27 July 2018
FRIDAY, July 27, 2018 (HealthDay News) — As much of the United States continues to swelter through 90-plus temperatures and high humidity, one emergency physician is offering advice on keeping safe. First, Dr. Robert Glatter said, it’s important to know that anyone can be a victim of heat stroke, but some people are at particular risk. “Heat stroke develops when the body is unable to effectively sweat to cool itself down,” said Glatter, an emergency physician at Lenox Hill Hospital, in New York City. “As core temperatures rapidly elevate, the skin becomes dry and your heart rate begins to elevate.” When body temperature rises, damage to the brain and other organs can occur unless help comes quickly. The very old and the very young are at highest risk, Glatter said. “Children are at higher risk for hyperthermia and consequently heat stroke due to their reduced ability to thermoregulate their body temperatures,” he explained. Kids have a “higher ratio of surface area to body mass, which reduces their ability to cool their bodies efficiently and effectively,” Glatter said. Too often, kids don’t hydrate themselves as they should, so parents need to be sure youngsters drink plenty of water when temperatures soar. “It’s important to drink plenty of cool fluids in the heat and even stay ‘ahead’ of your thirst,” Glatter said. “Water is preferable, but low-sugar sports drinks are recommended if you are working in the heat or exercising for more than one hour.” Two types of drinks — alcohol and sugary soft drinks — won’t help in the heat and may even harm, dehydrating you further. Elderly people also need to take special care, especially when air conditioning isn’t available, Glatter said. Check on seniors to see how they are feeling, he advised. “Make sure, if possible, that they have access to air conditioning and plenty of cool fluids. It’s also vital to have a ‘heat response’ plan to help reduce the chances for heat stroke developing in the first place,” he said. Compared to younger adults, seniors have a reduced ability to sweat and cool their bodies, making them particularly vulnerable in heat waves, Glatter noted. “They also may be taking medications to treat blood pressure [such as diuretics] that can reduce their ability to sweat effectively,” he said. Other drugs that make heat stroke more likely are antihistamines, antidepressants, antipsychotics and benzodiazepines. “Hypertension, coronary artery disease and kidney disease — common in the senior population — all elevate the risk for developing heat stroke, due to reduced cardiac reserve and plasticity of blood vessels,” Glatter said. “These are major risk factors for heat stroke.” How to tell if you or a loved one is suffering heat stroke? “Confusion is a common presenting symptom of patients who develop heat stroke, and this can even mimic a stroke,” Glatter said. According to the U.S. Centers for Disease Control and Prevention, other signs include a body temperature above 103 degrees Fahrenheit; red, hot and dry skin with little or no sweating; a rapid, strong pulse; throbbing headache; dizziness; nausea; and loss of consciousness. Remember, heat stroke is “a medical emergency, and it’s vital to seek treatment immediately in the emergency department by calling 911,” Glatter said. “A patient requires rapid cooling and attention to their airway and blood volume status to effectively resuscitate them.” More information Find out more about heat stroke at the U.S. Centers for Disease Control and Prevention.
