Global warming and the Summer Olympic and Paralympic games: a perspective from the Tokyo 2020 Games

The Tokyo 2020 Olympic and Paralympic Games provided a significant opportunity to consider global warming as an issue to be seriously addressed to run the safe and fair games in the era of climate change. As the global temperature continuously rises and extreme hot-weather events increase in frequency and intensity, the future summer Olympic and Paralympic games will need to deal with the heat by applying thorough and appropriate countermeasures. In the recent decades, many mitigation measures to protect athletes from heat have been rapidly discussed by the sports community, including countermeasures to hold games at times and places with moderate temperature and climatic risk assessments with Wet Bulb Globe Temperature (WBGT) during the games. However, the excessive heat conditions in the Tokyo 2020 Games affected not only athletes, but also all people concerned the events. While deliberate considerations by organizers had been given to mitigate extraordinary heat, the evaluations of these measures and epidemiological analyses of risk factors of patients must be further enhanced to develop efficient measures for the future. Therefore, we discussed the underlying climate-related problems of the summer Olympic and Paralympic Games in view of what we had experienced in the Tokyo 2020 Games. Facing with emerging global warming, future intervention against heat in the summer Olympic and Paralympic games will need to integrate systematic disease surveillance and evaluation of intervention with an effective combination with the approaches previously conducted. The Tokyo 2020 Games is a wake-up call to accelerate the public health measures towards the creeping global warming.

Effects of hydration practices on the severity of heatrelated illness among municipal workers during a heat wave phenomenon

@#Introduction: The continue rise in temperatures due to climate change increases the risk of heat-related illness (HRI) among outdoor workers. This study aims to evaluate the effects of hydration practices on the severity of HRI during a heat wave episode among municipal workers in Negeri Sembilan. Method: A cross-sectional study was performed in March and April 2016. The outdoor temperatures were measured using the wet-bulb globe temperature (WBGT) tool. The participants completed a self-administered questionnaire containing sociodemographic factors prior to work shift; while working profile, hydration practices, and HRI symptoms at the end of work shift. The hydration status of the respondents was assessed by direct observation of their urine colour. Multiple logistic regression was performed to ascertain the effects of age, working profile, hydration practice, history of previous HRI, and hydration status on the likelihood that outdoor workers having moderate to severe HRI. Results: A total of 320 respondents completed the questionnaire. The mean (standard deviation) outdoor workplace temperature was 30.5°C (SD 0.53°C). The percentage of respondents who experienced moderate to severe HRI was 44.1%. The likelihood that outdoor workers experienced moderate to severe HRI symptoms was associated with irregular fluid intake [odds ratio (OR): 16.11, 95% confidence interval (95%CI): 4.11; 63.20]; consumption of non-plain water (OR: 5.92, 95%CI: 2.79; 12.56); dehydration (OR: 3.32, 95%CI: 1.92; 5.74); and increasing outdoor workplace temperature (OR: 1.85, 95%CI: 1.09; 3.11). Conclusion: Irregular drinking pattern and non-plain fluid intake was found to have a large effect on HRI severity among outdoor workers exposed high temperatures during a heat wave phenomenon.

Thirst as the threshold symptom to prevent worsening heat-related illness

@#Introduction: The heat-related illness (HRI) is a continuum illness ranging from minor health effects to life-threatening medical emergencies when the pathological effects of heat load are not prevented. The aim of this study was to demonstrate the threshold HRI symptom for deciding to take simple preventative actions both by the individual workers and employers.

Heat-related illness in Jinshan District of Shanghai:A retrospective analysis of 70 patients / 世界急诊医学杂志（英文）

@#BACKGROUND: This study aimed to investigate the epidemiological and clinical characteristics of patients with heat-related il ness, and guide the prevention, diagnosis and treatment of heat-related il ness. METHODS: From June 2013 to August 2013, seventy patients with heat-related illness were treated at Jinshan Hospital of Fudan University, and their epidemiological characteristics, laboratory results, treatment and prognosis were retrospectively analyzed. RESULTS: In the 70 patients, 18 patients suffered from heat stroke and 52 patients from non-heat stroke. When the environmnent temperature was above 35 °C, the body temperature of the patients began to increase markedly. The patients with heat stroke were significantly older than those with non-heat stroke (P<0.05). The body temperature, heart rate, blood glucose, blood lactate dehydrogenase and blood creatine kinase in the patients with heat stroke were higher than those in the patients with non-heat stroke (P<0.05). Blood lactate dehydrogenase and blood creatine kinase were positively correlated with body temperature (r=0.801). CONCLUSION: When the environmental temperature goes above 35 °C, heat-related illness should be prevented, especially in the elderly. The body temperature, heart rate, blood glucose, blood lactate dehydrogenase and blood creatine kinase in patients with heat stroke are higher than those in patients with non-heat stroke. Blood lactate dehydrogenase and blood creatine kinase are positively correlated with body temperature, but their relationship with heat-related illness awaits further study.