Special precautions in hot weather

A message from the CDC,

The Centers for Disease Control and Prevention encourages coaches, athletes, and those exercising outside in hot weather to know the warning signs for heat-related illness and take action when needed. 
“Any athlete dying from heat is a tragedy that can be prevented,” said CDC’s Robin Ikeda, M.D., M.P.H., Deputy Director for Noncommunicable Diseases, Injury and Environmental Health.  “Coaches, parents, teachers, and athletes should educate themselves on how to recognize and prevent heat-related illness.”
CDC estimates that, each year, there are almost 6,000 emergency department visits for sports and recreation heat illnesses. CDC says the most common activities leading to the hospital visits are football, and exercises such as walking, jogging, running, and calisthenics.  People who exercise in extreme heat are more likely to become dehydrated and get heat-related illness.
Extremely hot weather can cause illness or death, but all heat-related illnesses and deaths are preventable.
Here are some ways to act against heat-related illness:

• Stop all activity and get to a cool environment if you feel faint or weak.
• Limit outdoor activity, especially midday when the sun is hottest.
• Schedule workouts and practices earlier or later in the day when the temperature is cooler.
• Pace activity. Start activities slow and pick up the pace gradually.
• Drink more water than usual and don’t wait until you′re thirsty to drink more.
• Have a workout partner. Monitor each other’s condition.
• Wear loose, lightweight, light-colored clothing.
• Seek medical care immediately if you or a teammate has symptoms of heat-related illness.

Coaches can learn more about how to protect the athletes in their care by taking CDC′s accredited Web–based course on how to recognize, treat, and prevent heat–related illness. School nurses and athletic trainers may also find the course useful for sharing information with others who work with athletes.

CDC has also published a toolkit to educate readers, especially caregivers for vulnerable groups such as athletes, as well as older adults and small children, about how to recognize warning signs of heat illness.  Materials such as posters for locker rooms and water bottle labels are targeted for use with school athletic programs.  

More information about heat illness in high school athletes can be found at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5932a1.htm.

For more information on extreme heat and heat safety, call 1-800-CDC-INFO (1-800-232-4636) or visit http://www.cdc.gov/.

Stay Cool to Stay Healthy As Temperatures Soar

Here is a message from the US Center for Disease Control (CDC) regarding the summer heat:
The Centers for Disease Control and Prevention officials are warning people to stay cool, hydrated and informed to prevent illnesses and injuries as cities across the Midwest, South and East Coast continue to issue heat warnings and watches. Extreme heat can lead to very high body temperatures, brain and organ damage, and even death. On average, 675 people die from complications related to extreme heat each year in the United States – more than tornadoes, hurricanes, floods, lightning or any other weather event combined.
"Extreme heat affects all of us but the most vulnerable are the elderly, those who work or exercise outdoors, infants and children, the homeless or poor, and people with a chronic medical condition," said Christopher Portier, PhD, director of CDC's National Center for Environmental Health. "Taking precautions to stay cool, hydrated and informed helps to prevent serious health effects such as heat exhaustion or heat stroke during this massive heat wave."
Heat related deaths and illness are completely preventable yet every year many people succumb to the effects of extreme heat. People suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. Common sense practices will keep you safe and healthy during the scorching days of summer.

Stay cool

Air-conditioning is the number one protective factor against heat-related illness and death. If a home is not air-conditioned, people can reduce their risk for heat-related illness by spending time in public facilities that are air-conditioned like shopping malls and libraries. (http://www.cdc.gov/nceh/extremeheat/)

Stay hydrated

Drink cool non-alcoholic beverages and increase your fluid intake regardless of your activity level; increase your intake hourly if you are outdoors working or exercising. Drink more water than usual and don't wait until you're thirsty to drink. Make sure your family, friends and neighbors are drinking enough water. (http://www.cdc.gov/nceh/extremeheat/)

