PREVENTION OF HEAT-RELATED ILLNESSES

Dr. ABHAY NIGAMM.B.B.S., M.D. (Medicine)

BACKGROUNDBACKGROUND

Heat related illnesses Heat related illnesses Are very much preventable yet prevelent Are very much preventable yet prevelent

worldwide, especially in regions worldwide, especially in regions characterized by high ambient temperatures. characterized by high ambient temperatures. Like UAELike UAE

Heat exhaustion, Heat stroke & Heat CrampsHeat exhaustion, Heat stroke & Heat Cramps

Most common preventable illness affecting Most common preventable illness affecting construction and industrial workers.construction and industrial workers.

BACKGROUNDBACKGROUNDAccording to the National Oceanic and According to the National Oceanic and Atmospheric Administration (NOAA), approx. Atmospheric Administration (NOAA), approx. 175-200 persons die from heat-related disorders 175-200 persons die from heat-related disorders during an average year in the United States. during an average year in the United States.

This statistics rises to more than 1500 persons This statistics rises to more than 1500 persons during heat waves. The exact number of persons during heat waves. The exact number of persons seeking treatment for heat-related disorders is seeking treatment for heat-related disorders is not recorded but reaches the thousands.not recorded but reaches the thousands.

UAE – Gulf News report -The number of UAE – Gulf News report -The number of occupational deaths mostly linked to heat-occupational deaths mostly linked to heat-related illnesses among workers, especially related illnesses among workers, especially during the summer months, was reported to have during the summer months, was reported to have reached 66 last year. reached 66 last year.

Humidity, Temperature, and the Heat IndexHumidity, Temperature, and the Heat Index

Since high humidity reduces your body's ability to get Since high humidity reduces your body's ability to get rid of excess heat by sweating, for a given air rid of excess heat by sweating, for a given air temperature the higher the humidity the higher the temperature the higher the humidity the higher the apparent temperature, or apparent temperature, or heat indexheat index. .

Heat IndexHeat Index

For example, For example, Air temp. Air temp. Rel. humidity Rel. humidity Apparent Temp Apparent Temp

(Feels Like)(Feels Like)30 C30 C 50%50% 31 C31 C30 C30 C 90%90% 40.5 C40.5 C

39 C39 C 25%25% 39.5 C39.5 C37 C37 C 13%13% 34.4 C 34.4 C

http://www.drreddy.com/heat.html http://www.srh.noaa.gov/elp/wxcalc/

heatindex.shtml

TYPES OF HEAT RELATED ILLNESSESTYPES OF HEAT RELATED ILLNESSES Heat exhaustionHeat exhaustion: is an acute heat injury with normal or : is an acute heat injury with normal or

slightly raised temperature caused by dehydration. slightly raised temperature caused by dehydration. HeatstrokeHeatstroke: is extreme hyperthermia (Very high fever). The : is extreme hyperthermia (Very high fever). The

condition is characterized by serious organ damage with condition is characterized by serious organ damage with universal involvement of the Brain. Heat Stroke is the universal involvement of the Brain. Heat Stroke is the most serious type of heat related illness. most serious type of heat related illness.

Heat CrampsHeat Cramps :are painful muscle cramps caused by a loss :are painful muscle cramps caused by a loss of body salt through excessive sweating. Although all the of body salt through excessive sweating. Although all the muscles may be involved, most commonly calf muscles muscles may be involved, most commonly calf muscles are affected. are affected.

Heat SyncopeHeat Syncope: (pronounced "sin-co-pay") is sudden : (pronounced "sin-co-pay") is sudden fainting caused by a reduced blood flow to the head. The fainting caused by a reduced blood flow to the head. The victim's skin will be cool and moist and their pulse will be victim's skin will be cool and moist and their pulse will be weak. Immediate medical attention is needed in the event weak. Immediate medical attention is needed in the event of syncope. of syncope.

