Heat Wave - 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.