{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:58:25Z","timestamp":1790175505849,"version":"4.1.0"},"reference-count":93,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hot springs, hot-water bathing, and saunas are widely practiced forms of acute heat exposure and are often perceived as health-promoting. However, emergency clinicians frequently encounter patients in whom these exposures precipitate syncope, hypotension, drowning\/aspiration, heat-related illness, and renal or electrolyte disturbances. This narrative review integrates these modalities within a unified \u201cacute heat exposure\u201d framework and summarizes pathophysiology and clinical implications from an emergency medicine perspective. We searched PubMed\/MEDLINE from inception to January 2026 using controlled vocabulary and free-text terms related to heat stress, thermoregulation, hot-water immersion, sauna exposure, and acute clinical outcomes; evidence was synthesized qualitatively. Across modalities, acute heat exposure induces shared physiological responses\u2014peripheral vasodilation, relative hypovolemia, circulatory stress, and internal heat storage\u2014that can trigger diverse emergency presentations. We classify acute heat exposure\u2013related illness into four domains: (1) cardiovascular events, including syncope, hypotension, and arrhythmic\/ischemic complications in vulnerable individuals; (2) the heat-illness spectrum from exhaustion to heat stroke with organ dysfunction; (3) renal and electrolyte disturbances related to dehydration and hypoperfusion; and (4) neurological and traumatic complications, including falls, drowning, and aspiration. This framework may support risk stratification, evaluation, management, and prevention after hot spring, hot bath, or sauna use.<\/jats:p>","DOI":"10.3390\/jcm15051910","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T09:45:12Z","timestamp":1772531112000},"page":"1910","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute Heat Exposure-Related Illness: A Unified Emergency Medicine Framework for Hot Baths, Hot Springs, and Saunas\u2014A Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2151-2878","authenticated-orcid":false,"given":"Ryuto","family":"Yokoyama","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Yamagata University Hospital, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6857-8077","authenticated-orcid":false,"given":"Kenya","family":"Yarimizu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Yamagata University Hospital, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1508-6938","authenticated-orcid":false,"given":"Tatsuya","family":"Hayasaka","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Yamagata University Hospital, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4185-8447","authenticated-orcid":false,"given":"Kento","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Yamagata University Hospital, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Kuroki","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Yamagata University Hospital, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5539-4104","authenticated-orcid":false,"given":"Kiyotaka","family":"Soekawa","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Yamagata University Hospital, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9219-3724","authenticated-orcid":false,"given":"Tadahiro","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Yamagata University Hospital, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7681-6469","authenticated-orcid":false,"given":"Tsuneo","family":"Konta","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/S0002-9343(00)00671-9","article-title":"Benefits and risks of sauna bathing","volume":"110","author":"Hannuksela","year":"2001","journal-title":"Am. 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