HEAT EXHAUSTION - SIGNS AND SYMPTOMS

Results from inadequate salt and water intake and is a sign the body is suffering from shortage of water & salts

The victim will sweat heavily, skin - cool and moist, Temp –normal or slighly elevated Pulse weak, Dizziness Tired, confused, clumsy, irritable or upset, May breathe rapidly, even faint and their vision may be

blurred. Muscle cramps Nausea & vomiting occasionally

The victim may strongly argue that they are okay even with these obvious symptoms. If you suspect heat exhaustion, don't let the victim talk you out of seeking immediate medical attention. The heat exhaustion will affect their ability to exercise good judgment.

Until medical help arrives, try to cool the victim and offer sips of cool water as long as the victim is conscious. Immediate medical attention is must. Heat exhaustion can quickly lead to heat stroke.

Delay in treatment can lead to permanent Kidney damage, shock & death

HEAT EXHAUSTION - SIGNS AND SYMPTOMS

FIRST AID – HEAT EXHAUSTIONMove to a cool place indoors or in the shade.

(Preferably air-conditioned area)Loosen clothing. Give fluids such as cold water. If available, give him any WHO approved O.R.S. (Oral Rehydration solution) otherwise add Some

sugar and ½ teaspoon of salt to 250 ml. ofwater and ask patient sip it frequently

Give salty foods such as saltine crackers, if tolerated. Make patient lie down in a cool, breezy place.

HEAT STROKE - SIGNS AND SYMPTOMS

Heat stroke, unlike heat exhaustion, strikes suddenly, with little warning. When the body's cooling system fails, the body's temperature rises fast. This creates an emergency condition.

HEAT STROKE - SIGNS AND SYMPTOMS

Heat Stroke is the deadliest of all heat stress conditions. It occurs when the body's cooling mechanism has shut down after extreme loss of salt and fluids.

The body temperature will rise, the victim's skin is hot, red, and dry,

Headache or dizziness. Patient will probably be weak, confused, and upset. Later stages may become unconscious and may lead to convulsions.

In the event of heat stroke, seek immediate medical attention. Until help arrives, try to cool the victim and offer sips of cool water if the victim is conscious.

Very high temperature (104 degrees F or higher)

Hot, dry, red skin No sweating Deep breathing and fast pulse (Tachycardia) -

then shallow breathing and weak pulse Dilated pupils Confusion, Convulsions (Fits) Loss of consciousness

HEAT STROKE - SIGNS AND SYMPTOMS

FIRST AID – HEAT STROKE

Until emergency care arrives, it is important to lower the body temperature. To do this:

Move the person to a cool place. Raise the legs .

Remove the clothing and either wrap the person in a cold, wet sheet; sponge the person with towels or sheets that are soaked in cold water; or spray the person with cool water.

Fan the person.

Keep the person with wet items far enough away from the fan so as not to cause electric shock.

Put ice packs or cold compresses to the neck, under the armpits and to the groin area.

FIRST AID – HEAT STROKEDo CPR (Cardio-Pulmonary Resuscitation) if the person is not breathing and has no pulse.

Do rescue breathing if the person is not breathing, but does have a pulse.

Support circulation with intravenous (IV) fluids, if possible.

Supplemental oxygen, @ 4-5 litres/minute.

TRANSFER TO NEAREST HOSPITAL AS SOON AS POSSIBLE

HEAT CRAMPSHEAT CRAMPS

Move to a cool place indoors or in the Move to a cool place indoors or in the shade. (Preferably air- conditioned area)shade. (Preferably air- conditioned area)

Loosen clothing. Loosen clothing. Treat like a case of Heat exhaustion.Treat like a case of Heat exhaustion.

HEAT SYNCOPEHEAT SYNCOPE

Keep patient in lying down position with legs Keep patient in lying down position with legs elevated to increase the blood flow to brain.elevated to increase the blood flow to brain.

Move to a cool place indoors or in the shade. Move to a cool place indoors or in the shade. (Preferably air-conditioned area)(Preferably air-conditioned area)

Loosen clothing. Loosen clothing. Treat like a case of Heat exhaustion but Heat Treat like a case of Heat exhaustion but Heat

syncope is more serious condition and any syncope is more serious condition and any delay in arranging medical aid could be fatal.delay in arranging medical aid could be fatal.

