It has been a hot week in the north. More than 100 million people in the US were under excessive heat warnings as of Tuesday evening, while parts of England set a new temperature record. The heat isn't just unpleasant. It can be life threatening.
The last two weeks in Spain and Portugal have resulted in over a thousand deaths. The deaths are reminiscent of the 2003 European heat wave, in which more than 15,000 people died. According to Richard Keller, a University of Wisconsin-Madison professor of medical history and bioethics and author of " Fatal Isolation: The Devastating Paris Heat Wave of 2003 (opens in new tab) ", most elderly people were living alone in apartment buildings without airconditioning.
How does it kill? The gut leaks toxins into the body, cells begin to die, and an inflammatory response can occur if core body temperature rises too high.
Part of the insidiousness of heat-related deaths is how quickly they can happen. Older individuals are more at risk, often because their cardiovascular systems are less resilient to the strain caused by excess heat, according to a 2014 article in the journal Medicine & Science in Sports & Exercise (opens in new tab). But in extreme enough temperatures, even young, physically fit people can succumb quickly. One victim of a heat wave in Phoenix in 2017 was a personal trainer who was mountain biking with friends on a day when temperatures would soar to 118 F (47.7 C). Despite drinking plenty of water and biking with two doctors who immediately attempted to resuscitate her, the woman died, according to ABC15 News (opens in new tab). And in 2021, Philip Kreycik, an expert trail runner in California succumbed to heat stroke, on a day when temperatures approached the triple-digits, Outside reported (opens in new tab).
And in Northern California that same summer, a family was found dead in Sierra National Forest for similar reasons. The story made national news because it was not clear at first what had killed the family. But an investigation showed that temperatures reached up to 109 F (42.7 C) that August day, and the family ran out of water, according to NPR (opens in new tab). Jonathan Gerrish, Ellen Chung, their 1-year-old daughter, Miju, and their dog, Oski, all died.
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These are not typical heat deaths, according to Keller. He said they're like shots across the bow telling you something is about to happen. The elderly and the mentally ill are the majority of deaths.
Hyperthermia is a term used for excessive body heat. The first phase of heat exhaustion is marked by heavy sweat and nausea. The skin is clammy when the pulse is running. According to the CDC, heat exhaustion can be an early sign of muscle pain.
If you want to reverse heat exhaustion, you need to move to a cool location, loosen clothing and apply wet wipes to the body. People with heat exhaustion can move quickly to heat stroke. A person's core body temperature goes above 104 F. There are a few degrees of variability among people as to how much heat they can tolerate.
The skin becomes dry and flushed in heat stroke. The pulse is moving fast. A person can become delirious and pass out. The body dilates the blood vessels in the skin in order to cool the blood. The body has to stop the flow of blood in the gut. The reduced blood flow to the gut increases the permeability between the cells that normally keep gut contents in and toxins can leak into the blood according to a book chapter.
The attempts to fight off the toxins damage the body's own tissues and organs. According to Wilderness Medicine, it can be difficult to tell what damage is caused by heat and what damage is caused by toxins. rhabdomyolysis is a condition in which the muscles break down and overload the kidneys.
The heat causes the cells in the spleen to clump together. The brain's blood-brain barrier can allow dangerous substances into the brain. According to Wilderness Medicine, 30% of heat stroke survivors experience permanent brain damage, and autopsies of people killed by heat stroke often reveal small strokes and swelling.
The American Association of Family Physicians says 10% of people who experience heat stroke die. Immediate medical treatment is required for heat exhaustion.
In the case of a hiker on a trail, there may not be time to get to a spot that is cooler. People who don't have air conditioning in urban areas can't get help before they die from heat stroke.
Keller said that the elderly and those with chronic medical conditions have a harder time regulating their body temperatures than those in midlife. In old age, the signals between brain and body may not function as well. Babies and young children have a harder time regulating their temperature.
Older, neurologically disabled and mentally ill people are more socially isolated than younger people.
They tend to be socially isolated. That is the biggest risk factor for dying during a heat wave.
Europeans went on vacation in France in the summer of 2003 Elderly people were forced to live in mostly empty apartment buildings during the heat wave. Keller said that some people were found dead with their doors ajar and that they were trying to get help.
He stated that others were functionally trapped. An elderly man who just had hip surgery cannot get down the stairs on his own.
They didn't have a way to seek help.
Some may not have realized how bad the situation was. The New York Department of Health and Mental Hygiene found that people who died of heat stroke in that city were not more likely to live alone than people who survived. The people who died in New York may not have been aware of the warning signs. Keller said that some people during the European heat wave probably didn't realize how precarious their survival was.
Keller said that regions used to high heat are not likely to see high levels of mortality. Low-income people and those living in marginal housing are the most at-risk. According to a report, only 5% of England's homes have air conditioning.
The Department of Health Services in Arizona has some tips on how to prevent heat illness.
The original article was published on Live Science in June of 2016
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