17 July 2018
TUESDAY, July 17, 2018 (American Heart Association) — Summer is a time for barbecues and other outdoor fun, but it’s also a time for sweltering heat. And experts say everyone, especially the elderly and very young, need to know how to limit the potentially deadly effects of high temperatures. The ancient Greeks and Romans called the sultriest days of summer the “dog days.” The Old Farmer’s Almanac marks the time as 40 days from July 3 to Aug. 11, coinciding with the rising of the star Sirius, also called the Dog Star. Already this year, the dog days have proved dangerous. Heat warnings and advisories have been issued over a large swath of the country, with heat waves smothering the Northeast and shifting into the South and West. In Quebec, at least 70 people reportedly have died from a heat wave hitting eastern and central Canada. More than 600 people die every year in the United States from heat-related illnesses that are preventable, according to the U.S. Centers for Disease Control and Prevention. The agency estimates more than 65,000 Americans visit an emergency room for acute heat illness each summer. “I think people underestimate how quickly it happens. And when it starts to happen, if someone is progressing to heat exhaustion or heat stroke, you lose your self-awareness,” said Dr. Robert O’Connor, chair of emergency medicine at the University of Virginia. “It’s important to keep an eye on those around you for heat-related problems. If someone is flushed, dizzy or uncoordinated, it can be an early sign.” Dehydration can begin within just a few hours of extreme heat, so drinking extra fluids is important, especially when taking certain medications. Fatigue, headaches, muscle cramps, dizziness, sleepiness and dry mouth can all be signs of dehydration. Dehydration causes the heart to work harder, putting it at risk. Hydration helps the heart more easily pump blood through the blood vessels to the muscles. And, it helps the muscles work efficiently. A 2016 Environmental Protection Agency analysis of heat-related deaths said high temperatures could be a factor in many more deaths than officials realize — or count. “By studying how daily death rates vary with temperature in selected cities, scientists have found that extreme heat contributes to far more deaths than the official death certificates might suggest,” the report said. “This is because the stress of a hot day can increase the chance of dying from a heart attack, other heart conditions, or respiratory diseases such as pneumonia.” While infants and the elderly are more vulnerable to problems from heat, O’Connor said sometimes medicines can make someone more sensitive to heat and dehydration. “They should talk to their doctor and look up their medications to see if it predisposes them,” he said. Heat exhaustion and heat stroke are serious medical emergencies that require treatment. Both can cause headaches, nausea or vomiting. Heat stroke also can cause a high fever, warm skin with no sweating, and confusion or unconsciousness. Heat stroke is not the same as a stroke. Stroke happens when a blood vessel to the brain either bursts or is blocked by a clot, causing a decrease in oxygen flow to the brain. Beyond some of the obvious and sometimes extreme physical symptoms brought on by sweltering temperatures, a recent study showed it could affect how you think. And it doesn’t just affect the most vulnerable. A group of researchers at Harvard University in Boston published an observational study last week showing students who lived in dormitories without air conditioning during a heat wave performed worse on a series of cognitive tests compared with students who lived in air-conditioned dorms. The study was conducted over 12 consecutive days in the summer of 2016. Students living in buildings without AC experienced 13.4 percent longer reaction times on color-word tests, and 13.3 percent lower scores on addition/subtraction tests compared with students in air-conditioned rooms. The research showed students in rooms with AC were not just faster in their responses, but also more accurate. Hot summers and heat waves won’t be going away any time soon, according to federal research. In fact, unusually high temperatures have become more common in recent decades, and heat waves are expected to become longer, more frequent and more intense in the future, according to the EPA and the CDC. O’Connor said thinking ahead and being prepared in the heat will help prevent trouble. “Drink plenty of fluids and limit the amount of time you are in the heat. Even if someone comes into a cooler environment for a few minutes every hour, that can prevent a heat-related illness,” he said. “Limit outdoor activity to early morning or late evening, and stay in the shade,” O’Connor said. “t might be tough if you are working outside or on the golf course. Soak a towel in cold water and put it around your neck. Evaporative cooling, dousing in cold water and letting it evaporate, is the best way to eliminate heat.”
05 July 2018
