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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School Children Learn about Altitude Awareness at Big Bang Fair!

The Environmental Extremes Lab (EEL) and Para-Monte joined forces on Wednesday 27th and Thursday 28th June at the seventh annual Big Bang Fair South East, held at the South of England Showground. More than 10,000 students between the ages of 9 and 19 attended from 200 schools across the region.

The event was part of the nationwide Big Bang Near Me programme, the biggest single celebration of science, technology, engineering and maths (STEM) for young people in the UK. Arguably, the feedback (see tweet) from the son of our very own Sarah Smith (Economic, Social Engangement & Research Administrator of the School of Sport and Service Management) meant the most to Chris and Jeannet Savory, who set up Para-Monte to raise awareness about altitude in memory of their son, Adam Savory, who tragically died form altitude illness in 2012. Continue reading

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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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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Hercule Poirot and Suchet Family Supported Before Inca Trail Trek to Machu Picchu!

In a nutshell, your advice was not only spot on, it saved us. I believe that if your words about “Headache+1” had not gone through my head on that first night, I would have toughed it out, and in Dougie’s (professional guide) words, I would have lost. How seriously? Doesn’t bear thinking about.” (John Suchet, 2018)

The Environmental Extremes Lab (EEL) hosted the Suchet family, including John (newsreader and musical host on Classic FM) and David (Hercule Poirot) Suchet, on the Saturday 17th March ahead of their trek two weeks later to the iconic and breath-taking Inca city of Machu Picchu. In collaboration with local altitude awareness charity, Para-Monte, Dr Neil Maxwell, Gregor Eichhorn (PhD student), Mel Stemper (recent MSc graduate) and Josh Pennick (current MSc student) carried out altitude screening on the six members of the Suchet family, before Neil provided education around altitude illness and ways to prepare for the trek to make it enjoyable but also safer.

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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.

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Marathon des Sables Support 2018…2 Months To Go!

With only two months to go until the 33rd annual Marathon des Sables 2018 race, the University of Brighton’s Environmental Extremes Laboratory (EEL) has been busy completing many one-off heat pre-screening tests and arranging heat acclimation protocols for ultra-endurance runners to include in their important tapering periods in the lead up to race departure. The key to a safe and successful Marathon des Sables race is preparation, education and adaptation.

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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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