Medical evaluation for exposure extremes: Heat
Abstract
Exertional heat illness can be a serious consequence of sports or exercise in hot environments. Participants can possess intrinsic or face extrinsic risk factors that may increase their risk for heat-related illness. Knowledge of the physiology and pathology of heat illness, identification of risk factors, and strategies to combat heat accumulation will aid both the practitioner and the participant in preparing for activities that occur in hot environments. Through preparation and mitigation of risk, safe and enjoyable wilderness adventure can be pursued.
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EHS has an estimated incidence of 1 in every 1000 athletes.
“It has an estimated incidence of 1 in every 1000 athletes [62]”
From Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations (2020) · cites this paper as [62]
EHS is frequently observed in adventure races, climbing, hiking, cycling competitions, and ultra-endurance races.
“and it is frequently observed in adventure races, climbing, hiking, cycling competitions, and ultra-endurance races [52,62].”
From Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations (2020) · cites this paper as [62]
Cites
(1992) · Applied Ergonomics · doi:10.1016/0003-6870(92)90318-p · Cited by 5,774 · see citing works
Exertional Heat Illness during Training and Competition
Armstrong, L. E., Casa, D. J., Millard-Stafford, M. L., Moran, D. S., Pyne, S. W., & Roberts, W. O. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31802fa199 · Cited by 1,024 · see citing works
Excess hospital admissions during the July 1995 heat wave in Chicago
Semenza, J. (1999) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(99)00025-2 · Cited by 619 · see citing works
Thermoregulatory and blood responses during exercise at graded hypohydration levels
Sawka, M. N., Young, A. J., Francesconi, R. P., Muza, S. R., & PANDOLF, K. B. (1985) · Journal of Applied Physiology · doi:10.1152/jappl.1985.59.5.1394 · Cited by 402 · see citing works
The Induction and Decay of Heat Acclimatisation in Trained Athletes
Armstrong, L. E., & Maresh, C. M. (1991) · Sports Medicine · doi:10.2165/00007256-199112050-00003 · Cited by 361 · see citing works
The Thermophysiology of Uncompensable Heat Stress
Cheung, S. S., McLellan, T. M., & Tenaglia, S. A. (2000) · Sports Medicine · doi:10.2165/00007256-200029050-00004 · Cited by 303 · see citing works
Casa, D. J., Armstrong, L. E., Kenny, G. P., O’Connor, F. G., & Huggins, R. A. (2012) · Current Sports Medicine Reports · doi:10.1249/jsr.0b013e31825615cc · Cited by 229 · see citing works
Self-citationStroke volume during exercise: interaction of environment and hydration
González‐Alonso, J., Mora‐Rodríguez, R., & Coyle, E. F. (2000) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.2000.278.2.h321 · Cited by 220 · see citing works
Risk factors predicting exertional heat illness in male Marine Corps recruits
Gardner, J. W., Kark, J. A., Karnei, K., Sanborn, J. S., GASTALDO, E., Burr, P., & Wenger, C. B. (1996) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199608000-00001 · Cited by 177 · see citing works
Time Course of Heat Acclimation and its Decay
Pandolf, K. (1998) · International Journal of Sports Medicine · doi:10.1055/s-2007-971985 · Cited by 155 · see citing works
O’Connor, F. G., Casa, D. J., Bergeron, M. F., Carter, R., Deuster, P. A., Heled, Y., Kark, J. A., Leon, L. R., McDermott, B. P., O'Brien, K., et al. (2010) · Current Sports Medicine Reports · doi:10.1249/jsr.0b013e3181f1d183 · Cited by 119 · see citing works
