1. HEAT-RELATED ILLNESSES
PREVENTION OF
HEAT-RELATED ILLNESSES
Dr. ABHAY NIGAM
M.B.B.S., M.D. (Medicine)

2. BACKGROUND Heat related illnesses
Are very much preventable yet prevelent worldwide, especially in regions characterized by high ambient temperatures. Like UAE
Heat exhaustion, Heat stroke & Heat Cramps
Most common preventable illness affecting construction and industrial workers.

3. BACKGROUND
According to the National Oceanic and Atmospheric Administration (NOAA), approx persons die from heat-related disorders during an average year in the United States.
This statistics rises to more than 1500 persons during heat waves. The exact number of persons seeking treatment for heat-related disorders is not recorded but reaches the thousands.
UAE – Gulf News report -The number of occupational deaths mostly linked to heat-related illnesses among workers, especially during the summer months, was reported to have reached 66 last year.

4. Humidity, Temperature, and the Heat Index
Since high humidity reduces your body's ability to get rid of excess heat by sweating, for a given air temperature the higher the humidity the higher the apparent temperature, or heat index.

5. Heat Index For example, Air temp. Rel. humidity Apparent Temp
(Feels Like)
30 C 50% C
30 C 90% C
39 C 25% C
37 C 13% C

7. TYPES OF HEAT RELATED ILLNESSES
Heat exhaustion: is an acute heat injury with normal or slightly raised temperature caused by dehydration.
Heatstroke: is extreme hyperthermia (Very high fever). The condition is characterized by serious organ damage with universal involvement of the Brain. Heat Stroke is the most serious type of heat related illness.
Heat Cramps :are painful muscle cramps caused by a loss of body salt through excessive sweating. Although all the muscles may be involved, most commonly calf muscles are affected.
Heat Syncope: (pronounced "sin-co-pay") is sudden fainting caused by a reduced blood flow to the head. The victim's skin will be cool and moist and their pulse will be weak. Immediate medical attention is needed in the event of syncope.

8. HEAT EXHAUSTION - SIGNS AND SYMPTOMS
Results from inadequate salt and water intake and is a sign the body is suffering from shortage of water & salts
The victim will sweat heavily,
skin - cool and moist,
Temp –normal or slighly elevated
Pulse weak,
Dizziness
Tired, confused, clumsy, irritable or upset,
May breathe rapidly, even faint and their vision may be blurred.
Muscle cramps
Nausea & vomiting occasionally

9. HEAT EXHAUSTION - SIGNS AND SYMPTOMS
The victim may strongly argue that they are okay even with these obvious symptoms. If you suspect heat exhaustion, don't let the victim talk you out of seeking immediate medical attention. The heat exhaustion will affect their ability to exercise good judgment.
Until medical help arrives, try to cool the victim and offer sips of cool water as long as the victim is conscious. Immediate medical attention is must. Heat exhaustion can quickly lead to heat stroke.
Delay in treatment can lead to permanent Kidney damage, shock & death

10. FIRST AID – HEAT EXHAUSTION
Move to a cool place indoors or in the shade.
(Preferably air-conditioned area)
Loosen clothing.
Give fluids such as cold water. If available, give him any WHO approved O.R.S. (Oral Rehydration solution) otherwise add Some
sugar and ½ teaspoon of salt to 250 ml. of
water and ask patient sip it frequently
Give salty foods such as saltine crackers, if
tolerated.
Make patient lie down in a cool, breezy place.

12. HEAT STROKE - SIGNS AND SYMPTOMS
Heat stroke, unlike heat exhaustion, strikes suddenly, with little warning. When the body's cooling system fails, the body's temperature rises fast. This creates an emergency condition.

13. HEAT STROKE - SIGNS AND SYMPTOMS
Heat Stroke is the deadliest of all heat stress conditions. It occurs when the body's cooling mechanism has shut down after extreme loss of salt and fluids.
The body temperature will rise, the victim's skin is hot, red, and dry,
Headache or dizziness. Patient will probably be weak, confused, and upset. Later stages may become unconscious and may lead to convulsions.
In the event of heat stroke, seek immediate medical attention. Until help arrives, try to cool the victim and offer sips of cool water if the victim is conscious.

