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Guideline for the Prevention of Heat Disorder in Japan
Masami ASAYAMA
Faculty of Wellness, Chukyo Women’s University
55 Nadakayama, Yokone-cho, Obu-shi, Aichi 474-8651, Japane-mail: asayama@chujo-u.ac.jp

Abstract
In a hot and humid environment the risk of heat disorders is increased in general, and in particular inconditions of high rates of metabolic heat generation as during labor or endurance sports. Heat disorders include heat collapse, heat cramps, heat exhaustion, and heat stroke. Appropriate water replenishment,
reduced physical activity and relief from heat exposure can prevent heat disorders. Once heat disorders havedeveloped, applying first aid measures immediately is required to prevent serious aftereffects or a fatal outcome. To prevent heat disorders during sports activities, the Japan Amateur Sports Association (JASA) has
announced a “Guideline for the Prevention of Heat disorder” with “Eight Key Tips for the Prevention of
Heat disorders” in 1993. In Japan they are widely used in various fields of daily activities. Heat disorders
may occur, however, also in the absence of intense physical activity, with heat exposed infants and the aged
being at particularly high risk. The Japanese Society of Biometeorology (JSB) has launched a study groupfor the “Prevention of Heat disorder” in 2006, outlining guideline criteria in order to compile a newprevention guideline. This paper mainly provides background information of relevance for the two
prevention guidelines and about organizations engaged in Japan in the implementation of guidelines for heatdisorder prevention.
Key words: Guideline for the Prevention of Heat disorder, heat disorders

1. Introduction
The author has taken part as one of the authors in a
project putting into practice the guide book named A
Guidebook for the Prevention of Heat Disorder during
Sports Activities (Kawahara & Morimoto, 1993) issued
by the Japan Sports Association (JSA). The first editionof the guidebook had been issued in 1993, and a total of
approximately 150 million copies have been publishedand distributed up to November 2008. In addition, theauthor is engaged in compiling the “Guideline of heatdisorders during ordinary life activities” in cooperation
with Professor Inaba from Juntendo University as thechairman of the Association for the Prevention of Heat
Disorder study group of the Meteorological Society ofJapan. The booklet mainly introduces to the public two
guidelines how to avoid heat disorders and about activities required for prevention, which have been recommended by various study groups.

2. “A Guidebook for the Prevention of Heat
Disorder during Sports Activities” Issued
by JSA
According to annual reports regarding payments ofdeath benefit announced by the National Agency for the
Global Environmental Research
13/2009: 19-25
printed in Japan

Advancement of Sports and Health, the percentage offatal heat disorder casualties among students during
sports activities is around 2 to 5%. This is a small
fraction compared with the approximately 60% diagnosed as cardiovascular sudden death.
However, the fraction of life-threatening cases ofheat disorders may be further reduced because they areoften due to avoidable incidents or to accidents resulting
from “lack of knowledge and overexertion” and, consequently, could be reduced by educational information
about how to prevent heat disorder accidents in advanceand about measures to be taken adequately as first aid
treatment which is of great importance.
For this purpose JSA had launched and organized athree year project with a study group in 1991 in order tospread and familiarize essential knowledge about heatdisorder prevention, starting with the project: “Study
regarding the prevention of heat disorders accident.”
Since then, this specific project study was continued
over eleven years until 2001 with an engagement of
more than 20 man-days being required (Asayama, 2001).
2.1 Definition of heat disorders
Upon launching the above-mentioned project study,
the definition of the term “heat disorders” had to be discussed. It includes heat collapse, heat cramps, heat©2009 AIRIES20

