Materiały źródłowe

• #1

  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. […] 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 2000-2004 and 2017-2021. […] Between 2000-2019 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 June-August event. In 2010, 56,000 excess deaths occurred during a 44-day heatwave in the Russian Federation.

• #1 Heat exhaustion and heat stroke among active component members of the U.S. Armed Forces, 2019-2023 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38722363/

  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. […] In 2023, the crude incidence of heat stroke and heat exhaustion were 31.7 and 172.7 cases per 100,000 person-years, respectively. […] The rates of incident heat stroke declined during the 2019 to 2023 surveillance period, but rates of incident heat exhaustion increased over the same period. […] Heat illness rates were also higher among those younger than age 20, Marine Corps and Army service members, non-Hispanic Black service members, and recruits. […] Leaders, training cadres, and supporting medical and safety personnel must inform their subordinate and supported service members of heat illness risks, preventive measures, early signs and symptoms of illness, and appropriate interventions.

• #2 Heat Related Illness – Nevada Heat Preparedness

  https://nvose.org/heat-related-illness/

  In 2023, heat was the leading cause of weather-related deaths in the United States, killing more people than tornadoes, floods, and hurricanes. […] Nevada’s warming climate increases the risk for heat-related illnesses, some of which can be serious and even deadly. However, heat-related illnesses are preventable. […] Heat exhaustion is less severe than heat stroke, but if untreated, it may progress to heat stroke. Heat exhaustion happens when the body experiences significant loss of water and salt, typically due to excessive sweating. […] Heat-related illness can affect anyone, but some groups are at higher risk. […] Heat-related illness is preventable. However, brief exposure to high temperatures can lead to severe and potentially life-threatening health issues.

• #2 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. […] In 2023, higher rates of heat stroke were observed among male service members compared to their female counterparts, and female service members experienced higher rates of heat exhaustion compared to male personnel.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11107842/

  The most serious types of heat illnesses, heat exhaustion and heat stroke, are occupational hazards associated with many of the militarys training and operational environments. […] In 2023, the crude incidence of heat stroke and heat exhaustion were 31.7 and 172.7 cases per 100,000 person-years, respectively. […] The rates of incident heat stroke declined during the 2019 to 2023 surveillance period, but rates of incident heat exhaustion increased over the same period. […] 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. […] This update presents summaries of heat stroke and heat exhaustion case counts, incidence rates, and locations between 2019 and 2023.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11107842/

  The crude annual incidence rate of heat stroke decreased 15.6% from 2019 through 2023, with a 5.9% decline from 2022 to 2023. […] Meanwhile, the proportion of heat stroke cases that were hospitalized increased from 36.9% in 2022 to 40.2% in 2023. […] The 2,263 cases of heat exhaustion in 2023 correspond to a crude incidence rate of 172.7 cases per 100,000 p-yrs. […] Between 2019 and 2023, the crude annual incidence rate of heat exhaustion increased 4.6%, including an 8.0% increase from 2022 to 2023. […] Maintaining regular heat illness surveillance helps identify the magnitude of the impact these conditions have on service member health, training, and force readiness.

• #5 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%.

• #6 How hot is too hot — Harvard Gazette

  https://news.harvard.edu/gazette/story/2025/05/how-hot-is-too-hot-climate-change/

  Harvard researchers are working with community leaders in India to build one of the largest datasets ever recorded on extreme heat and human well-being. […] The data will let civil society groups lobby on behalf of policy solutions, because there are no precise statistics in India on how heat affects work. […] Policies meant to offset extreme heat often focus on the risk of heat stroke, but there’s a range of other health impacts that injure and kill people more slowly, she added. […] Still, argued one of its authors, Dileep Mavalankar of the Indian Institute of Public Health, there is gross underreporting of heatwave-related deaths across India, which might be recorded as heart attacks or other emergencies. […] Initial data from the project is validating concerns about the home environments, which remain hot and humid well into monsoon season. […] The research cluster is now scaling up expanding to other parts of India, distributing Fitbits and sensors in time for peak heat this year.