Stay active

Doing too much on a hot day, spending too much time in the sun or staying too long in an overheated place can cause heat-related illnesses especially during sports and recreational activities.
"Take breaks; stay hydrated and move physical activities to the cooler parts of the day if they can't be moved indoors," said Linda Degutis, Dr. PH, M.S.N., director of CDC's National Center for Injury Prevention and Control. "We encourage people to continue sports and recreational activities as much as possible during this heat wave, but take the necessary steps to prevent heat-related illness and injury."
Be sure to gradually increase exercise frequency, duration and intensity to allow your body to adjust to the heat if you are just getting started or returning to practices (e.g. football or band rehearsals). It's also a good idea to have an exercise partner or practice partner and watch for signs and symptoms of heat illness in each other. If leading organized activities, follow established guidelines from schools, sports organizations or medical organizations regarding changing or canceling activities to prevent heat illness, and alter practices to remove the need for heavy safety gear (e.g., football pads) on hot or humid days.

Stay safe

Even short periods of high temperatures can cause serious health problems, debilitating injury or death, never leave infants, children or pets in parked cars; check on people who are overweight they may be prone to heat sickness because of their tendency to retain more body heat. People who suffer from chronic conditions such as heart disease or high blood pressure, or who take certain medications, such as for depression, insomnia, or poor circulation, may be affected by extreme heat. Know the symptoms of heat disorders, overexposure to the sun, and be ready to give first aid treatment. http://www.cdc.gov/Features/ExtremeHeat/

Bottom Line

Check your local news for extreme heat warnings and safety tips, or sign up for free weather alerts to your phone or e-mail from websites such as www.weather.com/mobile. Visit http://www.cdc.gov/ for tips for preventing heat sickness, keep an eye on your friends, family and neighbors and be aware of weather and heat safety information.
For more information on extreme heat and heat safety, call 1-800-CDC-INFO (1-800-232-4636) or visit http://www.cdc.gov/.

It's Hot, Hot, Hot

“Some people change their ways when they see the light;
others when they feel the heat”

- Caroline Schoeder

What is the deadliest type of natural disaster? A supernova as pictured yesterday would top the list by frying the entire planet but we should be safe from that for several billion years. Other obvious candidates include hurricanes, massive earthquakes, and tidal waves. Hurricane Katrina may have killed 1700 people directly with a total of 4000 deaths if you include secondary causes. And yet according to a new book called "Hot Time in the Old Town" by professor Edward P. Kohn, the deadliest type of natural disaster in America is heat waves.

"We all enjoyed pictures of children playing in fountains and eating ice cream.  To the media, a heat wave means a holiday.  This obscures the sinister fact that heat waves are this country’s number one natural disaster killer. On average, heat kills more Americans than floods, hurricanes, and tornadoes combined. "

This summer Russian had a terrible heat wave that caused forest fires and burned wheat fields. American TV showed pictures of a smoke-choked Moscow but news agencies failed to mention the death count. The Moscow city government reported a doubling of deaths during the heat wave; every day three hundred additional people died over a period of  several weeks. This quickly adds up to a catastrophe.

The 1896 heat wave in New York City killed as many as thirteen hundred people who literally roasted to death in brick buildings. The media and the government basically ignored the emergency. The one person who took action was a young Theodore Roosevelt, President of the Board of Police Commissioners, who distributed free ice to the poor. No one learned anything from this and history continued to repeat itself. In 1972 as many as nine hundred people died during a New York heat wave.  The 1995 Chicago heat wave killed seven hundred, while a 2003 European heat wave killed over 50,000.

Bottom Line

Perhaps it was the 2003 European disaster that finally convinced cities to take heat waves seriously.

Today, most cities have heat wave response plans in place even before summer arrives.  Emergency cooling centers are set up in local community centers, and officials check on the elderly and chronically ill through phone calls and home visits. 

