurred. High intensity heatwave events can bring high acute mortality; in 2003, 70 000 people in Europe died as a result of the JuneAugust event. In 2010, 56 000 excess deaths occurred during a 44day heatwave in the Russian Federation.

• #7

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  Heat is an important environmental and occupational health hazard. Heat stress is the leading cause of weather-related deaths and can exacerbate underlying illnesses including cardiovascular disease, diabetes, mental health, asthma, and can increase the risk of accidents and transmission of some infectious diseases. Heatstroke is a medical emergency with a high-case fatality rate. […] The number of people exposed to extreme heat is growing exponentially due to climate change in all world regions. Heat-related mortality for people over 65 years of age increased by approximately 85% between 20002004 and 20172021. […] Between 20002019 studies show approximately 489 000 heat-related deaths occur each year, with 45% of these in Asia and 36% in Europe. In Europe alone in the summer of 2022, an estimated 61 672 heat-related excess deaths occurred. High intensity heatwave events can bring high acute mortality; in 2003, 70 000 people in Europe died as a result of the JuneAugust event. In 2010, 56 000 excess deaths occurred during a 44day heatwave in the Russian Federation.

• #8

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  Heat is an important environmental and occupational health hazard. Heat stress is the leading cause of weather-related deaths and can exacerbate underlying illnesses including cardiovascular disease, diabetes, mental health, asthma, and can increase the risk of accidents and transmission of some infectious diseases. Heatstroke is a medical emergency with a high-case fatality rate. […] The number of people exposed to extreme heat is growing exponentially due to climate change in all world regions. Heat-related mortality for people over 65 years of age increased by approximately 85% between 20002004 and 20172021. […] Between 20002019 studies show approximately 489 000 heat-related deaths occur each year, with 45% of these in Asia and 36% in Europe. In Europe alone in the summer of 2022, an estimated 61 672 heat-related excess deaths occurred. High intensity heatwave events can bring high acute mortality; in 2003, 70 000 people in Europe died as a result of the JuneAugust event. In 2010, 56 000 excess deaths occurred during a 44day heatwave in the Russian Federation.

• #9 Heat-related mortality in Europe during the summer of 2022 | Nature Medicine

  https://www.nature.com/articles/s41591-023-02419-z

  The aim of this study was to use epidemiological models to estimate the sex- and age-specific mortality burden associated with the record-breaking temperatures registered during the 14-week period between 30 May and 4 September 2022. […] Overall, we estimated 62,862 heat-related deaths in Europe in 2022; 61,672 of those deaths occurred between 30 May and 4 September. […] The results showed that there was a large increase in heat-related mortality during June-August 2022, approaching the record-breaking excess mortality of June-September 2003. […] The burden of heat-related mortality was higher among women. […] Despite the experience accumulated since 2003, and the excess mortality estimates captured by EuroMOMO and Eurostat in several European countries, the magnitude of the overall death toll received relatively little attention. […] The high heat-related mortality that Europe experienced during the summer of 2022 calls for national governments and relevant agencies in the European Union and continental levels to increase the ambition and effectiveness of heat prevention and adaptation plans with urgency.

• #10

  https://www.gov.uk/government/publications/heat-mortality-monitoring-reports/heat-mortality-monitoring-report-2023

  During summer 2023, there were an estimated 2,295 (95% confidence interval (CI): 1,681 to 2,910) deaths associated with the 5 periods of heat across the summer. […] UKHSA has published annual statistics on the impact of adverse heat episodes since 2016. […] For the first time, estimates of the years of life lost (YLL) from heat-associated mortality are also included in the report. […] During summer 2023, there were an estimated 2,295 (1,681 to 2,910) deaths associated with the 5 heat periods that occurred during the heat-health alerting season. […] Overall, the highest heat-associated deaths per one million population were seen in the Southeast region. […] Significant heat-associated deaths were observed in the 65-and-over age groups and in males and females. […] The recent trend of increasing number of HHAs being issued and heat-associated deaths has continued in 2023, as have other trends observed since the start of the COVID-19 pandemic, such as the shifting mortality baselines and underlying patterns in mortality. […] Despite the relatively cooler weather in 2023 than other recent summers, significant heat-associated mortality was still observed in 4 out of 5 of the heat episodes that occurred, including in short spells of heat lasting only 3 days and in heat episodes where only yellow HHAs were issued.

• #11 Heat Exhaustion and Heat Stroke Among Active Component Members of the U.S. Armed Forces, 2019-2023 | Health.mil

  https://health.mil/News/Articles/2024/04/01/MSMR-Heat-Illness-2024

  Heat illnesses can drastically affect both individual and unit readiness, and continue to contribute significantly to annual morbidity within the active component of the U.S. Armed Forces. […] The most serious types of heat illnesses, heat exhaustion and heat stroke, are occupational hazards associated with many of the military’s training and operational environments. These illnesses can typically be prevented by appropriate situational awareness, risk management strategies, along with effective countermeasures. In 2023, the crude incidence of heat stroke and heat exhaustion were 31.7 and 172.7 cases per 100,000 person-years, respectively. […] Ongoing surveillance of heat illnesses is necessary to determine if prevention guidelines and countermeasures are working, in addition to identifying high-risk groups and activities that may lead to heat illness. […] Maintaining regular heat illness surveillance helps identify the magnitude of the impact these conditions have on service member health, training, and force readiness.

• #12 Heat Exhaustion and Heat Stroke Among Active Component Members of the U.S. Armed Forces, 2019-2023 | Health.mil

  https://health.mil/News/Articles/2024/04/01/MSMR-Heat-Illness-2024

  Heat illnesses can drastically affect both individual and unit readiness, and continue to contribute significantly to annual morbidity within the active component of the U.S. Armed Forces. […] The most serious types of heat illnesses, heat exhaustion and heat stroke, are occupational hazards associated with many of the military’s training and operational environments. These illnesses can typically be prevented by appropriate situational awareness, risk management strategies, along with effective countermeasures. In 2023, the crude incidence of heat stroke and heat exhaustion were 31.7 and 172.7 cases per 100,000 person-years, respectively. […] Ongoing surveillance of heat illnesses is necessary to determine if prevention guidelines and countermeasures are working, in addition to identifying high-risk groups and activities that may lead to heat illness. […] Maintaining regular heat illness surveillance helps identify the magnitude of the impact these conditions have on service member health, training, and force readiness.

