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).

Do Breast Cancer Survivors Respond Differently in the Heat Compared to Healthy Females?

Rebecca Relf, a Technical Instructor and PhD Student within our Environmental Extremes Lab is investigating the ‘physiological differences in females that have been diagnosed and treated for breast cancer compared to those females who have not’.

Why Study Cancer & Environmental Extremes?

Cancer is one of the leading causes of mortality in the UK and worldwide, with approximately 2 million individuals living with cancer in the UK, and 1 in 8 females facing a diagnosis of breast cancer in their lifetime (Eisemann et al, 2013). With increasing advancements in technology and treatment, the survival rate is currently 78% in the UK and rising (Cancer Research UK, 2017).

However, the literature indicates that following the treatment of breast cancer, survivors are left with a multitude of varying side effects which differ in intensity for each person. The most common side effects have been reported as;

  • Risk of recurrent cancer
  • Hot flashes
  • Night sweats
  • Persistent Fatigue
  • Decreased immune function
  • Depression and reduced quality of life

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Dr Alan Richardson Secures Funding to Support UK Firefighters

Congratulations to Dr Alan Richardson and the occupational team (Associate Professor Peter Watt, Dr. Mark Hayes and Emily Watkins) of the Environmental Extremes Lab (EEL) who recently secured funding to support their research investigating firefighter and instructor health.

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A PhD Student’s Pathway to Research Impact – Heatwaves in the Elderly

The research excellence framework (REF) provides funding to UK universities with the purpose to support the continuation of world-class research. The amount of funding received by a university is assessed against three main criteria: the quality of research outputs; the research impact beyond academia; and the environment that supports research (REF, 2018). A priority from the outset of my PhD (Heat waves in the elderly and the impact of acute and chronic heat alleviating strategies on health) was to achieve impact beyond academia. My aim was to provide evidence-based advice that the elderly could use to improve their health and wellbeing during periods of hot weather.

Kirsty Waldock (3rd year PhD student)

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Recruiting Individuals over 65 years for Hot Weather Research Study

We are currently recruiting participants who are over 65 years old to take part in a research study that is examining different ways to prepare for hot weather in the UK. Kirsty Waldock, Rebecca Relf and Gregor Eichhorn are conducting this research as part of their PhD studies and would like to speak to you if you are interested in getting involved. Please see the recruitment poster below for details.

This research fits into a broader research theme within the Environmental Extremes Laboratory of ‘heat waves and the elderly’ and what practical heat alleviating methods can be used to reduce the negative consequences that hot weather can have on health, particularly during exercise.

EEL Beat the Heat with Science!

Dr Neil Maxwell and a number of the Environmental Extremes Lab presented ‘Beat the heat with science’ at the British Science Festival Event in Falmer on the 5th September 2017. The presentation consisted of live experiments, myths and a range of other content delivered to some very enthusiastic members of the public as well as medical/science students.

 

Dr Neil Maxwell at the British Science Festival with (from left to right) Gregor Eichhorn (PhD Student), Kirsty Waldock (PhD Student), Bill Norton (MSc Student and Technician), Dr Mark Hayes (Senior Lecturer), Rebecca Relf (PhD Student and Technical Instructor) and Associate Professor Peter Watt (not pictured)

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EEL Contribute to PHE’s Annual Heat Wave Seminar

Dr Neil Maxwell and Kirsty Waldock (PhD student), presented at Public Health England’s Annual Heatwave Seminar on March 14 2017 that reviewed the Heatwave Plan in an attempt to reduce the number of deaths, reduce illness and hospital visits and increase public awareness. The seminar hosted delegates and speakers from PHE, NHS, Met Office, national climate change committees and charities, as well as regional council public health departments and universities from around the country. International representation also came from the US National Oceanic and Atmospheric Administration.

Background

In Europe, 71,000 people died during the 2003 heat wave, with over 2000 of these excess deaths in England and Wales. For every 1°C above 23.3°C, an extra 75 deaths per week are estimated in the UK [Public Health England (PHE), 2015]. Last year was the third consecutive warmest year since records began and as the earth’s climate is warming with the frequency, intensity and duration of heatwaves increasing, this presents a significant health risk to vulnerable populations (e.g. elderly, children, chronically ill and those with heat sensitivity). Continue reading

EEL Present at a House of Lords Select Committee

Head of EEL, Dr Neil Maxwell and PhD student, Rebecca Relf, were invited to present to a House of Lords Government Select Committee on Breast Cancer Symptom Management in November 2016, to talk about their up-coming research linked to heat sensitivity amongst breast cancer survivors. Following breast cancer, survivors experience intense heat reactions (hot flashes) and night sweats similar to symptoms associated with menopause that can be very debilitating and impact quality of life. In addition to pharmaceutically-based interventions to treat these symptoms, there is interest in non-pharmaceutically based methods. However, current methods have shown variable success. After hearing about the research coming out of the University of Brighton linked to applied heat-alleviation methods, the committee were keen to learn whether cooling interventions could be potential candidates to recommend post treatment.

The committee were very encouraged by the planned research programme, offered their assistance as the project develops and have linked the research team [Neil, Rebecca, Dr Mel Flint (School of Pharmacy and Biological Sciences) and Dr Louisa Beale] with a Brighton-based Oncologist Consultant. The meeting was held at the Breast Cancer UK headquarters in London and was nevertheless a great experience for both Neil and Rebecca to showcase the research activity of the Environmental Extremes Lab.

The presentation was a bit of a baptism of fire for Rebecca who had only started her PhD seven weeks beforehand. However, she did an excellent job and the committee were very encouraged by the planned research programme, offered their assistance as the project develops and have linked the research team [Neil, Rebecca, Dr Mel Flint (School of Pharmacy and Biological Sciences) and Dr Louisa Beale] with a Brighton-based Oncologist Consultant. Unfortunately, the meeting was moved from Westminster to the Breast Cancer UK Headquarters, but was nevertheless a great experience for both Neil and Rebecca to showcase the research activity of SESAME’s Environmental Extremes Lab.

 

EEL Present at House of Lords Select Committee!

Dr Neil Maxwell and Rebecca Relf (Technical Instructor and PhD Student) were invited to present to a House of Lords Government Select Committee on Breast Cancer Symptom Management in November, to talk about their up-coming research linked to heat sensitivity amongst breast cancer survivors. Following breast cancer, survivors experience intense heat reactions (hot flashes) and night sweats similar to symptoms associated with menopause that can be very debilitating and impact quality of life. In addition to pharmaceutically-based interventions to treat these symptoms, there is interest in non-pharmaceutically based methods. However, current methods have shown variable success. After hearing about the research coming out of the University of Brighton linked to applied heat-alleviation methods, the committee were keen to learn whether cooling interventions could be potential candidates to recommend post treatment.