Monday, June 9, 2008

Health Care and the Weather

Have you ever complained about how you are feeling and blame it on the weather? Weather follows your life and makes you cheerful, moody or sick. The weather and health are on our lips more often than we probably realize. We say things like: "The heat is killing me. I can't stand the cold. This wind is driving me crazy". When we are short of a topic for a conversation, we talk about the weather and its myriad ill effects. Instinctively, we know when weather affects us. When you think of weather events that may injure or kill a person, you probably think of extreme events such as the strong winds in tornados; the consequences of floods may come to mind; or you may imagine a person being struck by lightning. The weather can harm you in more subtle ways and affect more people than it does in its violent form.

A conference of broadcast meteorologists in 2003 talked about how weather causes certain health issues. A number of diseases and other health impacts may be affected by climatic conditions and weather. These include:
1.) Heat stroke, dehydration and heat exhaustion, loss of water supplies—Heat waves
2.) Hypothermia, heart attacks—Extreme winter weather
3.) Asthma, cardio-respiratory disease—Air quality degradation
4.) Emerging and spreading infectious diseases—Climate warming and variability
5.) Traumatic injuries and infrastructure damages (e.g., water systems)—Extreme weather
6.) Gastro-intestinal infections (related to water and food quality)—Climate warming, and sea surface temperature variations.

While each one of the above impacts (e.g., heat stroke or emerging infectious diseases) can
occur in the absence of weather and climate changes, it is projected that climate change and
associated alterations in weather patterns may influence the frequency, intensity and geographic
distribution of these health outcomes. Also to be considered are the morbidity and mortality rates associated with weather-related impacts on food quality (especially seafood), and the health impacts of sea level rise and storm surges (e.g., flooding, saltwater intrusion into fresh water supplies).

The State of Pennsylvania has information on their site about how to handle heat related illnesses. People of all ages are sensitive to extremes in temperature. But as you age, your body may become less able to respond to extremely hot or cold temperatures. In addition, taking certain types of medications can affect how your body responds to heat. Be aware of days when extreme heat conditions are predicted by paying attention to your local weather forecast. On hot days, you should:

· Drink plenty of water;
· Avoid long periods in the direct sun or in unventilated rooms;
· Keep air conditioning or fans running;
· Avoid vigorous activity when it is hot and humid;
· Reschedule activities for cooler times of the day;
· Wear light-colored, lightweight, loose-fitting clothing;
· Wear a hat or other head covering when out in the sun;
· Wear appropriate sunscreen protection; and
· Take frequent baths or showers and remain in a cool place.

Heat-related health problems may include the following:

Heat Cramps:
Symptoms: Painful spasms usually in leg and abdominal muscles. Heavy sweating.
First Aid: Firm pressure on cramping muscles or gentle massage to relieve spasm. Give sips of water. If nausea occurs, discontinue.

Heat Exhaustion:
Symptoms: Heavy sweating, weakness, skin may be cold, pale and clammy. Weak pulse. Normal temperature possible. Fainting, vomiting.
First Aid: Get victim to lie down in a cool place. Loosen clothing. Apply cool, wet cloths. Fan or move victim to air-conditioned place. Give sips of water. If nausea occurs, discontinue. If vomiting occurs, seek immediate medical attention.

Heat Stroke (Sun Stroke):
Symptoms: Extremely high body temperature (106+). Hot, dry skin. Rapid, strong pulse. Possible unconsciousness. Victim will likely not sweat.
First Aid: Heat stroke is a severe medical emergency. Dial 911 or emergency medical services or get the victim to a hospital immediately. Delay can be fatal. Move victim to a cooler environment. Try a cool bath or sponging to reduce body temperature. Remove clothing. Use fans and/or air conditioners. DO NOT GIVE FLUIDS.

The Center for Disease Control has information on their site about how to handle health related issues in extreme cold weather. Serious health problems can result from prolonged exposure to the cold. The most common cold-related problems are hypothermia and frostbite.

Hypothermia:
When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won’t be able to do anything about it. Hypothermia is most likely at very cold temperatures, but it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water. Victims of hypothermia are often (1) elderly people with inadequate food, clothing, or heating; (2) babies sleeping in cold bedrooms; (3) people who remain outdoors for long periods—the homeless, hikers, hunters, etc.; and (4) people who drink alcohol or use illicit drugs.

Recognizing Hypothermia:
Warnings signs of hypothermia: Adults: shivering, exhaustion, confusion, fumbling hands,
memory loss, slurred speech, and drowsiness. Infants: bright red, cold skin, very low energy

What to Do:
If you notice any of these signs, take the person’s temperature. If it is below 95°, the situation is an emergency—get medical attention immediately. If medical care is not available, begin warming the person, as follows: Get the victim into a warm room or shelter. If the victim has on any wet clothing, remove it. Warm the center of the body first—chest, neck, head, and groin—using an electric blanket, if available. Or use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets. Warm beverages can help increase the body temperature, but do not give alcoholic beverages. Do not try to give beverages to an unconscious person.
After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck. Get medical attention as soon as possible. A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing. In this case, handle the victim gently, and get emergency assistance immediately. Even if the victim appears dead, CPR should be provided. CPR should continue while the victim is being warmed, until the victim responds or medical aid becomes available. In some cases, hypothermia victims who appear to be dead can be successfully resuscitated.

Frostbite:
--Frostbite is an injury to the body that is caused by freezing. Frostbite causes a loss of feeling and color in affected areas. It most often affects the nose, ears, cheeks, chin, fingers, or toes. Frostbite can permanently damage the body, and severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation and among people who are not dressed properly for extremely cold temperatures.
--Recognizing Frostbite: At the first signs of redness or pain in any skin area, get out of the cold or protect any exposed skin—frostbite may be beginning. Any of the following signs may indicate frostbite: a white or grayish-yellow skin area skin that feels unusually firm or waxy, and numbness. A victim is often unaware of frostbite until someone else points it out because the frozen tissues are numb.
--What to Do: If you detect symptoms of frostbite, seek medical care. Because frostbite and hypothermia both result from exposure, first determine whether the victim also shows signs of hypothermia, as described previously. Hypothermia is a more serious medical condition and requires emergency medical assistance.

If (1) there is frostbite but no sign of hypothermia and (2) immediate medical care is not available, proceed as follows: Get into a warm room as soon as possible. Unless absolutely necessary, do not walk on frostbitten feet or toes—this increases the damage. Immerse the affected area in warm—not hot—water (the temperature should be comfortable to the touch for unaffected parts of the body). Or, warm the affected area using body heat. For example, the heat of an armpit can be used to warm frostbitten fingers. Do not rub the frostbitten area with snow or massage it at all. This can cause more damage. Don’t use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for warming. Affected areas are numb and can be easily burned.

These procedures are not substitutes for proper medical care. Hypothermia is a medical emergency and frostbite should be evaluated by a health care provider. It is a good idea to take a first aid and emergency resuscitation (CPR) course to prepare for cold-weather health problems. Knowing what to do is an important part of protecting your health and the health of others. Taking preventive action is your best defense against having to deal with extreme cold-weather conditions. By preparing your home and car in advance for winter emergencies, and by observing safety precautions during times of extremely cold weather, you can reduce the risk of weather-related health problems.

Weather can affect your health. Knowing what to do in certain situations is the best prevention for avoiding serious health issues related to both extreme weather conditions and everyday lifestyles. Knowledge is the first step to prevent the ill effects of some weather events. Use common sense. Get educated about how to handle your health when it comes to heat, cold, and any other weather condition.

Until next time. Let me know what you think.

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