• #7 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.

• #8 Beat the Heat | Pima County, AZ

  https://www.pima.gov/2042/Beat-the-Heat

  Heat-related illness, like heat exhaustion or heat stroke, is when our bodies cannot properly cool themselves. Our bodies normally cool down by sweating, but during extreme heat a person’s body temperature might rise faster than it can cool itself down, sometimes causing severe illness or death. […] Each year, nearly 2,000 people visit Arizona emergency rooms because of heat-related illnesses. […] The good news is that heat-related illnesses and deaths are preventable. […] Although anyone can suffer from heat-related illness, some people are at greater risk than others: Infants and young children, People who are pregnant, People 65 years of age or older, People who are overweight, People who overexert during work or exercise, People who are physically ill, especially with heart disease or high blood pressure, or who take certain medications, such as for depression, insomnia, or poor circulation.

• #9 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.

• #10 Hot Weather: Understanding and Preventing Heat-Related Illnesses

  https://dph.illinois.gov/topics-services/environmental-health-protection/hot-weather.html

  Heat exhaustion can result when too much time is spent in a very warm environment, resulting in excessive sweating without adequate fluid and electrolyte (salt and minerals) replacement. […] Symptoms of heat exhaustion may include dizziness, headache, nausea, abdominal cramps, shallow breathing, cool and clammy skin, muscle tremors and heavy perspiration. Body temperature will be near normal. […] A person suffering from heat exhaustion should be moved to an air-conditioned environment if possible. […] Anyone can develop heat-related illnesses. However, certain groups of people are at increased risk during extremely hot weather. These include people who work outside, elderly persons living alone, people with chronic medical conditions, and persons taking certain medications. […] A number of different kinds of medications can pose problems during periods of extremely hot weather. These include diuretics (water pills), many heart medicines, diabetes medicines (tablets and insulin), psychoactive drugs (antidepressants and mood altering drugs), antihistamines (hay fever and allergy medicine) and antihypertensive (high blood pressure) drugs.

• #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

  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. […] This update presents summaries of heat stroke and heat exhaustion case counts, incidence rates, and locations between 2019 and 2023. […] Maintaining regular heat illness surveillance helps identify the magnitude of the impact these conditions have on service member health, training, and force readiness.

• #12 Real-time heat-related illness in NYC.

  https://a816-dohbesp.nyc.gov/IndicatorPublic/data-features/heat-syndrome/

  We can also track heat-related illness with near real-time electronic data from emergency departments at hospitals throughout NYC. […] Heat-related illnesses – including heat exhaustion, muscle cramps, fainting, and heat stroke (the most serious form) – happen when the body cannot cool down enough. […] Heat syndrome is identified in surveillance data by looking for diagnostic codes for heat-related illness and by searching chief complaints (descriptions of why patients are at the ED) for words related to heat exposure and heat-related illness, such as overheating, sunstroke, and similar terms. […] In addition, heat-related illness cases in syndromic surveillance data provide a useful indicator of the lethal impacts of extreme heat events, but the number of HRI cases does not reflect the full burden of health impacts, such as increases in death or hospital visits for heat-sensitive chronic conditions, which are not available in near-real time. […] Tracking heat-related illness (HRI) in near-real time can help provide situational awareness, supplementing the weather forecast as an indicator of public health risk.

• #13 Exploring Tangible Health Impact From Heat | National Syndromic Surveillance Program (NSSP) | CDC

  https://www.cdc.gov/nssp/php/partnerships/health-impact-from-heat-waves.html

  Heat exposure is one of the leading causes of weather-related deaths nationwide. More than two-thirds of all Americans were under heat alerts in 2023. […] By integrating data sources, including emergency department (ED) data, CDC’s National Syndromic Surveillance Program (NSSP) provides an early detection system for public health threats, including HRI. […] An HRI Workgroup accomplishment includes an MMWR published in April 2024, Heat-Related Emergency Department Visits United States, MaySeptember 2023. These data demonstrate that rates of ED visits for HRI substantially increased across several regions in MaySeptember 2023, compared with previous years. […] NSSP continually strives to eliminate public health siloes and aid decision-making by merging electronic data sources through dashboards and other tools.

