June 2011
100F11017
During an average
summer, approximately
1,500 people die from
excessive heat events in
the U.S.' A single heat
wave in Chicago killed
more than 700 people
in 7995. In Europe,
a record heat wave
claimed an estimated
35,000 lives in 2003. In
both cases, most of the
victims were 65 or older.
"It's Too Dam Hot" -
Planning for Excessive
Heat Events
Information for Older Adults and
Family Caregivers
Did you know that each
year more people die
from "excessive heat
events" than from
hurricanes, lightning, tornadoes,
floods, and earthquakes
combined?2 Anyone can be
adversely affected by excessive
heat, but older adults are
particularly vulnerable.
Excessive heat events are prolonged
periods when temperatures
reach 10 degrees Fahrenheit or
more above the average high
temperature for a region.3
Excessive heat events are believed
to have a disproportionate public
health impact in cities. One reason
is that roads and buildings absorb
the sun's energy and contribute
to the formation of "heat islands."
While rural areas cool off at night,
cities retain this absorbed heat.
As a result, urban residents get
less nighttime relief from high
temperatures. Fortunately, there are
simple steps that older adults, their
care-givers, and community leaders
can take to decrease the impact of
excessive heat events.
Who is At Risk from
Extreme Heat?
Older adults, as well as young
children, are at high risk from
excessive heat events. For the
growing number of aging Americans,
the body's cooling mechanisms may
become impaired. Living alone or
being confined to a bed and unable
to care for one's self further increases
risk.
Existing health conditions such as
chronic illness, mental impairment,
and obesity can also heighten an
individual's vulnerability. Persons
taking certain medications are
likewise susceptible.
In addition, people who live on
the top floors of buildings without
air-conditioning are more likely
to be exposed to excessive heat.
Participating in strenuous outdoor
activities and consuming alcohol
"Excessive heat events" are surprisingly deadly. Vulnerable
groups like older adults are at particularly high risk.
The good news is that there are simple steps
people can take to protect themselves.
-------
I
I
I
I
I
I
I
I
I
I
I
How Can I Reduce Exposure
to Excessive Heat?
The best defense against excessive heat is
prevention. Air-conditioning is one of the
best protective factors against heat-related
illness and death.4 Even a few hours a day in
air conditioning can greatly reduce the risk.
Electric fans may provide comfort, but when
temperatures are in the high 90s fans do not
prevent heat-related illness.
During excessive heat events, the following
prevention strategies can save lives:
Visit air-conditioned buildings in your
community if your home is not air-
conditioned. These may include: senior
centers, movie theaters, libraries, shopping
malls, or designated "cooling centers."
Take a cool shower or bath.5
Drink lots of fluids. Don't wait until you
are thirsty to drink. If a doctor limits your
fluid intake, make sure to ask how much
to drink when if s hot. Avoid beverages
containing caffeine, alcohol, or large
amounts of sugar. These drinks cause
dehydration.
Ask your doctor or other health care
provider if the medications you take could
increase your susceptibility to heat-related
illness.
Wear lightweight, light-colored, and
loose-fitting clothing.
Visit at-risk individuals at least twice a day.
Watch for signs of heat-related illness such
as hot, dry skin, confusion, hallucinations,
and aggression.
Call 9-1-1 if medical attention is needed.
I
I
I
I
I
I
I
I
during unusually hot weather likewise
exacerbates heat-related health effects.
How Does Excessive Heat Affect
the Body?
The body normally cools itself by increasing
blood flow to the skin and perspiring. Heat-
related illness and mortality occur when
the body's temperature control system
becomes overloaded. When this happens,
perspiring may not be enough. High levels
of humidity can make it even harder for the
body to cool itself.
How are Excessive Heat and
Heat Stroke Related?
Heat stroke is the most serious health effect
of excessive heat events. It is the failure
of the body's temperature control system.
When the body loses its ability to cool itself,
core body temperature rises rapidly. As a
result, heat stroke can cause severe and
permanent damage to vital organs.
Victims can be identified by skin that
appears hot, dry, and red in color. Other
warning signs are confusion, hallucinations,
and aggression. If not treated immediately,
heat stroke can result in permanent
disability or death. The good news is that
heat stroke can be prevented by taking the
easy steps outlined on this page.
-------
What Can Your Local
Government Do to Help?
Local governments can play an important role
in predicting and responding to excessive heat
events. Two increasingly common strategies are
heat alert systems and heat reduction measures.