M. ASAYAMA

exhaustion, and heat stroke (Kawahara & Morimoto,
1993; Morimoto, 2005). Heat collapse is caused byorthostatic cerebral malperfusion following from inadequate supply of blood volume to the heart due to a deficit in blood volume or its peripheral accumulation in
cutaneous venous vessels. Heat cramps are tonic skeletal
muscle contractions, following imbalances of bloodelectrolytes, e.g., lowered plasma Na+ when only water
but not salt is ingested to replenish water loss due tosweating. Heat exhaustion is a fatigue syndrome during
strenuous exercise or labor resulting from loss of waterand salt in amounts causing major reduction of theextra-cellular body fluid compartment. Heat exhaustion
can deteriorate towards heat stroke. Heat stroke is themost damaging and potentially life-threatening disorder.
This is characterized by a multitude of path physiological disturbance with symptoms indicating impaired
brain function, which may irreversible and ultimately
fatal due to structural damage in the central nervous system (CNS). This is the result of excessive CNS hyperthermia or insufficient oxygen supply, if brain food isinadequate, from general circulatory in sufficiency, from
respiratory insufficiency, or from severe disturbance ofelectrolyte balance.
Regarding the terminology, “heat stroke or heatstroke” has been proposed as an all-including term bysome investigators to characterize heat-related pathophysiological states. However, “heat disorder” as the
all-inclusive term seems to be more suited because it
takes account of the different degrees of severity outlined above. “Thermal fever” as a state of hyperthermia
is a specific pathophysiological condition attributable tothe action of pyrogens and cytokines. However, in
combination with hot conditions it may aggravate heatdisorders. Using the term “heat stroke” should be restricted to the most severe and potentially fatal state ofheat disorder. The JSA study group has adopted “heatdisorder” as the all-inclusive term when explicating
medical problems associated with the impact of heat or
hyperthermia. As mentioned later, JSB follows the same
terminology, which is also used subsequently.
2.2 Study for preventing accidents caused by heatdisorders
The project study was carried out to “establish”
guidelines to be observed in order to propose adequate
strategies how to supervise and control sports activities
under hot environmental conditions. It has taken into
account a wide variety of worldwide research concerning measures to be taken for heat disorder prevention
and presents a survey of the actual state of knowledge
about the relationship between frequency of heat disorder accidents and weather conditions. As an important
aspect of completing the study, basic research concerning physiological mechanisms of body temperatureadjustment in hot (and humid) environments and pathophysiological mechanisms important for the occurrenceof heat disorders have been reviewed.
In cooperation with the Japan High School BaseballFederation observations of high school baseball games,
where heat-related fatal accidents rank highest in number, have provided information about environmental
temperature, amount of sweat loss, amount of water
replenishment, as well as body temperatures to define
safety limits for physical activity. These results havebeen well utilized and referred to in setting guidelines.
Emphasis has also been put on teaching how to takepreventive measures to avoid heat disorders which havematerialized in a number of lectures conducted andsummarized as a guidebook entitled Guidelines for thePrevention of Heat Disorders in 1993.
2.3 “Guidelines for the Promotion of Heat Disorder
Prevention”
The guidebook consists of “Exercise for the prevention of heat disorders” as shown in Table 1, “Eight key
tips for the prevention of heat disorder” as shown in
Table 2, and supporting documents. The key tips are
based on “Guidelines for preventing heat disorders” as
the reference work based on the results of epidemiological findings of environmental temperature conditions,
number of cases of heat disorders accidents and frequency of casualties (Nakai, 1993; Nakai et al, 1998;
Morimoto & Nakai, 2008).
The index considered to be most informative for theenvironmental thermal conditions indicating heat disorder probability is Wet-Bulb Globe Temperature (WBGT)
because it comprises three important factors: air temperature, air humidity, and radiant heat, among four environment factors which are temperature (1), humidity(2), radiant heat (3), and air velocity (4).
WBGT is worked out in two different calculating
formula, depending on the survey places or sites (outdoors or indoors).
Outdoors:
WBGT = 0.7 × wet-bulb temperature + 0.2 × globe
temperature + 0.1 × dry-bulb temperature
Indoors:
WBGT = 0.7 × wet-bulb temperature + 0.3 × globe
temperature
Globe temperature is usually not measured in daily
life. Therefore as an approximation to the actual WBGT,
dry-bulb temperature and wet-bulb temperature areweighed as indicated for indoor conditions.
Thanks to the efforts of JASA for the education of
preventing heat disorder, the importance of paying attention to the actual climatic conditions and of taking careof appropriate liquid intake or water replenishment has
become known widely and generally accepted by the
public.

