Planning ahead for heat combats excess mortality

Planning ahead for heat helps prevent excess mortality
Planning ahead for heat helps prevent excess mortality

HealthDay News -- The responses of several states to a 2012 heat wave may have limited the subsequent death toll, reaffirming that heat-related deaths can be prevented, especially if plans that focus on identifying and limiting heat exposure among vulnerable populations are in place before an extreme heat event (EHE).

"Public health and emergency management personnel should work together to identify vulnerable populations in their area and design response plans to guide actions during an EHE," CDC researchers reported in Morbidity & Mortality Weekly Report

They studied the effects of a two-week long heat wave following intense thunderstorms caused widespread power outages in Maryland, Ohio, Virginia and West Virginia. From June 30 to July 13, 2012, temperatures ranged from 83 to 104 degrees, almost 10 degrees higher than normal.

A total of 32 EHE-related deaths were reported, including 12 in Maryland, 12 in Virginia, seven in Ohio and one in West Virginia, for a fatality rate of 0.11 per 100,000 population. An average of eight EHE-related deaths occurred in those four states, during the same two-week summer period each year from 1999 to 2009.

The median age of those who died was 65 years. Most were male (72%), unmarried (75%) or living alone. Twenty-two (69%) died at home. Cardiovascular disease (in 14 decedents) and chronic respiratory disease (in four decedents) may have contributed to the deaths, as did loss of power in at least seven (22%) of the deaths.

A lack of air conditioning was cited in 20 of the 22 deaths reported at home. Power outages might have led to the dysfunction of some air conditioners, while other decedents might have assumed their units were not working, as a functional but unused air conditioner was found in five cases. 

Symptoms of heat illness include fainting, heavy perspiration and muscle cramps, according to the CDC.

"Interventions during an EHE include staying cool, hydrated and informed about extreme heat alerts in the area and symptoms of heat illness," the agency noted.

One strategy to combat heat illness is to increase the number of local cooling stations where citizens might find shelter from high temperatures. However, the researchers noted that these stations often go underused due to "perceived and real barriers, including lack of transportation access, safety issues, stigma of public shelters, inability to bring pets and limited operating hours."

Several other examples of useful measures include Ohio's "Check On Your Neighbor" and "Knock and Talk" campaigns, which sent residents door-to-door to check on potentially at-risk citizens. Maryland required any assisted-living program serving 50 or more patients to have an emergency power generator. 

In West Virginia, the National Guard was called upon to visit particularly imperiled individuals, such as the elderly and isolated, and the state of Virginia prepared public messages informing citizens of the hazards of prolonged heat exposure before the summer began. 

"Heat-related deaths are preventable, and heat response plans should be in place before an extreme heat event. Interventions should focus on identifying and limiting heat exposure among vulnerable populations," the CDC said.


References

  1. Fowler et al. MMWR. 2013;62(22):433-436.
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