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Heat illness

From Wikipedia, the free encyclopedia

This article is about heat-related illness. For overheating of the body, see Hyperthermia.
"Calenture" redirects here. For the album by The Triffids, see Calenture (album).
Heat stroke treatment at Baton Rouge during 2016 Louisiana floods
Heat exhaustion
Other namesHeat-related illness
SpecialtyEmergency medicine

Heat illness is a spectrum of disorders due to increased body temperature. It can be caused by either environmental conditions or by exertion. It includes minor conditions such as heat cramps, heat syncope, and heat exhaustion as well as the more severe condition known as heat stroke.[1] It can affect any or all anatomical systems.[2] Heat illnesses include:[3][4] heat stroke, heat exhaustion, heat syncope, heat edema, heat cramps, heat rash, heat tetany.

Prevention includes avoiding medications that can increase the risk of heat illness, gradual adjustment to heat, and sufficient fluids and electrolytes.[5][6]

YouTube Encyclopedic

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  • Heat Illness Prevention
  • Beat the Heat: Tips for Preventing Heat Illness
  • Heat illness in athletes - Everything You Need To Know - Dr. Nabil Ebraheim

Transcription

It started out just like any other day. I was building the frame of a house. It was getting really hot — but, you know, it's hard to avoid being in the sun when you're doing work on a home. But after a few hours, I started getting cramps in my legs... My head was spinning; I wanted to vomit. I thought maybe it was something I ate... Later on, I found out that I had collapsed. IT'S ONE OF THE EASIEST THINGS TO PREVENT. YET IF ACTION ISN'T TAKEN EARLY AND QUICKLY, IT CAN BE DEADLY. AND IT CAN HAPPEN JUST BY WORKING UNDER THE SUN. Last summer, I was out in the field. I noticed I felt really tired. I kept working because I wanted to pick as much as possible. After a while, it seemed hard to concentrate; I felt confused, disoriented. I knew I had to cool off somewhere... But there was no shade anywhere, no place for me to sit down in the shade. I started stumbling around, looking for somewhere to sit down. IT'S HEAT ILLNESS, AND IT CAN HAPPEN TO ANYONE WHO WORKS OUTDOORS. BUT IF EMPLOYERS AND WORKERS TAKE STEPS TO PREVENT IT, EVERYONE CAN STAY SAFE AND HEALTHY. WHEN YOU WORK OUTDOORS DOING PHYSICAL WORK — ESPECIALLY WHEN IT'S HOT AND HUMID — YOUR BODY GETS HOT. IF YOU DON'T DRINK PLENTY OF WATER AND TAKE TIME TO REST AND COOL OFF, YOU CAN OVERHEAT. I found out it doesn't take much for your health to take a turn. One minute you can be fine, just feeling a little warm. And all of sudden it hits you — you're exhausted, thirsty and very sick. SOME OF THE EARLY SIGNS INCLUDE MUSCLE CRAMPS, HEAVY SWEATING, RAPID HEART BEAT, FEELING TIRED, HEADACHES, NAUSEA, VOMITING AND DIZZINESS. ALL THESE THINGS ARE SYMPTOMS OF HEAT EXHAUSTION. HEAT STROKE IS A MORE SERIOUS FORM OF HEAT ILLNESS AND WORKERS CAN OFTEN DIE FROM IT. SIGNS OF HEAT STROKE INCLUDE HIGH BODY TEMPERATURE, LITTLE OR NO SWEATING, AND RED, HOT, DRY SKIN. YOU CAN ALSO EXPERIENCE DIZZINESS, FAINTING, CONFUSION, AND EVEN CONVULSIONS. BE AWARE OF THE EARLY SYMPTOMS OF HEAT ILLNESS, AS YOU MAY NEED MEDICAL HELP. SOME HEALTH CONDITIONS SUCH AS HEART PROBLEMS OR DIABETES PUT YOU AT AN EVEN GREATER RISK, SO BE SURE TO TALK TO YOUR DOCTOR ABOUT YOUR WORK IN THE HEAT. FORTUNATELY, HEAT ILLNESS IS EASY TO PREVENT — AND THE STEPS TO PREVENT IT SHOULD SIMPLY BE PART OF THE JOB: THESE INCLUDE WATER, SHADE, REST, AND TRAINING. DRINK WATER OFTEN, EVEN IF YOU AREN'T THIRSTY. IT'S RECOMMENDED THAT YOU DRINK 4 CUPS OR 8 CONES