Sweltering summer heat deserves your respect. Intense heat exposure can leave you weak and exhausted, lead to dangerous heat stroke and turn a car interior into a lethal trap for kids.
You can take steps to minimize heat exposure and avoid unhealthy effects. Here’s what to know about hot-weather hazards and how to keep yourself and your family safe.
Overexposure to heat can create these health issues:
— Heat exhaustion.
— Heat stroke.
— Exertional health injury.
— Death if unrecognized and untreated.
Dehydration is when your body uses or loses more fluid than it takes in without it being replaced.
Simple dehydration is likely the most common cause of health problems from intense summer heat, says Dr. Samuel Keim, a professor and head of the department of emergency medicine at the University of Arizona.
“When the temperature is over 90 degrees, the body tries to keep cool through protective mechanisms,” says Keim, who is also affiliated with Banner University Medical Center in Tucson. “The most important is probably sweating.” As you sweat, you need to replenish that fluid.
Heat Exhaustion vs. Heat Stroke
Heat exhaustion is the “I feel weak, dehydrated, heat cramps and even passing out” condition, Ferrigno says. Heat stroke, by contrast, involves a whole-body reaction from your brain to the rest of your vital organs.
“Heat stroke, which is a high body temperature plus brain dysfunction, is very deadly,” says Keim, who has conducted research on the condition for about two decades. “A heat index over 100 degrees is a high-risk environment for heat stroke.”
Exertional Heat Injury
Also called exertional heat stroke, exertional heat injury is the most common cause of death among pediatric athletes, Ferrigno says.
The point where you should seek medical treatment is not always clear-cut. “It’s certainly an easy decision if someone collapses or passes out,” Ferrigno says. “But heat exhaustion and heat stroke can often sneak up on you. Be aware, and if you are feeling poorly or acting oddly, then get out of the heat. Spray yourself with water while a fan blows on you — this can really make a difference.
Don’t brush off early signs like fatigue and thirst, Keim cautions. “These should result in a decision to get out of the heat,” he says. “That behavioral response is key. Once an individual approaches heat stroke, the cognitive ability to reason decreases.”
Signs You’re Overheating
If it’s hot out and you’re feeling poorly — respect that feeling, says Dr. Rockman Ferrigno, chair of emergency medicine and associate chief medical officer at Bridgeport Hospital, part of Yale New Haven Health.
Pay attention to heat-exhaustion symptoms like these:
— Profuse sweating.
— Decreased coordination.
Seek immediate treatment for yourself — or anyone else — for symptoms like confusion or fainting. However, Keim says, you should always try to start the cooling process immediately, even before EMTs arrive.
Use proven methods like these to keep your core body temperature under control:
— Wear loose, lightweight and light-colored clothing, and add a hat.
— Stay hydrated.
— Seek shelter from blazing heat.
— Avoid strenuous exercise in the heat.
— Get wet. Take a shower or bath, or a dip in a pool or lake.
— Use air conditioning when possible.
— Turn on a fan.
— Take indoor breaks.
Don’t try to complete strenuous outdoor tasks in one fell swoop. “Push-mowing the grass is a classic,” Ferrigno says. Set up a planned break or two to come inside and make sure you get cooled off, he suggests.
Keep these fluid and hydration pointers in mind:
— Women should consume about 2.7 liters, and men about 3. 7 liters, of total water a day, according to the National Academy of Medicine.
— About 80% of daily fluid intake comes from drinking water and other beverages — including caffeinated beverages — with the other 20% derived from foods, the NAM says.
— Drink plenty of water. Plain, fruit-infused or naturally flavored sparkling water all work.
— Refrain from alcoholic beverages, which can contribute to dehydration.
— Incorporate veggies with high water content, such as cucumbers, lettuce and celery, into your summertime diet.
— Eat fruits such as tomatoes, strawberries and watermelons, which are also high in water.
— Chilled soups, like gazpacho, are particularly appealing when it’s hot out.
Taking in fluid is crucial if you’re feeling symptoms of heat illness. If someone cannot drink because heat illness is so severe, they must immediately seek care at an emergency department, Ferrigno emphasizes.
Humidity and Heat Index
Heat index is the combination of ambient (surrounding) air temperature plus humidity. A heat index over 90 degrees puts people at high risk with any activity, Keim says.
“Higher humidity adds to the thermal load the body must try to compensate for,” Keim says. When the heat index is high, hydrate yourself throughout the day and exercise only in the early morning.
Dry heat really does make a difference, Ferrigno says: “The lower the humidity, the more heat one can tolerate.” However, low humidity isn’t a magic buffer.
“When a dry heat exceeds 100 degrees, with a humidity under 20%, it is still a dangerous condition,” Keim says. “We find that visitors to Arizona who come from humid climates frequently don’t perceive the true temperature. They tend to go for hikes, golf or other sports activities when it is actually dangerous.”
— Certain groups are at particularly vulnerable to experiencing health problems in the heat of summer:
— Older adults.
— Urban and rural residents.
— Lower-income groups.
— Socially isolated.
— Outdoor workers.
— Those with pre-existing conditions.
— Anyone not acclimated to heat.
Older Adults and Medical Conditions
As you get older, you need to take extra care as temperatures rise. By age 70, the ability to compensate for high-temperature environments decreases, Keim explains. Thirst mechanisms also become less efficient with age, so people are less likely to feel thirsty or realize they’re getting dehydrated.
