Heat: The Silent But Avoidable Killer
< July 16 2002 > In hot weather, the absence of sweat could mean danger.
With much of the country sweltering, government health officials recently put out a reminder that this is the time of year when heat kills people and that it is important to be alert to the warning signs.
Failure to sweat means that the body's basic control mechanisms have shut down and that immediate steps must be taken to avoid serious problems, says Michael McGeehin, an environmental health expert with the Centers for Disease Control and Prevention (CDC). But there are earlier signs of heat-related physical trouble that, if noticed, can save lives.
The CDC's Morbidity and Mortality Weekly Report notes that there are an average of 400 heat-related deaths every year in the United States, but "in years when we have heat waves, we can have 600 or 700 deaths in as little as 10 days," McGeehin says. "We consider that each of these deaths is preventable. An important public health message is that heat can be a big risk to health and life."
According to the National Weather Service, extreme heat kills more people in a given year than any weather phenomenon except for extreme cold—more than hurricanes, lightning, and tornadoes. It also kills more quietly, in part because people tend to treat it more like an inconvenience than a health hazard and in part because many victims die alone at home.
The time to be especially alert is when a heat wave has gone on for several days, McGeehin says. Public health officials still are talking about the 1995 heat wave that killed 500 people in Chicago and another 85 in Milwaukee in less than two weeks.
And the danger is greatest for the youngest and the oldest of us. With children, the problem is mostly physical, because their bodies have not fully developed their defense mechanisms. The elderly have a similar physical problem; their protective mechanisms are not as good as they once were, but there is a social component to their risk, since "the elderly in urban areas tend to be poor, live alone, and have no access to air conditioning," McGeehin says.
Staying in an air-conditioned room is a simple and effective defense. For those who go out, on business or pleasure, staying in the hot sun for too long is not advisable, McGeehin says. Getting into the shade now and then will help; drinking a lot of nonalcoholic, non-caffeinated beverages is better, and the more the better. Alcohol and caffeine make your body lose moisture.
"People who are exercising should drink more water than they think is reasonable," McGeehin says, because the body can lose water through sweating faster than most people realize.
Sweating very profusely and feeling unusually warm and uncomfortable are early warning signs of trouble. Feeling unusually hot, with body temperature rising, is another. And "if you stop sweating, you should proceed immediately to a cooler environment," McGeehin says. Heat stroke is a medical emergency, so someone should summon help.
Another urgent danger sign is a deterioration of mental functioning. If you or a companion start to act confused or start talking incoherently, immediate medical attention is necessary.
One particularly dangerous combination is a young person, a car, and hot weather. Between July 1, 2000, and June 30, 2001, the report says, 78 children age 14 or under died when they were left in or around parked cars; more than a third of those deaths happened when the child was left in a motor vehicle in hot weather.
Those deaths can happen even when the weather is not unusually hot. "A young child should never be left in a car, no matter what the temperature," McGeehin says. "Every time the sun is out, a car can become very hot very quickly. On an 80-degree day, the temperature inside a car can rise to over 100 degrees in just 10 minutes."
Always consult your physician for more information.
Information That Could Save Your Life:
More About Heat Stroke
Heat stroke is the most severe form of heat illness and is a life-threatening emergency. It is the result of long, extreme exposure to the sun, in which a person does not sweat enough to lower body temperature. The elderly, infants, persons who work outdoors, and those on certain types of medications are most susceptible to heat stroke. It is a condition that develops rapidly and requires immediate medical treatment.
Our bodies produce a tremendous amount of internal heat and we normally cool ourselves by sweating and radiating heat through the skin. However, in certain circumstances, such as extreme heat, high humidity, or vigorous activity in the hot sun, this cooling system may begin to fail, allowing heat to build up to dangerous levels.
If a person becomes dehydrated and cannot sweat enough to cool their body, their internal temperature may rise to dangerously high levels, causing heat stroke.
