CDC Urges: Stay Cool to Stay Healthy As Temperatures Soar

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/

Stay informed

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/.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Information for Those Most Vulnerable to Extreme Heat

Heat and the Elderly

People aged 65 years or older are less likely to sense and respond to changes in temperature. People in this category must be given and reminded of the following information.

Closely monitor people who depend on you for their care:

• Are they drinking enough water?
• Do they have access to air conditioning?
• Do they know how to keep cool?

• Stay in air-conditioned buildings as much as possible. Contact your local health department or locate an air-conditioned shelter in your area.
• Do not rely on a fan as your primary cooling device during an extreme heat event.
• Drink more water than usual and don’t wait until you’re thirsty to drink.
• Check on a friend or neighbor and have someone do the same for you.
• Don’t use the stove or oven to cook—it will make you and your house hotter.
• Wear loose, lightweight, light-colored clothing.
• Take cool showers or baths to cool down.
• Check the local news for health and safety updates.
• Seek medical care immediately if you have, or someone you know has, symptoms of heat-related illness like muscle cramps, headaches, nausea or vomiting.

Heat and Infants and Children

Infants and young children are sensitive to the effects of extreme heat, and must rely on other people to keep them cool and hydrated.

Never

leave infants or children in a parked car, even if the windows are open.

Never

leave pets in a parked car - they can suffer heat-related illness too.

• Never leave infants or children in a parked car. Nor should pets be left in parked cars—they can suffer heat-related illness too.
• Dress infants and children in loose, lightweight, light-colored clothing.
• Seek medical care immediately if your child has symptoms of symptoms of heat-related illness.

Heat and People with Chronic Medical Conditions

People with a chronic medical condition are less likely to sense and respond to changes in temperature. Also, they may be taking medications that can worsen the impact of extreme heat. People in this category need the following information.

Closely monitor people who depend on you for their care:

• Are they drinking enough water?
• Do they have access to air conditioning?
• Do they know how to keep cool?

• Drink more water than usual and don’t wait until you’re thirsty to drink.
• Check on a friend or neighbor, and have someone do the same for you.
• Check the local news for health and safety updates regularly.
• Don’t use the stove or oven to cook——it will make you and your house hotter.
• Wear loose, lightweight, light-colored clothing.
• Take cool showers or baths to cool down.
• Sign up to receive free weather alerts to your phone or e-mail at (http://www.weather.com/mobile/).
• Seek medical care immediately if you or someone you know experiences symptoms of heat-related illness.

Heat and Outdoor Workers

People who work outdoors are more likely to become dehydrated and are more likely to get heat-related illness.

STOP

all activity and get to a cool environment if you feel faint or weak.

• Drink from two to four cups of water every hour while working. Don’t wait until you are thirsty to drink.
• Avoid alcohol or liquids containing large amounts of sugar.
• Wear and reapply sunscreen as indicated on the package.
• Ask if tasks can be scheduled for earlier or later in the day to avoid midday heat.
• Wear a brimmed hat and loose, lightweight, light-colored clothing.
• Spend time in air-conditioned buildings during breaks and after work.
• Encourage co-workers to take breaks to cool off and drink water.
• Sign up to receive free weather alerts to your phone or e-mail (http://www.weather.com/mobile/)
• Seek medical care immediately if you or a co-worker has symptoms of heat-related illness.
• For more information, please visit: http://www.cdc.gov/niosh/topics/heatstress/.

Heat and Athletes

People who exercise in extreme heat are more likely to become dehydrated and get 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.
• Wear and reapply sunscreen as indicated on the package.
• 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. Muscle cramping may be an early sign of heat-related illness.
• Monitor a teammate’s condition, and have someone do the same for you.
• Wear loose, lightweight, light-colored clothing.
• Know when it’s hot! Sign up to receive free weather alerts to your phone or e-mail (http://www.weather.com/mobile/)
• Seek medical care immediately if you or a teammate has symptoms of heat-related illness.
• Learn more by participating in a CDC course on preventing heat-related illness.

Content source: National Center for Environmental Health

Frequently Asked Questions (FAQ) About Extreme Heat

1. What happens to the body as a result of exposure to extreme heat?
    
   People suffer heat-related illness when the body’s temperature control system is overloaded. The body normally cools itself by sweating. But under some conditions, sweating just isn’t enough. In such cases, a person’s body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs. Several factors affect the body’s ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions that can limit the ability to regulate temperature include old age, youth (age 0-4), obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug use and alcohol use.
    
2. Who is at greatest risk for heat-related illness?
    
   Those at greatest risk for heat-related illness include infants and children up to four years of age, people 65 years of age and older, people who are overweight, and people who are ill or on certain medications.
    
3. What is heat stroke?
   
   Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Body temperature may rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.
    
