Introduction: Global health risks from extreme heat are escalating at unprecedented rates. Before the hottest years on record, mortality estimates exceeded 480,000 deaths per year for 20 years. For some countries, attributed mortality is higher than any other natural hazard. The universal emergency medical and health response aims to reduce harm through early warning and self-protection advisories. Unlike other natural hazards, such as SARS-CoV-2, no standardized health protection advisory is recommended by health authorities, nor has existing content been evaluated for efficacy in reducing risk. The primary objective of this study was to analyze, compare, and assess the quality of health advice provided by health authorities in different countries aimed at reducing the risk of extreme heat. Methods: The study applied a qualitative multi-case study methodology using WHO HEPR (2023) guidance and ISO 31000 risk management standard to create domains to compare, analyze, and grade national/state health advisory guidance of 32 countries. Local country heat hazard classification indices and contextual factors were incorporated. Analysis was performed using QSR NVivo12. Results: Health protection/risk mitigation advice varied across all framework domains. All countries included hazard-threat parameters, vulnerable groups, actions to reduce exposure, improve cooling, and manage fluid intake. Interventions were universally generic, unclear, and often misaligned with the local hazard scale. No country recommended in-situ temperature or wet bulb monitoring, detailed water consumption rates, or signals to confirm dehydration/rehydration, defined triggers to seek medical advice, included actions in the event of power loss or failure to maintain a safe thermal range, or business continuity actions. Quality rankings did not correlate with a higher relative risk of extreme heat events. Conclusion: Significant review and improvement of existing health advisories are urgently required to reduce the risk from extreme heat. Failing to address current deficits will contribute to the rising catastrophic mortality impacts from extreme heat events.
Gerard Finnigan (Sun,) studied this question.