熱射病（Heat Stroke），是所有熱相關疾病中最嚴重、最致命的一種。它不單單是中暑的延伸，而是一種急性高溫中樞失調的重症，當人體長時間暴露於高溫環境中，無法有效散熱時，體溫會迅速升高，超過40°C以上，進而導致神經系統受損、重要器官衰竭，最終可能引致死亡。近年來，隨著極端氣候頻繁發生，熱射病病例也不斷增加，特別是在戶外工作者、老年人與體質較差的族群中尤為常見。

在中國，有媒體報導一位農民工為賺取每小時12元人民幣的搬運費，烈日下工作，最後不幸昏倒送醫，檢查後發現其內臟因過熱被「烤成五分熟」，這不是比喻，而是真實發生的生理破壞。當核心體溫超過40°C，人體內部的酶與細胞結構開始崩解，肝臟、腎臟、小腸、甚至腦部都會出現壞死現象，導致不可逆的器官衰竭。這種狀況發展迅速，一旦病發，死亡率極高，即使即時送醫，也可能無法挽回生命。

對於需要長期在戶外曝曬工作的族群，特別是建築工人、送貨員、環衛工等，防範熱射病必須極為謹慎。首先，人體散熱主要依賴於排汗與血液循環將熱量帶到體表，因此當環境溫度與濕度同時偏高時（例如35°C以上並伴隨高濕），汗液蒸發效率大幅下降，散熱機制失效，體溫會在短時間內急劇上升。此外，若長時間未補充水分與電解質，會進一步導致脫水、低血容量與中樞神經系統功能失調，增加熱射病風險。

因此，在高溫工作環境下，應格外注意幾個方面的防護。穿著方面應選擇淺色、寬鬆且透氣的衣物，避免深色衣物吸熱。工作安排上應盡量避免在一天中氣溫最高的時段（如中午11點到下午3點）長時間暴露在陽光下。若必須工作，也應設定定時休息、喝水與降溫的時間點。水分攝取應以常溫水為主，並適量補充含鹽飲料或電解質飲品，避免大量飲用含糖飲料或冰水，後者反而會抑制出汗與造成腸胃不適。

更關鍵的是，要有對「早期熱中暑徵兆」的警覺性。當出現頭暈、噁心、皮膚灼熱但無汗、心跳加快、行為異常、注意力不集中、甚至開始意識模糊時，極可能已經進入熱衰竭或熱射病的前期，必須立刻尋找陰涼處、進行降溫處理並儘速就醫。若錯過這段黃金處理時間，體溫將失控升高，接下來就是器官功能一一崩潰的悲劇。

從社會層面而言，「熱射病是窮人的病」這句話令人心痛卻寫實。許多從事高風險體力勞動者，往往為了微薄薪資，不敢請假、不敢休息，加上僱主不願提供適當防暑措施，使其在完全沒有保護下暴露於高熱環境之中。因此除個人防範，制度層面的改善同樣重要，例如政府應加強對高溫作業的法規約束，要求企業提供冷氣休息站、定時補水、發放防暑津貼，並設立極端高溫下的停工指引，減少基層勞動者的健康風險。

總而言之，熱射病不是簡單的「天氣太熱中暑」，而是一種致命的高溫殺手。它來得快、傷得深、救治難，對於戶外工作者尤其危險。唯有提升大眾對其嚴重性的認識，並從個人與制度兩方面共同建立保護網，才能避免這類本可預防的悲劇一再重演。

Heat stroke is the most severe and deadly of all heat-related illnesses. It is not merely an advanced form of heat exhaustion, but rather a critical medical condition caused by acute dysfunction of the body’s heat regulation system. When a person is exposed to high temperatures for an extended period and cannot effectively dissipate heat, their core body temperature can rapidly rise above 40°C (104°F), leading to damage to the nervous system, failure of vital organs, and ultimately, death. In recent years, due to increasingly frequent extreme weather events, the number of heat stroke cases has steadily increased, especially among outdoor workers, the elderly, and those with weaker constitutions.

In China, a media report revealed the tragic case of a migrant worker who, for the sake of earning 12 yuan per hour for carrying heavy loads, worked under the scorching sun and eventually collapsed. After being rushed to the hospital, doctors found that his internal organs were essentially “cooked medium rare” due to the heat—this was not a metaphor, but an actual physiological breakdown. When core body temperature exceeds 40°C, enzymes and cell structures begin to degrade, leading to necrosis in the liver, kidneys, intestines, and even the brain. This cascade of internal damage can happen very quickly, and once it begins, the fatality rate is extremely high. Even with emergency medical treatment, saving the patient's life may not be possible.

For those who work long hours under direct sunlight—such as construction workers, delivery drivers, and sanitation workers—extreme caution must be taken to prevent heat stroke. The body primarily relies on sweating and blood circulation to release heat to the surface. However, when both temperature and humidity are high (e.g., over 35°C with high humidity), sweat evaporation is severely impaired. As a result, the body loses its ability to cool itself, and temperature can spike dangerously in a short time. If water and electrolytes are not replenished during this process, dehydration, low blood volume, and central nervous system dysfunction can quickly follow, dramatically increasing the risk of heat stroke.

Therefore, working in high-temperature environments requires proactive measures for protection. Clothing should be light-colored, loose-fitting, and breathable to minimize heat absorption. Work schedules should avoid the hottest parts of the day—typically between 11 a.m. and 3 p.m.—to reduce exposure to direct sunlight. If outdoor work is unavoidable during these hours, mandatory rest breaks, hydration intervals, and cooling procedures should be implemented. Water intake should consist mainly of room-temperature water, with occasional electrolyte or lightly salted drinks to maintain balance. Sugary beverages and iced water should be avoided, as they can suppress sweating and cause gastrointestinal discomfort.

More importantly, workers and employers must be alert to early signs of heat-related illness. Symptoms such as dizziness, nausea, hot but dry skin, rapid heartbeat, unusual behavior, loss of concentration, or confusion could indicate early heat exhaustion or the onset of heat stroke. Immediate action—moving to a shaded area, cooling the body, and seeking medical attention—is essential. Missing this window for intervention may lead to irreversible organ failure and death.

From a societal perspective, the saying “heat stroke is a poor man’s illness” is both heartbreaking and brutally accurate. Many low-income manual laborers continue working in extreme heat to earn their modest wages, often afraid to take breaks or ask for leave. Employers, in turn, may fail to provide adequate heat protection. These workers are left completely exposed to harsh conditions with no safeguards. Thus, in addition to individual prevention efforts, systemic changes are equally important. Governments should strengthen laws and regulations governing high-temperature labor, requiring companies to offer air-conditioned rest areas, regular hydration, heat allowances, and clear guidelines for work suspension during extreme weather.

In conclusion, heat stroke is not just “being too hot” or “mild heat exhaustion”—it is a lethal heat-related condition. It strikes quickly, causes deep internal damage, and is difficult to treat. Outdoor workers are especially vulnerable. Only by raising public awareness about its severity and establishing a dual layer of protection—both personal and institutional—can we prevent the recurrence of such avoidable tragedies.