July 24, 2006
It's July, and it's hot.
In some parts of the country,
people have been dealing with extreme heat in addition to power
outages that have lasted for days. The dangerously hot weather has
been front page news, but not all the risks associated with high
temperatures can make the front page. Some heat hazards are less
hidden, while others rarely make the news:
"Extremely hot weather
can result in illness -- including physiological disruptions and
organ damage -- and even death. Excessive heat events, or abrupt
and dramatic temperature increases, are particularly dangerous and
can result in above-average rates of mortality. In fact, the Centers
for Disease Control and Prevention (CDC) says that excessive heat
claims more lives in the United States each year than hurricanes,
lightning, tornadoes, floods, and
While everyone is potentially
at risk, there are those who are more vulnerable to the risks associated
with excessive heat exposure.
"About 400 people
die each year from heat exposure, according to the CDC. The risk
of heat illness goes up during exertion and sports and with certain
health conditions such as diabetes, obesity, and heart disease.
Alcohol use also increases the risk. So do medications that slow
sweat production such as antihistamines, tricyclic antidepressants,
and diuretics used to treat water retention, high blood pressure,
and some liver and kidney conditions. People ages 65 and older and
young children are especially vulnerable to heat illness. During
the summer of 2003, at least 42 children in the United States died
after being left in hot cars, according to Jan Null, a meteorologist
in San Francisco who tracks heat-related deaths. What some people
don't realize is that the temperature inside a car can climb much
higher than temperatures outside during a sunny day. Heat stroke
in children can occur within minutes, even if a car window is opened
Children are not the only
ones at risk when left alone in a car. Adults and seniors may know
how to get out of a car that is getting too hot, but they also need
to be aware of the warning signs so that they know when to get out.
Then there are the pets...
"Americans have a
love affair with their cars--and their pets. During the summer months,
however, the combination can be deadly. ... Common sense tells most
people that leaving their pet inside a parked vehicle on a hot,
summer day could be dangerous after an extended period of time.
But most people don't realize that the temperature can skyrocket
after just a few minutes. Parking in the shade or leaving the windows
cracked does little to alleviate this pressure cooker. On a warm,
sunny day windows collect light, trapping heat inside the vehicle,
and pushing the temperature inside to dangerous levels. On an 85-degree
Fahrenheit day, for example, the temperature inside a car with the
windows opened slightly can reach 102 degrees within ten minutes.
After 30 minutes, the temperature will reach 120 degrees. At 110
degrees, pets are in danger of heatstroke. On hot and humid days,
the temperature in a car parked in direct sunlight can rise more
than 30 degrees per minute, and quickly become lethal."
Having heard what to do
during extreme heat is one thing, but it is often more difficult
for people to follow the guidelines if they don't understand why
they exist. (For even more detail on the following topics, visit
the reference link at the bottom of the quote.)
"What to Do During
- "Slow down. Avoid strenuous
activity. Reduce, eliminate or reschedule strenuous activities.
High-risk individuals should stay in cool places. ...
- "Avoid too much sunshine. Sunburn
slows the skin's ability to cool itself. ...
- "Postpone outdoor games and
activities. Extreme heat can threaten the health of athletes,
staff, and spectators of outdoor games and activities.
- "Avoid extreme temperature changes.
A cool shower immediately after coming in from hot temperatures
can result in hypothermia, particularly for elderly and very young
- "Stay indoors as much as possible.
If air conditioning is not available, stay on the lowest floor,
out of the sunshine. ...
- "Vacuum air conditioner filters
weekly during periods of high use. ...
- "If your home does not have
air conditioning, go to a public building with air conditioning
each day for several hours. ...
- "Dress appropriately: Wear loose-fitting,
lightweight, light-colored clothing that will cover as much skin
as possible. ...
- "Drink plenty of water regularly
and often even if you do not feel thirsty. Injury and death can
occur from dehydration, which can happen quickly and unnoticed....
- "Eat small meals and eat more
- "Take frequent breaks if you
must work outdoors. Frequent breaks, especially in a cool area
or to drink fluids, can help people tolerate heat better.
- "NEVER leave children or pets
alone in closed vehicles. Temperatures inside a closed vehicle
can reach over 140 degrees F within minutes. Exposure to such
high temperatures can kill in minutes."
It becomes more difficult
to stay in the air conditioning and drink cold fluids when the power
goes out. While many areas set up cooling centers for the air conditioning
access, what happens to the heat-sensitive items that are stored
"When the Power Goes
* Keep the refrigerator and freezer doors closed as much as possible
to maintain the cold temperature. The refrigerator will keep food
cold for about 4 hours if it is unopened....
Buy dry or block ice to keep the refrigerator as cold as possible
if the power is going to be out for a prolonged period of time.
* If you plan to eat refrigerated or frozen meat, poultry, fish
or eggs while they are still at safe temperatures, it's important
that the food is thoroughly cooked to the proper temperature to
assure that any foodborne bacteria that may be present is destroyed.
"Once Power is Restored
- Determine the safety of your food.
If an appliance thermometer was kept in the freezer, check the
temperature when the power comes back on. If the freezer thermometer
reads 40°F or below, the food is safe and may be refrozen.
- ... You can't rely on appearance
or odor. If the food still contains ice crystals or is 40°F
or below, it is safe to refreeze or cook.
- Refrigerated food should be safe
as long as the power was out for no more than 4 hours. Keep the
door closed as much as possible. Discard any perishable food (such
as meat, poultry, fish, eggs or leftovers) that has been above
40°F for two hours or more.
- Perishable food such as meat, poultry,
seafood, milk, and eggs that are not kept adequately refrigerated
or frozen may cause illness if consumed, even when they are thoroughly
Food safety is a concern
during a power outage (or a picnic on a warm day). Beyond food safety,
some medications need to be refrigerated. Consult your pharmacist
if you have questions about medication safety after a power outage.
Even with the power on, temperatures can rise, and medications can
be compromised (especially if left in the car or in the sun on a
For example, many with
severe allergies carry an EpiPen® with them at all times. If
they are out in 90* F - 100* F heat, this could cause the EpiPen®
to be ineffective:
"* Epinephrine is stable at room temperature ...
* EpiPen® should not be exposed to extreme heat, such as in
the glove compartment or trunk of a car during the summer.
* Do not expose the EpiPen® to direct sunlight; light and heat
can cause epinephrine to oxidize and go bad, turning brown.
* Check contents of the cartridge periodically through the viewing
window to make sure the solution is clear and colorless. If the
solution appears brown, replace the unit immediately."
While these directions
specifically mention the glove compartment of a car, the EpiPen®
website has a link to the Patient Package Insert which provides
more specific temperature information:
"* Store at 25*C (77*F);
excursions permitted to 15*C-30*C (59*F-86*F) (See USP Controlled
Room Temperature). Contains no latex. Protect from light.
* Do NOT store in refrigerator.
* Do NOT expose to extreme cold or heat. For example, do NOT store
in your vehicles glove box."
***Please note: The
EpiPen® is ONE example. If you have questions about the heat-sensitivity
of your medication (whether prescription or over the counter), please
contact your pharmacist.***
There are other examples.
There are other risks. No one article can cover them all. Newspapers,
TV broadcasts, radio reports, and online articles all have to pick
and choose what to point out.
Questions of the Week:
When should you contact your pharmacist or doctor with a heat-related
question? What do your peers, friends, and relatives need to know
about the effects of the heat on themselves, their pets, their food,
and their medications? What other heat-related topics should be
addressed? Which heat-related issues would you choose to focus on
if you were to write an article? What might be a better way to reach
your peers or relatives with this information?
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum