Launching Criteria of “Heatstroke Alert” in Japan According to Regionality and Age Group


 To reduce heatstroke cases, the Japanese government launched “Heatstroke Alert” in 2020. In this initiative, an alert is issued when the daily maximum wet bulb globe temperature (WBGT) is expected to reach or exceed 33 °C. However, heatstroke incidents at a daily maximum of WBGT of 33 °C can vary by regions and by age groups. In this study, we analyzed the heatstroke incidence in all 47 prefectures of Japan at the daily maximum WBGT of 33 °C, considering age groups. In addition, considering variations in heatstroke incidence by prefectures and age groups, alternative “Heatstroke Alert” criteria (AHAC) by each prefecture and age group were examined. We also analyzed the daily maximum WBGT at which heatstroke incidence starts to increase (the WBGT threshold), as this can be an additional metric to “Heatstroke Alert” for the prevention of heatstroke. The results showed that the northern region (higher latitudes) of Japan has more patients with heatstroke per population, at a daily maximum WBGT of 33 °C, than the southern region (lower latitudes), by factors of approximately 3–5, considering each age group. The suggested AHAC among 47 prefectures were 29.8 [27.7–31.4] °C for 7–17 years, 32.4 [30.2–33.9] °C for 18–64 years, and 30.8 [28.5–33.2] °C for ≥ 65 years, respectively. The northern region exhibited a lower WBGT threshold (defined as the value at which heatstroke incidence is 0.1 persons per 105 people) than the southern region by approximately 3.5–5 °C, considering each age group. The calculated average WBGT threshold among 47 prefectures was 23.2 [20.4–25.3] °C for 7–17 years, 26.3 [24.2–28.1] °C for 18–64 years, and 23.1 [20.2–25.6] °C for ≥ 65 years, respectively. These findings are expected to contribute to the reinforcement of “Heatstroke Alert” and the use of WBGT information in a more preventive manner.