OF WATER C EACH HOUR WHEN WORKING IN HOT WEATHER. YOUR EMPLOYER IS REQUIRED TO PROVIDE PLENTY OF FRESH, COOL WATER DURING THE WORK DAY. When I first heard that I needed to be drinking at least four cups of water every hour, it sounded like way too much. I thought that I'd have to take a lot of bathroom breaks. But being out in the sun, I sweat away most of the water I drink, and I'm not taking extra bathroom breaks MAKE SURE YOU REST IN THE SHADE. BY LAW YOU CAN ASK FOR AT LEAST 5 MINUTES TO REST AND RECOVER FROM HEAT AND YOUR EMPLOYER MUST PROVIDE SHADED AREAS. SOMETIMES WORKERS FEAR STOPPING TO REST. THEY FEEL THE PRESSURE TO WORK AND EARNMORE MONEY, OR WANT TO SHOW THEY ARE GOOD, STRONG WORKERS. BUT RESTING CAN ACTUALLY MAKE YOU MORE PRODUCTIVE. As employers we have to train our employees about heat illness, what we're doing on our site to prevent it, and how to respond in an emergency. It's worth it in the end to make sure everyone is well-prepared. EMPLOYERS NEED TO TRAIN WORKERS ABOUT HEAT ILLNESS AND HOW TO PREVENT IT. EMPLOYERS ALSO NEED TO PLAN FOR EMERGENCIES. THIS INCLUDES TRAINING WORKERS ON WHAT STEPS TO TAKE IF SOMEONE GETS SICK, WHO TO CALL FOR MEDICAL HELP, AND HOW TO GIVE CLEAR DIRECTIONS TO THE WORKSITE. Since we learned what the signs are, we can now be alert for early symptoms, in ourselves and in our coworkers. We also know what to do if one of us gets sick. IT'S IMPORTANT TO ACT EARLY. SO BE AWARE OF EARLY SYMPTOMS WATCH OUT FOR EACHOTHER KNOW WHERE YOU ARE WORKING, AND WHO TO CALL FOR MEDICAL HELP. At our site we also change the way we do the work, like starting earlier in the morning to avoid the hot hours. I also give workers a lighter work load during their first 2 weeks so they can get used to working in the heat. My employees and I all wear light-colored clothing and hats to stay cool. I learned early on that when I make sure my employees are staying healthy and cool, their morale is up and they are more productive, and that benefits the whole company. THERE IS A LAW IN CALIFORNIA THAT PROTECTS YOU FROM HEAT! ALL WORKERS ARE PROTECTED UNDER THIS LAW — REGARDLESS OF IMMIGRATION STATUS. UNDER THE LAW, EMPLOYERS MUST PROVIDE: - PLENTY OF COOL, FRESH WATER, - SHADE AND REST PERIODS - TIME TO GET USED TO THE HEAT - TRAINING - A PLAN FOR EMERGENCIES IT'S ALSO IMPORTANT TO LET YOUR BODY RECUPERATE AND COOL DOWN WHILE YOU'RE OFF WORK. IF YOU DON'T, YOU COULD BE EASILY AFFECTED BY THE HEAT THE NEXT DAY. WHEN YOU'RE AT HOME, CONTINUE TO DRINK WATER, AVOID CAFFEINE AND ALCOHOLIC DRINKS, AND GET PLENTY OF REST. WHAT IF YOU DON'T HAVE ACCESS TO THE REQUIRED WATER, SHADE, REST AND TRAINING, OR YOU DON'T FEEL PREPARED FOR AN EMERGENCY? I never knew it was OK to take a few minutes to get cool in the shade, even on the hottest days. I told my coworkers we should talk to our boss about it. We went to him as a group and told him that if we don't rest in the shade, we aren't as productive because we get too hot and tired and sometimes we get sick from the heat. But if we're able to take breaks, in shaded areas, throughout the day, it will help keep us safe, and healthy. It benefits the whole company when we are able to do our jobs well. IF YOUR EMPLOYER ISN'T GIVING YOU THE PROPER TOOLS TO PREVENT HEAT ILLNESS, YOU CAN CALL CAL OSHA. THEY ARE RESPONSIBLE FOR HEALTH AND SAFETY IN THE WORKPLACE. YOU CAN REPORT THE PROBLEM WITHOUT GIVING YOUR NAME. It's really made a difference having shade in the fields and drinking water often. We feel better and can work harder. Now we know how to look out for each other — and more importantly, we know how to save a life. WATER, REST, SHADE THE WORK CAN'T GET DONE WITHOUT THEM!