• #13 Results of Operating the 2023 Heat-related Illness Surveillance System

  https://eng.phwr.org/journal/view.html?pn=vol&uid=743&vmd=Full

  Since 2011, the Korea Disease Control and Prevention Agency has been operating a Heat-related Illness Surveillance System to monitor the occurrence of illnesses (such as heatstroke, heat exhaustion, heat cramps, heat syncope, and heat edema) caused by heat waves at approximately 500 emergency room-operating medical institutions nationwide during the summer. […] In 2023, 504 medical institutions participated in the Heat-related Illness Surveillance System, and during the operation period (May 20, 2023, to September 30, 2023), 2,818 patients were reported to have heat-related illnesses, of whom 32 were presumed to have died. The number of patients with heat-related illnesses increased by 80.2% compared with the previous year. […] The estimated number of deaths reported in 2023 was 32, a 255.6% increase from the previous year, and the cause of death was mainly heatstroke (90.6%). Health damage due to heat waves is expected to increase in the future. Therefore, information sharing regarding and monitoring the impact of heat waves on health are expected to become even more important.

• #14 Heat-Related Emergency Department Visits — United States, May–September 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7315a1.htm

  During the 2023 warm-season months (MaySeptember), rates of emergency department visits for heat-related illness substantially increased across several U.S. regions compared with previous years, especially among males and adults aged 1864 years. […] Heat-related illness will continue to be a significant public health concern as climate change results in longer, hotter, and more frequent episodes of extreme heat. By monitoring heat-related health impacts, public health agencies can detect trends in health care utilization rates, identify subpopulations at increased risk, and guide public health actions tailored to specific heat exposure levels. […] CDC examined emergency department (ED) visits associated with heat-related illness (HRI) from the National Syndromic Surveillance Program and compared daily HRI ED visit rates during the warm-season months (MaySeptember) of 2023 with those during 20182022.

• #15 Heat-Related Emergency Department Visits — United States, May–September 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7315a1.htm

  During the 2023 warm-season months (MaySeptember), rates of emergency department visits for heat-related illness substantially increased across several U.S. regions compared with previous years, especially among males and adults aged 1864 years. […] Heat-related illness will continue to be a significant public health concern as climate change results in longer, hotter, and more frequent episodes of extreme heat. By monitoring heat-related health impacts, public health agencies can detect trends in health care utilization rates, identify subpopulations at increased risk, and guide public health actions tailored to specific heat exposure levels. […] CDC examined emergency department (ED) visits associated with heat-related illness (HRI) from the National Syndromic Surveillance Program and compared daily HRI ED visit rates during the warm-season months (MaySeptember) of 2023 with those during 20182022.

• #16 Real-time surveillance of heat-related morbidity: Relation to excess mortality associated with extreme heat | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184364

  The impact of heat on mortality is well documented but deaths tend to occur after (or lag) extreme heat events, and mortality data is generally not available for timely surveillance during extreme heat events. […] Mortality data are generally not available for timely surveillance during extreme heat events. Emergency medical services (EMS) and emergency departments (ED) data, which have been used for near real time surveillance of influenza and other communicable diseases, have the potential to enable more timely surveillance of public health impacts during heat waves. […] Following a severe heat wave in 2006, syndromic surveillance of daily heat-related calls to EMS (determined by dispatchers) and heat-related visits to ED (based on chief complaint text) was implemented by the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) in 2007 and is actively monitored in NYC during the warm weather months from May 1 to September 30.

• #17 Heat stroke internet searches can be a new heatwave health warning surveillance indicator | Scientific Reports

  https://www.nature.com/articles/srep37294

  The impact of major heatwave shocks on population morbidity and mortality has become an urgent public health concern. […] Current heatwave warning systems suffer from a lack of validation and an inability to provide accurate health risk warnings in a timely way. […] Surveillance during heatwave conditions is of critical public health concern, in order to determine whether the heatwave is associated with an increase in mortality or morbidity so that appropriate public health actions can be taken. […] Current public health surveillance methods of heatwaves do not provide the information quickly enough to detect the increased number of adverse health outcomes in time to respond so its use is normally limited to retrospective analyses in order to better understand the relationship between heatwaves and health.

• #18 Heat stroke internet searches can be a new heatwave health warning surveillance indicator | Scientific Reports

  https://www.nature.com/articles/srep37294

  As a result, effective surveillance systems for adverse health effects during heatwaves are very rare despite the fact that prompt surveillance information during a heatwave may be of great benefit to public health. […] Recently, syndromic surveillance data have been used in heatwave health surveillance, such as by monitoring emergency department visits and calls to emergency or health services. […] Our study showed that the relationship between heat stroke internet searches and health outcomes is much higher than that between temperature and health outcomes. […] Therefore, heat stroke searches can be expected to largely avoid the two issues that led to Google Flu Trends prediction errors. […] Our study shows that heat stroke internet searching could form a new tool for confronting the challenge of heatwaves worldwide.

• #19 Using web data to improve surveillance for heat sensitive health outcomes | Environmental Health | Full Text

  https://ehjournal.biomedcentral.com/articles/10.1186/s12940-019-0499-x

  Elevated and prolonged exposure to extreme heat is an important cause of excess summertime mortality and morbidity. To protect people from health threats, some governments are currently operating syndromic surveillance systems. […] The barriers to establishing syndromic surveillance systems include a lack of resources to support time- and labor-intensive diagnostic and reporting processes, delay of official government data and results, and complexed or expensive procedures to gather health data from various sources, etc. […] Our findings suggest web data created by social medias and search engines could improve the current syndromic surveillance systems. In particular, heat-related illness and dehydration cases were positively related with web data. […] The goal of this study is to examine the relationship between social media messages/web search results and health outcomes, and ultimately improve upon models that only consider temperature.

