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Objectives: This document aimed to summarise the key components of exertional heat stroke (EHS) prehospital management.Methods: Members of the International Olympic Committee Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020 summarised the current best practice regarding the EHS prehospital management.Results: Sports competitions that are scheduled under high environmental heat stress or those that include events with high metabolic demands should implement and adopt policy and procedures for EHS prehospital management. The basic principles of EHS prehospital care are: early recognition, early diagnosis, rapid, on-site cooling and advanced clinical care. In order to achieve these principles, medical organisers must establish an area called the heat deck within or adjacent to the main medical tent that is optimised for EHS diagnosis, treatment and monitoring. Once admitted to the heat deck, the rectal temperature of the athlete with suspected EHS is assessed to confirm an elevated core body temperature. After EHS is diagnosed, the athlete must be cooled on-site until the rectal temperature is below 39°C. While cooling the athlete, medical providers are recommended to conduct a blood analysis to rule out exercise-associated hyponatraemia or hypoglycaemia, provided that this can be safely performed without interrupting cooling. The athlete is transported to advanced care for a full medical evaluation only after the treatment has been provided on-site.Conclusions: A coordination of care among all medical stakeholders at the sports venue, during transport, and at the hospital is warranted to ensure effective management is provided to the EHS athlete. [ABSTRACT FROM AUTHOR]

Introduction Heat waves are extreme weather events that can exert notable impacts on the economy and public health (Field et al. 2014). Although the definition of a heat wave varies [...], BACKGROUND: Heat waves are extreme weather events that have been associated with adverse health outcomes. However, there is limited knowledge of heat waves' impact on population morbidity, such as emergency department (ED) visits. OBJECTIVES: We investigated associations between heat waves and ED visits for 17 outcomes in Atlanta over a 20-year period, 1993-2012. METHODS: Associations were estimated using Poisson log-linear models controlling for continuous air temperature, dew-point temperature, day of week, holidays, and time trends. We defined heat waves as periods of > 2 consecutive days with temperatures beyond the 98th percentile of the temperature distribution over the period from 1945-2012. We considered six heat wave definitions using maximum, minimum, and average air temperatures and apparent temperatures. Associations by heat wave characteristics were examined. RESULTS: Among all outcome-heat wave combinations, associations were strongest between ED visits for acute renal failure and heat waves defined by maximum apparent temperature at lag 0 [relative risk (RR) = 1.15; 95% confidence interval (CI): 1.03-1.29], ED visits for ischemic stroke and heat waves defined by minimum temperature at lag 0 (RR = 1.09; 95% CI: 1.02-1.17), and ED visits for intestinal infection and heat waves defined by average temperature at lag 1 (RR = 1.10; 95% CI: 1.00-1.21). ED visits for all internal causes were associated with heat waves defined by maximum temperature at lag 1 (RR = 1.02; 95% CI: 1.00, 1.04). CONCLUSIONS: Heat waves can confer additional risks of ED visits beyond those of daily air temperature, even in a region with high air-conditioning prevalence. https://doi.org/10.1289/EHP44

Context: Exposure to severe heat can have detrimental effects on athletic performance and increase the risk of exertional heat injuries. Therefore, proactive assessment of the environmental characteristics of international football match venues becomes critical in ensuring the safety and optimal performance of the athletes. Objective: To propose the use of climatologic data (modeled wet-bulb globe temperature [WBGT]) in making athleticevent management decisions for the 2020 Summer Olympic Games and the 2022 Fédération Internationale de Football Association World Cup. Design: Descriptive study. Setting: Hourly meteorologic input data for a WBGT model were obtained from the second Modern-Era Retrospective Analysis for Research and Applications for Japan (Yokohama and Saitama) and Qatar (Doha and Al-Daayen). Main Outcome Measure(s): The pattern of hourly WBGT and percentage of hours between 308C and 328C and exceeding 328C WBGT during the expected competition periods for the 2020 Summer Olympic Games in Japan and the scheduled (November, December) and traditional (June, July) periods of the World Cup games in Qatar. Results: The WBGT during the 2020 Olympic football tournament in Japan may exceed 308C in 40% to 50% of the late mornings and early afternoons. The shift in tournament timing for the 2022 Fédération Internationale de Football Association World Cup in Qatar from the summer to late fall will reduce the exposure to -308C WBGT to null. Conclusions: Directors of mass sporting events should consider using climatologic data in their organizational decision making to assess the potential heat illness risk and to implement risk-mitigation plans. [ABSTRACT FROM AUTHOR]