Classification

A number of heat illnesses exist including:[3][4]

  • Heat stroke - Defined by a body temperature of greater than 40 °C (104 °F) due to environmental heat exposure with lack of thermoregulation. Symptoms include dry skin, rapid, strong pulse and dizziness.[7]
  • Heat exhaustion - Can be a precursor of heatstroke; the symptoms include heavy sweating, rapid breathing and a fast, weak pulse.
  • Heat syncope - Fainting or dizziness as a result of overheating.
  • Heat edema
  • Heat cramps - Muscle pains that happen during heavy exercise in hot weather.
  • Heat rash - Skin irritation from excessive sweating.
  • Heat tetany - Usually results from short periods of stress in intense heat. Symptoms may include hyperventilation, respiratory problems, numbness or tingling, or muscle spasms.[8]

Overview of diseases

Hyperthermia, also known as heat stroke, becomes commonplace during periods of sustained high temperature and humidity.[9] Older adults, very young children, and those who are sick or overweight are at a higher risk for heat-related illness.[10] 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.[11]

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 stockings and elevating the affected legs will help minimize the edema.[12]

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. 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.[13]

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.[14] 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.[15]

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 diarrhea, 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.[16]

Symptoms

Increased temperatures have been reported to cause heat stroke, heat exhaustion, heat syncope, and heat cramps.[17] Some studies have also looked at how severe heat stroke can lead to permanent damage to organ systems.[17] This damage can increase the risk of early mortality because the damage can cause severe impairment in organ function.[17] Other complications of heat stroke include respiratory distress syndrome in adults and disseminated intravascular coagulation.[18] Some researchers have noted that any compromise to the human body's ability to thermoregulate would in theory increase risk of mortality.[17] This includes illnesses that may affect a person's mobility, awareness, or behavior.[17]

Prevention

Prevention includes avoiding medications that can increase the risk of heat illness (e.g. antihypertensives, diuretics, and anticholinergics), gradual adjustment to heat, and sufficient fluids and electrolytes.[5][6]

Some common medications that have an effect on thermoregulation can also increase the risk of mortality. Specific examples include anticholinergics,[17] diuretics,[17] phenothiazines[18] and barbiturates.[18]

Epidemiology

Heat stroke is relatively common in sports. About 2 percent of sports-related deaths that occurred in the United States between 1980 and 2006 were caused by exertional heat stroke.[19] Football in the United States has the highest rates.[19] The month of August, which is associated with pre-season football camps across the country, accounts for 66.3% of exertion heat-related illness time-loss events.[20] Heat illness is also not limited geographically and is widely distributed throughout the United States.[21] An average of 5946 persons were treated annually in US hospital emergency departments (2 visits/ 100,00 population) with a hospitalization rate of 7.1%.[20] Most commonly males are brought in 72.5% and persons 15–19 years of age 35.6%[20] When taking into consideration all high school athletes, heat illness occurs at a rate of 1.2 per 100,000 kids.[21] When comparing risk by sport, Football was 11.4 times more likely than all other sports combined to be exposed to an exertional heat illness.[21]