• #14 This CDC data shows where rates of heat-related illness are highest | KUNC

  https://www.kunc.org/npr-news/2023-07-26/this-cdc-data-shows-where-rates-of-heat-related-illness-are-highest

  The U.S. is seeing high levels of heat-related illness this year, according to data the Centers for Disease Control and Prevention provided to NPR. […] The agency has been collecting national data on heat-related illness from emergency departments since 2018 and currently releases it daily through its Heat Health Tracker. […] The CDC collects this data through its National Syndromic Surveillance Program, which takes in anonymized information from electronic health records shared by participating medical facilities. About 75% of the nation’s emergency departments report into the program. […] This summer, hospitals recorded a large spike in heat-related illness in the region that includes Texas as well as Arkansas, Louisiana, New Mexico and Oklahoma. […] According to the CDC analysis, for several days in June, the rates of emergency department visits for heat-related illness were the highest seen in this region in the past five years.

• #15 Heat-related illness surveillance data for Wednesday, July 27, 2022 – King County, Washington

  https://kingcounty.gov/en/dept/dph/about-king-county/about-public-health/news/news-archive-2022/july-28-heat-illness

  High temperatures are forecast for the Puget Sound Region this week. […] During this heat event, Public Health – Seattle King County is releasing daily reports of preliminary data on heat-related illness surveillance. […] Public Health is releasing daily reports of preliminary data on heat-related illness surveillance. […] There were 18 emergency department visits for heat-related illness on Tuesday, 7/26 in King County (revised up from previous report). […] There were 10 emergency department visits for heat-related illness on Wednesday, 7/27 in King County. […] Emergency department visits for heat-related illnesses (HRI) are defined as those that meet a syndrome definition that include mention of the terms „hyperthermia,” „sun stroke,” „heat exhaustion,” or related terms. […] EMS incidents for suspected heat-related illness include prehospital clinical impressions and patient symptoms of heatstroke, sunstroke, heat exhaustion, heat-related illness, and heat syncope.

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

  https://eng.phwr.org/journal/view.html?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.

• #17

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

  This briefing outlines the status of surveillance for heat-related health impacts and heat-health actions plans in 38 European countries. It draws on a survey issued to National Public Health Institutes. It is published under the European Climate and Health Observatory initiative. […] Timely and reliable data on the number of deaths and illnesses associated with heat are essential for deploying targeted emergency responses during hot periods. In the long term, this type of data supports prioritising, implementation and evaluation of actions that keep people safe from extreme heat. […] 20 of the EEA-38 countries currently monitor heat impacts on health and three additional countries are developing heat-health monitoring systems. Methods of data collection and analysis vary considerably in the existing surveillance systems.

• #18 Results of the 2020 Heat-Related Illness Surveillance

  https://eng.phwr.org/journal/view.html?pn=vol&uid=456&vmd=Full

  In 2011, the Korea Disease Control and Prevention Agency (KDCA) launched a heat-related illness (HRI) surveillance system. […] From May 20 to September 13, 2020, the KCDA operated the HRI surveillance system to monitor heat stroke, heat exhaustion, heat cramps, heat syncope, and heat edema. […] Findings indicated that the main cause of HRI was heat exhaustion (53.4%) followed by heat stroke (20.6%).

• #19 Annex F – Heat-Related Illness Surveillance System – Canada.ca

  https://www.canada.ca/en/department-national-defence/services/bases-support-units/canadian-armed-forces-health-services-centre-kingston/annex-f.html

  To prevent cases of heat-related illness (HRI) in CAF members, it is vital to have accurate knowledge of how often it occurs in the CAF population and the risk factors associated with it. The Heat-Related Illness Surveillance System (HRISS) is a tool that provides this crucial epidemiologic information. It helps inform and evaluate efforts to prevent cases of HRI and raises awareness of the problem within the CAF. […] Whenever a CAF member is assessed by a clinician for a suspected HRI, a clinical note is created in CFHIS that includes a coded ICD-10 diagnosis. It is this diagnostic code that permits epidemiology to count the number of HRI cases over a specified time period and determine the rate of HRI in CAF members. […] DFHP is attempting to more accurately track cases and identify risk factors of HRI in CAF members. Examples of HRI include heat rash, heat edema, heat cramps, heat syncope, heat exhaustion, heat injury and heat stroke. To assist DFHP in conducting surveillance of HRI.