Self-citationEffect of age on heat-activated sweat gland density and flow during exercise in dry heat
Anderson, R. K., & Kenney, W. L. (1987) · Journal of Applied Physiology · doi:10.1152/jappl.1987.63.3.1089 · Cited by 119 · see citing works
Exercise in the heat: challenges and opportunities
Maughan, R., & Shirreffs, S. M. (2004) · Journal of Sports Sciences · doi:10.1080/02640410400005909 · Cited by 115 · see citing works
A retrospective analysis of American football hyperthermia deaths in the United States
Grundstein, A., Ramseyer, C. A., Zhao, F., Pesses, J. L., Akers, P. D., Qureshi, A., Becker, L., Knox, J. A., & Petro, M. T. (2010) · International Journal of Biometeorology · doi:10.1007/s00484-010-0391-4 · Cited by 105 · see citing works
Heat Intolerance in Former Heatstroke Patients
Shapiro, Y., MAGAZANIK, A., UDASSIN, R., BEN-BARUCH, G., SHVARTZ, E., & Shoenfeld, Y. (1979) · Annals of Internal Medicine · doi:10.7326/0003-4819-90-6-913 · Cited by 88 · see citing works
Conley, K. M., Bolin, D. J., Carek, P. J., Konin, J. G., Neal, T. L., & Violette, D. (2014) · Journal of Athletic Training · doi:10.4085/1062-6050-48.6.05 · Cited by 86 · see citing works
Armstrong, L. E. (2003) · Medical Entomology and Zoology · Cited by 64 · see citing works
Influence of Hydration Status on Pacing During Trail Running in the Heat
Stearns, R. L., Casa, D. J., Lopez, R. M., McDermott, B. P., Ganio, M. S., Decher, N. R., Scruggs, I. C., West, A. E., Armstrong, L. E., & Maresh, C. M. (2009) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0b013e3181b73c3f · Cited by 64 · see citing works
Lopez, R. M., Casa, D. J., Jensen, K. A., DeMartini, J. K., Pagnotta, K. D., Ruiz, R. C., Roti, M. W., Stearns, R. L., Armstrong, L. E., & Maresh, C. M. (2011) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0b013e318231a6c8 · Cited by 62 · see citing works
Lipman, G. S., Eifling, K. P., Ellis, M. A., Gaudio, F. G., Otten, E. M., & Grissom, C. K. (2013) · Wilderness and Environmental Medicine · doi:10.1016/j.wem.2013.07.004 · Cited by 57 · see citing works
Hyponatremia in recreational hikers in Grand Canyon National Park
Backer, H., Shopes, E., & Collins, S. L. (1993) · Journal of Wilderness Medicine · doi:10.1580/0953-9859-4.4.391 · Cited by 49 · see citing works
Long-term psychological and physiological effects of heat stroke
Royburt, M., Epstein, Y., Solomon, Z., & Shemer, J. (1993) · Physiology & Behavior · doi:10.1016/0031-9384(93)90109-s · Cited by 44 · see citing works
Exertional Heat-Related Illnesses at the Grand Canyon National Park, 2004–2009
Noe, C. R. S., Choudhary, E., Cheng-Dobson, L. J., Wolkin, A. F., & Newman, C. S. B. (2013) · Wilderness and Environmental Medicine · doi:10.1016/j.wem.2013.06.008 · Cited by 37 · see citing works
Development of a Heat-Illness Screening Instrument Using the Delphi Panel Technique
Eberman, L. E., & Cleary, M. A. (2011) · Journal of Athletic Training · doi:10.4085/1062-6050-46.2.176 · Cited by 26 · see citing works
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Treatment and Prevention of Heat-Related Illness
Sorensen, C. J., & Hess, J. J. (2022) · New England Journal of Medicine · doi:10.1056/nejmcp2210623 · Cited by 221 · see citing works
Lipman, G. S., Gaudio, F. G., Eifling, K. P., Ellis, M. A., Otten, E. M., & Grissom, C. K. (2019) · Wilderness and Environmental Medicine · doi:10.1016/j.wem.2018.10.004 · Cited by 97 · see citing works