Between 1999 and 2003, the US had a total of 3442 deaths from heat illness. Those who work outdoors are at particular risk for heat illness, though those who work in poorly-cooled spaces indoors are also at risk. Between 1992 and 2006, 423 workers died from heat illness in the US.[6] Exposure to environmental heat led to 37 work-related deaths. There were 2,830 nonfatal occupational injuries and illnesses involving days away from work as well, in 2015.[22] Kansas had the highest heat related injury while on the job with a rate of 1.3 per 10,000 workers, while Texas had the most overall.[22] Due to the much higher state population of Texas, their prevalence was only 0.4 per 10,000 or 4 per 100,000. Of the 37 deaths reported heat illnesses, 33 of the 37 occurred between the summer months of June through September. The most dangerous profession that was documented was transportation and material moving.[22] Transportation and material moving accounted for 720 of the 2,830 reported nonfatal occupational injuries or 25.4 percent.[22] After transportation and material moving, Production placed second followed by protective services, installation, maintenance, and repair and construction all in succession[22]

Effects of climate change

Further information: Effects of climate change on human health and Effects of climate change § Heat waves and temperature extremes

A 2016 U.S. government report said that climate change could result in "tens of thousands of additional premature deaths per year across the United States by the end of this century."[23] Indeed, between 2014 and 2017, heat exposure deaths tripled in Arizona (76 deaths in 2014; 235 deaths in 2017) and increased fivefold in Nevada (29 deaths in 2014; 139 deaths in 2017).[24]

History

Heat illness used to be blamed on a tropical fever named calenture.[25]

