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Heat Wave Alerts
Are Not Just for Wimps!

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 19 in the July 20, 2011 issue of
The Mississauga News under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

One of my pet peeves involves the lack of understanding of what a “heat alert” entails. The sporting community is perhaps the most at fault. Heat wave alerts are seen as a point of information for the infirm and sick by many sports organizations. Using the “it doesn’t apply to me as long as I wear a hat and drink water philosophy” during alerts is foolhardy.

Sending children out to run around in hot smog-laden air is even worse. Engaging in strenuous physical activity during an extreme heat alert does not make one “tougher”. Breathing in toxic fumes, heavy metals and such simply taxes natural body systems to limits usually reserved for last-ditch survival. There is no benefit or “training effect” in doing this, and it should not be confused with acclimatization in which there is a slow and controlled introduction to a new atmosphere for the purpose of adaptation.

The price paid by the body for survival in adverse heat conditions is an increase in unwanted inflammatory substances and waste products. We coroners tend to stay very busy during smoggy heat waves. We see many deaths in which the weather is a final factor pushing constellations of health problems over the edge and resulting in a final cascade.

When your body responds by feeling sleepy and groggy, listen to what it is saying. Slow down and take a siesta. Those muscle aches and cramps, dull headache are not just coincidences. A slow and steady intake of tap water is the cure.

We have also seen some extreme temperatures and humidity. I am not certain that most people understand the concept of “humidex”, which is a calculation used to describe how the humidity and temperature combine to produce a certain comfort level. Your normal body temperature is 37° C.

One way of keeping our body that way is to dump internal heat outside and to use perspiration to cool ourselves. For example, jogging when the humidex is above 37° C is quite unwise because you simply cannot cool your body for prolonged periods of time. Water depletion occurs quickly and core temperatures begin to rise. Yet we continue to see large groups of youngsters running around sports fields in such unfavorable conditions. I sometimes wonder if the severe weather advisories broadcast in the media are simply figments of my own imagination.

Extreme heat alerts should be taken seriously. You should no sooner send the kids out in extreme heat that you would during severe storm alerts. But parents continue to do both!

Learn about the hazards and teach your kids the safe way to survive extreme weather. I implore sport organizations to provide proper guidance to the volunteer coaches and officials for the mandatory suspension of activity during these dangerous times. And for the older Grey Blade crowd, let’s not forget that to metabolize any alcohol in our system requires a generous amount of body water to be excreted.

Related resources:

Heat Alert Levels, image from City of Frederiction http://www.fredericton.ca/en/environment/2010mar30heatalertmain.asp
Heat Alert Levels

Heat Alert and Response System (HARS) from Office of the Chief Medical Officer of Health (Public Health), New Brunswick, Canada. "As climate change increases, it is expected that extreme heat events will become more frequent ... extreme heat events can have lethal consequences ... HARS has three alert levels. The levels are based on the Humidex value. *Humidex is a temperature index that describes how hot the weather actually feels to a person, by adding the effect of heat and humidity.

Level 1 - Yellow - When a Heat Alert (Level 1) is issued, certain vulnerable persons may be affected. The main cause of illness and death during a heat wave is the aggravation of pre-existing respiratory and cardiovascular diseases.

Level 2 - Orange - When a High Heat Alert (Level 2) is called, everyone is at increased risk of heat stress and heat stroke under the conditions.
● People living alone without air conditioning are at high risk especially if the heat wave lasts many days.
● Check regularly on your neighbours and relatives to make sure they are not in danger.
● Organizers of sport and recreational activities should build in regular water breaks and rest or consider rescheduling activities.

Level 3 - Red - During an Extreme Heat Alert (Level 3) everyone is at high risk for heat related illnesses and heat stroke.
● People living alone without air conditioning are at extreme risk.
● Check regularly on your neighbours and relatives to make sure they are not in danger.
● Organizers of sport and recreational activities should reschedule activities."

Heat Alert and Response System from City of Fredericton. "Extreme heat poses a major health risk to the public, especially vulnerable populations like older adults, young children, and the homeless, as well as those with chronic health conditions and those using certain medications."

Heat Alert from Regional Municipality of Halton. What is a Heat Alert? Who is at risk from extreme heat? What are the symptoms of extreme heat exposure? How does exercise and physical activity increase my health risk? How can I prevent heat related illness?

Heatwave: level three alert from National Health Service (NHS) UK.

The Heat Alert System from City of Toronto. Hot Weather Response Plan.

Fan Facts (Heat Alert Facts). Summer Safety Tips to Beat the Heat from City of Toronto.

Heat Wave from Wikipedia. Health effects: Mortality, Psychological and sociological effects, Power outage, Wildfires, Physical damage.

Heat Wave Alert: Prevent Heat Stroke in Pets from American Society for the Prevention of Cruelty to Animals (ASPCA). "Avoid dehydration ... Limit exercise ... Bring outdoor pets inside ... Never leave an animal alone in a parked vehicle. Watch out for symptoms of overheating: excessive panting or difficulty breathing, drooling, mild weakness, stupor, seizures, bloody diarrhea and vomiting."

How to Avoid and Treat Heat Exhaustion and Heat Stroke by Sharon O'Brien, About.com Guide.

Preventing Heat Stress at Work from WorkSafeBC (Workers' Compensation Board, British Columbia, Canada). What is heat stress? Primary factors contributing to heat stress: Heat from activity, Heat from environment. Removal of heat from body: Increasing blood flow, Sweating. Recognizing and treating heat stress: Heat cramps, Heat exhaustion, Heat stroke. Preventing heat stress. Heat rash. Personal risk factors.

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