Tuesday 26 July 2011

Heat Stress & Heat Stroke

Published in Panorama



Beating the heat

Temperatures are soaring high, well above 40 degrees Celsius. And with the high temperatures, our body is stressed, its cooling system is strained since it requires greater effort to reduce the heat stress. This physical stress coupled with the body’s stress from work, fatigue and loss of fluids, often leads to heat related symptoms which could even be fatal, says Dr.Vani Krishna Warrier, Physician, Indian Specialist Medical Centre, Dubai.

What happens in a heat disorder? Dr.Vani explains, “When people are exposed to heat for prolonged periods of time or are unaccustomed to the heat, their body’s cooling mechanism breaks down, leading to damages to the body's heat regulating mechanism. An individual may be engaged in physical activity to a degree where the heat that is produced within his body, exceeds the body’s ability to lose heat adequately. This in turn may raise the body’s core temperature to levels thus interfering with the normal functioning of the body.

When an individual's coping capacity to heat stress is compromised, exposure can lead to various physical disorders, which may range from mild to moderate and severe besides reduced ability to perform quality work and increased accidents at work place, says Dr.Vani. Besides the more serious consequences and feeling the physical discomfort of too much heat, victims of heat stress are emotionally disturbed as well, feeling irritated, angry and slow to react to situations. These physical and mental discomforts which are well avoidable, often result in productive manhours at workplaces. So it’s as well that the situation be attended to and prevented before it becomes a problem and cause for concern.

Who are the people at risk of falling prey to heat disorders? “Practically everyone who lives in very warm climates having high humidity levels can suffer from illness caused by heat,” explains Dr.Vani. “The body's ability to respond adequately to heat stress decreases with age and obesity. Of course, this risk is also heightened in young children, school going children, besides people working at construction sites and other areas where heat is generated in substantial levels, adding further to the atmospheric ambience.”

What are the hazards of heat stress? Sunburn and prickly heat or heat rash are a couple of very common and mild manifestations of heat stress. The sunburn occurs due to over exposure of unprotected skin areas to ultraviolet light and causes red, painful skin or blistering and peeling in some instances, says Dr.Vani. Heat rash lowers the body’s ability to lose heat since the sweat ducts get clogged, preventing perspiration. The skin and clothing often remain damp, resulting in red rashes and itching skin which may involve small areas of the skin or the entire upper region of the body.

“Some people may suffer from heat cramps,” explains Dr.Vani, “because they do not have adequate intake of fluids and salt. This may be particularly so in the case of people doing hard physical work in hot environments. Painful cramps may occur in the stomach, arms or legs and the person may sweat heavily. With sufficient intake of water, salt or any other fluids, the victims can be easily managed. It is important that these people should rest a while in cool environs at regular intervals, if they are engaged in hard physical work, as is often the case with laborers at construction sites.”

Heat exhaustion may be a cause for greater concern according to Dr.Vani. “This happens because of an overactive heat control mechanism of the body. The body gets overheated due to excessive loss of fluids and salt depletion. The dilatation of the blood vessels to cool the system, may actually progress to a collapse of the vessels. Heat exhaustion usually develops after several days of exposure to high temperatures and the victim may experience symptoms of severe sweating, have clammy, flushed, or pale skin, suffer dizziness, nauseas or vomiting, feel weak and fatigued and have either rapid or weak pulse rate and blood pressure may be low.

Heat stroke is the worst in the gamut of illness brought on by heat, says Dr.Vani, and it could be life-threatening if emergency measures are not taken at the appropriate time, in the appropriate manner. “In this disorder, the body may lose its ability to regulate temperature because the central nervous system fails to regulate sweat control. Alternately, the body’s normal heat-regulating mechanism may simply be overwhelmed. Whatever may be the cause, the body’s fluid and salt content is severely depleted, the victim is dehydrated, he may stop sweating and his body temperature could go as high as 106 degrees Fahrenheit, delirium, his pulse is rapid, there may be shortness of breath, high blood pressure, dizziness, nausea, vomiting. The person may eventually collapse, go into coma and succumb to the symptoms unless medical attention is given promptly without loss of time. The key symptom to look for in heat stroke is disorientation in the individual.”

How does one deal with these various heat related illnesses? Dr. Vani emphasizes taking the following measures:
• For heat rash and sunburn, minimize skin exposure to heat and use appropriate topical applications, keep skin clean with frequent wash or bath.
• For treatment of heat cramps, exhaustion and stroke, loosen the victims’ clothes, take them to a cool place and fan and if the victim is conscious (he may become unconscious if he’s suffered a heat stroke) give him water or electrolytes.
• Raise the victim’s legs and massage the limbs if he suffers from heat exhaustion
• The heat stroke victim’s body needs to be cooled to bring down the temperature as speedily as possible. This may even require massaging him with ice or drenching him with cold water.

How can one prevent the ill effects of heat stress? The answer lies in taking plenty of fluids, particularly water and sufficient salt, says Dr.Vani. The easiest way to avoid Heat stroke and other heat disorders is to keep your body well hydrated. This means drinking plenty of water before, during and after exposure to the elements and not waiting to feel thirsty to drink water!

This apart, people living in hot climates should first adapt themselves to the climes, through a process called acclimatization which involves gradual adjustment to the heat over a period of few days or a week. To make this adjustment, it is essentially that people keep themselves physically fit and alternate work with rest in a cool place at regular intervals, of perhaps two hours.

In addition to these precautions, Dr. Vani advocates sporting light and loose-fitting clothes that allow permeation of air.

Since heat stroke can set in less than an hour, it is imperative to keep vigil on the amount of activity you are doing in the hottest hours of the day. The moment you begin to feel uncomfortable or light headed, it’s best to cease work and rest in a cool area.

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