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When is it too dangerous to be outside? New wearable tech could tell you.

When is it too dangerous to be outside? New wearable tech could tell you.

Illnesses caused by heat—dehydration, cramps, and even strokes—can come on quickly and quietly. New, wearable technology could help alert wearers to lurking danger. Two people pick grapes in a vineyard near Fresno, California. Outdoor farm workers are on average 35 times more likely to experience heat-related illnesses than the general population. Photograph by Karla Gachet, Nat Geo Image Collection
Globally, health experts anticipate a 370 percent rise in yearly heat-related deaths and a 50 percent increase in hours of labor lost due to heat exposure.
Heat is one of the most dangerous forms of extreme weather, but symptoms can develop slowly, leading to delays in recognizing the signs of a more serious illness. That's why scientists are also developing technologies that could help save lives by telling device wearers precisely when they're overheating.
Some of these same technologies are also being developed for the public, in the form of wearable watches or sweat patches that warn when dangerous outdoor conditions are present. A worker on a farm looks out at the hot summer sun from a tractor. Greenhouse gas emissions have made extremely hot days more common. Photograph by Brian L. Frank, Nat Geo Image Collection Farm laborers are facing record high temperatures while working in unshaded fields. Above, an unplanted cotton field in Brownfield, Texas, is damaged by erosion during a heat wave. Photograph by Robb Kendrick, Nat Geo Image Collection
Long before recent heatwaves, scientists have been researching ways to measure heat stress in the body, without relying on an individual's perception of their own risk. What you put in your body can have a big impact on what you keep in your head.
The U.S. military uses an algorithm developed by scientists in 2013 that estimates the chances of heat stroke, heat exhaustion, and debilitating heat cramps by measuring changes in heart rate, skin temperature, and gait.
"This is the future," said Emma Atkinson, a biomedical researcher for the U.S. Army Research Institute of Environmental Medicine, in a 2024 press release announcing a device worn around the chest that resulted from testing the algorithms on 14,000 soldiers. "This is a life-saving device."
The army's core body temperature algorithm is the most advanced to date and is being integrated into products for the general public, said Zachary Schlader , a University of Iowa Bloomington associate professor who studies the implications of heat stress.
He acknowledges there is 'no gold standard' technology for combating heat stress in work settings, but says the most promising are algorithms to estimate internal body temperature. A construction worker covered up from the sun as morning temperatures reached 92 degrees Fahrenheit at a housing development in Marana, Arizona on Friday, July 12, 2024. Photograph by Cassidy Araiza, The New York Times/Redux
'In a clinical setting or lab, to measure the internal temperature of the body requires the measurement of rectal temperature or esophageal temperature, or different blood temperatures,' he said. 'Those aren't feasible in a work setting and in a bigger population setting. But how hot you get it, hot the inside of the body gets, is largely what determines the health risks of heat, as well as the productivity risk.'
For the public, Apple Watch, Galaxy Watch 5, and the Garmin watch can all detect skin temperature, primarily to track menstrual cycles. But to determine if someone is at risk of heat stress, wearable devices need to measure core body temperature, a capability they lack. Core body temperature measures the temperature of internal organs — like your heart, liver and brain, whereas skin temperature only captures your temperature on the surface.
Epicore , a digital health company, has created sweat-sensing patches that let wearers see their electrolyte loss, body temperature, and body movement to inform how much they need to drink to prevent dehydration.
Sony released the REON Pocket Pro , a wearable that sits between your shoulder blades and cools your body via a metal plate, in June . A separate sensor clips to your shirt to measure temperature and humidity. Testing new devices
In real-world work settings, it's unclear how effectively these devices prevent serious heat-related illnesses, according to a 2024 review of research studies of devices .
Early tests have shown some promise. In May, a startup called VigiLife released a heat stress sensor, costing between $100 and $300, that attaches to a bicep or forearm. It measures heart rate, along with core body and skin temperatures. It then gathers information from the wearable and environmental sensors to formulate health and safety insights.
For now, the technology is only available to commercial entities.
Texas-based construction firm Rogers-O'Brien adopted VigiLife's technology across its sites in mid-June. The firm saw zero heat-related illnesses and over $200,000 in savings when it piloted VigiLife's technology from May to September 2023. During a typical summer like 2023, the company might see five or six heat-related incidents that require basic on-site first aid, according to a spokesperson.