For more information on the risks of extreme heat check out these prior blog posts:

2009/07/greenhouse-effect-in-cars
2009/07/exercising-on-hot-days
2009/07/extreme-heat
2008/08/heat-exhaustion
2008/08/hyperthermia   (note: hyper not hypo)

Fire Hydrants

“Some people change their ways when they see the light; others when they feel the heat”-Caroline Schoeder

In New York it's hot, hot, hot. We are breaking heat records with 100 F days so it comes as no suprise that people are looking for relief. The following news item was sent out by New York City:

Opening fire hydrants without spray caps is illegal, wasteful and dangerous. Illegally opened hydrants can lower water pressure, which can put lives at risk at hospitals and hinder fire-fighting by reducing the flow of water to hoses and pumps. The powerful force of an open hydrant without a spray cap can push children into oncoming traffic. New Yorkers should call 311 to report open hydrants.

Hydrants can be opened legally if equipped with a City-approved spray cap [pictured above]. One illegally opened hydrant wastes up to 1,000 gallons of water per minute, while a hydrant with a spray cap only puts out around 25 gallons per minute. Spray caps can be obtained by someone 18 or over, free of charge at local firehouses.

Bottom Line

Pundits are calling NYC the "Baked" apple. To escape the heat NYC opens up public cooling centers, such as Department for the Aging (DFTA) senior centers and New York City Housing Authority (NYCHA) and Salvation Army community centers where air conditioning is available. To find the cooling center closest to you, call 311 (TTY: 212-504-4115) or log on to www.nyc.gov/oem.

Exercising on Hot Days

“Laughter is as good as jogging for our heart, lungs, and brain” - unknown

Exercising in hot weather can be dangerous for your and your dog.

Pets need exercise, but on very hot days it is best to limit walks or exercise to early morning or evening hours when it’s cooler. Hot asphalt and beach sand can burn pet paws. Pets can get sunburned too, and may require sunscreen on their nose and ear tips.

With people, heat exhaustion, heat stroke, and dehydration are real possibilities when the temperature is greater than 70 degrees with humidity of 70% and above. High humidity means sweat doesn't evaporate very well because the air is already saturated with moisture. So you're losing fluids but not cooling down.

1. Stay hydrated. Take a drink every 15 minutes when exercising and consider a sports drink like Gatorade to replace lost salts and electrolytes.

2. Avoid the peak heat between 10am and 3pm.

3. Dress in light, comfortable clothes in light colors

4. Know the symptoms of heat illness: headache, nausea, dizziness, and light-headedness. Stop your fitness workout routine immediately, start replacing fluid, and find shade or spray your body with cool water.
Signs of heat stroke include confusion, rapid pulse, difficultly breathing, and dry skin with no sweat. If you suspect heat stroke, it's important to seek medical attention immediately as this can be a life threatening.

5. Wear sunscreen.

6. Cut yourself a little slack on extra hot days. This is NOT the time to maximize your workout. The good news is that you’ll be burning extra calories just coping with the heat.

7. When the temperature hits 80 with humidity consider moving your workout to an air-conditioned mall or gym. An increase in your body’s core temperature reduces the endurance capacity of your muscles.

8. If you insist on working out outdoors, build up to it slowly with short workouts in the heat for two weeks before your body is ready for the full routine.

9. Train with other people when it’s extra hot. Remember confusion is a symptom of heat stroke so a friend may notice if you’re in trouble, even if you don’t.

Bottom Line

If you live in a city, high heat can also mean poor air quality with ozone or smog. Long term exposure to smog can reduce the immune system's ability to fight off respiratory infections and can damage lung cells.

See Also
http://www.hss.edu/conditions_14593.asp/
www.50plus.com/Health/Fitness/index.cfm?documentID=21577
www.bukisa.com/articles/84831_how-to-exercise-in-hot-weather

Extreme Heat

“Some people change their ways when they see the light; others when they feel the heat”-Caroline Schoeder

My friends and colleagues in New York have been grumbling about the lack of “summer”. We’ve had weeks of rainy days and cool temperatures with rare glimpses of sun. So it was somewhat shocking to have a “hot” day earlier this week with 91 Fahrenheit.