• #20 Real-time surveillance of heat-related morbidity: Relation to excess mortality associated with extreme heat | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184364

  The impact of heat on mortality is well documented but deaths tend to occur after (or lag) extreme heat events, and mortality data is generally not available for timely surveillance during extreme heat events. […] Mortality data are generally not available for timely surveillance during extreme heat events. Emergency medical services (EMS) and emergency departments (ED) data, which have been used for near real time surveillance of influenza and other communicable diseases, have the potential to enable more timely surveillance of public health impacts during heat waves. […] Following a severe heat wave in 2006, syndromic surveillance of daily heat-related calls to EMS (determined by dispatchers) and heat-related visits to ED (based on chief complaint text) was implemented by the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) in 2007 and is actively monitored in NYC during the warm weather months from May 1 to September 30.

• #21 Climate Change Indicators: Heat-Related Deaths | US EPA

  https://www.epa.gov/climate-indicators/climate-change-indicators-heat-related-deaths

  It is difficult to determine if the United States has experienced a meaningful increase or decrease in deaths classified as heat-related over time. While dramatic increases in heat-related deaths are closely associated with the occurrence of hot temperatures and heat waves, deaths may not be reported as heat-related on death certificates and there is considerable year-to-year variability in the data.

• #22 Using web data to improve surveillance for heat sensitive health outcomes | Environmental Health | Full Text

  https://ehjournal.biomedcentral.com/articles/10.1186/s12940-019-0499-x

  Elevated and prolonged exposure to extreme heat is an important cause of excess summertime mortality and morbidity. To protect people from health threats, some governments are currently operating syndromic surveillance systems. […] The barriers to establishing syndromic surveillance systems include a lack of resources to support time- and labor-intensive diagnostic and reporting processes, delay of official government data and results, and complexed or expensive procedures to gather health data from various sources, etc. […] Our findings suggest web data created by social medias and search engines could improve the current syndromic surveillance systems. In particular, heat-related illness and dehydration cases were positively related with web data. […] The goal of this study is to examine the relationship between social media messages/web search results and health outcomes, and ultimately improve upon models that only consider temperature.

• #23 Using web data to improve surveillance for heat sensitive health outcomes | Environmental Health | Full Text

  https://ehjournal.biomedcentral.com/articles/10.1186/s12940-019-0499-x

  We found that heat-related illness and dehydration cases are positively associated with the concurrent days keywords such as heat, AC, park, pool, swim, and water. Other keywords were also positively associated with health outcomes when lagged effects were considered. […] The present study also found a consistent relationship between searching for water and dehydration cases. The results suggest web data could enhance existing heat-related and dehydration surveillance systems.

• #24 Heat stroke internet searches can be a new heatwave health warning surveillance indicator | Scientific Reports

  https://www.nature.com/articles/srep37294

  As a result, effective surveillance systems for adverse health effects during heatwaves are very rare despite the fact that prompt surveillance information during a heatwave may be of great benefit to public health. […] Recently, syndromic surveillance data have been used in heatwave health surveillance, such as by monitoring emergency department visits and calls to emergency or health services. […] Our study showed that the relationship between heat stroke internet searches and health outcomes is much higher than that between temperature and health outcomes. […] Therefore, heat stroke searches can be expected to largely avoid the two issues that led to Google Flu Trends prediction errors. […] Our study shows that heat stroke internet searching could form a new tool for confronting the challenge of heatwaves worldwide.

• #25 Heat stroke internet searches can be a new heatwave health warning surveillance indicator | Scientific Reports

  https://www.nature.com/articles/srep37294

  As a result, effective surveillance systems for adverse health effects during heatwaves are very rare despite the fact that prompt surveillance information during a heatwave may be of great benefit to public health. […] Recently, syndromic surveillance data have been used in heatwave health surveillance, such as by monitoring emergency department visits and calls to emergency or health services. […] Our study showed that the relationship between heat stroke internet searches and health outcomes is much higher than that between temperature and health outcomes. […] Therefore, heat stroke searches can be expected to largely avoid the two issues that led to Google Flu Trends prediction errors. […] Our study shows that heat stroke internet searching could form a new tool for confronting the challenge of heatwaves worldwide.

• #26 Heat Risk Surveillance

  https://urbanclimate.gatech.edu/heat-risk/

  The UCL Heat Tolerance Index (HTI) tracks the incidence of combined levels of outdoor temperature and humidity at which an individual will experience a rise in core body temperatures from exposures of 1-2 hours. […] With sustained exposures (3 hours), core body temperatures may exceed 104F, elevating the risk of heat stroke (see Cottle et al. 2022). […] Our analysis finds that no major US city has experienced a wet bulb temperature of 87F over the 18 years (2005-2023) of data collected by the National Oceanic and Atmospheric Administration (NOAA). […] If recent warming trends continue, as many as six US cities could exceed the heat tolerance threshold in the next five years. […] Should this threshold be exceeded, outdoor activities such as landscaping, construction, municipal services (e.g., garbage collection), and athletic events would pose an acute health risk and should be discontinued. […] The Urban Climate Lab has constructed dense climate monitoring networks in Atlanta and New Orleans to better understand how heat risk varies within cities and to support heat risk surveillance at the neighborhood level.

• #27 Heat Risk Surveillance

  https://urbanclimate.gatech.edu/heat-risk/

  The UCL Heat Tolerance Index (HTI) tracks the incidence of combined levels of outdoor temperature and humidity at which an individual will experience a rise in core body temperatures from exposures of 1-2 hours. […] With sustained exposures (3 hours), core body temperatures may exceed 104F, elevating the risk of heat stroke (see Cottle et al. 2022). […] Our analysis finds that no major US city has experienced a wet bulb temperature of 87F over the 18 years (2005-2023) of data collected by the National Oceanic and Atmospheric Administration (NOAA). […] If recent warming trends continue, as many as six US cities could exceed the heat tolerance threshold in the next five years. […] Should this threshold be exceeded, outdoor activities such as landscaping, construction, municipal services (e.g., garbage collection), and athletic events would pose an acute health risk and should be discontinued. […] The Urban Climate Lab has constructed dense climate monitoring networks in Atlanta and New Orleans to better understand how heat risk varies within cities and to support heat risk surveillance at the neighborhood level.

• #28 Heat Illness – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553117/

  In addition to older patients who have many of the risk factors presented above, specific population groups that are susceptible to heat-related injuries include adolescents and athletes. Although heat injury appears to be more significant in the elderly due to decreased health reserves, it also frequently occurs in adolescents and teenagers during the summer months, which may be due to increased participation in activities outside, including in sports. Athletes, in general, are at considerable risk of heat illness and heat stroke, which research shows the latter of these has to be the third-highest cause of mortality in this population. The risk for all groups of people increases in these environments due largely to a large volume of sweat loss accompanied by clinically significant sodium and chloride loss leading to dehydration.