“Intense summer heat causes havoc with our respiratory patients, our elderly and patients who have preexisting medical conditions like diabetes, high blood pressure and heart conditions,” Ferrigno says.
Medications can disrupt your natural reflexes and reduce heat tolerance in different ways, such as these drug classes:
— Anticholinergics. Cogentin and Bentyl make you sweat less.
— Antihistamines. Benadryl also reduces your ability to sweat.
— Diuretics. Lasix is a commonly prescribed diuretic, which makes you urinate more and lose fluid.
— Psychiatric drugs. Haldol and Risperdal are antipsychotic drugs that decrease signaling to the brain that body temperature is rising.
— Beta-blockers. Beta-blocker drugs, which keep your heart beating slowly, can blunt your body’s normal response to becoming slightly dehydrated, Ferrigno explains. Lopressor is a common beta-blocker. Propanol is both a diuretic and beta-blocker.
Infants and Children
Infants and younger children need extra protection from heat exposure. One frightening reason is they can’t always escape a hot environment like a car.
“Tragically, we have deaths each year related to children in cars,” Ferrigno says. “Nothing can console the grief of a parent who has inadvertently left their child in a car — absolutely one of the most tragic scenarios we encounter.”
His suggestion: “If you have an infant in a car seat, put your wallet or purse in the back seat with them. This will make it less likely for you to leave your car without your child.”
Summer in the city can be dangerous, as “heat islands” result. Climate change is expected to further increase death rates from heat exposure in cities such as Chicago, Los Angeles, Miami, New York and Philadelphia, according to a June 2019 study in the journal Science Advances.
Dense concentrations of concrete and asphalt combined with a lack of vegetation reduce the cooling capabilities of evaporation, explains Danielle Rhubart, a postdoctoral fellow with the Lerner Center for Public Health Promotion in the Maxwell School of Citizenship and Public Affairs at Syracuse University.
Although it may seem surprising, the most rural U.S. areas have the second-highest rates of heat-related morality. Higher rates of poverty and preexisting conditions, combined with less access to health care, may account for this rural disadvantage, Rhubart explains.
COVID-19 and Health Disparities
With the pandemic, physical distancing restrictions to prevent the virus from spreading mean there are fewer public places — like pools, cooling stations, libraries and indoor shopping malls — for people to go, Rhubart points out in a July 1 research brief.
Hot-weather standbys people have previously taken for granted — like water fountains — are missing.
Social determinants of health — like income, housing and location — contribute to heat exposure risks and prevention. Air conditioning may be an unavailable luxury for some people working from home, or who find themselves essentially confined to home for health reasons.
Cooling Your Home
If you lack access to air conditioning, protecting yourself from the heat is more challenging. The Global Heat Health Information Network offers these for creating a cooler indoor environment:
— Cover windows and patio doors. Close blinds, shutters and drapes to reduce direct sun exposure.
— Create a cross-breeze. When it’s cooler than 95 degrees, open windows on the opposite side of the building. Next, use an electric fan to pull cool air into living spaces and another fan to blow hot air out, GHHIN suggests.
— Avoid cooking indoors when it’s hottest. Prepare hot foods in cooler times of day.
— Produce your own cool breeze. If you live in a low-humidity area, place a bowl of ice or cold water in front of an electric fan to cool the blowing air.
Exercise, Athletes and Heat
Whether you play team sports or exercise on your own, don’t try to power through in extreme heat. Instead, take sensible precautions:
— Find a cool spot to work out. If you’re a runner, run in the shade.
— When exercising, drink about 1 quart of liquids an hour to replace essential fluids, Ferrigno advises.
— Cancel or postpone athletic activities in periods of high heat and humidity.
— Know the signs of heat-related illness so you can administer first aid.
When it comes to exertional heat injuries, Ferrigno says, the pandemic may actually help matters in terms of having fewer organized sports during the current summer and fall.
Kids flock to swimming pools in the summer heat. This year, many families are turning to backyard pools at home. As their use increases, Ferrigno shares these safety tips:
— Never allow children to play in the pool or pool area unsupervised.
— In the immediate pool area, post 911 and other rescue numbers and CPR instructions.
— Keep life-preservers and other lifesaving equipment in the pool area.
— Focus your full attention on the pool — not your phone — while kids are swimming.
— Regularly check gate latches. When the pool is not in use, keep all doors and gates leading there locked and secure.
Lethal Heat Exposure
— Adults ages 65 and older have the highest heat-related mortality rates. Among those 85 and older, 1 in 100,000 dies of heat-related causes, according to Centers for Disease Control and Prevention data collected over two decades.
— Urban areas have the highest rates of heat-related mortality among adults 65 and older. In the most urban areas, that rate is nearly 1.5 per 100,000 people in that group.
— Rural areas have the second-highest heat-morality rates for older adults, at about 0.8 deaths per 100,000 people in the most rural locations.
Public health strategies to protect people from heat-related illness and fatalities should include the following actions, according to Rhubart:
— Boosting heat-warning systems and media coverage to alert the public to rising temperatures.
— Mobilizing social services for vulnerable groups like older adults, essential workers and people with underlying health conditions.
— Promoting low-tech cooling options, particularly for people who are isolated.
— Enabling cooling centers and outdoor cooling areas that meet CDC physical distancing recommendations.
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