Yet, for now, most smartwatches also can't run core body temperature software without draining their batteries, CEO Zachary Kiehl noted. To reduce exposure during the hottest parts of the day, many farms hire harvesters to work overnight or in the early morning hours. Left: Workers pick tomatoes in a field in the early morning in Los Baños, California. Right: Laborers in the Western Cape province of South Africa harvest Pinot Noir wine grapes overnight. Photograph by Karla Gachet, Nat Geo Image Collection (Top) (Left) and Photograph by David Silverman, Getty Images (Bottom) (Right)
Some aren't sold on a wearable-only solution. One skeptic is Jason Glaser, the CEO of La Isla Network , a company that advocates for worker safety. The network pairs weather and health data to model heat strain on workers and recommend the best hours for avoiding outside work.
'A wearable is only an alarm system,' he said, adding that most farm workers can't afford it.
It's also unclear if, given access to wearable technology, workers would be incentivized to listen to its alerts. Intense manual labor and piece-rate payment systems, based on the quantity of produce they harvest, encourage workers to work beyond their limits without adequate access to water, shade, and breaks.
One preliminary study looking at the link between high temperatures and chronic kidney disease also found that implementing a heat safety program—added rest periods, improved access to shade and fluids, placing bathroom facilities nearby and more, at a sugar mill in Nicaragua, decreased kidney injury in workers. Some argue these company-mandated solutions might be more effective than using wearable technology.
Glaser would like to integrate wearables into his research, but that is on hold until the nonprofit receives more funding.
To save money and avoid pushback from workers who don't want to wear devices to avoid lost wages if the device indicates they need to be pulled off the job, Schlader of University of Iowa Bloomington recommends, based on his research , that only the highest risk workers wear devices. Traffic warden Rai Rogers mans his street corner during an 8-hour shift under the hot sun in Las Vegas, Nevada on July 12, 2023, where temperatures reached 106 degrees Fahrenheit amid an ongoing heatwave. Photograph by Frederic J. Brown, AFP/Getty Images
In addition to telling individuals about their own heat risk, wearable technology can also help scientists create algorithms that model the risk of working outside on a given day.
One ongoing project provides wearable biosensors that collect vital signs, measure skin hydration, and analyzes movement data from farm workers in Florida.
Researchers from Emory University in Atlanta and Georgia Tech, using a National Institute of Environmental Health Sciences grant, feed this information to an AI algorithm that may someday accurately predict when a worker could be struck by heat illness.
Experts like Schlader say it's hard to know when these heat-stress technologies will have a true impact on working conditions. It's also difficult to predict when core body temperature measurements will be easily integrated into your Apple Watch or Garmin watch by default, he said.
'To my knowledge, this is a ways off,' he said.
For now, those interested in monitoring their health during periods of intense heat can look for well-documented symptoms, such as cramps, dizziness, nausea, or headaches. Go to the CDC's website for more information on staying safe.

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When climbing the world's tallest mountains, what counts as cheating?
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And earlier this year, the International Climbing and Mountaineering Federation issued a statement warning about the absence of scientific studies to prove the safety and efficacy of xenon at high altitude. Then there's the question of whether xenon, banned in professional sport by the World Anti-Doping Agency, makes the climb up Everest so easy that it obscures the line between sportsmanship and tourism. Around 7,000 people climb Everest every year with the help of supplemental oxygen. For others, using supplemental oxygen is considered a cheap shortcut akin to utilizing sherpas and fixed-ropes. Left, a climber scales Mount Everest with the aid of supplemental oxygen. Right, oxygen tanks are seen along a section of Everest called "the Balcony" near the summit. Photograph by Matthew Irving, Nat Geo Image Collection (Top) (Left) and Photograph by Mark Fisher, Nat Geo Image Collection (Bottom) (Right) In the world of mountaineering, there's no regulatory body governing monitoring performance-enhancing drugs, but the style of a climber's ascent still holds reputational cache. Ever since Messner and Habeler's 1978 expedition proved that even the highest mountain on Earth could be climbed without supplemental oxygen, not using it has become an essential part of pushing the limits of the human body in high altitude. Called alpine style, this form of mountaineering—embraced by elite climbers—prizes climbs done without medical aids, fixed lines, or large support teams. In contrast, a 30-year boom in commercial expeditions has focused on making the mountains more accessible to less experienced climbers, with hundreds of feet of fixed ropes, large amounts of supplemental oxygen, and the support of Sherpas. Some tour guides who lead these large groups say the controversy ignited by xenon places unfair scrutiny on what's simply the latest of many tools making mountain climbing more accessible and safer. American climber Adrian Ballinger, owner of Alpenglow Expeditions, thinks climbers should just be honest about the style they choose. 