• #29 Heat Illness – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553117/

  In addition to older patients who have many of the risk factors presented above, specific population groups that are susceptible to heat-related injuries include adolescents and athletes. Although heat injury appears to be more significant in the elderly due to decreased health reserves, it also frequently occurs in adolescents and teenagers during the summer months, which may be due to increased participation in activities outside, including in sports. Athletes, in general, are at considerable risk of heat illness and heat stroke, which research shows the latter of these has to be the third-highest cause of mortality in this population. The risk for all groups of people increases in these environments due largely to a large volume of sweat loss accompanied by clinically significant sodium and chloride loss leading to dehydration.

• #30 Heat-Related Illnesses | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p482.html

  The incidence of heat-related illness in U.S. high school athletes is 1.6 cases per 100,000 athletic exposures, or approximately 9,000 cases annually, with the highest rates occurring during football season. It is the third leading cause of death in high school athletes. […] In the U.S. Armed Forces, there were 2,163 cases of heat-related illness and 464 cases of heat stroke in 2017, with an incidence of 1.41 and 0.38 cases per 1,000 person-years, respectively. The incidence has gradually increased since 2014. The rate of emergency department visits for heat-related illnesses was five per 10,000 visits from 2006 to 2010 (n = 326,497); 75% of these patients were diagnosed with heat exhaustion and 5.4% with heat stroke. Approximately 12% of these patients were admitted, and the mortality rate was 0.07%.

• #31 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  With the same risk factors and under the same environmental conditions, heat stroke affects all races equally. However, because of differences in social advantages, the annual death rate due to environmental conditions is more than three times higher in Blacks than in Whites. Factors investigated as influencing this disparity include housing and neighborhood characteristics (eg, urban heat islands, crime and safety), using air conditioning (more common among whites, particularly central air conditioning), opening windows, using fans, using cooler public spaces, and social isolation. […] Infants, children, and elderly persons have a higher incidence of heat stroke than young, healthy adults. Infants and children are at risk for heat illness due to inefficient sweating, a higher metabolic rate, and their inability to care for themselves and control their environment. Elderly persons also are at increased risk for heat-related illnesses because of their limited cardiovascular reserves, preexisting illness, and use of many medications that may affect their volume status or sweating ability. In addition, elderly people who are unable to care for themselves are at increased risk for heat stroke, presumably because of their inability to control their environment. The CDC reports that the rate of heat-related mortality tends to be higher in persons aged 65 years and older. […] Exertional heat stroke (EHS) is a leading cause of injury and death in high school athletes; approximately two-thirds of such cases occur in August and involve football players, often those who are obese or overweight. Lack of acclimatization is a major risk factor for EHS in young adults.

• #32 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  With the same risk factors and under the same environmental conditions, heat stroke affects all races equally. However, because of differences in social advantages, the annual death rate due to environmental conditions is more than three times higher in Blacks than in Whites. Factors investigated as influencing this disparity include housing and neighborhood characteristics (eg, urban heat islands, crime and safety), using air conditioning (more common among whites, particularly central air conditioning), opening windows, using fans, using cooler public spaces, and social isolation. […] Infants, children, and elderly persons have a higher incidence of heat stroke than young, healthy adults. Infants and children are at risk for heat illness due to inefficient sweating, a higher metabolic rate, and their inability to care for themselves and control their environment. Elderly persons also are at increased risk for heat-related illnesses because of their limited cardiovascular reserves, preexisting illness, and use of many medications that may affect their volume status or sweating ability. In addition, elderly people who are unable to care for themselves are at increased risk for heat stroke, presumably because of their inability to control their environment. The CDC reports that the rate of heat-related mortality tends to be higher in persons aged 65 years and older. […] Exertional heat stroke (EHS) is a leading cause of injury and death in high school athletes; approximately two-thirds of such cases occur in August and involve football players, often those who are obese or overweight. Lack of acclimatization is a major risk factor for EHS in young adults.

• #33 Heat Illness – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553117/

  Risk factors for the development of heat-related illness include: High temperatures and humidity, Heatwave (greater-than-or-equal to three days of temperature more than 32.2C (90.0F)), Age (older and young patients), Obesity, Concurrent infection, Hydration status, Alcohol consumption, Drugs including but not limited to: diuretics, anticholinergics, beta- or calcium-channel blockers, antihistamines, amphetamines, Comorbid medical conditions including diabetes mellitus, infections, skin disorders, sickle cell trait, and cardiovascular disease.

• #34 Heat Illness – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553117/

  In addition to older patients who have many of the risk factors presented above, specific population groups that are susceptible to heat-related injuries include adolescents and athletes. Although heat injury appears to be more significant in the elderly due to decreased health reserves, it also frequently occurs in adolescents and teenagers during the summer months, which may be due to increased participation in activities outside, including in sports. Athletes, in general, are at considerable risk of heat illness and heat stroke, which research shows the latter of these has to be the third-highest cause of mortality in this population. The risk for all groups of people increases in these environments due largely to a large volume of sweat loss accompanied by clinically significant sodium and chloride loss leading to dehydration.

• #35 Heat stroke – Wikipedia

  https://en.wikipedia.org/wiki/Heat_stroke

  Various aspects can affect the incidence of heat stroke, including sex, age, geographical location, and occupation. The incidence of heat stroke is higher among men; however, the incidence of other heat illnesses is higher among women. […] Different parts of the world also have different rates of heat stroke. […] During the 2003 European heatwave more than 70,000 people died of heat related illnesses, and during the 2022 European heatwave, 61,672 people died from heat related illnesses.

