Six Things to Know About Heat Waves (or Excessive Heat Events) - Dr. Dora Anne Mills

 

Dora Anne Mills, MD, MPH, FAA:

The View from Maine

Six Things to Know About Heat Waves (or Excessive Heat Events)

June 17, 2024

 

1.     What’s the leading cause of weather deaths over the last several decades? Heat events. Heat events (e.g., heat waves) cause more illness and deaths than any other weather event. Air conditioning (AC) is a critical antidote, especially when the heat index is 95 and above, and especially for those at high-risk. Take it easy, keep hydrated, and check on others.

•   Several examples:

o   a 1995 heat wave in Chicago killed 739 people over a 3-day period;

o   a 2003 heat wave in France killed over 14,800 people over a 20-day period;

o   The hot summer of 2022 in Europe killed an estimated 61,672 due to heat;

o   US CDC recently reported that in the summer of 2023, about 2,300 people died with heat listed as a cause of death.

•   These numbers far outweigh the tragic but much smaller (and increasing) annual U.S. tolls from flooding (88), tornadoes (71), hurricanes (45), lightning (37), and wildfires

(16) during the period 1992-2021 (NOAA).

•   Deaths due to heat are often related to complications to an existing chronic illness.

•   Poor air quality due to increase in ozone is also associated with heat waves, complicating the health impacts of heat.

 

 

2.     What to do to prevent heat illness

•   Keep cool:

o   use air conditioning (AC);

o   keep windows/shades closed during the day and open them up at night;

o   take a cool shower/bath/swim;

o   use a fan, though realize when temperatures are in the 90s or above, fans are of limited use, and AC is more important.

•   Drink fluids.

•   Lie low.

•   Check on others who are vulnerable. Neighbors helping neighbors.

•   AC. When the heat index is about 95 or higher, exposure to air conditioning is very important, especially for those most vulnerable, such as the elderly and infants. Check for local cooling centers. Stores and libraries are often a source for AC.

 

 

3.     Definition of a heat wave varies from place to place.

•   Just because we know people in the South who are living with much higher temperatures, doesn’t mean we can scoff at heat events in New England. Our bodies are not as used to heat events, and we do not have the infrastructure (e.g., AC) to handle the heat throughout our communities.

•   Traditionally, in Maine and New Hampshire, it is a temperature of 90 degrees or more for 3 or more days.

•   The heat index (HI) is an important measure, since it integrates humidity. A heat advisory in ME and NH is issued when the HI is 95 or more for at least two hours.

 

 

4.     Who is most at risk for health effects of excessive heat? They include:

•   Older people (due to declines in temperature regulation seen in ages 50+);

•   Infants and young children (also due to limited abilities to regulate temperature);

•   Psychiatric illness (especially those who take medications such as antipsychotics that impact temperature regulation);

•   Obesity (due to increased heat production, adipose tissue providing insulation and impeding heat loss);

•   Those with cardiovascular or cerebrovascular conditions (e.g., heart disease and strokes) or diabetes - due to disease impacts on circulation and temperature regulation, impacts of medications, etc.;

•   Social isolation and poverty;

•   Living in a long-term care facility or home without access to air conditioning (AC);

•   Athletes and outdoor workers.

Bottom line: even if heat hasn’t impacted your health in the past, do not assume it won’t now.

 

 

5.     Heat Illnesses include:

•   Heat Stroke (is a medical emergency with high body temperature, hot, red, often dry skin, often with confusion);

•   Heat Exhaustion (heavy sweating, cold, pale, clammy skin, tiredness or weakness).

•   Infographic on heat illnesses: https://www.cdc.gov/extreme- heat/media/pdf/Heat_Related_Illness.pdf

 

 

6.     A heat wave was a precipitating event leading to major mental health changes in Maine.

•   In 1988 five patients at AMHI (Augusta Mental Health Institute, the state’s psychiatric hospital) died during a summer heat wave (allegedly after fire doors were installed without concomitant revisions to ventilation).

•   A class-action lawsuit resulted in a 1990 consent decree that led to improved community programs and a new hospital.

 

 

Extreme Heat Resources

•   Numerous and excellent resources:

o   https://www.maine.gov/dhhs/mecdc/environmental-health/heat/resources.html

•   How to keep your home cool

o   https://theconversation.com/how-to-keep-your-house-cool-in-a-heatwave-21991

•   Some resources for those who may have trouble in the heat:

o   Older adults: https://www.cdc.gov/aging/emergency-preparedness/older-adults- extreme-heat/index.html

o   Children: https://www.maine.gov/dhhs/mecdc/environmental- health/heat/documents/KeepingKidsSafe.pdf

o   Outdoor workers: https://www.osha.gov/heat

•   Community guide for heat events:

o   Brief version: https://www.epa.gov/sites/default/files/2014- 07/documents/eheguide-brief_final.pdf

o   Full version: https://www.epa.gov/sites/default/files/2016- 03/documents/eheguide_final.pdf

•   National Weather Service, Gray Maine

o   https://www.weather.gov/gyx/

•   US CDC Heat Illnesses

o   https://www.cdc.gov/extreme-heat/prevention/

•   Heat Stress and Public Health: A Critical Review, 2007

o   https://www.annualreviews.org/doi/10.1146/annurev.publhealth.29.020907.09084 3