'Professional athletes don't use supplemental oxygen when climbing in the mountains because it makes things easier. But for recreational and non-professional climbers who hire guiding companies, it's different,' he says. However, he draws the line at the use of xenon in mountaineering—even in commercial expeditions. 'I don't see any reason,' he says, 'to use a substance banned as doping.' Doing drugs, 29,032 feet high Climbers have a long history of employing different drugs to survive the cold and dangerous conditions of Earth's highest peaks. In 1953, mountaineering legend Hermann Buhl took methamphetamine pills, then known by the brand name Pervitin, to stay awake during a perilous descent after summiting the Himalayan mountain Nanga Parbat in Pakistan. (Buhl made his climb without supplementary oxygen and became the first and only person to achieve a solo first ascent of an 8,000-meter peak, famously surviving the night at 26,000 feet by standing on a tiny ledge.) In the following decades, mountaineers experimented with both banned and legal substances, from amphetamine to Viagra. Two well-known prescription drugs, diuretic acetazolamide (commonly known as Diamox) and corticosteroid dexamethasone (Decadron) are often used to treat high-altitude conditions like acute mountain sickness or cerebral edema—but against expert recommendations, some climbers take them preventatively. Nothing, however, works better to fight hypoxia and enhance performance at high altitude than a steady flow of supplemental oxygen. Hermann Buhl in 1953, after summiting Nanga Parba, the ninth highest mountain in world, located in Pakistan. Under the influence of the drug pervitin, a stimulant similar to methamphetamine, Buhl was able to push on to the summit after the rest of his team was forced to return to camp, making Buhl the first and only person to make a solo-ascent of an 8,000 meter peak. Photograph by Touring Club Italiano/Marka/UniversalA view of Nanga Parbat as seen from Jammu & Kashmir, 1933. Photograph by Royal Air Force/Royal'If you use supplemental oxygen continuously, oxygen delivery to tissues is maintained. You will not develop altitude illness, and exercise performance will not be affected,' explains Martin Burtscher, a long-time researcher in the field of high-altitude medicine and retired professor at the University of Innsbruck in Austria. This is why some climbers, still devoted to purist alpine style, refrain from using supplemental oxygen, since they consider it a form of high-altitude doping. Furtenbach adhered to this minimalist climbing style when he was younger, but over time opted for climbing aids that he says made ascents safer for him and his clients. He doesn't think new techniques should be looked down on if they make climbing in the Himalaya safer. 'If you want to climb at this altitude, you can do it in either an extremely dangerous way and risk your life, or you can try to climb as safely as possible,' says Furtenbach. 'And that means you need to use all the medical aids that are available.' He argues that singling out xenon is hypocritical: 'If someone wants to ban xenon from mountaineering, then it needs to be consistent and ban everything—from oxygen to dexamethasone.' The tinkling of bells accompanies yaks hauling propane and other supplies to Advanced Base Camp. Photograph by Renan Ozturk, Nat Geo Image Collection Before he became an advocate of xenon, Furtenbach had experimented with having clients sleep at home in tents with reduced oxygen and training with limited oxygen to help simulate the acclimatization process. That shortened the ascent time to three weeks. Knowing this, Fries, the anaesthesiologist, approached Furtenbach back in 2019 with the idea of using xenon and its erythropoietin production ability to accelerate acclimatisation even further. When confronted with limited oxygen at high altitude, the human body gradually releases erythropoietin after several weeks of acclimatisation, as a climber makes rounds up and down the mountain, slowly gaining altitude. Fries, who spent 15 years researching different effects of xenon while working at Aachen University's hospital in Germany, theorized that a one-time low-dose administration of the gas could produce the same results in a matter of days. Fries also contends that xenon can prevent high-altitude sickness due, in part, to its positive effect on the blood vessels that connect the heart and lungs. Furtenbach first tested xenon on himself in 2020 while climbing Argentina's 22,831-foot Aconcagua and, two years later, on Everest. Both times, he says, he felt strong and fast, and didn't experience any negative side effects. Then he crafted a plan for including xenon in the expeditions offered by his self-titled company, Furtenbach Adventures, which facilitates climbs up Everest and other famous mountains. The decision to offer xenon to clients, he says, was done to make climbing safer. 