Some may adore summer heat but it is also a potential killer (175 Americans die of heat exposure in a normal year. 1,250 died in the heat wave of 1980.) With extreme cold you can protect yourself with layers of coats, gloves, scarves, etc. But you can only strip so far (without getting arrested) in extreme heat. Here are some recommendations to avoid Dehydration, Heat Exhaustion, and Hyperthermia(Heat Stroke).

• Stay hydrated by drinking more fluids
  This is not as easy as it sounds. First off, fluids with caffeine, alcohol, or sugar will dry you out. So this eliminates ice coffee, ice teas (unless herbal), most sodas, and all alcoholic drinks. Second, the drink should not be icy cold – this can cause stomach cramps. Third, you need to remember to drink regularly even if not thirsty. Forth, your doctor may place a limit on how much you may drink; for example if you’re taking water pills to lower your blood pressure.
  
• Find cool places to hang out
  If you don’t have an air conditioner then seek out other “cool” places during extreme heat. My wife and I will go grocery shopping and linger in the frozen food aisles examining all products closely. We’ll get some exercise walking in an air-conditioned mall. Or catch up on magazine reading at our library. Or eat out (we immediately walked out of one restaurant when we realized their A/C was broke). Or go for a long drive in our air-conditioned car. During heat emergencies the Red Cross may open “cool” down shelters that you can sleep at. Electric fans won’t help when the air is hotter than your body (98.6 F). When the air is high 90 and above you’re just blowing heat at your body and making things worse.
  
• Take precautions when outside
  Wear light-colored, loose-fitting clothing and a wide brimmed hat. Wear sunscreen and seek out shade. Move slowly and stop frequently to rest and cool down.

Bottom Line

Be creative when the going gets hot. Take cold showers or baths. I like to wrap up an ice cube and apply it to the back of my neck letting the melt water run down my back. Wet your hair or shirt or a hat. Stay out of the sun as much as possible.

Recommended Links:

www.sanjoseca.gov/pdf/HeatAlert07/Heat_Wave_Safety_Tips.pdf
www.bt.cdc.gov/disasters/extremeheat/heat_guide.asp
For Athletes: www.athleticadvisor.com/Injuries/General_Inj/heat_safety_tips.htm

Heat Exhaustion

"It's too darn hot..." - Cole Porter song "Too Darn Hot"

Yesterday's post focused mostly on Heat Stroke, the deadly stage of heat related illnesses. Today I'd like to spend more time on Heat Exhaustion and how to treat it. Hopefully you'll spot Heat Exhaustion when it occurs and prevent it from progressing to Heat Stroke.

Recognizing Heat Exhaustion
Warning signs of heat exhaustion include:

• heavy sweating
• paleness
• muscle cramps
• tiredness or weakness
• dizziness or headache
• dark urine
• fast heartbeat
• nausea or vomiting (call 911)
• fainting (call 911)

Treatment for Heat Exhaustion
Help the victim to cool off with:

• Cool, non-alcoholic, non-caffeinated, beverages.
• Cool shower, bath, or sponge bath. Outdoors: Gently spray with a hose.
• Get to an air-conditioned environment. At the very least find shade.
• Rest, lie down with feet slightly elevated.

Seek medical attention if symptoms worsen or last longer than 30 minutes. If fever greater than 102 F (38.9 C), fainting, confusion or seizures occur, dial 911 or call for emergency medical assistance.

Having heat exhaustion or heatstroke makes you more sensitive to hot conditions for about a week afterwards.

Bottom Line
If you lead or manage outdoor activities, memorize the symptoms and treatment for Heat Exhaustion so you can spot it and respond quickly. If you're a scout leader, sports coach, work crew chief, hiking guide, tour guide - this means you!

Sources
http://www.webmd.com/a-to-z-guides/heat-exhaustion
http://familydoctor.org/online/famdocen/home/healthy/firstaid/basics/088.html
http://www.medicinenet.com/heat_exhaustion/article.htm
http://www.mayoclinic.com/health/first-aid-heat-exhaustion/FA00020