Guideline for the Prevention of Heat Disorder in Japan

21

Table 1 Exercise indices for the prevention of heat disorders.

Based on the “Eight key tips for the prevention of heat disorders,” these indices provide guides to how much exercise can be safely performed invarious environments. The Wet Bulb Globe Temperature (WBGT) index is employed, but for the case when the WBGT cannot be measured, wet
and dry-bulb temperature guides are provided.

WBGT
ºC

Wet-bulb Dry-bulb
Temp.ºC Temp.ºC

31

27

35

28

24

31

25

21

28

21

18

24

Notes
Exercise:
Prohibited

Above the WBGT 31ºC, the actual temperature is higher than the skintemperature, so the body cannot let heat escape, and except for special cases,
all exercise should be stopped.
Severe Warning: Above the WBGT 28ºC, danger of heat disorders is high, so events that require
Heavy exercise
heavy exercise or events where the body temperature will rise, like endurance
prohibited.
races should be avoided. When such events are held, rest periods should be
provided often and water replenishment conducted aggressively. People who are
weak or not used to the heat should stop exercise.
Warning:
Above the WBGT 25ºC, the danger of heat disorders increases, so rest periods
Rests should beshould be provided often and water replenishment conducted. Rest periods should
provided often.
be provided every 30 minutes for events requiring heavy exercise.
Caution:Above the WBGT 25ºC, the danger of heat disorders increases, so rest period
Water should be should be provided often and water replenishment conducted. Rest period should
replenished often. be provided every 30 minutes for events requiring heavy exercise.
Almost safe:
Below the WBGT 21ºC, normally the danger of heat disorders is small but
Appropriate
appropriate water replenishment is necessary.
water replenish- Heatstroke can occur even under these conditions in events such as citizen
ment suggested. marathons, so caution is advised.

WBGT (Wet Bulb Globe Temperature):
Outdoors: WBGT = 0.7 × wet-bulb temperature + 0.2 × globe temperature + 0.1 × dry-bulb temperature
Indoors: WBGT = 0.7 × wet-bulb temperature + 0.3 × globe temperature
The WBGT is desirable for assessments of environmental conditions.
Assessments based on wet-bulb temperature can be underestimated when the humidity is high, so the dry-bulb temperature should also be considered.
(ICB2008, Human 1, Symposium)

Table 2 Eight Key Tips for the Prevention of Heat disorder.
1
2
3
4
5
6
7
8

Knowledge is the key to the prevention of heat disorders
Don’t panic, but apply first aid immediately
When it is hot, strenuous exercise can cause accidents
Heat waves require caution
Replenish lost water and salt
Body weight loss indicates sweat loss and dehydration
Dress lightly and stay cool
Poor physical condition can cause accidents

3. “Guidelines for the Prevention of Heat
Disorder in Daily Life” by JSB
The JSB has been established in 1962, in order tostudy those aspects of environmental biology whichhave to be analyzed in order to understand how life andperformance of plants, animals and, in particular humans respond to climatic and meteorological challenges
and which adaptive processes are available to plant andanimal species to cope with long lasting changes of
meteorological and climatic parameters. Because of thecomplexity of interactions that are effective between life
functions and the physical and chemical environment,
research in Biometeorology encompasses a wide field ofdisciplines including Geography, Atmospheric Researchand Oceanography which, together with Hydrology andGlaciology, serve as important sources of information
for short-term and long-term developments in Climatology. Associated with these studies, the introduction ofsophisticated technologies for corresponding research is.
The results are of indispensable prognostic value to analyze and predict the development of those parameterswhich ultimately determine regional and local climateswith special consideration of Global Warming. Targets
in the Biosphere of the environmental impacts identified
and predicted by the multitude of environmental research activities are in the focus of Life Sciences which
encompass biological and ecological aspects of life
including agriculture and Cattle raising as importantfields of research. With special respect to human life,
Medicine, Environmental Epidemiology, Exercise
Physiology, Physical Education are complemented by amultitude of scientific approaches to study Adaptation to
the Environment including hyperbaric (deep sea) andreal or simulated spacecraft conditions.
With special respect to Heat disorders and Global
warming the JBS has started a working group named“Heat disorders prevention survey committee” in 2006,
and launched the setting of “Guidelines of preventing
heat disorders during daily life activities.” Analysis of
age-related mortality has revealed that the frequency ofheat disorder incidences increases in the 7th age decadeand culminates in the 8th age decade (Fig. 1) (Nakai
et al, 1992; Morimoto & Nakai, 2008). This is understandable by the fact that physiological capacities tocounteract heat loads imposed on the body decline
progressively with advancing age. Infants also show ahigh score of casualties; they are particularly susceptible
to fluid losses and to insolation, i.e., absorption of heatfrom solar radiation including its ultraviolet component.
A peak during the phase of adolescence may be attributable to excess physical activity, especially of those engaged in sports. There is also an enhanced level ofcasualtis among the middle-aged, i.e., among those persons engaged in professional work which may imply
heat exposure in factories and mines as well as during
outdoor work in the field. Among the aged or seniors, a