BACKGROUND: Heat waves are extreme weather events that have been associated with adverse health outcomes. However, there is limited knowledge of heat waves' impact on population morbidity, such as emergency department (ED) visits. OBJECTIVES: We investigated associations between heat waves and ED visits for 17 outcomes in Atlanta over a 20-year period, 1993-2012. METHODS: Associations were estimated using Poisson log-linear models controlling for continuous air temperature, dew-point temperature, day of week, holidays, and time trends. We defined heat waves as periods of =2 consecutive days with temperatures beyond the 98th percentile of the temperature distribution over the period from 1945-2012. We considered six heat wave definitions using maximum, minimum, and average air temperatures and apparent temperatures. Associations by heat wave characteristics were examined. RESULTS: Among all outcome-heat wave combinations, associations were strongest between ED visits for acute renal failure and heat waves defined by maximum apparent temperature at lag 0 [relative risk (RR) = 1.15; 95% confidence interval (CI): 1.03-1.29], ED visits for ischemic stroke and heat waves defined by minimum temperature at lag 0 (RR = 1.09; 95% CI: 1.02-1.17), and ED visits for intestinal infection and heat waves defined by average temperature at lag 1 (RR = 1.10; 95% CI: 1.00-1.21). ED visits for all internal causes were associated with heat waves defined by maximum temperature at lag 1 (RR = 1.02; 95% CI: 1.00, 1.04). CONCLUSIONS: Heat waves can confer additional risks of ED visits beyond those of daily air temperature, even in a region with high air-conditioning prevalence. [ABSTRACT FROM AUTHOR]

An examination of oxygen and hydrogen isotopic compositions of precipitation in NE Asia from the IAEA/WMO data set reveals that many sites have a distinct winter-summer seasonal pattern in deuterium excess (d-) values that appears to reflect different climatic conditions. To further understand this pattern, stable isotopic data were obtained for individual rainfall events over a 2 yr period at Jeju Island, Korea. The δ[sup 18]O- and δD-values of precipitation at Jeju Island are not dependent upon temperature. However, the deuterium excess values, which range from 3.0 to 40.6%, show a distinct seasonal variation with higher d-values in winter (>∼15‰) and lower values in summer (∼10‰). Such a seasonal variation is closely related to different air masses affecting the island during different seasons: a cold-dry continental polar air mass in winter and a hot-humid maritime tropical air mass in summer. [ABSTRACT FROM AUTHOR]

Snow cover is found across extensive areas of the northern hemisphere during the winter and early spring seasons. Meltwater provided by this snow cover can be an important source of freshwater for agriculture, domestic uses and hydroelectric power. Rapid ablation of the snowpack, however, can also pose environmental hazards such as flooding. The ability to forecast meltwater quantities is dependent upon a knowledge of the factors influencing the snowmelt process. This paper employs a hybrid modeling and synoptic climatological approach to investigate the relationships between synoptic weather patterns, surface energy fluxes and midwinter snowmelt in the northern Great Plains. The first objective of this study is to identify distinct synoptic patterns that are associated with days where significant snow cover ablation occurred. The second objective is to evaluate the relationships between synoptic-scale weather patterns, snow surface energy transfers and snowmelt. A case study of 21 February 1975 is used to illustrate these relationships. Unlike the other synoptic-type studies, which rely on empirically derived energy flux data from single index sites, this study employs a physically based snowpack model to generate estimates of energy fluxes. The use of modelled fluxes instead of measured values allows for a more spatially extensive analysis as surface fluxes over the entire study region can be analyzed in conjunction with the prevailing synoptic-scale weather patterns. Three major synoptic types, characterized by the presence of a midlatitude cyclone, are associated with large midwinter snowmelt episodes in the northern Great Plains. The case study illustrates how variations in temperature, humidity, cloud cover and wind speeds associated with such cyclonic storms can play a major role in affecting snow surface-atmosphere energy exchanges. As expected, elevated wind speeds and stronger temperatureand humidity gradients significantly increased the transfers of sensi [ABSTRACT FROM AUTHOR]