Heat Alert Systems
Heat Health Watch-Warning Systems identify
when a heat-related public health threat is likely.
These systems use computer programs that
analyze National Weather Service forecasts and
other local data to predict dangerous conditions.
Heat Health Watch-Warning Systems have been
established in Philadelphia, Seattle, Chicago, St.
Louis, and other cities in the U.S. and Europe.
After a warning has been called, city health
authorities communicate this information to older
adults, their care-givers, and other at-risk groups.
Assist the Homeless and Those With
Mental Health Illness
The following steps are "best-practices" that city
officials can take to alert residents and provide
direct assistance:
Distribute media advisories
Activate telephone hotlines
Alert neighborhood volunteers, family
members, and friends
Provide air-conditioned buildings and
offer transportation to these facilities
Assist the homeless
Work with local "area agencies on aging"
to educate at-risk individuals
Cities may also coordinate with local utilities to
ensure that no customer's electricity is turned off
during a heat wave.
What Cost-Effective Steps Can
Communities Take to Cool the Air?
Two steps that communities can take include
using construction material that reflect the sun's
rays, and planting trees and vegetation to provide
shade and natural cooling. Both strategies reduce
the urban heat island effect - urban temperatures
2-10 degrees Fahrenheit hotter than surrounding
rural areas - and may limit the frequency,
duration, and magnitude of excessive heat events.
Heat reduction strategies such as using reflective
"cool roofs" and light-colored pavements, and
planting shade trees, have numerous benefits.
These measures:
Lower ambient temperatures
Slow heat-driven reaction that forms
ozone air pollution
Decrease energy consumption
Improve comfort and livability
-------
Other References
Endnotes
Environmental Protection Agency,
Excessive Heat Events Guidebook
Quick Tips for Responding to Excessive
Heat Events
http://www.epa.gov/aging/resources/epareports.
htm#ehe_hw
Poster: Beat the Heat8 Simple Steps for
Older Adults
http://www.epa.gov/aging/resources/posters/
index.htm#beattheheat-es
Heat Island Reduction Initiative
http://www.epa.gov/heatisland
Center for Disease Control and Prevention
http://www.cdc.gov/aging/
http://www.bt.cdc.gov/disasters/extremeheat/
http://www.cdc.gov/mmwr/preview/mmwrhtml/
mm5529a2.htm
American Medical Association, Heat-Related
Illness During Extreme Emergencies
http://search.ama-assn.org/Search/query.html7qc
=public+amnews+pubs&qt=heat
National Weather Service, Heat Wave and Heat
Index
http://usasearch.gov/search?v%3Aproject=firstgov
&query=heat+wave&affiliate=nws.noaa.gov
Heat and Other Natural Hazard Statistics
http://www.nws.noaa.gov/om/hazstats.shtml
Heat Wave Awareness Project
http://www.isse.ucar.edu/heat/
United States Department of Commerce,
National Oceanic and Atmospheric
Administration
Heat Wave: A Major Summer Killer
http://www.noaawatch.gov/themes/heat.php
1 Kallkstein, L.S. and J.S. Greene, 1997. An
Evaluation of Climate/Mortality Relationships
in Large U.S. Cities and the Possible Impact
of a Climate Change. Environmental Health
Perspectives, 105(l):84-93.
2 Centers for Disease Control and Prevention,
2003. Extreme Heat. Available online:
http://www.bt.cdc.gov/disasters/extremeheat/
3 Federal Emergency Management
Administration, Backgrounder on Extreme
Heat, Feb. 2003
4 Naughton MP, Henderson A, Mirabelli MC,
Kaiser R, Wilhelm JL, Kieszak SM, Rubin CH,
McGeehin MA. Heat-related mortality during
a 1999 heat wave in Chicago. Am J Prev Med.
2002 May;22(4):328-9.
5 McMichael, A.J., LS. Kalkstein and other lead
authors, 1996. Climate Change and Human
Health, (eds. A.J. McMichael, A. Haines, R.
Slooff, S. Kovats). World Health Organization,
and United Nations Environment Programme
(Who/WMO/UNEP), Geneva, 297 pp.
Learn A/lore
The EPA Aging Initiative is working to protect the
environmental health of older adults through the
coordination of research, prevention strategies,
and public education. For more information or to
join the listserve visit: www.epa.gov/aging
Protecting the Health
of Older Americans
Publication Number: 100-F-l 1-017
------- |