Nearly 19,000 people around the world die from excessive heat every year while they are on the job. Exertional heat stroke—different from classic heat stroke—is a pressing public health issue, especially as climate change increases the frequency and intensity of heat waves. Harvard Public Health spoke with Jacob Berry, a resident in occupational and environmental medicine at the Harvard T.H. Chan School of Public Health, about improving public health messaging on this condition.
Why study this topic?
During a training incident, a young military member collapsed, and medics hesitated to cool her because she was sweating, and they thought that meant she wasn’t suffering from heat stroke. When she couldn’t answer my questions, a sign of neurological change, I knew we had to act quickly. I demanded water and the cooler.
This experience led me to study exertional heat stroke, which affects healthy individuals. Gaps in public awareness hinder timely care, risking lives during peak health years.
What did you find?
Existing public health messages about heat stroke contain dangerous misconceptions. One of the most common errors is the emphasis on “no sweating” as a key symptom of heat stroke, which is inaccurate in exertional heat stroke. My findings underline the need to shift focus from these misconceptions to more reliable indicators of exertional heat stroke, like changes in mental status, such as confusion and disorientation. Immediate and aggressive cooling is essential.
What would you like to see happen based on the results of the study?
We need a consistent public health campaign that emphasizes the urgency of early recognition and treatment of exertional heat stroke, such as the HASTE mnemonic (heat exposure, altered mental status, start cooling, time, emergency). Clear, unified messaging can improve response times and save lives.
–Jeremy Berger
(Study in Journal of Occupational and Environmental Medicine, November 2024)
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