• #36 Heat stroke epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Heat_stroke_epidemiology_and_demographics

  The United States Centers for Disease Control (CDC) reports an average of 9000 cases per year among high school athletes. The highest incidence of heat stroke in athletes in the United States has been reported among football players. Young athletes are more prone to exertional heat stroke while, classic heat stroke is more common among elderly. Men are more affected by heat stroke than women. […] The United States Centers for Disease Control report a weighted average of 9237 cases of exercise heat stroke among high school athletes per year for the period 2005 to 2009. Its incidence has been increased among the United States military personnel in 2014 compared to 2013 despite preventive measures. […] In Saudi Arabia, the incidence varies seasonally, from 22 to 250 cases per 100,000 population. Epidemiologic studies showed an incidence of 17.6 to 26.5 cases per 100,000 population in urban areas of the United States during heat waves. The highest incidence of exertional heat stroke in athletes in the United States is among football players and it’s approximately 4.5 cases per 100,000 athlete exposures. […] Exertional heat stroke is more common in age group 15-50 years. Classic heat stroke is more common in early childhood and elderly. […] Exertional heat stroke is more common among men than in women. […] Heat stroke is more common among Asian/Pacific Islander than other ethnicities.

• #37 Heat stroke epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Heat_stroke_epidemiology_and_demographics

  The United States Centers for Disease Control (CDC) reports an average of 9000 cases per year among high school athletes. The highest incidence of heat stroke in athletes in the United States has been reported among football players. Young athletes are more prone to exertional heat stroke while, classic heat stroke is more common among elderly. Men are more affected by heat stroke than women. […] The United States Centers for Disease Control report a weighted average of 9237 cases of exercise heat stroke among high school athletes per year for the period 2005 to 2009. Its incidence has been increased among the United States military personnel in 2014 compared to 2013 despite preventive measures. […] In Saudi Arabia, the incidence varies seasonally, from 22 to 250 cases per 100,000 population. Epidemiologic studies showed an incidence of 17.6 to 26.5 cases per 100,000 population in urban areas of the United States during heat waves. The highest incidence of exertional heat stroke in athletes in the United States is among football players and it’s approximately 4.5 cases per 100,000 athlete exposures. […] Exertional heat stroke is more common in age group 15-50 years. Classic heat stroke is more common in early childhood and elderly. […] Exertional heat stroke is more common among men than in women. […] Heat stroke is more common among Asian/Pacific Islander than other ethnicities.

• #38 Climate Change Indicators: Heat-Related Illnesses | US EPA

  https://www.epa.gov/climate-indicators/heat-related-illnesses

  This indicator tracks how often people are hospitalized because of exposure to heat. […] The rate has been age-adjusted to account for the effects of population change over time for example, if the proportion of older adults has increased. […] This map shows the 2001-2010 average rate of hospitalizations classified as heat-related by medical professionals in 23 states that participate in CDCs hospitalization tracking program. […] Heat-related hospitalization rates vary widely among the 23 states studied. […] People aged 65+ accounted for more heat-related hospitalizations than any other age group from 2001 to 2010, and males were hospitalized for heat-related illnesses more than twice as often as females. […] This indicator shows hospitalization rates for heat-related illnesses such as heat exhaustion, heat cramps, mild heat edema (swelling in the legs and hands), heat syncope (fainting), and heat stroke.

• #39 Heat-related mortality in Europe during the summer of 2022 | Nature Medicine

  https://www.nature.com/articles/s41591-023-02419-z

  The aim of this study was to use epidemiological models to estimate the sex- and age-specific mortality burden associated with the record-breaking temperatures registered during the 14-week period between 30 May and 4 September 2022. […] Overall, we estimated 62,862 heat-related deaths in Europe in 2022; 61,672 of those deaths occurred between 30 May and 4 September. […] The results showed that there was a large increase in heat-related mortality during June-August 2022, approaching the record-breaking excess mortality of June-September 2003. […] The burden of heat-related mortality was higher among women. […] Despite the experience accumulated since 2003, and the excess mortality estimates captured by EuroMOMO and Eurostat in several European countries, the magnitude of the overall death toll received relatively little attention. […] The high heat-related mortality that Europe experienced during the summer of 2022 calls for national governments and relevant agencies in the European Union and continental levels to increase the ambition and effectiveness of heat prevention and adaptation plans with urgency.

• #40 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  With the same risk factors and under the same environmental conditions, heat stroke affects all races equally. However, because of differences in social advantages, the annual death rate due to environmental conditions is more than three times higher in Blacks than in Whites. Factors investigated as influencing this disparity include housing and neighborhood characteristics (eg, urban heat islands, crime and safety), using air conditioning (more common among whites, particularly central air conditioning), opening windows, using fans, using cooler public spaces, and social isolation. […] Infants, children, and elderly persons have a higher incidence of heat stroke than young, healthy adults. Infants and children are at risk for heat illness due to inefficient sweating, a higher metabolic rate, and their inability to care for themselves and control their environment. Elderly persons also are at increased risk for heat-related illnesses because of their limited cardiovascular reserves, preexisting illness, and use of many medications that may affect their volume status or sweating ability. In addition, elderly people who are unable to care for themselves are at increased risk for heat stroke, presumably because of their inability to control their environment. The CDC reports that the rate of heat-related mortality tends to be higher in persons aged 65 years and older. […] Exertional heat stroke (EHS) is a leading cause of injury and death in high school athletes; approximately two-thirds of such cases occur in August and involve football players, often those who are obese or overweight. Lack of acclimatization is a major risk factor for EHS in young adults.

• #41 Heat stroke – Wikipedia

  https://en.wikipedia.org/wiki/Heat_stroke

  Various aspects can affect the incidence of heat stroke, including sex, age, geographical location, and occupation. The incidence of heat stroke is higher among men; however, the incidence of other heat illnesses is higher among women. […] Different parts of the world also have different rates of heat stroke. […] During the 2003 European heatwave more than 70,000 people died of heat related illnesses, and during the 2022 European heatwave, 61,672 people died from heat related illnesses.