Health Risks and Interventions in Exertional Heat Stress
Leyk, D. (2019) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2019.0537 · Cited by 95 · see citing works
Savioli, G., Zanza, C., Longhitano, Y., Nardone, A., Varesi, A., Ceresa, I. F., Manetti, A. C., Volonnino, G., Maiese, A., & Russa, R. L. (2022) · Biomedicines · doi:10.3390/biomedicines10102542 · Cited by 44 · see citing works
Short-Term, Low-Volume Training Improves Heat Acclimatization in an Operational Context
Charlot, K., Tardo‐Dino, P., Buchet, J.-F., Koulmann, N., Bourdon, S., Lepetit, B., Roslonski, M., Jousseaume, L., & Malgoyre, A. (2017) · Frontiers in Physiology · doi:10.3389/fphys.2017.00419 · Cited by 28 · see citing works
A novel mouse model of heatstroke accounting for ambient temperature and relative humidity
Miyamoto, K., Suzuki, K., Ohtaki, H., Nakamura, M., Yamaga, H., Yagi, M., Honda, K., Hayashi, M., & Dohi, K. (2021) · Journal of Intensive Care · doi:10.1186/s40560-021-00546-8 · Cited by 26 · see citing works
Martínez-Sanz, J. M., Fernández Nuñez, A., Sospedra, I., Martínez-Rodríguez, A., Domínguez, R., González-Jurado, J. A., & Sánchez-Oliver, A. J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17114082 · Cited by 25 · see citing works
Tarp-Assisted Cooling for Exertional Heat Stroke Treatment in Wildland Firefighting
Pryor, R. R., Haboian, K., Fitts, T., & Stooks, J. (2023) · Wilderness and Environmental Medicine · doi:10.1016/j.wem.2023.08.002 · Cited by 15 · see citing works
Self-citationOjha, A., Shakerian, S., Habibnezhad, M., Jebelli, H., Lee, S. H., & Fardhosseini, M. S. (2020) · Creative Construction e-Conference · doi:10.3311/ccc2020-004 · Cited by 15 · see citing works
Evaluating the potential public health impacts of the Toronto cold weather program
Benmarhnia, T., Zhao, X., Wang, J. C., Macdonald, M., & Chen, H. (2019) · Environment International · doi:10.1016/j.envint.2019.03.042 · Cited by 14 · see citing works
Chambers, S. N., Boyce, G. A., & Jacobs, W. J. (2021) · Emotion, space and society · doi:10.1016/j.emospa.2021.100764 · Cited by 11 · see citing works
Implications of climate change on acute kidney injury
Freidin, N. T., Hayes, E., & Struthers, S. A. (2023) · Current Opinion in Nephrology & Hypertension · doi:10.1097/mnh.0000000000000926 · Cited by 9 · see citing works
AlSahow, A. (2023) · International Journal of Nephrology · doi:10.1155/2023/2636507 · Cited by 9 · see citing works
Climate change and liver disease: a mini review
Ribeiro, T., & Macedo, G. (2024) · Frontiers in Gastroenterology · doi:10.3389/fgstr.2024.1334877 · Cited by 7 · see citing works
Assessing heat-related health risk in Ghana using bioclimatic indices
Adjei, M. J., Yamba, E. I., Tuholske, C. P., Wemegah, C. S., & Amekudzi, L. K. (2025) · Scientific African · doi:10.1016/j.sciaf.2025.e02926 · Cited by 7 · see citing works
Diagnosis and treatment of patients with heat-related illnesses
Ryu, J. H., & Min, M. K. (2021) · Journal of Korean Medical Association · doi:10.5124/jkma.2021.64.4.296 · Cited by 6 · see citing works
Climate change's implications for practice
Mueller, K., Allstrom, H., Smith, D. J. B., Downes, E. A., & Modly, L. A. (2024) · The Nurse Practitioner · doi:10.1097/01.npr.0000000000000230 · Cited by 5 · see citing works
Applicability of Heat Stress Index in the Context of Military Work: Pilot Study
Galan, J. C. A., & Guedes, J. C. (2019) · Studies in systems, decision and control · doi:10.1007/978-3-030-14730-3_34 · Cited by 5 · see citing works