• #20 Extreme Heat and Heat-Related Illnesses – Newsroom

  https://www.vdh.virginia.gov/news/extreme-heat-and-heat-related-illnesses/

  The Virginia Department of Health (VDH) receives data on visits to emergency departments and urgent care centers in Virginia for purposes of public health surveillance. These data are analyzed through a syndromic surveillance system, known as ESSENCE, to monitor the health of the community and identify emerging trends of public health concern. […] During the summer months (May to September), the Office of Epidemiology conducts surveillance for heat-related illness. […] For more data about the affects of heat-related illness in Virginia, please visit the Heat-Related Illness Surveillance page on the Office of Epidemiology Syndromic Surveillance program website.

• #21 Heat-Related Illness Surveillance – Surveillance and Investigation

  https://www.vdh.virginia.gov/surveillance-and-investigation/syndromic-surveillance/hri-surveillance/

  This dashboard is updated on weekdays (Monday Friday) in July and August, and weekly on Mondays in May, June, and September. […] VDH collects and analyzes health data from participating EDs and urgent care centers in Virginia. All non-federal acute care hospitals and free-standing emergency care centers report ED visit data to VDH. […] Public health surveillance is a secondary use. When interpreting HRI data, please consider syndromic surveillance data limitations. […] The Enhanced Surveillance team identified and monitored one heat-related illness event so far between April 1 to September 30, 2021. The heat related illness event occurred June 28-30. […] The Enhanced Surveillance team identified and monitored one heat-related illness event between April 1 to September 30, 2020. The heat related illness event occurred July 17-30.

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

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

  From 2001 to 2010, the 20 states covered in Figure 1 recorded a total of about 28,000 heat-related hospitalizations. The resulting annual rates ranged from 1.1 cases per 100,000 people in 2004 to 2.5 cases per 100,000 people in 2006, with a 10-year average rate of 1.8 cases per 100,000 people (see Figure 1). […] Heat-related hospitalization rates vary widely among the 23 states studied (see Figure 2). Average rates from 2001 to 2010 ranged from fewer than one case per 100,000 people in some states to nearly four cases per 100,000 people in others. The highest rates occurred in Kansas, Louisiana, Missouri, South Carolina, and Tennessee. Relatively high hospitalization rates in the Southeast and Midwest suggest a connection between hotter and more humid summers and increased rates of heat-related illness, compared with other regions.

• #23 Heat illness – Wikipedia

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

  Heat stroke is relatively common in sports. About 2 percent of sports-related deaths that occurred in the United States between 1980 and 2006 were caused by exertional heat stroke. Football in the United States has the highest rates. The month of August, which is associated with pre-season football camps across the country, accounts for 66.3% of exertion heat-related illness time-loss events. Heat illness is also not limited geographically and is widely distributed throughout the United States. An average of 5946 persons were treated annually in US hospital emergency departments (2 visits/ 100,00 population) with a hospitalization rate of 7.1%. Most commonly males are brought in 72.5% and persons 15-19 years of age 35.6%. When taking into consideration all high school athletes, heat illness occurs at a rate of 1.2 per 100,000 kids. When comparing risk by sport, Football was 11.4 times more likely than all other sports combined to be exposed to an exertional heat illness.