• #42 Heat stroke epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Heat_stroke_epidemiology_and_demographics

  The United States Centers for Disease Control (CDC) reports an average of 9000 cases per year among high school athletes. The highest incidence of heat stroke in athletes in the United States has been reported among football players. Young athletes are more prone to exertional heat stroke while, classic heat stroke is more common among elderly. Men are more affected by heat stroke than women. […] The United States Centers for Disease Control report a weighted average of 9237 cases of exercise heat stroke among high school athletes per year for the period 2005 to 2009. Its incidence has been increased among the United States military personnel in 2014 compared to 2013 despite preventive measures. […] In Saudi Arabia, the incidence varies seasonally, from 22 to 250 cases per 100,000 population. Epidemiologic studies showed an incidence of 17.6 to 26.5 cases per 100,000 population in urban areas of the United States during heat waves. The highest incidence of exertional heat stroke in athletes in the United States is among football players and it’s approximately 4.5 cases per 100,000 athlete exposures. […] Exertional heat stroke is more common in age group 15-50 years. Classic heat stroke is more common in early childhood and elderly. […] Exertional heat stroke is more common among men than in women. […] Heat stroke is more common among Asian/Pacific Islander than other ethnicities.

• #43 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  With the same risk factors and under the same environmental conditions, heat stroke affects all races equally. However, because of differences in social advantages, the annual death rate due to environmental conditions is more than three times higher in Blacks than in Whites. Factors investigated as influencing this disparity include housing and neighborhood characteristics (eg, urban heat islands, crime and safety), using air conditioning (more common among whites, particularly central air conditioning), opening windows, using fans, using cooler public spaces, and social isolation. […] Infants, children, and elderly persons have a higher incidence of heat stroke than young, healthy adults. Infants and children are at risk for heat illness due to inefficient sweating, a higher metabolic rate, and their inability to care for themselves and control their environment. Elderly persons also are at increased risk for heat-related illnesses because of their limited cardiovascular reserves, preexisting illness, and use of many medications that may affect their volume status or sweating ability. In addition, elderly people who are unable to care for themselves are at increased risk for heat stroke, presumably because of their inability to control their environment. The CDC reports that the rate of heat-related mortality tends to be higher in persons aged 65 years and older. […] Exertional heat stroke (EHS) is a leading cause of injury and death in high school athletes; approximately two-thirds of such cases occur in August and involve football players, often those who are obese or overweight. Lack of acclimatization is a major risk factor for EHS in young adults.

• #44 Heat stroke epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Heat_stroke_epidemiology_and_demographics

  The United States Centers for Disease Control (CDC) reports an average of 9000 cases per year among high school athletes. The highest incidence of heat stroke in athletes in the United States has been reported among football players. Young athletes are more prone to exertional heat stroke while, classic heat stroke is more common among elderly. Men are more affected by heat stroke than women. […] The United States Centers for Disease Control report a weighted average of 9237 cases of exercise heat stroke among high school athletes per year for the period 2005 to 2009. Its incidence has been increased among the United States military personnel in 2014 compared to 2013 despite preventive measures. […] In Saudi Arabia, the incidence varies seasonally, from 22 to 250 cases per 100,000 population. Epidemiologic studies showed an incidence of 17.6 to 26.5 cases per 100,000 population in urban areas of the United States during heat waves. The highest incidence of exertional heat stroke in athletes in the United States is among football players and it’s approximately 4.5 cases per 100,000 athlete exposures. […] Exertional heat stroke is more common in age group 15-50 years. Classic heat stroke is more common in early childhood and elderly. […] Exertional heat stroke is more common among men than in women. […] Heat stroke is more common among Asian/Pacific Islander than other ethnicities.

• #45 Heat-related mortality: a review and exploration of heterogeneity | Journal of Epidemiology & Community Health

  https://jech.bmj.com/content/64/9/753

  Lower GDP of a city was associated with higher heat risk. […] Higher heat thresholds were observed in populations experiencing higher summertime temperatures and also broadly in those closer to the equator. […] Published studies indicate that in many populations ambient heat affects mortality. […] Measures designed to minimise heat islands in cities, to keep building interiors cool and to improve the general care of older people are likely to play a key role in reducing future heat burdens.

• #46

  https://www.eea.europa.eu/en/analysis/publications/the-impacts-of-heat-on-health

  HHAPs are recognised as a key tool for reducing deaths and preventing other health impacts during periods of high temperatures. […] According to the 2024 survey, 12 of the 28 responding NPHIs have HHAPs in place at either the national, regional or local level, while four more are in the process of developing HHAPs. […] Over a quarter of countries in Europe do not have HHAPs, which may negatively impact their preparedness to heat.

• #47

  https://www.eea.europa.eu/en/analysis/publications/the-impacts-of-heat-on-health

  21 of the EEA-38 countries have heat-health action plans (HHAPs) in place, and another four National Public Health Institutes are developing HHAPs. Further development, evaluation and revision of HHAPs with a particular focus on vulnerable populations is recommended to better prepare countries for future heat extremes. […] The surveillance of the health impacts of heat is central to the public health response to this climate hazard. Just over a quarter of the responding countries forecast heat-related mortality and fewer than half monitor heat-related deaths in near-real time. The lack of timely data in the remaining countries can be regarded as an obstacle to timely and effective action against heat-related deaths. […] Data on the health impacts of heat is also essential for the long-term development of public health policies, selecting adaptive measures and planning for future heat-related impacts on human health and healthcare systems.

• #48

  https://www.eea.europa.eu/en/analysis/publications/the-impacts-of-heat-on-health

  21 of the EEA-38 countries have heat-health action plans (HHAPs) in place, and another four National Public Health Institutes are developing HHAPs. Further development, evaluation and revision of HHAPs with a particular focus on vulnerable populations is recommended to better prepare countries for future heat extremes. […] The surveillance of the health impacts of heat is central to the public health response to this climate hazard. Just over a quarter of the responding countries forecast heat-related mortality and fewer than half monitor heat-related deaths in near-real time. The lack of timely data in the remaining countries can be regarded as an obstacle to timely and effective action against heat-related deaths. […] Data on the health impacts of heat is also essential for the long-term development of public health policies, selecting adaptive measures and planning for future heat-related impacts on human health and healthcare systems.

• #49 Heat-related mortality in Europe during the summer of 2022 | Nature Medicine

  https://www.nature.com/articles/s41591-023-02419-z

  The aim of this study was to use epidemiological models to estimate the sex- and age-specific mortality burden associated with the record-breaking temperatures registered during the 14-week period between 30 May and 4 September 2022. […] Overall, we estimated 62,862 heat-related deaths in Europe in 2022; 61,672 of those deaths occurred between 30 May and 4 September. […] The results showed that there was a large increase in heat-related mortality during June-August 2022, approaching the record-breaking excess mortality of June-September 2003. […] The burden of heat-related mortality was higher among women. […] Despite the experience accumulated since 2003, and the excess mortality estimates captured by EuroMOMO and Eurostat in several European countries, the magnitude of the overall death toll received relatively little attention. […] The high heat-related mortality that Europe experienced during the summer of 2022 calls for national governments and relevant agencies in the European Union and continental levels to increase the ambition and effectiveness of heat prevention and adaptation plans with urgency.