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M. ASAYAMA
Accumulative heat stroke mortality

Fig. 1 Distribution of heat stroke mortality by age groupin Japan (From 1968 through 2005).
Filled column; male, and open column: female

Table 3 A guide to prevent heatstroke in daily life.
Temperature(WBGT scale)Threat of heatdisorder(Higher than
31ºC)
Severe warning(28ºC-31ºC)
Warning(25ºC-28ºC)

Physical activity
level and the riskof heat disorder
At any physicalactivity level

At any physicalactivity level

Medium physicalactivity level
might lead to heatdisorderCautionRisk with high(less than 25ºC) level of physicalactivity

Notes
In the elderly, heatdisorder might occur
even under resting
conditions．
Avoid outdoor activity,and stay in a cool room.
Avoid direct sun lightoutdoors. Watch for any
increase in room
temperature.
When high level physicalactivity is repuired,frequent rest periods
are recommended.
Generally the risk is low,
but heavy physicalactivity might cause an
accident.

comparably high frequency of heat disorders occurs
even during ordinary life activities (Yamanouchi et al,
2004; Iriki & Simon, 2006). These observations havefound their expression in the publication of additional
information by the JSB, as Guidelines to Prevent Heat
Disorders in Daily life, from a draft by Dr. Hoshi, one of
the committee members of JSB. It is introduced into thissurvey as shown in Table 3 on behalf of JSB (2008) as a
guidance especially for the aged.
3.1 Outlines of Guidelines
Individual physiological limits such as gender,
anamnesis for health risks and state of training have to
be considered and weighed against the actual conditionsof thermal strain and against exercise intensity required
for the desired level of performance in order to judge on
degrees of heat stress which an individual may safely
tolerate during strenuous (endurance) exercice. Preconditions would be presence of a competent supervisor andmeasures to be taken (supply of energy, water andelectrolytes) to prevent deterioration of the subject’s
ability to remove heat from the body without becoming

