Dear Test,
I hope you are enjoying the beginning of summer.
This month’s Newsletter is about an important health issue that can be fatal if not recognized and treated promptly—Heat Related Illness (HRI). I developed acute heat exhaustion a few weeks ago, while attending my college reunion outside in hot weather. I quickly developed the symptoms of heat exhaustion—thirst, muscle cramps, and nausea. I had worn a hat, drank a liter of water, and even ate a bag of salted potato chips to ensure I had some salt. But that was not enough. The symptoms came on suddenly within minutes. I was taken by ambulance to the local ER and treated with IV fluids, antinausea medication, and electrolytes.
Heat related Illness is on the rise because of Climate Change. There are more heat waves of longer duration and intensity, which increase our risk of heat exposure. (1,2)
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Heat Stroke vs. Heat Exhaustion
Heat Exhaustion:
“Heat exhaustion is characterized by an elevated core body temperature up to 104°F (40°C), along with heavy sweating, dizziness, headache, nausea, tachycardia, muscle cramps, and fatigue.”(3)
Heat Stroke:
“Heat stroke is defined as a core body temperature greater than 104°F (40°C) accompanied by hot, dry skin and central nervous system dysfunction such as delirium, seizures, or coma.” (3)
Who is at Risk for Heat Related Illness?
Basically everybody, but especially people over 60, young children, athletes and adolescents ( because they are outdoors more during the hotter months), people who work outside, people with obesity, diabetes, cardiovascular conditions, lung conditions, and skin conditions. (1,5,6)
Other Risk Factors for Heat Related Illness: (5,6)
• No Acclimatization
• Medications
• Dehydration
• Alcohol use within the past 24 hours
• Prior Heat Illness
• Non-breathable clothing or personal protective equipment
• Short term medical illnesses such as diarrhea, vomiting, or respiratory infections.
• Poor physical fitness
People living in Urban Areas The “Heat Island Effect” (7)
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Prevention of Heat Related Illness is Key!!
1. Check the weather and air quality index (airnow.gov) before going out for the day and/or an outing or trip.
2. “Pre-Hydrate”–drink water even if you are not thirsty . The CDC says: “When working in the heat, drink 1 cup (8 ounces) of water every 15–20 minutes. Drinking at shorter intervals is more effective than drinking large amounts infrequently. Do not drink more than 48 oz (1½ quarts) per hour!”(8)
3. Electrolyte replacement–in addition to water, drink sports drinks that are NOT sugary during long heat exposure.
4. Post-Hydrate–after working in the heat or being in the heat. “Most people need several hours to drink enough fluids to replace what they have lost through sweat. The sooner you get started, the less strain you place on your body from dehydration.” (8)
5. Stay Cool--either inside in air conditioned spaces, or if outside, try and stay in the shade and and wear loose fitting clothing.
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FREE Webinar on Climate Change and Health!
I am pleased to invite you to a truly informative and educational FREE Webinar, “Climate Change and Health,” on Tuesday, June 18th at 6pm. It is sponsored by the New York County Medical Society, where a panel of esteemed medical experts will be talking about the effect of heat, air pollution, and vector borne diseases on health. Click on the image below to register.
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Treatment of Heat Related Illness may require Emergency Care.
Mild Heat Exhaustion may only require moving to a cool environment, and rehydration.
Recognize the warning signs and symptoms of heat related illness early and call 911 in emergent conditions.
I hope this Newsletter has provided helpful information as we negotiate climate change and more heat waves. The best medicine is PREVENTION.
To Your Health,
Dr. Jill
References:
1. Environmental Resilience Institute: https://eri.iu.edu/erit/implications/extreme-heat-health.html
2. Ebi KL, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Jay O. Hot weather and heat extremes: health risks. Lancet. 2021 Aug 21;398(10301):698-708. https://pubmed.ncbi.nlm.nih.gov/34419205/
3. Perplexity. ai—These two quoted statements provided by Perplexity AI did not correlate with the reference it provided, however, the descriptions of Heat Exhaustion and Heat Stroke are correct and valid descriptions. Hence I have included them here.
4. Dehydration and Heat Stroke–https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke
5. Heat Stress–Risk Factors: https://www.cdc.gov/niosh/mining/UserFiles/works/pdfs/2017-125.pdf
6. Leiva DF, Church B. Heat Illness. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553117/
7. Learn about Heat Islands: https://www.epa.gov/heatislands/learn-about-heat-islands#:~:text=Structures%20such%20as%20buildings%2C%20roads,climates%2C%20and%20in%20any%20season.
8. Heat Stress–Hydration: https://www.cdc.gov/niosh/mining/userfiles/works/pdfs/2017-126.pdf
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Disclaimer: Please note that the content on this Newsletter does not constitute medical advice. Please consult with a physician before making any medical, nutritional, or lifestyle changes recommended in this Newsletter.