Heat Waves - Health Effects

Health Effects

NOAA national weather service: heat index
temperature (°F)
80 82 84 86 88 90 92 94 96 98 100 102 104 106 108 110
Relative Humidity (%)
40 80 81 83 85 88 91 94 97 101 105 109 114 119 124 130 136
45 80 82 84 87 89 93 96 100 104 109 114 119 124 130 137
50 81 83 85 88 91 95 99 103 108 113 118 124 131 137
55 81 84 86 89 93 97 101 106 112 117 124 130 137
60 82 84 88 91 95 100 105 110 116 123 129 137
65 82 85 89 93 98 103 108 114 121 128 136
70 83 86 90 95 100 105 112 119 126 134
75 84 88 92 97 103 109 116 124 132
80 84 89 94 100 106 113 121 129
85 85 90 96 102 110 117 126 135
90 86 91 98 105 113 122 131
95 86 93 100 108 117 127
100 87 95 103 112 121 132
Caution Extreme Caution Danger Extreme Danger

The Heat Index (as shown in the table above) is a measure of how hot it feels when relative humidity is factored with the actual air temperature. Hyperthermia, also known as heat stroke, becomes commonplace during periods of sustained high temperature and humidity. Sweating is absent from 84%–100% of those affected. Older adults, very young children, and those who are sick or overweight are at a higher risk for heat-related illness. The chronically ill and elderly are often taking prescription medications (e.g., diuretics, anticholinergics, antipsychotics, and antihypertensives) that interfere with the body's ability to dissipate heat.

Heat edema presents as a transient swelling of the hands, feet, and ankles and is generally secondary to increased aldosterone secretion, which enhances water retention. When combined with peripheral vasodilation and venous stasis, the excess fluid accumulates in the dependent areas of the extremities. The heat edema usually resolves within several days after the patient becomes acclimated to the warmer environment. No treatment is required, although wearing support stocking and elevating the affected legs with help minimize the edema.

Heat rash, also known as prickly heat, is a maculopapular rash accompanied by acute inflammation and blocked sweat ducts. The sweat ducts may become dilated and may eventually rupture, producing small pruritic vesicles on an erythematous base. Heat rash affects areas of the body covered by tight clothing. If this continues for a duration of time it can lead to the development of chronic dermatitis or a secondary bacterial infection. Prevention is the best therapy. It is also advised to wear loose-fitting clothing in the heat. However, once heat rash has developed, the initial treatment involves the application of chlorhexidine lotion to remove any desquamated skin. The associated itching may be treated with topical or systemic antihistamines. If infection occurs a regimen of antibiotics is required.

Heat cramps are painful, often severe, involuntary spasms of the large muscle groups used in strenuous exercise. Heat cramps tend to occur after intense exertion. They usually develop in people performing heavy exercise while sweating profusely and replenishing fluid loss with non-electrolyte containing water. This is believed to lead to hyponatremia that induces cramping in stressed muscles. Rehydration with salt-containing fluids provides rapid relief. Patients with mild cramps can be given oral .2% salt solutions, while those with severe cramps require IV isotonic fluids. The many sport drinks on the market are a good source of electrolytes and are readily accessible.

Heat syncope is related to heat exposure that produces orthostatic hypotension. This hypotension can precipitate a near-syncopal episode. Heat syncope is believed to result from intense sweating, which leads to dehydration, followed by peripheral vasodilation and reduced venous blood return in the face of decreased vasomotor control. Management of heat syncope consists of cooling and rehydration of the patient using oral rehydration therapy (sport drinks) or isotonic IV fluids. People who experience heat syncope should avoid standing in the heat for long periods of time. They should move to a cooler environment and lie down if they recognize the initial symptoms. Wearing support stockings and engaging in deep knee-bending movements can help promote venous blood return.

Heat exhaustion is considered by experts to be the forerunner of heat stroke (hyperthermia). It may even resemble heat stroke, with the difference being that the neurologic function remains intact. Heat exhaustion is marked by excessive dehydration and electrolyte depletion. Symptoms may include headache, nausea, and vomiting, dizziness, tachycardia, malaise, and myalgia. Definitive therapy includes removing patients from the heat and replenishing their fluids. Most patients will require fluid replacement with IV isotonic fluids at first. The salt content is adjusted as necessary once the electrolyte levels are known. After discharge from the hospital, patients are instructed to rest, drink plenty of fluids for 2–3 hours, and avoid the heat for several days. If this advice is not followed it may then lead to heat stroke.

One public health measure taken during heat waves is the setting-up of air-conditioned public cooling centers.

Read more about this topic:  Heat Waves

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