• #50

  https://www.eea.europa.eu/en/newsroom/news/eea-countries-take-action-on-heat-and-health

  Collecting timely and reliable data on the number of deaths and illnesses associated with heat are vital to deploy targeted emergency responses during heatwaves. Twenty of the European Environment Agency’s (EEA) 38 member and cooperating countries currently monitor heat impacts on health, according to an EEA briefing published today. […] The EEA briefing 'Impacts of heat on health’ gives a first EEA state of play on national surveillance for heat-related health impacts. […] The briefing explains the key importance of monitoring heat-related deaths and health impacts as a basis for planning actions preventing such impacts, especially amongst the most vulnerable groups. […] The briefing explains that deploying emergency response measures during extreme weather events and having long-term adaptation actions in place is crucial to reduce heat-related deaths and illnesses. Accurate and timely data on the health impacts of heat is also critical for designing and implementing these measures.

• #51

  https://www.eea.europa.eu/en/newsroom/news/eea-countries-take-action-on-heat-and-health

  In addition to collecting data on deaths, it is essential to collect data on heat-related health impacts, such as dehydration, hyperthermia, or worsening of symptoms of existing diseases. This data allows for the full scope of the health impacts of heat to be understood and enables targeted measures to be deployed to counteract them, according to the briefing. Further, information about the number of heat-related deaths and health effects allows assessment of whether the preventative measures used have been effective in reducing impacts. Proper surveillance and data collection can also help in developing heat mortality forecasting and putting in place early warning systems.

• #52

  https://www.eea.europa.eu/en/newsroom/news/eea-countries-take-action-on-heat-and-health

  In addition to collecting data on deaths, it is essential to collect data on heat-related health impacts, such as dehydration, hyperthermia, or worsening of symptoms of existing diseases. This data allows for the full scope of the health impacts of heat to be understood and enables targeted measures to be deployed to counteract them, according to the briefing. Further, information about the number of heat-related deaths and health effects allows assessment of whether the preventative measures used have been effective in reducing impacts. Proper surveillance and data collection can also help in developing heat mortality forecasting and putting in place early warning systems.

• #53

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  Awareness among health workers and the public remains insufficient of the health risks posed by heat. Health professionals should adjust their guidance, planning and interventions to account for increasing heat exposures, as well as to manage acute increases in admissions associated with heatwaves. […] The bodys inability to regulate internal temperature and eliminate heat gain in such conditions increases the risk of heat exhaustion and heatstroke. […] Deaths and hospitalizations triggered by extreme hot weather occur rapidly (same day and following days), which means interventions also need to be rapid when a heat alert is issued. […] Heat can also disrupt and compromise essential health services, such as the loss of power supply and transport. […] WHO is addressing climate change through the Alliance for Transformational Change in Climate and Health (ATACH), as well as country support of technical and policy resources to help the health sector and communities adapt to the risks of climate change. […] WHO works with the health sector to strengthen governance, preparedness and response to acute impacts of heatwaves by developing heat action plans, heat early warning systems and advisories, and emergency response plans that map the risks, vulnerable populations, available capacities and resources.

• #54

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  The negative health impacts of heat are predictable and largely preventable with specific public health and multi-sectoral policies and interventions. WHO has issued guidance for public health institutions to identify and manage extreme heat risks. Action on climate change combined with comprehensive preparedness and risk management can save lives now and in the future. […] The frequency and intensity of extreme heat and heat waves will continue to rise in the 21st century because of climate change. Extended periods of high day and nighttime temperature conditions create cumulative stress on the human body, increasing the risk of illness and death from heat exposure. […] Population ageing and the growing prevalence of non-communicable diseases (respiratory and cardiovascular diseases, diabetes, dementia, renal disease and musculoskeletal disease) means that populations are becoming more susceptible to negative heat impacts.

• #55

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  The negative health impacts of heat are predictable and largely preventable with specific public health and multi-sectoral policies and interventions. WHO has issued guidance for public health institutions to identify and manage extreme heat risks. Action on climate change combined with comprehensive preparedness and risk management can save lives now and in the future. […] The frequency and intensity of extreme heat and heat waves will continue to rise in the 21st century because of climate change. Extended periods of high day and nighttime temperature conditions create cumulative stress on the human body, increasing the risk of illness and death from heat exposure. […] Population ageing and the growing prevalence of non-communicable diseases (respiratory and cardiovascular diseases, diabetes, dementia, renal disease and musculoskeletal disease) means that populations are becoming more susceptible to negative heat impacts.

• #56 Climate Change Indicators: Heat-Related Illnesses | US EPA

  https://www.epa.gov/climate-indicators/heat-related-illnesses

  This data set represents the best available source of observed data for tracking heat-related hospitalizations across multiple states. […] Heat response measures, such as early warning and surveillance systems, air conditioning, health care, public education, cooling centers, infrastructure standards, and air quality management, can also make a big difference in heat-related hospitalization rates.

• #57

  https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health

  Awareness among health workers and the public remains insufficient of the health risks posed by heat. Health professionals should adjust their guidance, planning and interventions to account for increasing heat exposures, as well as to manage acute increases in admissions associated with heatwaves. […] The bodys inability to regulate internal temperature and eliminate heat gain in such conditions increases the risk of heat exhaustion and heatstroke. […] Deaths and hospitalizations triggered by extreme hot weather occur rapidly (same day and following days), which means interventions also need to be rapid when a heat alert is issued. […] Heat can also disrupt and compromise essential health services, such as the loss of power supply and transport. […] WHO is addressing climate change through the Alliance for Transformational Change in Climate and Health (ATACH), as well as country support of technical and policy resources to help the health sector and communities adapt to the risks of climate change. […] WHO works with the health sector to strengthen governance, preparedness and response to acute impacts of heatwaves by developing heat action plans, heat early warning systems and advisories, and emergency response plans that map the risks, vulnerable populations, available capacities and resources.

