NEW YORK, Jun 22 (Reuters) -- Alcohol consumption, obesity, strenuous physical activity and the use of certain medications can greatly increase the risk of death on hot summer days, say experts at the Centers for Disease Control and Prevention (CDC).
"Environmental heat exposure can cause illness, injury, and death," warns a CDC report appearing in the June 19th issue of the agency's journal, Morbidity and Mortality Weekly Report.
Over 6,600 Americans died from heat exposure between 1979 and 1995. The CDC officials believe that many of these deaths could have been prevented.
They say certain individuals, including the elderly, small children, the ill, and the overweight or obese, are at especially high risk during hot weather.
The CDC point to the example of a 47-year-old Los Angeles woman, who died in her non-air-conditioned home on a day when temperatures soared to over 100 degrees Fahrenheit. They say her obesity (over 300 lbs) and history of hypertension may have may her especially vulnerable to the physiologic stress brought on by high temperatures.
Substance abuse, or the use of certain medications, can also raise heat-related risks. The CDC describe the case of one New York City woman, found dead in a sauna. "The sauna room temperature was 90 degrees Fahrenheit," they say, noting that her blood alcohol level was 0.21%, more than double the state limit of 0.10%. The authors report the cause of death as "heat exposure associated with acute alcohol intoxication."
In another case, a 37-year-old psychiatric patient was found dead in a homeless shelter in New York City on a day when temperatures climbed to over 90 degrees Fahrenheit. The CDC say "he died from hyperthermia (extreme core body temperature) complicated by lithium (drug) therapy for bipolar disorder."
Otherwise healthy individuals can die after performing strenuous activity or exercise in hot conditions. The study authors describe the case of a 14-year-old overweight Michigan boy found dead in his room, the thermostat of which was set to 85 degrees Fahrenheit. "He had been lifting weights," the CDC authors report, and had died from "acute congestive heart failure caused by strenuous weight lifting and heat exhaustion."
The study urges that individuals who expect to engage in vigorous activity in extreme heat allow "10 to 14 days to acclimate to (the) environment," and consult a healthcare professional before beginning any exercise regimen. Since dehydration is closely linked to heat-related death, all individuals should drink lots of non-alcoholic beverages during hot weather, and ensure that they get adequate levels of salt in their diet (salt tablets are not recommended, however).
Air-conditioning is, of course, the best escape from summer's heat, and the CDC recommend that elderly persons without home air-conditioning "should be encouraged to take advantage of air-conditioned environments" such as shopping malls and public libraries. The experts warn that fans "are not protective against heat-related illness when temperatures are at or above 90 degrees Fahrenheit and humidity is at or above 35%."
SOURCE: Morbidity and Mortality Weekly Report 1998;47:473-475.