• #24 Exertional heat illness in adolescents and adults: Epidemiology, thermoregulation, risk factors, and diagnosis – UpToDate

  https://www.uptodate.com/contents/exertional-heat-illness-in-adolescents-and-adults-epidemiology-thermoregulation-risk-factors-and-diagnosis

  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 and Prevention (CDC) found that EHI occurs both during practice and competition and noted a disturbing trend of increasing incidence. The United States military reported that the crude incidence of heat stroke and heat exhaustion during the 2019 to 2023 surveillance period were 31.7 and 172.7 cases per 100,000 person-years, respectively. While the rates of incident heat stroke declined during this period, the rates of incident heat exhaustion increased. In the United States, the highest incidence of EHS is found among participants in American football, in whom the condition occurs at a rate of over 4 cases per 100,000 athlete exposures. According to an annual survey of catastrophic American football injuries presented in 2008, 31 players have died from EHS since 1995. Most cases occurred during summer practice when players are less fit, and temperatures and humidity are often high. A comprehensive study of fatal episodes of EHS among military personnel provides further insight into important risk factors. According to this study, the absence of appropriate medical triage and physical effort beyond the fitness capacities of the victims were found in all deaths. Training in extreme heat was also common. High motivation among military personnel to achieve at demanding physical tasks is another important risk factor for exertional illness. Other studies emphasize the importance of adverse environmental conditions in heat illness. Data from large-scale endurance events, such as marathons, show a strong correlation between the severity of environmental conditions and the incidence of heat illness, especially EHS. According to annual surveillance studies of the Falmouth (Massachusetts, USA) Road Race (7 mile/11 km event), elevations in the temperature and heat index correlate with an increase in the incidence of exertional heat stroke. A four-year study of collegiate American football players found the incidence of heat illness to be closely associated with rising wet bulb globe temperature (WBGT) and lack of heat acclimatization.

• #25 Heat illness – Wikipedia

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

  Between 1999 and 2003, the US had a total of 3442 deaths from heat illness. Those who work outdoors are at particular risk for heat illness, though those who work in poorly-cooled spaces indoors are also at risk. Between 1992 and 2006, 423 workers died from heat illness in the US. Exposure to environmental heat led to 37 work-related deaths. There were 2,830 nonfatal occupational injuries and illnesses involving days away from work as well, in 2015. Kansas had the highest heat related injury while on the job with a rate of 1.3 per 10,000 workers, while Texas had the most overall. Due to the much higher state population of Texas, their prevalence was only 0.4 per 10,000 or 4 per 100,000. Of the 37 deaths reported heat illnesses, 33 of the 37 occurred between the summer months of June through September. The most dangerous profession that was documented was transportation and material moving. Transportation and material moving accounted for 720 of the 2,830 reported nonfatal occupational injuries or 25.4 percent. After transportation and material moving, Production placed second followed by protective services, installation, maintenance, and repair and construction all in succession.

• #26 Heat stress and heat strain among outdoor workers in El Salvador and Nicaragua | Journal of Exposure Science & Environmental Epidemiology

  https://www.nature.com/articles/s41370-023-00537-x

  There is growing attention on occupational heat stress in Central America, as workers in this region are affected by a unique form of chronic kidney disease. […] The aims were to characterize heat stress and heat strain and examine whether job task, break duration, hydration practices, and kidney function were associated with heat strain. […] This is the largest study to-date examining heat stress and strain among outdoor workers in Central America. […] Workers at sugar companies regularly experienced Tc 38C (76.9% of monitored person-days at Nicaraguan companies; 46.5% at Salvadoran companies). […] This study examined levels of occupational heat stress and heat strain experienced among outdoor workers in five industries in El Salvador and Nicaragua. […] We characterized heat stress using wet bulb globe temperatures and estimated metabolic rate and heat strain using core body temperature and heart rate.

• #27 Heat stress and heat strain among outdoor workers in El Salvador and Nicaragua | Journal of Exposure Science & Environmental Epidemiology

  https://www.nature.com/articles/s41370-023-00537-x

  Sugarcane workers, particularly cane cutters and Nicaraguan agrichemical applicators, performed more strenuous work and experienced greater levels of heat strain. […] Impaired kidney function was associated with higher heart rates and core body temperatures. […] Occupational heat stress is a significant concern for outdoor workers in physically demanding jobs, particularly under climate change projections that predict increasingly hot ambient conditions. […] Heavy physical exertion in high heat increases the risk of heat-related illnesses (e.g., heat stroke and heat exhaustion), decline in cognitive function, injury, and death. […] Interest in occupational heat stress has grown considerably. […] Growing evidence supports the hypothesis that chronic exposure to occupational heat stress plays a role in the disease’s etiology.

