Exercise, Sport, and Movement: 2023 Paper of the Year

In an era when the impacts of climate change are increasingly evident, understanding its effects on human health and physical activity has never been more urgent. We are honored to recognize the following paper as our 2023 Paper of the Year: “Critical Environmental Limits for Human Tolerance to Severe Heat and Implications for Physical Activity” by Daniel J. Vecellio, Rachel M. Cottle, S. Tony Wolf, and W. Larry Kenney. This groundbreaking work not only addresses a significant knowledge gap but also shifts paradigms by integrating human physiology into climate health projections, a crucial aspect that has been largely overlooked. SIGNIFICANCE AND PARADIGM SHIFT The paper’s significance lies in its timely and critical examination of climate change impacts on human health, specifically within the context of physical activity. For too long, climate health projections have been dominated by climate scientists who often overlook the complexities of human physiology. This paper challenges this dogma by demonstrating that accounting for the limitations of human physiology reveals much severer health impact projections associated with climate change. As Ollie Jay, Ph.D., FACSM—a reviewer for Exercise, Sport, and Movement (ESM) and Professor of Heat and Health at the University of Sydney—underscores, this paradigm shift is essential for developing effective strategies to mitigate the adverse health effects of climate change. He notes that by integrating an understanding of human physiology, the authors present a more accurate and alarming picture of the future. FILLING A KNOWLEDGE GAP One of the most commendable aspects of this paper is its ability to fill a crucial knowledge gap. Previous projections often overlooked the impact of human physiological limits on heat tolerance, leading to underestimations of potential health risks. This research addresses this gap by providing evidence-based insights into how severe heat can exacerbate health issues beyond previous understandings. Celina H. Shirazipour, Ph.D.—an Associate Editor for ESM and Assistant Professor in Health Behavior Change at Cedars–Sinai Medical Center—highlights the extensive impact of this work on her own research: “It touches every facet of our field, from sociology and psychology to basic science. As climate change continues to alter our environment, researchers can no longer afford to ignore its impact on health and physical activity.” Living in Los Angeles, Celina has witnessed these changes firsthand and adjusted her research protocols accordingly: “My outdoor interventions for cancer survivors now include heat and pollution indicators to ensure the safety of our high-risk participants.” The implications of this paper extend far beyond its immediate findings. It serves as a critical reminder that climate change is already influencing the way we conduct science. Researchers working with vulnerable populations, like cancer survivors and older adults, have had to adjust their protocols to account for environmental factors such as heat and pollution. As the paper warns, these considerations will soon become universal. Heat stress is poised to affect everyone, making it imperative that we adapt our research methodologies accordingly. INNOVATIVE APPROACH AND BROADER IMPLICATIONS The paper’s innovative graphical-review format is particularly noteworthy. This format effectively conveys complex research findings in an accessible and engaging manner, enhancing comprehension and facilitating broader dissemination of the crucial insights presented. L. Bruce Gladden, Ph.D., FACSM—Associate Editor for ESM, distinguished university professor, and renowned exercise physiologist—commends this approach. He highlights the paper’s effectiveness in summarizing key physiological issues related to human thermoregulation within the context of global warming. Christina L. Master, M.D., FAAP, CAQSM, FACSM—Associate Editor for ESM and a prominent sports medicine pediatrician—aptly describes climate change as the “canary in the coal mine” for our field. Exercise and sport are among the first areas where the impacts of climate change are becoming apparent. This paper highlights that even fit individuals are not immune to severe heat stress, especially in high humidity or un-compensable heat environments, and children and youth participating sports may be particularly vulnerable. This revelation underscores the urgency for immediate and comprehensive climate action. CONCLUSION Our 2023 Paper of the Year represents an essential contribution to our field’s understanding of climate change. It not only highlights the immediate health risks posed by severe heat but also calls for a reevaluation of how we design and conduct research. By reading this paper, researchers are encouraged to consider the impact of climate on their protocols and explore new areas of study focused on thermoregulation and climate in the context of physical activity and health and how our field’s scientific advances in this area may inform policy change to lessen the negative impact of climate change on human health and well-being. In recognizing this paper, we aim to inspire further research and action. Climate change is a real and pressing threat, and the insights provided by this research are invaluable in our collective effort to mitigate its impacts. This paper is a call to action for more innovative solutions to the real-world problems that affect us all.

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