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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Heat Illness Susceptibility Questionnaire Trialled at Brighton Marathon

This year members of the Environmental Extreme Lab (EEL) returned to the medical tent at the Brighton Marathon to carry out heat illness prevention research. The purpose of this year’s research was to collect questionnaire data on runners who were suffering from a heat illness. The heat illness susceptibility questionnaire (HIS-Q) was developed by a team of researchers within EEL and the initial reliability and validity was completed within a controlled laboratory environment at the University of Brighton. The Brighton Marathon presented the opportunity to test the HIS-Q in a field based environment, where core temperatures are often higher than that achieved through controlled laboratory testing.

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Heat acclimation athletes successful in “The world’s toughest foot race”

The Environmental Extremes Lab once again supported athletes preparing for the Marathon des Sables this year, considered by many to be the world’s toughest foot race. Adding to the challenge of six stages, covering over 250km across sand dunes and desert, participants are required to carry all their own kit, have a limited water supply and, of greatest interest to our lab, do so in temperatures ranging from 30-50oC.

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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.

MSc Students Pilot Local Sweat Map Measures

Over the past few weeks, Dr Ash Willmott and PhD students Rebecca Relf and Kirsty Waldock, have helped the MSc Applied Sport Physiology and MSc Applied Exercise Physiology students investigate the sudomotor responses while exercising in a hot, humid environment (35⁰C, 60% relative humidity), replicating expected conditions for the Tokyo 2020 Olympic Games.

Led by Ash and his current research theme of investigating alternate methods of heat acclimation outside of the traditional lab-based environmental chamber protocols, the students also assessed the efficacy of wearing a sauna suit during exercise in temperate conditions (20⁰C, 40% relative humidity).

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Congratulations Josie Adams – 5th in Coastal Challenge!

Josie Adams, 26, an ultra-endurance athlete sponsored by the charity Paramonte, approached Dr Neil Maxwell and the EEL team at the University of Brighton to aid her with preparations for the Coastal Challenge in February 2018 – a 236 km race through part jungle, over trails and up into alpine terrain. Of course, the EEL team did not hesitate in declaring their support for Josie. Rebecca Relf took the lead, organising the week leading up to Josie’s departure  for Costa Rica, where temperatures during the challenge were expected to be around 30°C whilst also very humid (~60-80% relative humidity). Rebecca and three other PhD students (Jason Newbery, Greg Eichhorn and Rosie Lewis) supported Josie in completing 9 heat acclimation sessions in 6 days. Although, taking a backseat on this occasion, support in the form of spreadsheet design and heads popping into the labs by Ash Willmott and Neil was greatly appreciated.

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Hot vs. Cold vs. Altitude: which environmental extreme is worse?

As part of our HB710 – Applied Environmental Physiology – Module which sits within our MSc in Applied Sport Physiology or Applied Exercise Physiology we ran a debate yesterday which we have run for the last few years on which environmental extreme is worse – heat, cold or altitude? The idea came from two BBC articles that posed the question of which environment was more challenging. It was a fun activity at the start of the module to help contextualise some of the problems that environmental extremes can bring and allow some of the students who are newer to environmental extremes to become acquainted with the subject and considerations. There is an underlying objective, which is to make the students think more about how they use research evidence, especially in graphical or tabular form to strengthen their arguments and rationales as this will help them later in the module’s assessment, but also stand them in good stead beyond their degree.

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