'The fewer rotations you have to do on the mountain, the safer the expedition becomes,' he argues. (Furtenbach also thinks shorter trips could help curtail the large amounts of garbage long expeditions leave behind.) For the first-ever xenon 'powered' expedition, he chose four British clients, who boasted a combination of high-altitude climbing experience and military training. After ten weeks of pre-acclimatisation at home, sleeping and training with limited oxygen, they received a low dose of xenon in a German hospital and two weeks later embarked from London on their five-day-long ascent. No immediate serious side effects from the xenon treatment were observed by Furtenbach or the members of the expedition. The price of the climb was 150,000 euros a person. Furtenbach declined to specify how much xenon, an expensive gas, added to this total. Climbing rope is a ubiquitous tool amongst mountaineers, and learning how to safely build anchors and belay are essential skills. However, on some mountains, ropes may be pre-anchored and left in place for the entirety of the season to aid less experienced climbers. Left, the first Nepali female to climb Manaslu studies ice anchors in a climbing class. Right, a mountaineer descends to camp III during an attempt to summit Hkakabo Razi, said to be Southeast Asia's tallest mountain. Photograph by Aaron Huey, Nat Geo Image Collection (Top) (Left) and Photograph by Renan Ozturk, Nat Geo Image Collection (Bottom) (Right) Not everyone with high-altitude expertise is convinced that xenon is the best way to quickly climb Everest. Some experts argued that a one-week ascent might be possible without a miracle drug like xenon, if only the climbers would use a high enough flow of oxygen right from the bottom. 'If you have a big flow of oxygen, you don't need to work as hard to acclimatise. From an oxygen perspective, you're not going to the summit of Everest, but much lower,' says Mike Grocott, professor of anaesthesia and critical care at the University of Southampton in England and expert on the physiology of hypoxia. This theory, too, was tested this May when Ukraine-born Andrew Ushakov stated that he climbed to the top of Everest in a little less than four days after leaving New York. To achieve this, he used supplemental oxygen and trained in low-oxygen conditions. A team from the Elite Exped company guided Ushakov to the top. He says he used oxygen as soon as he started his ascent from the base camp, starting with a flow of 0.5 liters per minute and slowly increasing it to three to four liters per minute, which he used on the summit day. The xenon team, Furtenbach says, didn't start using oxygen until they reached 19,700 feet, continuing from there with a usual flow of 1 to 2 litres per minute. Higher flow was used only above 26,000 feet. This theoretically means xenon could indeed have some effect on the acclimatisation process, beyond supplemental oxygen. Still, without peer-reviewed studies, it's hard to conclude that the xenon made a difference, warns Peter Hackett, a high-altitude researcher and professor at the University of Colorado Anschutz Medical Campus. 'My question is—why the big rush,' he says. 'These ascents reveal that Everest's challenge is now all about dealing with hypoxia and not really climbing.' For some climbers, no extra help wanted Climbers who abstain from performance-boosting drugs and supplemental oxygen see xenon as just another departure from the purest, and thereby most elite, form of climbing. The Piolet d'Or, the most coveted mountaineering award, perhaps best exemplifies the most prestigious climbing styles. The award currently doesn't consider ascents done with supplemental oxygen or fixed lines, giving the spotlight to imaginative and innovative new routes, doing more with less, and building on experience. One of the winning teams of last year's Piolet d'Or, American climbers Matt Cornell, Jackson Marvell, and Alan Rousseau, spent seven days charting a new route up the steep north face of Jannu in Nepal. To pack lightly, they shared a single sleeping bag. 'Alpinism without the factor of the unknown is only the plain physical activity,' says Slovenian climbing legend Marko Prezelj, four-time winner of Piolet d'Or. 'If somebody prepares the mountain for you by putting in fixed lines and you climb together with 500 people, there is nothing unknown.' The Everest massif from Camp I on Pumori. Photograph by Cory Richards, Nat Geo Image Collection Famous American alpinist Steve House, best known for his bold 'alpine style' first ascent on the Rupal face of Nanga Parbat in 2005, sees alpinism as a process of stripping away excesses to get closer to the experience. 'There is nothing inherently wrong with the ascents done with supplemental oxygen and xenon, but we need to understand these climbs as tourism, not alpinism,' says House. And Mingma Gyalje Sherpa, the first Nepali to climb all 14 of the world's 8,000-meter peaks without supplemental oxygen and founder of the Nepal-based guiding company Imagine Nepal, says there should be a limit to what tour companies offer. He thinks that the traditional way of doing proper acclimatisation is more valuable. 'I would always suggest to clients to do at least one rotation on the mountain up to Camp 2, before the summit push, so they can understand their body at high altitude. We also don't take clients without previous experience,' he says. But even if assisted climbs and medical aids become more common, Alpenglow Expeditions' Ballinger thinks there will always be an interest in unassisted alpine climbing. 'There are endless new route opportunities for alpinism in the Himalaya. And I don't think the fact that we have commercial guiding on a handful of routes on the world's most popular mountains gets in the way of the cutting-edge side of the sport,' says Ballinger. Peter Hackett, the high-altitude researcher, is less optimistic. 'The improved access, safety, and success on Everest have led to a new 'generation' of high-altitude tourists with high ambition but little climbing experience, and more money than time,' he says. 'It's all about— how I can bag this summit and miss as little work as possible.'

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