THURSDAY, July 5, 2018 (HealthDay News) — Much of the United States has been sweltering in triple-digit heat this week, but new research finds outdoor workers can suffer fatal heat stroke from temperatures that only reach the high 80s. In fact, six of 14 cases of fatal heat stroke investigated in the new study “occurred when the Heat Index was below 91 degrees Fahrenheit,” noted a team led by Dr. Aaron Tustin, from the U.S. Occupational Safety and Health Administration (OSHA). The Heat Index — often announced on media weather forecasts — is a calculation of heat and humidity that gauges how the combination “feels” to the human body. It also assumes the person is in the shade, wearing a single layer of light clothing. Early summer heat waves are particularly deadly, the OSHA researchers said, since people may not yet be acclimatized to high temperatures. Dr. Robert Glatter, an ER doctor at Lenox Hill Hospital in New York City, has seen many cases of heat stroke. “It’s important to remember that extreme heat combined with humidity can kill,” said Glatter, who wasn’t involved in the new study. “Extremes of heat are most concerning to public safety, and a large number of heat-related deaths are generally preventable.” Glatter called heat stroke “a medical emergency. Patients may develop temperatures of up to 106-108 F, with confusion and disorientation, and loss of ability to produce sweat to cool the body. Skin is generally is red, hot and dry … Cooling ice baths and misting fans can help reduce core temperatures.” Workers — who often wear bulky clothing and have little choice but to labor outside in searing temperatures — are at particular risk. In the new report, Tustin and his colleagues focused on 25 cases of outdoor, on-the-job heat stroke occurring between 2011 and 2016, 14 of which proved fatal. The study found that in half the cases, victims had at least one “predisposing personal risk factor” for heat stroke — illnesses such as diabetes or heart disease, or use of certain medications or illicit drugs. According to Glatter, medicines such as blood pressure pills or diuretics affect a person’s “fluid balance,” upping the odds for dehydration in severe heat. A strenuous workload also increases the risk. On the day workers suffered an attack, “workload was moderate, heavy or very heavy in 13 of 14 fatalities,” the OSHA researchers noted. Four cases were also likely exacerbated by workers wearing heavier clothing, another known risk factor for heat stroke, they said. Across the 25 cases, the median Heat Index was 91 degrees, but temperatures for individual cases of heat stroke ranged from just 83 degrees to 110. Glatter said hydration is crucial for people who must work outside in the heat. “Water is the ideal fluid for hydration, and it is recommended to avoid excessive amounts of caffeine, which can lead to dehydration,” he said. Tustin’s team offered these tips to stay safe from the heat when working outside: Make sure workplace supervisors are trained to recognize the signs of heat stroke, and in first aid to help if it occurs. Designate at worksite heat “monitor” to be mindful of rising temperatures and oversee protective measures. Make sure new workers get the protective measures they need to acclimatize to working outdoors in the heat, and be mindful that workers with predisposing risk factors might need extra precautions. Schedule frequent breaks in shade or air-conditioned spaces to allow workers to cool down, and adjust work schedules to try and avoid the worst conditions. Provide plenty of accessible water or electrolyte-bearing beverages. The new report was published July 5 in Morbidity and Mortality Weekly Report, a journal of the U.S. Centers for Disease Control and Prevention. More information There’s more on summertime heat safety at the U.S. National Weather Service.
02 July 2018
MONDAY, July 2, 2018 (HealthDay News) — Before you head out for a sunny summer getaway, get familiar with the signs of heat-related illnesses. Once at your destination, build in time for your body to adjust to the climate. If you’re lounging by the water and taking only short walks, your risk of a heat illness is low. But if you’re not in great shape and aren’t used to the heat, beware of strenuous activities like hiking and biking. Your body’s cooling system could fail if you’re in high temperatures and humidity for too long, sweating heavily, and not drinking the right fluids. Toss in a few fruity alcoholic beverages and you could be thrown for a loop. Respect your fitness level. If you’re out of shape, go slow, even for fun activities like kayaking. Take frequent breaks. Don’t wait until you feel thirsty to drink bottled water. And don’t forget the sunscreen. Heat-related illnesses include: Heat cramps: painful muscle contractions, usually after exercising in the heat. Heat syncope: lightheadedness or fainting caused by high temperatures. Exercise-associated collapse: lightheadedness or fainting right after exercising. Heat exhaustion: body temperature as high as 104 Fahrenheit with cold, clammy skin, headache, weakness, nausea and vomiting. Heat stroke: the above symptoms plus a body temperature over 104 F; you may no longer be able to sweat to cool yourself. Preventing heat-related illnesses: Give yourself time to acclimate to the heat. Avoid activities during the hottest part of the day — exercise in the morning or evening, and in the shade. Wear light, loose clothes and a wide-brimmed hat. Stay hydrated, but don’t overdo fluid intake. If you’ve been exercising for many hours in the heat, eat a salty snack or lightly salt your next meal to replace salt losses. Know the signs of heat-related illnesses: Cramping. Confusion or irritability. Excessive sweating. Fatigue. Feeling dizzy, lightheaded, nauseous or weak. Headache. Increased heart rate and/or low blood pressure. Vision trouble. Vomiting. Take immediate steps if you develop any of these symptoms. Get out of the heat, lower your body temperature with wet towels or sit in a tub filled with cold water, and rehydrate with water or a sports drink. And contact a physician if necessary. More information The U.S. Centers for Disease Control and Prevention’s Travelers’ Health Problems With Heat and Cold page has more on heat-related illnesses.