• #28 Heat stress and heat strain among outdoor workers in El Salvador and Nicaragua | Journal of Exposure Science & Environmental Epidemiology

  https://www.nature.com/articles/s41370-023-00537-x

  Occupational heat stress is often characterized using wet bulb globe temperature (WBGT) compared against established thresholds meant to protect workers from exceeding dangerous core body temperatures (Tc). […] For example, a study among sugarcane workers in El Salvador at different locations and time periods during the 2015 harvest consistently recorded maximum WBGTs above 28C. […] A study among sugarcane workers in Guatemala during the 2017 harvest recorded maximum WBGTs above 35C and mean WBGTs above 30C. […] A study of 45 Salvadoran sugarcane cutters found that workers spent the majority of a typical workday above 50% of their estimated maximum HR while being exposed to WBGTs above 26C for 79% of the day. […] We found that among MANOS participants, workers in the sugarcane industry, especially in Nicaragua, seem to be performing the most physically intense work, working in ambient conditions above recommended guidelines, and experiencing the greatest levels of heat strain.

• #29 This CDC data shows where rates of heat-related illness are highest | KUNC

  https://www.kunc.org/npr-news/2023-07-26/this-cdc-data-shows-where-rates-of-heat-related-illness-are-highest

  Record high rates of heat-related illness showed up early in the year in several other regions. […] CDC’s Brown notes that extreme summer heat is increasing in the U.S. „It’s hot again, and it’s getting hotter every summer,” she says. […] And she says that despite some improvements in forecasting, public messaging and access to air conditioning, „extreme heat events remain a cause of preventable deaths nationwide.” […] She cites the increase in heat-related deaths in 2020, 2021 and 2022, as tracked by the National Center for Health Statistics. […] The CDC warns that anyone spending time in the heat should take precautions. Heat-related illness may start as a rash, headache, dizziness or nausea, but can quickly escalate. […] Those who are more vulnerable to heat-related illness include pregnant people, those with lung conditions, young children and the elderly. […] The CDC is working with cities on preparing for more extreme weather, expected to get worse in the coming decades due to climate change.

• #30 Heat-Related Illness

  https://www.lni.wa.gov/safety-health/safety-research/ongoing-projects/heat-related-illness

  Heat-related Illness (HRI) ranges from relatively mild conditions such as heat cramps to more serious illnesses such as heat exhaustion. […] Cases of HRI are expected to rise in the future with changes in the climate. […] Workers compensation data are used to track Washington State HRIs every year. Data are compiled to describe case counts and to identify high-risk industries and occupations. […] SHARP also works to develop methods to identify occupational HRIs using other data sources.

• #31 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.

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

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

  Between 1979 and 2022, the death rate as a direct result of exposure to heat (underlying cause of death) generally hovered between 0.5 and 2 deaths per million people, with spikes in certain years (see Figure 1). Overall, a total of more than 14,000 Americans have died directly from heat-related causes since 1979, according to death certificates. […] For years in which the two records overlap (1999-2021), accounting for those additional deaths in which heat was listed as a contributing factor results in a higher death rate—nearly double for some years—compared with the estimate that only includes deaths where heat was listed as the underlying cause (see Figure 1). […] The indicator shows heat-related deaths reaching new highs in 2021 and 2022, which were two of the hottest years on record in the contiguous 48 states (see the U.S. and Global Temperature indicator) and featured several notable heat waves.