dangerously hyperthermic and not to run out of fuel (soto speak). When setting Prevention Guidelines to avoid
heat stroke only general recommendations are possible,
as they are listed in Tables 1 and 2.
However, a general and clear distinction may bemade between healthy adults and aged persons. Even if
the aged are healthy, they are at higher risk to sufferfrom heat disorders or heat stroke. Therefore age related-risks have to be outlined separately, i.e., generally
for persons who are at or beyond the age of retirement.
Although there are still large individual differences, ageneral outline is presented in Table 3.
As a general guide for the average individual, thecommittee has adopted “Life activity standards” qualitatively describing the intensity of daily life activities.
They are listed in Table 4. The life activity standards
listed in the table present a survey for individuals withnormal fitness. “Life activity standards” are presented atthree levels and categorize all everyday activities according to whether they represent “everyday activities
categorized as light work,” “life activities categorized as
middle work” or “life activities at the level of hard workor strenuous exercise.” As an attempt to provide
information about the compatibility of the various exercise levels listed in Table 4 with the WBGT levels,
sections are colored to indicate the activity levels
permitted at the respective WBGT levels. For thehighest WBGT level activities are most limited. The
lowest WBGT level is considered to permit all activities
listed in Table 4.
Within these categories of work intensities the fourlevels presenting recommendations according to thelevel of WBGT, as they were listed in Table 3, should beobserved too: Danger of heat stroke: Exercise prohibited(above 31°C WBGT). Severe warning: Awareness ofdanger for heat stroke (at 28°C-31°C WBGT). Warning:
Awareness of heat disorders (at 25°C-28°C WBGT).
Caution: Not to exaggerate physical activities towards
the degree of exhaustion (<25°C WBGT). As a fifth
category the JSA defines a category when even intense
exercise is Almost safe: (<21°C WBGT), provided
that maintenance of water and electrolye balance isobserved.
As safety measures for students at Sports Faculties
the limits set by the four WBGT levels should beobserved. The limiting conditions for sports exercise arepresented in Table 5 showing a comparison between“Guidelines for the prevention of heat disorder during
sports activities” by JSA and “Guidelines for preventionof heat disorder in daily life” by JSB.
These guidelines do not set strict limits, however, forindividuals who are fully trained for heavy physicalexercise, e.g., when doing advanced amateur or professional sports. But supervision by trainers or comrades
should pay attention to avoid that highly trainedcompetitive athlets transgress their individual limits.
Reflecting the fact that standard temperature segmentation by “Heat disorders prevention guidelines” by
JSA is widely known, the same classifications are ap-

Guideline for the Prevention of Heat Disorder in Japan

23

Table 4 Popular listing of examples for light, middle and heavy exercise, three respective metabolic levels of internal heatproduction and ambient thermal conditions. Colored fields corresponding to different levels of WBGT temperaturesindicate what may be permitted within a given range of WBGT.

Table 5 Comparison between JSA and JSB in guidelines for thepreventions of heat disorder.
Guidelines for theprevention of heatdisorder during sports
activities by JSA
Exercise: Prohibit
Severe warning:
Heavy exercise
prohibited.
Warning: Rests should
be often provided.
Caution: Water should
be replenished often.
Almost safe:
Appropriate water
replenishment
suggested.

Guidelines for thepreventions of heatdisorder in daily
life by JSB
Threat of heat
Higher than 31°C
stroke
WBGT(°C)

28-31°C

Severe warning

25-28°C

Warning21-25°C
Less than 21°C

Less than 25°C
Cautionplied to the “Scheme for the Prevention of Heat disorder
guidelines during daily activities” issued by the Japan
Weather Association. However some of the expressions
used are unreasonable and thus have been changed
accordingly. The sentence “Physical exercise are to be
principally stopped” in the “Heat disorders prevention
guideline” is not a common expression, and has beenchanged to “severe warning” in “Scheme for the Prevention of Heat disorder guidelines during daily life,” while“warning” and “caution” remains unchanged. “Heat disorders prevention guideline” defines WBGT below

21°C as “almost safe.” This condition is rarely observed
during daily summer outdoor life in Japan except special
cases such as the case being locked up in the car. Therefore “almost safe” has been deleted and below 25°C isdefined as “caution.”

4. Activities of Related Organizations
These days various educational activities regarding
heat disorders are getting more and more promoted, including publishing of guidebooks and leaflets, withinformation provided on websites by related organizations. Below some introductory remarks on these activities follow.
4.1 “Let us prevent heat disorders” by the Ministryof Education
Under the planning and editorship of the Ministry of
Education, Culture, Sports, Science and Technology, in
National Agency for the Advancement of Sports and
Health, which is an Independent Administrative Legal
Entity, an investigation committee has been establishedwith Professor Saito of Musashigaoka Junior College aschairman to put forward information about countermeasures against heat disorders.
The committee has issued and is distributing abooklet consisting of eight pages with A4 in size, whose
content is a digest version of the Guidebook for thePrevention of Heat Disorder during Sports Activities,
published by JSA.