• #58 Exertional heat illness in adolescents and adults: Management and prevention – UpToDate

  https://www.uptodate.com/contents/exertional-heat-illness-in-adolescents-and-adults-management-and-prevention

  Accordingly, effective management of any severe heat illness requires careful evaluation at the field and hospital, and treatment of EHS with rapid cooling is paramount. […] The risk of multiorgan failure and mortality from EHS depends upon how fast it is diagnosed and rapid cooling implemented. […] Nearly all patients who develop EHS, including all of those at risk or with signs of complications, are hospitalized for a period of observation and monitoring for complications. Indications for admission include difficulty correcting hypotension, seizure, severe encephalopathy, moderate encephalopathy (eg, confusion) that is not clearing rapidly, persistent oliguria, persistent myalgia suggesting evolving rhabdomyolysis, persistent electrolyte abnormalities, persistent creatinine above 2 mg/dL, evidence of acute kidney injury or myoglobinuria, evidence of disseminated intravascular coagulation, exertional hypoglycemia, persistent substantial diarrhea, and significant gastrointestinal bleeding. […] Exertional heat illness (EHI) is often preventable. Important principles for developing a prevention program for EHI and specific measures for reducing risk, including several recommendations included in consensus statements, are described below.

• #59 Exertional heat illness in adolescents and adults: Management and prevention – UpToDate

  https://www.uptodate.com/contents/exertional-heat-illness-in-adolescents-and-adults-management-and-prevention

  Accordingly, effective management of any severe heat illness requires careful evaluation at the field and hospital, and treatment of EHS with rapid cooling is paramount. […] The risk of multiorgan failure and mortality from EHS depends upon how fast it is diagnosed and rapid cooling implemented. […] Nearly all patients who develop EHS, including all of those at risk or with signs of complications, are hospitalized for a period of observation and monitoring for complications. Indications for admission include difficulty correcting hypotension, seizure, severe encephalopathy, moderate encephalopathy (eg, confusion) that is not clearing rapidly, persistent oliguria, persistent myalgia suggesting evolving rhabdomyolysis, persistent electrolyte abnormalities, persistent creatinine above 2 mg/dL, evidence of acute kidney injury or myoglobinuria, evidence of disseminated intravascular coagulation, exertional hypoglycemia, persistent substantial diarrhea, and significant gastrointestinal bleeding. […] Exertional heat illness (EHI) is often preventable. Important principles for developing a prevention program for EHI and specific measures for reducing risk, including several recommendations included in consensus statements, are described below.

• #60 Exertional heat illness in adolescents and adults: Management and prevention – UpToDate

  https://www.uptodate.com/contents/exertional-heat-illness-in-adolescents-and-adults-management-and-prevention

  Accordingly, effective management of any severe heat illness requires careful evaluation at the field and hospital, and treatment of EHS with rapid cooling is paramount. […] The risk of multiorgan failure and mortality from EHS depends upon how fast it is diagnosed and rapid cooling implemented. […] Nearly all patients who develop EHS, including all of those at risk or with signs of complications, are hospitalized for a period of observation and monitoring for complications. Indications for admission include difficulty correcting hypotension, seizure, severe encephalopathy, moderate encephalopathy (eg, confusion) that is not clearing rapidly, persistent oliguria, persistent myalgia suggesting evolving rhabdomyolysis, persistent electrolyte abnormalities, persistent creatinine above 2 mg/dL, evidence of acute kidney injury or myoglobinuria, evidence of disseminated intravascular coagulation, exertional hypoglycemia, persistent substantial diarrhea, and significant gastrointestinal bleeding. […] Exertional heat illness (EHI) is often preventable. Important principles for developing a prevention program for EHI and specific measures for reducing risk, including several recommendations included in consensus statements, are described below.

• #61 Exertional heat illness in adolescents and adults: Management and prevention – UpToDate

  https://www.uptodate.com/contents/exertional-heat-illness-in-adolescents-and-adults-management-and-prevention

  Exertional heat illness (EHI) is among the leading causes of death in young athletes each year. A report by the United States Centers for Disease Control (CDC) found that EHI occurs both during practice and competition and noted a disturbing trend of increasing incidence; in addition, despite prevention efforts, exertional heat stroke (EHS) in the military remains a significant operational challenge. […] Clinicians who care for athletes, both young and old, and for others who exert themselves in the heat need to be aware of the basic physiologic principles of thermoregulation, the spectrum of heat illness, strategies for prevention and treatment, and current guidelines for determining safe return to play or work. […] The management and prevention of EHI are reviewed here. […] The severity of a heat illness may not be apparent during the initial presentation. Morbidity and mortality are directly related to the duration of core temperature elevation.

• #62 Heat exposure may increase inflammation and impair the immune system | American Heart Association

  https://newsroom.heart.org/news/heat-exposure-may-increase-inflammation-and-impair-the-immune-system

  Short-term exposure to higher heat may increase inflammation and interfere with normal immune system functions in the body, which may, in turn, increase susceptibility to infections and accelerate the progression of cardiovascular disease, according to preliminary research to be presented at the American Heart Associations Epidemiology and PreventionLifestyle and Cardiometabolic Scientific Sessions 2024, March 18- 21, in Chicago. […] Heat waves are known to promote inflammation, however, studies examining air temperature and biomarkers of inflammation have had mixed results. […] Most research only considers temperature as the exposure of interest, which may not be adequate to capture a persons response to heat, said lead study author Daniel W. Riggs, Ph.D., an assistant professor of medicine in the Christina Lee Brown Envirome Institute at the University of Louisville in Louisville, Kentucky.

• #63 Heat exposure may increase inflammation and impair the immune system | American Heart Association

  https://newsroom.heart.org/news/heat-exposure-may-increase-inflammation-and-impair-the-immune-system

  With rising global temperatures, the association between heat exposure and a temporarily weakened response from the immune system is a concern because temperature and humidity are known to be important environmental drivers of infectious, airborne disease transmission. […] Adults older than age 60 and adults with existing cardiovascular disease are particularly at risk for heat-related cardiovascular events and deaths, Riggs explained. […] Its important for physicians to communicate with patients about the risk of adverse health effects from heat exposure.

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