As tem­per­a­tures soar, study warns of fa­tal heat stroke at work

The Borneo Post - Nature and health - - Alert -

MUCH of the United States has been swel­ter­ing in triple-digit heat this week, but new re­search finds out­door work­ers can suf­fer fa­tal heat stroke from tem­per­a­tures that only reach the high 80s. In fact, six of 14 cases of fa­tal heat stroke in­ves­ti­gated in the new study “oc­curred when the Heat In­dex was be­low 91 de­grees Fahren­heit,” noted a team led by Dr Aaron Tustin, from the US Oc­cu­pa­tional Safety and Health Ad­min­is­tra­tion (OSHA).

Early sum­mer heat waves are par­tic­u­larly deadly, the OSHA re­searchers said, since peo­ple may not yet be ac­cli­ma­tized to high tem­per­a­tures. Dr Robert Glat­ter, an ER doctor at Lenox Hill Hos­pi­tal in New York City, has seen many cases of heat stroke. “It’s im­por­tant to re­mem­ber that ex­treme heat com­bined with hu­mid­ity can kill,” said Glat­ter, who wasn’t in­volved in the new study. “Ex­tremes of heat are most con­cern­ing to pub­lic safety, and a large num­ber of heat-re­lated deaths are gen­er­ally pre­ventable.”

Glat­ter called heat stroke “a med­i­cal emer­gency. Pa­tients may de­velop tem­per­a­tures of up to 106-108 F, with con­fu­sion and dis­ori­en­ta­tion, and loss of abil­ity to pro­duce sweat to cool the body. Skin is gen­er­ally is red, hot and dry … Cool­ing ice baths and mist­ing fans can help re­duce core tem­per­a­tures.” Work­ers -- who of­ten wear bulky cloth­ing and have lit­tle choice but to labour out­side in sear­ing tem­per­a­tures -- are at par­tic­u­lar risk. In the new report, Tustin and his col­leagues fo­cused on 25 cases of out­door, on-the­job heat stroke oc­cur­ring be­tween 2011 and 2016, 14 of which proved fa­tal.

The study found that in half the cases, vic­tims had at least one “pre­dis­pos­ing per­sonal risk fac­tor” for heat stroke -- ill­nesses such as di­a­betes or heart dis­ease, or use of cer­tain med­i­ca­tions or il­licit drugs. Ac­cord­ing to Glat­ter, medicines such as blood pres­sure pills or di­uret­ics af­fect a per­son’s “fluid bal­ance,” up­ping the odds for de­hy­dra­tion in se­vere heat. A stren­u­ous work­load also in­creases the risk. On the day work­ers suf­fered an at­tack, “work­load was mod­er­ate, heavy or very heavy in 13 of 14 fa­tal­i­ties,” the OSHA re­searchers noted. Four cases were also likely ex­ac­er­bated by work­ers wear­ing heav­ier cloth­ing, an­other known risk fac­tor for heat stroke, they said.

Across the 25 cases, the me­dian Heat In­dex was 91 de­grees, but tem­per­a­tures for in­di­vid­ual cases of heat stroke ranged from just 83 de­grees to 110. Glat­ter said hy­dra­tion is cru­cial for peo­ple who must work out­side in the heat. “Water is the ideal fluid for hy­dra­tion, and it is rec­om­mended to avoid ex­ces­sive amounts of caf­feine, which can lead to de­hy­dra­tion,” he said.

Tustin’s team of­fered these tips to stay safe from the heat when work­ing out­side:

• Make sure work­place su­per­vi­sors are trained to recog­nise the signs of heat stroke, and in first aid to help if it oc­curs.

• Des­ig­nate at work­site heat “mon­i­tor” to be mind­ful of ris­ing tem­per­a­tures and over­see pro­tec­tive mea­sures.

• Make sure new work­ers get the pro­tec­tive mea­sures they need to ac­cli­ma­tise to work­ing out­doors in the heat, and be mind­ful that work­ers with pre­dis­pos­ing risk fac­tors might need ex­tra pre­cau­tions.

• Sched­ule fre­quent breaks in shade or air-con­di­tioned spa­ces to al­low work­ers to cool down, and ad­just work sched­ules to try and avoid the worst con­di­tions.

• Pro­vide plenty of ac­ces­si­ble water or elec­trolyte-bear­ing bev­er­ages.

The new report was pub­lished in Mor­bid­ity and Mor­tal­ity Weekly Report, a jour­nal of the US Cen­tres for Dis­ease Con­trol and Pre­ven­tion.

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