Hot weather brings risk of heat-related illness

Release Date: July 31, 2008
Contact: Carol Schriber, 919-733-9190

RALEIGH – With hot weather predicted for the next few weeks, state health officials stress that high temperatures in combination with high humidity are commonplace during summer months and can pose a serious health risk to the elderly, children and anyone exercising or working outdoors.  Heat-related illness is preventable and the N.C. Division of Public Health is encouraging citizens, workers and employers to take precautions now.

“People suffer from heat-related illness when their bodies are unable to compensate and properly cool themselves,” said Sheila Higgins, an occupational health nurse consultant with the state Occupational and Environmental Epidemiology Branch.  “Body temperatures can rise, and very high temperatures may damage the brain and other vital organs.  Conditions putting people at high risk for heat-related illness include high humidity, dehydration, poor conditioning to heat, poor health, certain prescription drugs, and alcohol use.”

Symptoms of heat-related illness can be subtle at first, but if not addressed can turn into a life-threatening condition and even cause death.  In a recent “Morbidity and Mortality Weekly Report” article published by the CDC, crop production workers were noted as having experienced a high death toll related to heat, especially in North Carolina.  During 1992-2006, a total of 68 crop workers in the United States died from heat stroke – a rate nearly 20 times greater than that for the general workforce.  The majority of these deaths were in adults aged 20-54 years, a population not usually considered to be at high risk for heat-related illnesses.  In addition, the majority of these deaths were among foreign-born workers.  Nearly 60 percent of all heat-related deaths among crop workers occurred in July, and most deaths occurred in the afternoon.  

“Our state had the highest rate of heat-related deaths of these farm workers among the 21 states reporting,” Higgins said.  “Crop workers might be at increased risk for heat stroke because they often wear extra clothing and personal protective equipment to protect against pesticide poisoning or green tobacco illness.”

Heat-related illnesses range from minor heat cramps or rash to heat exhaustion and stroke.  Heat exhaustion warning signs include heavy sweating, poor concentration, paleness, cramps, weakness, dizziness, headache, and fainting.  If not treated, this condition can lead to heat stroke, which can be deadly.   Heat stroke is characterized by a body temperature greater than 103o F; red, hot, and dry skin (with no sweating); rapid, strong pulse; throbbing headache; dizziness; nausea; confusion; and unconsciousness.

The most important thing to do if a person demonstrates warning signs is to get them out of the sun and provide fluids.  Get them to a shady area or air conditioned space and have them rest.

If the person is experiencing symptoms of heat stroke, call emergency medical services and cool the victim using whatever methods you can, including spraying with a nearby garden hose, sponging off with water, or wrapping the person in a wet sheet. If medical help is delayed, call the emergency room to get instructions.

There are simple but important measures people can take to prevent heat-related illness.  They include:

• pacing yourself;
• eating light, non-fatty meals;
• wearing cool, loose clothing;
• avoiding activity during the mid-day;
• increasing normal fluid intake and not waiting until you are thirsty to drink (Hydrate hourly with 2 - 4 large glasses of fluids, avoiding soda, sugary drinks and alcohol);
• getting out of sun and resting when you start to overheat (Get in shade or air conditioning. If you do not have air conditioning, go to a local shopping mall or public library.); and
• do not leave children or pets in cars.

If you work outdoors, also remember to:

• always know who and how to call for help;
• notify your supervisor immediately if you think you are getting sick from the heat;
• know the location of your closest drinking water supplies;
• if you are new to working in the heat, tell your supervisor;
• keep track of co-workers if temperatures and humidity are high;
• avoid alcohol, even beer, to avoid dehydration; and
• after work take a cold bath or shower to help stay at a proper temperature.

Guidance to help employers establish heat-illness prevention programs and additional information can be found on the Web (see below).  The essential elements of a heat-illness prevention program include training supervisors and employees to prevent, recognize, and treat heat-related illness; establishing a heat acclimatization program; encouraging proper hydration with proper amounts and types of fluids; establishing work/rest schedules appropriate for current heat indices; ensuring access to shade or cooling areas; monitoring the environment and workers during hot conditions; and providing prompt medical attention to workers who show signs of heat-related illness.

Heat-related safety materials in English and Spanish are available from the N.C. Department of Labor (NCDOL), www.nclabor.com. The Agricultural Safety and Health Bureau developed a DVD this spring on four hazards in agriculture, including heat stress. A live streaming version of this segment is available under “Quick Clicks” on the NCDOL Web site.

Additional resources include:

• California OSHA
• Centers for Disease Control and Prevention;
• Environmental Protection Agency and
• Department of the Army and Air Force