PREVENTION PREVENTION Heat exhaustion and heat stroke can be Heat exhaustion and heat stroke can be prevented with following simple prevented with following simple precautionsprecautions: :

Recognizing the symptoms of heat stress is very Recognizing the symptoms of heat stress is very important, particularly since the victim may not important, particularly since the victim may not realize what is happening. If you work alone in a realize what is happening. If you work alone in a hot environment, develop a "buddy system" so hot environment, develop a "buddy system" so someone will check in on you periodically to look someone will check in on you periodically to look for signs of heat stress. for signs of heat stress. Preventing heat stress is a matter of controlling Preventing heat stress is a matter of controlling the factors that cause it. Use the precautions the factors that cause it. Use the precautions mentioned in this article and don't hesitate to seek mentioned in this article and don't hesitate to seek assistance if you suspect heat stress. Your good assistance if you suspect heat stress. Your good health depends on it!health depends on it!

PREVENTION (Contd..) PREVENTION (Contd..) Take caution when you must work in hot environment. At the Take caution when you must work in hot environment. At the first signs of heat exhaustion, get out of the place of hot first signs of heat exhaustion, get out of the place of hot environment environment Wear light, loose clothing, such as cotton, so sweat can Wear light, loose clothing, such as cotton, so sweat can

evaporate. And, put on a wide-brimmed hat with vents. evaporate. And, put on a wide-brimmed hat with vents.

Thirst is not a reliable sign that your body needs fluids. When Thirst is not a reliable sign that your body needs fluids. When you when you work in extreme hot weather, it is better to sip you when you work in extreme hot weather, it is better to sip rather than gulp the liquids. rather than gulp the liquids.

drink two litres of water every 2-3 hoursdrink two litres of water every 2-3 hours Drink water Drink water or water with salt added if you sweat a lot. (Use 1/2 teaspoon or water with salt added if you sweat a lot. (Use 1/2 teaspoon salt in 250 ml. of water.) salt in 250 ml. of water.)

Do not drink alcohol or beverages with caffeine because they Do not drink alcohol or beverages with caffeine because they speed up fluid loss.speed up fluid loss.

PREVENTION (Contd..) PREVENTION (Contd..) It is possible to prevent heat-related illnesses. It is possible to prevent heat-related illnesses.

The important thing is to stay well-hydrated.The important thing is to stay well-hydrated.

The best fluid to drink when you are sweating The best fluid to drink when you are sweating is water. is water.

Salt tablets – to be taken only under medical Salt tablets – to be taken only under medical supervisionsupervision

"Sport drinks" such as Isostar & Pokari are "Sport drinks" such as Isostar & Pokari are fine, too, but water is easier to obtain.fine, too, but water is easier to obtain.

Role Of Administrative Controls In PreventionRole Of Administrative Controls In Prevention

Increase the frequency and duration of rest breaks Increase the frequency and duration of rest breaks Schedule tasks to avoid heavy physical activity during Schedule tasks to avoid heavy physical activity during

the hottest parts of the day the hottest parts of the day Provide cool drinking water or an electrolyte-Provide cool drinking water or an electrolyte-

replacement drink and encourage its consumption at replacement drink and encourage its consumption at work place.work place.

Use additional workers for the job or slow down the Use additional workers for the job or slow down the pace of the work whenever possible.pace of the work whenever possible.

Make sure everyone understands the signs and Make sure everyone understands the signs and symptoms of heat stress.symptoms of heat stress.

Acclimatize the new workers before assigning them full Acclimatize the new workers before assigning them full duties. All the new workers must be acclimatized before duties. All the new workers must be acclimatized before they are put on full duty.they are put on full duty.

Early recognition of symptoms & signs of Heat Early recognition of symptoms & signs of Heat Exhaustion/Stroke and summon of emergency medical Exhaustion/Stroke and summon of emergency medical assistance may save a valuable life.assistance may save a valuable life.

THANK YOUTHANK YOU