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

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

  The death rate from heat-related cardiovascular disease ranged from 0.08 deaths per million people in 2004 to 1.08 deaths per million people in 1999 (see Figure 2). Overall, the interaction of heat and cardiovascular disease caused about one-fifth of the heat-related deaths recorded in the underlying and contributing causes analysis since 1999 (see Figures 1 and 2). […] Since 1999, people aged 65+ have been several times more likely to die from heat-related cardiovascular disease than the general population, while non-Hispanic Black people generally have had higher-than-average rates (see Figure 2). […] Examination of extreme events has revealed challenges in capturing the full extent of heat-related deaths. For example, studies of the 1995 heat wave event in Chicago (see example figure) suggest that there may have been hundreds more deaths than were actually reported as heat-related on death certificates.

• #33 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.

• #34

  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.

• #35 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.

• #36

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

  Vulnerability to heat is shaped by both physiological factors, such as age and health status, and exposure factors such as occupation and socio-economic conditions. […] 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.

• #37

  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.

• #38

  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 impacts of heat on health: surveillance and preparedness in Europe. […] Monitoring heat impacts on health is key. […] High temperatures cause heat stress, heat exhaustion, heat stroke and complications from pre-existing medical conditions, in some cases leading to premature death. […] 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.

• #39

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

  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. […] 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.

• #40 Hot Weather: Understanding and Preventing Heat-Related Illnesses

  https://dph.illinois.gov/topics-services/environmental-health-protection/hot-weather.html

  Young children, particularly infants, are extremely sensitive to heat and can easily become dehydrated (lose more body fluids than usual) from high air temperatures. […] Age-appropriate prevention education regarding heat-related illnesses should be made available for all students, parents and staff.

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

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

  The Korea Disease Control and Prevention Agency (KDCA) has been operating the Heat-related Illness Surveillance Program since 2011, monitoring cases of heat-related illnesses and providing readily accessible reports on key case characteristics. This report analyze the key operational outcomes of the 2023 Heat-related Illness Surveillance Program and present the implications of the findings. […] In 2023, 2,818 cases of heat-related illnesses were reported through the surveillance program, an increase of 80.2% from the previous year (1,564 in 2022), and a total of 32 deaths were presumed to be heat-related, representing an increase of 255.6% from the previous year (9 in 2022). […] Heat-related illnesses occurring during the summer can be reduced or prevented with the adoption of simple health measures; failure to adhere to these recommendations can lead to casualties.

• #42 What’s New

  https://www.cdph.ca.gov/Programs/EPO/Pages/Extreme%20Heat%20Pages/BI_Natural-Disasters_Extreme-Heat.aspx

  Climate change is leading to more frequent, more severe, and longer-lasting episodes of extreme heat in California, posing a greater danger to Californians. Heat kills more people directly than any other weather-related hazard. Certain population groups are at greater risk of heat-related health impacts, including unhoused people, those working outdoors or in unconditioned indoor environments, older adults, infants and children, those with chronic health conditions, people with disabilities, pregnant people, and those with low income. However, heat-related illnesses and deaths are preventable. […] Heat-related illnesses include heat cramps, heat exhaustion and most seriously, heat stroke and death. Warning signs of heat-related illnesses vary, but may include heavy sweating, muscle cramps, weakness, headache, nausea or vomiting, paleness, tiredness or dizziness.

• #43 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

  CHICAGO, March 19, 2024 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. […] 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.

• #44 Heat illness presentations to emergency departments in Western Sydney: surveillance for environmental, personal and behavioural risk factors «

  https://www.phrp.com.au/issues/december-2023-volume-33-issue-4/heat-illness-surveillance-in-western-sydney/

  Of people presenting to EDs with heat problems, most were exposed to heat through work or outdoor activities. […] Surveillance for heat illness in emergency presentations provides insights into risk behaviours, but a modified heat illness definition may be necessary to identify those exposed in the home and built environment.

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

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

  To minimize the adverse effects of heat waves on health, the government is systematically implementing measures through relevant ministries and sectors. During the annual government-wide comprehensive planning period (May 20 to September 30), the KDCA will continue to operate the Heat-related Illness Surveillance Program to quickly identify health effects caused by heat waves.

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