14. HEAT STROKE - SIGNS AND SYMPTOMS
Very high temperature (104 degrees F or higher)
Hot, dry, red skin
No sweating
Deep breathing and fast pulse (Tachycardia) - then shallow breathing and weak pulse
Dilated pupils
Confusion,
Convulsions (Fits)
Loss of consciousness

15. FIRST AID – HEAT STROKE
Until emergency care arrives, it is important to lower the body temperature. To do this:
Move the person to a cool place. Raise the legs .
Remove the clothing and either wrap the person in a
cold, wet sheet; sponge the person with towels or
sheets that are soaked in cold water; or spray the
person with cool water.
Fan the person.
Keep the person with wet items far enough away from
the fan so as not to cause electric shock.
Put ice packs or cold compresses to the neck, under
the armpits and to the groin area.

17. FIRST AID – HEAT STROKE Do CPR (Cardio-Pulmonary Resuscitation) if
the person is not breathing and has no pulse.
Do rescue breathing if the person is not
breathing, but does have a pulse.
Support circulation with intravenous (IV)
fluids, if possible.
Supplemental 4-5 litres/minute.
TRANSFER TO NEAREST HOSPITAL AS
SOON AS POSSIBLE

18. HEAT CRAMPS
Move to a cool place indoors or in the shade. (Preferably air- conditioned area)
Loosen clothing.
Treat like a case of Heat exhaustion.

20. HEAT SYNCOPE
Keep patient in lying down position with legs elevated to increase the blood flow to brain.
Move to a cool place indoors or in the shade. (Preferably air-conditioned area)
Loosen clothing.
Treat like a case of Heat exhaustion but Heat syncope is more serious condition and any delay in arranging medical aid could be fatal.

21. PREVENTION
Heat exhaustion and heat stroke can be prevented with following simple precautions:
Recognizing the symptoms of heat stress is very important, particularly since the victim may not realize what is happening. If you work alone in a hot environment, develop a "buddy system" so someone will check in on you periodically to look for signs of heat stress.
Preventing heat stress is a matter of controlling the factors that cause it. Use the precautions mentioned in this article and don't hesitate to seek assistance if you suspect heat stress. Your good health depends on it!

22. PREVENTION (Contd..)
Take caution when you must work in hot environment. At the first signs of heat exhaustion, get out of the place of hot environment
Wear light, loose clothing, such as cotton, so sweat can evaporate. And, put on a wide-brimmed hat with vents.
Thirst is not a reliable sign that your body needs fluids. When you when you work in extreme hot weather, it is better to sip rather than gulp the liquids.
drink two litres of water every 2-3 hours Drink water or water with salt added if you sweat a lot. (Use 1/2 teaspoon salt in 250 ml. of water.)
Do not drink alcohol or beverages with caffeine because they speed up fluid loss.

23. PREVENTION (Contd..)
It is possible to prevent heat-related illnesses. The important thing is to stay well-hydrated.
The best fluid to drink when you are sweating is water.
Salt tablets – to be taken only under medical supervision
"Sport drinks" such as Isostar & Pokari are fine, too, but water is easier to obtain.

24. Role Of Administrative Controls In Prevention
Increase the frequency and duration of rest breaks
Schedule tasks to avoid heavy physical activity during the hottest parts of the day
Provide cool drinking water or an electrolyte-replacement drink and encourage its consumption at work place.
Use additional workers for the job or slow down the pace of the work whenever possible.
Make sure everyone understands the signs and symptoms of heat stress.
Acclimatize the new workers before assigning them full duties. All the new workers must be acclimatized before they are put on full duty.
Early recognition of symptoms & signs of Heat Exhaustion/Stroke and summon of emergency medical assistance may save a valuable life.

25. THANK YOU