See also

References

  1. ^ Lugo-Amador, Nannette M; Rothenhaus, Todd; Moyer, Peter (2004). "Heat-related illness". Emergency Medicine Clinics of North America. 22 (2): 315–27, viii. doi:10.1016/j.emc.2004.01.004. PMID 15163570.
  2. ^ Morca, Camilo; Counsell, Bielecki, Louis (November 2017), "Twenty-Seven Ways a Heat Wave Can Kill You: Deadly Heat in the Era of Climate Change", Cardiovascular Quality and Outcomes, 10 (11), doi:10.1161/CIRCOUTCOMES.117.004233, PMID 29122837{{citation}}: CS1 maint: multiple names: authors list (link)
  3. ^ a b Tintinalli, Judith (2004). Emergency Medicine: A Comprehensive Study Guide (6th ed.). McGraw-Hill Professional. p. 1186. ISBN 0-07-138875-3.
  4. ^ a b "Heat Illness: MedlinePlus". Nlm.nih.gov. Archived from the original on 2014-07-04. Retrieved 2014-07-10.
  5. ^ a b Lipman, GS; Eifling, KP; Ellis, MA; Gaudio, FG; Otten, EM; Grissom, CK; Wilderness Medical Society (December 2013). "Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness". Wilderness & Environmental Medicine. 24 (4): 351–61. doi:10.1016/j.wem.2013.07.004. PMID 24140191.
  6. ^ a b c Jacklitsch, Brenda L. (June 29, 2011). "Summer Heat Can Be Deadly for Outdoor Workers". NIOSH: Workplace Safety and Health. Medscape and NIOSH. Archived from the original on December 4, 2012.
  7. ^ "Reducing a Heat Stroke in the Summertime For Seniors". Open Arms Home Care. 2022-05-20. Retrieved 2022-05-30.
  8. ^ [1] Archived July 21, 2010, at the Wayback Machine
  9. ^ "About Extreme Heat | Natural Disasters and Severe Weather | CDC". www.cdc.gov. 2023-09-12. Retrieved 2023-11-08.
  10. ^ "Heat Illness". medlineplus.gov. Retrieved 2023-09-20.
  11. ^ "Extreme Heat". FEMA:Are You Ready?. Archived from the original on 5 August 2006. Retrieved 27 July 2006.
  12. ^ Gauer, Robert; Meyers, Bryce K. (2019-04-15). "Heat-Related Illnesses". American Family Physician. 99 (8): 482–489. ISSN 1532-0650. PMID 30990296.
  13. ^ "Heat rash - Symptoms & causes - Mayo Clinic". www.mayoclinic.org. Retrieved 2023-09-20.
  14. ^ "Heat Cramps, First Aid Condition, Treatments and Pictures for". Skinsight. 2022-08-16. Retrieved 2023-09-20.
  15. ^ Gauer, Robert; Meyers, Bryce K. (2019-04-15). "Heat-Related Illnesses". American Family Physician. 99 (8): 482–489. ISSN 1532-0650. PMID 30990296.
  16. ^ Kenny, Glen P.; Wilson, Thad E.; Flouris, Andreas D.; Fujii, Naoto (2018). "Heat exhaustion". Handbook of Clinical Neurology. 157: 505–529. doi:10.1016/B978-0-444-64074-1.00031-8. ISSN 0072-9752. PMID 30459023.
  17. ^ a b c d e f g Kovats, R. Sari; Hajat, Shakoor (April 2008). "Heat Stress and Public Health: A Critical Review". Annual Review of Public Health. 29 (1): 41–55. doi:10.1146/annurev.publhealth.29.020907.090843. PMID 18031221.
  18. ^ a b c Koppe, Christina; Sari Kovats; Gerd Jendritzky; Bettina Menne (2004). "Heat-waves: risks and responses". Health and Global Environmental Change Series. 2.
  19. ^ a b Yeargin, SW; Kerr, ZY; Casa, DJ; Djoko, A; Hayden, R; Parsons, JT; Dompier, TP (August 2016). "Epidemiology of Exertional Heat Illnesses in Youth, High School, and College Football". Medicine & Science in Sports & Exercise. 48 (8): 1523–9. doi:10.1249/mss.0000000000000934. PMID 27433959.
  20. ^ a b c Nichols, Andrew W. (2014-09-21). "Heat-related illness in sports and exercise". Current Reviews in Musculoskeletal Medicine. 7 (4): 355–365. doi:10.1007/s12178-014-9240-0. ISSN 1935-973X. PMC 4596225. PMID 25240413.
  21. ^ a b c Kerr, Zachary Y.; Casa, Douglas J.; Marshall, Stephen W.; Comstock, R. Dawn (January 2013). "Epidemiology of exertional heat illness among U.S. high school athletes". American Journal of Preventive Medicine. 44 (1): 8–14. doi:10.1016/j.amepre.2012.09.058. ISSN 1873-2607. PMID 23253644.
  22. ^ a b c d e "Work injuries in the heat in 2015 : The Economics Daily: U.S. Bureau of Labor Statistics". www.bls.gov. Retrieved 2019-12-06.
  23. ^ U.S. Global Change Research Program (USGCRP) (2016). "The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. Section 2.7: Projected Deaths and Illness from Temperature Exposure". health2016.globalchange.gov. Archived from the original on 2019-08-30. Retrieved 2019-08-30.
  24. ^ Flavelle, Christopher; Popovich, Nadja (2019-08-26). "Heat Deaths Jump in Southwest United States, Puzzling Officials". The New York Times. ISSN 0362-4331. Retrieved 2019-08-30.
  25. ^ "Calenture: the free dictionary". thefreedictionary.com. Retrieved 2016-01-26.

External links

This page was last edited on 11 April 2024, at 09:16
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