Intense Heat Threatens Health of the Young and the Old

NEEDLES, Calif., July 6 -- The temperature climbed toward a life-threatening 120 degrees here today, with forecasters predicting that by next week dangerous heat may stretch from coast-to-coast. When temperatures rise, so do health risks.

As the western states entered the fourth consecutive day of triple-digit temperatures there was growing concern about the ability of electric power grids to stand the strain. On Thursday, when temperatures in Las Vegas reached a record 117 degrees overheated transformers caused fires on electricity poles. It was 115 degrees in Phoenix.

In Orofino, Idaho, a 15-month-old boy died after spending the night amid stifling heat in a locked car.

The first major heat wave of this summer is similar to one that gripped the nation last year, although that the worst of last summer's heat came about a month later.

By August 5, 2006, there were 20 heat-related deaths in New York City, a relatively small number compared with an estimated 160 heat-related deaths in California.

The best advice for people of any age is to stay cool-air conditioning is best but fans are helpful as well. Adequate hydrated is also important.

Heat-related illness spans from dehydration to heat exhaustion and heat stroke, all of which can be life threatening.

•Dehydration may be treatable at home with extra water and fluids such as sports drinks.
•Heat cramps cause intense, persistent pain with muscle contractions. Light stretching and massage may ease the pain while rehydration, particularly with sports drinks, is required.
•Heat exhaustion causes heavy sweating, weakness and sometimes fainting and vomiting. It should be immediately treated by hydration and cooling with misting, a wet towel or sheet, and fanning to promote evaporation.
•Heat stroke occurs after the body's thermal regulation systems are overwhelmed and temperatures quickly rise above even the hottest possible fever and can cause permanent cardiac, brain, muscle, kidney and other organ damage.

Although dehydration, heat cramp and heat exhaustion may have no long term consequences, the opposite is often true for severe heat stroke.

"I don't think most of these patients who get to this stage get back to normal," said Paul Hamilton, M.D., an emergency physician at Mount Sinai Hospital of Queens, during the 2006 heat wave. "It's even worse than having the highest fever you can have."

Disadvantaged Elderly Particularly Vulnerable to Heat Wave

Along with the elderly, those who are overweight, have hypertension or heart disease, diabetes, or suffer from chronic respiratory illnesses are more susceptible to heat-related illness.

Infants and children are also at heightened risk in part because they can become dehydrated faster than adults.

Heat-related illness is more difficult to diagnose in young infants. Rather than headache and nausea, they may present as fussy and irritated, said pediatrician Dee Hodge, M.D., of Washington University in St. Louis. Taking a good history will generally help in these cases, he said.

Primary-care physicians and general internists who typically see most of the older people in communities should be alert to opportunities to educate elderly patients and their families about coping with the heat, said geriatrician Sharon A. Brangman, M.D., of the State University of New York in Syracuse.

"Ask patients how are they handling the heat and what are they doing," she recommended. "I try to impress on them the fact that air conditioners are a necessity now, not a luxury."

Extreme heat can come on fairly quickly, so the dangers of heat exposure are "something people need to be aware of all the time," cautioned Charles Pattavina, M.D., an emergency physician at Saint Vincent Hospital in Worcester, Massachusetts.