Stimulant medications effects in heat-related illness in ADHD patients: a large database study
Zinabu, S., Gasmelseed, H. I., Wheaton, N., Girma, F., Wong, C., Tabraiz, S. A., Mubasher, A., Mack, A. A., Lexima, P., Qazi, O., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1509385 · Cited by 4 · see citing works
Sharma, A., Muresanu, D. F., Lafuente, J. V., Ozkızılcık, A., Tian, Z. R., Buzoianu, A. D., & Sharma, H. S. (2017) · Springer eBooks · doi:10.1007/978-3-319-57696-1_5 · Cited by 4 · see citing works
Chambers, S. N., & Miranker, M. (2022) · The Professional Geographer · doi:10.1080/00330124.2022.2081223 · Cited by 4 · see citing works
Yılmaz, S., Tatlıparmak, A. C., Erbil, B., Akarca, F. K., Karakayali, O., Bozkurt, S., Dursun, R., BIÇAKÇI, N., Çelikmen, M. F., YILMAZ, S., et al. (2026) · Turkish Journal of Emergency Medicine · doi:10.4103/tjem.tjem_280_25 · Cited by 2 · see citing works
General Medical Emergencies in Athletes
Verhey, J. T., & Poon, S. K. (2023) · Clinics in Sports Medicine · doi:10.1016/j.csm.2023.02.007 · Cited by 2 · see citing works
Tetzlaff, E. J., Goulet, N., Gorman, M., & Kenny, G. P. (2025) · PLoS ONE · doi:10.1371/journal.pone.0318229 · Cited by 2 · see citing works
Naldo, R., Boeckman, J., Vanos, J., Kavouras, S. A., & Wardenaar, F. C. (2023) · Nutrition and Health · doi:10.1177/02601060221150303 · Cited by 2 · see citing works
Infant heat balance in hot, dry conditions: Implications for infant health in a warming world
van de Kamp, E., Klomp, A. M. H., Morrison, S. A., & Daanen, H. A. M. (2026) · Hygiene and Environmental Health Advances · doi:10.1016/j.heha.2026.100194 · Cited by 1 · see citing works
Aerts, R., & November, E. J. J. (2017) · Wilderness and Environmental Medicine · doi:10.1016/j.wem.2017.03.001 · Cited by 1 · see citing works
Kim, J. H., Ryoo, H. W., Moon, S., Jang, T. C., Jin, S.-C., Mun, Y. H., Soo, B., Lee, S. B., & Kim, J.-Y. (2019) · Journal of Yeungnam Medical Science · doi:10.12701/yujm.2019.00248 · Cited by 1 · see citing works
Marquis, J., Benlamri, M., Dent, E., & Suyeshkumar, T. (2017) · University of Western Ontario Medical Journal · doi:10.5206/uwomj.v86i1.2147
Bigard, X. A. (2020) · Elsevier eBooks · doi:10.1016/b978-2-294-76248-2.00022-8
Alhamaid, Y. A., Alhashim, F. A., Alhussain, H. S., Abuzaid, A. H., Al-Abdullah, G. H., Ahmed, F. A., Alaithan, T. M., & Alfaraj, D. (2026) · Journal of Taibah University Medical Sciences · doi:10.1016/j.jtumed.2026.02.005
Domenico, H. D. (2023) · doi:10.70675/99cdde1dza6ffz482ez840ez34bade84539a
- Authors
- Pryor, R. R., Bennett, B. L., O’Connor, F. G., Young, J. M. J., & Asplund, C. A.
- Affiliations
- University of Connecticut (US)
- Uniformed Services University of the Health Sciences (US)
- University of Hawaiʻi at Mānoa (US)
- Augusta University (US)
- Corresponding author
- Pryor, Riana R.
- Venue
- Wilderness & Environmental Medicine
- Publisher
- SAGE Publications
- Published
- 2015-12
- Volume
- 26
- Issue
- 4_suppl
- Pages
- 69-75
- ISSN
- 1080-6032 (ISSN-L)
- 1545-1534
- OpenAlex
- W4254328238
- Cited by
- 32
- References
- 24
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 5 · 2017: 4
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Wilderness and Environmental Medicine (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- exertional heat illness, heat exposure, risk factors, heat accumulation, heat mitigation strategies, exercise in the heat, medical assessment
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