Elderly people during heatwaves

The Problem

The Met Office announced a level 3 heatwave warning earlier this week and today could be the hottest day on record. The EEL team discuss the increasing trend in hot summers here in the UK and provide readers with research informed advice on how to keep the elderly free of heat illness. The three previous summers have been the warmest on record, with 2018 expected to be the hottest ever recorded. Researchers predict that this global trend will see further increases in the frequency and the severity of heatwaves, like that experienced throughout Europe in 2003, where the UK had 2000 excess deaths related to the heat. The majority of heat-related deaths during heatwaves are within the elderly population, with up to 92% occurring in the over 65’s.

Part of the reason for the disproportionate amount of deaths in the elderly is due to an ageing society. Between 1951-2011 there was an 80% increase in the number of people aged over 65 years. By 2040 it is predicted that 1 in 7 people will be 75 years old or older.

Secondly, aging negatively changes the way the body maintains heat balance. Healthy older individuals rely on a much larger percentage of their heart rate reserve to increase stroke volume in order to redistribute blood flow to the skin and thereby dissipate internal heat. Therefore, the burden placed on the heart is greater for the elderly than young adults. Leading to most deaths during heatwaves occurring due to cardiovascular complications in the elderly population. This scenario is further exacerbated in older populations with underlying co-morbidities.

Older adults may further intensify the problem as they may not feel thirsty until they are dehydrated. Avoiding levels of dehydration can be seen as avoiding reductions in blood volume. Decreased blood volumes lead to low blood pressure which then results in individuals passing out and injuring themselves. Furthermore, some medications further contribute to dehydration.

Research from our lab has also shown that older individuals demonstrate a reduced perception of heat. This can potentially lead to a delayed behavioral response (i.e. taking of layers of clothing or seeking shade) and increase the risk of heat related illness.

 Be aware of the warning signs of heat illness

  • Profuse sweating, heat rashes and being thirsty alongside feeling weak are the first signs to look out for. In some cases were exertion is high you may experience muscle cramps.

  • Headaches, dizziness and feelings of nausea or actual sickness followed by severe fatigue can then develop, where the skin may be pale and cool to touch.

  • When heat stroke develops, people will look flushed, often have hot and dry skin as dehydration stops sweating and will appear confused.

  • Stopping sweating will cause your body temperature to become very high very quickly and with a more confused state over time, this indicates heat stroke has set in and medical attention is required urgently (Call 999).

The solution

Advice on how to enjoy the weather safely:

There are 6 key areas to consider when maintaining heat-related health.

  • Hydration: drink refrigerated water/juice regularly throughout the day even if you do not feel thirsty, eat foods high in water content, fruit and salads. Avoid alcohol, caffeinated and sugary drinks.
  • Indoor environment: the use of electric fans, keep windows open if safe to do so, keep curtains shut, It may be cooler outdoors in the shade than indoors. Take cool showers/baths or splash yourself with cool water
  • Outdoor environment: seek shade and cooler refuges when out and about. Try to avoid the sun between 11am and 3pm.
  • Clothing and protection: light and loose fitting clothes that allows for sweat evaporation. Apply sun screen and wear a hat when going outside in the heat.
  • Medication: have a medication check with your G.P. as many medication will impact thermoregulation and may need to be adjusted during periods of hot weather
  • Activity: keep activities of daily living to cooler parts of the day i.e. early morning late evening
  • Thermal Comfort: remember people above the age of ≥55 may not feel uncomfortable or dehydrated during periods of hot weather, so try to put in place the above strategies because the body could still be at risk of developing heat illness.

If you think someone might be suffering from a heat illness call NHS 111 for advice.

If you suspect heat stroke then cool patient immediately and seek urgent medical attention CALL 999

For further advice look up the public health England’s beat the heat campaign (click here).

2017-18 Academic year – Round up

As the heat wave descends and the EEL team gravitate towards the beach, we would like to round up on what we consider as another successful year for the research lab.

This year we have produced fifteen peer reviewed publications, ranging from heat acclimation performance through to alleviating heat stress in the elderly and fire personnel.

The team have presented at five conferences including ICEE in Kobe Japan and staff have presented twelve invited talks including FireFit, British Science Festival, UK Home Office, EIS Tokyo Heat Workshop and UK Fire R&D.

 

 

 

 

 

We have written eleven funding applications of which four have been successful in recieving funding. The team have produced three commissioned reports for the English Institute of Sport, BASES and the Fire Brigades Union. We have had one PhD completion by Ash Willmott and hope to have a few more in 2018/19.

We also continue to work on research consultancy projects with Fire Brigades Union, UK Fire R&D, East Sussex Fire & Rescue, KuduSmart, Para-Monte and Cosinuss. While the consultancy team have helped support a number of athletes going to Marathon de Sables, Machu Picchu Peru, Aconcagua Chile, MdS Peru and the Coastal Challenge Costa Rica.

 

 

Practical Pre-Cooling Methods for PPE wearers

Research by Emily Watkins into practical pre-cooling methods for PPE wearers during severe heat exposure was published in Applied Ergonomics today (15/2/18). Pre-cooling is a method used to reduce core temperature, heart rate, and the sensation of being hot when individuals are exposed to hot environments. The aim is to reduce core temperature before the heat exposure, meaning an individual will stay at a safe core temperature for longer. In our previous study “Fire Service Instructors’ Working Practices: A UK Survey” it was indicated that few instructors used pre-cooling and those that did were using a variety of methods. This study aimed to assess three practical pre-cooling methods currently being used by instructors, to identify which method is the most beneficial in terms of reducing physiological and perceptual strain experienced from a heat exposure. Inflammatory responses were also investigated, as they can be markers of an increased risk of a cardiovascular event. The pre-cooling methods used were ice slurry consumption, phase change vest, and forearm cooling.

Continue reading