The following are the most common symptoms of heat stroke. However, each individual may experience symptoms differently. Symptoms may include:
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headache
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dizziness
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disorientation, agitation, or confusion
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sluggishness or fatigue
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seizure
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hot, dry skin that is flushed but not sweaty
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high body temperature
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loss of consciousness
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rapid heartbeat
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hallucinations
The symptoms of a heat stroke may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
Seek Immediate Treatment
It is important for the person to be treated immediately as heat stroke can cause permanent damage or death. There are some immediate first-aid measures you can take while waiting for help to arrive, including the following:
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Get the person indoors.
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Remove clothing and gently apply cool water to the skin followed by fanning to stimulate sweating.
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Apply ice packs to the groin and armpits.
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Have the person lie down in a cool area with their feet slightly elevated.
Intravenous (IV) fluids are often necessary to compensate for fluid or electrolyte loss. Bed rest is generally advised and body temperature may fluctuate abnormally for weeks after heat stroke.
Prevention is Key
There are precautions that can help protect you against the adverse effects of heat stroke. These include the following:
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Drink plenty of fluids during outdoor activities, especially on hot days. Water and sports drinks are the drinks of choice. Avoid tea, coffee, soda, and alcohol, as these can lead to dehydration.
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Wear lightweight, tightly woven, loose-fitting clothing in light colors.
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Schedule vigorous activity and sports for cooler times of the day.
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Protect yourself from the sun by wearing a hat and sunglasses and by using an umbrella.
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Increase time spent outdoors gradually to get your body used to the heat.
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During outdoor activities, take frequent drink breaks and mist yourself with a spray bottle to avoid becoming overheated.
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Try to spend as much time indoors as possible on very hot and humid days.
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If you live in a hot climate and have a chronic condition, talk to your physician about extra precautions you can take to protect yourself against heat stroke.
Always consult your physician for more information.
Online Resources:
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Centers for Disease Control and Prevention (CDC)
National Weather Service
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For more information staying healthy in the heat, ______________________.
The Danger of Dehydration
Dehydration is a common heat-related disease that can be life threatening if left untreated.
What is dehydration?
Dehydration can be a serious heat-related disease, as well as being a dangerous side effect of diarrhea, vomiting, and fever. Children and persons over the age of 60 are particularly susceptible to dehydration.
What causes dehydration?
Under normal conditions, we all lose body water daily through sweat, tears, urine, and stool. In a healthy person, this water is replaced by drinking fluids and eating foods that contain water. When a person becomes so sick with fever, diarrhea, or vomiting, or if an individual is overexposed to the sun, dehydration occurs. This is caused when the body loses water content and essential body salts such as sodium, potassium, calcium bicarbonate, and phosphate.
Occasionally, dehydration can be caused by drugs, such as diuretics, which deplete body fluids and electrolytes. Whatever the cause, dehydration should be treated as soon as possible.
What are the symptoms of dehydration?
The following are the most common symptoms of dehydration. However, each individual may experience symptoms differently. Symptoms may include:
In children, additional symptoms may include:
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dry mouth and tongue
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no tears when crying
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no wet diapers for more than three hours
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sunken abdomen, eyes, or cheeks
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high fever
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listlessness
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irritability
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skin that does not flatten when pinched and released
The symptoms of dehydration may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
Treatment for dehydration:
If caught early, dehydration can often be treated at home under a physician's guidance. In children, directions for giving food and fluids will differ according to the cause of the dehydration, so it is important to consult your child's physician.
In cases of mild dehydration, simple rehydration is recommended by drinking fluids. Many sports drinks on the market effectively restore body fluids, electrolytes, and salt balance.
For moderate dehydration, intravenous (IV) fluids may be required, although, if caught early enough, simple rehydration may be effective. Cases of serious dehydration should be treated as a medical emergency, and hospitalization, along with intravenous fluids, is necessary. Immediate action should be taken.
How can dehydration be prevented?
Take precautionary measures to avoid the harmful effects of dehydration, including the following:
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Drink plenty of fluids, especially when working or playing in the sun.
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Make sure you are taking in more fluid than you are losing.
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Try to schedule physical outdoor activities for the cooler parts of the day.
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Drink appropriate sports drinks to help maintain electrolyte balance.
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For infants and young children, solutions such as Pedialyte® will help maintain electrolyte balance during illness or heat exposure. Do not try to make fluid and salt solutions at home for children.
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