4. What are the warning signs of a heat stroke?
    
   Warning signs of heat stroke vary but may include the following:

• An extremely high body temperature (above 103°F)
• Red, hot, and dry skin (no sweating)
• Rapid, strong pulse
• Throbbing headache
• Dizziness
• Nausea
• Confusion
• Unconsciousness

5. What should I do if I see someone with any of the warning signs of heat stroke?
    
   If you see any of these signs, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the victim. Do the following:

• Get the victim to a shady area.
• Cool the victim rapidly, using whatever methods you can. For example, immerse the victim in a tub of cool water; place the person in a cool shower; spray the victim with cool water from a garden hose; sponge the person with cool water; or if the humidity is low, wrap the victim in a cool, wet sheet and fan him or her vigorously. 
• Monitor body temperature and continue cooling efforts until the body temperature drops to 101-102°F.
• If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
• Do not give the victim alcohol to drink.
• Get medical assistance as soon as possible.

6. What is heat exhaustion?
    
   Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Those most prone to heat exhaustion are elderly people, those with high blood pressure, and those working or exercising in a hot environment.
    
7. What are the warning signs of heat exhaustion?
    
   The warning signs of heat exhaustion include the following:

• Heavy sweating
• Paleness
• Muscle cramps
• Tiredness
• Weakness
• Dizziness
• Headache 
• Nausea or vomiting
• Fainting

The skin may be cool and moist. The pulse rate will be fast and weak, and breathing will be fast and shallow. If heat exhaustion is untreated, it may progress to heat stroke. See medical attention if symptoms worsen or last longer than one hour.

8. What steps can be taken to cool the body during heat exhaustion? 

• Drink cool, nonalcoholic beverages.
• Rest.
• Take a cool shower, bath, or sponge bath.
• Seek an air-conditioned environment.
• Wear lightweight clothing.

9. What are heat cramps and who is affected?
   
   Heat cramps are muscle pains or spasms – usually in the abdomen, arms, or legs – that may occur in association with strenuous activity. People who sweat a lot during strenuous activity are prone to heat cramps. This sweating depletes the body’s salt and moisture. The low salt level in the muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion. If you have heart problems or are on a low-sodium diet, seek medical attention for heat cramps.
    
10. What should I do if I have heat cramps?
    
    If medical attention is not necessary, take the following steps:

• Stop all activity and sit quietly in a cool place.
• Drink clear juice or a sports beverage.
• Do not return to strenuous activity for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke.
• Seek medical attention for heat cramps if they do not subside in 1 hour.

11. What is heat rash?
     
    Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. It can occur at any age but is most common in young children. Heat rash looks like a red cluster of pimples or small blisters. It is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.
     
12. What is the best treatment for heat rash?
     
    The best treatment for heat rash is to provide a cooler, less humid environment. Keep the affected area dry. Dusting powder may be used to increase comfort.
     
13. Can medications increase the risk of heat-related illness?
     
    The risk for heat-related illness and death may increase among people using the following drugs: (1) psychotropics, which affect psychic function, behavior, or experience (e.g. haloperidol or chlorpromazine); (2) medications for Parkinson’s disease, because they can inhibit perspiration; (3) tranquilizers such as phenothiazines, butyrophenones, and thiozanthenes; and (4) diuretic medications or "water pills" that affect fluid balance in the body.
     
14. How effective are electric fans in preventing heat-related illness?
    
    Electric fans may provide comfort, but when the temperature is in the high 90s, fans will not prevent heat-related illness. Taking a cool shower or bath or moving to an air-conditioned place is a much better way to cool off. Air conditioning is the strongest protective factor against heat-related illness. Exposure to air conditioning for even a few hours a day will reduce the risk for heat-related illness. Consider visiting a shopping mall or public library for a few hours.
     
15. How can people protect their health when temperatures are extremely high?
     
    Remember to keep cool and use common sense. Drink plenty of fluid, replace salts and minerals, wear appropriate clothing and sunscreen, pace yourself, stay cool indoors, schedule outdoor activities carefully, use a buddy system, monitor those at risk, and adjust to the environment.
     
16. How much should I drink during hot weather?
     
    During hot weather you will need to drink more liquid than your thirst indicates. Increase your fluid intake, regardless of your activity level. During heavy exercise in a hot environment, drink two to four glasses (16-32 ounces) of cool fluids each hour. Avoid drinks containing alcohol because they will actually cause you to lose more fluid.
     
17. Should I take salt tablets during hot weather?
     
    Do not take salt tablets unless directed by your doctor. Heavy sweating removes salt and minerals from the body. These are necessary for your body and must be replaced. The easiest and safest way to do this is through your diet. Drink fruit juice or a sports beverage when you exercise or work in the heat.
     
18. What is the best clothing for hot weather or a heat wave?
    
    Wear as little clothing as possible when you are at home. Choose lightweight, light-colored, loose-fitting clothing. In the hot sun, a wide-brimmed hat will provide shade and keep the head cool. If you must go outdoors, be sure to apply sunscreen 30 minutes prior to going out and continue to reapply according to the package directions. Sunburn affects your body’s ability to cool itself and causes a loss of body fluids. It also causes pain and damages the skin.
     
19. What should I do if I work in a hot environment?
    
    Pace yourself. If you are not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP all activity. Get into a cool area or at least in the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

This information provided by NCEH's Health Studies Branch.