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M. ASAYAMA

4.2 “Prevent heat disorders” by the Japan
Industrial Safety and Health Association
Seichi Horie, a professor of the University of Occupational and Environmental Health has written and published guidebooks called Let Us Protect Our Body from
Heat and Let Us Prevent Heat Disease with a Healthy
Life, which are both B5 in size and total seven pages inamount. Let Us Protect Our Body from Heat has gone
through several revisions since first issued in 1998, accordingly explaining how to escape from heat disorders
during labor, while Let Us Prevent Heat Disease with a
Healthy Life clarifies and summarizes the points to prevent heat disorders for laboring men and their family.
4.3 Heat disorders health guidance manual by the
Ministry of the Environment
Expecting everyone to make efforts in prevention ofheat island phenomena and earth warming, attention ispaid to prevent heat disorders by providing good andcorrect knowledge, including how to perform adequate
treatment of heat disorder victims. It is not only meant
to inform public health advisors but is of interest for
many others who are widely utilizing the respective
manual. Since such information has contributed toprevention of heat disorders (quoted from foreword), thefirst issue, released in 2005, has bee revised and published in 2006 and 2007, thus covering three consecutive years. Twelve members of the editorial board are
specialists in industrial hygiene, first-aid medicine, environmental science, aerography, sports medicine, and ofother relevant fields. The manual presents five chapters
including I. Definition of heat disorders, II. What to dowhen heat disorders takes place, III. How to prevent theheat disorder, and so on.
4.4 Heat disorders prevention system of Kusatsu
city by local administration
Kusatsu city in Shiga prefecture has established “An
Ordinance regarding Heat disorders Prevention,” to starta “severe heat disorders accidental warning system” in
2005. The large number of citizens have been carried byambulance as victims of heat disorders in the summer of
2004. This was a turning point, recognized by the mayorof the city who realized the necessity of a “Prevention of
Heat Disorder” scheme, with the crisis management
team of the city environmental department. The teamplayed a central role in setting up corresponding ordinance, as well as establishing an official “Announcement system.” These measures have attracted attentionof both national and international academic organizations. In 2006, Tajimi city in Gifu prefecture has introduced a same type of system, which has been operating
up to now.
4.5 Websites regarding heat disorders
Information regarding “heat disorders” could beobtained by accessing to websites as listed below.
Ministry of the Environment
http://www.env.go.jp/

National Institute for Environmental Studies
http://www.nies.go.jp/
Japan Sports Association
http://www.japan-sports.or.jp/
Japan Weather Association
http://www.jwa.or.jp/
Japanese Society of Biometeorology
http://www.med.shimane-u.ac.jp/

5. Challenges for the Future
Increasing numbers of casualties or fatalities resulting from heat disorders are expected, firstly because theold-old, who are over 75 of age, and largest in numberof fatal cases, will rise in number rapidly. Secondly,with global heating urban heat island phenomena will
become more frequent. Thirdly, low adaptability or
acclimatization to heat is prevailing because withincreasing civilization the fraction of the population
experiencing physiological heat defense, e.g., “sweating” will diminish with the progress in comfort of theliving conditions, especially with the progress of installation of air conditioning equipment and the transformation of facilities for labor and for playing (and amateur
sports) with the aim to establish indoor environments
imposing no heat challenge.
The accidents during sports activities certainly tend
to increase by “heat environment of 25˚C and above,”“sudden heating up,” and “long time lasting physicalexercise.” It is obvious that adequate liquid or water
replenishment and avoidance of heavy load physicalexercise in hot environments are effective measures toprevent heat disorders.
However, there are reports claiming that there iseven an increase of heat disorders occurring in conditions of “cool environment,” “right after starting exercise,” and “with light exercise.” There are reports thataged persons are even prone to be afflicted by heatdisorders in conditions that are characterized as “indoor
and calm” where conditions may be warm in theabsence of air conditions but not aggravated by elevatedinterior heat loads due to physical activity. These cases
could be explained as resulting from high body temperature which may be indicative of a febrile disease but
may also be caused by insufficient heat dissipation following dysfunction of autonomic circulatory and sweat
gland control resulting in insufficient sweat glandsecretion and compromised peripheral blood perfusion,
including capillary fragility. Attention has to be focusedin the aged on these causes of physiological deconditioning, and the best precaution to avoid suchcomplications in the aged would be effective air
conditioning.
For these reasons, I think that among the eight key
tips for prevention of heat disorder, “Poor physicalcondition factors can cause accidents,” which is introduced by JASA, has to be emphasized most, in order toprevent heat disorders. In other words, physical training,training to adapt heat dissipating capabilities are very

