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THE KDK REPORT: Dire health consequences of extreme heat on the body

By DR KENNETH D KEMP

EVERY year, Bahamians from one end of the archipelago to the other lament the relentless broil of the summer’s heat. And this summer’s simmer has been particularly ruthless. Some of the hottest days on record occurred during July of this year with a heat index (feels like temperature) that oscillated between 105 and 115 degrees Fahrenheit. But unlike other, less tropical, locales we are often shielded from the intense heat by the shade of palm and coconut trees and cooled by the balmy breeze of our turquoise ocean.

Despite such enviable conditions, even the healthiest amongst us can fall victim to the heat and become at best exhausted or at worst medically compromised unless we have proper hydration. The most vulnerable to heat stroke are children, the elderly, the homeless, patients with high blood pressure and individuals who take any range of medications that directly or indirectly cause alterations in fluid or electrolyte balance.

For the past two years, I’ve shared stories of my patients anonymously and always with their permission. The information they share and the stories of their struggles and successes, resonated deeply with individuals throughout our country because these are the stories of our family, neighbours and friends. Today’s report, however, isn’t based on one of my patients. It was inspired by a news article that I read recently and I’m sharing it in hopes that the message impacts whoever sees it and the awareness is sufficient to negate a similar tragedy.

A few days ago, on August 29, a 12-year-old boy in Southern California named Yahshua Robinson, returned to school following an enjoyable summer break. He had physical education (PE) class that morning but his parents forgot to pack his PE clothes. According to fellow classmates, his PE teacher made him run outside in his school uniform. The weather at the time was in the low to mid 90s. A short while later, Yahshua allegedly experienced shortness of breath, felt dizzy and asked for water before collapsing. Paramedics arrived on the scene at 11am and Yahshua was quickly transferred to a hospital ten miles from his school but was pronounced dead approximately two hours after he collapsed.

The irony is that Yahshua’s mother is a PE teacher at another school and earlier that day she’d informed school administrators that it was too hot for her students to exercise outdoors. Yahshua is survived by his two loving parents and three siblings. An autopsy is pending to officially confirm his cause of death but no answer will be enough to negate their anger or soothe their pain.

Closer to home, a little more than a year ago at age 85, former governor general CA Smith was airlifted from Eleuthera to New Providence after suffering from heat exhaustion. He was outside taking pictures when his symptoms began. Fortunately, he recovered quickly. And, just this year, several local priests who are frequently bedecked in multiple thick robes also suddenly fell ill with similar symptoms.

All too frequently, we learn of another death of a child left unattended in a closed car. A child’s body temperature rises up to five times as fast as that of an adult, meaning the time it takes to suffer heatstroke is condensed and can be fatal in minutes. So far this year, 15 children in the US have died in a locked, hot car, losing their lives tragically in a totally preventable accident.

In its early (prodromal) stage heat exhaustion manifests as headache and fatigue but quickly progresses to nausea, vomiting, dizziness, unsteady gait, muscle cramps, an increasingly rapid heartbeat and eventually fainting. This occurs because the body temperature becomes elevated and incapable of cooling down despite excessive sweating.

Heat stroke is much more concerning and can lead to death if left untreated. It occurs when the body is no longer capable of maintaining core temperature, which ranges between approximately 97 to 99 degrees Fahrenheit (F) for a typical adult. A core temperature between 100 and 104 degrees F can result in exhaustion while a temperature above 104 degrees F can lead to stroke. Symptoms of heat stroke may include altered mental status, slurred speech, combativeness, seizures and coma. If treatment is delayed, the condition is inevitably fatal.

Experts recommend that for anyone suffering from symptoms of either heat exhaustion or heat stroke, treatment should revolve around removing the patient from direct heat and rapidly cooling the body. Applying ice packs to neck, groin and underarm regions are particularly effective. Then once able, cool liquids should be administered to improve hydration.

The Bahamas meteorological department regularly updates locals with regards to climate and weather information and advises the public to consume water to avoid dehydration. Coconut water if available has the added benefit of replenishing electrolytes. Limiting outdoor activity during peak hours and taking frequent breaks are other recommendations along with staying in the shade when outdoors as much as possible, wearing a hat and loose, light-coloured clothing made of breathable fabric like cotton. It is no accident that field workers wore big floppy hats, fishermen and fisherwomen are rarely seen without something atop their head and ballplayers and golfers hit the field or course with caps. Taking cool showers and ventilating vehicles before driving, particularly when travelling with children are other important tips. If you know you are going somewhere in your car or truck at a certain time, take the extra minute to open the door and let some of that hot air out before you and your passengers get in.

Worthy of note is that animals, like dogs with thick manes, are also and perhaps more so vulnerable to increasingly hot weather. The Bahamas Humane Society cautions pet owners to be on guard for signs of dehydration in their pets. Just imagine how unbearable it would be to walk outside all day with a heavy fur coat on. But even ocean fauna are at risk since record high temperatures are not only isolated to land. Climate change specialists are equally concerned that sea temperatures are rising to unprecedented levels resulting in coral bleaching and reports suggest that there has already been a mass death of fish off the coast of Florida as a result.

According to the US Environmental Protection Agency, more than 11,000 Americans died from heat-related causes between 1979 and 2018. A research study published in 2020 in the journal of Environmental Epidemiology, however, suggests that the number of deaths related to heat in the United States is substantially higher than previously reported. Nonetheless, it's hard to imagine that with just a fan and shade, a life, perhaps young Yahshua’s life, could have been saved.

My take home message is for parents to speak to their children and educate them about properly staying hydrated. I’m also advocating that schools heed the advice of Yahshua’s mom and prevent children from exercising on days outside when the sun is at its peak and the temperature index is above a certain point, as determined by administration and weather experts. School auditoriums, if available, can be used temporarily for gym class on exceptionally hot days with alterations in physical exercise focusing on jumping jacks, skipping to music and a myriad of similar activities that will have minimal damage to the area.

As temperatures continue to rise, finding unique ways to protect our loved ones from heat-related emergencies will become increasingly more essential not just in The Bahamas but in every nation throughout the world.

This is The KDK Report.

Comments

zemilou 5 months, 3 weeks ago

About the United States, but perhaps universally applicable: A July 21, 2023 headline in Scientific American reads, "Extreme Heat Is Deadlier Than Hurricanes, Floods and Tornadoes Combined."

As the story notes: "Extreme heat is the number-one weather-related cause of death in the U.S., and it kills more people most years than hurricanes, floods and tornadoes combined."

In addition to the reasons for people dying from heat mentioned in The KDK Report, prolonged exposure to extreme heat can damage the central nervous system, the brain and other vital organs and worsen existing chronic medical problems, including hypertension and heart disease (both widespread health issues in The Bahamas).

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Porcupine 5 months, 3 weeks ago

Thanks for this article. I think we need to reexamine our work requirements for those who work outside in summer. Also, here in The Bahamas, do we ever really need to have our kids wearing long pants?

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