Guideline for the Prevention of Heat Disorder in Japan

important preventive measures, and air conditioning
may be indispensable in the aged.
In Aichi prefecture, concerned parties have sent reports or papers to prosecutors in charge of professional
negligence resulting in the death, in a case of incidental
mortality of a junior high school student. The issue disputed here is whether the eight key articles were followed accordingly or not. One decade ago, as a result of
ignorance of the concerned parties, not knowing even
the word or term of heat disorders was a major issue;
while nowadays the responsibilities of “not having
enough knowledge of heat disorders” are increasingly
under consideration.
There are many schools with poor facilities of watersupply and resort facilities for avoiding heat. Besides
taking measures for corresponding improvement of
infrastructure further improvements are sought including the development of forecast systems at field site
levels and availability for reviewing emergency aid systems for treating heat victims. Further survey is sought,with countermeasures against heat disorders based on
individual difference considered, e.g., the epidemic
occurrence of heat disorders among obese individuals.
References
Asayama, M. (2001) The course of specific project study regarding the prevention of heat disorder during sports activities. The
JSA Annual Reports of Sport Medicine and Science in 2001,
3-8. (in Japanese)
Iriki, M. and E. Simon (2006) Heat disorder in Yamanashi prefecture during the summer from 1995 to 2004, Industrial Health2006, 44: 445-457.
Japanese Society of Biometeorology (2008) Guidelines to prevent
heat disorder in daily life. Jpn. J. Biometeor, 45: 34-42.
Kawahara, T. and T. Morimoto, eds (1993) A Guidebook for thePrevention of Heat Disorder During Sports Activities. Japan

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Sports Association. (in Japanese, English Ver., 2008)
Morimoto, T. (2005) Heat stroke and its etymology. J. of Kobe
Women’s Junior College, 50: 1-7. (in Japanese)
Morimoto, T. and S. Nakai (2008) Trend in Heatstroke Fatalities
in Japan and Guidebooks for Prevention, ICB2008, Human 1.
Symposium. (in press)
Nakai, S. (1993) Number of deaths from heatstroke and meteorological condition-A survey of the last 21 years in Japan. Jpn. J.
Biometer., 30: 169-177. (in Japanese with English abstract)
Nakai, S., A. Yorimoto and T. Morimoto (1992). The relation
between environmental conditions and the occurrence of exertional heat disorders during physical activity. Jpn. J. Phys.
Fitness Sports Med., 41: 540-547. (in Japanese with English
abstract).
Nakai, S, T. Itoh and T. Morimoto (1998) Deaths from heatstrokein Japan: 1968-1994. Int. J., Biometer, 43: 124-127.
Yamanouchi, S., Y. Miyake, et al. (2004) Heat illness at present
from the field work in Tokyo, 2002. J. Jpn. Congress on
Neurological Emergencies, 17: 58-63. (in Japanese withEnglish abstract)

Masami ASAYAMA
Masami ASAYAMA is a professor of
Faculty of Wellness, Chukyo Women’s
University and Graduate School. His
major is Environmental Physiology, andhe gives lectures to female students about
Health Science and Exercise Physiology.
He is involved in education of overseas
students, being appointed as Guest
Professor of Beijing University ofPhysical Education. As for social activities, he travels all over the nation
to give lectures regarding prevention of heat disorder, sponsored by JapanSports Association. He is a chairman of local committee of Health
Promotion in Obu-city, and Administrative Manager of Sakata Golf
School, which is famous for supporting golf elites, growing up a numberof professional golfers.

(Received 6 January 2009, Accepted 5 February 2009)